[Efficacy of intravenous thrombolysis in acute ischemic stroke with hyperdense middle cerebral artery sign]

Objective: To observe the efficacy and safety of recombinant tissue-type plasminogen activator (rtPA) intravenous thrombolysis (IVT) in the treatment of acute cerebral infarction with hyperdense middle cerebral artery sign (HMCAS). Methods: Acute cerebral infarction patients with HMCAS from July 2010 to November 2015 at the First Affiliated Hospital of Dalian Medical University were collected.These patients were divided into two groups depending on whether they received IVT or not.The Nation Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to evaluate early and long-time therapeutic effects.Efficacy and safety were compared between the two groups. Results: A total of 93 patients were eligible for the analysis, with 45 cases in IVT group and 48 cases in non-IVT group.As time went by, NIHSS score in IVT group showed significant downward trend than the non-IVT group.The rate of patients with good outcome in IVT group was higher than that in non-IVT group (P<0.05). The rate of hemorrhage transformation (HT) in IVT group and non-IVT group was 35.6% (16/45) and 10.4% (11/48), respectively, and the difference was statistically significant (P<0.05). While no statistically significant difference was found about the rate of symptomatic intracranial hemorrhage (sICH) (8.9% vs 2.1%, P>0.05) and mortality (33.3% vs 27.1%, P>0.05) between these two groups.Logistic regression analysis identified relativity between IVT treatment and good outcome (P<0.05), hemorrhage transformation (P<0.05), rather than mortality (P>0.05). Conclusions: Intravenous thrombolysis with rt-PA is an effective and safe treatment for most acute ischemic stroke patients with HMCAS and can promote early neurologic improvement and significantly improve long-term functional prognosis.Although Ⅳ thrombolysis can increase the risk of overall HT, it does not add risk in sICH and mortality.

The culture of HaCaT cells on liquid substrates is mediated by a mechanically strong liquid–liquid interface

The mechanical properties of naturally-derived matrices and biomaterials are thought to play an important role in directing cell adhesion, spreading, motility, proliferation and differentiation. However, recent reports have indicated that cells may respond to local nanoscale physical cues, rather than bulk mechanical properties. We had previously reported that primary keratinocytes and mesenchymal stem cells did not seem to respond to the bulk mechanical properties of poly(dimethyl siloxane) (PDMS) substrates. In this study, we examine the mechanical properties of weakly crosslinked PDMS substrates and observe a liquid-like behaviour, with complete stress relaxation. We then report the observation that HaCaT cells, an epidermal cell line, proliferate readily at the surface of uncrosslinked liquid PDMS, as well as on low viscosity (0.77 cSt) fluorinated oil. These results are surprising, considering current views in the field of mechanotransduction on the importance of bulk mechanical properties, but we find that strong mechanical interfaces, presumably resulting from protein assembly, are formed at liquid–liquid interfaces for which cell adhesion and proliferation are observed. Hence our results suggest that cells sense the nanoscale mechanical properties of liquid–liquid interfaces and that such physical cues are sufficient to sustain the proliferation of adherent cells.

Downregulated ECRG4 is correlated with lymph node metastasis and predicts poor outcome for nasopharyngeal carcinoma patients

OBJECTIVE

Esophageal cancer-related gene 4 (ECRG4) is a new candidate tumor suppressor gene. In this retrospective study, we evaluated ECRG4 protein expression in patients with nasopharyngeal carcinoma (NPC) under curative treatment and examined its association with pathological features and clinical outcomes as a possible biomarker for diagnosis and prognosis of NPC.

METHODS

We enrolled 122 patients with a first diagnosis between January 2001 and December 2003. Tumor tissue and control tissue from biopsies underwent immunohistochemical staining for ECRG4. ECRG4 expression was analyzed by clinicopathological variables. After Kaplan-Meier survival analysis, we used Cox proportional hazards regression to estimate the predictive effect of ECRG4 expression on overall survival.

RESULTS

ECRG4 protein level was lower in NPC than control tissue (P < 0.01). It was inversely related to node status (P < 0.001) and clinical stage (P = 0.027). ECRG4 expression was associated with overall survival, and downregulated ECRG4 expression was an independent prognostic factor of poor survival (hazard ratio = 0.677, 95 % confidence interval 0.463-0.989, P = 0.044).

CONCLUSIONS

A significant NPC patients showed downregulated ECRG4 expression, which is correlated with lymph node metastasis. The marker could be an independent prognostic factor for NPC patients. The precise function of ECRG4 in the progression of NPC, especially for lymphatic metastasis, deserves further investigation, which would bring a new target for personalized therapy.

Erythropoietin Receptor Activation Protects the Kidney From Ischemia/Reperfusion-Induced Apoptosis by Activating ERK/p53 Signal Pathway

BACKGROUND

Apoptosis plays an important role in renal ischemia/reperfusion (IR) injury. Evidence has shown that erythropoietin (EPO) has an antiapoptotic effect. Therefore, this study aimed to explore the effect and potential mechanism of EPO in renal IR injury.

METHODS

Kidney IR injury in rats was established by clamping the left renal artery for 30 minutes followed by 24 hours of reperfusion, along with contralateral nephrectomy. Renal function, renal histology, and expression of EPOR, p-EPOR, ERK, p-ERK, p-p53, p53, Bcl-2, Bcl-xl, Bad, and Bax were examined.

RESULTS

Pretreatment with EPO significantly reduced renal dysfunction, pathologic change, and expression of Bad and Bax. Furthermore, EPO treatment enhanced the expression of p-ERK, p-p53, Bcl-2, and Bcl-xl with no influence on the expression of EPOR, ERK, and p53.

CONCLUSIONS

These findings demonstrated that EPO pretreatment can attenuate renal IR injury by inhibiting apoptosis by promoting activation of the ERK/p53 signaling.

MiR-204 regulates HMGA2 expression and inhibits cell proliferation in human thyroid cancer

BACKGROUND

Analysis using publicly available algorithms has found that high mobility group AT-hook 2 (HMGA2), a key transcriptional regulatory factor, is a potential target of microRNA-204 (miR-204). Some studies have shown that both miR-204 and HMGA2 are associated with cancer development.

OBJECTIVE

We examined the possible relationship between miR-204 and HMGA2 in the development of thyroid cancer.

METHODS

We assessed miR-204 expression in thyroid cancer specimens and cell lines using real-time polymerase chain reaction (PCR). Luciferase reporter assay was used to confirm the target associations. The effect of miR-204 on cell proliferation was confirmed with tetrazolium and colony formation assays. Gene and protein expression were examined using real-time PCR and western blotting, respectively.

RESULTS

MiR-204 was downregulated in the thyroid cancer specimens and cell lines, and targeted the 3^\prime untranslated region of HMGA2 directly. MiR-204 overexpression decreased cyclin D1 and Ki67 expression and increased P21 expression, which subsequently inhibited thyroid cancer cell proliferation.

CONCLUSIONS

Our findings suggest that miR-204 plays a protective role by inhibiting thyroid cancer cell proliferation, and may identify new targets for anti-cancer treatment.

TMEM2 inhibits hepatitis B virus infection in HepG2 and HepG2.2.15 cells by activating the JAK-STAT signaling pathway

We have previously observed the downregulation of TMEM2 in the liver tissue of patients with chronic hepatitis B virus (HBV) infection and in HepG2.2.15 cells with HBV genomic DNA. In the present study, we investigated the role and mechanism of TMEM2 in HepG2 and HepG2.2.15 during HBV infection HepG2 and HepG2.2.15. HepG2 shTMEM2 cells with stable TMEM2 knockdown and HepG2 TMEM2 and HepG2.2.15 TMEM2 cells with stable TMEM2 overexpression were established using lentivirus vectors. We observed reduced expression of TMEM2 in HBV-infected liver tissues and HepG2.2.15 cells. HBsAg, HBcAg, HBV DNA, and HBV cccDNA levels were significantly increased in HepG2 shTMEM2 cells but decreased in HepG2 TMEM2 and HepG2.2.15 TMEM2 cells compared with naive HepG2 cells. On the basis of the western blotting results, the JAK-STAT signaling pathway was inhibited in HepG2 shTMEM2 cells but activated in HepG2 TMEM2 and HepG2.2.15 TMEM2 cells. In addition, reduced and increased expression of the antiviral proteins MxA and OAS1 was observed in TMEM2-silenced cells (HepG2 shTMEM2 cells) and TMEM2-overexpressing cells (HepG2 TMEM2 and HepG2.2.15 TMEM2 cells), respectively. The expression of Interferon regulatory factor 9 (IRF9) was not affected by TMEM2. However, we found that overexpression and knockdown of TMEM2, respectively, promoted and inhibited importation of IRF9 into nuclei. The luciferase reporter assay showed that IRF9 nuclear translocation affected interferon-stimulated response element activities. In addition, the inhibitory effects of TMEM2 on HBV infection in HepG2 shTMEM2 cells was significantly enhanced by pre-treatment with interferon but significantly inhibited in HepG2.2.15 TMEM2 cells by pre-treatment with JAK1 inhibitor. TMEM2 inhibits HBV infection in HepG2 and HepG2.2.15 by activating the JAK-STAT signaling pathway.

[The diagnosis and treatment of esophageal perforation and neck abscess induced by esophageal foreign body]

Objective:To explore the clinical characteristics and treatment methods of esophageal perforation and neck abscess induced by esophageal foreign body. Method:Twenty-six cases with esophageal perforation and neck abscess caused by esophageal foreign body treated in our department were performed surgery under general anesthesia. Result:The foreign bodies were removed via esophagoscope in 24 cases, no foreign bodies were found in 2 cases. Twenty-five case cured and one case was sent to the department of thoracic surgery. Conclusion:For the patients with esophageal perforation and neck abscess, regular perfect preoperative CT scan, timely take out foreign body; meanwhile indwelling nasal-stomach tube, the vacancy of the esophagus, avoid food spillage through the perforation and aggravating infection; adequate antibiotics and nutritional support can improve the cure rate.

Nanoparticle shape, thermodynamics and kinetics

Nanoparticles can be beautiful, as in stained glass windows, or they can be ugly as in wear and corrosion debris from implants. We estimate that there will be about 70,000 papers in 2015 with nanoparticles as a keyword, but only one in thirteen uses the nanoparticle shape as an additional keyword and research focus, and only one in two hundred has thermodynamics. Methods for synthesizing nanoparticles have exploded over the last decade, but our understanding of how and why they take their forms has not progressed as fast. This topical review attempts to take a critical snapshot of the current understanding, focusing more on methods to predict than a purely synthetic or descriptive approach. We look at models and themes which are largely independent of the exact synthetic method whether it is deposition, gas-phase condensation, solution based or hydrothermal synthesis. Elements are old dating back to the beginning of the 20th century-some of the pioneering models developed then are still relevant today. Others are newer, a merging of older concepts such as kinetic-Wulff constructions with methods to understand minimum energy shapes for particles with twins. Overall we find that while there are still many unknowns, the broad framework of understanding and predicting the structure of nanoparticles via diverse Wulff constructions, either thermodynamic, local minima or kinetic has been exceedingly successful. However, the field is still developing and there remain many unknowns and new avenues for research, a few of these being suggested towards the end of the review.

Decreased miR-134 expression and its tumor-suppressive function in human osteosarcoma

Dysregulation of microRNA (miR) is often associated with cancer development and progression. Aberrant expression of miR-134 has been found in some types of cancer. However, its expression and function in osteosarcoma remain unclear. The aim of this study was to explore the effects of miR-134 in osteosarcoma tumorigenesis and development. The expression level of miR-134 was quantified by real-time reverse transcription-polymerase chain reaction in human osteosarcoma cell lines and tissues. The effects of miR-134 on MG-63 cell phenotypes and tumorigenicity in vivo were observed using flow cytometry, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, transwell invasion, migration, and scratch migration assays. MiR-134 was significantly downregulated in osteosarcoma cell lines and clinical specimens. Decreased miR-134 expression was significantly associated with large tumor size, positive distant metastasis, and advanced clinical stage. Low miR-134 expression in osteosarcoma was an independent predictor of poor survival. Overexpression of miR-134 inhibited MG-63 cell proliferation, invasion, and migration, promoted cell apoptosis in vitro, and suppressed tumorigenicity in vivo. These findings indicate that miR-134 may act as a tumor suppressor in osteosarcoma and could serve as a novel therapeutic agent for miRNA-based therapy.

Treatment of tibia avulsion fracture of posterior cruciate ligament with high-strength suture fixation under arthroscopy

Aim

To evaluate the outcome of arthroscopy treatment using high-strength line in the treatment of tibial avulsion fracture of posterior cruciate ligament.

Methods

Both the avulsed bone block and the tibia bone bed were refreshed. The procedure was completed with the assistance of PCL director drill guide. The reduction and fixation using high-strength line were used to fix the avulsed bone by from posterior middle portal. Rehabilitation began early postoperatively.

Results

From January 2010 to June 2012, a total of 18 arthroscopically treated cases of PCL tibial avulsion fracture were retrospectively evaluated. Reduction of the avulsion fragment was obtained in all cases. 16 cases were followed up for 7–30 months (average 13.6), and 2 cases were out of follow-up. In the 16 followed patients, flexion and extension were back to normal within 6 weeks, and return to normal walk in 12 weeks. The bone healing was good without any vascular or nerve complications. All the patients regained the preinjury activity level. The mean score (and standard deviation) increased from 38.9 ± 4.9 points to 95.2 ± 3.8 points with the system of Lysholm, from 57.1 ± 10.3 points to 94.3 ± 4.4 points with the system of IKDC. Post-test displacement of KT3000 declined from 3.6 ± 0.39 to 1.1 ± 0.27 mm.

Conclusion

Arthroscopic vertical fixation by high-strength line is a simple, safe, reliable, and micro-invasive treatment to PCL tibial avulsion fracture. It is a kind of real all arthroscopic technique, and good for early postoperative rehabilitation. The total stability of the knee could be gained, and the second operation to remove the internal fixation is avoided.

Development of a nano-particle-assisted PCR assay for detection of duck tembusu virus

Duck tembusu virus (DTMUV) has caused significant economic losses to the poultry industry in China since the spring of 2010. In this study, a nano-PCR assay targeting E gene of DTMUV was developed and their sensitivities and specificities were investigated. Under the optimized conditions of nano-PCR assay for detection of DTMUV, the nano-PCR assay was 10-fold more sensitive than a conventional PCR assay. The lower detection limit of the nano-PCR assay was 1·8 × 10(2)  copies μl(-1) of DTMUV RNA, as no cross-reaction was observed with other viruses. This is the first report to demonstrate the application of a nano-PCR assay for the detection of DTMUV. The sensitive, and specific nano-PCR assay developed in this study can be applied widely in clinical diagnosis and field surveillance of DTMUV-infection.

SIGNIFICANCE AND IMPACT OF THE STUDY

A nanoparticle-assisted polymerase chain reaction (nano-PCR) assay was developed in this study for the rapid detection of duck tembusu virus (DTMUV) with high sensitivity and specificity. This technique has potential application in both clinical diagnosis and field surveillance of DTMUV-infection.

Incidence and risk of peripheral neuropathy with nab-paclitaxel in patients with cancer: a meta-analysis

Nab-paclitaxel, a Cremophor EL-free formulation of paclitaxel, is used to treat various malignancies. Peripheral neuropathy is one of its major toxicities, although the overall incidence remains unclear. We performed a meta-analysis to calculate the incidence of peripheral neuropathy in cancer patients treated with nab-paclitaxel and to compare the relative risk (RR) with conventional taxanes. The electronic databases were searched for relevant clinical trials. Eligible studies included phase II and III prospective clinical trials of cancer patients treated with nab-paclitaxel with toxicity profile on peripheral neuropathy. Statistical analyses were done to calculate summary incidences, RRs and 95% confidence intervals (CI), using fixed-effects or random-effects models based on the heterogeneity of the included studies. Nineteen trials were selected for the meta-analysis, yielding a total of 2878 cancer patients. The overall incidences of peripheral neuropathy (all-grade) was 51.0% (95% CI: 45.1-57.6%), and that of high-grade peripheral neuropathy was 12.4% (9.8-15.7%). The RRs of peripheral neuropathy of nab-paclitaxel compared to taxanes were not increased for all-grade and high-grade peripheral neuropathy. Nab-paclitaxel is associated with an increased risk of developing peripheral neuropathy. Future clinical studies are still needed to investigate the risk reduction and possible use of nab-paclitaxel.

Satisfactory Usage of a Lacerated Kidney for Transplantation: A Case Report

BACKGROUND

Organ shortage is the main bottleneck in the wait-list for transplantation; therefore, expanding the donor pool is an effective way to solve the problem. Usage of the traumatized liver for transplantation has been applied, but the use of lacerated kidneys for transplant donor is rarely reported.

METHODS

We reported a successful case of donation after brain death. The donor committed suicide by jumping from a campus dormitory building. One of the donated kidneys was severely injured. Two lacerations measured 4 × 1 × 1 cm in the medial margin of the graft and 1 × 1 × 1.5 cm in the front side of the graft, respectively. After repair with continuous absorbable suture, the lacerated kidney was transplanted to a recipient.

RESULTS

The post-transplantation renal function gradually recovered. Furthermore, serious complications, such as large amounts of hemorrhage, delayed graft function, or urinary fistula did not occur. The serum creatinine dropped from 1232 μmol/L to 120 μmol/L and maintained normal range after surgery. In addition, the daily urine output was normal. At day 12 after operation, the patient was discharged.

CONCLUSIONS

Our case shows that the use of a lacerated donor kidney appears to be feasible, but long-term effects need further observation.

Genetic diversity in intraspecific hybrid populations of Eucommia ulmoides Oliver evaluated from ISSR and SRAP molecular marker analysis

Eucommia ulmoides Oliver, the only extant species of Eucommiaceae, is a second-category state-protected endangered plant in China. Evaluation of genetic diversity among some intraspecific hybrid populations of E. ulmoides Oliver is vital for breeding programs and further conservation of this rare species. We studied the genetic diversity of 130 accessions from 13 E. ulmoides intraspecific hybrid populations using inter-simple sequence related (ISSR) and sequence-related amplified polymorphism (SRAP) markers. Of the 100 ISSR primers and 100 SRAP primer combinations screened, eight ISSRs and eight SRAPs were used to evaluate the level of polymorphism and discriminating capacity. A total number of 65 bands were amplified using eight ISSR primers, in which 50 bands (76.9%) were polymorphic, with an average of 8.1 polymorphic fragments per primer. Alternatively, another 244 bands were observed using eight SRAP primer combinations, and 163 (66.8%) of them were polymorphic, with an average of 30.5 polymorphic fragments per primer. The unweighted pair-group method (UPGMA) analysis showed that these 13 populations could be classified into three groups by the ISSR marker and two groups by the SRAP marker. Principal coordinate analysis using SRAP was completely identical to the UPGMA-based clustering, although this was partly confirmed by the results of UPGMA cluster analysis using the ISSR marker. This study provides insights into the genetic background of E. ulmoides intraspecific hybrids. The progenies of the variations "Huazhong-3", "big fruit", "Yanci", and "smooth bark" present high genetic diversity and offer great potential for E. ulmoides breeding and conservation.

Ammonium increases Ca(2+) signalling and upregulates expression of Cav1.2 gene in astrocytes in primary cultures and in the in vivo brain

AIM

The primary aim of this study was to identify the effects of hyperammonaemia on functional expression of Cav1.2 L-type Ca(2+) channels in astroglia.

METHODS

Primary cultures of mouse astrocytes were used to study effects of chronic treatment (1-5 days) with ammonium chloride, at 1, 3 and 5 mm on depolarization-induced increases in free cytosolic Ca(2+) concentration ([Ca(2+)]i , measured with Fura-2 based microfluorimetry) in control conditions and following treatment with the L-type Ca(2+) channel inhibitor, nifedipine, or with ryanodine receptor inhibitor, ryanodine. Expression of Cav1.2 mRNA was identified with RT-PCR, whereas protein content was determined by Western blotting. Sustained hyperammonaemia in vivo was induced by daily injections of urease (33 units kg body weight(-1), i.p.) for 3 days.

RESULTS

Depolarization-induced [Ca(2+)]i transients sensitive to nifedipine (peak of the response) and to ryanodine (plateau phase) were significantly increased in astrocytes chronically exposed to ammonium. The ammonium-induced increase in Ca(2+) influx in astrocytes resulted from an upregulation of Cav1.2 channel's expression detected at mRNA and protein levels. Increase in Cav1.2 expression was prevented by ouabain antagonist canrenone. Similar upregulation of Cav1.2 gene expression was found in the brains of adult mice subjected to intraperitoneal injection of urease. In transgenic mice tagged with an astrocyte-specific or neurone-specific markers and treated with intraperitoneal injections of urease, the fluorescence-activated cell sorting of neurones and astrocytes demonstrated that Cav1.2 mRNA expression was upregulated in astrocytes, but not in neurones.

CONCLUSIONS

Ammonium-induced deregulation of astroglial Ca(2+) signalling, is, in part, associated with upregulation of Cav1.2 L-type calcium channels.

Single-nucleotide polymorphisms in dopamine receptor D1 are associated with heroin dependence but not impulsive behavior

Previous studies suggested that dopamine receptors may be associated with drug dependence and impulsive behavior. In this study, we examined whether dopamine receptor D1 (DRD1) is associated with heroin dependence and the impulsive behavior in patients with heroin dependence. The participants included 367 patients with heroin dependence and 372 healthy controls from a Chinese Han population. We examined the potential association between heroin dependence and 8 single-nucleotide polymorphisms (rs686, rs4867798, rs1799914, rs4532, rs5326, rs265981, rs10078714, rs10078866) of DRD1, and the associations between single single-nucleotide polymorphism, haplotypes, and impulsive behavior. Compared with the healthy controls, heroin dependence patients showed a significantly lower frequency of GG homozygotes of rs5326 (P = 0.027), significantly lower frequency of the G allele of rs5326 (P = 0.007, odds ratio = 0.718, 95% confidence interval = 0.565-0.913), and higher frequency of the rs265981 G allele (P = 0.0002, odds ratio = 1.711, 95% confidence interval = 1.281-2.287). Furthermore, strong linkage disequilibrium was observed in 2 blocks (D' > 0.9). However, no association was observed between haplotypes and heroin dependence in the 2 blocks. This genetic behavior correlation study showed that the 2 single-nucleotide polymorphisms, rs5326 and rs265981, were not associated with the impulsive behavior in patients with heroin dependence. These findings indicate that DRD1 gene polymorphisms are related to heroin dependence in a Chinese Han population and may be informative for future genetic or biological studies on heroin dependence.

Genetic diversity and population structure of Eucommia ulmoides Oliver, an endangered medicinal plant in China

Eucommia ulmoides Oliver, one of the tertiary relict species found only in China, is the only extant species of Eucommiaceae. Using inter-simple sequence repeat (ISSR) and sequence-related amplified polymorphism (SRAP) markers, we studied the genetic diversity and population genetic structure of 187 accessions from 17 E. ulmoides populations throughout its main distribution in China. A total of 65 bands were amplified using eight ISSR primers, of which 50 bands (76.9%) were polymorphic. Meanwhile, another 244 bands were observed using eight SRAP primer combinations and 163 (66.8%) of these were polymorphic. The analysis of molecular variation (AMOVA) indicated that 88.8 and 92.4% of the total variation resided within populations based on ISSR and SRAP analysis, respectively. Moreover, we found that the E. ulmoides populations were clustered into six distinct groups using ISSR and SRAP markers via the unweighted pair-group method (UPGMA). Furthermore, STRUCTURE analysis showed that these 17 populations could be classified into four groups using ISSR markers, but only two groups using SRAP markers. No significant relevancy was observed between genetic and geographic distances among the sampled populations. The results of this study support the view that exchange of seeds among local farmers plays an important role in shaping the present genetic distribution pattern. "Core collection" is suggested for genetic diversity conservation of E. ulmoides in China.

Reverse-dipper pattern of blood pressure may predict lacunar infarction in patients with essential hypertension

BACKGROUND AND PURPOSE

The fluctuation of circadian blood pressure (BP) is of great diversity in patients with essential hypertension and may provide significant prognostic value for stroke. However, it remains uncertain whether reverse-dipper pattern of BP influences the incidence of lacunar infarction in hypertensive patients.

METHODS

In the current study, 362 hypertensive patients (195 males, 167 females) were enrolled. BP patterns were evaluated with 24-h ambulatory BP monitoring (ABPM). Multinomial logistic regression was applied to analyse the possible relationships between lacunar infarction and various clinical risk factors such as ABPM.

RESULTS

A total of 93 patients (25.7%) had reverse-dipper BP pattern. Non-dipper pattern of BP was observed in 179 hypertensive patients (49.4%) and dipper pattern in 90 patients (24.9%). The percentage of lacunar infarction was the highest in the patients with reverse-dipper pattern compared with pure hypertension or atherothrombotic cerebral infarction (P < 0.05). After multinomial logistic regression analysis, reverse-dipper pattern of BP (odds ratio 2.492; 95% confidence interval 1.133-5.479; P < 0.05) and age (odds ratio 1.084; 95% confidence interval 1.047-1.123; P < 0.01) were found to be directly associated with lacunar infarction.

CONCLUSIONS

Reverse-dipper BP pattern may serve as an independent risk factor for lacunar infarction and more personalized BP management should be offered to the patients who have elevated nocturnal BP.

Bosentan protects the spinal cord from ischemia reperfusion injury in rats through vascular endothelial growth factor receptors

STUDY DESIGN

Experimental study.

OBJECTIVES

To investigate whether Bosentan, an endothelin-A/-B dual receptor antagonist, could protect neurons after spinal cord ischemia reperfusion (SCIR) injury in rats and its underlying signaling pathway.

SETTING

Department of Neurosurgery, the Second Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi Province, China.

METHODS

Sprague-Dawley rats were randomly divided into two groups, saline group (IRS, n=48) and Bosentan group (IRB, 5 mg kg(-1), n=48). After ischemia for 1 h with occlusion of the infrarenal aorta, spinal cord were reperfused for 6h, 12h, 24h, 3d, 5d, and 7d separately. Enzyme-linked immunosorbent assay was used to detect vascular endothelial growth factor (VEGF) in serum. Immunohistochemistry was performed to detect protein expression of VEGF, VEGF receptor 1 (FLT-1) and VEGF receptor 2 (FLK-1). Gene expressions of VEGF and its receptors were evaluated using the quantitative reverse transcription polymerase chain reaction.

RESULTS

Compared with the IRS group, gene and protein expressions of VEGF, FLT-1 and FLK-1 were significantly increased (P<0.05), so was the concentration of VEGF in plasma (P<0.05). FLK-1 was expressed on spinal cord neurons.

Deacetylation of the tumor suppressor protein PML regulates hydrogen peroxide-induced cell death

The promyelocytic leukemia protein (PML) is a tumor suppressor that is expressed at a low level in various cancers. Although post-translational modifications including SUMOylation, phosphorylation, and ubiquitination have been found to regulate the stability or activity of PML, little is known about the role of its acetylation in the control of cell survival. Here we demonstrate that acetylation of lysine 487 (K487) and SUMO1 conjugation of K490 at PML protein are mutually exclusive. We found that hydrogen peroxide (H₂O₂) promotes PML deacetylation and identified SIRT1 and SIRT5 as PML deacetylases. Both SIRT1 and SIRT5 are required for H₂O₂-mediated deacetylation of PML and accumulation of nuclear PML protein in HeLa cells. Knockdown of SIRT1 reduces the number of H₂O₂-induced PML-nuclear bodies (NBs) and increases the survival of HeLa cells. Ectopic expression of wild-type PML but not the K487R mutant rescues H₂O₂-induced cell death in SIRT1 knockdown cells. Furthermore, ectopic expression of wild-type SIRT5 but not a catalytic defective mutant can also restore H₂O₂-induced cell death in SIRT1 knockdown cells. Taken together, our findings reveal a novel regulatory mechanism in which SIRT1/SIRT5-mediated PML deacetylation plays a role in the regulation of cancer cell survival.

Osteogenic efficacy of bone marrow concentrate in rabbit maxillary sinus grafting

Maxillary sinus grafting is required to increase bone volume in the atrophic posterior maxilla to facilitate dental implant placement. Grafting with autogenous bone (AB) is ideal, but additional bone harvesting surgery is unpleasant. Alternatively, bone substitutes have been used but they limit new bone formation. The strategy of single-visit clinical stem cell therapy using bone marrow aspirate concentrate (BMAC) to facilitate new bone formation has been proposed. This study aimed to assess bone regeneration capacity of autologous BMAC mixed with bovine bone mineral (BBM) in maxillary sinus grafting. Twenty-four white New Zealand rabbits were used and their maxillary sinuses were randomly assigned for grafting with 4 different materials. Rates of new bone apposition in augmented sinuses were measured and bone histomorphometry were examined. Significant increase in the quantity of nucleated cells and colony forming unit-fibroblasts were confirmed in BMAC. Mesenchymal stem cells in BMAC retained their in vitro multi-differentiation capability. Higher rates of mineral appositions in the early period were detected in BBM + BMAC and AB than BBM alone, though they are not significantly different. Graft volume/tissue volumes in BBM and BBM + BMAC were found to be higher than those in AB and sham.

Enhanced susceptibility-weighted angiography (ESWAN) of cerebral arteries and veins at 1.5 Tesla

OBJECTIVE

Enhanced susceptibility-weighted angiography (ESWAN) is a three-dimensional (3D) multi-echo gradient-echo sequence which consists of both magnitude and phase images. This study aims to demonstrate the feasibility of ESWAN for the depiction of both cerebral arteries and veins at 1.5 T by comparing with time-of-flight (TOF) MR angiography (MRA) and MR venography (MRV).

METHODS

13 healthy volunteers underwent both ESWAN and 3D-TOF-MRA examinations. Among them, nine volunteers underwent an additional two-dimensional-TOF-MRV examination. With regard to the ESWAN sequence, both maximum intensity projection (MIP) and minimum intensity projection (mIP) images were reconstructed and compared with MIP reconstructions of the TOF MRA and the TOF MRV.

RESULTS

Concerning the depiction of the constituent segments of the Circle of Willis, as well as A1, A2, A3 (segments of the anterior cerebral artery), M1, M2 (segments of the middle cerebral artery), P1 and P2 (segments of the posterior cerebral artery), the value of the ESWAN MIP was comparable to that of the TOF MRA without regard to visualization of branches, vessel homogeneity and wall irregularities or slight stenosis. ESWAN-mIP visualized more deep cerebral veins than TOF MRV in this study.

CONCLUSION

By use of either mIP reconstruction of a long echo data set or MIP reconstruction of a short echo data set, ESWAN allows simultaneous visualization of both cerebral veins and proximal segments of intracerebral arteries at 1.5 T.

ADVANCES IN KNOWLEDGE

ESWAN acquires multiple images at different echo times corresponding to different T2* weightings, wherein a short echo TOF-MRA data set and a long echo susceptibility-weighted imaging-MRV data set are obtained simultaneously.

Novel RNA oligonucleotide improves liver function and inhibits liver carcinogenesis in vivo

Hepatocellular carcinoma (HCC) occurs predominantly in patients with liver cirrhosis. Here we show an innovative RNA-based targeted approach to enhance endogenous albumin production while reducing liver tumor burden. We designed short-activating RNAs (saRNA) to enhance expression of C/EBPα (CCAAT/enhancer-binding protein-α), a transcriptional regulator and activator of albumin gene expression. Increased levels of both C/EBPα and albumin mRNA in addition to a 3-fold increase in albumin secretion and 50% decrease in cell proliferation was observed in C/EBPα-saRNA transfected HepG2 cells. Intravenous injection of C/EBPα-saRNA in a cirrhotic rat model with multifocal liver tumors increased circulating serum albumin by over 30%, showing evidence of improved liver function. Tumor burden decreased by 80% (P = 0.003) with a 40% reduction in a marker of preneoplastic transformation. Since C/EBPα has known antiproliferative activities by way of retinoblastoma, p21, and cyclins, we used messenger RNA (mRNA) expression liver cancer-specific microarray in C/EBPα-saRNA-transfected HepG2 cells to confirm down-regulation of genes strongly enriched for negative regulation of apoptosis, angiogenesis, and metastasis. Up-regulated genes were enriched for tumor suppressors and positive regulators of cell differentiation. A quantitative polymerase chain reaction (PCR) and western blot analysis of C/EBPα-saRNA-transfected cells suggested that in addition to the known antiproliferative targets of C/EBPα, we also observed suppression of interleukin (IL)6R, c-Myc, and reduced STAT3 phosphorylation.

CONCLUSION

A novel injectable saRNA-oligonucleotide that enhances C/EBPα expression successfully reduces tumor burden and simultaneously improves liver function in a clinically relevant liver cirrhosis/HCC model.

Histological characteristics of induced membranes in subcutaneous, intramuscular sites and bone defect

BACKGROUND

The induced membrane technique was proposed as a treatment of large segmental bone defects. The influence of the surrounding tissues on its characteristics remains unknown. It is therefore not known which kind of plastic surgery procedure (muscular or facio-cutaneous flap) would optimize bone osteointegration within a bone defect reconstructed using the induced-membrane technique.

HYPOTHESIS

We hypothesized that membrane characteristics could be influenced by the soft-tissue environment either subcutaneous or muscular.

OBJECTIVE

To evaluate the histological characteristics of poly-methylmethacrylate (PMMA) induced membranes in intramuscular, subcutaneous and bony environment (radius defects) at 2 steps: spacer implantation; secondary bone graft and its subsequent osteintegration after spacer removal.

METHODS

PMMA-induced membranes were obtained in the three sites of 15 rabbits. Subsequent new bone formation was studied in the same environments in 24 other rabbits. Six weeks after the initial implantation, PMMA spacers were replaced with iliac autografts. Animals were euthanized at 2, 4, and 8 weeks postoperatively. Tissue samples were harvested and stained with hematoxylin and eosin. The histological characteristics of the membrane (thickness and microvessel density) and the newly-formed bone (cortical thickness) were quantitatively analyzed.

RESULTS

The membranes in the subcutaneous sites developed quicker, were thicker and had the lowest microvessel density (P<0.01). The membranes in the intramuscular sites developed later and were thinner (P<0.01). The membranes in the osseous defects had the greatest microvessel density (P<0.01). After bone grafting, induced membranes became thinner and their microvessel density decreased substantially, but maintained better in osseous site. The newly-formed bone that developed in the radius defects, had the thickest cortices (P<0.01).

CONCLUSIONS

The evolution of membranes induced in the intramuscular and subcutaneous environments was close to that of the bone defect model, although bone formation appeared weaker.

Bosentan reduces neuronal apoptosis following spinal cord ischemic reperfusion injury

STUDY DESIGN

Experimental study.

OBJECTIVES

To investigate the effects of endothelin-receptor antagonist Bosentan on the spinal neural apoptosis in rats with ischemic reperfusion (IR) injury.

SETTING

Department of Neurosurgery, the Second Affiliated Hospital, Xi'an Jiaotong University School of Medcine, Xi'an, Shaanxi Province, China:

METHODS

Sprague-Dawley Rats were randomly divided into two groups, saline (IRS, n=48) and Bosentan (IRB, n=48) treatment, respectively, when reperfused in 6 h, 12 h, 24 h, 3 days, 5 days and 7 days. Immunohistochemical staining was used to assess endothelin-1 (ET-1), endothelin receptor type A (ETRA), endothelin receptor type B (ETRB), Bcl-2, Bax, Caspase-8, Caspase-9 and Caspase-3 expression. ET-1 and its receptor in spinal cord tissue were evaluated by real-time PCR. Plasma ET-1 concentration was also detected using radioimmunoassay.

RESULTS

Compared with the group IRS, plasma concentration of ET-1 in group IRB was significantly increased at each time point (P<0.05) and peaked at 24 h (P<0.01). ETRB expression in group IRB was significantly higher than group IRS at each time point (P<0.05) and peaked at day 3 (P<0.01). The difference in the expression of ETRA was not statistically significant in the group IRS and IRB (P>0.05). The apoptosis rate in group IRB was significantly decreased at each time point (P<0.05). The protein expressions of Bcl-2, Bax, Caspase-8, Caspase-9 and Caspase-3 were significantly increased in response to Bosentan treatment after IR.

CONCLUSION

These results suggest Bosentan decreases apoptosis rate after IR injury in the spinal cord, possibly through the ET-1-ETRB signaling pathway.

Abstract B225: Short activating RNA (saRNA) targeting C/EBPA significantly inhibits cell proliferation of undifferentiated cancer cells

In general, ‘poorly’ differentiated tumours have a worse prognosis when compared to more ‘well’ differentiated ones. Therefore, the use of a biological agent that could promote differentiation might have a therapeutic advantage. CCAAT enhancer binding protein alpha (C/EBPα) is a transcription factor known to be involved in the regulation of cell differentiation in a number of tissue types. Loss of C/EBPα expression, for example, causes abnormal levels of biliary transcription factors, impaired hepatocyte maturation and liver fibrosis. In contrast C/EBPα overexpression inhibits the development of hepatocellular carcinoma, restores myeloid differentiation and prevents hyperproliferation of hematopoietic cells in acute myeloid leukemia. In this study, we tested the effect of stimulation of C/EBPα expression by a specific small activating RNA (saRNA) on a panel of cell lines representing both well-differentiated and poorly-differentiated cancer cell types. The C/EBPα-saRNA inhibited proliferation of poorly differentiated small cell lung cancer and pancreatic cancer cell lines compared to treatment with scrambled double-stranded RNA controls. However C/EBPα-saRNA was not as effective in suppressing proliferation in well-differentiated insulinoma and breast cancer (MCF7) cell lines. Comparison of endogenous levels of C/EBPα, using qPCR and Western blots, showed that undifferentiated tumour cell lines expressed lower levels of C/EBPα when compared to the well-differentiated tumor types. Gene expression analysis in tumours from xenografts and cirrhotic DEN treated HCC rats, demonstrated that saRNA mediated stimulation of C/EBPα expression, could suppress the steady-state transcript levels for KLF4, OCT3, SOX2, C-Myc and C-Kit. The inhibited expression of these transcription factors correlated with greater expression of differentiation markers and reduced epithelial mesenchymal transition by the C/EBPα saRNA treated cells. Our results suggest that saRNA mediated stimulation of C/EBPα, could be of potential therapeutic value, especially in poorly differentiated cancers. Furthermore, intracellular expression levels of C/EBPα could be an important prognostic factor for predicting the therapeutic response in poor or un-differentiated tumors.

Citation Information: Mol Cancer Ther 2013;12(11 Suppl):B225.

Citation Format: K W. Huang, Vikash Reebye, Paul J. Mintz, Pal Saetrom, Piotr Swiderski, L Peng, C Liu, X X. Liu, Steen Lindkaer Jensen, Dimitris Zacharoulis, Nikos Kostomitsopoulos, Noriyaki Kasahara, Joanna Nicholls, Long R. Jiao, Madhava Pai, Duncan Spalding, Farzin Farzaneh, Malkhaz Mizandari, Tina Chikovani, Mohammed Emara, Abdelali Haoudi, Don Tomalia, John J. Rossi, Nagy A. Habib. Short activating RNA (saRNA) targeting C/EBPA significantly inhibits cell proliferation of undifferentiated cancer cells. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr B225.

An odd application of artificial vascular graft in the kidney transplantation of a patient with severe deep vein thrombosis: a case report

Transplantation of a living-related donor kidney was performed for a 41-year-old man. The planned right donor nephrectomy from the patient's 64-year-old father was uneventful. However the recipient's bilateral iliac veins and inferior vena cava were occluded, requiring a connection of the donor renal vein to the recipient's right great saphenous vein using an artificial vascular graft. On postoperative day 9, the patient recovered normal renal function with a serum creatinine that gradually decreased to 1.399 mg/dL. Color Doppler and computed tomography angiography imaging showed patency of the artificial vascular graft with no evidence of thrombosis. In addition, warfarin was used to improve his protein S deficiency.

Exome sequencing reveals new insights into the progression of abdominal aortic aneurysm

BACKGROUND

Abdominal aortic aneurysm (AAA) is a multi-factorial disease and its underlying pathogenesis remains poorly understood.

AIM

We aim to search for the underlying etiology of AAA using whole exome sequencing and gene expression analysis.

MATERIALS AND METHODS

We performed whole exome sequencing for AAA and adjacent normal abdominal aorta tissue from one male AAA patient. Further gene expression analysis using downloaded dataset from the GEO database was also carried out to explore the underlying molecular mechanisms.

RESULTS

A total of 5.97 Gb clean data were generated for the two samples, achieving a mean depth of coverage of 31.96 and 32.88 for the AAA and normal samples, respectively. We identified 203 somatic variants and confirmed 34 protein-altering somatic mutations in 25 genes. Among the confirmed variants, 11 mutations were not reported in the dbSNP database before. According to the literature review, none of these 25 genes were reportedly associated with AAA.

CONCLUSIONS

Our findings here may provide potential targets for effective prevention of human AAA development and progression.

Identification of microRNAs associated with lymphangiogenesis in human gastric cancer

PURPOSE

Lymphatic metastasis is a primary cause of gastric cancer-related death, yet factors governing tumor cell lymphatic metastasis have not been fully elucidated. MicroRNAs (miRNAs) are a recently discovered class of regulatory, non-coding RNAs, some of which are involved in gastric cancer progression. However, little is known about which miRNA contributes to the lymphatic metastasis in human gastric cancer. This prompted us to find the significant miRNAs associated with lymphangiogenesis in human gastric cancer.

METHODS

We screened vascular endothelial growth factor C (VEGF-C) expression in several gastric cancer cell lines as well as in the immortalized human gastric mucosal cell line GES-1, by real-time reverse transcriptase PCR (qRT-PCR). The gastric cancer cell lines MKN-45 and SGC-7901, which have commonly been cultured with human lymphatic endothelial cells (HLECs) in vitro, promoted tube formation of HLECs following transformation with a VEGF-C expression vector. Using microarrays, we identified a panel of differentially expressed miRNAs in HLECs that had been co-cultured with VEGF-C-transformed gastric cancer cells compared with non-transformed gastric cancer cells. A subset of miRNAs was further validated using qRT-PCR.

RESULTS

We found altered expression of miRNAs in HLECs co-cultured with lymphangiogenesis-inducing VEGF-C-transformed gastric cancer cells, with 47 up-regulated and 42 down-regulated miRNAs. These findings were confirmed by qRT-PCR of selected miRNAs. Furthermore, several miRNAs were differentially expressed in patients with positive lymphatic metastasis of the primary gastric tumor. Up-regulated miRNAs included miR-648, miR-5002-3p, miR-4754, miR-4760-5p, miR-4491, miR-4252, miR-5007-3p, and miR-647; and down-regulated miRNAs included miR-3178, miR-593-5p, miR-4485, miR-135a-3p, miR-17, miR-1469, and miR-124-5p.

CONCLUSIONS

Several lymphangiogenesis-related miRNAs are significantly altered during lymphatic metastasis of gastric cancer.

The FUS1 gene inhibits EC109 cell growth mediated by a lentivirus vector

The effects of the FUS1 gene on the oesophageal carcinoma cell line EC109 are investigated. The messenger RNA (mRNA) expression level of the FUS1 gene was detected by a reverse transcription polymerase chain reaction (RT-PCR) technique in the cell lines SHEE, SHEEC and EC109. The full length of the FUS1 gene was amplified using a PCR technique from the total RNA of umbilical mesenchymal stem cells. The FUS1 gene was cloned into a pSL6-IRES-EGFP vector and identified by PCR, digestion and sequencing. The recombinant pSL6-FUS1-IRES-EGFP plasmid was transfected into 293FT cells and the resulting lentivirus was collected. The growth of EC109 cells after transfection with lentivirus containing the FUS1 gene was determined by MTT assay and plate colony formation. Expression of the FUS1 gene in EC109 cells was weaker than that in SHEE, SHEEC cells and human umbilical vein endothelial cells (HUVEE; used as a control). Transfection efficiency was more than 80% after 48 h. Cell growth assessed by MTT assay was inhibited by about 40% compared with the control group; a finding that was in accordance with the plate colony formation results. The results suggest that the FUS1 gene might be a candidate tumour suppressor gene for the treatment of oesophageal carcinoma; however, these results require confirmation in in vivo studies.

Efficacy of sequential use of telbivudine in hepatitis B e antigen-positive chronic hepatitis B patients with partial responses to pegylated interferon: a pilot study

The aim of this study was to investigate the efficacy of sequential use of telbivudine in hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients with partial responses to pegylated interferon. Patients with partial responses to 48 weeks of pegylated interferon treatment were divided into two groups. In group A, patients stopped pegylated interferon directly without sequential treatment. In group B, patients received sequential treatment with telbivudine 600 mg/day. HBeAg, HBeAb, hepatitis B virus (HBV) DNA, alanine aminotransferase (ALT) and creatine kinase levels were determined at baseline and at weeks 12, 24, 36 and 48. Responses and safety were assessed after 48 weeks of telbivudine treatment. Thirty-six patients were recruited. Eighteen of these patients stopped pegylated interferon without sequential treatment (group A). After 48 weeks of follow-up, five patients (28%) had undergone HBeAg seroconversion, nine patients (50%) had undetectable levels of HBV DNA, and 11 patients (61%) achieved normal alanine aminotransferase (ALT) levels. The other 18 patients received sequential telbivudine treatment (group B). After 48 weeks of treatment, 11 patients (61%) had undergone HBeAg seroconversion, and all patients had undetectable levels of HBV DNA and normal ALT levels. All patients tolerated sequential telbivudine treatment, and only slightly elevated creatine kinase levels were observed. Switching to telbivudine therapy was efficient and safe in HBeAg-positive chronic hepatitis B patients with partial responses to 48 weeks of pegylated interferon. Sequential treatment with telbivudine resulted in an HBeAg seroconversion rate of 61% and an HBV DNA loss rate of 100% after 48 weeks. This promising strategy warrants further investigation.

Pancreatic neuroendocrine tumors: signal pathways and targeted therapies

Pancreatic neuroendocrine tumors (PNETs) are rare but are well understood to cover a broad spectrum of clinical presentation, tumor biology and prognosis. More than 60% of PNETs are diagnosed at advanced disease stage and are ineligible for surgical resection. Prior to 2011, streptozocin was the only approved agent for unresectable advanced PNETs. In recent years, breakthroughs in signal pathway research have led to the identification of new therapeutic targets and agents directed at the molecular level. In 2011, two new targeted therapeutic agents, sunitinib and everolimus, were approved by the Food and Drug Administration (FDA). Sunitinib is an inhibitor of multiple tyrosine kinases, and everolimus is an inhibitor of the mammalian target of rapamycin (mTOR) pathway. This review discusses the major signaling pathways that are frequently mutated or deregulated in PNETs, and the implications of molecular alterations for PNET therapy. Biologic therapy through targeting relevant pathways represents a promising approach in the therapy of advanced and unresectable PNETs.

Disruption of cellulose synthesis by 2,6-dichlorobenzonitrile affects the structure of the cytoskeleton and cell wall construction in Arabidopsis

Cellulose is the major component of plant cell walls and is an important source of industrial raw material. Although cellulose biosynthesis is one of the most important biochemical processes in plant biology, the regulatory mechanisms of cellulose synthesis are still unclear. Here, we report that 2,6-dichlorobenzonitrile (DCB), an inhibitor of cellulose synthesis, inhibits Arabidopsis root development in a dose- and time-dependent manner. When treated with DCB, the plant cell wall showed altered cellulose distribution and intensity, as shown by calcofluor white and S4B staining. Moreover, pectin deposition was reduced in the presence of DCB when immunostained with the monoclonal antibody JIM5, which was raised against pectin epitopes. This result was confirmed using Fourier transform infrared (FTIR) analysis. Confocal microscopy revealed that the organisation of the microtubule cytoskeleton was significantly disrupted in the presence of low concentrations of DCB, whereas the actin cytoskeleton only showed changes with the application of high DCB concentrations. In addition, the subcellular dynamics of Golgi bodies labelled with N-ST-YFP and TGN labelled with VHA-a1-GFP were both partially blocked by DCB. Transmission electron microscopy indicated that the cell wall structure was affected by DCB, as were the Golgi bodies. Scanning electron microscopy showed changes in the organisation of cellulose microfibrils. These results suggest that the inhibition of cellulose synthesis by DCB not only induced changes in the chemical composition of the root cell wall and cytoskeleton structure, but also changed the distribution of cellulose microfibrils, implying that cellulose plays an important role in root development in Arabidopsis.