Adult-onset congenital intestinal malrotation: A case report and literature review.

BACKGROUND: Intestinal malrotation is an infrequent congenital anomaly primarily observed in neonates, and adult-onset cases are exceedingly rare. Studies on adult congenital intestinal malrotation are limited. METHODS: A case with congenital intestinal malrotation is reported in our study. The clinical data were collected and the treatment process and effect were evaluated. RESULTS: A 45-year-old female who had been experiencing vomiting for over 40 years was admitted to our hospital. According to the result of CT scan, intestinal volvulus accompanied by bowel obstruction was suspected. Then laparoscopic examination was applied to the patient and was ultimately diagnosed with adult congenital intestinal malrotation. We performed Ladd's procedure combined with gastrojejunostomy and Braun anastomosis. The patient recovered well and was successfully discharged from the hospital on the 13th day after surgery. After a 6-month follow-up, the symptom of vomiting was significantly alleviated and body weight was gained for 10 kg. She was very satisfied with the treatment. CONCLUSION: Adult congenital intestinal malrotation is a rare disease that is often misdiagnosed owing to nonspecific clinical manifestations. Therefore, awareness about this condition should be enhanced. Surgery remains the cornerstone of treatment for this disease. Combining gastrojejunostomy and Braun anastomosis with the traditional Ladd procedure can optimize surgical outcomes.

Theoretical insights into the photophysics of an unnatural base Z: A MS-CASPT2 investigation.

We have employed the highly accurate multistate complete active space second-order perturbation theory (MS-CASPT2) method to investigate the photoinduced excited state relaxation properties of one unnatural base, namely Z. Upon excitation to the S2 state of Z, the internal conversion to the S1 state would be dominant. From the S1 state, two intersystem crossing paths leading to the T2 and T1 states and one internal conversion path to the S0 state are possible. However, considering the large barrier to access the S1 /S0 conical intersection and the strong spin-orbit coupling between S1 and T2 states (>40 cm-1 ), the intersystem crossing to the triplet manifolds is predicted to be more preferred. Arriving at the T2 state, the internal conversion to the T1 state and the intersystem crossing back to the S1 state are both possible considering the S1 /T2 /T1 three-state intersection near the T2 minimum. Upon arrival at the T1 state, the deactivation to S0 can be efficient after overcoming a small barrier to access T1 /S0 crossing point, where the spin-orbit coupling (SOC) is as large as 39.7 cm-1 . Our present work not only provides in-depth insights into the photoinduced process of unnatural base Z, but can also help the future design of novel unnatural bases with better photostability.

[Efficacy and Prognostic Factors of Nonmyeloablative Allogeneic Hematopoietic Stem Cell Transplantation for Patients with Acute Myeloid Leukemia].

OBJECTIVE: To retrospectively analyze the efficacy and complications of our institution's modified nonmyeloablative allogeneic hematopoietic stem cell transplantation (NST) in treating intermediate-risk acute myeloid leukemia (AML) - first complete remission (CR1) and prognostic factors. METHODS: Clinical data of 50 intermediate-risk AML-CR1 patients who underwent matched related NST at the Fifth Medical Center of Chinese People's Liberation Army General Hospital from August 2004 to April 2021 were collected, the hematopoietic recovery, donor engraftment and complications were observed, and overall survival (OS) rate, leukemia-free survival (LFS) rate, treatment-related mortality (TRM), and cumulative relapse rate were calculated. Statistical analysis of factors affecting prognosis was also preformed. RESULTS: The median times for neutrophil and platelet recovery after transplantation were 10 (6-16) and 13 (6-33) days, respectively. One month after transplantation, 22 patients (44%) achieved full donor chimerism (FDC), and 22 patients (44%) achieved mixed chimerism (MC), among whom 18 cases gradually transited to FDC during 1-11 months, 4 cases maintained MC status. The overall incidence of acute graft-versus-host disease (aGVHD) was 36%, with a rate of 18% for grade II-IV aGVHD and a median onset time of 45 (20-70) days after transplantation. The overall incidence of chronic GVHD (cGVHD) was 34%, with 20% and 14% of patients having limited or extensive cGVHD, respectively. The incidence rates of infections, interstitial pneumonia, and hemorrhagic cystitis were 30%, 10%, and 16%, respectively. The 5-year OS rate, LFS rate, TRM, and cumulative relapse rate were 68%, 64%, 16%, and 20%, respectively. The increase of the number of CD34+ cells infused had shortened the recovery time for neutrophils and platelets (r =0.563, r =0.350). The number of CD34+ cells infused significantly influenced the occurrence of extensive cGVHD (OR =1.36, 95%CI : 1.06-1.84, P =0.024). CONCLUSION: Modified NST is effective in treating intermediate-risk AML-CR1 patients, however, further expansion of sample size is needed to study prognostic factors.

Mechanisms of Thymic Repair of In Vitro-Induced Precursor T Cells as a Haploidentical Hematopoietic Stem Cell Transplantation Regimen.

Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is currently an effective treatment for malignant hematologic disease, but the immune deficiency and severe infection triggered by slow immune reconstitution are the main causes of high mortality and transplant failure. One of these outstanding problems is thymus damage, which is associated with graft-versus-host disease (GVHD), and preconditioning including irradiation and chemotherapy. Therefore, rapid repair of damaged thymus and rapid proliferation of thymus-derived donor T cells post-transplantation are key to solving the problem. This study was designed to accelerate the recovery of thymus-derived T cells post-transplantation. Wild-type mice with normal immunity were used as recipients in a haplo-HSCT mouse model to mimic clinical haplo-HSCT. A modified cell culture system using Notch ligand Delta4 and IL-7 was established that is capable of inducing and amplifying the differentiation and proliferation of hematopoietic stem cells into precursor T (preT) cells in vitro. The haplo-HSCT protocol included preT and G-CSF-mobilized donor splenic mononuclear cell (MNC) coinfusion in one group and MNC infusion alone in a second group. Thymic GVHD, thymic repair, and thymus-derived T cell development were compared in the 2 groups by polychromatic immunofluorescence tracking, flow cytometry, and detection of T cell receptor Vß. The thymus homing and T cell regeneration of allogenic preT cells were observed. The functions of preT cells in accelerating immune reconstitution, restoring thymic architecture, weakening graft-versus-host (GVH) effects, and enhancing immunotolerance post-transplantation were demonstrated. Further studies revealed that allogeneic preT cells induced by a culture system containing IL-7 and Delta4 highly express ccr9 and RANKL. Interestingly, RANK expression was promoted after preT cell thymus homing. These results suggest that the RANK/RANKL pathway may play an important role in thymus homing. Our results provide a potential therapeutic option to optimize haplo-HSCT, and also open up a new field of T cell therapy for artificial induction of allogeneic preT cells in vitro to repair the damaged thymus from irradiation and chemotherapy and to compensate for the recovery of immune function in patients with immune deficiency of various etiologies.

Ultrafast charge transfer in a nonfullerene all-small-molecule organic solar cell: a nonadiabatic dynamics simulation with optimally tuned range-separated functional.

Herein, we have employed linear-response time dependent density functional theory (LR-TDDFT)-based nonadiabatic dynamics simulations to investigate the ultrafast charge transfer in a nonfullerene all-small-molecule donor-acceptor (D-A) system formed by a porphyrin small-molecule donor ZnP and a recently developed nonfullerene small-molecule acceptor 6TIC, during which the optimally tuned range-separated hybrid (OT-RSH) functional was adopted. In combination with static electronic structure calculations, several important conclusions were drawn. Firstly, the ZnP and 6TIC are more likely combined together non-covalently in parallel rather than in perpendicular to form ZnP-6TIC due to the much larger adsorption energies, i.e. -44.6 kcal mol-1vs. -25.2 kcal mol-1. Secondly, the excited state properties obtained by OT-RSH functionals seem more consistent with the experimental results compared to their untuned versions. Specifically, the energy of the lowest charge transfer (CT) state was predicted to be smaller than the lowest lying local excitation (LE) states using the OT-RSH functional-based LR-TDDFT calculations, which is beneficial for the charge transfer process that might be crucial for the high power conversion efficiency (PCE) achieved experimentally. In contrast, the untuned RS functionals all predict higher CT state energies, which is contradictory to the high PCE obtained in the experiment. Moreover, strong hybridization upon excitation between these states was revealed, which might be one of the reasons responsible for the high PCE observed in the experiment. Finally, ultrafast excited state relaxation can be completed within 500 fs due to the small energy gaps and the strong nonadiabatic couplings between these states, which is accompanied by ultrafast photoinduced electron transfer from ZnP to 6TIC and photoinduced hole transfer the other way around. The efficient charge transfer processes and the involvement of two charge generation channels might be another cause resulting in the excellent photovoltaic performance of ZnP-6TIC based OSCs. Our present work not only provides solid evidence for elucidating the underlying mechanism observed in previous experiments, but also suggests that the combination of OT-RSH functionals and LR-TDDFT-based nonadiabatic dynamics simulations might be a powerful tool for investigating the excited state dynamics of organic D-A systems, which is crucial for the theoretical design of novel OSCs with better performances in the future.

Transition-Metal-Free Domino Reaction of [60]Fullerene, Indole, and DMSO/HCl: One-Pot Access to Diverse N-Substituted [60]Fulleroindole Derivatives.

An unprecedented multicomponent domino reaction of [60]fullerene, indole, and DMSO/HCl has been developed for the one-pot efficient synthesis of diverse N-substituted [60]fulleroindole derivatives. This methodology features simple operation, low cost, and transition-metal-circumvented and good functional group tolerance in indole.

An "Umpolung Relay" Strategy: One-Pot, Twice Polarity Inversion Cascade Synthesis of Diversified [60]Fulleroindoles.

An "umpolung relay" strategy, which includes an one-pot, twice polarity inversion cascade of C60 via carbanion and carbocation polarity reversed relay pathway, has been developed for the synthesis of a diverse range of novel [60]fulleroindole derivatives.

[Effects of Nano Material on Cadmium Accumulation Capacity and Grain Yield of Indica Hybrid Rice Under Wetting-drying Alternation Irrigation].

Wetting-drying alternation irrigation (WDI) can harvest high grain yield under effective irrigation water saving conditions. However, the kernel cadmium (Cd) content usually exceeds the national standard of 0.20 mg Cd per kg kernel in WDI. Applying a passivating agent with high-efficient repairing capabilities could be a feasible approach to reduce Cd content lower than 0.20 mg·kg-1 in WDI. Therefore, a field experiment was conducted with different irrigation regimes and passivating agents in a mildly Cd-polluted paddy field, of which the irrigation regimes were WDI and traditional flooded irrigation (FI) and the six passivating agents treatments were CK (no passivating agent; T1), slaked lime with 1125 kg·hm-2(T2), 1125 kg slaked lime and 3000 kg biochar per hectare (T3), 1125 kg slaked lime and 3000 kg organic fertilizer per hectare (T4), 1500 kg porous Nano stupalith per hectare (T5), and 1125 kg slaked lime combined with 1500 kg porous Nano stupalith per hectare (T6). Two typical Indica hybrid rice varieties with a high accumulated capacity named cultivar Shenliangyou 1813 and a low accumulated trait named cultivar Liangyou 6206 were utilized. The main reason that Indica hybrid rice cultivars were selected was their higher absorbed and accumulated characteristics than that of Japonica rice. The results indicated that available Cd content of the soil significantly declined with 17.13%-61.01% decreasing amplitude at maturity when compared with pre-transplanting in WDI; however, the reduction was in the range of -43.45%-21.07% for the FI treatment across cultivars and passivating agents treatments. The available Cd content at maturity was significantly greater in FI than in WDI (P<0.05). In contrast, WDI had higher Cd content on stem, leaf, and kernel organs at maturity than with FI treatment of both cultivars and all of the passivating agents (P<0.05). Generally, the T1 treatment had the maximum available Cd content in the soil layer and highest accumulated Cd content on different aboveground organs, followed by the T2, T3, T4, T5, and T6 treatments considering both cultivars and irrigation regimes. The Cd kernel contents were 0.23-0.24 mg·kg-1 and 0.16-0.21 mg·kg-1 for cultivars Shenliangyou 1813 and Liangyou 6206, respectively, in the T6 treatment. The higher Cd kernel content was generally related to a larger Cd content in the stem organ. For the grain yield, no significant differences were observed among cultivars, irrigation regimes, or passivating agents treatments (P>0.05). Under WDI, the kernel Cd content was still slightly higher than 0.20 mg·kg-1 in the T6 treatment (0.24 mg·kg-1 for cultivar Shenliangyou 1813 and 0.21 mg·kg-1 for cultivar Liangyou 6206); however, there is a predictability potential to produce lower than 0.20 mg·kg-1 kernel content in the T6 treatment if a cultivar with low accumulated capacity is used. Thus, the combined mode of the WDI+T6+cultivar with accumulated low Cd content could be considered an optimized cultivation scheme to obtain no Cd contaminated kernels with high grain yield and water-use efficiency in mildly polluted paddy fields.

[The subpopulation CD4(+); CD25(+); Foxp3(+);/CD127(low/-); regulatory T cells in peripheral blood of HIV-infected patients correlated with disease progression].

AIM: To explore the subpopulation of CD4(+); CD25(+); Foxp3(+); regulatory T cells (Treg), CD4(+); CD25(+); CD127(low/-); Treg in peripheral blood of HIV-infected patients and study its correlation with other immune indicators. METHODS: We enrolled 68 cases of HIV/AIDS patients without anti-HIV treatment [29 cases of long-term non-progressive (LTNP) group, 27 cases of typical progressive HIV infection group and 12 cases of AIDS group] and 20 healthy individuals as a control group. Blood samples of these cases were analyzed by flow cytometry after immunofluorescent staining to determine the levels of CD4(+); T cells, CD8(+); T cells, NK cells and CD4(+); CD25(+); Foxp3(+);/CD127(low/-); Treg. RESULTS: Except CD8(+); T cells, the levels of CD4(+); T, NK cells and CD4(+);/CD8(+); in peripheral blood of HIV/AIDS patients were significantly lower than those in the control group (P<0.05); With the progression of disease, the percentage and absolute count of CD4(+);T cells, the absolute counts of CD8(+);T cells and NK cells, and CD4(+);/CD8(+); T cell ratio in the LTNP group, HIV group and AIDS group decreased gradually, while the percentage of CD8(+);T cells increased gradually. Our multiple comparison analysis revealed that the percentages of CD4(+); CD25(+); Foxp3(+); Treg and CD4(+); CD25(+); CD127(low/-); Treg in CD4(+); T cells were significantly different among groups (P<0.05). With the progression of disease, the percentages of CD4(+); CD25(+); Foxp3(+); Treg and CD4(+); CD25(+); CD127(low/-); Treg increased gradually; in addition, the difference in the absolute count of CD4(+); CD25(+); Foxp3(+);/CD127(low/-); Treg was not statistically significant between LTNP group and healthy control group(P>0.05), so was between HIV and AIDS groups (P>0.05); no significant difference was found in every other two groups (P<0.05); the absolute count of CD4(+); CD25(+); Foxp3(+);/CD127(low/-); Treg decreased gradually. CONCLUSION: CD4(+); CD25(+); Foxp3(+);/CD127(low/-); Treg may play a role in the immunopathogenesis of persistent HIV infection.

[Inhibitory effect of resveratrol on the proliferation of synoviocytes in rheumatoid arthritis and its mechanism in vitro].

OBJECTIVE: To investigate the effect of resveratrol on the proliferation and apoptosis of synoviocytes in patients with rheumatoid arthritis (RA) in vitro and explore its mechanism. METHODS: The levels of cell proliferation of synoviocytes in RA after 24 h treated with different concentrations of resveratrol were measured by monotetrazolium colourmetric assay method. The percentages of synoviocytes apoptosis in RA after 24 h treated with different concentrations of resveratrol were tested by TUNEL and flow cytometry. The relative activities of caspase-3 were determined by colorimetric assay after 4, 8, 12, 18, and 24 h treated with resveratrol (200 micromol/L) and 12 h treated with different concentrations of resveratrol. The cleavages of pro-caspase-3 were analyzed by Western blot after 24 h treated with different concentrations of resveratrol. RESULTS: The levels of cell proliferation of synoviocytes with RA after 24 h treated with different concentrations of resveratrol were significantly decreased compared with the control group (P<0.01). The percentages of the apoptotic cells were increased of resveratrol-treated after 24 h, the apoptosis rates between the treated groups and the control group were significantly different (P<0.01). When the synoviocytes in RA were treated with 200 micromol/L resveratrol for different time respectively, the caspase-3 activity began to rise significantly at 4h, reaching the peak at 12 h, and was still much higher than that of the control group at 24 h (P<0.01). After the cells were treated with different concentrations of resveratrol for 12 h, caspase-3 activity increased in a concentration-dependent manner. After synoviocytes in RA were treated with different concentrations of resveratrol for 24 h, the expressions of pro-caspase-3 decreased as the concentration increased, the caspase-3 active fragment P11 (11 kD) appeared at 100 micromol/L and was increased at 400 micromol/L. CONCLUSION: Resveratrol inhibits the proliferation of synoviocytes and induces cell apoptosis in rheumatoid arthritis in vitro, which may relate to the activation of caspase-3.