Baicalin inhibits IL-1β-induced ferroptosis in human osteoarthritis chondrocytes by activating Nrf-2 signaling pathway

BACKGROUND

Osteoarthritis (OA) is a common degenerative disease involving articular cartilage, in which ferroptosis of chondrocytes plays an important role. Baicalin (BAI) exerts regulatory effects in a wide range of orthopedic diseases including OA, but its effect on ferroptosis of chondrocytes (CHs) is still unclear. The purpose of this study was to determine the effect of BAI on ferroptosis in human OA chondrocytes (OACs), and to explore its possible mechanism.

METHODS

CHs were treated with IL-1β (10 ng/mL) to simulate inflammation in vitro. Immunofluorescence, quantitative RT-PCR, Western blotting and cell viability assay were performed to evaluate the impacts of BAI on Fe2+ level, mitochondrial dysfunction, ferroptosis-related proteins, oxidative stress and cytotoxicity in CHs. Additionally, siRNA was made use of to knock out nuclear factor E2-related factor 2 (Nrf2) to analyze the role played by Nrf2 in BAI-induced CH ferroptosis.

RESULTS

BAI eliminated IL-1β-induced Fe2+ accumulation, changes in mitochondrial membrane potential and ferroptosis-related protein GPX4, SLC7A11, P53 and ACSL4 levels, as well as reactive oxygen species (ROS), lipid peroxidation (LPO) and malondialdehyde (MDA) accumulation in CHs. Besides, BAI reversed IL-1β-induced decrease of Collagen II and increase of MMP13 in CHs. Meanwhile, BAI attenuated IL-1β-induced CH toxicity and promoted Nrf2 antioxidant system activation. When Nrf2 was knocked down by siRNA, the effects of BAI on IL-1β-induced ferroptosis-related proteins and antioxidant stress in CHs were significantly weakened.

CONCLUSIONS

This study demonstrates that IL-1β can induce CH ferroptosis. BAI is able to inhibit IL-1β-induced CH ferroptosis and ECM degradation, and the specific mechanism may be that it can inhibit IL-1β-induced CH ferroptosis by activating Nrf2 antioxidant system to attenuate the accumulation of intracellular ROS and lipid ROS.

Under flooding conditions, controlled-release fertiliser coated microplastics affect the growth and accumulation of cadmium in rice by increasing the fluidity of cadmium and interfering with metabolic pathways

The combined pollution of microplastics (MPs) and Cd can affect plant growth and development and Cd accumulation, with most studies focusing on dryland soil. However, the effects of polyurethane (PU) controlled-release fertiliser coated MPs (PU MPs), which widely exist in rice systems, coupled with Cd on plant growth and Cd accumulation under flooding conditions are still unknown. Therefore, in the present study, in situ techniques were used to systematically study the effects of PU MPs and Cd coupling on the physiological and biochemical performance, metabolomics characteristics, rhizosphere bacterial community, and Cd bioavailability of rice in different soil types (red soil/cinnamon soil). The results showed that the effects of PU MPs on rice growth and Cd accumulation were concentration-dependent, especially in red soil. High PU concentration (1 %) inhibited rice root growth significantly (44 %). The addition of PU MPs inhibited photosynthetically active radiation, net photosynthesis, and transpiration rate of rice, mainly with low concentration (0.1 %) in red soil and high concentration (1 %) in cinnamon soil. PU MPs can enhance the expression of Cd resistance genes (cadC and copA) in soil, enhance the mobility of Cd, and affect the metabolic pathways of metabolites in the rhizosphere soil (red soil: fatty acid metabolism; cinnamon soil: amino acid degradation, heterobiodegradation, and nucleotide metabolism) to promote Cd absorption in rice. Especially in red soil, Cd accumulation in the root and aboveground parts of rice after the addition of high concentration PU (1 %) was 1.7 times and 1.3 times, respectively, that of the control (p < 0.05). Simultaneously, microorganisms can affect rice growth and Cd bioavailability by affecting functional bacteria related to carbon, iron, sulfur, and manganese. The results of the present study provide novel insights into the potential effects of PU MPs coupled with Cd on plants, rhizosphere bacterial communities, and Cd bioavailability.

Comparison of the clinical efficacy of three cannulated screws with parallel distribution and inverted triangular distribution in the treatment of femoral neck fractures in the elderly

The aim of the present study was to investigate the clinical efficacy of three cannulated screws with parallel distribution in comparison with the 'gold standard' of inverting three cannulated screws with triangular distribution, in the treatment of femoral neck fractures in the elderly. A total of 106 elderly patients with femoral neck fractures treated at the Department of Orthopedics of the First Affiliated Hospital of Nanjing Medical University (Jiangsu Provincial Hospital) from October 2018 to March 2020 were retrospectively analyzed and divided into groups A and B. Group A consisted of 51 patients with a mean age of 73.3±6.8 years; and group B consisted of 55 patients with a mean age of 74.5±7.3 years. Group A was treated with closed reduction + inverted triangular distribution of three cannulated screws, while group B was treated with closed reduction + parallel distribution of three cannulated screws, and the general surgical conditions, including fracture reduction quality, fracture healing, incidence of avascular necrosis of the femoral head, and functional recovery scale (FRS) score of hip joint function were assessed in both groups. All patients were followed up for an average of 14.8 months. Compared with group A, group B had significant advantages in operation time, number of times intraoperative fluoroscopy was performed, number of intraoperative guide wire adjustments, and proportion of postoperative referrals to the intensive care unit (P<0.05). There were no significant differences in fracture reduction quality, fracture healing, incidence of avascular necrosis of the femoral head, and FRS score of hip joint function between groups A and B (P>0.05). For elderly patients with femoral neck fractures, distributing three cannulated screws in parallel after closed reduction achieved similar clinical efficacy to 'gold standard' inverted triangular distribution, and had obvious advantages in operation time, with significantly reduced surgical difficulty. This procedure is therefore deemed worthy of promotion and clinical application in the primary hospitals of China.

Pretreatment fibrinogen levels are associated with survival outcome in patients with cancer using immunotherapy as a second‑line treatment

The present study aimed to investigate the predictive value of pretreatment fibrinogen (FIB) levels in patients with cancer who received immunotherapy as a second-line treatment. A total of 61 patients with stage III-IV cancer were included. The cut-off value of FIB for predicting overall survival (OS) was determined by receiver operating characteristic curve analysis. The prognostic value of pretreatment FIB on progression-free survival (PFS) and OS was determined by univariate and multivariate analyses. Based on a cut-off point of 3.47 g/l, patients were divided into low pretreatment FIB (<3.47 g/l) and high pretreatment FIB (≥3.47 g/l) groups. A high pretreatment FIB level was more common in older patients (P=0.03). Kaplan-Meier analysis showed that patients with high pretreatment FIB levels had shorter PFS and OS times than patients with low FIB levels (P<0.05). In multivariate analysis, pretreatment FIB was an independent prognostic factor for OS [hazard ratio (HR), 6.06; 95% CI, 2.01-18.28; P<0.01] and OS from the initiation of second-line treatment (HR, 3.69; 95% CI, 1.28-10.63; P=0.02). Overall, FIB is associated with survival outcome in patients with cancer who are administered immunotherapy as a second-line treatment.

Molecular mechanism of XB130 adaptor protein mediates trastuzumab resistance in gastric cancer

BACKGROUND

Recent studies have shown that the activation of PI3K/AKT signaling pathway is an essential molecular mechanism participating in trastuzumab resistance in HER2 + GC (gastric cancer). However, how can we effectively inhibit AKT activity associated with drug resistance during trastuzumab treatment? Screening inhibitors against the upstream receptors of PI3K/AKT signaling pathway or interacting proteins of members has become an important way.

METHODS

In this study, western blot, qRT-PCR, CCK8, Co-IP and other techniques were used to explore possible mechanisms participating in trastuzumab resistance in vitro. Besides, the xenograft mouse model and GC tissue samples from patients were used to further validate the in-vitro results.

RESULTS

The expression of XB130 adaptor protein was remarkably increased in GC cell lines resistant to trastuzumab, and knockdown of XB130 could reverse the resistance via downregulating p-AKT. In addition, p-SRC (Tyr416) was increased in resistant cells, which could facilitate the binding of XB130 to PI3K p85α. It was also discovered that XB130 could negatively regulate PTEN gene transcription, and thus a positive feedback loop was formed between SRC-XB130-PTEN.

CONCLUSIONS

In HER2 + GC, XB130 contributes to trastuzumab resistance by stimulating the PI3K/AKT signaling pathway through binding to PI3K p85α under the mediation of SRC kinase and regulating PTEN gene transcription, and in turn forming a positive feedback loop between SRC-XB130-PTEN.

The N6-methyladenosine METTL3 regulates tumorigenesis and glycolysis by mediating m6A methylation of the tumor suppressor LATS1 in breast cancer

BACKGROUND

Posttranscriptional modification of tumor-associated factors plays a pivotal role in breast cancer progression. However, the underlying mechanism remains unknown. M6A modifications in cancer cells are dynamic and reversible and have been found to impact tumor initiation and progression through various mechanisms. In this study, we explored the regulatory mechanism of breast cancer cell proliferation and metabolism through m6A methylation in the Hippo pathway.  METHODS: A combination of MeRIP-seq, RNA-seq and metabolomics-seq was utilized to reveal a map of m6A modifications in breast cancer tissues and cells. We conducted RNA pull-down assays, RIP-qPCR, MeRIP-qPCR, and RNA stability analysis to identify the relationship between m6A proteins and LATS1 in m6A regulation in breast cancer cells. The expression and biological functions of m6A proteins were confirmed in breast cancer cells in vitro and in vivo. Furthermore, we investigated the phosphorylation levels and localization of YAP/TAZ to reveal that the activity of the Hippo pathway was affected by m6A regulation of LATS1 in breast cancer cells.  RESULTS: We demonstrated that m6A regulation plays an important role in proliferation and glycolytic metabolism in breast cancer through the Hippo pathway factor, LATS1. METTL3 was identified as the m6A writer, with YTHDF2 as the reader protein of LATS1 mRNA, which plays a positive role in promoting both tumorigenesis and glycolysis in breast cancer. High levels of m6A modification were induced by METTL3 in LATS1 mRNA. YTHDF2 identified m6A sites in LATS1 mRNA and reduced its stability. Knockout of the protein expression of METTL3 or YTHDF2 increased the expression of LATS1 mRNA and suppressed breast cancer tumorigenesis by activating YAP/TAZ in the Hippo pathway.

CONCLUSIONS

In summary, we discovered that the METTL3-LATS1-YTHDF2 pathway plays an important role in the progression of breast cancer by activating YAP/TAZ in the Hippo pathway.

Soil bacterial community and metabolism showed a more sensitive response to PBAT biodegradable mulch residues than that of LDPE mulch residues

Biodegradable mulch film (BDM) is considered as an environmentally sustainable alternative to low density polyethylene (LDPE) mulch film. However, the low degradation rate of BDM resulted in residues in soil after service period which were similar to LDPE mulch film. Distinguishing the differential responses of crop growth, soil bacteria and metabolism to residues of BDM and LDPE mulch films is favourable for comparing the environmental toxicities of the two materials. The results indicated that emergence rate and yield of Chinese cabbage (Brassica campestris L. ssp. chinensis Makino) were significantly inhibited by two types mulch residues. BDM residues significantly decreased bacterial diversity by 1.2-2.3% through the enrichment of dominant phyla and inhibition of inferior phyla, while LDPE mulch residues not. The effects of BDM residues on soil metabolite spectrum were stronger than LDPE mulch residues with significant increase (3.9% 5.8%) in the abundance of total metabolites. Besides the pathways of metabolism, organismal systems, environmental information processing influenced by LDPE mulch resides, differential pathways including human diseases and cellular processes were also determined in soil with BDM residues. According to all the results of the present study, prior to the promotion of BDM, its influences on soil safety must be carefully investigated through critical and systematic research.

A nomogram integrating ferroptosis-and immune-related biomarker for prediction of prognosis and diagnosis in kidney renal clear cell carcinoma

OBJECTIVE

Approximately 60% of patients with kidney renal clear cell carcinoma (KIRC) die within the first 2-3 years. The prognosis for patients with KIRC and its metastases is poor. Ferroptosis and providing immunity are novel treatment targets for several cancers, including KIRC. Therefore, it is important to identify suitable ferroptosis- and immune-related signatures to predict the prognosis and diagnosis of patients with KIRC.

MATERIALS AND METHODS

The corresponding data of patients with KIRC were obtained from the Cancer Genome Atlas. Univariate and multivariate Cox regression analyses were used to screen candidate biomarkers in patients with KIRC.

RESULTS

We found that four FI-DEGs (BID, MET, LTB4R, and HMOX1) were independently associated with the overall survival of patients with KIRC. The prognosis and diagnosis model constructed using these four biomarkers could predict the outcome of KIRC, as measured by the receiver operating characteristic analyses.

CONCLUSIONS

We identified 4 FI-DEGs that could be used as biomarkers in patients with KIRC. The present study not only contributes to understanding the roles of ferroptosis and immunity in the development of KIRC, but also to the diagnosis and prognosis of KIRC, although it remains to be further studied.

Baseline serum uric acid level is associated with progression-free survival, disease control rate, and safety in postoperative patients with colorectal cancer treated by FOLFOX, FOLFIRI, or XELOX

Background

High serum uric acid (SUA) levels increase the risk of overall cancer morbidity and mortality, particularly for digestive malignancies. Nevertheless, the correlation between SUA level and clinical outcomes of the postoperative patients with colorectal cancer (CRC) treated by chemotherapy is unclear. This study aimed at exploring the relationship between baseline SUA level and progression-free survival (PFS), disease control rate (DCR), and safety in postoperative CRC patients receiving chemotherapy.

Patients and Methods

We conducted a retrospective study to evaluate the relationship between baseline SUA level and PFS, DCR, and incidence of serious adverse events of 736 postoperative CRC patients treated with FOLFOX, FOLFIRI or XELOX at our center.

Results

Data from our center suggested that high baseline SUA level is linked to poor PFS in non-metastatic CRC patients using FOLFOX (HR=2.59, 95%CI: 1.29-11.31, p=0.018) and in male patients using FOLFIRI (HR=3.77, 95%CI: 1.57-39.49, p=0.012). In patients treated by FOLFIRI, a high SUA is also linked to a low DCR (p=0.035). In patients using FOLFOX, high baseline SUA level is also linked to a high incidence of neutropenia (p=0.0037). For patients using XELOX, there is no significant correlation between SUA level and PFS, effectiveness, or safety.

Conclusions

These findings imply that a high SUA level is a promising biomarker associated with poor PFS, DCR and safety of postoperative CRC patients when treated with FOLFOX or FOLFIRI.

YAP knockdown in combination with ferroptosis induction increases the sensitivity of HOS human osteosarcoma cells to Pyropheophorbide-α methyl ester-mediated photodynamic therapy

BACKGROUND AND AIMS

This study was designed to explore the effects of Yes-associated protein (YAP) knockdown on human osteosarcoma (HOS) cell sensitivity to Pyropheophorbide-α methyl ester-mediated photodynamic therapy (MPPa-PDT), and to assess how YAP silencing in combination with treatment with the ferroptosis inducer Erastin improves HOS cell sensitivity to MPPa-PDT in an effort to better clarify the molecular mechanisms underlying these phenotypes.

METHODS

At 12 h post-MPPa-PDT, Hoechst staining and flow cytometry were conducted to evaluate the apoptotic death of HOS cells. The expression of YAP in these cells at 12 h post-MPPa-PDT treatment was assessed via Western blotting and immunofluorescent staining. BODIPY^581/591-C11 was used to evaluate lipid peroxidation. Following shYAP lentiviral transduction, Western blotting was conducted to assess the expression of proteins associated with proliferation, apoptosis, and ferroptosis. EdU assays and clonogenic assays were performed to analyze cellular proliferation. Erastin-treated HOS cells were used to establish a ferroptosis model. Western blotting was used to measure ferroptosis-associated protein levels following shYAP and erastin treatment, while changes in proliferation and MDA levels in each group were examined using an MDA kit.

RESULTS

At 12 h post-MPPa-PDT, HOS cells exhibited apoptotic characteristics including nuclear fragmentation and pyknosis, with concomitant increases in apoptosis-associated proteins as detected via Western blotting and apoptotic induction as measured via flow cytometry. Phosphorylated YAP levels fell and non-phosphorylated YAP levels rose following such treatment. Transfection with shYAP was successful as a means of generating stable HOS cell lines, and Western blotting analyses of these cells revealed reductions in proteins associated with cellular proliferation together with the upregulation of apoptosis-related proteins.  MDA assays indicated that erastin combined with YAP knockdown enhanced the sensitivity of HOS cells to MPPa-PDT treatment.

CONCLUSIONS

These data indicate that ferroptosis and YAP knockdown can enhance osteosarcoma cell sensitivity to MPPa-PDT therapy.

Exosomes derived from hypoxia preconditioned mesenchymal stem cells laden in a silk hydrogel promote cartilage regeneration via the miR-205-5p/PTEN/AKT pathway

Tissue engineering has promising prospects for cartilage regeneration. However, there remains an urgent need to harvest high quality seed cells. Bone marrow mesenchymal cells (BMSCs), and in particular their exosomes, might promote the function of articular chondrocytes (ACs) via paracrine mechanisms. Furthermore, preconditioned BMSCs could provide an enhanced therapeutic effect. BMSCs naturally exist in a relatively hypoxic environment (1%-5% O₂); however, they are usually cultured under higher oxygen concentrations (21% O₂). Herein, we hypothesized that hypoxia preconditioned exosomes (H-Exos) could improve the quality of ACs and be more conducive to cartilage repair. In our study, we compared the effects of exosomes derived from BMSCs preconditioned with hypoxia and normoxia (N-Exos) on ACs, demonstrating that H-Exos significantly promoted the proliferation, migration, anabolism and anti-inflammation effects of ACs. Furthermore, we confirmed that hypoxia preconditioning upregulated the expression of miR-205-5p in H-Exos, suggesting that ACs were promoted via the miR-205-5p/PTEN/AKT pathway. Finally, an injectable silk fibroin (SF) hydrogel containing ACs and H-Exos (SF/ACs/H-Exos) was utilized to repair cartilage defects and effectively promote cartilage regeneration in vivo. The application of SF/ACs/H-Exos hydrogel in cartilage regeneration therefore has promising prospects. STATEMENT OF SIGNIFICANCE: Cartilage tissue engineering (CTE) has presented a promising prospect. However, the quality of seed cells is an important factor affecting the repair efficiency. Our study demonstrates for the first time that the exosomes derived from hypoxia preconditioned BMSCs (H-Exos) effectively promote the proliferation, migration and anabolism of chondrocytes and inhibit inflammation through miR-205-5p/PTEN/AKT pathway. Furthermore, we fabricated an injectable silk fibrion (SF) hydrogel to preserve and sustained release H-Exos. A complex composed of SF hydrogel, H-Exos and chondrocytes can effectively promote the regeneration of cartilage defects. Therefore, this study demonstrates that hypoxia pretreatment could optimize the therapeutic effects of BMSCs-derived exosomes, and the combination of exosomes and SF hydrogel could be a promising therapeutic method for cartilage regeneration.

Overexpression of miR-328-5p influences cell growth and migration to promote NSCLC progression by targeting LOXL4

Background

Lung cancer is the leading cause of cancer-associated mortality worldwide, and most lung cancers are classified as non-small cell lung cancer (NSCLC). MiR-328 influence the progression of multiple tumors, but the role of miR-328-5p in NSCLC has not been elucidated. The aim of this study was to illuminate the oncogenic role and potential molecular mechanisms of the miR-328-5p and lysyl oxidase like 4 (LOXL4) in NSCLC.

Methods

Expression of miR-328-5p was detected by real-time quantitative polymerase chain reaction (qRT-PCR) in tumor and non-tumor adjacent tissues. After Lentivirus-miR-328-5p was employed to intervene this miRNA in NSCLC cell lines, RT-qPCR was used to detect the expression levels of miR-328-5p. Cell Counting Kit-8 (CCK-8), cell colony formation, flow cytometry, wound healing, Transwell assays were used to determine the malignant phenotypes of NSCLC cells. Nude mice models of subcutaneous tumors were established to observe the effect of miR-328-5p on tumorigenesis. Targeting the 3'UTR of LOXL4 by miR-328-5p was verified by integrated analysis including transcriptome sequencing, dual-luciferase and western-blot assays.

Results

High miR-328-5p level was observed in NSCLC cells from The Cancer Genome Atlas (TCGA) database and tumor tissues collected from NSCLC patients. Overexpressed miR-328-5p promoted NSCLC cell proliferation, survival, and migration, and promoted tumor growth in vivo. Knockdown of miR-328-5p suppressed tumorigenic activities. Transcriptome sequencing analysis revealed that LOXL4 was downregulated by miR-328-5p, which was confirmed by dual-luciferase reporter and western-blot assays.

Conclusions

miR-328-5p showed targeted regulation of LOXL4 to promote cell proliferation and migration in NSCLC.

The Mechanisms Responsible for N Deficiency in Well-Watered Wheat Under Elevated CO2

Elevated CO₂ concentration [e(CO₂)] often promotes plant growth with a decrease in tissue N concentration. In this study, three experiments, two under hydroponic and one in well-watered soil, including various levels or patterns of CO₂, humidity, and N supply were conducted on wheat (Triticum aestivum L.) to explore the mechanisms of e[CO₂]-induced N deficiency (ECIND). Under hydroponic conditions, N uptake remained constant even as transpiration was limited 40% by raising air relative humidity and only was reduced about 20% by supplying N during nighttime rather than daytime with a reduction of 85% in transpiration. Compared to ambient CO₂ concentration, whether under hydroponic or well-watered soil conditions, and whether transpiration was kept stable or decreased to 12%, e[CO₂] consistently led to more N uptake and higher biomass, while lower N concentration was observed in aboveground organs, especially leaves, as long as N supply was insufficient. These results show that, due to compensation caused by active uptake, N uptake can be uncoupled from water uptake under well-watered conditions, and changes in transpiration therefore do not account for ECIND. Similar or lower tissue NO 3 - -N concentration under e[CO₂] indicated that NO 3 - assimilation was not limited and could therefore also be eliminated as a major cause of ECIND under our conditions. Active uptake has the potential to bridge the gap between N taken up passively and plant demand, but is limited by the energy required to drive it. Compared to ambient CO₂ concentration, the increase in N uptake under e[CO₂] failed to match the increase of carbohydrates, leading to N dilution in plant tissues, the apparent dominant mechanism explaining ECIND. Lower N concentration in leaves rather than roots under e[CO₂] validated that ECIND was at least partially also related to changes in resource allocation, apparently to maintain root uptake activity and prevent more serious N deficiency.

External penetrating laryngeal trauma caused by a metal fragment: A Case Report

BACKGROUND

Although external penetrating laryngeal trauma is rare in the clinic, such cases often result in a high mortality rate. The early recognition of injury, protection of the airway, one-stage laryngeal reconstruction with miniplates and interdisciplinary cooperation are important in the treatment of such patients.

CASE SUMMARY

A 58-year-old male worker sustained a penetrating injury in the left neck. After computed tomography scanning at a local hospital, he was transferred to our hospital, where he underwent tracheotomy, neck exploration, extraction of the foreign object, debridement and repair of the thyroid cartilage using titanium miniplates. An endo laryngeal stent was inserted, which was removed 12 days later. The patient recovered well and his voice rapidly improved after surgery.

CONCLUSION

Penetrating laryngeal trauma is uncommon. We successfully treated a patient with early laryngeal reconstruction and management by interdisciplinary cooperation.

Understanding the Role of a Silane-Coupling Agent in Bio-Based Polyurethane Nanocomposite-Coated Fertilizers

Bio-based polyurethane (PU)-coated controlled release fertilizers are attracting a lot of attention; however, generally they have poor properties, so it is difficult for them to meet the agricultural needs. Herein, γ-aminopropyl triethoxy silane (KH550) was first used with nanosilica (NS) to prepare bio-based PU nanocomposite-coated urea (KSPCU). The coating microstructures and nutrient controlled release behaviors of KSPCU were investigated and compared with those of unmodified NS containing PU nanocomposite-coated urea (SPCU) and bio-based PU-coated urea (PCU). The KSPCU with KH550 exhibited an excellent controlled release performance. Its nutrient release longevity exceeded 105 d, which was nearly 6 times greater than that of PCU and 2 times more than that of SPCU, and it was much longer than that of PCU reported in previous research at a coating rate of 3 wt %. A series of characterization methods combined with water resistance capacity and porosity measurements confirmed that a hydrogen bond was formed by the reaction between the nanoparticle and PM200, the nanoparticle was bonded on the macromolecular chain, and KH550 in the coating increased the cross-linking degree, which were beneficial to slowing down the nutrient release of the KSPCU. The innovative application of KH550 on bio-based PU-coated fertilizers will provide a new coating technology for improving their controlled release property.

Protective effect of Qingre Huoxue decoction against myocardial infarction via PI3K/Akt autophagy pathway based on UPLC-MS, network pharmacology, and in vivo evidence

CONTEXT

Qingre Huoxue (QRHX) decoction, a traditional Chinese medicine, has been widely used to prevent and treat myocardial infarction (MI).

OBJECTIVE

This study elucidates the possible mechanisms of QRHX in preventing or treating MI in a rat model.

MATERIALS AND METHODS

The chemical constituents of QRHX were identified by UPLC-MS. Sprague-Dawley rats were randomly divided into the Sham (normal saline), Model (normal saline), QRHX-L, QRHX-M and QRHX-H group (n = 10 per group). QRHX decoction was administered by gavage to the rats for 14 days (5, 10 and 20 g/kg/day). The left anterior descending ligation method was performed to develop MI in Model and QRHX groups, and the same surgical procedures excluding ligation sutures were performed for the sham group. Finally, we evaluated cardiac function, myocardial fibrosis degree, serum inflammatory factors, autophagy levels and verified the signalling pathways in vivo.

RESULTS

A total of 68 active components of QRHX corresponding to 223 active targets were obtained and 2558 MI-related disease targets were collected. After integration, 123 QRHX anti-MI targets were obtained, and 70 signalling pathways, such as PI3K/Akt, were identified by enrichment analysis. In vivo experiments suggest that QRHX could reduce the degree of myocardial fibrosis, downregulate serum inflammatory factors, and promote autophagy in MI rats.

DISCUSSION AND CONCLUSIONS

QRHX plays a protective role in the myocardium by mediating PI3K/Akt signalling pathway to activate autophagy and inhibiting inflammatory factor expression. These findings provide a scientific basis for further research and validation of QRHX as a potential therapeutic for MI.

3D Bioprinting of Biomimetic Bilayered Scaffold Consisting of Decellularized Extracellular Matrix and Silk Fibroin for Osteochondral Repair

Recently, three-dimensional (3D) bioprinting technology is becoming an appealing approach for osteochondral repair. However, it is challenging to develop a bilayered scaffold with anisotropic structural properties to mimic a native osteochondral tissue. Herein, we developed a bioink consisting of decellularized extracellular matrix and silk fibroin to print the bilayered scaffold. The bilayered scaffold mimics the natural osteochondral tissue by controlling the composition, mechanical properties, and growth factor release in each layer of the scaffold. The in vitro results show that each layer of scaffolds had a suitable mechanical strength and degradation rate. Furthermore, the scaffolds encapsulating transforming growth factor-beta (TGF-β) and bone morphogenetic protein-2 (BMP-2) can act as a controlled release system and promote directed differentiation of bone marrow-derived mesenchymal stem cells. Furthermore, the in vivo experiments suggested that the scaffolds loaded with growth factors promoted osteochondral regeneration in the rabbit knee joint model. Consequently, the biomimetic bilayered scaffold loaded with TGF-β and BMP-2 would be a promising strategy for osteochondral repair.

Targeting X box-binding protein-1 (XBP1) enhances the sensitivity of HOS osteosarcoma cells to pyropheophorbide- α methyl ester-mediated photodynamic therapy

Photodynamic therapy (PDT), utilizes a photochemical reaction between photosensitizer and light to cause cancer death by generating reactive oxygen species (ROS). X-box binding protein 1 (XBP1), a downstream product of the IRE1α-XBP1 pathway, regulates diverse target genes, including various proto-oncogenes and its overexpression was closely related to the occurrence and progression of malignant tumors. The present study was performed to explore the role of XBP1 in human osteosarcoma HOS cells treated with pyropheophorbide-α methyl ester (MPPα)-mediated photodynamic therapy (PDT) (MPPα-PDT) and its potential mechanisms. The protein IRE1α and XBP1 increased with a time-dependent manner after MPPα-PDT treated, which indicated that MPPα-PDT induced the activation of the IRE1α-XBP1 pathway in HOS cells. Besides, MPPα-PDT treated alone or combined with XBP1 knockdown could both restrain the cell viability, but the latter one has more notable effect, which indicated that XBP1 knockdown may enhance the cell inhibitory effect by MPPα-PDT. Simultaneously, the apoptotic rate measured by flow cytometry (FCM) was increased surprisedly and the expression of apoptosis proteins was increased when knockdown XBP1 under the MPPα-PDT. In addition, antioxidant-related proteins such as the Catalase and SOD1 protein levels decreased, while the intracellular ROS content increased in HOS cells when knockdown XBP1 under the MPPα-PDT. These results suggested that the mechanism of XBP1 mediating resistance in HOS cells might be related to the expression of antioxidant molecules. In summary, this study found that the IRE1α-XBP1 pathway was activated in HOS cells after MPPα-PDT treated, and furthermore, XBP1 knockdown could decrease HOS cell viability through apoptosis and enhance the anti-tumor effect of MPPα-PDT remarkably in the meantime, which related to the regulation of oxidation-antioxidant system.

Intracortical screw insertion plus limited open reduction in treating type 31A3 irreducible intertrochanteric fractures in the elderly

BACKGROUND

In most elderly patients with intertrochanteric fractures, satisfactory fracture reduction can be achieved by closed reduction using a traction table. However, intertrochanteric fractures cannot achieve satisfactory reduction in a few patients, which is called irreducible intertrochanteric fractures. Especially for type 31A3 irreducible intertrochanteric fractures, limited open reduction of the broken end with different intraoperative reduction methods is required to achieve satisfactory reduction and fixation.

AIM

To discuss clinical efficacy of intracortical screw insertion plus limited open reduction in type 31A3 irreducible intertrochanteric fractures in the elderly.

METHODS

A retrospective analysis was performed on 23 elderly patients with type 31A3 irreducible intertrochanteric fractures (12 males and 11 females, aged 65-89-years-old) who received treatment at the orthopedics department. After type 31A3 irreducible intertrochanteric fractures were confirmed by intraoperative C-arm, all of these cases received intracortical screw insertion plus limited open reduction in the broken end with intramedullary screw internal fixation. The basic information of surgery, reduction effects, and functional recovery scores of the hip joint were assessed.

RESULTS

All patients were followed up for 13.8 mo on average. The operation time was 53.8 ± 13.6 min (40-95 min). The intraoperative blood loss was 218.5 ± 28.6 mL (170-320 mL). The average number of intraoperative X-rays was 22.8 ± 4.6 (18-33). The average time to fracture union was 4.8 ± 0.7 mo. The reduction effect was assessed using Kim’s fracture reduction evaluation. Twenty cases achieved grade I fracture reduction and three cases grade II fracture reduction. All of them achieved excellent or good fracture reduction. Upon the last follow-up, the functional recovery scores score was 83.6 ± 9.8, which was not significantly different from the functional recovery scores score (84.8 ± 10.7) before the fracture (t = 0.397, P = 0.694).

CONCLUSION

With careful preoperative preparation, intracortical screw insertion plus limited open reduction contributed to high-quality fracture reduction and fixation. Good clinical outcomes were achieved without increasing operation time and intraoperative blood loss.

Trelagliptin ameliorates IL-1β-impaired chondrocyte function via the AMPK/SOX-9 pathway

Chondrocyte dysregulation plays a critical role in the development of osteoarthritis (OA). The pro-inflammatory cytokine interleukin-1β (IL-1β) activates chondrocytes and degrades the structural extracellular matrix (ECM). These events are the important mechanism of OA. Trelagliptin, a selective inhibitor of dipeptidyl Peptidase 4 (DPP-4) used for the treatment of type 2 diabetes mellitus (T2DM), has displayed a wide range of anti-inflammatory capacities. The effects of Trelagliptin in OA and chondrocytes have not been tested before. Here, we show that Trelagliptin mitigates IL-1β-induced production of inflammatory cytokines such as interleukin 6 (IL-6), interleukin 8 (IL-8), and tumor necrosis factor-alpha (TNF-α) in human chondrocytes. Trelagliptin ameliorates IL-1β-induced oxidative stress by reducing the generation of reactive oxygen species (ROS). Particularly, the presence of Trelagliptin prevents IL-1β-induced reduction of Acan genes and the protein Aggrecan. Moreover, we show that Trelagliptin restores IL-1β-induced reduction of SOX-9 and that the knockdown of SOX-9 abolishes the protective effects of Trelagliptin. Mechanistically, we demonstrate that AMPK is required for the amelioration of Trelagliptin on SOX-9- reduction by IL-1β. Collectively, our study demonstrates that the DPP-4 inhibitor Trelagliptin has a protective effect on chondrocyte function. Trelagliptin may have the potential role to antagonize chondrocyte-derived inflammation in OA.

Targeting GRP78 enhances the sensitivity of HOS osteosarcoma cells to pyropheophorbide-α methyl ester-mediated photodynamic therapy via the Wnt/β-catenin signaling pathway

Photodynamic therapy (PDT), which is a new method for treating tumors, has been used in the treatment of cancer. In-depth research has shown that PDT cannot completely kill tumor cells, indicating that tumor cells are resistant to PDT. Glucose regulatory protein 78 (GRP78), which is a key regulator of endoplasmic reticulum stress, has been confirmed to be related to tumor resistance and recurrence, but there are relatively few studies on the further mechanism of GRP78 in PDT. Our experiment aimed to observe the role of GRP78 in HOS human osteosarcoma cells treated with pyropheophorbide-α methyl ester-mediated photodynamic therapy (MPPα-PDT) and to explore the possible mechanism by which the silencing of GRP78 expression enhances the sensitivity of HOS osteosarcoma cells to MPPα-PDT. HOS osteosarcoma cells were transfected with siRNA-GRP78. Apoptosis and reactive oxygen species (ROS) levels were detected by Hoechst staining and flow cytometry, cell viability was detected by Cell Counting Kit-8 assay, GRP78 protein fluorescence intensity was detected by immunofluorescence, and apoptosis-related proteins, cell proliferation-related proteins, and Wnt pathway-related proteins were detected by western blot. The results showed that MPPα-PDT can induce HOS cell apoptosis and increase GRP78 expression. After successful siRNA-GRP78 transfection, HOS cell proliferation was decreased, and apoptosis-related proteins expressions was increased, Wnt/β-catenin-related proteins expressions was decreased, and ROS levels was increased. In summary, siRNA-GRP78 enhances the sensitivity of HOS cells to MPPα-PDT, the mechanism may be related to inhibiting Wnt pathway activation and increasing ROS levels.

[Causes analysis of mastoid cavity infection after mastoidectomy and key techniques of revision mastoidectomy]

Objective:To analyze the causes of infected mastoid cavity after mastoidectomy and explore the key techniques of revision mastoidectomy. Methods:Ninety-two patients, who underwent revision mastoidectomy due to mastoid cavity infection after mastoidectomy were retrospectively analyzed. There were 56 cases of canal wall up mastoidectomy plus tympanoplasty and 36 cases of canal wall down mastoidectomy plus tympanoplasty in previous surgery. The interval between the previous operation and this revision ranged from 7 months to 50 years, with a median of 9 years. By reviewing the general clinical data, preoperative HRCT scan of temporal bone and intraoperative findings, the defects of the previous operation and the region of the lesion were analyzed and counted. Results:Out of the 92 cases, 7 cases（7.6%） had sigmoid sinus antedisplacement and low-lying middle cranial fossa, and 45 cases（48.9%） with facial nerve canal loss. Among the 36 patients who underwent canal wall down mastoidectomy and tympanoplasty, mastoid cells were removed in completely; 26 patients had high facial ridge, accounting for 72.2%（26/36）. The defects of the previous operation included: stenosis of external auditory meatus（65/92, 70.7%）, obstruction of Eustachian tube（11/92, 12.0%）, and tympanitis（2/92, 2.2%）. Residual or recurrent lesions were most common in mastoid process and tympanic sinus（50/92, 54.3%）, followed by attic cell and anterior cavity（44/92, 47.8%）, posterior tympanic cavity（29/92, 31.5%）, perilabyrinthine cells（13/92, 14.1%）, sinus meningeal angle（13/92, 14.1%）, cells behind the facial nerve（12/92, 13.0%）, Eustachian tube（10/92, 10.9%）, and hypotympanum（9/92, 9.8%）. Conclusion:The main causes of mastoid cavity infecion after mastoidectomy include incomplete removal of the lesion and inadequate drainage conditions. The key techniques of revisional mastoidectomy include disc-shaped operative cavity, skeletonization of mastoid process, reduction of facial nerve ridge, management of Eustachian tube and conchaplasty. The above techniques are also key in the first operation in order to improve the success rate of operation and avoid revision operation.

miR-301a-3p induced by endoplasmic reticulum stress mediates the occurrence and transmission of trastuzumab resistance in HER2-positive gastric cancer

Trastuzumab resistance negatively influences the clinical efficacy of the therapy for human epidermal growth factor receptor 2 (HER2) positive gastric cancer (GC), and the underlying mechanisms remain elusive. Exploring the mechanisms and finding effective approaches to address trastuzumab resistance are of great necessity. Here, we confirmed that endoplasmic reticulum (ER) stress-induced trastuzumab resistance by up-regulating miR-301a-3p in HER2-positive GC cells. Moreover, we elucidated that miR-301a-3p mediated trastuzumab resistance by down-regulating the expression of leucine-rich repeats and immunoglobulin-like domains containing protein 1 (LRIG1) and subsequently activating the expression of insulin-like growth factor 1 receptor (IGF-1R) and fibroblast growth factor receptor 1 (FGFR1) under ER stress. We also found that intercellular transfer of miR-301a-3p by exosomes disseminated trastuzumab resistance. The present study demonstrated that exosomal miR-301a-3p could serve as a non-invasive biomarker for trastuzumab resistance, which was maybe a novel potential therapeutic target to overcome trastuzumab resistance and improve the curative effect of trastuzumab in HER2-positive GC patients.

Cardiolipin-Dependent Mitophagy Guides Outcome after Traumatic Brain Injury

Mitochondrial energy production is essential for normal brain function. Traumatic brain injury (TBI) increases brain energy demands, results in the activation of mitochondrial respiration, associated with enhanced generation of reactive oxygen species. This chain of events triggers neuronal apoptosis via oxidation of a mitochondria-specific phospholipid, cardiolipin (CL). One pathway through which cells can avoid apoptosis is via elimination of damaged mitochondria by mitophagy. Previously, we showed that externalization of CL to the mitochondrial surface acts as an elimination signal in cells. Whether CL-mediated mitophagy occurs in vivo or its significance in the disease processes are not known. In this study, we showed that TBI leads to increased mitophagy in the human brain, which was also detected using TBI models in male rats. Knockdown of CL synthase, responsible for de novo synthesis of CL, or phospholipid scramblase-3, responsible for CL translocation to the outer mitochondrial membrane, significantly decreased TBI-induced mitophagy. Inhibition of mitochondrial clearance by 3-methyladenine, mdivi-1, or phospholipid scramblase-3 knockdown after TBI led to a worse outcome, suggesting that mitophagy is beneficial. Together, our findings indicate that TBI-induced mitophagy is an endogenous neuroprotective process that is directed by CL, which marks damaged mitochondria for elimination, thereby limiting neuronal death and behavioral deficits.SIGNIFICANCE STATEMENT Traumatic brain injury (TBI) increases energy demands leading to activation of mitochondrial respiration associated with enhanced generation of reactive oxygen species and resultant damage to mitochondria. We demonstrate that the complete elimination of irreparably damaged organelles via mitophagy is activated as an early response to TBI. This response includes translocation of mitochondria phospholipid cardiolipin from the inner membrane to the outer membrane where externalized cardiolipin mediates targeted protein light chain 3-mediated autophagy of damaged mitochondria. Our data on targeting phospholipid scramblase and cardiolipin synthase in genetically manipulated cells and animals strongly support the essential role of cardiolipin externalization mechanisms in the endogenous reparative plasticity of injured brain cells. Furthermore, successful execution and completion of mitophagy is beneficial in the context of preservation of cognitive functions after TBI.

A newly synthesized oleanolic acid derivative inhibits the growth of osteosarcoma cells in vitro and in vivo by decreasing c-MYC-dependent glycolysis

Osteosarcoma (OS) is the primary malignant bone tumor with a peak incidence in children and adolescents. However, the little molecular mechanism of pathogenesis has been known and it is urgent to develop new therapeutical strategies to improve outcomes for patients. CDDO-NFM (N-formylmorpholine substituent of CDDO) is a newly synthesized triterpenoid, which is a derivative of oleanolic acid. In this study, we explored whether CDDO-NFM possesses a potential antitumor effect and revealed its molecular mechanism. We found that CDDO-NFM efficiently inhibited cell growth of OS cells and this inhibitory effect was independent of apoptosis-related and cell-cycle-related proteins. CDDO-NFM could decrease the level of glucose uptake, the generation of lactate, and the production of adenosine triphosphate to block the process of glycolysis. In vitro and in vivo cell-based assays showed that CDDO-NFM inhibited glycolysis via degradation of c-MYC rather than activating peroxisome proliferator-activated receptor gamma. Finally, CDDO-NFM could reduce tumor volume and weight with low toxicity, and down-regulate the expression of glycolysis-related enzymes in nude mice. Taken together, these results showed that CDDO-NFM might be a promising antitumor compound.

[Clinicopathologic analysis of extranodal non-hodgkin lymphoma of the sinonasal cavities: a 15-case report]

Objective:To investigate the clinical manifestation, imaging and histological features of different histological subtypes of non-Hodgkin's lymphoma of nasal cavity and paranasal sinuses.Method:Fifteen NHL patients of the sinonasal region were collected from the Department of Otolaryngology of Peking University Third Hospital from 2010 to 2016. HE staining and immunohistochemical staining were performed. The clinical characteristics and imaging features of different subtypes were described and analyzed.Result::We analyzed a total of 6 patients with localized sinonasal diffuse large B cell lymphoma and 9 patients with localized sinonasal extranodal NK/T cell lymphoma. The age distribution for these two subtypes is very distinct. The median age of the patients with localized sinonasal extranodal NK/T cell lymphoma was 39 years. There were 5 males and 4 females. Nine sinonasal NHLs were NK/T-cell lymphoma, nasal type, all of which were infected with EBV. The median age of the patients with localized sinonasal diffuse large B cell lymphoma was 64 years. There were 3males and 3 females. Symptoms for patients with SN-DLBCL and SN-ENKTL were significantly different in epiphora, proptosis, diplopia and nasal congestion (P=0.18, 0.004, 0.18, 0.18). Imaging features for patients with SN-DLBCL and SN-ENKTL were significantly different in tumor extended to orbit and inferior turbinate (P>0.05). Positive staining for CD 56 was detected in 9 patients, for CD 3 in 9 patients, for EBER in 9 patients. The Hans algorithm identified 1 patient with the germinal center B-cell (GCB) subtype and 5 with the non-GCB subtype.Compared with the control group, the observation group was significantly better than the control group (P < 0.01).Conclusion:Early symptoms of epiphora, proptosis, diplopia, and images finding with orbital invasion should be highly suspected of diffuse large B cell lymphoma. Positive staining for CD 56 and EBER were detected in all patients with extranodal NK/T cell lymphoma, and positive staining for CD20 was detected in all patients with SN-DLBCL.

Application of Ilizarov transverse tibial bone transport and microcirculation reconstruction in the treatment of chronic ischemic diseases in lower limbs

The aim of the present study is to investigate the clinical value of Ilizarov transverse tibial bone transport and microcirculation reconstruction in the treatment of chronic ischemic diseases in lower limbs. A total of 90 patients with chronic ischemic diseases in lower limbs were selected and randomly divided into two groups: The observation group (n=45) and the control group (n=45). Those patients were treated with Ilizarov transverse tibial bone transport and microcirculation reconstruction, and percutaneous balloon angioplasty (PTBA), respectively. Changes in the diameter, blood flow of lower limb arteries in the paretic side, wound healing time, disappearance time of pains, dorsal foot skin temperature, and the expression area of vascular endothelial growth factors (VEGFs) were detected in both groups. Compared with control group, the diameters and blood flows of lower limb arteries were significantly larger (P<0.05), and the dorsal foot skin temperature was significantly higher at 1 day, 1 week and 1 month after operation, respectively. Meantime, the expression area of VEGFs in the observation group was significantly larger than that in the control group at 1 day, 1 week and 1 month, respectively. Furthermore, compared with control group, wound healing time and disappearance time of pains of patients were earlier in the observation group (P<0.05). At 1 month after operation, the intermittent claudication, rest pain and lower limb ulcer or gangrene among clinical symptoms of patients in the observation group improved significantly more than those in the control group (P<0.05). In conclusion, the application of Ilizarov transverse tibial bone transport and microcirculation reconstruction could achieve better outcomes in the treatment of chronic ischemic diseases in lower limbs.

AXL/AKT axis mediated-resistance to BRAF inhibitor depends on PTEN status in melanoma

Multiple genetic mutations within melanoma not only cause lesion-specific responses to targeted therapy but also alter the molecular route of resistance to that therapy. Inactivation of PTEN occurs in up to 30% of melanomas, frequently with a concurrent activating BRAF mutation. PTEN loss regulates both acquired and intrinsic drug resistance. Here we show that AXL/AKT axis mediated-resistance to BRAF inhibitor (BRAFi) depends upon PTEN status in melanoma. Hyperactivation of both ERK and AKT pathways was associated with BRAFi resistance in melanoma with wildtype PTEN. The PTEN-impaired melanoma cells required only the ERK resistance mechanism. Moreover, we identified AXL as a key upstream effector of AKT pathway-associated resistance to BRAFi in melanoma with wildtype PTEN, but not in melanoma with impaired PTEN. Notably, we confirmed that blocking AXL by shRNA and a small molecular inhibitor could rescue the sensitivity of resistant melanoma cells with wildtype PTEN to BRAFi and inhibit their growth in vitro and in vivo. Our study has uncovered a mechanism by which PTEN status contributes to acquired resistance to BRAFi and offers a rational strategy to guide clinical testing in pre-identified subsets of patients who relapse during treatment with BRAFi. The identified protein AXL represents a promising therapeutic target for BRAF mutant melanoma patients with wildtype PTEN.

Capture-based ultra-deep sequencing in plasma ctDNA reveals the resistance mechanism of ALK inhibitors in a patient with advanced ALK-positive NSCLC

BACKGROUND

Anaplastic lymphoma kinase (ALK) is a validated molecular target in non-small-cell lung cancer (NSCLC). However, the clinical benefits of ALK inhibitors are almost universally limited by the emergence of drug resistance.

METHODS

We monitored the plasma circulating tumor DNA (ctDNA) using captured-based ultra-deep sequencing analysis of one patient with metastatic ALK-positive NSCLC who had received therapies including first-, second- and third-generation ALK inhibitors. Functional in vitro studies were further undertaken to elucidate the mechanism of resistance.

RESULTS

ALK T1151Sins mutation was detected when the patient developed resistance to ceritinib, and undetectable when she responded to lorlatinib. MET amplification was present when the tumor developed resistance to lorlatinib, and reduced when the patient received combination therapy of lorlatinib with crizotinib, which corresponded to clinical radiologic responses. In addition, further functional in vitro studies demonstrated that ALK harboring the T1151Sins mutation, while conferring resistance to ceritinib, was inhibited by lorlatinib.

CONCLUSIONS

Clinical evidence and in vitro validation revealed the clinical usefulness of captured-base ultra-deep sequencing on longitudinal plasma ctDNA in revealing the underlying resistance mechanism and guiding the precise administration of ALK inhibitors in patients with advanced ALK-positive NSCLC.

Pretreatment blood neutrophil/lymphocyte ratio is associated with metastasis and predicts survival in patients with pancreatic cancer

BACKGROUND

The predictive value of systemic inflammatory markers has been explored in various types of cancer. In the present study, we aimed to investigate the association between pretreatment neutrophil/lymphocyte ratio (NLR) and tumor metastasis in pancreatic cancer, and the values of NLR as a prognostic factor of overall survival.

METHODS

Clinical and laboratory data from 256 consecutive pancreatic cancer patients were analyzed retrospectively. The NLR was recorded before treatment and analyzed along with clinicopathological characteristics and overall survival of pancreatic cancer patients.

RESULTS

Multivariate analysis revealed that pretreatment NLR (HR: 2.393; 95% CI: 1.326-4.320; P=0.004) was an independent risk factor for distant metastasis. Furthermore, COX regression analysis showed that in addition to pretreatment NLR (HR: 1.871; 95% CI: 1.413-2.477; P<0.001), metastasis and stage were independent prognostic factors.

CONCLUSION

Pretreatment NLR values were significantly associated with distant metastasis in pancreatic cancer patients. Higher NLR values were detected in metastatic disease and may be an independent prognostic factor of overall survival in pancreatic cancer patients.

Ezrin mediates both HGF/Met autocrine and non-autocrine signaling-induced metastasis in melanoma

Aberrant HGF/Met signaling promotes tumor migration, invasion, and metastasis through both autocrine and non-autocrine mechanisms; however, the molecular downstream signaling mechanisms by which HGF/Met induces metastasis are incompletely understood. We here report that Ezrin expression is stimulated by HGF and correlates with activated HGF/Met, indicating that HGF/Met signaling regulates the expression of Ezrin. We show that HGF/Met signaling activates the transcription factor Sp1 through the MAPK pathway, and activated Sp1 can in turn directly bind to the promoter of Ezrin gene and regulate its transcription. Notably, knockdown of Ezrin expression by shRNAs inhibits the metastasis induced by either HGF/Met autocrine or non-autocrine signaling in syngeneic wildtype and HGF transgenic mouse hosts. We also used small molecule drugs in preclinical mouse models to confirm that Ezrin is one of the downstream molecules mediating HGF/Met signaling-induced metastasis in melanoma. We conclude that Ezrin is a key downstream factor involved in the regulation of HGF/Met signaling-induced metastasis and demonstrate a link between Ezrin and HGF/Met/MAPK/Sp1 activation in the metastatic process. Our data indicate that Ezrin represents a promising therapeutic target for patients bearing tumors with activated HGF/Met signaling.

Characterizing roots and water uptake in a ground cover rice production system

Background and aims

Water-saving ground cover rice production systems (GCRPS) are gaining popularity in many parts of the world. We aimed to describe the characteristics of root growth, morphology, distribution, and water uptake for a GCRPS.

Methods

A traditional paddy rice production system (TPRPS) was compared with GCRPS in greenhouse and field experiments. In the greenhouse, GCRPS where root zone average soil water content was kept near saturation (GCRPS_sat), field capacity (GCRPS_fwc) and 80% field capacity (GCRPS_80%), were evaluated. In a two-year field experiment, GCRPS_sat and GCRPS_80% were applied.

Results

Similar results were found in greenhouse and field experiments. Before mid-tillering the upper soil temperature was higher for GCRPS, leading to enhanced root dry weight, length, surface area, specific root length, and smaller diameter of roots but lower water uptake rate per root length compared to TPRPS. In subsequent growth stages, the reduced soil water content under GCRPS caused that the preponderance of root growth under GCRPS_sat disappeared in comparison to TPRPS. Under other GCRPS treatments (GCRPS_fwc and GCRPS_80%), significant limitation on root growth, bigger root diameter and higher water uptake rate per root length were found.

Conclusions

Discrepancies in soil water and temperature between TPRPS and GCRPS caused adjustments to root growth, morphology, distribution and function. Even though drought stress was inevitable after mid-tillering under GCRPS, especially GCRPS_80%, similar or even enhanced root water uptake capacity in comparison to TPRPS might promote allocation of photosynthetic products to shoots and increase water productivity.

Improving rice production sustainability by reducing water demand and greenhouse gas emissions with biodegradable films

In China, rice production is facing unprecedented challenges, including the increasing demand, looming water crisis and on-going climate change. Thus, producing more rice at lower environmental cost is required for future development, i.e., the use of less water and the production of fewer greenhouse gas (GHG) per unit of rice. Ground cover rice production systems (GCRPSs) could potentially address these concerns, although no studies have systematically and simultaneously evaluated the benefits of GCRPS regarding yields and considering water use and GHG emissions. This study reports the results of a 2-year study comparing conventional paddy and various GCRPS practices. Relative to conventional paddy, GCRPSs had greater rice yields and nitrogen use efficiencies (8.5% and 70%, respectively), required less irrigation (−64%) and resulted in less total CH₄ and N₂O emissions (−54%). On average, annual emission factors of N₂O were 1.67% and 2.00% for conventional paddy and GCRPS, respectively. A cost-benefit analysis considering yields, GHG emissions, water demand and labor and mulching costs indicated GCRPSs are an environmentally and economically profitable technology. Furthermore, substituting the polyethylene film with a biodegradable film resulted in comparable benefits of yield and climate. Overall, GCRPSs, particularly with biodegradable films, provide a promising solution for farmers to secure or even increase yields while reducing the environmental footprint.

A new mechanism of trastuzumab resistance in gastric cancer: MACC1 promotes the Warburg effect via activation of the PI3K/AKT signaling pathway

Background

Trastuzumab, a humanized antibody targeting HER2, exhibits remarkable therapeutic efficacy against HER2-positive gastric cancer. However, recurrent therapeutic resistance presents revolutionary claims. Warburg effect and AKT signaling pathway was involved in the resistance to trastuzumab. Our previous studies have demonstrated that overexpression of metastasis associated with the colon cancer 1 (MACC1) predicted poor prognosis of GC and promoted tumor cells proliferation and invasion. In this study, we found that MACC1 was significantly upregulated in trastuzumab-resistant cell lines. Besides, downregulation of MACC1 reversed this resistance.

Methods

The effect of trastuzumab and glycolysis inhibitor combination on cell viability, apoptosis, and cell metabolism was investigated in vitro using established trastuzumab-resistant GC cell lines. We assessed the impact of trastuzumab combined with oxamate on tumor growth and metabolism in an established xenograft model of HER2-positive GC cell lines.

Results

Here, we found that MACC1 was significantly upregulated in trastuzumab-resistant cell lines. Besides, downregulation of MACC1 in trastuzumab-resistant cells reversed this resistance. Overexpression of MACC1-induced trastuzumab resistance, enhanced the Warburg effect, and activated the PI3K/AKT signaling pathway, while downregulation of MACC1 presented the opposite effects. Moreover, when the PI3K/AKT signaling pathway was inhibited, the effects of MACC1 on resistance and glycolysis were diminished. Our findings indicated that MACC1 promoted the Warburg effect mainly through the PI3K/AKT signaling pathway, which further enhanced GC cells trastuzumab resistance.

Conclusions

Our results indicate that co-targeting of HER2 and the Warburg effect reversed trastuzumab resistance in vitro and in vivo, suggesting that the combination might overcome trastuzumab resistance in MACC1-overexpressed, HER2-positive GC patients.

Electronic supplementary material

The online version of this article (doi:10.1186/s13045-016-0302-1) contains supplementary material, which is available to authorized users.

[Clinically predictive factors of Gleason score upgrading in patients after radical prostatectomy]

OBJECTIVE

To assess the discrepancy between preoperative needle biopsy (NB) Gleason score and pathological specimen Gleason score (GS) after radical prostatectomy, and to explore the risk factors of postoperative upgrading of GS.

METHODS

We retrospectively evaluated 160 patients who suffered from biopsy proved prostatic carcinoma and performed radical prostatectomy. Age of the patients was 57-82 years, with the average age of 71.6; prebiopsy prostate specific antigen (PSA) was 0.31-40.32 μg/L,with the average PSA of 11.29 μg/L; body mass index (BMI) was 16.41-32.04 kg/m², with the average BMI of 23.63 kg/m²; prostate volume (PV) was 9.52-148.46 mL, with the average PV of 40.19 mL. All the patients included in the study had complete information for clinical variables, including age, BMI, prebiopsy PSA level, PV, number of biopsy cores obtained, percentage, clinical stage, and biopsy GS. Grading of NB Gleason score was compared with their corresponding radical prostatectomy specimens, and the discrepancy between the NB and prostatectomy specimens GS assessed. Upgrading was defined as any increase in the pathological GS over that of the biopsy GS as a total sum of primary and secondary grades or a change in the order of primary and secondary grades towards higher ones. Univariable and multivariable Logistic regression analyses were used to identify predictors of pathological grading changes.

RESULTS

Of the 160 patients, the specimen GS was upgraded in 49 (30.6%) patients and remained with no change in 82 (51.3%) patients. Univariate and multivariate regression analysis showed that prostate volume and biopsy GS were independent predictors with postoperative upgrading of GS. Age, BMI, PSA before needle biopsy, clinical stage and needle number showed no statistical significance (P>0.05).

CONCLUSION

Lower biopsy GS and smaller prostate volume are increased risks for clinically upgrading of GS after radical prostatectomy. This fact should be kept in mind when deciding on therapy decisions for patients with prostate cancer.

The C-reactive protein/albumin ratio predicts overall survival of patients with advanced pancreatic cancer

Recent studies have demonstrated the prognostic value of the C-reactive protein/albumin (CRP/Alb) ratio in cancer. However, the role of the CRP/Alb ratio in advanced pancreatic cancer (PC) has not been examined. A retrospective study of 233 patients with advanced PC was conducted. We investigated the relationship between the CRP/Alb ratio, clinicopathological variables, and overall survival (OS). The optimal cutoff point of the CRP/Alb ratio was 0.54. A higher CRP/Alb ratio was significantly associated with an elevated neutrophil-lymphocyte ratio (NLR) (P < 0.001) and higher modified Glasgow prognostic score (mGPS) (P < 0.001). Using univariate analyses, we found that the age (P = 0.009), disease stage (P < 0.001), NLR (P < 0.001), mGPS (P < 0.001), and CRP/Alb ratio (P < 0.001) were significant predictors of OS. Patients with a higher CRP/Alb ratio had a worse OS than patients with a lower CRP/Alb ratio (hazard ratio (HR) 3.619; 95 % CI 2.681-4.886; P < 0.001). However, the CRP/Alb ratio was identified as the only inflammation-based parameter with an independent prognostic ability in the multivariate analyses (P < 0.001). The pretreatment CRP/Alb ratio is a superior prognostic and therapeutic predictor of OS in advanced PC.

[Correlation between cyclin-dependent kinase inhibitor p27kip1 and trastuzumab-resistance in gastric cancer]

OBJECTIVE

To investigate the correlation between cyclin-dependent kinase inhibitor p27kip1 and trastuzumab-resistance in gastric cancer.


METHODS

We selected HER2-overexpressed human gastric cancer cell line NCI-N87 to establish trastuzumab-resistant NCI-N87/TR cell line by stepwise exposure to different doses of trastuzumab. The 50% inhibitory concentration (IC(50)) of trastuzumab and resistance index (RI) were calculated or analyzed by MTT assay. The expression levels of cdk2 and p27kip1 were detected by Western blot. After the treatment with cdk2 inhibitor (Purvalanol A), the expression levels of relevant proteins in NCI-N87/TR cells were detected by Western blot, and the sensitivity to trastuzumab was analyzed by MTT assay. 


RESULTS

Compared with NCI-N87 cells, the expression of cdk2 was significantly increased in NCI-N87/TR cells (P<0.001), while the expression of p27kip1 showed a significant decrease (P<0.001). Restoration of the p27kip1 protein expression by cdk2 inhibitor (Purvalanol A) increased the sensitivity of NCI-N87/TR to trastuzumab.


CONCLUSION

Down-regulation of p27kip1 might be a mechanism for triggering trastuzumab resistance to gastric cancer cell line NCI-N87.

[Clinically predictive factors of Gleason score upgrading in patients after radical prostatectomy]

OBJECTIVE

To assess the discrepancy between preoperative needle biopsy (NB) Gleason score and pathological specimen Gleason score (GS) after radical prostatectomy, and to explore the risk factors of postoperative upgrading of GS.

METHODS

We retrospectively evaluated 160 patients who suffered from biopsy proved prostatic carcinoma and performed radical prostatectomy. Age of the patients was 57-82 years, with the average age of 71.6; prebiopsy prostate specific antigen (PSA) was 0.31-40.32 μg/L,with the average PSA of 11.29 μg/L; body mass index (BMI) was 16.41-32.04 kg/m(2), with the average BMI of 23.63 kg/m(2); prostate volume (PV) was 9.52-148.46 mL, with the average PV of 40.19 mL. All the patients included in the study had complete information for clinical variables, including age, BMI, prebiopsy PSA level, PV, number of biopsy cores obtained, percentage, clinical stage, and biopsy GS. Grading of NB Gleason score was compared with their corresponding radical prostatectomy specimens, and the discrepancy between the NB and prostatectomy specimens GS assessed. Upgrading was defined as any increase in the pathological GS over that of the biopsy GS as a total sum of primary and secondary grades or a change in the order of primary and secondary grades towards higher ones. Univariable and multivariable Logistic regression analyses were used to identify predictors of pathological grading changes.

RESULTS

Of the 160 patients, the specimen GS was upgraded in 49 (30.6%) patients and remained with no change in 82 (51.3%) patients. Univariate and multivariate regression analysis showed that prostate volume and biopsy GS were independent predictors with postoperative upgrading of GS. Age, BMI, PSA before needle biopsy, clinical stage and needle number showed no statistical significance (P>0.05).

CONCLUSION

Lower biopsy GS and smaller prostate volume are increased risks for clinically upgrading of GS after radical prostatectomy. This fact should be kept in mind when deciding on therapy decisions for patients with prostate cancer.

Development of trastuzumab-resistant human gastric carcinoma cell lines and mechanisms of drug resistance

Trastuzumab has been successfully employed for the treatment of Her-2-positive gastric cancer. However, there are problems with both primary and secondary resistance to trastuzumab. In this study, we employed the human gastric carcinoma cell line NCI-N87 with high Her-2 expression to create trastuzumab-resistant NCI-N87/TR cells by stepwise exposure to increasing doses of trastuzumab. Western blotting and Real-time PCR were conducted to detect protein and gene levels. Compared with NCI-N87 cells, the expression of P-IGF-1R and P-AKT proteins was significantly increased in NCI-N87/TR cells (both P = 0.000), while PTEN gene and protein expression showed a significant decrease (both P = 0.000). In addition, mutations of the PTEN gene were detected at exons 5, 7, and 8. The sensitivity of NCI-N87/TR cells to trastuzumab was increased by transfection with the PTEN gene, or by incubation with a PI3K inhibitor (LY294002) or an IGF-IR inhibitor (AG1024), as well as siRNA targeting PI3K p110 or IGF-1R. Taken together, our findings showed that activation of the PI3K-AKT signaling pathway was one of the major mechanisms leading to resistance of NCI-N87/TR gastric cancer cells to trastuzumab, which was probably associated with PTEN gene down-regulation and mutation, as well as with over-activity of the IGF-1R signaling pathway.

Effects of mesenchymal stem cells on interleukin-1β-treated chondrocytes and cartilage in a rat osteoarthritic model

In the present study, the effects and mechanisms of mesenchymal stem cells (MSCs) on interleukin (IL)-1β-stimulated rat chondrocytes, as well as cartilage from a rat model of osteoarthritis (OA) induced by anterior cruciate ligament transection and medial meniscectomy were investigated. Confluent rat chondrocytes were treated with IL-1β (10 ng/ml), then cultured indirectly with or without MSCs at a ratio of 2:1. Total RNA and protein were collected at various time-points, and western blot and reverse transcription-quantitative polymerase chain reaction analyses were used to investigate the expression of type II collagen (Col2), aggrecan, matrix metalloproteinase-13 (MMP-13) and cyclooxygenase-2 (COX-2). The activation of extracellular signal-regulated kinases 1/2 (ERK1/2), c-Jun N-terminal kinase (JNK), p38 mitogen-activated protein kinase (MAPK), nuclear factor-κB (NF-κB) p65 and inhibitory-κ-B-α (IκBα) were also assessed by western blotting. In addition, the in vivo effects of MSCs in a rat OA model were assessed by histology and western blot analysis. The results indicated that in vitro, IL-1β markedly upregulated the expression of MMP-13, COX-2, phosphorylated ERK1/2, JNK, p38 MAPK and NF-κB p65, and inhibited the expression of Col2, aggrecan and IκBα. Conversely, MSCs enhanced the expression of Col2, aggrecan and IκBα, and inhibited the expression of MMP-13 and NF-κB p65 in IL-1β-stimulated rat chondrocytes. In vivo histological and western blot analyses revealed analogous results to the in vitro findings. The results of the present study demonstrated that MSCs suppressed the inflammatory response and extracellular matrix degradation in IL-1β-induced rat chondrocytes, as well as cartilage in a osteoarthritic rat model, in part via the NF-κB signaling pathway.

Trichosporon asahii infection after total knee arthroplasty: A case report and review of the literature

Reports of fungal infection after total knee arthroplasty are extremely rare. In most reports, the infecting organism is a Candida species. The present report describes a case involving a 73-year-old immunocompetent woman who underwent total knee arthroplasty and presented one month later with signs of prosthetic infection. She underwent joint debridement and the fluid was sent for culture and sensitivity testing. The culture showed growth of Trichosporon asahii. The patient was administered intravenous and intra-articular injections of amphotericin B, followed by antifungal treatment with voriconazole for one year. At 26 months of follow-up, there was no evidence of infection and the patient was ambulating with a walker. To the authors' knowledge, the present case is the first report of T asahii infection following knee replacement. Early detection, prompt institution of the appropriate antibiotics and regular follow-up are recommended.

Utilizing tissue-engineered cartilage or BMNC-PLGA composites to fill empty spaces during autologous osteochondral mosaicplasty in porcine knees

The potential empty spaces between cylindrical plugs remaining after autologous osteochondral mosaicplasty rely on fibrous repair, which may constrain the quality and integrity of the repair. Thus, the empty spaces should be repaired, and how to fill the empty spaces is still a problem. In the present study, a standardized full-thickness defect (diameter, 6 mm) was created in the weight-bearing area of each medial femoral condyle in both knees of 18 miniature pigs. The 36 knees were randomly assigned to four groups with nine in each group. The defects were initially repaired by autologous osteochondral mosaicplasty. Simultaneously, any empty spaces between the multiple plugs were filled with cell-free poly(lactide-co-glycolide) (PLGA) scaffolds (the scaffold group), tissue-engineered cartilage (the TE group) or bone marrow mononuclear cell (BMNC)-PLGA composites (the composite group). The empty spaces were left untreated as control (the control group). Six months after surgery, the repair results were assessed via macroscopic observation, histological evaluation, magnetic resonance imaging, biomechanical assessment and glycosaminoglycan content. The results demonstrated that mosaicplasty combined with the treatment of the empty spaces could improve cartilage regeneration. The filling of empty spaces by tissue-engineered cartilage produced the best result in all the four groups. Meanwhile, utilizing BMNC-PLGA composites achieved a similar repair result. Considering the cost-effective, time-saving and convenient performance, the BMNC-PLGA composite could be an alternative option to fill the empty spaces combined with mosaicplasty. Copyright © 2014 John Wiley & Sons, Ltd.

Morphological MRI and T2 mapping of cartilage repair tissue after mosaicplasty with tissue-engineered cartilage in a pig model

The aim of this study was to evaluate the efficacy of mosaicplasty with tissue-engineered cartilage for the treatment of osteochondral defects in a pig model with advanced MR technique. Eight adolescent miniature pigs were used. The right knee underwent mosaicplasty with tissue-engineered cartilage for treatment of focal osteochondral defects, while the left knee was repaired via single mosaicplasty as controls. At 6, 12, 18 and 26 weeks after surgery, repair tissue was evaluated by magnetic resonance imaging (MRI) with the cartilage repair tissue (MOCART) scoring system and T2 mapping. Then, the results of MRI for 26 weeks were compared with findings of macroscopic and histologic studies. The MOCART scores showed that the repaired tissue of the tissue-engineered cartilage group was statistically better than that of controls (P < 0.001). A significant correlation was found between macroscopic and MOCART scores (P < 0.001). Comparable mean T2 values were found between adjacent cartilage and repair tissue in the experimental group (P > 0.05). For zonal T2 value evaluation, there were no significant zonal T2 differences for repair tissue in controls (P > 0.05). For the experimental group, zonal T2 variation was found in repair tissue (P < 0.05). MRI, macroscopy and histology showed better repair results and bony incorporation in mosaicplasty with the tissue-engineered cartilage group than those of the single mosaicplasty group. Mosaicplasty with the tissue-engineered cartilage is a promising approach to repair osteochodndral defects. Morphological MRI and T2 mapping provide a non-invasive method for monitoring the maturation and integration of cartilage repair tissue in vivo.