Clinical characteristics of late-onset myasthenia gravis.

Objective: Late-onset myasthenia gravis (LOMG) often has comorbidities, and its initial symptoms may be ignored or misdiagnosed as other diseases. There were few large surveys on LOMG. Our study aimed to summarize clinical characteristics of LOMG to improve the rate of correct MG diagnosis. Methods: A retrospective cohort study included 240 LOMG patients with onset age ≥65 years old who were treated at PLA General Hospital from January 1, 2003 to January 1, 2023. Results: The male to female ratio was 1:1.2 (P = 0.699). MGFA clinical classification: Class I 31.3%, Class IIa 12.9%, Class IIb 51.3%, Class IIIa 0.8%, Class IIIb 0.8%, Class IV 0.4%, Class V2.5%. The onset symptom was ptosis in 78.8% and diplopia was in 18.8%. Swallowing dysfunction in the stage of LOMG was in 41.7%. The incidence of thymoma in LOMG was 14.2%. 85.4% of patients antibodies against the muscle acetylcholine receptor (AChR) are detected. The overall incidence of supramaximal repetitive nerve stimulation (Jolly test) was 57.1%, among which the highest positive rate (50.7%) was in the facial nerve. Jolly test of Class IIb was tested in the highest positive rate and Class I was in the lowest one (χ2 = 7.023, P = 0.030). Conclusion: There was no significant difference in the incidence of LOMG between males and females. The clinical manifestations were mainly Class I and Class II, and severe MG was rare. The most common onset symptom was ptosis. The incidence of LOMG with thymoma was low. Supramaximal repetitive nerve stimulation (Jolly test) of the facial nerve was the easiest to detect and Jolly test of Class IIb was tested in the highest positive rate and Class I was in the lowest one.

Role of the CXCR6/CXCL16 axis in autoimmune diseases.

The C-X-C motif ligand 16, or CXCL16, is a chemokine that belongs to the ELR - CXC subfamily. Its function is to bind to the chemokine receptor CXCR6, which is a G protein-coupled receptor with 7 transmembrane domains. The CXCR6/CXCL16 axis has been linked to the development of numerous autoimmune diseases and is connected to clinical parameters that reflect disease severity, activity, and prognosis in conditions such as multiple sclerosis, autoimmune hepatitis, rheumatoid arthritis, Crohn's disease, and psoriasis. CXCL16 is expressed in various immune cells, such as dendritic cells, monocytes, macrophages, and B cells. During autoimmune diseases, CXCL16 can facilitate the adhesion of immune cells like monocytes, T cells, NKT cells, and others to endothelial cells and dendritic cells. Additionally, sCXCL16 can regulate the migration of CXCR6-expressing leukocytes, which includes CD8+ T cells, CD4+ T cells, NK cells, constant natural killer T cells, plasma cells, and monocytes. Further investigation is required to comprehend the intricate interactions between chemokines and the pathogenesis of autoimmune diseases. It remains to be seen whether the CXCR6/CXCL16 axis represents a new target for the treatment of these conditions.

Heterogeneous changes of chemical compositions, sources and health risks of PM2.5 with the "Clean Heating" policy at urban/suburban/industrial sites.

China has enacted the "Clean Heating" (CH) policy in north China. The domain-specific impacts on PM2.5 constituents and sources in small cities are still lacking, which obstruct the further policy optimization. Here, we performed an intensive observation covering the heating period (HP) and pre-heating period (PHP) in winter of 2017 at urban (UR), industrial (IS), and suburban (SUR) sites in one of the "2 + 26" cities. The mean PM2.5 concentrations at UR and IS decreased by 15.2 % and 4.6 %, while increased by 9.8 % at SUR in the HP compared with the PHP, indicating the heterogeneous responses. The lowest contribution percentages of coal combustion (14.6 %) and industrial emissions (17.1 %) to PM2.5 at UR in the HP implied the CH policy played more effective role. The most increase in NO3-/SO42- ratio by 26.8 % and the highest NO3- concentration at UR in the HP were linked mainly with the thermal-NOx emitted from natural gas (NG) burning in view of NOx emission reductions from other sources. The highest concentrations of OC, SO42-, K+, and Cl-, and contribution percentages of biomass burning (20.0 %) and coal combustion (24.8 %) to PM2.5 at SUR in the HP evidenced the enhanced usage of biomass/coal. Coal banning in the HP at IS and UR led to the obvious decreases in OC, SO42-, As, and Sb. Secondary nitrate became the largest PM2.5 source at IS and UR in the HP. Coal banning, emission control on large-size enterprises and ignored control on small-size enterprises efficiently modified the concentrations and health risks of heavy metals. The lowest carcinogenic risks moved from SUR in the PHP to UR in the HP. The policies on de-NOx of NG-burning related enterprises, reduction of biomass/coal usage in suburban area, and strict regulation of small-size enterprises were urgently need to further improve the air quality.

Atomically Dispersed Co2+ Sites Incorporated into a Silicalite-1 Zeolite Framework as a High-Performance and Coking-Resistant Catalyst for Propane Nonoxidative Dehydrogenation to Propylene.

Propane nonoxidative dehydrogenation (PDH) is a promising route to produce propylene with the development of shale gas exploration technology. Co-based catalysts with low cost and low toxicity could activate C-H effectively, but they suffer from deactivation with coke formation. In this work, a catalyst formed by incorporating highly dispersed Co sites into a Silicalite-1 zeolite framework (Co-Silicalite-1) is synthesized by a hydrothermal protocol in the presence of ammonia, which exhibits superior propane dehydrogenation catalytic performance with 0.0946 mmol C3H6·s-1·gCo-1 and propylene selectivity higher than 98.5%. It also shows outstanding catalytic stability and coking resistance in a 3560 min time-on-stream. Combined characterization results demonstrate that the tetrahedrally coordinated Co2+ site serves as the PDH catalytic active site, which is stabilized by Si-O units of the zeolite framework. Incorporation of Co sites into the zeolite framework could avoid the reduction of Co species to metallic Co. Moreover, the catalytic performance is improved by the enhanced propane adsorption and propylene desorption.