Inhibin A, activin A, placental growth factor and uterine artery Doppler pulsatility index in the prediction of pre-eclampsia

OBJECTIVES

To evaluate whether the measurement of maternal serum inhibin A, activin A and placental growth factor (PlGF) at 12 + 0 to 16 + 0 weeks of gestation alone or in combination with second-trimester uterine artery Doppler pulsatility index (PI) is useful in predicting pre-eclampsia.

METHODS

This was a case-control study of pre-eclampsia. From pregnant women attending their first antenatal examination at 12-16 weeks we collected serum samples and stored them at - 80 °C. All patients also underwent uterine artery Doppler examination to measure the PI at 22-24 weeks' gestation. We retrieved for analysis frozen samples from women who then developed pre-eclampsia, as well as three control samples per woman, matched for gestational age and storage time. Inhibin A, activin A and PlGF were measured using an enzyme-linked immunosorbent assay (ELISA) by an examiner who was blinded to the pregnancy outcome.

RESULTS

There were 31 cases with pre-eclampsia and 93 controls. Second-trimester uterine artery PI and marker levels were expressed as multiples of the median (MoM). The uterine artery PI was increased in pregnancies with pre-eclampsia compared with controls (mean ± SD, 1.45 ± 0.31 MoM vs. 1.02 ± 0.25 MoM, P < 0.001), as were the level of inhibin A (mean ± SD, 1.57 ± 0.34 MoM vs. 1.08 ± 0.43 MoM, P < 0.001) and the level of activin A (mean ± SD, 1.68 ± 0.38 MoM vs. 1.06 ± 0.42 MoM, P < 0.001). The level of PlGF was decreased in pre-eclampsia compared with controls (mean ± SD, 0.69 ± 0.23 MoM vs. 1.00 ± 0.26 MoM, P < 0.001). Receiver-operating characteristics curves were analyzed for controls and cases and areas under the curve (AUC) were 0.796 (95% CI, 0.712-0.880, P < 0.001) for inhibin A, 0.823 (95% CI, 0.746-0.899, P < 0.001) for activin A, 0.831 (95% CI, 0.752-0.910, P < 0.001) for PlGF and 0.851 (95% CI, 0.783-0.920, P < 0.001) for uterine artery PI. The combination of activin A, inhibin A and PI using logistic regression analysis yielded an AUC of 0.907 (95% CI, 0.830-0.938, P < 0.001) with a sensitivity of 87% and a specificity of 80%. The combination of activin A, PlGF and PI gave an AUC of 0.925 (95% CI, 0.852-0.978, P < 0.001) with a sensitivity of 90% and a specificity of 80%. Combining all four markers gave an AUC of 0.941 (95% CI, 0.891-0.990, P < 0.001) with a sensitivity of 93% and a specificity of 80%.

CONCLUSION

Early second-trimester serum inhibin A, activin A, PlGF and second-trimester uterine artery Doppler PI may add further information for the prediction of pre-eclampsia. The combination of the three serum markers and uterine artery Doppler PI has the highest prediction value for pre-eclampsia.

Effect of the traditional Chinese medicine tongxinluo on endothelial dysfunction rats studied by using urinary metabonomics based on liquid chromatography-mass spectrometry

A urinary metabonomic method based on ultra-fast liquid chromatography coupled with ion trap-time of flight mass spectrometry (UFLC/MS-IT-TOF) was employed to study the preventive efficacy and the metabolic changes caused by simavastatin and the traditional Chinese medicine tongxinluo in endothelial dysfunction rats. Principal component analysis (PCA) was applied to study metabolic patterns of endothelial dysfunction rats and healthy control rats. 1-Methyladenosine, indoxyl sulfate, hippuric acid, riboflavin, coproporphyrin, and p-cresol glucuronide were identified as potential biomarkers, indicating that pathways of adenine, tryptophan, phenylalanine, riboflavin and porphyrin metabolism were disturbed in endothelial dysfunction rats. Applications of simvastatin and tongxinluo to endothelial dysfunction rats improved endothelial function according to the results of histopathology and measurements of endothelin-1 and nitric oxide. Metabonomic studies suggested that tongxinluo prevents endothelial dysfunction by regulating multiple metabolic pathways to their normal state, whereas simvastatin only altered selected metabolic pathways. This research demonstrated that metabonomics is a powerful and promising tool for disease investigation and the efficacy evaluation of complex traditional Chinese medicines.

The effect of spatial resolution on wall shear stress measurements acquired using radial phase contrast magnetic resonance angiography in the middle cerebral arteries of healthy volunteers. Preliminary results

We have recently implemented radial phase-contrast techniques that allow high resolution angiograms with velocity information to be acquired within clinically-useful imaging times. 10 healthy volunteers were scanned using PC-VIPR and PC-SOS, two high resolution phase-contrast techniques at spatial resolutions of 0.67×0.67×0.67 mm(3) and 0.4×0.4×1 mm(3) respectively. The velocity measurements from the two acquisitions were imported into a custom Matlab runtime environment that automatically calculated WSS values using Green's Theorem and B-spline interpolation. Time average axial WSS was 1.069 N/m(2) (95% confidence interval: 0.8628< x < 1.276) in the left and right middle cerebral arteries of the 10 healthy volunteers (n=20) when scanned by PC-VIPR, and 1.670 N/m(2) when scanned by PC-SOS (95% confidence interval: 1.395 < x < 1.946). This difference in means was statistically significant (p < 0.002). Previous investigators have found that higher spatial resolution results in higher WSS measurements because smaller voxel size results in fewer partial volume effects. This was true in our study as well. In this study, we found that PC-SOS has significantly higher spatial resolution than PC-VIPR and this followed in the WSS measurements. Higher in-plane spatial resolution allows WSS calculations to be performed more accurately because of increased precision near the vessel boundary.

Purging efficacy of ZnPcH₁-based photodynamic therapy on chronic myeloid leukemia bone marrow

INTRODUCTION

Ex vivo purging is an emerging technique for successful transplantation of autologous hematopoietic stem cells in the treatment of leukemia. Among them, photodynamic therapy (PDT) might be a promising modality. The objective of this study was to evaluate the purging efficacy of ex vivo PDT on chronic myeloid leukemia (CML).

METHODS

A new amphiphilic mono-α-substituted zinc (II) phthalocyanine (ZnPcH₁) was used as a PDT photosensitizer. Nest reverse transcription polymerase chain reaction (RT-PCR) and real-time quantitative PCR of BCR/ABL1 fusion gene remained positive were performed to determine the purging effects of ZnPcH₁-PDT on the mixture of CML cell line K562 cells and normal bone marrow mononuclear cells (MNC) and on the CML cells from the bone marrow of patients with CML who had achieved complete hematology remission but whose BCR/ABL1 fusion genes remained positive.

RESULTS

CML cells exhibited higher susceptibility to ZnPcH₁-PDT than normal granulocyte/macrophage progenitors. PDT could eliminate K562 cells from K562-normal MNC mixture and the residual BCR/ABL1 positive CML cells from the bone marrow of patients with CML.

CONCLUSION

Our data suggest that ZnPcH₁-PDT may be a useful modality for purging CML cells for autologous grafts.

Bonding characters of Al-containing bulk metallic glasses studied by 27Al NMR

We report very small (27)Al metallic shifts in a series of Cu-Zr-Al bulk metallic glasses. This observation and the Korringa type of spin-lattice relaxation behavior suggest that s-character wavefunctions weakly participate in bonding and opens the possibility of enhanced covalency (pd hybridization) with increasing Al concentration, in good agreement with elastic constants and hardness measurements. Moreover, ab initio calculations show that this bonding character originates from the strong Al 3p band and Zr 4d band hybridization since their atomic energy levels are closer to each other while the Al 3s band is localized far below the Fermi level. This study might provide a chemical view for understanding flow and fracture mechanisms of these bulk glass-forming alloys.

Impact of lapatinib plus trastuzumab versus single-agent lapatinib on quality of life of patients with trastuzumab-refractory HER2+ metastatic breast cancer

BACKGROUND

Progression-free survival (PFS) was significantly longer for the lapatinib plus trastuzumab (L+T) arm than for L alone in a phase III, randomized, open-label study of women with human epidermal growth factor receptor 2 positive metastatic breast cancer who had documented progression on at least one T-containing regimen in the metastatic setting. This analysis focused on impact of treatments on health-related quality of life (HRQOL).

METHODS

HRQOL was assessed using the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire. Changes from baseline and time to deterioration were analyzed in the intent-to-treat population.

RESULTS

Differences between the treatment arms in adjusted mean change from baseline favored the L+T arm, ranging from 0.0 to 4.1 (FACT-B), 1.0-4.0 [Functional Assessment of Cancer Therapy-General (FACT-G)], and 0.5-2.7 (Trial Outcome Index). Most differences were not statistically significant, except for FACT-G at week 12 (delta = 4.0, P = 0.037). Similar results were found in a sensitivity analysis that included HRQOL records up to patient withdrawal from original randomized treatment. The longer time to HRQOL deterioration in the L+T arm was not statistically significant (FACT-B hazard ratio, 0.82; 95% confidence interval 0.56-1.20).

CONCLUSION

The addition of lapatinib to trastuzumab prolonged PFS while improving or maintaining near-term HRQOL, suggesting a meaningful clinical benefit to patients.

Identification and genetic effect of haplotypes in the promoter region of porcine myostatin gene

Myostatin plays a pivotal role in controlling skeletal muscle mass in mammals. Polymorphisms in its promoter region likely impact on transcription and production traits. In this study, haplotypes involving three polymorphic sites in the promoter region of the porcine myostatin gene, namely at sites 435, 447 and 879, were identified and their effect on production traits, gene expression as well as on skeletal muscle traits were analysed. Four haplotypes were revealed and the linkage disequilibrium and evolutionary relationship were assessed. The results revealed that haplotypes A, B and C are predominant in Yorkshire and Landrace, Duroc and two Chinese indigenous pig breeds (Laiwu and Dapulian) respectively. The genotypes are associated with body weight on day 21 (BW21), average daily gain from birth to day 21 (ADG1) and average daily gain from day 21 to day 70 (ADG2) (P < 0.05) in Duroc pigs. The activity of haplotype A (pGL3-A) is significantly higher than other constructs in driving reporter gene transcription (P < 0.01). As compared with CC animals, the myostatin mRNA level in BC animals is relatively lower in both semimembranosus (SM) and semitendinosus (ST) skeletal muscles, and the difference was significant in the SM muscle (P < 0.01). Moreover, the mRNA levels of MyHCI, MyHCIIa, MyHCIIb and MyHCIIx and the muscle fibre diameter and density were also compared between BC and CC animals.

Comparison of health care resource use before and after docetaxel treatment among prostate cancer patients

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Background: Docetaxel is standard of care among late-stage prostate cancer patients. We analyzed patterns of health care resource utilization (RU) among patients before and after exposure to docetaxel using a large commercial claims database.

Methods: A random sample of patients (N = 336) with a diagnosis of prostate cancer (ICD 9 code: 185.X) and a claim for docetaxel (2003–2009) was identified from the PharMetrics database, a nationally representative, non-payer-owned integrated commercial U.S. claims database. All patients had ≥ 12 months of enrollment prior to initiation of docetaxel. Patients were followed from their first docetaxel claim until lost to follow-up or June 30, 2009 (censored). RU was defined as all-cause hospitalization, ER, physician, and ambulatory visits. Incidence rates were derived.

Results: Mean age of patients was 67.9 years (SD 10.6); mean number of docetaxel prescriptions was 9.9 (SD 10.3). Mean time to study end/lost to follow-up was 15.41 (SD 12.49) months from the index date. The table shows health care RU for the 12 months before, and over the follow-up period after docetaxel initiation. Hospitalizations, ER, physician, and ambulatory visits were significantly higher in the follow-up period. The average length of hospital stay was significantly longer after docetaxel treatment (8.2 vs 5.5 days). Prior to docetaxel, two-thirds of the patients were on hormonal therapy; 51% on analgesics, and 31% on bisphosphonates. After docetaxel, the proportions were 62%, 58%, and 54%, respectively.

Conclusions: The significantly higher RU with disease progression in prostate cancer patients suggests a need for new treatment options that can effectively manage and improve patient outcomes.

[Table: see text]

[Table: see text]

The farther from town the lower the blood pressure: report from rural Yunnan province

BACKGROUND

Hypertension (HTN) is a major cause of death in Chinese farmers. Remoteness from population centers may independently affect HTN prevalence and severity.

METHODS

We used random cluster sampling to select 27 villages in Yunnan province, China. Within each village, we randomly selected 50-80 men and women between the ages of 50 and 70 years. A total of 1,177 participants underwent interviews and blood pressure (BP) measurement. We evaluated the relationship between BP and distance of the participants' village from the town and county centers with and without adjustment for covariates.

RESULTS

There was a significant (P < 0.001) inverse relationship between BP and distance from populations centers. For every 10 km from the town center, the mean systolic BP (SBP) in the village decreased by 1.2 mm Hg and the mean diastolic by 0.5 mm Hg. After adjustment for age, gender, ethnicity, body mass index, smoking, and drinking, we found that SBP decreased by 1.8 mm Hg (P = 0.03) and diastolic BP by 1.0 mm Hg (P = 0.02) for every 10 km distance from the town center.

CONCLUSIONS

HTN prevalence and severity are significantly linked to distance from population centers in rural Chinese farmers. The farther a farmer's village is from larger population centers, the greater is the probability that his/her BP will be normal. This relationship is independent of age, gender, ethnicity, body mass index, smoking, and alcohol use. Strategies in addressing HTN in rural regions should take account of this geographic dependence on distance from population centers.

Streptozotocin-induced diabetic rat-derived bone marrow mesenchymal stem cells have impaired abilities in proliferation, paracrine, antiapoptosis, and myogenic differentiation

BACKGROUND

Diabetes has been widely recognized as a major risk factor for cardiovascular disease. With the development of the regenerative medicine, autologous bone marrow-derived mesenchymal stem cells (BMSCs), transplantation can effectively improve cardiac function after myocardial infarction. However, the BMSCs used in most previous studies are derived from young or normal donors. Little is know about the biological characters change of BMSCs in diabetes mellitus.

METHODS

BMSCs were taken from the streptozotocin (STZ)-induced diabetic rats and normal control rats. Cell proliferation was evaluated by CCK-8 assay. Production of vascular endothelial growth factor (VEGF) and insulin-like growth factor (IGF)-1 were measured by enzyme-linked immunosorbent assay. Apoptosis under hypoxia and serum deprivation culture conditions were detected by Hoechst 33342 stain and flow cytometry. Myogenic differentiation, induced by 5-azacytidine was assessed by using immunocytochemical staining for the expression of sarcomeric α-actin and desmin.

RESULTS

Diabetic rat models were successfully induced by intraperitoneal injection of STZ. The proliferative abilities of BMSCs derived from diabetic rats decreased significantly compared with that from normal rats (P < .05). Similar results were also presented in the cytokines (VEGF and IGF-1) release (P = .02 and P < .01, respectively) that the ability of antiapoptosis and myogenic differentiation decreased obviously between diabetes group and the normal control group (P < .01).

CONCLUSION

BMSCs from STZ-induced diabetic rats could be successfully harvested and expanded in vitro culture condition; their morphology was very similar to normal control group, with minor changes. However, the proliferative and differentiation properties of diabetic BMSCs, as well as cytokine release and antiapoptosis ability, were significantly impaired.

Anthocyanin production as a potential visual selection marker during plant transformation

A mutant allele of the transcription factor gene MYB10 from apple induces anthocyanin production throughout the plant. This gene, including its upstream promoter, gene coding region and terminator sequence, was introduced into apple, strawberry and potato plants to determine whether it could be used as a visible selectable marker for plant transformation as an alternative to chemically selectable markers, such as kanamycin resistance. After transformation, red coloured calli, red shoots and red well-growing plants were scored. Red and green shoots were harvested from apple explants and examined for the presence of the MYB10 gene by PCR analysis. Red shoots of apple explants always contained the MYB10 gene but not all MYB10 containing shoots were red. Strawberry plants transformed with the MYB10 gene showed anthocyanin accumulation in leaves and roots. No visible accumulation of anthocyanin could be observed in potato plants grown in vitro, even the ones carrying the MYB10 gene. However, acid methanol extracts of potato shoots or roots carrying the MYB10 gene contained up to four times higher anthocyanin content than control plants. Therefore anthocyanin production as result of the apple MYB10 gene can be used as a selectable marker for apple, strawberry and potato transformation, replacing kanamycin resistance.

Electronic Structures of Single-Walled Carbon Nanotubes Studied by NMR

An individual single-walled carbon nanotube (SWNT) has been shown [1-4] to exhibit remarkable electronic properties which depend on its diameter and chirality. In this work, the 13C nuclear magnetic resonance technique is used to measure quantitatively the electronic density-of-state (DOS) at the Fermi level in a bulk SWNT sample. Two types of 13C nuclear spins are observed with drastically different nuclear spin-lattice relaxation time (Tl). About onethird of the 13C nuclear spins with shorter Tl, are identified to reside at the metallic SWNTs and two-thirds can be associated with the semiconducting SWNTs. For the metallic SWNTs, the DOS at the Feimi level is measured quantitatively, which is about 0.022 states/(eV·atom·spin). The measured electronic DOS at the Fermi level agrees with the theoretical prediction for metallic tubes. This study also found that the semiconducting SWNTs in bundles, in fact, possess weak metallic characters. This indicates that tube-tube interactions within SWNT bundles could change the electronic properties.

TRPV4 mutations and cytotoxic hypercalcemia in axonal Charcot-Marie-Tooth neuropathies

OBJECTIVE

To improve understanding of TRPV4-associated axonal Charcot-Marie-Tooth (CMT) neuropathy phenotypes and their debated pathologic mechanism.

METHODS

A total of 17 CMT2C phenotypic families with vocal cord and diaphragmatic involvement and 36 clinically undifferentiated CMT2 subjects underwent sequencing analysis of the coding region of TRPV4. Functional studies of mutant proteins were performed using transiently transfected cells for TRPV4 subcellular localization, basal and stimulated Ca(2+) channel analysis, and cell viability assay with or without channel blockade.

RESULTS

Two TRPV4 mutations R232C and R316H from 17 CMT2C families were identified in the ankyrin repeat domains. The R316H is a novel de novo mutation found in a patient with CMT2C phenotype. The family with R232C mutation had individuals with and without vocal cord and diaphragm involvement. Both mutant TRPV4 proteins had normal subcellular localization in HEK293 and HeLa cells. Cells transfected with R232C and R316H displayed increased intracellular Ca(2+) levels and reversible cell death by the TRPV channel antagonist, ruthenium red.

CONCLUSION

TRPV4 ankyrin domain alterations including a novel de novo mutation cause axonal CMT2. Individuals with the same mutation may have nondistinct CMT2 or have phenotypic CMT2C with vocal cord paresis. Reversible hypercalcemic gain-of-function of mutant TRPV4 instead of loss-of-function appears to be pathologically important. The reversibility of cell death by channel blockade provides an attractive area of investigation in consideration of treatable axonal degeneration.

Alterations of Serum Lipid and Inflammatory Cytokine Profiles in Patients with Coronary Heart Disease and Chronic Periodontitis: A Pilot Study

Serum lipid and inflammatory cytokine profiles were assessed in 124 in-patients with coronary heart disease (CHD) (CHD group) and 43 inpatients with no evidence of CHD (control group). In all patients, research questionnaires and examinations of periodontal health were conducted and venous blood samples were analysed. Both groups were divided into two subgroups according to the presence or absence of chronic periodontitis in individual patients. The prevalence of chronic periodontitis was higher in patients from the CHD group than in the control group. Levels of total cholesterol, triglycerides, low-density lipoprotein, oxidized low-density lipoprotein, high-sensitivity C-reactive protein, interleukin-6 and tumour necrosis factor-a were significantly higher in CHD patients with chronic periodontitis than in those without periodontitis. In conclusion, chronic periodontitis may be associated with CHD.