The significance of mild hypothermia therapy on patients with successful resuscitation of cardiac arrest

OBJECTIVE

To investigate the clinical significance of mild hypothermia therapy in patients with resuscitation of cardiac arrest and analyze the possible molecular mechanism.

PATIENTS AND METHODS

Ninety-six patients with successful resuscitation of cardiac arrest in ICU were hospitalized from June 2009 to July 2014. They were divided into a control group (n=37 cases) and an observation group (n=59 cases). All patients received high-grade life support treatment immediately after resuscitation. The treatment for the control group was combined with normal temperature treatment while the treatment for the observation group was combined with mild hypothermia therapy.

RESULTS

1. Glasgow coma scale (GCS) scores of the patients in the two groups increased gradually after treatment as the APACHE II scores decreased. Comparisons within the group showed significant differences (p < 0.05). The GCS scores of the observation group were significantly increased compared to those in the control group, and the APACHE score decreased significantly. The differences between the groups were statistically significant (p < 0.05). 2. The serum lactic acid, sCD14, S100 β protein and TNF-a level of patients in two groups all decreased after treatment. The difference was statistically significant (p < 0.05 =. 3. The 24h and 7d survival rates of patients in the observation group are higher than that in the control group (p < 0.05).

CONCLUSIONS

The early treatment of hypothermia, can improve the outcome of patients with cardiac arrest.

Subclinical hypothyroidism and the associations with macrovascular complications and chronic kidney disease in patients with Type 2 diabetes

AIMS

The prevalence of subclinical hypothyroidism (SCH) is high among patients with diabetes, although the relationship between SCH and diabetic vascular complications is unknown. This study aimed to determine the relationship between SCH and vascular complications in patients with Type 2 diabetes.

METHODS

In this cross sectional study, 991 patients with Type 2 diabetes were screened for thyroid function at their admission to the Second Affiliated Hospital of Chongqing Medical University. We compared the prevalence of coronary heart disease (CHD), ischaemic stroke and chronic kidney disease (CKD) with the prevalence of euthyroidism and SCH.

RESULTS

Among the 991 patients, 126 (12.7%) patients had SCH. The prevalence of CHD was significantly higher in the SCH group than in the euthyroid group (22.2% and 15.0%, respectively; P = 0.039). In the logistic regression analyses, SCH was associated with CHD [odds ratio (OR): 1.993; 95% confidence interval (CI): 1.135-3.497; P = 0.016]. This association was stronger in patients aged ≥ 65 years than in younger patients [2.474 (1.173-5.220); P = 0.017]. No significant association was found between SCH and ischaemic stroke. Patients with severe SCH had a high risk of CKD [1.842 (1.120-3.029); P = 0.016].

CONCLUSIONS

This study provides evidence that SCH in patients with Type 2 diabetes is associated with a high prevalence of CHD (and CKD in severe SCH), although not with ischaemic stroke.

Association of TLR2 and TLR4 non-missense single nucleotide polymorphisms with type 2 diabetes risk in a southern Chinese population: a case-control study

Toll-like receptors (TLRs), the triggers of the innate and adaptive immune responses, are involved in the pathogenesis of type 2 diabetes mellitus (T2DM). Several studies have investigated the effects of genetic polymorphisms in TLR4 and TLR2, but they have yielded limited results. We investigated whether non-missense genetic polymorphisms in the regulatory regions of TLR4 and TLR2 were related to T2DM in a southern Chinese population. Single nucleotide polymorphisms (SNPs) in TLR4 (rs1927911, rs11536889, rs1927907, rs1927906, rs1927914, rs7873784, and rs2149356) and TLR2 (rs1898830, rs3804099, rs4696480, and rs3804100) were genotyped in 552 T2DM and 552 unrelated age- and gender-matched controls by SNaPShot Multiplex assay. Genotypes GG (OR = 0.09, 95%CI = 0.01- 0.83, P = 0.03) and CG (OR = 0.08, 95%CI = 0.01-0.74, P = 0.03) of the 3'-untranslated region (UTR) SNP rs7873784 in TLR4, and genotype AG (OR = 0.67, 95%CI = 0.46-0.97, P = 0.04) and allele G (OR = 0.88, 95%CI = 0.79-0.97, P = 0.01) of the intron SNP rs1898830 in TLR2 were identified as protective against the development of T2DM in southern Chinese people. In contrast, a meta-analysis of rs1927911 and rs1927914 showed no association. Haplotypes AGTT (OR = 0.34, 95%CI = 0.15-0.77, P = 0.01) and AATT (OR = 1.20, 95%CI = 1.01- 1.44, P = 0.05) in TLR2 were significantly associated with susceptibility to T2DM. Our results suggest that the effects of non-missense polymorphisms located in the regulatory regions of TLR4 and TLR2 should not be neglected in T2DM association analysis.

Discovery of a BTK/MNK dual inhibitor for lymphoma and leukemia

Bruton's tyrosine kinase (BTK) kinase is a member of the TEC kinase family and is a key regulator of the B-cell receptor (BCR)-mediated signaling pathway. It is important for B-cell maturation, proliferation, survival and metastasis. Pharmacological inhibition of BTK is clinically effective against a variety of B-cell malignances, such as mantle cell lymphoma, chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML) and activated B-cell-diffuse large B-cell lymphoma. MNK kinase is one of the key downstream regulators in the RAF-MEK-ERK signaling pathway and controls protein synthesis via regulating the activity of eIF4E. Inhibition of MNK activity has been observed to moderately inhibit the proliferation of AML cells. Through a structure-based drug-design approach, we have discovered a selective and potent BTK/MNK dual kinase inhibitor (QL-X-138), which exhibits covalent binding to BTK and noncovalent binding to MNK. Compared with the BTK kinase inhibitor (PCI-32765) and the MNK kinase inhibitor (cercosporamide), QL-X-138 enhanced the antiproliferative efficacies in vitro against a variety of B-cell cancer cell lines, as well as AML and CLL primary patient cells, which respond moderately to BTK inhibitor in vitro. The agent can effectively arrest the growth of lymphoma and leukemia cells at the G0-G1 stage and can induce strong apoptotic cell death. These primary results demonstrate that simultaneous inhibition of BTK and MNK kinase activity might be a new therapeutic strategy for B-cell malignances.

An array of virtual Frisch-grid CdZnTe detectors and a front-end application-specific integrated circuit for large-area position-sensitive gamma-ray cameras

We developed a robust and low-cost array of virtual Frisch-grid CdZnTe detectors coupled to a front-end readout application-specific integrated circuit (ASIC) for spectroscopy and imaging of gamma rays. The array operates as a self-reliant detector module. It is comprised of 36 close-packed 6 × 6 × 15 mm(3) detectors grouped into 3 × 3 sub-arrays of 2 × 2 detectors with the common cathodes. The front-end analog ASIC accommodates up to 36 anode and 9 cathode inputs. Several detector modules can be integrated into a single- or multi-layer unit operating as a Compton or a coded-aperture camera. We present the results from testing two fully assembled modules and readout electronics. The further enhancement of the arrays' performance and reduction of their cost are possible by using position-sensitive virtual Frisch-grid detectors, which allow for accurate corrections of the response of material non-uniformities caused by crystal defects.

Stromal miR-200s contribute to breast cancer cell invasion through CAF activation and ECM remodeling

The activation of cancer-associated fibroblasts (CAFs) is a key event in tumor progression, and alternative extracellular matrix (ECM) proteins derived from CAFs induce ECM remodeling and cancer cell invasion. Here we found that miR-200 s, which are generally downregulated in activated CAFs in breast cancer tissues and in normal fibroblasts (NFs) activated by breast cancer cells, are direct mediators of NF reprogramming into CAFs and of ECM remodeling. NFs with downregulated miR-200 s displayed the traits of activated CAFs, including accelerated migration and invasion. Ectopic expression of miR-200 s in CAFs at least partially restored the phenotypes of NFs. CAF activation may be governed by the targets of miR-200 s, Fli-1 and TCF12, which are responsible for cell development and differentiation; Fli-1 and TCF12 were obviously elevated in CAFs. Furthermore, miR-200 s and their targets influenced collagen contraction by CAFs. The upregulation of fibronectin and lysyl oxidase directly by miR-200 or indirectly through Fli-1 or TCF12 contributed to ECM remodeling, triggering the invasion and metastasis of breast cancer cells both in vitro and vivo. Thus, these data provide important and novel insights into breast CAF activation and ECM remodeling, which trigger tumor cell invasion.

[Under hypoxia condition contactin-1 regulates migration of MKN45 cells through RhoA pathway]

Recent studies have suggested that contactin-1 has a key role in cancer cell proliferation and migration, however the detailed mechanism of this process is still unclear. Here, human gastric cancer cell line MKN45 was employed. It was found that under hypoxia conditions contactin-1 mRNA and protein levels were both up-regulated by HIF-1alpha expression. Furthermore, although hypoxia increased the migration rate of MKN45 cells, contactin-1 (CNTN1) shRNA reversed this process. Meanwhile, RhoA V14 and RhoA V14N19 mutation constructs were employed, and it was found that constitutively active form of RhoA reversed the cell migration suppression induced by contactin-1 knockdown, while dominant-negative form of RhoA blocked hypoxia induced hypermigration. Apart from this, contactin-1 displayed the ability to phosphorylate the RhoA activator p115 RhoGEF. Thus, under hypoxia conditions, elevated HIF-1alpha seems to up-regulate contactin-1 expression and by this activate RhoA and facilitate migration of cancer cells.

A new strategy for complete identification of sea buckthorn cultivars by using random amplified polymorphic DNA markers

DNA fingerprinting is both a popular and important technique with several advantages in plant cultivar identification. However, this technique has not been used widely and efficiently in practical plant identification because the analysis and recording of data generated from fingerprinting and genotyping are tedious and difficult. We developed a novel approach known as a cultivar identification diagram (CID) strategy that uses DNA markers to separate plant individuals in a more efficient, practical, and referable manner. A CID was manually constructed and a polymorphic marker was generated from each polymerase chain reaction for sample separation. In this study, 67 important sea buckthorn cultivars cultivated in China were successfully separated with random amplified polymorphic DNA markers using the CID analysis strategy, with only seven 11-nucleotide primers employed. The utilization of the CID of these 67 sea buckthorn cultivars was verified by identifying 2 randomly chosen groups of cultivars among the 67 cultivars. The main advantages of this identification strategy include fewer primers used and separation of all cultivars using the corresponding primers. This sea buckthorn CID was able to separate any sea buckthorn cultivars among the 67 studied, which is useful for sea buckthorn cultivar identification, cultivar-right-protection, and for the sea buckthorn nursery industry in China.

Bone morphogenetic protein 7 attenuates epithelial-mesenchymal transition induced by silica

The epithelial-mesenchymal transition (EMT) is a critical process in the pulmonary fibrosis. It has been reported that bone morphogenetic protein 7 (BMP-7) was able to reverse EMT in proximal tubular cells. Therefore, we test the hypothesis that EMT contributes to silica-induced pulmonary fibrosis and BMP-7 inhibits EMT in silica-induced pulmonary fibrosis. Progressive silica-induced pulmonary fibrosis in the rat was used as a model of silicosis. Epithelial and mesenchymal markers were measured from rat fibrotic lungs. Then the effects of BMP-7 on the EMT were further confirmed in A549 cells. There are increases of vimentin as a mesenchymal marker and decreases of E-cadherin as an epithelial marker in the silica-exposed rat lungs, which is in agreement with the A549 cells data. However, BMP-7 treatment significantly reduced expression of vimentin in the rat pulmonary fibrosis model and in A549 cells. In conclusion, EMT contributes to silica-induced pulmonary fibrosis. Meanwhile, the treatment of BMP-7 can inhibit silica-induced EMT in vitro and in vivo.

Canagliflozin in Asian patients with type 2 diabetes on metformin alone or metformin in combination with sulphonylurea

AIMS

To evaluate the efficacy and safety of canagliflozin, a sodium glucose co-transporter 2 inhibitor, in Asian patients with type 2 diabetes mellitus (T2DM) inadequately controlled by metformin or metformin in combination with sulphonylurea.

METHODS

In this 18-week, randomized, double-blind, placebo-controlled phase III study, patients (N = 676) received canagliflozin 100 or 300 mg or placebo once daily. The primary efficacy endpoint was change in glycated haemoglobin (HbA1c) level from baseline at week 18. Additional endpoints included change in fasting plasma glucose (FPG) and percent change in body weight. Adverse events (AEs) were recorded throughout the study. Efficacy and safety were assessed in the overall population and in two strata based on background therapy.

RESULTS

At week 18, canagliflozin 100 and 300 mg provided significant reductions from baseline in HbA1c compared with placebo (-0.97, -1.06 and -0.47%, respectively; p < 0.001). Relative to placebo, canagliflozin 100 and 300 mg also significantly reduced FPG (-1.0 and -1.4 mmol/l) and body weight [-2.2% (-1.5 kg) and -2.3% (-1.6 kg)]. Both canagliflozin doses lowered systolic blood pressure (BP) compared with placebo. The overall incidence of AEs was 38.6, 43.2 and 42.0% with canagliflozin 100 and 300 mg and placebo, respectively. The incidence of genital mycotic infections and urinary tract infections was low and similar across groups. Efficacy and safety findings in the two strata were generally consistent with the overall population.

CONCLUSIONS

Canagliflozin provided glycaemic improvements and reductions in body weight and systolic BP, and was generally well tolerated in Asian patients with T2DM on metformin or metformin in combination with sulphonylurea.

Plasma FGF23 levels and heart rate variability in patients with stage 5 CKD

Fibroblast growth factor 23(FGF23) is a bone-derived hormone which regulates mineral homeostasis but may also have a role in cardiovascular disease. Here, we found that higher plasma FGF23 was independently associated with decreased heart rate variability in stage 5 CKD patients and parathyroidectomy may reverse these abnormal indicators.

INTRODUCTION

Lower heart rate variability (HRV) in patients with chronic kidney disease (CKD) compared with healthy controls is associated with increased risk of cardiovascular disease (CVD). Higher levels of plasma FGF23 also predict higher risk of CVD. Here, we aimed to evaluate the relationship between plasma FGF23 levels and HRV in patients with stage 5 CKD and to investigate longitudinal changes of them together with the correlation between their changes in two severe secondary hyperparathyroidism (SHPT) subgroups with successful parathyroidectomy (PTX) and persistent SHPT.

METHODS

This cross-sectional study included 100 stage 5 CKD patients, 78 controls, and a prospective study in two PTX subgroups classified as successful PTX (n = 24) and persistent SHPT (n = 4) follow-up. Blood examination and 24-h Holter monitoring for HRV were measured.

RESULTS

Most HRV indices were lower in stage 5 CKD patients than in healthy controls, and plasma FGF23 levels were higher. In multivariate stepwise regression models, levels of plasma FGF23 and serum parathyroid hormone (PTH) were correlated with HRV. The successful PTX subgroup had significant improvements over baseline in HRV indices. Persistent SHPT subgroup had numerically similar changes in HRV indices. However, plasma FGF23 levels decreased in both subgroups.

CONCLUSIONS

Plasma FGF23 levels were higher in CKD patients than in controls, much higher in patients with severe SHPT. FGF23 was independently associated with decreased HRV in stage 5 CKD. Successful PTX may reverse these abnormal indicators and contribute to decreases in the risk of cardiovascular disease.

Resistance of non-transgenic papaya plants to papaya ringspot virus (PRSV) mediated by intron-containing hairpin dsRNAs expressed in bacteria

RNA-mediated virus resistance based on natural antiviral RNA silencing has been exploited as a powerful tool for engineering virus resistance in plants. In this study, a conserved 3'-region (positions 9839-10117, 279 nt) of the capsid protein (CP) gene of papaya ringspot virus (PRSV), designated CP279, was used to generate an intron-containing hairpin RNA (ihpRNA) construct by one-step, zero-background ligation-independent cloning (OZ-LIC). The RNaseIII-deficient Escherichia coli strain M-JM109lacY was identified as the best choice for producing large quantities of specific ihpRNA-CP279. Resistance analyses and ELISA data verified that most papaya plants mechanically co-inoculated with TRIzol-extracted ihpRNA-CP279 and PRSV were resistant to PRSV, and resistance was maintained throughout the test period (>2 months post-inoculation). In contrast, a 1-2 day interval between sequential inoculation of PRSV and ihpRNA-CP279 did not result in complete protection against PRSV infection, but delayed the appearance of viral symptoms by 3 to 4 days. These findings indicate that direct mechanical inoculation of papaya plants with bacterially-expressed ihpRNA-CP279 targeting the PRSV CP gene can interfere with virus infection. This work lays a foundation for developing a non-transgenic approach to control PRSV by directly spraying plants with ihpRNA or crude bacterial extract preparations.

Early hyperglycaemia and the early-term death in patients with spontaneous intracerebral haemorrhage: a meta-analysis

BACKGROUND AND AIMS

Stroke is often accompanied by hyperglycaemia, and this has an important impact on prognosis. The aim of this study was to investigate the relationship between early hyperglycaemia and the outcome of spontaneous intracerebral haemorrhage (sICH).

METHODS

A systematic literature search on PubMed, Embase, Cochran, WANFANG DATA, VIP and CNKI databases was conducted, and eight eligible studies were retrieved. Relative risks and 95% confidence interval (CI) in the hyperglycaemia group compared with the non-hyperglycaemia group were calculated and meta-analysed when possible.

RESULTS

Eight controlled trials and cohort studies totalling 3756 patients addressing early hyperglycaemia and the outcome of sICH were compiled for this meta-analysis. Cut-off points for defining hyperglycaemia was 6.1-8.3 mmol/L, and the median cut-off value was 7.5 mmol/L. Studies were assigned to one of the two subgroups: the group A (for studies with the values of glucose concentrations above the median cut-off) and the group B (for studies with the values of glucose concentrations below the median cut-off). The RR for short-term death associated with hyperglycaemia was 3.65 (95% confidence interval (CI) (3.08, 4.33); P < 0.0001). In the subgroup analysis, the relative risk values were 3.46 (95% CI (1.66, 7.20); P = 0.0009) and 3.53 (95% CI (2.92, 4.26); P < 0.00001) for the groups A and B respectively. The publication bias showed that Egger's test (P > 0.1), Begg's test (P > 0.05) and Nfs0.05 exceeded included studies.

CONCLUSIONS

Early hyperglycaemia can significantly increase the rate of early-term death in patients with sICH, independent of the cut-off points for hyperglycaemia.

Reliability of intra-oral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls - a multicentre study

The reliability of comprehensive intra-oral quantitative sensory testing (QST) protocol has not been examined systematically in patients with chronic oro-facial pain. The aim of the present multicentre study was to examine test-retest and interexaminer reliability of intra-oral QST measures in terms of absolute values and z-scores as well as within-session coefficients of variation (CV) values in patients with atypical odontalgia (AO) and healthy pain-free controls. Forty-five patients with AO and 68 healthy controls were subjected to bilateral intra-oral gingival QST and unilateral extratrigeminal QST (thenar) on three occasions (twice on 1 day by two different examiners and once approximately 1 week later by one of the examiners). Intra-class correlation coefficients and kappa values for interexaminer and test-retest reliability were computed. Most of the standardised intra-oral QST measures showed fair to excellent interexaminer (9-12 of 13 measures) and test-retest (7-11 of 13 measures) reliability. Furthermore, no robust differences in reliability measures or within-session variability (CV) were detected between patients with AO and the healthy reference group. These reliability results in chronic orofacial pain patients support earlier suggestions based on data from healthy subjects that intra-oral QST is sufficiently reliable for use as a part of a comprehensive evaluation of patients with somatosensory disturbances or neuropathic pain in the trigeminal region.

Genetic variation in the ovine uncoupling protein 1 gene: association with carcass traits in New Zealand (NZ) Romney sheep, but no association with growth traits in either NZ Romney or NZ Suffolk sheep

The uncoupling protein 1 (UCP1) plays an important role in the regulation of lipolysis and thermogenesis in adipose tissues. Genetic variation within three regions (the promoter, intron 2 and exon 5) of the ovine UCP1 gene (UCP1) was investigated using polymerase chain reaction-single-strand conformational polymorphism (PCR-SSCP) analyses. These revealed three promoter variants (designated A, B and C) and two intron 2 variants (a and b). The association of this genetic variation with variation in lamb carcass traits and postweaning growth was investigated in New Zealand (NZ) Romney and Suffolk sheep. The presence of B in a lamb's genotype was associated with decreased subcutaneous carcass fat depth (V-GR) (p = 0.004) and proportion of total lean meat yield of loin meat (p = 0.005), and an increased proportion of total lean meat yield of hind-leg meat (p = 0.018). In contrast, having two copies of C was associated with increased V-GR (p < 0.001) and proportion of total lean meat yield of shoulder meat (p = 0.009), and a decreased hind-leg yield (p = 0.032). No associations were found with postweaning growth. These results suggest that ovine UCP1 is a potential gene marker for carcass traits.

Detection of malignant B lymphocytes by PCR clonality assay using direct lysis of cerebrospinal fluid and low volume specimens

INTRODUCTION

The diagnosis of lymphoid malignancies is often challenging in paucicellular specimens. PCR may also be limited by insufficient cells for DNA isolation and incomplete coverage of gene rearrangements. This study aims to evaluate a PCR method for IgH clonality using direct cell lysates.

METHODS

PCR amplification used cell lysate from detergent-based lysis and BIOMED-2 primers. CSF specimens were tested for 20 patients with primary CNS lymphoma or systemic lymphoma suspected for CNS involvement. Cytology and flow cytometry analysis was performed in parallel with PCR.

RESULTS

Direct lysis produced a better yield than the column-based method for DNA isolation. PCR using lysate showed an efficiency of clonality detection from a minimum of 20 tumor cells. PCR clonality was found in nine of the 20 CSFs, and positive PCR was concordant with both cytology and flow cytometry in seven cases. There were two cases positive for PCR, but indeterminate for flow cytometry because of insufficient cell events. Of the eleven PCR-negative cases, two were considered as false negative, as flow cytometry showed positive for malignant cells. The PCR was also performed successfully with a specimen from the anterior chamber of the eye.

CONCLUSION

PCR clonality with direct cell lysis of CSF is feasible, and it may overcome the limitation of DNA isolation. This PCR method may be particularly useful for small volume and low cell CSF when flow cytometry is inconclusive.

Zinc-finger BED domain-containing 3 (Zbed3) is a novel secreted protein associated with insulin resistance in humans

OBJECTIVES

Genome-wide association studies (GWAS) have shown that Zbed3 is associated with T2DM. To date, no report has demonstrated a relationship between Zbed3 and insulin resistance in humans, however. The purpose of this study was to determine whether the Zbed3 protein is secreted and identify any associations between Zbed3 and insulin resistance in cross-sectional and interventional studies.

METHODS

We found that Zbed3 protein was secreted in an in vitro secretion study. Plasma Zbed3 levels were determined in an ELISA and were compared with various parameters related to insulin resistance in subjects with NGT, IGT and nT2DM. EHC was performed in healthy subjects. Real-time PCR and Western blotting were used to assess the mRNA and protein expression of Zbed3.

RESULTS

Zbed3 was detected in an analysis of in vitro secretion in both conditioned medium and lysates of HEK-293T cells transfected with an overexpressed vector. In a clinical study, there were significantly higher levels of circulating Zbed3 in IGT and nT2DM relative to NGT. Zbed3 levels were positively correlated with BMI, WHR, FAT%, blood pressure, FBG, TG, HbA1c, FIns and HOMA-IR and inversely correlated with HDL-C. Increasing levels of Zbed3 were independently associated with IGT and T2DM. Zbed3 mRNA and protein in muscle and fat were significantly elevated in both db/db mice and T2DM patients. Moreover, there was a concentration-dependent effect of glucose on Zbed3 release, whereas insulin exhibited an inhibitory effect on Zbed3 levels. Zbed3 suppressed insulin-induced IR and Akt phosphorylation.

CONCLUSIONS

These results suggest that the Zbed3 protein may be a cytokine associated with insulin resistance in humans that is influenced by glucose and insulin levels.

Total parathyroidectomy with autotransplantation for a rare disease derived from uremic secondary hyperparathyroidism, the uremic leontiasis ossea

SUMMARY

We described six uremic leontiasis ossea (ULO) patients who underwent total parathyroidectomy with autotransplantation. ULO demonstrated more a systemic disease than a simple craniofacial deformation. The surgery seemed an effective treatment to alleviate secondary hyperparathyroidism and to improve patients' quality of life. ULO may have a high postoperative recurrence tendency.

INTRODUCTION

ULO is a rare disease derived from uremic secondary hyperparathyroidism (SHPT). Previous studies mostly focused on the craniofacial deformations. This study aims to investigate the systemic features of the disease and the surgical outcomes.

METHODS

The present study retrospectively assessed six ULO patients who underwent total parathyroidectomy (TPTX) with autotransplantation (AT). Follow-up data were recorded. The follow-up status was considered as "effectiveness" if serum intact parathyroid hormone (iPTH) levels were <150 pg/mL in the first 3 days after surgery, or as "recurrence" if serum iPTH gradually increased >300 pg/mL during follow-up in patients whose status was initially considered as "effectiveness".

RESULTS

Craniofacial deformations, short stature, thoracocyllosis, spine malformations, osteodynia, and muscle weakness were observed in all patients. Abnormal pulmonary functions were observed in five patients. After surgery, one patient died from respiratory failure. Surgery was effective in the remaining five patients with relieved osteodynia and stopped craniofacial deformation. A mean follow-up of 7.6 (4 to 12) months was available. Three patients suffered from recurrence of hyperparathyroidism originating from autografts.

CONCLUSIONS

Our data suggests that ULO is not only a simple disease with craniofacial malformations but is a severe systemic disease leading to increased surgical risks. TPTX with AT seems an effective treatment to relieve SHPT and to improve quality of life. ULO may have a high postoperative recurrence tendency.

Risk factors for anal fistula: a case-control study

BACKGROUND

The aim of our study was to identify potential risk factors for anal fistula in order to improve prevention and treatment of anal fistula.

METHODS

A retrospective case-control study for anal fistula was conducted at our unit. Logistic regression analyses were carried out to identify associated risk factors for anal fistula.

RESULTS

The final model obtained by the stepwise forward logistic regression analysis method identified the following items as independent risk factors: body mass index of >25.0 kg/m(2), high daily salt intake, history of diabetes, hyperlipidemia, dermatosis, anorectal surgery, history of smoking and alcohol intake, sedentary lifestyle, excessive intake of spicy/greasy food, very infrequent participation in sports and prolonged sitting on the toilet for defecation.

CONCLUSIONS

Our results indicate that lifestyle factors and certain medical conditions increase an individual's risk of developing anal fistula.

Association of SCN1A gene polymorphisms with infantile spasms and adrenocorticotropic hormone responsiveness

OBJECTIVES

Infantile spasms (IS) are severe epileptic encephalopathy during infancy. The SCN1A encodes the α1 subunit of the neuronal voltage-gated sodium channels, and mutations in SCN1A have been frequently detected in idiopathic epilepsy and encephalopathy, which had similar symptoms as IS. Therefore, we investigated the association of SCN1A polymorphism with the IS and the responsiveness to adrenocorticotropic hormone (ACTH) treatment in the present study.

PATIENTS AND METHODS

We totally collected 113 IS patients and and 122 age-matched healthy controls. All of the subjects were Han Chinese descent, and the 113 cases were further divided into subgroups of cryptogenic and symptomatic patients. Nine tag SNPs within the SCN1A gene were selected and genotyped by the direct sequencing of PCR-amplified products. The ACTH was then applied to all of the cases.

RESULTS

Two SNPs in high linkage disequilibrium, rs13397210 and rs760543, were significantly associated with IS under genotype model (p = 0.015). In addition, we also found that a 4-SNP haplotype (CAGC) which contains the aforementioned 2 SNPs, was associated with increased responsiveness to ACTH therapy in IS (p = 0.018, OR = 4.8) under recessive model. Of the 2 subgroups of cases, more cryptogenic patients responded to the ACTH treatment than the symptomatic patients.

CONCLUSIONS

The results suggested that genetic variants of the SCN1A gene were associated with IS and ACTH responsiveness.

Efficacy of endoscopic stapled transanal rectal resection for the treatment of rectocele

OBJECTIVE

The objective of the study was to determine the efficacy of endoscopic stapled transanal rectal resection for the treatment of rectocele.

PATIENTS AND METHODS

For this purpose, the data were collected from 61 patients with severe rectocele that underwent endoscopic stapled transanal rectal resection within the time period from April 2010 to April 2012. The pre- and post-operative Longo's obstructed defecation syndrome (ODS) were compared. The reduction of the rectocele was assessed by defecography on visit and from patients' satisfaction obtained through following up.

RESULTS

We found that the postoperative Longo's ODS was significantly lower than the preoperative value (p < 0.01); and defecography showed that the rectocele was significantly reduced or disappeared. Furthermore, 57 of the 61 (93.4%) patients expressed their satisfaction at follow up.

CONCLUSIONS

The endoscopic stapled transanal rectal resection can be recommended as the treatment of choice for rectocele since it is an easy-to-perform procedure that has satisfactory short and mid to long-term therapeutic efficacy.

Treatment of tubal pregnancy using comprehensive interventional methods

OBJECTIVE

To investigate the efficacy of combined interventional methods in treatment of tubal pregnancy.

MATERIALS AND METHODS

One hundred sixty-two patients with tubal pregnancy were enrolled in this study. In all patients, the feeding uterine artery at affected side was perfused with methotrexate (MTX), followed by occlusion using gelatin sponge. Nineteen patients were also treated by perfusion of MTX in ovarian artery at affected side which partially participated in blood supply. Seven patients received direct puncture perfusion of MTX under B ultrasound guidance. Four cases received perfusion of MTX through fallopian tube. After surgery, the serum beta-human chorionic gonadotropin (β-HCG) level was regularly detected, and B ultrasound was used to monitor the pelvic mass change. For 33 patients with fertility requirement, hysterosalpingography (HSG) was conducted after menstruation restoration.

RESULTS

Tubal pregnancy was terminated in 160 patients (98.76%), with inefficacy in two patients (1.23%) who were treated by surgery. HSG showed tubal patency in 27 patients. Tubal obstruction was found in the other six patients. After recanalization, three cases were unobstructed, with obstruction in other three cases. Fifteen patients achieved intrauterine pregnancy after six to 17 months from surgery.

CONCLUSIONS

Comprehensive interventional treatment can prevent internal bleeding caused by failure of many conservative treatments, improve the indication and success rate of treatment, and preserve the complete fallopian tube.

Chemical and ultrastructural analysis of corn cuticular lipids and their effect on feeding by fall armyworm larvae

The cuticular lipid composition of lower and upper leaves of five genotypes of field-grown corn,Zea mays L., was determined by combined gas chromatography-mass spectrometry. Surface lipids of the upper leaves had a higher proportion ofn-alkanes (45-52%) than the lower leaves, while the lower leaves had higher percentages of fatty alcohols (12-18%) than the upper leaves. Scanning electron microscopy showed that the upper leaves of two corn genotypes, MpSWCB-4 and Cacahuacintle X's, had a smooth amorphous appearance, while the lower leaves had a dense array of wax crystals.Spodoptera frugiperda (J.E. Smith) larvae weighed more and developed more rapidly when they were reared on diet containing corn foliage from which the cuticular lipids had been removed than when they were fed untreated foliage. However, growth was not inhibited when larvae were fed diet containing the cuticular lipid extracts or individual cuticular lipid components.

Selective neuronal differentiation of neural stem cells induced by nanosecond microplasma agitation

An essential step for therapeutic and research applications of stem cells is their ability to differentiate into specific cell types. Neuronal cells are of great interest for medical treatment of neurodegenerative diseases and traumatic injuries of central nervous system (CNS), but efforts to produce these cells have been met with only modest success. In an attempt of finding new approaches, atmospheric-pressure room-temperature microplasma jets (MPJs) are shown to effectively direct in vitro differentiation of neural stem cells (NSCs) predominantly into neuronal lineage. Murine neural stem cells (C17.2-NSCs) treated with MPJs exhibit rapid proliferation and differentiation with longer neurites and cell bodies eventually forming neuronal networks. MPJs regulate ~75% of NSCs to differentiate into neurons, which is a higher efficiency compared to common protein- and growth factors-based differentiation. NSCs exposure to quantized and transient (~150 ns) micro-plasma bullets up-regulates expression of different cell lineage markers as β-Tubulin III (for neurons) and O4 (for oligodendrocytes), while the expression of GFAP (for astrocytes) remains unchanged, as evidenced by quantitative PCR, immunofluorescence microscopy and Western Blot assay. It is shown that the plasma-increased nitric oxide (NO) production is a factor in the fate choice and differentiation of NSCs followed by axonal growth. The differentiated NSC cells matured and produced mostly cholinergic and motor neuronal progeny. It is also demonstrated that exposure of primary rat NSCs to the microplasma leads to quite similar differentiation effects. This suggests that the observed effect may potentially be generic and applicable to other types of neural progenitor cells. The application of this new in vitro strategy to selectively differentiate NSCs into neurons represents a step towards reproducible and efficient production of the desired NSC derivatives.

An efficient algorithm for finding attractors in synchronous Boolean networks with biochemical applications

Self-organized systems, genetic regulatory systems and other living systems can be modeled as synchronous Boolean networks with stable states, which are also called state-cycle attractors (SCAs). This paper summarizes three classes of SCAs and presents a new efficient binary decision diagram based algorithm to find all SCAs of synchronous Boolean networks. After comparison with the tool BooleNet, empirical experiments with biochemical systems demonstrated the feasibility and efficiency of our approach.

Birth oxidative stress and the development of an antioxidant system in newborn piglets

Birth oxidative stress is an oxidative response to a sudden transition process from maternal mediated respiration in uterus to autonomous pulmonary respiration outside the uterus. Meanwhile, oxidative stress has been demonstrated to be associated with various pathologies recorded in newborns. So, this research aimed to study the oxidative stress and the development of antioxidant system in newborn piglets. The measured variables include plasma lipid, protein and DNA oxidant injury, the activities of plasma antioxidant enzymes and the jejunal and ileal antioxidant gene expressions at 1, 7, 14, and 21 days after birth. Meanwhile, the nuclear factor erythroid 2-related factor 2 (Nrf2), transcription factor p65, and tumor protein 53 (p53) were determined by western blot. The results showed that newborn piglets suffered seriously from birth oxidative stress because of the naive antioxidant system. In addition, oxidant injury activated Nrf2 signaling pathway, resulting in the expression of antioxidant genes and release of antioxidant enzymes. With the development of antioxidant system, the oxidative balance gradually recovered on Day 7 after birth. In conclusion, birth caused oxidative stress and the oxidative balance gradually recovered with the development of antioxidant system.

Relationship between endothelial nitric oxide synthase gene polymorphisms and ischemic stroke: a meta-analysis

OBJECTIVES

Previous studies examining whether polymorphisms (G894T, 4b/a, and T786C) in the endothelial nitric oxide synthase (eNOS) gene are associated with ischemic stroke have yielded conflicting results. We performed a meta-analysis to investigate the potential association between these three eNOS gene polymorphisms and ischemic stroke risk.

MATERIALS AND METHODS

We searched databases until April 30, 2012 and used fixed or random effects models to estimate the pooled odds ratios (ORs).

RESULTS

We analyzed 34 case-control data sets from 33 publications involving 5261/5823 cases/controls for G894T, 4295/4682 for 4b/a, and 2698/3254 for T786C polymorphisms. For Asian populations, all models showed significantly increased risk of ischemic stroke for the G894T (dominant model: OR = 1.58; 95% CI, 1.30-1.91; P = 0.000) and 4b/a polymorphisms (dominant model: OR = 1.46; 95% CI, 1.25-1.71; P = 0.000), even after Bonferroni correction (because 0.000 < 0.017). In white populations, the aa genotype seemed to be protective for ischemic stroke, as indicated by the recessive model (OR = 0.44; 95% CI, 0.22-0.87; P = 0.019). In Asian populations, the T786C polymorphism was significantly associated with ischemic stroke, as found using the dominant (OR = 1.17; 95% CI, 1.02-1.34; P = 0.025) and additive models (OR = 1.18; 95% CI, 1.05-1.33; P = 0.006).

CONCLUSIONS

Our comprehensive meta-analysis ascertains that the G894T, 4b/a, and T786C polymorphisms are associated with ischemic stroke risk in Asians. A possible contrasting role of the 4b/a polymorphism in ischemic stroke was indicated in white populations.