The Increased Ratio of Blood CD56bright NK to CD56dim NK Is a Distinguishing Feature of Primary Sjögren’s Syndrome

Objective. The aim of this study was to characterize the subsets of circulating CD56+ NK cells in pSS patients and their potential value in the diagnosis and/or prediction of prognosis in patients with pSS. Methods. We included 52 pSS patients fulfilling the 2002 AECG criteria or 2012 ACR criteria and 20 age- and gender-matched healthy volunteers. The frequency and absolute number of NK cells and CD56 NK cell subsets in peripheral blood samples were detected by flow cytometry. Other laboratory parameters such as the IgG level and complement protein levels were extracted from the clinical system. Results. Both the frequency and the absolute number of peripheral blood NK cells were reduced in pSS patients compared to healthy controls. The proportion of CD56bright NK cell subset was increased, and the proportion of CD56dim NK cell subset was decreased among NK cells, resulting in the ratio of CD56bright NK to CD56dim NK which was significantly elevated in pSS patients. ROC analysis indicated that the AUC of CD56bright NK/CD56dim NK ratio was 0.838, and the best diagnostic cut-off point was 0.0487 for pSS patients. Furthermore, this CD56bright NK/CD56dim NK ratio was positively correlated with the IgG level and negatively correlated with the complement protein C3 and C4 levels. More importantly, the CD56bright/CD56dim NK ratio was either slightly increased or not changed in other autoimmune diseases such as SLE and IgG4-related disease. Conclusion. Our findings suggest that the ratio of blood CD56bright NK to CD56dim NK might have a diagnostic value relatively specific for pSS

Origin and tectonic implications of Early Cretaceous high- and low-Mg series rocks and mafic enclaves in the Bomi-Chayu Fold Belt, SE Tibet

Early Cretaceous granitoids are widespread on the Tibetan Plateau and record the tectonic evolution of several Tethyan oceans. We describe Early Cretaceous high-Mg (Mg-# > 50) and low-Mg (Mg-# < 50) granitoids, minor diorites, and mafic enclaves from the Bomi-Chayu Fold Belt, SE Tibet. Zircon U-Pb dating reveals two episodes of granitoid emplacement at similar to 122 and similar to 117 Ma. High-Mg series rocks have higher Mg-# and compatible element concentrations (e.g., Cr and Ni) than low-Mg series samples. Their Mg-# and compatible element abundances are also elevated relative to an experimental melt generated under the conditions of a thickened lower crustal. Enriched whole-rock Nd and zircon Hf isotopic signatures, coupled with low Y (<18 ppm) and Yb (<1.9 ppm) concentrations in some samples, indicate that the high-Mg series was derived from thickened lower crust and underwent minor mixing with cumulate pyroxenite in the lower crust. In contrast, low-Mg series rocks record a purely crustal origin, although differences are noted between Na-rich (subgroup 1) and K-rich (subgroup 2) compositions. Mafic enclaves hosted in the granitoids yield identical formation ages and isotopic compositions to their host rocks, suggesting a common origin. The spatial-temporal distribution of Early Cretaceous granitoids in the Bomi-Chayu Fold Belt indicates that magmatism occurred in an analogous tectonic regime to that of similar rocks in the Tengchong Terrane. The Bomi-Chayu granitoids are therefore distinct from those in the northern and central Lhasa subterranes and are related to the evolution of the Myitkyina Tethys Ocean in eastern Myanmar. (C) 2019 Elsevier B.V. All rights reserved

High-flow nasal cannula oxygen therapy versus noninvasive ventilation for patients with blunt chest trauma: protocol for a randomized controlled trial

Abstract Background High-flow nasal cannula oxygen therapy (HFNC) is recommended by some scholars as an optimized respiratory support method for blunt chest trauma (BCT) patients. The basis of this recommendation is limited, however, and the efficacy of HFNC or noninvasive ventilation (NIV) in BCT patients has not yet been rigorously explored. This study aims to determine if HFNC is non-inferior to NIV in reducing treatment failure in moderate to severe BCT patients with acute respiratory failure. Methods This will be a prospective, open-label, multicenter, non-inferiority, randomized controlled trial. Moderate to severe BCT patients with acute respiratory failure (100mmHg < PaO2/FiO2 ≦ 200mmHg) who do not need immediate intubation will be randomized to HFNC or NIV within 48 h after trauma. The primary outcome is treatment failure, defined as invasive ventilation or a switch in respiratory support modality (from HFNC to NIV or vice-versa). Secondary outcomes include arterial blood gas analysis and vital signs at 2 and 12 h after initiating HFNC or NIV treatment, as well as patients’ comfort scores, dyspnea scores, daily number of nursing airway care interventions, incidence of pneumonia or pneumothorax, facial skin breakdown, duration of NIV or HFNC, 28-day mortality, and total ICU and hospital lengths of stay. Based on an α error of 5% and a β error of 80%, with a non-inferiority limit of 9%, a sample size of 562 will be required to accomplish the trial goal, considering potential patient dropouts and nonparametric analysis. Discussion We hypothesize that HFNC will be non-inferior to NIV in reducing treatment failure in moderate to severe BCT with acute respiratory failure. The results should be useful for judging whether HFNC could be an effective alternative to NIV to treat moderate to severe BCT patients, especially for those who do not tolerate or have contraindications for NIV. Trial registration Chinese Clinical Trial Registry ChiCTR1800017313 . Registered on July 24, 2018

Mid-Triassic felsic igneous rocks from the southern Lancangjiang Zone, SW China: Petrogenesis and implications for the evolution of Paleo-Tethys

The southern Lancangjiang magmatic belt is an important component of the Triassic San-Jiang igneous zone in Southwestern China and is mainly composed of the Lincang (LC) batholith and aMesozoic volcanic belt that contains abundant rhyolites. Our new LA-ICP-MS zircon U–Pb results, together with previous SHRIMP and LA-ICP-MS ages, define two emplacement ages for the Lincang batholith: at ~230 Ma and ~220 Ma, corresponding to the eruption times of volcanic rocks of theManghuai and Xiaodingxi formations, respectively.Most of the ~230 Ma LC granites possess high A/CNK values (>1.1) and display strongly peraluminous characteristics, similar to S-type granite, whereas the Manghuai Formation (MHF) rhyolites show an affinity to A-type granite, especially their elevated FeOt/(FeOt+MgO) and Ga/Al ratios. Both of the granitic and volcanic rocks have strongly fractionated REE patterns ((La/Yb)N=2.66–33.2 and 13.1–19.7, respectively) and have conspicuous negative Eu anomalies (Eu*/Eu=0.06–0.65 and 0.52–0.74, respectively) with a similar depletion in HFSE (Nb,Zr, Hf), P, Ba and Sr. The Sr–Nd isotopic data and TDM2 model ages suggest that the LC graniticmagma had a dominantly crustal source,whereas theMHF rhyoliteswere derived frommixing betweenmiddle/upper crustal rocks similar to the source of the LC granitic magma, with a small volume of mantle-derived melt.In combination with regional studies, our new geochemical data and geochronological results show that the mid-Triassic magmatism was generated in a post-collisional tectonic setting. The spatial distribution pattern of the Mesozoic igneous rocks along the Lancangjiang zone favors a slab breakoff model, which resulted in post-collisional extension and asthenospheric upwelling that induced large-scale partial melting of the middle-lower crust to produce voluminous amounts of felsic magma. Therefore, the occurrence of the mid-Triassic post-collisional magmatism clearly indicates that the final continent–continent/arc collision between the Gondwana-derived Sibumasu and Indochina blocks of Paleo-Tethys was completed by the early mid-Triassic