[Assessment of MS-Score and HScore in timeliness of diagnosis of macrophage activation syndrome associated with adult-onset Still's disease].

The data of 33 patients with adult-onset still's disease (AOSD)-associated macrophage activation syndrome (MAS) were retrospectively collected from January 2013 to December 2020 in Peking Union Medical College Hospital. Hemophagocytic lymphohistiocytosis (HLH)-2004 criteria, macrophage activation syndrome/juvenile idiopathic arthritis (MS-Score) and hemophagocytic syndrome diagnostic score (HScore) were used to diagnose AOSD-associated MAS, respectively. The time of diagnosis of AOSD-associated MAS by MS-Score was 19.0 (4.5, 31.0) days [M (Q1,Q3)] earlier than by HLH-2004 criteria, and 13.5 (0.5, 21.5) days earlier than by HScore (both P<0.05). The difference was not statistically significant between the time of diagnosis of AOSD-associated MAS by Hscore and by HLH-2004 criteria (P>0.05). There was significant difference among the three criteria (P<0.001). MS-Score can be used to diagnose AOSD-associated MAS earlier than HLH-2004 criteria, while the timeliness of HScore is not certain.

[Observation and analysis of lens turbidity lesion induced by low intensity 635 nm laser radiation].

Objective: To study the characteristics of the lens turbidity after long-term exposure to low intensity 635nm laser. Methods: Cluster sampling method was adopted to select 812 employees in a laser leveler workshop in a city of Guangdong Province from January 2014 to December 2018. They were divided into the control group, diffuse reflection (DR) group and direct vision (DV) group for retrospective observation and analysis of lens turbidity. The laser irradiation intensity of each group was investigated, the position and shape of lens opacity were analyzed, and the influencing factors were statistically analyzed with the repeated measurement data of dichotomy. Results: The laser irradiance and radiant exposure of DV group were between 0.72×10(-4) and 9.92×10(-4) mW/cm(2) and between 2.61×10(-2) and 1.53 J/cm(2), respectively. The subjects were mainly diagnosed with lens turbidity lesion, especially for the DV group. Most of lesions occurred in the pole and periphery of the anterior cortex. The lesions exhibited multipoint patterns with greyish white color. The turbidity rates in DV group (before work and work for 1, 2, 3 years) were 0%, 1.99% (8/402) , 4.98% (20/402) and 6.72% (27/402) , respectively, in the order of observation points. The statistical analysis of single factor effect showed that the turbidity rate was higher in DV group and higher in the second year in the DV group (P<0.01) . Multi-factor analysis of the laser effect on the lens showed that the main effect between groups, between the observation point were statistically significant (P<0.05) , but no statistical significance in the interaction between group×observation points (P>0.05) . Conclusion: Lens turbidity lesion can be caused by long-term exposure to low intensity 635 nm laser, so the product safety classification should be strictly strengthened. It is necessary to strengthen the protection of laser photochemical damage in the production process.

[Characteristic analysis of organic fluorosis caused by appliying of touch screen anti-fingerprint nanocoating material].

Objective: To analysis pathogenic conditions and pathogenic characteristics of organic fluorosis caused by applying of anti-fingerprint coating material on touch screen glass of the mobile phone. Methods: To collect clinical data and analyze the causes and pathogenic characteristics of poisoning through surveying occupational health, detecting occupational hazards in the workplace, collecting clinical data and diagnosing of occupational diseases. 6 employees in workshop 1 of packaging were as the organic fluorine exdposed group, and 16 employees in other workshops were as the non-exposed group. Results: Organic fluorine chemicals (perfluoro-1, 3-dimethylcyclohexane, hexadecafluoroheptane, perfluoro-hexane, perfluoromethy lopentane, perfluoro-2-methyl-2-pentene, etc.) can be volatilized by spraying and baking of anti-fingerprint nano-coating material on touch screen. The relative percentage of volatile components in air is 85.65%. Four cases of acute poisoning were caused by organic fluorosis deposited in a dustless air conditioning workshop with poor ventilation.The clinical manifestations of the patients were acute bronchitis, pulmonary edema and/or myocarditis. The average concentration of urine fluorine in the organic fluorine exposed group was 13.7± 4.4 mmol/mol creatinine, which was 4-5 times higher than that of other non-organic fluorine exposed groups. The difference of urine fluorine level between the organic fluorine exposed group and non exposed group was statistically significant (P<0.01) . The main indicators were abnormal for the blood oxygen saturation of finger pulse under suction air, leukocytes, neutrophils, monocytes, hypersensitivec-reactive protein, procalcitonin, l-lactate dehydrogenase, forebrain diuretic natriuretic peptide, hypersensitive troponin T in the four cases. One case was myocardial ischemia, four cases had bilateral lung symmetrically exudative lesions, one case was accompanied by a small amount of pleural pericardial effusion. Conclusion: Acute organofluorine poisoning can caused by the applying of the fingerprint nano-coating material on touch screen of the mobile phone. Attention should be paid to occupational poisoning caused by the applying of the small molecular perfluoroalkanes (olefins) in new industries, new processes and new materials.

[Occupational health investigate of 1-bromopropane used in a factory].

Objective: To investigate the occupational health survey of 1-brominepropane (1-BP) enterprises and understand the impact of 1-BP on the health of occupational exposure population. Methods: The occupational health data of 15 1-BP workers were collected from 3 time nodes in 0 months, June and December, and the effects of occupational exposure to 1-BP on health were analyzed. Results: In the workplace with pure 1-BP, the mean air concentration in the workplace was 26.8 mg/m(3), and the personal contact level was 29.7 to 63.4 mg/m(3). The occupational health monitoring data showed that white blood cell count (WBC) , red blood cell count (RBC) , aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were compared in 0 months, June, and 12 months, the difference was statistically significant (P<0.05) . Conclusion: During the 12 months observation period, the occupational exposure to 1-BP caused the number of peripheral blood erythrocyte and leukocyte count and the level of alanine transaminase in the workers, but it did not exceed the normal reference range.

[The 461th case: fever, hematuria, and right lumbar pain].

A 56-year-old female was admitted to the Department of Rheumatology, Peking Union Medical College Hospital with complaint of recurrent fever and acute lumbar pain. Fever was complicated with malaise, cough and occasional blood-streaked sputum. Lab tests showed elevated white blood cell count, increased serum creatinine, erythrocyte sedimentation rate and C-reactive protein. Other lab findings included severe anemia, hematuria, and proteinuria. Immunological examinations were positive for antinuclear antibodies, antineutrophil cytoplasmic antibodies and antiglomerular basement membrane antibody. Ultrasonography and CT scan detected a huge spontaneous perirenal hematoma at right side. Angiography revealed multiple microaneurysms on bilateral renal arteries and branches. A diagnosis of systemic vasculitis was suggested. Under the combination therapy of corticosteroids and cyclophosphamide, the patient presented sustained remission for one year. This case indicates that prompt and sufficient treatment of primary disease is essential to a promising outcome.

Formyl peptide receptor 2 mediated chemotherapeutics drug resistance in colon cancer cells.

OBJECTIVE: To determine the expression of formyl peptide receptor 2 (FPRL2) and its drug resistance role in cancer colon cells, and its underlying mechanisms. PATIENTS AND METHODS: The expression of FPRL2 and its legend (F2L) in colon cancer tissues or cancer cells was determined by immunohistochemistry assay and Real-time polymerase chain reaction (PCR), respectively. Chemosensitivity of 5-Fu and MMC in colon cancer cells were tested by cell counting kit-8 (CCK-8) method. Expression of p-ERK was determined by Western blot assay. RESULTS: The expression of FPRL2 and its legend was significantly higher in resistant colon cancer tissues than those in non-resistant colon cancer tissues. The FPRL2 positive cells were two-thirds in tested cell lines. All of cells were F2L positive. The IC50 (inhibitory concentration 50) by 5-Fu and MMC was significantly higher in FPRL2 positive cells than those negative cells. The expression of p-AKT was markedly increased in FPRL2 positive cells. Pretreatment with AKT inhibitor enhanced the drug-sensitivity of these cells to 5-Fu and MMC. CONCLUSIONS: The FPRL2 played a significant role in colon cancer drug resistance and this effect was through AKT pathway.

[The 454th case: a 29-week pregnant woman with abdominal pain, hyperlipemia and multiorgan dysfunction].

A 32 year-old woman in the third trimester of pregnancy was admitted for severe acute pancreatitis due to hypertriglyceridemia. During hospitalization she developed multiorgan dysfunction, infected pancreatic necrosis, abdominal compartment syndrome and intrauterine fetal death. She was successfully treated by multidisciplinary team including department of emergency medicine, ICU, gastroenterology, obstetrics, endocrinology, ultrasonography, radiology, infectious disease, nutrition and surgery.

Raf activation by Ras and promotion of cellular metastasis require phosphorylation of prohibitin in the raft domain of the plasma membrane.

Prohibitin (PHB) is indispensable for Ras-induced Raf-1 activation, cell migration and growth; however, the exact role of PHB in the molecular pathogenesis of cancer metastasis remains largely unexamined. Here, we found a positive correlation between plasma membrane-associated PHB and the clinical stages of cancer. The level of PHB phosphorylated at threonine 258 (T258) and tyrosine 259 (Y259) in human cancer-cell membranes correlated with the invasiveness of cancer cells. Overexpression of phosphorylated PHB (phospho-PHB) in the lipid-raft domain of the cell membrane enhanced cell migration/invasion through PI3K/Akt and Raf-1/ERK activation. It also enhanced epithelial-mesenchymal transition, matrix metalloproteinase-2 activity and invasiveness of cancer cells in vitro. Immunoprecipitation analysis demonstrated that phospho-PHB associated with Raf-1, Akt and Ras in the membrane and was essential for the activation of Raf-1 signaling by Ras. Mice implanted with cancer cells stably overexpressing PHB in the plasma membrane showed enlarged cervical tumors, enhanced metastasis and shorter survival time compared with mice implanted with cancer cells without PHB overexpression. Dephosphorylation of PHB at T258 by site-directed mutagenesis diminished the in vitro and in vivo effects of PHB. These results suggest that increase in phospho-PHB T258 in the raft domain of the plasma membrane has a role in the Ras-driven activation of PI3K/Akt and Raf-1/ERK-signaling cascades and results in the promotion of cancer metastasis.

Long terminal repeats are not the sole determinants of virulence for equine infectious anemia virus.

The long terminal repeats (LTRs) of equine infectious anemia virus donkey leukocyte-attenuated virus (EIAV-DLA) were substituted with those of the wild-type EIAV-L (wt EIAV-L, the parent virus of EIAV-DLA). The resulting chimeric plasmid was designated pOK-LTR DLA/L. Purified pOK-LTR DLA/L was transfected into monocyte-derived macrophage (MDM) cultures prepared from EIAV-negative, heparinized whole blood from a donkey. Eighth-passage cell cultures developed the typical cytopathogenic effects (CPE) of EIAV infection, and virions with typical EIAV profiles were observed with an electron microscope. Horses were inoculated with the chimeric virus or EIAV-DLA and challenged with the wt EIAV-L strain six months later. All of the horses inoculated with either the chimeric virus or EIAV-DLA were protected from disease, whereas the control horses died with typical EIA symptoms.

The N-terminal common domain of simian virus 40 large T and small t antigens acts as a transformation suppressor of the HER-2/neu oncogene.

Overexpression of HER-2/neu (also known as c-erbB-2) proto-oncogene frequently occurs in many different types of human cancers, including ovarian carcinoma, and is known to enhance tumor metastasis and chemoresistance. Previous studies showed that inhibition of HER-2/neu expression by various agents, such as adenovirus E1A and simian virus 40 large T, can lead to suppression of tumorigenicity of HER-2/neu-overexpressing cancer cells. Here we report that T/t-common, which contains the N-terminal common domain of simian virus 40 large T and small t antigens, could specifically repress the HER-2/neu promoter. When the coding sequence of T/t-common was stably transfected into the HER-2/neu-overexpressing human ovarian carcinoma SK-OV-3 cells, the expression of HER-2/neu was dramatically reduced by the expression of T/t-common. Accordingly the tumorigenic potential of these T/t-common-expressing clones, including the ability to grow anchorage-independently and the ability to induce tumor in nu/nu mice, was also drastically suppressed. Furthermore, when T/t-common was transiently cotransfected with the activated genomic neu into NIH3T3 cells, the transforming activity of the latter was suppressed by T/t-common in soft-agarose microcolony formation assays. Taken together, these data suggest that T/t-common may act as a transformation suppressor of the HER-2/neu oncogene. Oncogene (2000).