SUMMARY: The myodural bridge is a dense connective tissue connecting muscles and ligaments to the spinal dura mater in the atlanto-occipital interspace. Some researchers believe that the myodural bridge may play a vital physiological role. It is possible, for instance, that the prevention of spinal dura mater infoldings might be involved in regulated cerebrospinal fluid circulation. For instance, it is possible to prevent spinal dura mater infoldings, regulating cerebrospinal circulation. Bats are nocturnal and the only mammals that can perform a genuine and sustained flight, whereas tree shrews are arboreal mammals that often climb to a high altitude of about 10,000 feet. Both animals have lifestyles that are different from other previously studied mammals. The study of these two animals will shed further light on the existence of the myodural bridge in mammals. Gross anatomical dissection was used to observe the connections between the deep muscles of the neck and the dura mater at the level of the atlanto-occipital interspace. The existing structures were analyzed using conventional and special histological staining techniques. The suboccipital regions in bats and tree shrews contained the rectus capitis dorsal major (RCDma), rectus capitis dorsal minor (RCDmi), oblique capitis anterior (OCA), and oblique capitis posterior (OCP). Dense connective tissue connects the RCDmi to the posterior atlanto-occipital membrane (PAOM) and the latter to the spinal dura mater. The myodural bridge in these mammals shares a similar structure to the myodural bridge in humans. Histological analyses confirmed that the connective fibers of the myodural bridge were primarily type I collagen fibers. In this study, it is supplemented by the existence of the myodural bridge in mammals. This further demonstrates that myodural bridge widely exists in the normal anatomy of mammals. This provides morphological support for a comparative anatomical study of the physiological function of the myodural bridge.

RESUMEN: El puente miodural es un tejido conjuntivo denso que conecta los músculos y los ligamentos a la duramadre espinal en el espacio atlanto-occipital. Algunos investigadores creen que el puente miodural puede desempeñar un papel fisiológico vital. Es posible, por ejemplo, que la prevención de los pliegues de la duramadre espinal pueda estar involucrada en la circulación regulada del líquido cefalorraquídeo. En esta instancia, es posible prevenir los pliegues de la duramadre espinal, regulando la circulación cerebro espinal. Los murciélagos son animales nocturnos y los únicos mamíferos que pueden realizar un vuelo real y sostenido, mientras que las musarañas arborícolas son mamíferos arbóreos que a menudo ascienden a una gran altura de unos 10 000 pies. Ambos animales tienen estilos de vida diferentes a los de otros mamíferos previamente estudiados. El estudio de estos dos animales ofrecerá más información sobre la existencia del puente miodural en los mamíferos. Se realizó una disección anatómica macroscópica para observar las conexiones entre los músculos profundos del cuello y la duramadre a nivel del espacio atlanto-occipital. Las estructuras existentes se analizaron mediante técnicas de tinción histológica convencionales y especiales. Las regiones suboccipitales en murciélagos y musarañas arbóreas presentaban el músculo recto dorsal mayor de la cabeza (RCDma), el recto dorsal menor de la cabeza (RCDmi), el oblicuo anterior de la cabeza (OCA) y el oblicuo posterior de la cabeza (OCP). El tejido conjuntivo denso conecta el RCDmi con la membrana atlanto- occipital posterior (PAOM) y esta última con la duramadre espinal. El puente miodural en estos mamíferos comparte una estructura similar al puente miodural en humanos. Los análisis histológicos confirmaron que las fibras conectivas del puente miodural son principalmente fibras de colágeno tipo I. Esto demuestra además que el puente miodural existe ampliamente en la anatomía normal de los mamíferos. Esta investigación proporciona apoyo morfológico para un estudio anatómico comparativo de la función fisiológica del puente miodural.

ABSTRACT Introduction: New-onset postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG) surgery. Objective: To explore predictive factors and potential mechanisms of new-onset POAF in isolated off-pump CABG patients. Methods: Retrospective observational case-control study of 233 patients undergoing isolated off-pump CABG surgery between August 2018 and July 2020 at the Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School. Associations between predictor variables and new-onset POAF were identified. The main outcome was new-onset POAF after CABG surgery. Results: A total of 75 (32.19%) patients developed new-onset POAF after CABG surgery. The new-onset POAF patients had advanced age, higher baseline systolic blood pressure, more preoperative use of diuretic drug, more transfusion of blood products, atrial dilation and postoperative positive inotropic drug treatment. Nineteen variates entered the multivariable logistic regression model with a Hosmer-Lemeshow test score of 7.565 (P=0.477). Postoperative left atrial enlargement, postoperative drainage in the first 24 hours and total length of hospital stay were statistically significant, while postoperative right atrial enlargement (OR and 95% CI, 7.797 [0.200, 304.294], P=0.272) and left atrial enlargement (3.524 [1.141, 10.886], P=0.029) assessed by echocardiography had the largest OR value. Conclusion: Atrial enlargement is strongly associated with new-onset POAF in patients with isolated off-pump CABG, thus it highlights the advantage of echocardiography as a useful tool for predicting new-onset POAF. Careful monitoring and timely intervention should be considered for these patients.

ABSTRACT In order to make full use of aged asphalt, a light oil regenerant for cold mixing was prepared in this paper, and the ratio of regenerant and regeneration effect was studied through the performance test of recycled asphalt. The ratio of regenerant was determined by 60 °C kinematic viscosity, mass loss before and after aging, and asphalt three indicators. The thermogravimetric analysis determined the four-component ratio of recycled asphalt, and the mechanical properties of the recycled asphalt mixture were determined by the 15 °C splitting and 20 °C compression tests. Finally, the road performance of the recycled asphalt mixture was analyzed by rutting, low-temperature bending, and dry-wet splitting tests. When the mass ratio of light base oil: plasticizer: stable equilibrium agent: penetrant: the anti-aging agent is 80:20:25:8:5, it has a good regeneration effect. After adding 8% regenerant, the regenerated asphalt is compared with the recycled asphalt. The content of saturates and aromatics increases, and the content of resins and asphaltenes decreases. The four-component content of recycled asphalt is close to that of new asphalt. The mechanical properties test shows that the optimum content of the regenerant is 0.9%. With increased RAP content, the water stability and low-temperature crack resistance are also improved, and the high-temperature stability is reduced. However, it still meets the requirements of the regeneration specification.

SUMMARY: The atlanto-occipital joint is composed of the superior fossa of the lateral masses of the atlas (C1) and the occipital condyles. Congenital Atlanto-occipital fusion (AOF) involves the osseous union of the base of the occiput (C0) and the atlas (C1). AOF or atlas occipitalization/assimilation represents a craniovertebral junction malformation (CVJM) which can be accompanied by other cranial or spinal malformations. AOF may be asymptomatic or patients may experience symptoms from neural compression as well as limited neck movement. The myodural bridge (MDB) complex is a dense fibrous structure that connects the suboccipital muscular and its related facia to the cervical spinal dura mater, passing through both the posterior atlanto-occipital and atlanto-axial interspaces. It is not known if atlas occipitilization can induce structural changes in the MDB complex and its associated suboccipital musculature. The suboccipital region of a cadaveric head and neck specimen from an 87-year-old Chinese male having a congenital AOF malformation with resultant changes to the MDB complex was observed. After being treated with the P45 plastination method, multiple slices obtained from the cadaveric head and neck specimen were examined with special attention paid to the suboccipital region and the CVJM. Congenital atlanto-occipital fusion malformations are defined as partial or complete fusion of the base of the occiput (C0) with the atlas (C1). In the present case of CVJM, unilateral fusion of the left occipital condyle with the left lateral mass of C1 was observed, as well as posterior central fusion of the posterior margin of the foramen magnum with the posterior arch of C1. Also noted was a unilateral variation of the course of the vertebral artery due to the narrowed posterior atlanto-occipital interspace. Surprisingly, complete agenesis of the rectus capitis posterior minor (RCPmi) and the obliques capitis superior (OCS) muscles was also observed in the plastinated slices. Interestingly, the MDB, which normally originates in part from the RCPmi muscle, was observed to originate from a superior bifurcation within an aspect of the nuchal ligament. Therefore, the observed changes involving the MDB complex appear to be an effective compensation to the suboccipital malformations.

RESUMEN: La articulación atlanto-occipital está compuesta por las caras articulares superiores de las masas laterales del atlas (C1) y los cóndilos occipitales. La fusión atlanto-occipital congénita (FAO) implica la unión ósea de la base del occipucio (C0) y el atlas (C1). La FAO u occipitalización/asimilación del atlas representa una malformación de la unión craneovertebral (MUCV) que puede presentar otras malformaciones craneales o espinales. La FAO puede ser asintomática o los pacientes pueden experimentar síntomas de compresión neural así como movimiento limitado del cuello. El complejo del puente miodural (PMD) es una estructura fibrosa densa que conecta el músculo suboccipital y su fascia relacionada con la duramadre espinal cervical, pasando a través de los espacios intermedios atlanto-occipital posterior y atlanto-axial. No se sabe si la occipitilización del atlas puede inducir cambios estructurales en el complejo PMD y en la musculatura suboccipital. Se observó en la región suboccipital de un espécimen cadavérico, cabeza y cuello de un varón chino de 87 años con una malformación congénita de FAO con los cambios resultantes en el complejo PMD. Se examinaron múltiples cortes obtenidos de la muestra de cabeza y cuello después de ser tratados con el método de plastinación P45, con especial atención a la región suboccipital y la MUCV. Las malformaciones congénitas por fusión atlanto-occipital se definen como la fusión parcial o completa de la base del occipucio (C0) con el atlas (C1). En el presente caso de MUCV se observó la fusión unilateral del cóndilo occipital izquierdo con la masa lateral izquierda de C1, así como fusión posterior central del margen posterior del foramen magnum con el arco posterior de C1. También se observó una variación unilateral del curso de la arteria vertebral por el estrechamiento del espacio interatlanto-occipital posterior. Se observó además agenesia completa de los músculos Rectus capitis posterior minor (RCPmi) y oblicuos capitis superior (OCS) en los cortes plastinados. Curiosamente, se observó que el MDB, que normalmente se origina en parte del músculo RCPmi, se origina en una bifurcación superior dentro de un aspecto del ligamento nucal. Por lo tanto, los cambios observados en el complejo PMD parecen ser una compensación de las malformaciones suboccipitales.

Abstract Character strengths could effectively prevent negative psychological outcomes in adults. However, there was little research conducted among early adolescents. The present study aimed to explore character strengths that were independently related to fewer behavior problems in early adolescents. In total, 521 early adolescents (mean age 10.92 ± 0.04, range 10–12 years) were recruited from primary schools in Sichuan, China. Character strengths were measured using the Values in Action Inventory of Strengths for Youth (VIA-Youth). Behavior problems were measured using the Conners Parent Symptom Questionnaire (PSQ). The results showed that behavior problems were negatively correlated with character strengths ( r = −0.14 to −0.3, p < 0.05 Bonferroni corrected). Character strengths explained a significant proportion of additional variance (14–22%) in five types of behavior problems after controlling the effect of demographic factors (residence, left-behind experiences, maternal education level). Moreover, several specific character strengths showed an independent contribution ( β = −0.34 to −0.14 for self-regulation, perseverance, zest, humility, and leadership; β = 0.21 to 0.34, for hope; all p < 0.05) to behavior problems. Our study revealed that character strengths were protective factors against behavior problems in early adolescents.

Abstract Background: Duchenne muscular dystrophy (DMD) is a devastating genetic muscular disorder with no effective treatment that is caused by the loss of dystrophin. Human induced pluripotent stem cells (hiPSCs) offer a promising unlimited resource for cell-based therapies of muscular dystrophy. However, their clinical applications are hindered by inefficient myogenic differentiation, and moreover, the engraftment of non-transgene hiPSC-derived myogenic progenitors has not been examined in the mdx mouse model of DMD. Methods: We investigated the muscle regenerative potential of myogenic progenitors derived from hiPSCs in mdx mice. The hiPSCs were transfected with enhanced green fluorescent protein (EGFP) vector and defined as EGFP hiPSCs. Myogenic differentiation was performed on EGFP hiPSCs with supplementary of basic fibroblast growth factor, forskolin, 6-bromoindirubin-3′-oxime as well as horse serum. EGFP hiPSCs-derived myogenic progenitors were engrafted into mdx mice via both intramuscular and intravenous injection. The restoration of dystrophin expression, the ratio of central nuclear myofibers, and the transplanted cells-derived satellite cells were accessed after intramuscular and systemic transplantation. Results: We report that abundant myogenic progenitors can be generated from hiPSCs after treatment with these three small molecules, with consequent terminal differentiation giving rise to mature myotubes in vitro. Upon intramuscular or systemic transplantation into mdx mice, these myogenic progenitors engrafted and contributed to human-derived myofiber regeneration in host muscles, restored dystrophin expression, ameliorated pathological lesions, and seeded the satellite cell compartment in dystrophic muscles. Conclusions: This study demonstrates the muscle regeneration potential of myogenic progenitors derived from hiPSCs using non-transgenic induction methods. Engraftment of hiPSC-derived myogenic progenitors could be a potential future therapeutic strategy to treat DMD in a clinical setting.

Abstract Purpose: To investigate the prognostic value of 17 platelet-based prognostic scores in patients with malignant hepatic tumors after TACE therapy. Methods: In total, 92 patients were divided into death group and survival group according to long-term follow-up results. The AUC was calculated to determine the optimal cut-off values for predicting prognosis. To determine better prognostic models, platelet-based models were analyzed separately after being showed as binary according to cut-off values. Cumulative survival rates of malignant hepatic tumors were calculated using Kaplan-Meier curves and differences were analyzed by the log-rank test. Univariate and multivariate analyses were performed to identify platelet-based prognostic scores associated with overall survival. Results: Univariate analysis showed that APGA, APRI, FIB-4, FibroQ, GUCI, King's score, Lok index, PAPAS, cirrhosis, number of tumors, vascular cancer embolus, AFP, ALP and APTT were significantly related to prognosis. A multivariate analysis showed that the APGA, number of tumors, ALP and APTT were independently associated with overall survival. Conclusion: This study showed that the APGA, a platelet-based prognostic score, was an independent marker of prognosis in patients with malignant hepatic tumors after TACE and was superior to the other platelet-based prognostic scores in terms of prognostic ability.

RESUMO: A contaminação do solo por metais tóxicos tornou-se um problema grave nos últimos anos. Neste estudo, dois tipos de repolhos, o repolho chinês (maior acumulador de cádmio (Cd)) e o repolho comum (menor acumulador de Cd) foram cultivados em monocultivo e em consórcio, em solo contaminado com esse metal, para avaliar o efeito do consórcio na extração de Cd do solo. Os experimentos em vasos de campo indicaram que o consórcio aumentou a extração desse metal pelo repolho chinês e diminuiu a extração pelo repolho comum. Assim, aumentou a extração de Cd do solo, proporcionando segurança alimentar. Outro experimento em vaso foi conduzido para investigar as alterações das frações de Cd do solo, o pH do solo e atividades enzimáticas do solo, para revelar possíveis efeitos na extração desse metal entre os sistemas de plantio. Os resultados do experimento em vaso revelaram que três repolhos da china, em cultivo consorciado, proporcionaram o mesmo efeito nessas variáveis, que os observados com seis plantas desse tipo de repolho, em monocultura. O consórcio influenciou as frações de Cd do solo devido a maior influência das hortaliças no pH do solo e nas atividades enzimáticas (especialmente a urease), resultando maior extração de Cd pelo repolho chinês e menor pelo repolho comum.

ABSTRACT: Toxic metals contamination of soil has become a serious problem in recent years. In this study, Chinese cabbage (a relatively high-accumulator of cadmium (Cd)) and cabbage (a relatively low-accumulator of Cd) were cultured in monoculture and in intercropping in the Cd-contaminated soil, to evaluate the effect of intercropping on the alteration of Cd extraction. Both the pot experiments and field experiments indicated that intercropping increased the Cd extraction by Chinese cabbage and decreased the Cd extraction by cabbage. Thus, Cd extraction was advanced while safe production was obtained. Further pot experiment was conducted to investigate the alterations of soil Cd fractions, soil pH, and soil enzyme activities to reveal their possible relationship with Cd extraction between different planting patterns. Results revealed that three individual Chinese cabbages in one intercropping pot played the same effect on alteration of these factors as six individual Chinese cabbages in one monoculture pot. The intercropping increased Cd extraction by Chinese cabbage and decreased Cd extraction by cabbage, probably by influencing mechanisms such as soil enzyme activities (especially the urease activity) in the cultivation system. Effect of intercropping on Cd accumulation is an important issue in cultivation of vegetables in potentially contaminated land.

RESUMEN Este estudio se realizó para analizar las características de los ciclones marítimos en la costa de Guangdong entre los años 1949 y 2016, además de su variación interanual, la intensidad de los ciclones tropicales, el lugar y el momento de creación, y su recorrido. Las características temporales y espaciales también fueron estudiadas. Los resultados muestran que 183 ciclones tropicales tocaron tierra en la costa de Guangdong en estos 68 años, con un promedio de 2.7 por año, de los cuales el 60 por ciento se consideran tifones. Muchos de los ciclones tropicales se generaron en el noroeste del Pacífico, y van de abril a diciembre. Las direcciones de recorrido son principalmente norte, noroeste, y oeste. La fuerza de los ciclones tropicales se redujeron desde la costa central de Guangdong hacia el este y el oeste, mientras que el sector entre las ciudades de Zhanjiang y Shenzhen es el más vulnerable a los ciclones. Los ciclones tropicales generados en el mar del Sur de China tienden a tocar tierra en el oeste de la costa de Guangdong, mientras que aquellos que se producen en el noroeste del Pacífico suelen recorrer hacia la costa este. En el área de estudio, los ciclones tropicales frecuentemente ocurren de julio a septiembre y son más fuertes en septiembre. Se evidenciaron recorridos y direcciones de los ciclones propias a cada mes. Finalmente, de acuerdo con la información estadística y los resultados de investigación, el recorrido de los ciclones tropicales en la costa de Guangdong fueron analizados preliminarmente.

ABSTRACT This study was conducted to analyze the maritime cyclone characteristics in Guangdong coast in the years of 1949 to 2016, including inter-annual variation, the intensity of tropical cyclones, generating location and time, and path direction. Also, the temporal-spatial characteristics were also studied. Results show there were 183 tropical cyclones landed in Guangdong coast in the past 68 years, with an average of 2.7 each year, which more than 60 percent were a typhoon. Most of the tropical cyclones were generated in the northwest Pacific, spanning from April to December. The path directions were mainly north, northwest, and west. The strengths of the tropical cyclones were reduced from central Guangdong coast to the east and the west sides, and the section of Zhanjiang city to Shenzhen city was the most vulnerable to tropical cyclones. Tropical cyclones that generated in the South China Sea tend to attack the west of the Guangdong coast, while the ones that produced in the northwest Pacific tend to attack the east of the Guangdong coast. In the study area, the tropical cyclones frequently occurred from July to September and became strongest in September. There are a most common landing section and path direction for each month. Finally, based on the statistical data and research results, the tropical cyclone paths in Guangdong coast were preliminarily analyzed.

Abstract The study of metabolomics requires extracting as many metabolites as possible from a biological sample. This study aimed to determine the optimal method for the extraction of metabolites from solid-state fermented cottonseed meal (FCSM). The UPLC-Q-TOF-MS global metabolomics technology was used to detect the metabolites in FCSM, and the extraction quantity and extraction efficiency of seven different extraction methods, specifically the WA, 50MeOH, 50MeOHB, 50MeCNB, 80MeOHB, 80MeOH and AMF methods were evaluated. The results showed that the number of VIP metabolites extracted by AMF method are 196 and 184 in ESI+ and ESI- mode respectively, it is the largest number of all exacted methods; and the AMF methods also provided a higher extraction efficiency compared with the other methods, especially in indoleacrylic acid, dl-tryptophan and epicatechin (p < 0.01). As a result, AMF/-4 °C method was identified as the best method for the extraction of metabolites from FCSM by Lactobacillus acidophilus. Our study establishes a technical basis for future metabolomics research of fermented feed.

ABSTRACT Long-term excessive application of inorganic fertilizers not only wastes resources but also contaminates the environment. The use of natural substitutes could overcome these drawbacks. We hypothesize that organic fertilizers could increase soil C, N sequestration and improve soil fertility more effectively than inorganic fertilizers, and that in particular effective microorganism (EM) could improve the effects of traditional compost. So, a long-term field experiment regarding improvement of soil fertility, protecting soil environment, and increasing of maize and wheat yield was conducted at China Agricultural University’s Qu-Zhou experiment station since 1993. Field experiment included EM compost treatment, traditional compost treatment, chemical fertilizer treatment, and unfertilized treatment. Soil organic C (SOC), total N, nutrient concentrations, pH, bulk density, and crop yields were determined. The results revealed that long-term repeated application of EM compost promoted soil C and N sequestration, increased soil nutrient contents, decreased soil pH and bulk density, enhanced crop yields in contrast to chemical fertilizer and control treatment. Soil organic C stocks (0-20 cm) were increased by 87.32%, 81.51%, 33.05%, 25.20% and soil total N stocks were increased by 93.26%, 77.53%, 37.64%, 34.83% in contrast to initial values in EM compost, traditional compost, chemical fertilizer and control treatments, respectively. Moreover, maize grain yields in EM compost, traditional compost, and chemical fertilizer treatments were significantly increased by 163.49%, 128.34%, 62.36% compared with control treatment, respectively. The effect of increased soil C and N sequestration, improving soil fertility and enhanced crop yields in application of compost appending EM was better than alone application of compost.

ABSTRACT Altered metabolites level in the biosystems, is the potential cause of cancer, the primary reason of alteration of metabolism is change in nutrient consumption and waste excretion, as a result genetic mutation leads to cancer initiation and progression. Aberration of specific metabolites such as fumarate, succinate, 2-hydroxyglutarate may alter cell signaling. We collected liver and kidney samples and prepared for 1H NMR analysis, then executed NMR spectroscopy. We used a set of domestic R scripts to perform an unsupervised principal component analysis (PCA) and a supervised orthogonal signal correction partial least-squares discriminant analysis (OSC-PLS-DA). It signifies class discrimination for getting a clear separation, whereas PCA scores plot signifies the model group kept further away from the control group than drug group on the horizontal axis. In another PCA scores plots, most parts of the control group was overlapping with the drug group but was distant from the model group. Marsdenia tenacissima extract (MTE) (Chines name: Xiao-Ai-Ping, XAP) modulates level of crucial metabolites such as fumarate, lactate, succinate, determined by 1H NMR spectroscopy and their altered level contributes major role in cancer.

Cobalt blue pigments were prepared by self-propagating combustion followed by sol-gel method using aluminum nitrate and cobalt nitrate as the raw material. X ray diffraction (XRD), scanning electron microscopy (SEM), fiber optic spectrometer and colorimetric analysis were used to investigate the effect of reaction temperature, metal ion concentration and dispersant upon the gel formation. The results show that the formation of gel network could be promoted by increasing the concentration of metal ion (0.01~0.2 mol/L) and sol-gel reaction temperature (80~90°C), and the disper-sibility and stability of the pigment powder could be improved with dispersing agent. The dried gel precursor was calcined at 1250 °C to form 200~500 nm cobalt aluminum with spinel structure with highly negative value of b*.

Al films and TiO2 films were separately coated on AZ31 magnesium alloy substrates by means of magnetron sputtering method. The surface properties of the samples were explored and compared. Scanning electron microscope (SEM) observed the compact structure characteristics of as-deposited Al films and TiO2 films. After heat treatment under 200ºC for half an hour the films kept the compact structure characteristics and there didn’t exist structural defects on the surface of the films. Nano-indentation measurement results display that the micro-hardness of as-deposited Al film and TiO2 film reaches about 1.90 Gpa and 1.51 Gpa, separately. Al film is a bit harder than TiO2 film. Finally, the corrosion experiments in simulated body fluid initially indicate the different corrosion properties for Al film and TiO2 film. Al film presents more effective anti-corrosion properties than TiO2 film.

RESUMO CONTEXTO: Leucemia promielocítica aguda (LPA) compreende 8% a 10% dos casos de leucemia mieloide aguda (LMA). A remissão em casos de LPA de alto risco ainda é dificilmente conseguida, e recorrência é comum. RELATO DE CASO: Descrevemos aqui um caso de LPA com glóbulos brancos elevados no exame de sangue e a morfologia variante hipogranular na medula óssea, juntamente com fms-like tirosina-quinase-3 com mutações de duplicação em tandem interna (FLT3-ITD) e a isoforma bcr-3 de PML- RARα. Mais importante, detectamos alto nível de gene do tumor de Wilms (WT1) em blastos medulares por RT-PCR (reverse transcription polimerase chain reaction). Até agora, não há conclusões claras sobre a associação entre os níveis de expressão WT1 e APL. Este paciente recebeu sucessivamente regime de tratamento combinado, de hidroxicarbamida, trióxido de arsênico e idarrubicina e citarabina, alcançando finalmente a remissão completa. Infelizmente, em seguida, ele morreu de repente de hemoptise maciça devido a uma infecção pulmonar. CONCLUSÃO: Com base em nossos resultados e numa revisão da literatura, a função anormal de WT1 pode ser um fator de alto risco em casos de APL. Novos estudos, com o objetivo de avaliar o impacto da expressão de WT1 no prognóstico dos doentes com APL, são de interesse.

ABSTRACT CONTEXT: Acute promyelocytic leukemia (APL) accounts for 8% to 10% of cases of acute myeloid leukemia (AML). Remission in cases of high-risk APL is still difficult to achieve, and relapses occur readily. CASE REPORT: Here, we describe a case of APL with high white blood cell counts in blood tests and hypogranular variant morphology in bone marrow, together with fms-like tyrosine kinase-3 with internal tandem duplication mutations (FLT3-ITD), and bcr-3 isoform of PML-RARα. Most importantly, we detected high level of Wilms’ tumor gene (WT1) in marrow blasts, through the reverse transcription polymerase chain reaction (RT-PCR). To date, no clear conclusions about an association between WT1 expression levels and APL have been reached. This patient successively received a combined treatment regimen consisting of hydroxycarbamide, arsenic trioxide and idarubicin plus cytarabine, which ultimately enabled complete remission. Unfortunately, he subsequently died of sudden massive hemoptysis because of pulmonary infection. CONCLUSION: Based on our findings and a review of the literature, abnormal functioning of WT1 may be a high-risk factor in cases of APL. Further studies aimed towards evaluating the impact of WT1 expression on the prognosis for APL patients are of interest.