Effects of propofol and etomidate pretreatment on glucocorticoid receptor expression following induction of sepsis in rats

The aim of this study was to determine the effect of etomidate and propofol pretreatment on the expression of glucocorticoid receptor and the prognosis of sepsis. The sepsis rat was used as a model. During glucocorticoid treatment, etomidate and propofol were applied alone or together at different time points. Survival curves, glucocorticoid receptor expression in the rat adrenal cortex, and inflammation levels were determined. The outcome of sepsis in rats was evaluated based on the combined utilization of propofol and etomidate. The results indicated that the combined utilization of propofol and etomidate pretreatment could significantly improve the effects of glucocorticoids on rat sepsis. Etomidate was shown to enhance the expression of the glucocorticoid receptor, while propofol was shown to inhibit the inflammatory response. Etomidate was best used immediately after modeling, whereas propofol was most suitable for use during the peak inflammatory reaction. These results demonstrated that anesthetics had the ability to enhance the effect of glucocorticoids in the treatment of sepsis. Etomidate was indicated for use in the early stage of inflammation to enhance expression of the glucocorticoid receptor, while propofol application was indicated at the peak of the inflammatory reaction owing to its strong anti-inflammation effect.

Evaluation of the function status of the ulnar nerve in carpal tunnel syndrome

Many carpal tunnel syndrome (CTS) patients have symptoms in both the median and ulnar digits more frequently than in the median digits alone. This is possibly because of close anatomical contiguity of the carpal tunnel and Guyon's canal, and the high pressure may also affect the latter, causing indirect compression of ulnar nerve fibers. Thus, we evaluated the functional status of the ulnar nerve in patients with CTS in order to investigate the relationship between ulnar nerve impairment and sensory symptoms of the ulnar territory. Electrophysiological studies were conducted in CTS patients and healthy controls. CTS patients were divided into the mild/moderate group and severe group; they were further divided into the symptomatic and asymptomatic subgroups according to the sensory symptom of the fifth digit region. The findings suggest that CTS patients could have coexisting ulnar nerve wrist entrapments that might exacerbate the severity of CTS. Sensory impairment in the ulnar territory was observed more frequently in the mild/moderate stage of CTS, which is associated with ulnar nerve involvement. These findings also suggest that damage to the ulnar nerve fibers caused by compression forces in Guyon's canal may underlie the ulnar spread of symptoms in CTS.

Knockdown of H19 enhances differentiation capacity to epidermis of parthenogenetic embryonic stem cells

Parthenogenetic embryonic stem (pES) cells are pluripotent stem cells derived from artificially activated oocytes without embryo destruction, thus eliciting less ethic concerns, and have been demonstrated promising for autologous stem cell therapy. However, pES cells could carry inappropriate imprinting such as relatively high expression of H19, a paternal imprinted gene, and may negatively influence their lineage differentiation. We show that knockdown of H19 by shRNA in mouse pES cells does not alter self-renewal and expression of genes associated with pluripotency. We find that down-regulation of H19 promotes differentiation of pES cells to epidermis. In addition, H19 depletion also facilitates differentiation of pES cells to cardiomyocytes and strong heart-like beating. Our data support the notion that reduction of H19 improves pES cell differentiation in the lineages of ectoderm and mesoderm, and provide further evidence suggesting that defective imprinting can be manipulated to allow potential application of pES cells for stem cell therapy.

Effect of a pre-microRNA-149 (miR-149) genetic variation on the risk of ischemic stroke in a Chinese Han population

Clinical and experimental data have demonstrated that genetic factors play an important role in determining the susceptibility to ischemic stroke (IS). The present study was performed to clarify the association between the pre-microRNA-149 (miR-149) single nucleotide polymorphism rs71428439 and the risk of IS in the Jiangsu Han population. Polymerase chain reaction and restriction fragment length polymorphism were performed to identify the genotypes of the miR-149 single-nucleotide polymorphism rs71428439 in 730 unrelated subjects (IS, 348; healthy controls, 382). Plasma levels of homocysteine were determined using a radioassay kit. Compared to healthy controls, IS patients had a lower frequency of GG genotype distribution of the hsa-mir-149 polymorphism (11.5 vs 16.0%) and a higher frequency of TT (46.6 vs 39.0%). The risk of IS was significantly lower among subjects carrying the GG genotype than subjects carrying the AA genotype (odds ratio (95% confidence interval): 0.603 (0.382- 0.952), P = 0.030) or at least carrying the G allele than patients carrying the A allele (odds ratio (95% confidence interval): 0.769 (0.620-0.954), P = 0.019). Levels of folate were statistically higher in patients with the TT genotype (8.59 ± 7.75 ng/mL) than in those with the CC genotype (6.32 ± 5.97 ng/mL) in IS patients. Our results suggest that the miR- 149 single nucleotide polymorphism rs71428439 influences plasma levels of homocysteine and is associated with IS risk in the Jiangsu Han population.

Iatrogenic urological triggers of autonomic dysreflexia: a systematic review

STUDY DESIGN

This is a systematic review.

OBJECTIVE

The objective of this study was to review the literature on iatrogenic urological triggers of autonomic dysreflexia (AD).

SETTING

This study was conducted in an international setting.

METHODS

A systematic review was conducted from PubMed search using AD/ autonomic hyperreflexia and spinal cord injury (SCI). Studies selected for review involved iatrogenic urological triggers of AD in individuals with SCI, including original articles, previous practice guidelines, case reports and literature reviews. Studies that did not report AD or blood pressure (BP) assessments during urological procedures were excluded.

RESULTS

Forty studies were included for analysis and categorized into four groups: (1) urodynamics and cystometry; (2) cystoscopy and transurethral litholapaxy; (3) extracorporeal shock-wave lithotripsy (ESWL); and (4) other procedures. During urodynamics, the incidence of AD ranged from 36.7% to 77.8%. The symptomatic rate ranged from 50% to 65%, with AD symptoms seen predominantly in cervical SCI patients. The studies imply no consensus regarding the relationship between AD, neurogenic detrusor overactivity and detrusor sphincter dyssynergia. Without anesthesia, the majority of individuals develop AD during cystoscopy, transurethral litholapaxy and ESWL. The effectiveness of different anesthesia methods relies on blocking the nociceptive signals from the lower urinary tract (LUT) below the level of the neurological lesion. Other iatrogenic urological triggers were commonly associated with bladder filling.

CONCLUSION

The LUT triggers of episodes of AD are often associated with iatrogenic urological procedures. AD was more prevalent in cervical SCI than in thoracic SCI. To detect this potential life-threatening complication following cervical and high thoracic SCI, routine BP monitoring during urological procedures is highly recommended.

Identification and genetic mapping of the putative Thinopyrum intermedium-derived dominant powdery mildew resistance gene PmL962 on wheat chromosome arm 2BS

Powdery resistance putatively derived from Thinopyrum intermedium in the wheat line L962 is controlled by a single dominant gene designated PmL962 and mapped to chromosome arm 2BS. Powdery mildew, caused by Blumeria graminis f. sp. tritici (Bgt), is a destructive disease affecting the production of wheat (Triticum aestivum). Powdery mildew resistance was putatively transferred from Thinopyrum intermedium to the common wheat line L962, which conferred resistance to multiple Chinese Bgt isolates. Genetic analysis of the powdery mildew response was conducted by crossing the resistant line L962 with the susceptible line L983. Disease assessments of the F1, F2, and F2:3 populations from the cross L983/L962 indicated that resistance was controlled by a single dominant gene. A total of 373 F2:3 lines and 781 pairs of genomic simple sequence repeat (SSR) primers were employed to determine the chromosomal location of the resistance gene. The gene was linked to four publicly available and recently developed wheat genomic SSR markers and seven EST-STS markers. The resistance gene was mapped to chromosome arm 2BS based on the locations of the linked markers. Pedigree, molecular marker and resistance response data indicated that the powdery mildew resistance gene in L962 is novel. It was temporarily designated PmL962. It is flanked by Xwmc314 and BE443737at genetic distances of 2.09 and 3.74 cM, respectively, and located in a 20.77 cM interval that is co-linear with a 269.4 kb genomic region on chromosome 5 in Brachypodium distachyon and a 223.5 kb genomic region on rice (Oryza sativa) chromosome 4. The markers that are closely linked to this gene have potential applications in marker-assisted breeding.

MiR-34c suppresses tumor growth and metastasis in nasopharyngeal carcinoma by targeting MET

Our previous microarray analysis indicated that miR-34c was downregulated in nasopharyngeal carcinoma (NPC). However, little is known about the function and molecular mechanism of miR-34c in NPC. In this study, miR-34c was found to be significantly downregulated in NPC cell lines and clinical tissues. Ectopic expression of miR-34c suppressed NPC cell viability, colony formation, anchorage-independent growth, cell migration and invasion in vitro, and inhibited xenograft tumor growth and lung metastasis in vivo. MET proto-oncogene (MET) was identified as a direct target of miR-34c using luciferase reporter assays, quantitative RT-PCR, western blotting and immunofluorescent staining. Overexpression of miR-34c markedly reduced MET expression at both the mRNA and protein levels. Knockdown of MET suppressed NPC cell proliferation, migration and invasion, whereas the restoration of MET rescued the suppressive effects of miR-34c. The demethylation agent 5-aza-2′-deoxycytidine (DAC) restored the expression of miR-34c in NPC cell lines. The promoter region of miR-34c was hypermethylated in NPC cells. In conclusion, miR-34c suppresses tumor growth and metastasis in NPC by targeting MET. The newly identified miR-34c/MET pathway provides further insights into the development and progression of NPC, and may represent a novel therapeutic target for NPC treatment.

Upregulation of microRNA-200a associates with tumor proliferation, CSCs phenotype and chemosensitivity in ovarian cancer

Ovarian cancer is a lethal gynecologic malignancy and always has a poor prognosis. Despite new treatments modalities, the long term outcomes had not been significantly improved in the past 30 years. Although microRNA-200a (miR-200a) has been reported to be a prognostic marker in ovarian cancer, it's exact role in ovarian cancer remain unclear. In this study, we inserted the response element of miR-200a in ovarian cancer cell line via lentivirus-mediated transgene in vitro, and qRT-PCR (real time quantitative reverse transcription PCR) assay confirmed that miR-200a was up regulated compared with control. Then colony-formation assay, cell cycle analysis, CCK8 assays in vitro and xenograft experiments in vivo were performed and verified that miR-200a promoted proliferation, while blocked the formation of tumor spheroids and reduced the ratio of SP (side population) cells in ovarian cancer. Finally, we invalidated that miR-200a significantly enhanced the chemosensitivity of paclitaxel but not cisplatin in both adherent culture and sphere culture. Taken together, we demonstrated that upregulation miR-200a promoted proliferation and inhibited CSCs phenotype in OVCAR-3 ovarian cancer cell line, combined with cell cycle-targeting drug paclitaxel could effectively eliminate the "side effects" of proliferation, and showed evidences that this strategy may be promising for ovarian cancer treatment.

RTN4/Nogo is an independent prognostic marker for gastric cancer: preliminary results

OBJECTIVE

Gastric cancer is the fourth most common malignant cancer and is the second leading cause of cancer death worldwide. We evaluated the association of the immunohistochemical RTN4 expression with clinicopathological variables and patient outcome, and to evaluate its prognostic value.

PATIENTS AND METHODS

Histological samples from 95 primary gastric carcinoma patients were retrospectively studied with monoclonal antibody to RTN4.

RESULTS

Tumors with high RTN4 expression were found in 57.9% of patients. High RTN4 were associated with advanced stages (p = 0.0377) and different histology (p = 0.0030). In the overall population (median follow-up 42 months), patients with high RTN4 had shorter survival time than those with low RTN4 expression (p = 0.0119). In Cox multivariate analysis, high RTN4 (p = 0.0160) is an independent prognostic factor for overall survival of gastric cancer patients.

CONCLUSIONS

Our data suggest that RTN4 may contribute to the malignant progression of gastric cancer and serve as a novel prognostic indicator for gastric cancer patients.

Cytochalasin B inhibits the proliferation of human glioma U251 cells through cell cycle arrest and apoptosis

Cytochalasin B (CB) is known to inhibit a number of cancer types, but its effects on gliomas are unknown. We examined the in vitro effects of CB on the proliferation of human glioma U251 cells, as well as determined its mechanism of action. Cell proliferation was determined using CCK-8. The effect of CB on U251 cell morphology was observed under a transmission electron microscope. Cell cycle distribution was assessed using propidium iodine and Giemsa staining, and cell apoptosis was determined by annexin V-fluorescein isothiocyanate/propidium iodide. Cell cycle-related proteins were determined by Western blot. CB effectively inhibited U251 cell proliferation in a dose- and time-dependent manner. The 24, 48, 72, and 96 h IC50 values were 6.41 x 10(-2), 9.76 x 10(-4), 2.57 x 10(-5), and 2.08 x 10(-5) M, respectively. CB increased the proportion of cells in the G2/M phase in a dose-dependent manner, thus increasing the mitotic index and decreasing cdc2 and cyclin B1 protein levels. CB induced morphological changes in the cytoskeleton. Additionally, 10(-5) M CB induced apoptosis in 23.4 ± 0.5% of U251 cells (P < 0.05 vs control group). Caspase-3, -8, and -9 activities were increased after CB treatment. CB inhibited U251 glioma cell proliferation by damaging the microfilament structure. CB also induced glioma cell apoptosis, suggesting that it may be an effective therapeutic agent against gliomas.

Effect of miR-146a polymorphism on biochemical recurrence risk after radical prostatectomy in southern Chinese population

Evidence has shown that miR-146a is involved in carcinogenesis and a common G/C variant (rs2910164) in the pre-miR-146a gene has been found to be associated with various cancers. We investigated the potential prognostic role of miR-146a polymorphism in prostate cancer after radical prostatectomy. Seventy-two southern Chinese with prostate cancer undergoing radical prostatectomy were included in this study. miR-146a polymorphism was analyzed by PCR-RFLP. Its prognostic role in biochemical recurrence was assessed using Kaplan-Meier analysis and Cox regression model. We did not find a significant association between miR-146a polymorphism and prostrate-specific antigen failure in the Chinese population [HR (95%CI): 0.83 (0.30-2.32) for CC vs GG/GC]. However, high Gleason score (over 8) was associated with increased biochemical recurrence and poorer PSA-free survival. This study was limited by the length of follow-up. Future studies with longer follow-up would allow evaluation of more direct metrics, such as disease-specific survival, metastasis-free survival, and overall survival.

Health system costs for stage-specific breast cancer: a population-based approach

OBJECTIVE

The objective of the present analysis was to determine the publicly funded health care costs associated with the care of breast cancer (bca) patients by disease stage.

METHODS

Incident cases of female invasive bca (2005-2009) were extracted from the Ontario Cancer Registry and linked to administrative datasets from the publicly funded system. The type and use of health care services were stratified by disease stage over the first 2 years after diagnosis. Mean costs and costs by type of clinical resource used in the care of bca patients were compared with costs for a matched control group. The attributable cost for the 2-year time horizon was determined in 2008 Canadian dollars.

RESULTS

This cohort study involved 39,655 patients with bca and 190,520 control subjects. The average age in those groups was 61.1 and 60.9 years respectively. Most bca patients were classified as either stage i (34.4%) or stage ii (31.8%). Of the bca cohort, 8% died within the first 2 years after diagnosis. The overall mean cost per bca case from a public payer perspective in the first 2 years after diagnosis was $41,686. Over the 2-year time horizon, the mean cost increased by stage: i, $29,938; ii, $46,893; iii, $65,369; and iv, $66,627. The attributable cost of bca was $31,732. Cost drivers were cancer clinic visits, physician billings, and hospitalizations.

CONCLUSIONS

Costs of care increased by stage of bca. Cost drivers were cancer clinic visits, physician billings, and hospitalizations. These data will assist planning and decision-making for the use of limited health care resources.

The practice of spinal cord injury core data collection among Chinese physicians: a survey-based study

STUDY DESIGN

This is a survey-based study.

OBJECTIVE

To investigate the practice of spinal cord injury (SCI) core data collection by Chinese physicians to measure the extent and accuracy of routine collection of elements contained in the International Spinal Cord Injury Core Data Set (ISCICDS).

SETTING

This study was conducted in a workshop in Peking University, China.

METHODS

During an SCI workshop, a survey questionnaire was administered to 48 physicians from 20 provinces of China. The questions were developed on the basis of the data elements within the ISCICDS including the following issues: date of birth, injury, acute admission and inpatient discharge, total hospitalized days, gender, injury etiology, vertebral injury, associated injury, spinal surgery, ventilatory assistance and place of discharge. In addition, data collection practice on neurologic examinations including date, neurological level, injury severity and frequency of examination were involved.

RESULTS

The self-reported practice of data collection regarding date of birth, acute admission and inpatient discharge, gender, vertebral injury, associated injury, spinal surgery and frequency of neurological examination are consistent with the information in the ISCICDS among the majority (⩾76%) of physicians. However, only gender, vertebral injury, associated injury and spinal surgery are completely consistent. The consistency percentages of other data elements ranged from 39.5 to 66.8%.

CONCLUSION

Apart from four data elements, which were collected consistently with the intention in the ISCICDS, the collection of other core data elements need to be documented according to the guidelines included in the ISCICDS to ensure consistency of practice among Chinese physicians and to support worldwide comparison of SCI data.Suggestion:Only four data elements are collected in complete accordance with the ISCICDS by Chinese physicians. ISCICDS guidelines for the remaining elements need to be more rigorously adhered to in order to promote consistency and comparability of data.

Identification of the 2-tridecanone responsive region in the promoter of cytochrome P450 CYP6B6 of the cotton bollworm, Helicoverpa armigera (Lepidoptera: Noctuidae)

Eukaryote transcription is controlled by regulatory DNA sequences and transcription factors, so transcriptional control of gene plays a pivotal role in gene expression. In this study, we identified the region of the CYP6B6 gene promoter of Helicoverpa armigera which responds to the plant secondary toxicant 2-tridecanone. Transient transfection assay results from five of stepwise deletion fragments linked to the luciferase reporter gene revealed that the promoter activity of each CYP6B6 fragment was significantly higher than that of their basal activity after the Sf9 cells were treated with 2-tridecanone. Among all, the fragment spanning -373 to +405 bp of the CYP6B6 promoter showed an obviously 2-tridecanone inducibility (P<0.0001), which might have the 2-tridecanone responsive element based on promoter activity. Electrophoretic mobility shift assays revealed that the nuclear protein extracted from midgut of the 6th instar larva of H. armigera, reared on 10 mg 2-tridecanone per gram artificial diet for 48 h, could specifically bind to the active region from -373 to 21 bp of the CYP6B6 promoter. The combination feature also appeared when using a shorter fragment from -292 to -154 bp of the CYP6B6 promoter. Taken together, we found a 2-tridecanone core responsive region between -292 and -154 bp of the CYP6B6 promoter. This may lead us to a better understanding of transcriptional mechanism of P450 gene and provide very useful information for the pest control.

HbA1c levels as predictors of ablation outcome in type 2 diabetes mellitus and paroxysmal atrial fibrillation

AIMS

The aim of this study was to evaluate whether the levels of HbA1c could predict the outcome of ablation in patients with type 2 diabetes mellitus (T2DM) and paroxysmal atrial fibrillation (PAF).

PATIENTS AND METHODS

The study comprised 149 consecutive patients with T2DM and PAF who underwent their first circumferential pulmonary vein isolation. HbA1c levels were measured before ablation. Cox proportional hazards models were constructed to assess the relationship between HbA1c levels and the recurrence of atrial fibrillation (AF).

RESULTS

Of the 149 patients, 60 (40.3 %) developed AF recurrence after a median 12-month follow-up. Multivariate Cox regression analysis revealed that left atrium size and HbA1c were independent predictors of recurrent atrial tachyarrhythmia. Receiver operating characteristic analysis demonstrated that an HbA1c cut-off value of ≥ 6.9 % predicted recurrence with 55.0 % sensitivity and 67.4 % specificity (AUC = 0.634). The success rate of ablation was 69.0 % in patients with an HbA1c value of < 6.9 % compared with 46.8 % in those with an HbA1c value of ≥ 6.9 % (log-rank test, p = 0.004).

CONCLUSION

High levels of HbA1c were associated with an increased risk of recurrence of atrial tachyarrhythmia in patients with T2DM and PAF undergoing catheter ablation.

Downregulation of TIM-3 mRNA expression in peripheral blood mononuclear cells from patients with systemic lupus erythematosus

The T-cell immunoglobulin and mucin domain (TIM) family is associated with autoimmune diseases, but its expression level in the immune cells of systemic lupus erythematosus (SLE) patients is not known. The aim of this study was to investigate whether the expression of TIM-3 mRNA is associated with pathogenesis of SLE. Quantitative real-time reverse transcription-polymerase chain reaction analysis (qRT-PCR) was used to determine TIM-1, TIM-3, and TIM-4 mRNA expression in peripheral blood mononuclear cells (PBMCs) from 132 patients with SLE and 62 healthy controls. The PBMC surface protein expression of TIMs in PBMCs from 20 SLE patients and 15 healthy controls was assayed by flow cytometry. Only TIM-3 mRNA expression decreased significantly in SLE patients compared with healthy controls (P<0.001). No significant differences in TIM family protein expression were observed in leukocytes from SLE patients and healthy controls (P>0.05). SLE patients with lupus nephritis (LN) had a significantly lower expression of TIM-3 mRNA than those without LN (P=0.001). There was no significant difference in the expression of TIM-3 mRNA within different classes of LN (P>0.05). Correlation of TIM-3 mRNA expression with serum IgA was highly significant (r=0.425, P=0.004), but was weakly correlated with total serum protein (r_s=0.283, P=0.049) and serum albumin (r_s=0.297, P=0.047). TIM-3 mRNA expression was weakly correlated with the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI; r_s=-0.272, P=0.032). Our results suggest that below-normal expression of TIM-3 mRNA in PBMC may be involved in the pathogenesis of SLE.

Population-based utilization of radiation therapy by a Canadian breast cancer cohort

We examined trends in radiation therapy (rt) utilization by a population-based breast cancer cohort in Ontario. The provincial cancer registry provided a breast cancer cohort based on diagnosis dates from April 1, 2005, to March 31, 2010. Staging information was also available. The cohort was then linked, by encrypted health card number, to linkable administrative datasets, including rt utilization. The average age in the identified female breast cancer cohort (n = 39,656) was 61.6 ± 14.0 years. Almost two thirds of the patients (n = 25,225) received rt, and staging information was available for 22,988 patients (9541 stage i, 8516 stage ii, 4050 stage iii, and 881 stage iv). The average number of rt courses received by the patients was 1.4 ± 0.7 for stage i, 1.8 ± 1.1 for stage ii, 2.5 ± 1.3 for stage iii, and 2.8 ± 2.4 for stage iv. The ratio of conventional rt to intensity-modulated rt was 70.9%:16.6% for stage i, 71.6%:11.3% for stage ii, 74.6%:4.6% for stage iii, and 89.6%:2.2% for stage iv. From 2005 to 2010, almost two thirds of a Canadian female breast cancer cohort received rt, and the average number of courses increased with disease severity. A similar trend was observed with the type of rt (use of conventional rt increased with disease severity). The next step is to apply unit costs to the number of fractions and to obtain rt planning and radiation therapist times.

Mutation analysis and prenatal diagnosis for three families affected by isolated methylmalonic aciduria

Isolated methylmalonic acidemia (MMA) is a genetically heterogeneous disorder caused mainly by deficiency of methylmalonyl-CoA mutase. In the present study, we analyzed MUT gene mutations in 3 Chinese couples with a birth history of isolated MMA. We also provided prenatal diagnoses for the detected mutation. Exons and exon-intron boundaries of the MUT gene were analyzed by polymerase chain reaction and direct sequencing. Prenatal genetic diagnoses were performed by chorionic villus sampling after the genotypes of parents were determined. Six heterozygous mutations in the MUT gene were identified in the 3 families, including c.1880A>G (p.H627R) and IVS9-1G>A for family 1, c.1741C>T (p.R581X) and c.729insTT (p.D244fX39) for family 2, and c.616C>T (p.Q206X) and c.1280G>A (p.G427D) for family 3. Among these, c.616C>T (p.Q206X), c.1280G>A (p.G427D), IVS9-1G>A, and c.1741C>T (p.R581X) were novel mutations. These mutations were not detected in 100 normal controls. The fetus in pedigree 3 was free of the mutations carried by the parents, while the fetuses in pedigrees 1 and 2 were heterozygous mutation carriers. All 3 families decided to continue with their pregnancies and the neonates did not show any symptoms of MMA after birth. Our results indicated that mutations in the MUT gene are the primary cause of isolated MMA, and that most mutations were novel. For families with early-onset isolated MMA, direct sequencing of the MUT gene is crucial for genetic counseling, prenatal diagnosis, and identification of carriers.

Bioinformatics analysis of biomarkers and transcriptional factor motifs in Down syndrome

In this study, biomarkers and transcriptional factor motifs were identified in order to investigate the etiology and phenotypic severity of Down syndrome. GSE 1281, GSE 1611, and GSE 5390 were downloaded from the gene expression ominibus (GEO). A robust multiarray analysis (RMA) algorithm was applied to detect differentially expressed genes (DEGs). In order to screen for biological pathways and to interrogate the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway database, the database for annotation, visualization, and integrated discovery (DAVID) was used to carry out a gene ontology (GO) function enrichment for DEGs. Finally, a transcriptional regulatory network was constructed, and a hypergeometric distribution test was applied to select for significantly enriched transcriptional factor motifs. CBR1, DYRK1A, HMGN1, ITSN1, RCAN1, SON, TMEM50B, and TTC3 were each up-regulated two-fold in Down syndrome samples compared to normal samples; of these, SON and TTC3 were newly reported. CBR1, DYRK1A, HMGN1, ITSN1, RCAN1, SON, TMEM50B, and TTC3 were located on human chromosome 21 (mouse chromosome 16). The DEGs were significantly enriched in macromolecular complex subunit organization and focal adhesion pathways. Eleven significantly enriched transcription factor motifs (PAX5, EGR1, XBP1, SREBP1, OLF1, MZF1, NFY, NFKAPPAB, MYCMAX, NFE2, and RP58) were identified. The DEGs and transcription factor motifs identified in our study provide biomarkers for the understanding of Down syndrome pathogenesis and progression.

Correlation of coronary artery stenosis evaluation with left heart structure and function by multi-slice computed tomography

The aim of this study was to determine the impact of multi-slice computed tomography (MSCT) evaluation of coronary artery stenosis on left heart structure and systolic function. Coronary artery CT angiography was performed in 200 patients diagnosed with coronary heart disease, and then according to the AHA coronary artery 17-segment fractionation method, the Gensini score (GS) was determined for every narrow segment, and one-stop assessment of the correlation between left heart structure and function was performed. After the grouping of GS quartiles from low to high, there were differences between different patients with regard to LVDD, LADD, LVEDV, LVESV, MM, LVEF, and FS, while no difference in SV and CO. GS showed linear negative correlation with LVEF and FS, and linear positive correlation with LVDD, LADD, LVEDV, LVESV, and MM, while no correlation with SV and CO. That is, GS of coronary artery stenosis was negatively correlated with left ventricular systolic function and positively correlated with myocardial mass. The narrower the coronary artery, the worse the cardiac function and the higher the myocardial hypertrophy. Coronary artery stenosis was one of the important causes of the decrease in left ventricular systolic function and cardiac remodeling.

Regulation of tumor cell migration and invasion by the H19/let-7 axis is antagonized by metformin-induced DNA methylation

The imprinted, developmentally regulated H19 long noncoding RNA has been implicated in the pathogenesis of diverse human cancers, but the underlying mechanisms have remained poorly understood. Here, we report that H19 promotes tumor cell migration and invasion by inhibiting let-7, a potent tumor suppressor microRNA that functions to posttranscriptionally suppress the expression of oncogenes that regulate cell growth and motility. We show that H19 depletion impairs, whereas its overexpression enhances the motility and invasiveness of tumor cells. These phenomena occur, at least in part through affecting let-7-mediated regulation of metastasis-promoting genes, including Hmga2, c-Myc and Igf2bp3. This H19/let-7-dependent regulation is recapitulated in vivo where co-expressions of oncogenes and H19 exist in both primary human ovarian and endometrial cancers. Furthermore, we provide evidence that the anti-diabetic drug metformin inhibits tumor cell migration and invasion, partly by downregulating H19 via DNA methylation. Our results reveal a novel mechanism underpinning H19-mediated regulation in metastasis and may explain why in some cases increased let-7 expression unexpectedly correlates with poor prognosis, given the widely accepted role for let-7 as a tumor suppressor. Targeting this newly identified pathway might offer therapeutic opportunities.

Effect of xylanase on performance and apparent metabolisable energy in starter broilers fed diets containing one maize variety harvested in different regions of china

The objective of this study was to investigate the variability in broiler performance, apparent metabolisable energy (AME) and ileal digestible energy (IDE) between five different maize samples fed with and without xylanase at 16,000 U/kg. Various in vitro characterisations were conducted to determine if any could predict performance or AME. Samples of the maize were harvested in five diverse regions and fed individually in a mash diet as follows (g/kg): test maize 608.3; soya bean meal (SBM) 324.1; poultry fat 25.2; salt 4.6; met 2.6; lys 1.6; thr 0.5; limestone 9.7, dical 18.4; vit/min 5.0; CP 210 and ME (kcal/kg) 3,085. The diets were fed to 720 broilers with 6 replicates, each containing 12 birds per treatment, from 0 to 18 d of age. Maize samples were analysed for starch, protein, crude fibre, fat, protein solubility index (PSI) and vitreousness using near infra red reflectance spectroscopy (NIR). They were also assayed using an in vitro starch digestibility method. The results showed that there was no effect of harvest region on the feed intake (FI), body weight gain (BWG) or feed conversion ratio (FCR) of the broilers over the 18 d period (p = 0.959, 0.926, 0.819 respectively). There was an improvement in all parameters with the addition of xylanase (FI p = 0.011; BWG and FCR p<0.001). There was a significant positive effect of xylanase on IDE, AME, IDE Intake (IDEI) and AME intake (AMEI) (p<0.0001 in all cases). Although there was no significant effect of maize source, there was a strong trend towards variability in IDE (p = 0.066) and AME (p = 0.058). There were no significant correlations (p<0.05) between any proximate or physiochemical values and any performance or AME values. This may suggest that none of those selected were suitable predictors for performance or AME. The broilers performed well according to the breed guidelines, with slightly increased FI, increased BWG and similar FCR prior to the addition of xylanase. When FCR and BWG were analysed with FI as a covariate, xylanase addition remained significant suggesting that the improvement in BWG and FCR was driven by an increase in digestibility and nutrient availability.

First Report of Fusarium equiseti Causing a Sheath Rot of Corn in China

Corn is the most important cereal crop in China. Over 34.94 million ha of corn is cultivated in the country annually. However, fungal diseases are a major limiting factor in corn production. In August 2008, 50 ha in several corn fields in Liaoning, Jilin, and Heilongjiang provinces were observed to be severely affected by a disease causing a yield loss of 30%. Results from field surveys suggested an epidemic during late corn growth stages that affected corn sheaths, causing irregularly circular spots with grayish brown to dark brown lesions. Lesions ranged from 2.5 to 3 × 3 to 5 cm. To isolate the causal agent, tissue was removed from the border of lesions and surface sterilized in 75% ethanol for 30 sec and 0.1% HgCl₂ for 1 min. The sample was then triple rinsed in sterile distilled water. The isolate was purified and subcultured on potato dextrose agar (PDA) at 25 ± 2°C. The initial color of the mycelium was white, turning brown after being cultured for 7 days. A pale brown to dark brown pigment developed in the agar beneath the colony. Chlamydospores, solitary but also in short chains, measuring 7.2 to 15.3 μm, were produced on carnation leaf agar (CLA) after 10 days and became verrucose 20 days later. Macroconidia were produced on CLA in orange sporodochia from monophialides on branched conidiophores, usually 5- to 7-septate, and apical cells were tapered and elongate. Basal cells were prominent, foot-shaped, and elongated in appearance. Microconidia were not observed (1). These morphological characteristics matched the description of Fusarium equiseti reported by Leslie and Summerell (1). A pathogenicity test was conducted with an isolate from each of the 36 corn plants by spraying 2 ml of spore suspension (10⁶ conidia/ml) on 45-day-old corn sheaths (cv. Huang Zao). For the control treatment, 36 corn plants were sprayed with an equal volume of sterilized water. Inoculated plants were placed in a greenhouse at 32 to 34°C and 95% relative humidity. Typical irregularly circular lesions were observed 7 days after inoculation, except in the control samples. Each treatment was replicated three times. The suspected pathogen was consistently re-isolated from diseased tissue according to Koch's postulates, and was found to be morphologically similar to F. equiseti. Preliminary morphological identification of the fungus was confirmed by a PCR assay using genomic DNA extracted from the mycelia of a 7-day-old culture on PDA at 25 ± 2°C. A 750-bp amplified region of the transcription elongation factor (TEF) of rDNA was generated using TEF1 (5'-ATGGGTAAGGAGGACAAGAC-3') and TEF2 (5'-GGAAGTACCAGTGATCATGTT-3') primers. The TEF region (GenBank Accession No. KF754798) was sequenced by Sangon Biotech Co., Ltd. (Shanghai, China) and displayed 99% nucleotide similarity with the rDNA-TEF of F. equiseti (JN127347.1) separately after a BLASTn search in GenBank. Based on the symptoms, fungal morphology, TEF sequence, and pathogenicity testing, this fungus was identified as F. equiseti. To our knowledge, this is the first report of F. equiseti on corn sheaths in China. This report will establish a foundation for further study of F. equiseti to address the disease effectively and to determine the severity of damage caused by F. equiseti. Reference: (1) J. F. Leslie and B. A. Summerell. The Fusarium Laboratory Manual. Blackwell, Ames, IA, 2006.

Benzo(a)pyrene-7,8-diol-9,10-epoxide induced p53-independent necrosis via the mitochondria-associated pathway involving Bax and Bak activation

Benzo(a)pyrene-7,8-diol-9,10-epoxide (BPDE) is a highly reactive DNA damage agent and can induce cell death through both p53-independent and -dependent pathways. However, little is known about the molecular mechanisms of p53-independent pathways in BPDE-induced cell death. To understand the p53-independent mechanisms, we have now examined BPDE-induced cytotoxicity in p53-deficient baby mouse kidney (BMK) cells. The results showed that BPDE could induce Bax and Bak activation, cytochrome c release, caspases activation, and necrotic cell death in the BMK cells. Bax and Bak, two key molecules of mitochondrial permeability transition pore, were interdependently activated by BPDE, with Bax and Bak translocation to and Bax/Bak homo-oligomerization in mitochondria, release of cytochrome c was induced. Importantly, cytochrome c release and necrotic cell death were diminished in BMK cells (Bax−/−), BMK cells (Bak−/−), and BMK cells (Bax−/−/Bak−/−). Furthermore, overexpression of Bcl-2 could ameliorate BPDE-induced cytochrome c release and necrosis. Together the findings suggested that BPDE-induced necrosis was modulated by the p53-independent pathway, which was related to the translocation of Bax and Bak to mitochondria, release of cytochrome c, and activation of caspases.

A polymorphism in melanoma differentiation-associated gene 5 may be a risk factor for enterovirus 71 infection

Enterovirus 71 (EV71) infection has a wide variety of clinical manifestations, from no symptoms to fatal disease. Host immune response may be a determinant of disease severity. We investigated the association of polymorphisms in three pattern recognition receptor (PRR) genes-toll-like receptor 3 (TLR3) (rs3775291), retinoic acid-inducible gene I (RIG-I) (rs10813831) and melanoma differentiation-associated gene 5 (MDA5) (rs1990760)-with the severity of EV71 infection. Polymorphisms of candidate genes in 87 EV71-infected patients and 57 asymptomatic controls were detected. Binary logistic regression analysis revealed statistically significant differences in polymorphism of MDA5 (rs1990760) between patients with severe EV71 infection and asymptomatic controls in an additive model (OR 0.424, 95% CI 0.213-0.845, p 0.015) and a dominant model (OR 0.256, 95% CI 0.103-0.635, p 0.003). Polymorphism of MDA5 (rs1990760) (OR 0.399, 95% CI 0.199-0.798, p 0.009) was found to be associated with the severity of EV71 infection with the analysis of ordinal logistic regression. These results indicated the association between MDA5 (rs1990760) polymorphism and an increased risk of a severe EV71 infection in Chinese children, which offers potential for investigating the innate immune mechanism of EV71 infection and identifying at-risk infants, for whom a preventive strategy may reduce the severity of EV71 infection.

An electronic alert for HIV screening in the emergency department increases screening but not the diagnosis of HIV

OBJECTIVE

Based on US. Centers for Disease Control and Prevention recommendations, New York State enacted legislation in 2010 requiring healthcare providers to offer non-targeted human immunodeficiency virus (HIV) testing to all patients aged 13-64. Three New York City adult emergency departments implemented an electronic alert that required clinicians to document whether an HIV test was offered before discharging a patient. The purpose of this study was to assess the impact of the electronic alert on HIV testing rates and diagnosis of HIV positive individuals.

METHODS

During the pre-intervention period (2.5-4 months), an electronic "HIV Testing" order set was available for clinicians to order a test or document a reason for not offering the test (e.g., patient is not conscious). An electronic alert was then added to enforce completion of the order set, effectively preventing ED discharge until an HIV test was offered to the patient. We analyzed data from 79,786 visits, measuring HIV testing and detection rates during the pre-intervention period and during the six months following the implementation of the alert.

RESULTS

The percentage of visits where an HIV test was performed increased from 5.4% in the preintervention period to 8.7% (p<0.001) after the electronic alert. After the implementation of the electronic alert, there was a 61% increase in HIV tests performed per visit. However, the percentage of patients testing positive per total patients-tested was slightly lower in the post-intervention group than the pre-intervention group (0.48% vs. 0.55%), but this was not significant. The number of patients-testing positive per total-patient visit was higher in the post-intervention group (0.04% vs. 0.03%).

CONCLUSIONS

An electronic alert which enforced non-targeted screening was effective at increasing HIV testing rates but did not significantly increase the detection of persons living with HIV. The impact of this electronic alert on healthcare costs and quality of care merits further examination.

A sense inventory for clinical abbreviations and acronyms created using clinical notes and medical dictionary resources

OBJECTIVE

To create a sense inventory of abbreviations and acronyms from clinical texts.

METHODS

The most frequently occurring abbreviations and acronyms from 352,267 dictated clinical notes were used to create a clinical sense inventory. Senses of each abbreviation and acronym were manually annotated from 500 random instances and lexically matched with long forms within the Unified Medical Language System (UMLS V.2011AB), Another Database of Abbreviations in Medline (ADAM), and Stedman's Dictionary, Medical Abbreviations, Acronyms & Symbols, 4th edition (Stedman's). Redundant long forms were merged after they were lexically normalized using Lexical Variant Generation (LVG).

RESULTS

The clinical sense inventory was found to have skewed sense distributions, practice-specific senses, and incorrect uses. Of 440 abbreviations and acronyms analyzed in this study, 949 long forms were identified in clinical notes. This set was mapped to 17,359, 5233, and 4879 long forms in UMLS, ADAM, and Stedman's, respectively. After merging long forms, only 2.3% matched across all medical resources. The UMLS, ADAM, and Stedman's covered 5.7%, 8.4%, and 11% of the merged clinical long forms, respectively. The sense inventory of clinical abbreviations and acronyms and anonymized datasets generated from this study are available for public use at http://www.bmhi.umn.edu/ihi/research/nlpie/resources/index.htm ('Sense Inventories', website).

CONCLUSIONS

Clinical sense inventories of abbreviations and acronyms created using clinical notes and medical dictionary resources demonstrate challenges with term coverage and resource integration. Further work is needed to help with standardizing abbreviations and acronyms in clinical care and biomedicine to facilitate automated processes such as text-mining and information extraction.