Cytokine storm syndrome in coronavirus disease 2019: A narrative review

Cytokine storm syndrome (CSS) is a critical clinical condition induced by a cascade of cytokine activation, characterized by overwhelming systemic inflammation, hyperferritinaemia, haemodynamic instability and multiple organ failure (MOF). At the end of 2019, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, and rapidly developed into a global pandemic. More and more evidence shows that there is a dramatic increase of inflammatory cytokines in patients with COVID-19, suggesting the existence of cytokine storm in some critical illness patients. Here, we summarize the pathogenesis, clinical manifestation of CSS, and highlight the current understanding about the recognition and potential therapeutic options of CSS in COVID-19.

[The problems and countermeasures in the training of public health talents in colleges and universities in China]

Colleges and universities are the cradle for public health talents training. Under the epidemic situation, the new requirements for the construction of public health service system and the promotion of population health, urged us to rethink how to reform the training of public health talents in colleges and universities. This research focused on key problems of the construction and distribution, scale, orientation, and contents of training for various public health talents in colleges and universities. It was suggested to reinforce the balanced development of public health in colleges and universities in various areas in China, to refine interdisciplinary training, to intensively cultivate technical and research-oriented talents, to expand talents within and outside the colleges and universities, as well as to introduce and cultivate public health teachers simultaneously, so as to better play the role of colleges and universities in the training of the public health talents.

HSP70 inhibits pig pituitary gonadotrophin synthesis and secretion by regulating the corticotropin-releasing hormone signaling pathway and targeting SMAD3

High levels or long periods of stress have been shown to negatively impact cell homeostasis, including with respect to abnormalities in domestic animal reproduction, which are typically activated through the hypothalamus-pituitary-adrenal axis, in which corticotropin-releasing hormone (CRH) and heat shock protein 70 (HSP70) are involved. In addition, CRH has been reported to inhibit pituitary gonadotrophin synthesis, and HSP70 is expressed in the pituitary gland. The aim of this study was to determine whether HSP70 was involved in regulating gonadotrophin synthesis and secretion by mediating the CRH pathway in the porcine pituitary gland. Our results showed that HSP70 was highly expressed in the porcine pituitary gland, with over 90% of gonadotrophic cells testing HSP70 positive. The results of functional studies demonstrated that the HSP70 inducer decreased FSH and LH levels in cultured porcine primary pituitary cells, whereas an HSP70 inhibitor blocked the negative effect of CRH on gonadotrophin synthesis and secretion. Furthermore, our results demonstrated that HSP70 inhibited gonadotrophin synthesis and secretion by blocking GnRH-induced SMAD3 phosphorylation, which acts as the targeting molecule of HSP70, while CRH upregulated HSP70 expression through the PKC and ERK pathways. Collectively, these data demonstrate that HSP70 inhibits pituitary gonadotrophin synthesis and secretion by regulating the CRH signaling pathway and inhibiting SMAD3 phosphorylation, which are important for our understanding the mechanisms of the stress affects domestic animal reproductive functions.

GALNT10 promotes the proliferation and metastatic ability of gastric cancer and reduces 5-fluorouracil sensitivity by activating HOXD13

OBJECTIVE

To investigate the expression and potential mechanism of GALNT10 in gastric cancer (GC).

PATIENTS AND METHODS

A total of 60 cases of GC tissues, as well as normal tissues were collected. The total RNA of GC specimens and cells were extracted by TRIzol method and the level of GALNT10 was examined by quantitative real-time polymerase chain reaction (qRT-PCR). In addition, the relationship between GALNT10 and clinical parameters and prognosis of GC patients was analyzed. Subsequently, Lentivirus was used to construct GALNT10 knockdown GC cell lines, and cell counting kit-8 (CCK-8) and transwell assays were applied to analyze the influence of GALNT10 on GC cell function. Bioinformatics and Luciferase assay was used to evaluate the relationship between GALNT10 and HOXD13. Furthermore, 5-fluorouracil (5-Fu)-resistant cells were used to detect the relationship between GALNT10 and 5-Fu sensitivity of GC cells.

RESULTS

qRT-PCR results revealed that GALNT10 level was markedly increased in tissues, as well as cell lines of GC. Statistical analysis suggested that GALNT10 expression was in close relation with the incidence of lymph node and distant metastasis along with poor prognosis in GC patients, but not with other indicators. CCK-8 and transwell migration experiment results indicated that GALNT10 silencing can inhibit the proliferative and migration ability of GC cells. Western blot results displayed that the HOXD13 level was remarkably decreased after GALNT10 knocking down. In addition, Luciferase gene assay indicated that GALNT10 could bind to HOXD13. Further rescue experiments showed that HOXD13overexpression can synergistically reverse the inhibitory effect of GALNT10 knockdown on GC cell proliferative and migration ability, which further demonstrated that GALNT10 could promote GC cell metastasis ability and reduce the sensitivity to 5-Fu by regulating HOXD13.

CONCLUSIONS

GALNT10 could regulate the proliferative and migration ability of GC cells and reduce the sensitivity to 5-Fu by enhancing the expression of HOXD13. Therefore, GALNT10 was expected to be a new therapeutic target for diagnosis of 5-fluorouracil resistance in GC.

Nomogram predicting early neurological improvement in ischaemic stroke patients treated with endovascular thrombectomy

BACKGROUND AND PURPOSE

Early neurological improvement (ENI) after endovascular thrombectomy (EVT) has been associated with favorable outcomes. This study aimed to identify the optimal definition of ENI and develop a nomogram for predicting ENI after EVT in acute ischaemic stroke.

METHODS

Patients with EVT were enrolled from a multicenter registry as the training cohort. The receiver operating characteristic curve was used to estimate the optimal threshold for ENI at 24 h of EVT. Logistic regression analysis was utilized to generate the best-fit nomogram for predicting ENI. The discrimination of the nomogram was assessed using the area under the receiver operating characteristic curve (AUC). An additional 447 patients from two stroke centers were prospectively recruited as the test cohort for validating the nomogram.

RESULTS

A total of 612 patients with EVT were included in the training cohort. The optimal threshold for predicting 3-month favorable outcome (modified Rankin Scale 0-2) was an improvement of the National Institutes of Health Stroke Scale (NIHSS) score by ≥6 points (AUC 0.875; sensitivity 79.5%; specificity 90.7%). Age, blood glucose, recanalization, symptomatic intracranial hemorrhage (sICH) and baseline Alberta Stroke Program Early Computed Tomography Score (ASPECTS) were independently associated with ENI, and were incorporated in the nomogram. The AUC of the nomogram was 0.795 in the training cohort and 0.752 in the test cohort.

CONCLUSIONS

A reduction of NIHSS score ≥6 appeared to be the optimal definition of ENI. The nomogram composed of age, blood glucose, recanalization, sICH and baseline ASPECTS may predict the probability of ENI in ischaemic stroke patients treated with EVT.

Pozzolanic and mechanical properties of Date Palm Seed Ash (Dpsa) concrete

This paper presents the findings of a research work conducted on how to improve the mechanical properties of concrete using Date Palm Seed Ash (DPSA) as partial replacement of cement. The DPSA used was obtained by controlled burning of date palm seed in a kiln at a maximum temperature of 630oC for eight hours and air cooled afterwards. The ash obtained was sieved through 75μm sieve and its oxide composition analysed using X-ray fluorescence (XRF) procedures. DoE method of mix design was used to produce concrete ingredients for grade 30N/mm2 giving a water-cement ratio of 0.53. The effect of partial replacement of cement with DPSA on cement paste and concrete using 0, 2.5, 5, 7.5, 10, 15 and 20% DPSA was investigated through consistency and setting times tests, workability test, compressive strength test (at 7, 21, 28 and 56 days curing duration), pozzolanic activity index evaluation and water absorption test. Results show that DPSA has high silicon dioxide (45.50%), aluminum oxide (20.75%) and Iron oxide (7.25%). Findings indicate that the consistency and setting times of cement-DPSA paste increased with increase in the replacement of cement with DPSA. The workability of DPSA concrete decreased with increase in cement replacement. Compressive strength test results show that cement can be replaced with DPSA up to 10% as the compressive strength at 10% replacement is 31.5N/mm2 as against the 31N/mm2 of the normal concrete, at 56 days. The pozzolanic activity index result also show that DPSA concrete meets up the minimum requirement of 75% specified by ASTM C618-15. Also, the water absorption capacity of DPSA concrete at the highest replacement (20%) is 11% less than that at 0%. Keywords: Cement, Compressive strength, Concrete, Date palm seed ash, Partial replacement, Pozzolana

[Meta-analysis of the effects of dexmedetomidine combined with ketamine during dressing changes in burn patients]

Objective: To systematically evaluate the safety and efficacy of dexmedetomidine combined with ketamine during dressing changes in burn patients using meta-analysis. Methods: Foreign language databases including PubMed, Cochrane Central, Embase, and Web of Science were searched with the terms of " burns, dexmedetomidine, ketamine, and dressing" , and Chinese databases including Chinese Journal Full-Text Database, Wanfang Data, and China Academic Journal Network Publishing Database were searched with the terms in Chinese version of ",,,,," to retrieve the publicly published randomized controlled trials on the application of dexmedetomidine combined with ketamine for sedation and analgesia during dressing changes in burn patients from the establishment of each database to March 2019. The outcome indexes included systolic blood pressure at 5 minutes after administration, arousal restlessness score, ketamine dosage, dressing change time, body movement/recovery time, pain score, Ramsay sedation scores at 10 minutes after the start of dressing change and 1 hour after dressing change, physician satisfaction score, neuropsychological symptoms, nausea and vomiting times, nausea and vomiting score. RevMan 5.3 and Stata 14.0 statistical software were used to conduct a meta-analysis of eligible studies. Results: A total of 396 burn patients were included in 7 articles, including 198 patients in dexmedetomidine+ ketamine group who received dexmedetomidine and ketamine for sedation and analgesia, and 198 patients in ketamine alone group who received ketamine alone for sedation and analgesia. The bias risks of the seven studies included were uncertain. Compared with those of ketamine alone group, the systolic blood pressure at 5 minutes after administration, arousal restlessness score, nausea and vomiting score of patients in dexmedetomidine+ ketamine group were significantly decreased, with standardized mean differences of -13.89, -0.84, and -0.99 (95% confidence interval=-20.89--6.89, -1.17--0.52, -1.31--0.68, P<0.01), the Ramsay sedation score at 10 minutes after the start of dressing change and that at 1 hour after dressing change were significantly increased, with standardized mean differences of 1.53 and 0.72 (95% confidence interval=1.05-2.02, 0.13-1.31, P<0.05 or P<0.01), and the number of neuropsychological symptom and number of nausea and vomiting were significantly reduced, with relative risks of 0.20 and 0.16 (95% confidence interval=0.07-0.58, 0.05-0.58, P<0.01). The patients in the two groups were similar in ketamine dosage, dressing change time, body movement/recovery time, pain score, and physician satisfaction score. There was no publication bias in dressing change time or ketamine dosage (P>0.05), while the other indexes might have publication bias (P<0.05). Conclusions: Compared with ketamine alone, combination of dexmedetomidine and ketamine during dressing changes in burn patients can reduce the occurrence of restlessness, nausea and vomiting, neuropsychological symptoms, and other complications, better stabilize blood pressure, and enhance sedation effect.

AB0919 WHAT IS LOWER EXTREMITY ENTHESEAL INVOLVEMENT IN ACUTE GOUT ATTACK? AN ULTRASOUND-STUDY

Background:

Articular involvement in acute gout attack is extremely common and mainly characterized by arthritis, which are usually transient, severe, reversible and well responsive to treatment. The involvement of tendons and entheses in lower extremity in monosodium urate-related disease through US (ultrasound) assessment have been described1,2. US findings in gout raising the hypothesis that entheseal involvement could be a missing target in the clinical evaluation of gout patients.

Objectives:

To evaluate by ultrasound (US) the frequency and characteristics of lower extremity entheseal involvement in acute gout attack patients.

Methods:

US assessment were performed by independent rheumatologist on 31 patients with acute gout attack. Presence of lower extremity entheseal involvement were evaluated by grey-scale (GS) and power Doppler (PD). US assessment contain quadriceps, patellar and Achilles tendons, and plantar fascia entheses according to the OMERACT definitions.

Results:

US revealed one or more abnormalities in at least one enthesis in 22 out of 31 gout patients (71.0%) and 47 out of 310 entheses (15.2%). Among the affected entheses, the patellar insertion of quadriceps tendon was most commonly involved (57.4%) during acute gout attack, followed by the calcaneal insertion of the Achilles tendon (17.0%) and distal insertion of the patellar tendon (14.9%). The proximal insertion of the patellar tendon and calcaneal insertion of the plantar fascia were involved in 8.5% and 2.1%, respectively. Bone erosions and osteophytes were found in affected entheses (10.6% and 25.5%, respectively).

Conclusion:

Our study identifies that lower extremity entheseal involvement is a missing target in the evaluation of patients with acute gout attack. US plays a key role in the assessment of both clinical and subclinical enthesitis in gout patients.

References:

[1]Pineda C, Amezcua-Guerra LM, Solano C, et al. Joint and Tendon Subclinical Involvement Suggestive of Gouty Arthritis in Asymptomatic Hyperuricemia: an Ultrasound Controlled Study.J Rheumatol.2011;38(6):1195-1195.

[2]Carroll M, Dalbeth N, Allen B, et al. Ultrasound Characteristics of the Achilles Tendon in Tophaceous Gout: A Comparison with Age- and Sex-matched Controls.J Rheumatol.2017;44(10):1487-1492.

Disclosure of Interests:

None declared

[A case of chronic ulcer with ectopic ossification in lower right extremity]

On January 1st, 2019, one male patient, aged 55 years, with chronic ulcer in right lower extremity was admitted to Northern Jiangsu People's Hospital. After admission, ulcer debridement and vacuum sealing drainage (VSD) surgery was performed in lower right extremity. Two pieces of bone-like tissue was removed from the lateral space between the Achilles tendon and fibula in the right leg, which was confirmed as ossification tissue by histopathological sections after surgery. The wounds were treated with VSD technique and dressing changes. On the 49th day after surgery, split-thickness skin graft was taken from the lateral left thigh and grafted to the wound area, which was then treated with VSD. The skin graft of patient survived well. The wound healed completely and the patient was discharged from hospital on day 77 post hospitalization. This case suggests that the patients with chronic ulcer should complete all related examinations in time, and improving the blood circulation of the wound and clearing the ectopic ossification in the wound are critical for wound healing.

20-Hydroxyecdysone receptor-activated Bombyx mori CCAAT/enhancer-binding protein gamma regulates the expression of BmCBP and subsequent histone H3 lysine 27 acetylation in Bo. mori

Cyclic adenosine monophosphate (cAMP) response element binding protein (CREB)-binding protein (CBP or CREBBP) plays important roles in regulating gene transcription and animal development. However, the process by which CBP is up-regulated to impact insect development is unknown. In this study, the regulatory mechanism of Bombyx mori CBP (BmCBP) expression induced by 20-hydroxyecdysone (20E) was investigated. In the Bo. mori cell line, DZNU-Bm-12, 20E enhanced BmCBP transcription and histone H3K27 acetylation. BmCBP RNA interference (RNAi) resulted in decreased histone H3K27 acetylation. Additionally, the luciferase activity analysis revealed that the transcription factor, Bo. mori CCAAT/enhancer-binding protein gamma (BmC/EBPg), activated BmCBP transcription, which was suppressed by BmC/EBPg RNAi and promoted by BmC/EBPg overexpression. Electrophoretic mobility shift assay and chromatin immunoprecipitation results demonstrated that BmC/EBPg could bind to the C/EBP cis-regulatory elements in two positions of the BmCBP promoter. Moreover, BmC/EBPg transcription was enhanced by the 20E receptor (BmEcR), which bound to the BmC/EBPg promoter. BmEcR RNAi significantly inhibited the transcriptional levels of BmC/EBPg and BmCBP in the presence of 20E. Furthermore, the BmEcR-BmC/EBPg pathway regulated the acetylation levels of histone H3K27. Altogether, these results indicate that BmEcR enhances the expression of BmC/EBPg, which binds to the BmCBP promoter, activates BmCBP expression and leads to histone H3K27 acetylation.

RUNX1-activated upregulation of lncRNA RNCR3 promotes cell proliferation, invasion, and suppresses apoptosis in colorectal cancer via miR-1301-3p/AKT1 axis in vitro and in vivo

PURPOSE

Long non-coding RNAs (lncRNAs) have participated in progression of colorectal cancer. This study aims to study the role of RUNX1/RNCR3/miR-1301-3p/AKT1 axis in colorectal cancer.

METHODS

The cancer tissues were from patients with colorectal cancer. The qRT-PCR was used to determine expression of lncRNA RNCR3, miR-1301-3p, and AKT1. Both dual-luciferase reporter assay and ChIP assay were conducted to investigate the binding sites of RUNX1 on RNCR3 promoter. Western blot was performed to analyze expression of AKT1 protein. Both dual-luciferase reporter assay and RIP assay were performed to detect the interacting sites between RNCR3 and miR-1301-3p. The CCK-8 assay, soft agar assay, transwell assay, and annexin-V-FITC/PI staining were applied to analyze the cell growth, invasion, and apoptosis, respectively.

RESULTS

The data demonstrated that RNCR3 was elevated in colorectal cancer, and it was negatively correlated with expression of miR-1301-3p which was decreased in cancers. Then, RNCR3 could interact with and suppress miR-1301-3p expression in HCT116 and SW480. Knockdown of RNCR3 or miR-1301-3p overexpression significantly inhibited cell growth, invasion, and increased apoptosis through suppressing expression of Cyclin A1, PCNA, N-cadherin, Bcl-2, and promoting expression of E-cadherin, Bax in vitro and in vivo. RUNX1 was directly bound to RNCR3 promoter to activate RNCR3 expression. Furthermore, overexpression of RNCR3 blocked tumor inhibitory effects of miR-1301-3p on proliferation, colony formation, invasion, and apoptosis in vitro and in vivo. Additionally, RNCR3 and miR-1301-3p synergistically modulated AKT1 expression.

CONCLUSION

RUNX1-activated upregulation of RNCR3 promoted colorectal cancer progression by sponging miR-1301-3p to elevate AKT1 levels in vitro and in vivo.

Temporal and spatial expression of Sox9, Pax1, TGF-β1 and type I and II collagen in human intervertebral disc development

PURPOSE

An accurate understanding of cellular biochemical changes in human intervertebral disc (IVD)s and the corresponding mechanisms during the developmental process still remain unknown and important for investigating the function of critical factors in normal IVD development as well as ascertaining the therapeutic targets for the IVD degeneration.

METHODS

Under ethical conditions, human fetal cervical IVDs at 4, 5, and 6 months of pregnancy were collected at abortion surgery. Normal adult human C3-C7 cervical IVDs were taken from cadaveric donors. Sox9, Pax1, TGF-β1 and type I/II collagen protein and RNA were detected. The number of positive cells was counted to calculate the optical density value for each factor.

RESULTS

Sox9, Pax1, and TGF-β1 expression in the IVD was remarkably reduced with the developmental stage. The location of high expression of Sox9, Pax1, and TGF-β1 changed with the developmental stage, and migrated from the nucleus pulposus to the annulus fibrosus and endplate. Higher Sox9, Pax1, and TGF-β1 expression was finally observed around the sclerotome of the vertebral body. The anabolism of type I/II collagens is significantly increased in the IVD in the mid-trimester fetus.

CONCLUSIONS

Sox9, Pax1 and TGF-β1 participate in the developmental process of the human IVD and vertebral body. However, these factors show a separate expression of mRNA and protein, suggesting that they are expressed in the strict time and spatial order.

Uric acid level and risk of symptomatic intracranial haemorrhage in ischaemic stroke treated with endovascular treatment

BACKGROUND AND PURPOSE

There are limited data on the association between uric acid (UA) and symptomatic intracranial haemorrhage (SICH) in patients who have undergone mechanical thrombectomy [endovascular treatment (EVT)]. In the present study, we aimed to investigate the role of serum UA level in SICH after EVT in a real-world practice.

METHODS

Patients were selected from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke (ACTUAL) registry. SICH was identified using the Heidelberg Bleeding Classification. Multivariable logistic regression analysis was performed to explore the relationship between serum UA and SICH.

RESULTS

Among 611 enrolled patients, 90 (14.7%) were diagnosed with SICH within 72 h after EVT. Patients with SICH had a significantly higher level of serum UA (median, 341.0 vs. 302.0 μmol/L; P = 0.003) than those without SICH. Univariate logistic regression analysis indicated that patients with UA levels in the fourth quartile, compared with the first quartile, were more likely to have SICH (odds ratio, 2.846; 95% confidence intervals, 1.429-6.003; P = 0.003). The association remained significant after multivariable adjustment for potential confounders. Furthermore, the multiple-adjusted spline regression model showed an inverted U-shaped association between UA and SICH (P = 0.047 for non-linearity).

CONCLUSION

Our study indicated that increased serum UA level was independently associated with SICH after EVT in acute ischaemic stroke.

[Comparison of radiological and clinicopathological features of craniofacial fibro-osseous lesions]

Objective: To investigate the clinicopathological and radiological features of benign fibro-osseous lesion (BFOL). Methods: Sixty-five cases of craniofacial BFOL, eight cases of peripheral ossifying fibroma (POF) and one case of low-grade central osteosarcoma diagnosed at Sichuan Provincial People's Hospital between January 2010 and March 2019 were collected. The clinicopathologic features, hematoxylin-eosin and immunohistochemical (IHC) staining and radiographic features were analyzed. MDM2 gene amplification was detected by FISH in difficult borderline cases. Results: This cohort of BFOLs included 50 cases of fibrous dysplasia (FD), 12 cases of ossifying fibroma (OF), and three cases of juvenile psammomatoid ossifying fibroma (JPOF). The average ages of patients with FD,OF and JPOF were 31.7, 39.2 and 26.0 years respectively. The male to female ratio was 1.0∶1.8.The average age of POF was 47.0 years, with male to female ratio of 1∶7. Patient of low-grade central osteosarcoma was a 48-year-old man. Twenty-seven cases of FD were located in the jaw, and 23 cases were in other craniofacial bones. Nine cases of OF were located in the jaw, and three cases were in the nasal cavity. Two cases of JPOF were in the nasal sinus, and one was in the jaw. All POF were located in the gingiva, and low-grade central osteosarcoma was located in the mandible. The imaging features of FD were luffa-like or ground-glass like signal shadows with poorly defined borders with expansion. OF had clear borders or sclerosing margins. Both JOF and low-grade central osteosarcoma were expansile intraosseously and with focally invasive nodular masses with ground-glass like signal shadows; and POF showed soft tissue mass with bone formation. Histological features of BFOLs showed mixed fibrous and irregular osteoid lesions. FD had no clear relationship with the host bone and no osteoblasts surrounded the bone trabeculae. Osteoblasts rimming was found in OF, and the boundaries of the host bone were clear. JPOF and low-grade central osteosarcoma infiltrated the host bone focally, and the latter showed mild cellular atypia. MDM2 amplification was detected in low-grade central osteosarcoma. Conclusions: BFOLs are a group of fibro-osseous lesions with similar morphology in the head and neck and face, but their clinical features and prognosis are different; and their imaging and histological characteristics are also slightly different. Attentions should be given to the combination of clinical, imaging and pathologic features of BFOLs, especially the differential diagnosis between BFOLs and low-grade central osteosarcoma. Molecular detection could be used to assist the diagnosis in difficult cases.

Dietary Inflammatory Index and Leukoaraiosis in Patients with Ischemic Stroke

OBJECTIVES

Diet may change the chronic levels of systemic inflammation, which in turn influence the development of leukoaraiosis (LA). This study aimed to examine the association between dietary inflammatory index (DII) and LA in patients with ischemic stroke.

METHODS

Patients with first-ever ischemic stroke were enrolled from two centers. A semi-quantitative food frequency questionnaire (FFQ) was used to evaluate diet contents. The DII score of each patient was calculated based on the reported diet contents. Presence and degree of LA were evaluated with a magnetic resonance imaging (MRI) scan. LA was graded according to Fazekas scale.

RESULTS

Of the 497 enrolled patients, 337 (67.8%) were detected with LA. Patients with LA had a higher DII score (0.23 vs -0.88, P < 0.001). Logistic regression analysis detected that patients with highest quartile of DII score had an OR of 3.61 (95% CI: 2.05-6.36, P < 0.001) for LA compared with those with lowest quartile of DII. After adjusting for major confounders, the highest DII quartile remained as an independent predictor for LA (OR = 2.66, 95% CI: 1.41-5.00, P = 0.008).

CONCLUSIONS

A pro-inflammatory diet pattern, as indicated by higher DII values, appears to be associated with a higher risk of LA. This result suggested that dietary-mediated inflammation may involved in the pathogenesis of LA, which warrant further study.

LncRNA CCHE1 in the proliferation and apoptosis of gastric cancer cells

OBJECTIVE

We aimed at investigating the effects of long non-coding RNA (lncRNA) CCHE1 on proliferation and apoptosis of gastric cancer cells.

MATERIALS AND METHODS

qRT-PCR method was used to detect lncRNA CCHE1 in cancer cell lines. Cells with relative expression were selected to change the expression by transfecting with corresponding lentiviral vector, and nonsense transfection group and blank control group were also constructed; cell counting kit-8 (CCK-8) method was used to assess cell proliferation activity; colony formation assay was used to evaluate the rate of cell cloning; flow cytometry assay was used to determine the apoptosis rate and cell cycle. Western blot was utilized to detect the expressions of Bax and Bcl-2.

RESULTS

Expression of lncRNA CCHE1 in the tumor cell lines was increased (p<0.05). Up-regulated lncRNA CCHE1 increased proliferative activity and colony formation capacity. However, down-regulated lncRNA CCHE1 decreased proliferative activity and colony formation capacity. Bcl-2 protein expression increased, but Bax protein expression decreased in lncRNA CCHE1 upregulation group (p<0.05); the effect was reversed in lncRNA CCHE1 down-regulation group (p<0.05).

CONCLUSIONS

lncRNA CCHE1 may promote the proliferation of gastric cancer cells and inhibit cell apoptosis.

Up-regulation of miR-765 predicts a poor prognosis in patients with esophageal squamous cell carcinoma

OBJECTIVE

Up-regulation of miR-765 in esophageal squamous cell carcinoma (ESCC) has been reported in the previous study. The aim of the present study was to measure the levels of miR-765 expression in ESCC and evaluate its clinical significance in ESCC patients.

PATIENTS AND METHODS

Quantitative Real-time PCR assays were performed to analyze the expression of miR-765 in human ESCC tissues and adjacent esophageal tissues. The relationships between miR-765 expression levels and the clinical factors were investigated by x2-test. Kaplan-Meier analysis was performed to evaluate the overall survival (OS) and disease-free survival (DFS) of ESCC patients with a different expression level of miR-765. The Cox proportional hazards regression model was used to assess the independent prognostic factors.

RESULTS

The expression level of miR-765 in ESCC tissues was significantly higher than that in their corresponding normal tissues (p < 0.01). High miR-765 expression was significantly correlated with tumor stage (p = 0.001), lymph nodes metastasis (p = 0.005), clinical stage (p = 0.007). In addition, Kaplan-Meier analysis showed that patients with higher miR-765 expression had a significantly poorer OS (p = 0.0010) and DFS (p< 0.0001) than those with lower miR-765 expression. Multivariate analyses revealed that miR-765 expression served as an independent predictor for both OS (p = 0.001) and DFS (p = 0.001).

CONCLUSIONS

Our findings provided the first evidence that miR-765 may serve as an indicator for prognosis of ESCC.

Giant optical nonlinearity interferences in quantum structures

Second-order optical nonlinearities can be greatly enhanced by orders of magnitude in resonantly excited nanostructures. These resonant nonlinearities continually attract attention, particularly in newly discovered materials. However, they are frequently not as heightened as currently predicted, limiting their exploitation in nanostructured nonlinear optics. Here, we present a clear-cut theoretical and experimental demonstration that the second-order nonlinear susceptibility can vary by orders of magnitude as a result of giant destructive, as well as constructive, interference effects in complex systems. Using terahertz quantum cascade lasers as a model source to investigate interband and intersubband nonlinearities, we show that these giant interferences are a result of an unexpected interplay of the second-order nonlinear contributions of multiple light and heavy hole states. As well as of importance to understand and engineer the resonant optical properties of nanostructures, this advanced framework can be used as a novel, sensitive tool to elucidate the band structure properties of complex materials.

[Advances in the research of heterotopic ossification caused by burns]

Heterotopic ossification is a rare complication of burns, and its incidence and risk factors are still unclear. Through summarizing the literature on heterotopic ossification caused by burns at home and abroad, the author searched for the risk factors of heterotopic ossification after burn and the new progress of its prevention and treatment. It was realized that the size, depth and healing time of burn wounds were related to heterotopic ossification; the nonsteroidal anti-inflammatory drugs, radiation therapy, and their combination therapy can be used for the prevention of heterotopic ossification; surgery is an effective means of treating heterotopic ossification.

Effects of different diets on the intestinal microbiota and immunity of common carp (Cyprinus carpio)

AIMS

An 8-week trial was performed to evaluate the differences in the intestinal microbiota and immune function of common carp (Cyprinus carpio)-fed different diets.

METHODS AND RESULTS

The fish (initial weight 492·6 ± 30 g, n = 270) were randomly divided into three groups with three replicates and were fed earthworms (group A), earthworms + duckweed (group M) or duckweed (group P) respectively. The diversity and dominant microbiota of the intestinal bacteria were detected by denaturing gradient gel electrophoresis, and the abundance of dominant bacteria was quantified by qPCR. Additionally, the activities of some nonspecific immune enzymes and antioxidant enzymes were determined. The results showed that higher diversity and abundance of intestinal microbiota were observed in group M and group P (P < 0·05). Based on the intestinal microbiota, Cetobacterium was only detected in the intestines of common carp in group A, and Bacillus was identified in groups M and P. Additionally, a higher abundance of Bacteroidetes and Firmicutes was also found in the intestine in group P than in group A (P < 0·05). Interestingly, the higher activities of immune enzymes were detected in intestine of common carp in group M, such as acid phosphatase, phosphatase (AKP), lysozyme, total antioxidant capacity, superoxide dismutase, catalase, glutathione peroxidase. In addition, the lower level of metabolites were also detected, such as nitric oxide and malondialdehyde.

CONCLUSIONS

Our results indicate that the intestinal microbiota and intestinal immunity of common carp were affected by diet. Meanwhile, the results show that a mixed diet can promote and improve the immune function of the omnivorous carp intestine, which suggests that paddy fields might be more suitable for the intestinal health and animal welfare of omnivorous fishes because they contain plant and animal diets.

SIGNIFICANCE AND IMPACT OF THE STUDY

As an ecological aquaculture strategy, the rice-fish mode has attracted attention among farmers, researchers and even consumers, especially for the cultivation of common carp in paddy fields. In paddy fields, fish can eat plant- and animal-based diets. However, it is not clear whether common carp feeding on a mixed diet in paddy fields have better intestinal health. This experiment is one of only a few studies performed from the perspective of intestinal micro-organisms and immunity to successfully study the effects of different natural diets on adult common carp. This study also provides a theoretical basis for healthy breeding of common carp in paddy fields.

Association between native T1 mapping of the kidney and renal fibrosis in patients with IgA nephropathy

Introduction

IgA nephropathy (IgAN) is the commonest global cause of glomerulonephritis. Extent of fibrosis, tubular atrophy and glomerulosclerosis predict renal function decline. Extent of renal fibrosis is assessed with renal biopsy which is invasive and prone to sampling error. We assessed the utility of non-contrast native T1 mapping of the kidney in patients with IgAN for assessment of renal fibrosis.

Methods

Renal native T1 mapping was undertaken in 20 patients with IgAN and 10 healthy subjects. Ten IgAN patients had a second scan to assess test-retest reproducibility of the technique. Native T1 times were compared to markers of disease severity including degree of fibrosis, eGFR, rate of eGFR decline and proteinuria.

Results

All patients tolerated the MRI scan and analysable quality T1 maps were acquired in at least one kidney in all subjects. Cortical T1 times were significantly longer in patients with IgAN than healthy subjects (1540 ms ± 110 ms versus 1446 ± 88 ms, p = 0.038). There was excellent test-retest reproducibility of the technique, with Coefficient-of-variability of axial and coronal T1 mapping analysis being 2.9 and 3.7% respectively. T1 correlated with eGFR and proteinuria (r = − 0.444, p = 0.016; r = 0.533, p = 0.003 respectively).

Patients with an eGFR decline > 2 ml/min/year had increased T1 times compared to those with a decline < 2 ml/min/year (1615 ± 135 ms versus 1516 ± 87 ms, p = 0.068), and T1 time was also higher in patients with a histological ‘T’-score of > 0, compared to those with a ‘T’-score of 0 (1575 ± 106 ms versus 1496 ± 105 ms, p = 0.131), though not to significance.

Conclusions

Cortical native T1 time is significantly increased in patients with IgAN compared to healthy subjects and correlates with markers of renal disease. Reproducibility of renal T1 mapping is excellent. This study highlights the potential utility of native T1 mapping in IgAN and other progressive nephropathies, and larger prospective studies are warranted.

Electronic supplementary material

The online version of this article (10.1186/s12882-019-1447-2) contains supplementary material, which is available to authorized users.

Flotillin 1 is differentially expressed in human epithelial ovarian tumors

Although Flotillin 1 (FLOT1) is highly expressed in various human cancers, its relationship with ovarian cancer (OC) remains unknown. This study determines FLOT1 expression in human ovarian tumors and examines its effect on OC   cell proliferation. FLOT1 protein expression was assessed in a tissue microarray by immunohistochemical staining. We found that 81.48% malignant and 50% borderline tumors were FLOT1 protein-positive, whereas benign tumors and normal ovarian tissues were negative. The staining was strongest in serous malignant tumor and transitional cell carcinoma and weakest in mucinous tumor. Differentially expressed FLOT1 in freshly isolated serous tumors was confirmed by Western blot and we then evaluated FLOT1 expression association with OC patients' clinical characteristics. Histological typing established that FLOT1 protein expression was significantly associated with serous tumor (P Keywords: cell proliferation, epithelial ovarian cancer, FLOT1, miRNA, therapeutic target, tumorigenesis.

Spin fluctuation induced Weyl semimetal state in the paramagnetic phase of EuCd2As2

Weyl fermions as emergent quasiparticles can arise in Weyl semimetals (WSMs) in which the energy bands are nondegenerate, resulting from inversion or time-reversal symmetry breaking. Nevertheless, experimental evidence for magnetically induced WSMs is scarce. Here, using photoemission spectroscopy, we observe that the degeneracy of Bloch bands is already lifted in the paramagnetic phase of EuCd2As2. We attribute this effect to the itinerant electrons experiencing quasi-static and quasi-long-range ferromagnetic fluctuations. Moreover, the spin-nondegenerate band structure harbors a pair of ideal Weyl nodes near the Fermi level. Hence, we show that long-range magnetic order and the spontaneous breaking of time-reversal symmetry are not essential requirements for WSM states in centrosymmetric systems and that WSM states can emerge in a wider range of condensed matter systems than previously thought.

[Effects of physeal bar resection in treating post-traumatic distal radius partial physeal arrest]

Objective: To evaluate the effects of treatment of post-traumatic distal radius partial physeal arrest with physeal bar resection. Methods: From February 2007 to November 2017, 11 children with distal radius physeal arrest received physeal bar resection in the Department of Pediatric Orthopedics, Beijing Jishuitan Hospital. There were 2 females and 9 males. The average age of the patients was (10.1±1.8) years (range,7-13 years). All cases had previous history of distal radius trauma. The average duration from the previous fracture to the physeal bar resection operation was (22.8±3.2) months (range,22 to 41 months). Clinical and radiological evidence of distal radius physeal arrest were suggested in all patients. A CT or MRI scan was performed preoperatively to assess the size of the physeal bridge. Inclusion criteria were patients with a physeal bridge<30% of the physeal area,and with at least 2 years of growth remaining. The physeal bar resection operation was performed with the assistance of either fluoroscopy (5 cases) or intraoperative three dimensional navigation (6 cases). After resection, the void was then filled with bone wax in all cases and distal ulnar epiphysiodesis was conducted in 5 cases. The mean follow-up duration was (3.7±1.6) years (range,1-9 years). The clinical examination data and X ray were obtained during the follow up. Results: Four cases obtained fully recovery from the operation and the deformity got fully correction. The X ray showed no bone bridge recurred. The deformity did not aggravate in 1 case. The deformity aggravated and subsequent osteotomy was conducted in the left 6 cases. Three cases in the navigation group obtained fully recovery. One case in the fluoroscopy group obtained fully recovery. Conclusions: The intraoperative three dimensional navigation can precisely locate the bone bridge. The physeal bar resection is an effective technique in some post-traumatic distal radius partial physeal arrest.

Erythropoietin Protects Retina Against Ceramide 2-Induced Damage in Rat

BACKGROUND

Ceramide plays critical roles in cell proliferation, senescence and apoptosis, and is implicated in neurodegenerative diseases, etc. To clarify if ceramide plays some roles in retinal diseases, we established in vivo and in vitro retinal injury models with ceramide 2 (C2) treatment. In addition, Erythropoietin (EPO), which showed protective effects on retinal cells and blood-retinal barrier (BRB), was also tested for its protection and possible mechanism(s) in these models.

METHODS

Male Sprague-Dawley rats were divided into four groups, i.e., normal control, vehicle control, C2 treatment, and C2+EPO treatment. After intravitreal injection, the rats were examined for eye fundus, electroretinogram, histological study, and immunostaining, etc. In vitro, retinal neuronal cell line (R28) and the primary human retinal microvascular endothelial cells (HRMECs) were treated with C2, cell viability assay, transendothelial electrical resistance (TEER) and BRB-related molecules were studied to test the protective effect of EPO.

RESULTS

Intravitreal C2-treatment caused significant vision loss in rats, as reflected by reduced b-wave amplitude, increased TUNEL positive cells and GFAP immunostaining in retina. Another major retinal injury observed was BRB breakdown following C2- treatment. Such C2-induced injuries were further confirmed by in vitro study. When HRMECs were treated with C2, the TEER was significantly reduced. The mechanisms for C2 to induce such injuries might be through evidently increased expressions of the related molecules like plasmalemma vesicle-associated protein (PLVAP or PV-1), ecto- 5'-nucleotidase (CD73) and intercellular adhesion molecule-1 (ICAM-1), as observed in C2-treated R28 cells. All these injuries induced by C2 were significantly prevented by EPO both in vivo and in vitro, and its protective mechanisms here might be, in addition to neuroprotective, closely related to its maintenance of BRB integrity, through reducing the expressions of PV-1, CD73 and ICAM-1.

CONCLUSION

C2 could induce severe retinal injury, and such injuries could be effectively prevented by EPO treatment.

Phenotypic analysis of atopic dermatitis in children aged 1-12 months: elaboration of novel diagnostic criteria for infants in China and estimation of prevalence

BACKGROUND

Atopic dermatitis (AD) is the most common skin disorder in infancy. However, the diagnosis and definite significance of infantile AD remains a debated issue.

OBJECTIVE

To analyse the phenotypes of AD in infancy, to establish diagnostic criteria and to estimate the prevalence of this condition in China.

METHODS

This is a multicentric study, in which 12 locations were chosen from different metropolitan areas of China. Following careful and complete history-taking and skin examination, the definite diagnosis of AD was made and the severity based on the SCORAD index was determined by local experienced dermatologists. Based on the detailed phenotyping, the major and representative clinical features of infantile AD were selected to establish the diagnostic criteria and evaluate their diagnostic efficacy.

RESULTS

A total of 5967 infants were included in this study. The overall point prevalence of AD was 30.48%. The infantile AD developed as early as at the second month of life, and its incidence peaked in the third month of life at 40.81%. The proportion of mild, moderate and severe AD was 67.40%, 30.57% and 2.03%, respectively. The most commonly seen manifestations in the infantile AD were facial dermatitis (72.07%), xerosis (42.72%) and scalp dermatitis (27.93%). We established the novel diagnostic criteria of infants, which included: (i) onset after 2 weeks of birth; (ii) pruritus and/or irritability and sleeplessness comparable with lesions; and (iii) all two items above with one of the following items can reach a diagnosis of AD: (i) eczematous lesions distributed on cheeks and/or scalp and/or extensor limbs, and (ii) eczematous lesions on any other parts of body accompanied by xerosis.

CONCLUSIONS

In China, the prevalence of AD in infancy is 30.48% according to clinical diagnosis of dermatologists. The novel Chinese diagnostic criteria for AD in infants show a higher sensitivity and comparable specificity.

Systematic review of randomized controlled trials on antibiotic treatment for osteomyelitis in diabetes

AIM

To evaluate the efficacy of antibiotic therapy in osteomyelitis treatment among people with diabetes.

METHODS

A systematic search of PubMed, EMBASE, AMED, Web of Science, the WHO trial registry, Cochrane library databases, and ClinicalTrials.gov, in addition to hand-searching, was undertaken in July 2018. Two reviewers independently extracted data. The studies' methodological quality was assessed using the modified Jadad scale. Descriptive analysis was performed.

RESULTS

Seven randomized controlled trials, with 393 participants in total, were included. The antibiotic regimens, treatments and follow-up durations varied among the trials. The total scores showed that the overall methodological quality of the seven studies was high, despite two studies showing some flaws in double-blinding and withdrawals/drop-outs. Of four studies comparing different antibiotic regimens, three implied a similar remission effect, while one implied that ertapenem ± vancomycin treatment showed a higher remission rate than tigecycline treatment; this conclusion was not robust because of low power and small sample size. In the other three studies, which included two different doses of ciprofloxacin, an antibiotics group and a conservative surgical group, and two durations of the same antibiotic strategy, no significant differences in remission were reported between the groups. No difference was observed in the analyses of microbiological outcomes, superinfections and relapse, except adverse events.

CONCLUSIONS

There is no definitive evidence supporting the superiority of any particular antibiotic agent, dose, or administration duration in the treatment of osteomyelitis in diabetes. As the included studies had some flaws and limitations, further research is necessary.

Beclin 1, LC3, and p62 expression in paraquat-induced pulmonary fibrosis

Paraquat (PQ) is a highly toxic herbicide to humans. Pulmonary fibrosis is one of the most typical features of PQ poisoning, which develops from several days to weeks after ingestion. However, the mechanism of fibrosis is still unclear. In this study, we aimed to determine expressions of autophagy-related markers Beclin 1, microtubule-associated protein light chain 3 (LC3), and p62 in PQ-poisoned lungs and to explore the role of autophagy in pulmonary fibrosis induced by PQ. We detected markers of lung fibrosis and expressions of autophagy-related protein in the specimens from eight fatal cases of PQ poisoning by hematoxylin and eosin staining, Masson's trichrome staining, and immunohistochemistry. Based on the staining results of lung fibrosis, these cases were divided into two groups, fibrosis and non-fibrosis groups. The correlation between autophagy protein expressions and pulmonary fibrosis was examined. The results demonstrated that the autophagy-related proteins were significantly expressed in fibrosis group compared with the non-fibrosis group. There was a significantly positive correlation between these protein expressions and severity of lung fibrosis. In conclusion, autophagy dysfunction may be involved in lung fibrogenesis caused by PQ poisoning. This may be a promising clue for understanding the molecular mechanism underlying PQ-induced lung fibrosis and provide evidence for treating fibrosis by regulating the level of autophagy.

[The role of hypothalamus polycomb gene methylation in bisphenol A exposure during pregnancy and premature puberty in female offspring]

Objective: To explore the role of hypothalamus Polycomb Group (PcG) gene (Eed, Ezh) methylation in the relationship between bisphenol A (BPA) exposure during pregnancy and premature puberty in female offspring. Methods: A total of 40 pregnant CD-1 mice were randomly and averagely assigned into four groups: control group (corn oil) and low, middle and high BPA-exposed groups (the poisonous doses were 8 mg/kg, 40 mg/kg, and 200 mg/kg, respectively) by random number table method. Each group was administered by gavage from gestational day (GD) 1 to 18. The vaginal opening of female offspring was observed from postnatal day (PND) 21 to 33. All female offsprings were sacrificed, and hypothalamus was remained on the PND 34. The methylation levels of Eed and Ezh in the hypothalamus were measured. The early puberty of CD-1 mice was evaluated by the rate of vaginal opening in advance, initial time of vaginal opening, the first estrus occurrence and vaginal opening days in advance. The path model was used to explore the role of Eed and Ezh gene methylation in the early puberty of female offspring with maternal BPA exposed including the number of days of vaginal opening in advance as a dependent variable and BPA exposure as an independent variable. Results: The rate of vaginal opening on the 28 day in each maternal BPA-exposure group [low, middle and high BPA-exposed groups were 40.00% (29/72), 47.62% (25/53) and 37.84% (20/53), respectively] was higher than that rate in the control group [14.06%(9/64)]. Similarly, the P(50)(P(25), P(75)) values of initial time of vaginal opening in low, middle and high BPA-exposed group were 28 (26, 30), 28 (26, 29), 28 (26, 30) days, respectively and the P(50)(P(25), P(75)) values of the first estrus occurrence in low, middle and high BPA-exposed group were 31 (27, 32), 30 (27, 31), 31 (28, 33) days, respectively, which were earlier than those in the control group [initial time of vaginal opening was 30(28, 31) days, and the first estrus occurrence was 32(30, 33) days] (all P values<0.05). Compared with the control group (the methylation levels of Eed1, Eed2, Ezh2 were 1.47%, 1.26%, 2.56%, respectively), the methylation levels of Eed1 (1.61%-1.82%), Eed2 (1.36%-1.43%) and Ezh2 (2.87%-3.05%) in female offspring were significantly higher in BPA-exposed groups (all P values<0.05). The results of path model analysis showed that BPA had no direct influence on puberty in advance, but had an indirect effect on puberty in advance (indirect effect path coefficient was 0.045 and 0.142, respectively) by mediating methylation of Eed2, and Ezh2. Conclusion: Early puberty in female offspring induced by maternal exposure to BPA during pregnancy through the increased methylation levels of hypothalamus PcG gene (Eed, Ezh) in female offspring.

[Surgical results and sagittal alignment analysis of different fusion levels for degenerative scoliosis]

Objective: To retrospectively investigate the effects of long segment fusion and short segment fusion on lumbar sagittal alignment and quality of life in patients with degenerative scoliosis. Methods: From January 2011 to December 2014, 75 patients with degenerative scoliosis were treated with pedicle screw fixation. Total of 56 females and 19 males were included in this study. Fifty-four patients underwent short-segment fusion (≤3 segments) and 21 patients underwent long-segment fusion (>3 segments). The average age of the patients was (63±8) years. The patients were followed-up for a mean time of (2.9±1.3) years. The postoperative follow-up included Cobb angle, pelvic tilt, sacral slope, lumbar lordosis, visual analogue scale of pain on lumbar and lower extremities and Oswestry disability index. Fusion levels, blood loss, surgery length and postoperative hospital stay were recorded. All above parameters were evaluated statistically with Student's t test. Results: The short segment fusion group averaged (1.8±0.7) segments, and the long segment fusion group averaged (5.2±1.6) segments. Coronal Cobb angle changed from (21.3±7.8) degrees preoperatively to (15.3±5.6) degrees at final follow-up in short-segment fusion group (t=2.315, P=0.024) and from (44.5±11.2) degrees preoperatively to (11.4±5.8) degrees at the final follow-up in long-segment fusion group (t=8.214, P<0.01). In the short segment fixation group, the preoperative lumbar lordosis changed from (44.3±9.7) degrees to (48.9±8.2) degrees at final follow-up (t=2.123, P=0.038), and it changed from (25.3±9.5) degrees to (52.1±11.2) degrees in the long segment fusion group (t=5.982, P<0.01). The sacral slope in the short segment fusion group increased from (22.6±6.8) degrees preoperatively to (34.1±7.5) degrees at the final follow-up (t=2.872, P=0.006), and it increased from (12.1±9.5) degrees to (37.8±8.4) degrees in long segment fusion group (t=7.314, P<0.01). The pelvic tilt in the short segment fusion group changed from (23.5±5.5) degrees preoperatively to (19.5±4.7) degrees at final follow-up (t=2.217, P=0.031), and it decreased from (27.1±6.1) degrees to (22.9±4.3) degrees in the long segment fusion group(t=2.131, P=0.045). The visual analogue scale of pain on lumbar and lower extremities and Oswestry disability index were all improved after the operation in both groups. Conclusions: Both short segment fusion and long segment fusion can achieve satisfactory surgical results and improves the spinal-pelvic parameters. Short segment fusion can reduce surgery trauma and shorten hospital stay relative to long segment fixation.

Erythropoietin Ameliorates Lung Injury by Accelerating Pulmonary Endothelium Cell Proliferation via Janus Kinase-Signal Transducer and Activator of Transcription 3 Pathway After Kidney Ischemia and Reperfusion Injury

BACKGROUND/AIMS

Kidney ischemia and reperfusion injury could cause microvascular barrier dysfunction, lung inflammatory cascades activation, and programmed cell death of pulmonary endothelium, leading to acute lung injury. Our study aimed at determining whether erythropoietin (EPO) can ameliorate lung dysfunction following renal ischemia and reperfusion (IR) injury and explored the underlying mechanisms.

METHODS

In vivo, C57BL/6 mice received EPO (6000 U/kg) before right renal vascular pedicles clamping for 30 minutes, followed by 24 hours of reperfusion. The lung histopathologic changes and inflammatory cytokines expression were assessed. In vitro, cultured human umbilical vein endothelial cells were treated with EPO, and apoptosis rate, proliferation capacity, and phosphorylation status of the Janus kinase-signal transducer and activator of transcription 3 (Jak-STAT3) pathway were measured respectively in the presence or absence of lipopolysaccharide stimulation.

RESULTS

In vivo, EPO remarkably attenuated pulmonary interstitial and alveolar epithelial edema caused by renal IR injury. In vitro, the proliferation capacity of human umbilical vein endothelial cells was significantly increased under EPO stimulation, which correlated with changes in Jak-STAT3 signaling.

CONCLUSION

Our data indicated that EPO is able to ameliorate acute lung tissue damage induced by renal IR, and at least in part, via the Jak-STAT3 pathway.

Maresin 1 attenuates neuroinflammation in a mouse model of perioperative neurocognitive disorders

Background

Resolution of inflammation is an active and dynamic process after surgery. Maresin 1 (MaR1) is one of a growing number of specialised pro-resolving lipids biosynthesised by macrophages that regulates acute inflammation. We investigated the effects of MaR1 on postoperative neuroinflammation, macrophage activity, and cognitive function in mice.

Methods

Adult male C57BL/6 (n=111) and Ccr2^RFP/+Cx3cr1^GFP/+ (n=54) mice were treated with MaR1 before undergoing anaesthesia and orthopaedic surgery. Systemic inflammatory changes, bone healing, neuroinflammation, and cognition were assessed at different time points. MaR1 protective effects were also evaluated using bone marrow derived macrophage cultures.

Results

MaR1 exerted potent systemic anti-inflammatory effects without impairing fracture healing. Prophylaxis with MaR1 prevented surgery-induced glial activation and opening of the blood–brain barrier. In Ccr2^RFP/+Cx3cr1^GFP/+ mice, fewer infiltrating macrophages were detected in the hippocampus after surgery with MaR1 prophylaxis, which resulted in improved memory function. MaR1 treatment also reduced expression of pro-inflammatory cell surface markers and cytokines by in vitro cultured macrophages. MaR1 was detectable in the cerebrospinal fluid of older adults before and after surgery.

Conclusions

MaR1 exerts distinct anti-inflammatory and pro-resolving effects through regulation of macrophage infiltration, NF-κB signalling, and cytokine release after surgery. Future studies on the use of pro-resolving lipid mediators may inform novel approaches to treat neuroinflammation and postoperative neurocognitive disorders.

[Analysis of effects of discipline cooperation on rescue and treatment of severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident]

Objective: To analyze effects of cooperation between physicians in department of burn surgery and department of intensive care medicine on rescue and treatment of severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident. Methods: On August 2nd, 2014, 15 extremely severe burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident were admitted to temporary burn treatment center established in Department of Critical Care Medicine of the Second Affiliated Hospital of Soochow University. The 15 patients were equally divided into 3 groups, with 5 patients in each group. Fifteen surgeons and 30 nurses from department of burn surgery and 15 physicians and 30 nurses from department of intensive care medicine from different hospitals in China were divided into 3 groups, with 5 physicians and 10 nurses from department of burn surgery and 5 physicians and 10 nurses from department of intensive care medicine in each group. Each group of physicians and nurses were responsible for treatment of 5 patients. Treatment of patients was leaded by surgeons from department of burn surgery, who were responsible for wound dealing and operation. Physicians from department of intensive care medicine were responsible for systemic treatment and adjustment of relevant equipment's parameters. Volume of fluid infusion and urine output in shock period, severe systemic complication during period of treatment, using time and kind of antibiotics, death in 1 month after admission, length of hospital stay, and survival of patients were monitored. Results: Volume of fluid infusion of 15 extremely severe burn patients within the first 24 hours post injury was 10 360-17 162 (12 998±1 811) mL, including (1.62±0.23) mL·% total body surface area (TBSA)(-1)·kg(-1) electrolyte and colloid and (2 850±232) mL glucose, with electrolyte and colloid ratio of (1.76±0.23)∶1.00. Volume of urine output within the first 24 hours post injury was (2 384±1 242) mL, with (99±52) mL in each hour. Volume of fluid infusion of 15 extremely severe burn patients within the second 24 hours post injury was 8 720-11 616 (9 406±1 277) mL, including (1.04±0.22) mL·%TBSA(-1)·kg(-1) electrolyte and colloid and (2 910±187) mL glucose, with electrolyte and colloid ratio of (1.53±0.31)∶1.00. Volume of urine output within the second 24 hours post injury of patients was (2 299±1 362) mL , with (108±61) mL in each hour. One patient had pulmonary infection, and 7 patients had fungal infection, and no patient had gut microbiota dysbiosis. Patients were treated with combined 2 kinds of antibiotics for 21-85 (50±16) d. No patient died within 1 month after admission. The length of hospital stay was 53-132 (98±44) d. Ten patients survived finally. Conclusions: After being treated by cooperation between physicians in department of burn surgery and department of intensive care medicine, severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident had hemodynamic stability and could stably experience shock period, with less complication, shorter length of hospital stay, no death within 1 month after admission, more survived patients, which can provide reference for rescue and treatment of severe mass burn patients.