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INTRODUCTION: Platelet transfusion is a standard treatment to prevent bleeding in patients with hematological malignancies. Although transfusions can improve platelet count, their impact on platelet function remains controversial. METHODS: We conducted flow cytometry to assess platelet function before and after transfusion and performed subgroup analyses to examine differences based on blood type, corrected count increment (CCI), and platelet microparticles. RESULTS: Overall, 50 patients who received prophylactic platelet transfusion were enrolled. CD42b expression increased, whereas CD41 expression decreased after transfusion. Apheresis platelets exhibited the lowest expression of PAC-1 and P-selectin when exposed to agonist stimulations. PAC-1 expression increased under high adenosine diphosphate (ADP) stimulation, while P-selectin expression increased under both high ADP and thrombin receptor-activating peptide stimulation. In the subgroup analysis, patients with a CCI >4500 and those with the same blood types exhibited a more significant increase in PAC-1 and P-selectin expression under agonist stimulation. When comparing apheresis platelets collected on different days, only the percentage of platelet-derived microparticles showed a significant increase. CONCLUSION: Prophylactic transfusion improved platelet function. Platelet function significantly improved in patients with a CCI >4500, those with the same blood types as that of apheresis platelets, or those with platelet-derived microparticle levels <4.7%. No significant improvement in platelet function was noted after the transfusion of different blood types with acceptable compatibility or the transfusion of incompatible blood types. Our results suggest that transfusing platelets with the same blood type remains the optimal choice.
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Plaquetas , Neoplasias Hematológicas , Transfusión de Plaquetas , Humanos , Transfusión de Plaquetas/métodos , Neoplasias Hematológicas/terapia , Plaquetas/metabolismo , Femenino , Masculino , Persona de Mediana Edad , Anciano , Adulto , Pruebas de Función Plaquetaria , Recuento de Plaquetas , Selectina-P/sangre , Micropartículas Derivadas de Células/metabolismoRESUMEN
Acute-phase markers are often used to evaluate the disease activity of rheumatoid arthritis (RA). Occasionally, the serum levels of acute-phase reactants remain normal in patients with obvious inflamed joints. Hematological indices derived from complete blood counts have been shown to correlate with disease activity. This provides a potential practical implementation in daily practice. Only a few studies have evaluated the relation between hematological indices and novel RA treatment (i.e., biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs); no research has examined the changes in hematological indices in RA treatments longitudinally. We conducted a retrospective study involving 273 RA patients with b/tsDMARD treatment and followed them for at least a year. Baseline, 3-month, and 6-month lab data were collected. The results indicated a reduction in the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII) post-treatment. Higher baseline PLRs and SIIs were associated with a more significant reduction in ESR at three months (η2 = 0.03/0.13, p = 0.21/0.023). NLR and SII correlated with CRP moderately at three months (r = 0.373/0.394, p < 0.001/< 0.001). A correlation comparison showed that the correlation of NLR and PLR with CRP differs during different periods (p = 0.037/0.004). Subgroup analysis revealed that the time effect on correlation is related to treatment with Janus kinase inhibitor and anti-interleukin-6 but not antitumor necrosis factors.
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The authors wish to make the following corrections to this published paper [...].
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Coronavirus disease 2019 (COVID-19) vaccines are associated with serious thromboembolic or thrombocytopenic events including vaccine-induced immune thrombocytopenia and thrombosis and immune thrombocytopenia, particularly AZD1222/ChAdOx1. According to the proposed mechanism, COVID-19 vaccines stimulate inflammation and platelet activation. In this study, we analyzed the role of AZD1222/ChAdOx1 vaccines in the activation of platelets and the release of anti-PF4 antibodies and inflammatory cytokines in a cohort of healthy donors without vaccine-induced immune thrombotic thrombocytopenia (VITT). Forty-eight healthy volunteers were enrolled in this study. Blood samples were collected from peripheral blood at three time points: before vaccination and 1 and 7 days after vaccination. Compared with the prevaccination data, a decrease in the leukocyte and platelet counts was observed 1 day after vaccination, which recovered 7 days after injection. The percentage of activated GPIIb/IIIa complex (PAC-1) under high ADP or thrombin receptor-activating peptide stimulation increased 1 day after vaccination. Furthermore, interluekin-8 (IL-8) and interferon-gamma-induced protein 10 (IP-10) increased significantly. Additionally, platelet activation and inflammation, with the release of cytokines, were observed; however, none of the individuals developed VITT. Mild thrombocytopenia with platelet activation and inflammation with an elevation of IL-8 and IP-10 were observed after AZ vaccination.
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Platelets play an essential role in primary hemostasis through bleeding and thromboembolism. Thus, the diagnosis or evaluation of impaired hereditary, acquired, and drug-related platelet dysfunction has become imperative. The assessment of the platelet function is too complex for routine platelet function study. The major methods involved in platelet function study include platelet function analyzer testing, thromboelastography, thromboelastometry, light transmission aggregometry, and flow cytometry. The current review article focuses on the methods with flow cytometry for immunophenotyping of platelet and evaluating platelet function for platelet disorders, especially in patients with thrombocytopenia. According to the consensus published by the International Society on Thrombosis and Haemostasis, for inherited and acquired platelet disorders, the two major measures by which flow cytometry determines platelet function are glycoprotein IIb/IIIa/P-selectin (CD62p) expression and percentage of leukocyte-platelet aggregates. Using flow cytometry to determine platelet function has several advantages, including good sensitivity to low platelet counts, small blood volume required, and the nonnecessity of centrifugation. However, flow cytometry has still many limitations and challenges, with standardization for routine laboratory testing also proving difficult. Although flow cytometry is available for multipurpose and sensitive study of platelet functions at the same time, the challenging analysis gradually increases and needs to be addressed before reality.
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Background: Thrombocytosis is a common finding in hospitalized patients and is of two main types, essential thrombocytosis (ET) and reactive thrombocytosis (RT). It is important to distinguish the two due to increased risk of developing marrow fibrosis, acute leukemia, and thrombosis in the former. Molecular studies are the main tools to differentiate the two but are not available in all hospitals. We aimed to design a highly sensitive scoring system using routine lab data to classify thrombocytosis as essential or reactive. Methods: A total of 145 patients were enrolled in this study. Potential predictors included patient demographics and clinical laboratory parameters. Receiver operating characteristic curve analysis was used to decide the optimal cutoff level. Multivariate logistic regression with forward model selection method was performed to decide the predictors. Results: The risk scores by multivariate analysis were as follows: 1 point for WBC > 13,500/µL; 2.5 points for Hb > 10.9 g/dL; 3 points for platelet count > 659,000/µL; and 2 points for MPV > 9.3 fL. The cut off value was set as 4.5 points, and sensitivity of 91.1% and specificity of 75.8% were noted. Conclusion: In this study, we investigated lab data and developed a high-sensitivity convenient-to-use scoring system to differentiate ET from RT. The scoring system was assigned to the resulting model to make it more economical, simple, and convenient for clinical practice.
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Since it was discovered as the first human tumor virus in 1964, Epstein-Barr Virus (EBV) is now implicated in several types of malignancies. Accordingly, certain aspects of EBV pathobiology have shown promise in anti-cancer research in developing virus-targeting methods for EBV-associated cancers. The unique role of EBV nuclear antigen 1 (EBNA1) in triggering episome-dependent functions has made it as the only latent gene to be expressed in most EBV+ neoplasms. Dimeric EBNA1 binds to the replication origin (oriP) to display its biological impact on EBV-driven cell transformation and maintenance. Hence, EBNA1/oriP has been made an ideal drug target site for anti-EBV protocol development. GAP31 protein was originally isolated from the seeds of an ancient medicinal plant Gelonium multiflorum. Although GAP31 has been shown to exhibit both anti-viral and anti-tumor activity, current understanding of the mechanistic picture underlying GAP31 functioning is not clear. Herein, we identify the EBNA1 DNA-binding domain as a core for GAP31 binding by performing affinity pulldown assays. Recombinant GAP31 (rGAP31) was shown to impair EBNA1-induced dimerization; consequently, it abrogated both EBNA1/oriP-mediated binding and transcription. Importantly, the therapeutic effects of GAP31 showed its capability to abrogate EBV-driven cell transformation and proliferation, and EBV-dependent tumorigenesis in xenograft animal models. Notably, the EBNA1 binding-mutant rGAP31R166A/R169A simply exhibits defective phenotypes in the above-mentioned studies. Our data suggest rGAP31 is a potential anti-viral drug which can be applied to the development of therapeutic strategies against EBV-related malignancies.
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Antivirales/farmacología , Antígenos Nucleares del Virus de Epstein-Barr/metabolismo , Herpesvirus Humano 4/efectos de los fármacos , Extractos Vegetales/farmacología , Proteínas Inactivadoras de Ribosomas Tipo 1/farmacología , Animales , Proliferación Celular/efectos de los fármacos , Replicación del ADN , Femenino , Ratones Endogámicos NOD , Ratones SCID , Plantas Medicinales/química , Origen de Réplica , Replicación Viral/efectos de los fármacos , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
In this paper, a novel step-up converter is proposed, which has the particular features of single semiconductor switch, ultra-high conversion ratio, galvanic isolation, and easy control. Therefore, the proposed converter is suitable for the applications of fuel-cell power system. Coupled inductors and switched capacitors are incorporated in the converter to obtain an ultra-high voltage ratio that is much higher than that of a conventional high step-up converter. Even if the turns ratio of coupled inductor and duty ratio are only to be 1 and 0.5, respectively, the converter can readily achieve a voltage gain of up to 18. Owing to this outstanding performance, it can also be applied to any other low voltage source for voltage boosting. In the power stage, only one active switch is used to handle the converter operation. In addition, the leakage energy of the two couple inductors can be totally recycled without any snubber, which simplifies the control mechanism and improves the conversion efficiency. Magnetic material dominates the conversion performance of the converter. Different types of iron cores are discussed for the possibility to serve as a coupled inductor. A 200 W prototype with 400 V output voltage is built to validate the proposed converter. In measurement, it indicates that the highest efficiency can be up to 94%.
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Epstein-Barr Virus (EBV) Nuclear Antigen 1 (EBNA1)-mediated origin of plasmid replication (oriP) DNA episome maintenance is essential for EBV-mediated tumorigenesis. We have now found that EBNA1 binds to Ribosome Protein L4 (RPL4). RPL4 shRNA knockdown decreased EBNA1 activation of an oriP luciferase reporter, EBNA1 DNA binding in lymphoblastoid cell lines, and EBV genome number per lymphoblastoid cell line. EBV infection increased RPL4 expression and redistributed RPL4 to cell nuclei. RPL4 and Nucleolin (NCL) were a scaffold for an EBNA1-induced oriP complex. The RPL4 N terminus cooperated with NCL-K429 to support EBNA1 and oriP-mediated episome binding and maintenance, whereas the NCL C-terminal K380 and K393 induced oriP DNA H3K4me2 modification and promoted EBNA1 activation of oriP-dependent transcription. These observations provide new insights into the mechanisms by which EBV uses NCL and RPL4 to establish persistent B-lymphoblastoid cell infection.
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Antígenos Nucleares del Virus de Epstein-Barr/metabolismo , Herpesvirus Humano 4/metabolismo , Proteínas Ribosómicas/metabolismo , Linfocitos B/metabolismo , Linfocitos B/virología , Línea Celular , ADN Viral/genética , ADN Viral/metabolismo , Antígenos Nucleares del Virus de Epstein-Barr/genética , Técnicas de Silenciamiento del Gen , Genoma Viral , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/patogenicidad , Interacciones Huésped-Patógeno , Humanos , Fosfoproteínas/genética , Fosfoproteínas/metabolismo , Plásmidos/genética , Plásmidos/metabolismo , ARN Interferente Pequeño/genética , Proteínas de Unión al ARN/genética , Proteínas de Unión al ARN/metabolismo , Origen de Réplica , Proteínas Ribosómicas/antagonistas & inhibidores , Proteínas Ribosómicas/genética , Activación Transcripcional , NucleolinaRESUMEN
Epstein-Barr virus (EBV) nuclear antigen 2 (EBNA2) plays an important role in driving immortalization of EBV-infected B cells through regulating the expression of many viral and cellular genes. We report a structural study of the tumor suppressor BS69/ZMYND11 C-terminal region, comprised of tandem coiled-coil-MYND domains (BS69CC-MYND), in complex with an EBNA2 peptide containing a PXLXP motif. The coiled-coil domain of BS69 self-associates to bring two separate MYND domains in close proximity, thereby enhancing the BS69 MYND-EBNA2 interaction. ITC analysis of BS69CC-MYND with a C-terminal fragment of EBNA2 further suggests that the BS69CC-MYND homodimer synergistically binds to the two EBNA2 PXLXP motifs that are respectively located in the conserved regions CR7 and CR8. Furthermore, we showed that EBNA2 interacts with BS69 and down-regulates its expression at both mRNA and protein levels in EBV-infected B cells. Ectopic BS69CC-MYND is recruited to viral target promoters through interactions with EBNA2, inhibits EBNA2-mediated transcription activation, and impairs proliferation of lymphoblastoid cell lines (LCLs). Substitution of critical residues in the MYND domain impairs the BS69-EBNA2 interaction and abolishes the BS69 inhibition of the EBNA2-mediated transactivation and LCL proliferation. This study identifies the BS69 C-terminal domains as an inhibitor of EBNA2, which may have important implications in development of novel therapeutic strategies against EBV infection.
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Proteínas Portadoras/metabolismo , Infecciones por Virus de Epstein-Barr/virología , Herpesvirus Humano 4/fisiología , Proteínas Virales/antagonistas & inhibidores , Secuencia de Aminoácidos , Animales , Linfocitos B/virología , Proteínas Portadoras/química , Proteínas Portadoras/genética , Proteínas de Ciclo Celular , Línea Celular , Proteínas Co-Represoras , Cristalografía , Proteínas de Unión al ADN , Antígenos Nucleares del Virus de Epstein-Barr/genética , Antígenos Nucleares del Virus de Epstein-Barr/metabolismo , Humanos , Ratones , Datos de Secuencia Molecular , Regiones Promotoras Genéticas/genética , Unión Proteica , Mapeo de Interacción de Proteínas , Estructura Terciaria de Proteína , Alineación de Secuencia , Secuencias Repetidas en Tándem , Activación Transcripcional , Proteínas Virales/genética , Proteínas Virales/metabolismoRESUMEN
Cysts and cavities are common radiologic abnormalities. Pulmonary metastasis comprises a rare entity of thoracic cystic diseases. We reported a case of giant cyst at the left anterior mediastinum that was pathologically confirmed as a lung metastasis from previously resected gastric cancer. The cyst was completely removed with wedge resection of the surrounding lung through a left anterior thoracotomy. One should always keep in mind the possibility of an intrathoracic cyst near or at the mediastinal region that may originate from metastatic lesions to the lungs when patients have previous cancer history.
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Adenocarcinoma/secundario , Neoplasias Pulmonares/secundario , Quiste Mediastínico/diagnóstico , Neoplasias Gástricas/patología , Adenocarcinoma/diagnóstico , Adenocarcinoma/cirugía , Anciano , Diagnóstico Diferencial , Endoscopía Gastrointestinal , Estudios de Seguimiento , Gastrectomía , Humanos , Biopsia Guiada por Imagen , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirugía , Masculino , Neumonectomía , Radiografía Torácica , Neoplasias Gástricas/cirugía , Tomografía Computarizada por Rayos XRESUMEN
An electric igniter for engine/hybrid vehicles is presented. The igniter comprises a flyback converter, a voltage-stacked capacitor, a PIC-based controller, a differential voltage detector, and an ignition coil, of which structure is non-contact type. Since the electric igniter adopts a capacitor to accumulate energy for engine ignition instead of traditional contacttype approach, it enhances the igniting performance of a spark plug effectively. As a result, combustion efficiency is promoted, fuel consumption is saved, and exhaust emission is reduced. The igniter not only is good for fuel efficiency but also can reduce HC and CO emission significantly, which therefore is an environmentally friendly product. The control core of the igniter is implemented on a single chip, which lowers discrete component count, reduces system volume, and increases reliability. In addition, the ignition timing can be programmed so that a timing regulator can be removed from the proposed system, simplifying its structure. To verify the feasibility and functionality of the igniter, key waveforms are measured and real-car experiments are performed as well.