Gut microbially produced tryptophan metabolite melatonin ameliorates osteoporosis via modulating SCFA and TMAO metabolism

Osteoporosis (OP) is a severe global health issue that has significant implications for productivity and human lifespan. Gut microbiota dysbiosis has been demonstrated to be closely associated with OP progression. Melatonin (MLT) is an important endogenous hormone that modulates bone metabolism, maintains bone homeostasis, and improves OP progression. Multiple studies indicated that MLT participates in the regulation of intestinal microbiota and gut barrier function. However, the promising effects of gut microbiota-derived MLT in OP remain unclear. Here, we found that OP resulted in intestinal tryptophan disorder and decreased the production of gut microbiota-derived MLT, while administration with MLT could mitigate OP-related clinical symptoms and reverse gut microbiota dysbiosis, including the diversity of intestinal microbiota, the relative abundance of many probiotics such as Allobaculum and Parasutterella, and metabolic function of intestinal flora such as amino acid metabolism, nucleotide metabolism, and energy metabolism. Notably, MLT significantly increased the production of short-chain fatty acids and decreased trimethylamine N-oxide-related metabolites. Importantly, MLT could modulate the dynamic balance of M1/M2 macrophages, reduce the serum levels of pro-inflammatory cytokines, and restore gut-barrier function. Taken together, our results highlighted the important roles of gut microbially derived MLT in OP progression via the "gut-bone" axis associated with SCFA metabolism, which may provide novel insight into the development of MLT as a promising drug for treating OP.

Prediction of Radiomics-Based Machine Learning for Specific Dosimetric Verification of Pelvic Intensity Modulated Radiotherapy

PURPOSE/OBJECTIVE(S)

To establish the different machine learning classification predict models of gamma pass rates for specific dosimetric verification of pelvic intensity modulated radiotherapy plan which based on the radiomic features and to explore the best prediction model.

MATERIALS/METHODS

Retrospective analysis of the 3D dosimetric verification results based on measurements with gamma pass rate criteria of 3%/2 mm and 10% dose threshold of 196 pelvic intensity-modulated radiotherapy plans was carried. Prediction models were established by extracting radiomic features data. Four machine learning algorithms, random forest, support vector machine, adaptive boosting and gradient boosting decision trees, were used to calculate the AUC value, sensitivity and specificity respectively. The classification performance of the four prediction models were evaluated.

RESULTS

The sensitivity and specificity of the random forest, support vector machine, adaptive boosting, and gradient boosting decision trees models were 0.93,0.85,0.93,0.96, and 0.38,0.69,0.46, and 0.46, respectively. The AUC values for the random forest model and the adaptive boosting model were 0.81 and 0.82, respectively, and the AUC values for the support vector machine and gradient boosting decision tree models were 0.87.

CONCLUSION

Machine learning methods based on radiomics can be used to establish a prediction model of gamma pass rate for specific dosimetric verification of pelvic intensity modulated radiotherapy. The classification performance of support vector machine model and gradient boosting decision trees model is better than that of random forest model and adaptive boosting model. The prediction model for a specific site is helpful to improve the performance of the model.

B-Cell-Derived TGF-β1 Inhibits Osteogenesis and Contributes to Bone Loss in Periodontitis

B cells play a vital role in the elimination of periodontal pathogens, the regulation of the immune response, and the induction of tissue destruction. However, the role of B cells in the dysfunction of mesenchymal stem cell (MSC) differentiation to osteoblasts in periodontitis (PD) has been poorly studied. Here we show that the frequency of CD45^-CD105⁺CD73⁺ MSCs in inflamed periodontal tissues is significantly decreased in patients with PD compared with that of healthy controls. CD19⁺ B cells dominate the infiltrated immune cells in periodontal tissues of patients with PD. Besides, B-cell depletion therapy reduces the alveolar bone loss in a ligature-induced murine PD model. B cells from PD mice express a high level of TGF-β1 and inhibit osteoblast differentiation by upregulating p-Smad2/3 expression and downregulating Runx2 expression. The inhibitory effect of PD B cells on osteoblast differentiation is reduced by TGF-β1 neutralization or Smad2/3 inhibitor. Importantly, B-cell-specific knockout of TGF-β1 in PD mice significantly increases the number of CD45^-CD105⁺Sca1⁺ MSCs, ALP-positive osteoblast activity, and alveolar bone volume but decreases TRAP-positive osteoclast activity compared with that from control littermates. Lastly, CD19⁺CD27⁺CD38^- memory B cells dominate the B-cell infiltrates in periodontal tissues from both patients with PD and patients with PD after initial periodontal therapy. Memory B cells in periodontal tissues of patients with PD express a high level of TGF-β1 and inhibit MSC differentiation to osteoblasts. Thus, TGF-β1 produced by B cells may contribute to alveolar bone loss in periodontitis, in part, by suppressing osteoblast activity.

Oxidative Stress and Gut Microbiome in Inflammatory Skin Diseases

Oxidative stress plays a dominant role in inflammatory skin diseases. Emerging evidence has shown that the close interaction occurred between oxidative stress and the gut microbiome. Overall, in this review, we have summarized the impact of oxidative stress and gut microbiome during the progression and treatment for inflammatory skin diseases, the interactions between gut dysbiosis and redox imbalance, and discussed the potential possible role of oxidative stress in the gut-skin axis. In addition, we have also elucidated the promising gut microbiome/redox-targeted therapeutic strategies for inflammatory skin diseases.

Metabolomics Signature and Potential Application of Serum Polyunsaturated Fatty Acids Metabolism in Patients With Vitiligo

Vitiligo is a depigmented skin disorder caused by a variety of factors, including autoimmune, metabolic disturbance or their combined effect, etc. Non-targeted metabolomic analyses have denoted that dysregulated fatty acids metabolic pathways are involved in the pathogenesis of vitiligo. However, the exact category of fatty acids that participate in vitiligo development and how they functionally affect CD8⁺ T cells remain undefined. We aimed to determine the difference in specific fatty acids among vitiligo patients and healthy individuals and to investigate their association with clinical features in patients with vitiligo. Serum levels of fatty acids in 48 vitiligo patients and 28 healthy individuals were quantified by performing ultra-performance liquid chromatography-tandem mass spectrometry. Univariate and multivariate analyses were carried out to evaluate the significance of differences. Moreover, flow cytometry was used to explore the effect of indicated fatty acids on the function of CD8⁺ T cells derived from patients with vitiligo. We demonstrated that serological level of alpha-linolenic acid (ALA) was markedly upregulated, while that of arachidonic acid (ARA), arachidic acid (AA) and behenic acid were significantly downregulated in patients with vitiligo. Moreover, ALA levels were positively associated with vitiligo area scoring index (VASI) and ARA was a probable biomarker for vitiligo. We also revealed that supplementation with ARA or nordihydroguaiaretic acid (NDGA) could suppress the function of CD8⁺ T cells. Our results showed that vitiligo serum has disorder-specific phenotype profiles of fatty acids described by dysregulated metabolism of polyunsaturated fatty acids. Supplementation with ARA or NDGA might promote vitiligo treatment. These findings provide novel insights into vitiligo pathogenesis that might add to therapeutic options.

Sentinel lymph node biopsy with carbon nanoparticle suspension after neoadjuvant chemotherapy for breast cancer patients

INTRODUCTION

The aim of the study was to explore the feasibility of performing sentinel lymph node biopsy (SLNB) using a carbon nanoparticle suspension (CNPS) after neoadjuvant chemotherapy in breast cancer patients.

METHODS

Some 152 patients diagnosed with primary breast cancer (cT1-3N0-2M0) were recruited. Patients were divided into two groups according to axillary lymph node (ALN) status after four to six cycles of neoadjuvant chemotherapy. All patients received a CNPS injection, after which SLNB and axillary lymph node dissection (ALND) were performed.

RESULTS

Sentinel lymph nodes (SLN) of 143 patients were identified; with an accuracy rate of 94.4% and a false-negative rate of 9.9%. Group A included 67 patients, and the detection, accuracy and false-negative rates within this group were 95.5%, 96.9% and 6.7%, respectively. The corresponding rates for group B (85 patients) were 92.9%, 92.4% and 11.8%, respectively.

CONCLUSIONS

CNPS is an ideal tracer for improving the detection rate of SLN and can be used to determine SLN status following neoadjuvant chemotherapy.

Factors associated with Scrub Typhus infection: A case-control study from Luhe, China

INTRODUCTION

Scrub typhus (ST) is an acute febrile infection and remains a significant health problem globally. This study aimed to determine the factors associated with ST infection in Luhe District, China.

MATERIAL AND METHODS

The case-control study was conducted among 116 cases identified through passive surveillance systems over three years.The control subjects were 232 living in the same village for more than six months without any history of ST infection were selected by matching to the age (within 5-years) and identified through active surveillance. Statistical analyses were performed using SPSS v. 25.0 for Windows (IBM SPSS, Chicago, IL, USA).

RESULTS

The mean age of confirmed persons was 58.1(SD=10.15) years, while control subjects were 56.14 (11.57).There is no significant difference in gender, age, education, and occupations between case and control. Farmers had the most significant number of cases among occupational groups. The three factors that were significantly associated with an increased odds of having ST infection are bundling or moving waste straw (OR: 1.94, 95%CI; 0.99,381), morning exercise in the park or field (OR: 4.74 95%CI; 1.19, 18.95), and working as labourer in the vegetable field (OR:1.02, 95%CI:1.02,3.19).

CONCLUSIONS

Our findings suggested establishing a prevention and control strategy for these groups to lower ST development risk.

Perceptions of animal welfare and exotic pet ownership in China

China plays a critical role in global biodiversity conservation, as both a biodiversity hotspot and for its role in international and domestic animal trade. Efforts to promote wildlife conservation have sparked interest in the attitudes held by Chinese citizens towards animals. Using a questionnaire, we sought to investigate the attitudes of 317 Chinese nationals across 22 provincial-level administrative units regarding their uses of animals, their perceived emotional capacities and views on exotic pets. We reduced the variables related to perceived uses of animals via Principal Component Analysis and ran Generalised Linear Models and Structural Equation Modelling to test relationships between questionnaire-derived variables. Perceptions of animals were divided into two Kellert categories — Utilitarian and Humanistic uses — and 97% of participants believed in animals capacities to have and express emotions. We found few interactions, with exotic pets, ie playing with or taking photographs, but the acceptability of owning an exotic pet influenced the likelihood of purchasing one. A belief that animals express emotions encouraged people to look for them as pets but thinking that pets make people happy made exotic pet ownership less acceptable. The shift in attitudes to include humanistic perceptions of animals, a belief in animals as emotive beings and understanding of terminology changed from the previous utilitarian views of pre-reform China, suggesting a readiness to embrace further conservation efforts in China. This deeper understanding of Chinese attitudes toward animals and drivers of the exotic pet trade within China may enable conservation efforts to better target future campaigns.

The distinctive characteristics of the micro-vasculature and immune cell infiltration in cystic pancreatic neuroendocrine tumors

PURPOSE

Hypervascularity is a main characteristic of pancreatic neuroendocrine tumors (PanNETs), and cystic PanNETs (CPanNETs) are unique type of PanNETs in which the microenvironment remains unknown. We aim to compare the micro-vasculature features and immune cell infiltration between CPanNETs and solid PanNETs (SPanNETs).

METHODS

Data of 301 SPanNET and 36 CPanNET patients from a high-volume institution were evaluated. CD4, CD8, CD11c, CD15, CD20, CD68, CD34 and α-SMA expression levels were assessed by immunohistochemistry and immunofluorescent double staining. The microvessel density (MVD) and microvessel integrity (MVI) were examined.

RESULTS

MVD and MVI expression levels in CPanNETs were significantly higher than those in SPanNETs (p = 0.025 and 0.0092, respectively). CPanNETs had higher proportions of T1 (p = 0.023) and G1 (p = 0.052) than SPanNETs. In SPanNETs, higher MVD occurred in stages T1, N0 and G1 than in the T2/T3, N1 and G2 subgroups. In CPanNETs, CD34-MVD was uncorrelated with the T stage or grade. Higher CD34-MVD, but not MVI, was associated with better DFS (HR 0.3209, 95% CI 0.1259-0.8176, p = 0.004). There were significantly more peritumoral infiltrating immune cells than their intratumoral counterparts (p < 0.001 for each) in CPanNETs and SPanNETs. The mean number of peritumoral CD68 + TAM in CPanNETs was significantly lower than that in SPanNETs (p = 0.008). The counts of other peritumoral immune cells did not significantly differ between CPanNETs and SPanNETs.

CONCLUSIONS

CPanNETs had a microenvironment distinct from that of SPanNETs, including higher CD34-MVD, higher MVI and lower TAM. This specific microenvironment structure may partially help predicting the prognosis of patients with PanNET.

Gut Microbial Dysbiosis and Plasma Metabolic Profile in Individuals With Vitiligo

Autoimmune diseases are increasingly linked to aberrant gut microbiome and relevant metabolites. However, the association between vitiligo and the gut microbiome remains to be elucidated. Thus, we conducted a case-control study through 16S rRNA sequencing and serum untargeted-metabolomic profiling based on 30 vitiligo patients and 30 matched healthy controls. In vitiligo patients, the microbial composition was distinct from that of healthy controls according to the analysis on α- and β-diversity (P < 0.05), with a characteristic decreased Bacteroidetes: Firmicutes ratio. Meanwhile, the levels of 23 serum metabolites (including taurochenodeoxycholate and L-NG-monomethyl-arginine) in the vitiligo patients were different from those in the healthy individuals and showed significant correlations with some microbial markers. We found that Corynebacterium 1, Ruminococcus 2, Jeotgalibaca and Psychrobacter were correlated significantly with disease duration and serum IL-1β level in vitiligo patients. And Psychrobacter was identified as the most predictive features for vitiligo by machine learning analysis ("importance" = 0.0236). Finally, combining multi-omics data and joint prediction models with accuracies up to 0.929 were established with dominant contribution of Corynebacterium 1 and Psychrobacter. Our findings replenished the previously unknown relationship between gut dysbiosis and vitiligo circulating metabolome and enrolled the gut-skin axis into the understanding of vitiligo pathogenesis.

A20 regulates the therapeutic effect of anti-PD-1 immunotherapy in melanoma

Background

The therapeutic effect of immune checkpoint blockers, especially the neutralizing antibodies of programmed cell death (PD-1) and its ligand programmed death ligand 1 (PD-L1), has been well verified in melanoma. Nevertheless, the dissatisfactory response rate and the occurrence of resistance significantly hinder the treatment effect. Inflammation-related molecules like A20 are greatly implicated in cancer immune response, but the role of tumorous A20 in antitumor immunity and immunotherapy efficacy remains elusive.

Methods

The association between tumorous A20 expression and the effect of anti-PD-1 immunotherapy was determined by immunoblotting, immunofluorescence staining and flow cytometry analysis of primary tumor specimens from melanoma patients. Preclinical mouse model, in vitro coculture system, immunohistochemical staining and flow cytometry analysis were employed to investigate the role of A20 in regulating the effect of anti-PD-1 immunotherapy. Bioinformatics, mass spectrum analysis and a set of biochemical analyzes were used to figure out the underlying mechanism.

Results

We first discovered that upregulated A20 was associated with impaired antitumor capacity of CD8⁺T cells and poor response to anti-PD-1 immunotherapy in melanoma patients. Subsequent functional studies in preclinical mouse model and in vitro coculture system proved that targeting tumorous A20 prominently improved the effect of immunotherapy through the invigoration of infiltrating CD8⁺T cells via the regulation of PD-L1. Mechanistically, A20 facilitated the ubiquitination and degradation of prohibitin to potentiate STAT3 activation and PD-L1 expression. Moreover, tumorous A20 expression was highly associated with the ratio of Ki-67 percentage in circulating PD-1⁺CD8⁺T cells to tumor burden.

Conclusions

Together, our findings uncover a novel crosstalk between inflammatory molecules and antitumor immunity in melanoma, and highlight that A20 can be exploited as a promising target to bring clinical benefit to melanomas refractory to immune checkpoint blockade.

Age-related histological changes in rat tibial

BACKGROUND

At present, studies on osteochondral morphogenesis only focus on a certain period of time or only provide a pattern diagram, but lack of dynamic tracking observation from the initiation of development to maturity. This study was to dynamically observe the changes of skeleton morphology and structure from embryo to adult, to provide research data for enriching the knowledge of bone and cartilage tissue structure.

MATERIALS AND METHODS

In the intrauterine experiment, 5 normal pregnant Wistar rats were sacrificed under anesthesia at gestational day (GD) 14, 17, 20, respectively. One of their offspring was randomly selected, and a total of 5 offspring were obtained at each time point. In the postnatal experiment, on the 7th and 10th day after birth and at postnatal weeks (PW) 2, 3, 6, 12, 28, 5 offspring rats from 5 different pregnant Wistar rats were randomly selected and sacrificed under anesthesia at each time point. After obtaining the above offspring, the soft tissue was removed, and the tibia of hind limbs was retained for paraffin-embedded section. After stained with Safranin-O-fast-green and hematoxylin, the morphological development of the tibia was observed under an optical microscope.

RESULTS

At GD14, there was no obvious joint space, the whole hind limb was cartilage and bone tissue was not visible. At GD17, visible joint space was seen and the chondrocytes in the center region appeared to hypertrophy. At GD20, the primary ossification center was obvious, and a typical epiphysis growth plate structure could be seen. On the 7th day after birth, the chondrocytes in the center of epiphysis cartilage were hypertrophic and differentiated, the cartilage canal grow from the cartilage surface toward the center of the epiphysis cartilage, at postnatal day 14, the secondary ossification center was formed. At this time, the tibia had typical morphological characteristics of the metaphysis, however, there was no obvious layered structure of articular cartilage; the stratified structure of articular cartilage could be seen at PW6, but its mature marker (tidemark) was still not visible; however, at PW12, typical four layers of articular cartilage appeared, and the tidemark was visible. The growth plates were clearly visible at PW2, 6 and 12. At PW28, growth plates could still be observed, but its morphology is abnormal.

CONCLUSIONS

Our results, for the first time, dynamically observed the morphological changes of osteochondral at critical period of development from embryo to adult, especially the process of cartilage canal participating in the formation of secondary ossification center.

Intracellular virus sensor MDA5 exacerbates vitiligo by inducing the secretion of chemokines in keratinocytes under virus invasion

Vitiligo is a disfiguring disease featuring chemokines-mediated cutaneous infiltration of autoreactive CD8+ T cells that kill melanocytes. Copious studies have indicated that virus invasion participates in the pathogenesis of vitiligo. IFIH1, encoding MDA5 which is an intracellular virus sensor, has been identified as a vitiligo susceptibility gene. However, the specific role of MDA5 in melanocyte death under virus invasion is not clear. In this study, we first showed that the expression of anti-CMV IgM and MDA5 was higher in vitiligo patients than healthy controls. Then, by using Poly(I:C) to imitate virus invasion, we clarified that virus invasion significantly activated MDA5 and further potentiated the keratinocyte-derived CXCL10 and CXCL16 which are the two vital chemokines for the cutaneous infiltration of CD8+ T cells in vitiligo. More importantly, IFN-β mediated by the MDA5-MAVS-NF-κB/IRF3 signaling pathway orchestrated the secretion of CXCL10 via the JAK1-STAT1 pathway and MDA5-meidiated IRF3 transcriptionally induced the production of CXCL16 in keratinocytes under virus invasion. In summary, our results demonstrate that MDA5 signaling orchestrates the aberrant skin immunity engaging in melanocyte death via mediating CXCL10 and CXCL16 secretion, which supports MDA5 as a potential therapeutic target for vitiligo under virus invasion.

Laparoscopic uncut Roux-en-Y for radical distal gastrectomy: the study protocol for a multirandomized controlled trial

Gastric cancer is the third most common cause of cancer-related deaths and is the fifth highest incidence of cancer worldwide, especially in Eastern Asia, Central and Eastern Europe, and South America. Currently, surgery is the only curative treatment for gastric cancer; however, digestive tract reconstruction after distal gastrectomy for gastric cancer is controversial due to the postoperative complications such as reflux gastritis. There is an increasing trend toward laparoscopic uncut Roux-en-Y (URY) for radical gastrectomy. However, evidence on the feasibility of this procedure in patients undergoing laparoscopic radical distal gastrectomy is still absent. Thus, a prospective randomized trial is warranted. This is a prospective, multicenter, two-arm randomized controlled trial in which 210 patients will be randomly assigned to two groups: laparoscopic URY (n=105) and laparoscopic Billroth II plus Braun anastomosis (n=105). Each participant must be pathologically diagnosed with gastric cancer and undergo laparoscopic radical gastrectomy at Xijing Hospital and other four hospitals. The laparoscopic URY procedure is based on the Billroth II gastrojejunostomy plus Braun anastomosis, and then blocked the jejunum input loop at the stump–jejunal anastomosis. The patients’ demographic and pathological characteristics will be recorded. The total and oral nutritional intake, general data, total serum protein, serum albumin, blood glucose, and temperature will be recorded before surgery and at the time of hospitalization. Postoperative adverse events will also be recorded, as well as at follow-up appointments at three months and six months after surgery. The rate of reflux gastritis will represent the primary endpoint, and other secondary endpoints, which are all recorded.

Dual targeting and enhanced cytotoxicity to HER2-overexpressing tumors by immunoapoptotin-armored mesenchymal stem cells

Mesenchymal stem cells (MSCs) are promising vehicles for the delivery of anticancer agents in cancer therapy. However, the tumor targeting of loaded therapeutics is essential. Here, we explored a dual-targeting strategy to incorporate tumor-tropic MSC delivery with HER2-specific killing by the immunoapoptotin e23sFv-Fdt-tBid generated in our previous studies. The MSC engineering allowed simultaneous immunoapoptotin secretion and bioluminescence detection of the modified MSCs. Systemic administration of the immunoapoptotin-engineered MSCs was investigated in human HER2-reconstituted syngeneic mouse models of orthotopic and metastatic breast cancer, as well as in a xenograft nude mouse model of orthotopic gastric cancer. In vivo dual tumor targeting was confirmed by local accumulation of the bioluminescence-imaged MSCs and persistence of His-immunostained immunoapoptotins in tumor sites. The added tumor preference of MSC-secreted immunoapoptotins resulted in a significantly stronger antitumor effect compared with purified immunoapoptotins and Jurkat-delivered immunoapoptotins. This immunoapoptotin-armored MSC strategy provides a rationale for its use in extended malignancies by combining MSC mobility with redirected immunoapoptotins against a given tumor antigen.

High Expression of Human Leukocyte Antigen-G is Associated with a Poor Prognosis in Patients with PDAC

Pancreatic Adenocarcinoma (PDAC) is one of the most deadly malignant tumors worldwide. A variety of mechanisms are involved in PDAC biological behaviors, of which, the mechanisms of immune escape may be a pivotal hallmark. HLA-G is a tolerant molecule implicated in tumor escape and serves as a prognostic biomarker in tumors. Our study evaluated the expression of HLA-G in PDAC and explored its clinical significance. In a cohort of 122 PDAC patients, 78 patents (63.9%) exhibited high level of HLA-G tumor tissues. Multivariate analysis suggested that HLA-G level was an independent predictor for OS (HR = 3.894, 95% CI = 2.380-6.370, p <0.001). High level of HLA-G significantly correlated with PDAC aggressive features, such as more advanced stage (TNM Stage II) (p<0.001), extrapancreatic infiltration (T3 stage) (p<0.001), lymph node involvement (p=0.019) and poor differentiation (p=0.010). In western blot analysis, almost all of the tumor cell lines (5/6) expressed high levels of HLA-G. In ELISA analysis, the level of plasma sHLA-G in PDAC patients were significantly increased than in healthy control (P=0.0037). Further analysis revealed the level of sHLA-G inversely related to numbers of peripheral activated T cells (CD8+CD28+ T cells), which may indicate that sHLA-G inactivates T cell responses resulting in tumor immune escape. In conclusion, tumor-derived HLA-G may indicate the mechanism of immune escape and impaired PDAC clinical outcome, especially in early-stage patients, which may also be a potential therapeutic target.

Curved focal plane extreme ultraviolet detector array for a EUV camera on CHANG E lander

A novel curved focal plane extreme ultraviolet (EUV) detector array designed for a moon-based EUV camera is demonstrated. The curved focal plane detector array operating in a pulse-counting mode consists of a curved microchannel plate (MCP) stack and an induced charge wedge-strip anode (WSA). The curved MCP is fabricated by firstly thermally slumping of the MCPs, and then followed by optical polishing and core glass etching. By using this technology, curved MCPs with a length-to-diameter (L/D) ratio of 80:1 and a radius of curvature of 150 mm have been successfully achieved. The performance of the curved MCP detector is fully characterized in terms of the background noise, pulse height distribution, gain, image linearity and spatial resolution. It is measured that a spatial resolution of 7.13 lp/mm can be achieved with a background noise of less than 0.3 counts/cm2⋅s. The characterization results indicate that the curved focal plane detector can fulfill the requirements of the moon-based EUV camera.

Severe and moderate haemophilia A and B in US females

Haemophilia A and B are rare X-lined hemorrhagic disorders that typically affect men. Women are usually asymptomatic carriers, but may be symptomatic and, rarely, also express severe (factor VIII (FVIII) or factor IX (FIX) <0.01 U mL(-1)) or moderately severe (FVIII/FIX 0.01-0.05 U mL(-1)) phenotypes. However, data on clinical manifestations, genotype and the psychosocial ramifications of illness in severely affected females remain anecdotal. A national multi-centre retrospective study was conducted to collect a comprehensive data set on affected US girls and women, and to compare clinical observations to previously published information on haemophilic males of comparable severity and mildly affected haemophilic females. Twenty-two severe/moderate haemophilia A/B subjects were characterized with respect to clinical manifestations and disease complications; genetic determinants of phenotypic severity; and health-related quality of life (HR-QoL). Clinical data were compared as previously indicated. Female patients were older than male patients at diagnosis, but similarly experienced joint haemorrhage, disease- and treatment-related complications and access to treatment. Gynaecological and obstetrical bleeding was unexpectedly infrequent. F8 or F9 mutations, accompanied by extremely skewed X-chromosome inactivation pattern (XIP), were primary determinants of severity. HR-QoL was diminished by arthropathy and viral infection. Using systematic case verification of participants in a national surveillance registry, this study elucidated the genetics, clinical phenotype and quality of life issues in female patients with severe/moderate haemophilia. An ongoing international case-controlled study will further evaluate these observations. Novel mechanistic questions are raised about the relationship between XIP and both age and tissue-specific FVIII and FIX expression.

siRNA targeting prohibitins inhibits proliferation and promotes apoptosis of gastric carcinoma cell line SGC7901 in vitro and in vivo

In the present study we investigate the effects of small interfering RNA (siRNA)-mediated silencing of prohibitins (Phbs) gene expressions on gastric carcinoma cell proliferation and apoptosis in vitro and in vivo. Firstly, Phbs proteins in five human gastric carcinoma cell lines were evaluated by Western blotting. Then three siRNA sequences targeting Phbs were designed and transfected into the cancer cell line with the highest Phbs protein expressions. The cell proliferation and apoptosis were analyzed by MTT and flow cytometry methods. In vivo, the effects of siRNAs on the proliferation and apoptosis were assayed in xenografted tumors of nude mice. Phbs proteins were expressed highest in gastric carcinoma cell line SGC7901. The cell proliferation significantly decreased upon Phbs silencing. The cell percentage in S phase was significantly lower in Phbs silenced groups, and the apoptotic cell ratio was significantly higher. siRNA targeting Phbs significantly inhibited the growth of the xenografted tumors. Further, Bcl-2 and Bax was respectively downregulated and upregulated after the Phbs silencing in the xenografted tumors. Caspase-3 and caspase-9 activities were significantly enhanced in the Phbs-silenced tumors. In summary, siRNA-mediated silencings of Phbs inhibit proliferation and promotes apoptosis of gastric carcinoma cells SGC7901 in vitro and in vivo, suggesting key roles of Phbs in the development of SGC7901 cell line.

Profilin 1 potentiates apoptosis induced by staurosporine in cancer cells

The correlation between the loss of Profilin 1 (Pfn1) with tumor progression indicated that Pfn1 is a tumor suppressor in human carcinoma. The molecular mechanisms underlying Pfn1 tumor suppression has yet to be elucidated. In this study, we showed that Pfn1 overexpression sensitizes cancer cells to apoptosis through the typical intrinsic apoptotic pathway. Mechanistically, the increased Pfn1 expression mediated the upregulation of p53R273H, one of the most common tumor-associated hotspot mutations of p53, with transactivation deletion in tumorigenesis and increased localization of p53R273H in cytoplasm. Further studies showed that mutant p53R273H was involved in apoptosis induced by Staurosporine (STS) via transcription-independent mitochondrial functions. We observed (i) the increased cytosolic localization of p53R273H, (ii) the activation of phosphorylation at Ser15, (iii) its mitochondrial localization; Pfn1 acted as a positive regulator of these processes. We also found that Pfn1 interacted with p53R273H and thus facilitated its exertion over the transcription-independent activity in the cytoplasm during drug action. Our results define a new function and mechanism of Pfn1 demonstrating that the combined effect with apoptotic agents led to a synergistic increase in apoptosis. In addition, p53R273H abrogating DNA binding was found to play a major role in the Pfn1- sensitized apoptosis through a transactivation-independent and cytosolic activity.

Up-regulation of MBD1 promotes pancreatic cancer cell epithelial-mesenchymal transition and invasion by epigenetic down-regulation of E-cadherin

Methyl-CpG binding domain protein 1 (MBD1) has been implicated in transcriptional regulation, heterochromatin formation, genomic stability, cell-cycle progression and development. It is also predicted that MBD1 might be involved in tumor development and progression. However, whether and how MBD1 is involved in tumorigenesis, especially in pancreatic cancer (PC), is currently unknown. We found that MBD1 was significantly up-regulated in PC tissues compared with the surrounding normal tissues according to RT-PCR data. Tissue microarray (TMA) based immunohistochemical study from 58 surgically resected PC specimens indicated that higher MBD1 expression correlated with lymph node metastasis and poor survival in PC patients. Gain- and loss-of-function studies in vitro validated MBD1 as a potent oncogene promoting PC cell invasion as well as epithelial-mesenchymal transition (EMT). Mechanistically, MBD1 is associated with Twist and NAD-dependent deacetylase sirtuin-1 (SIRT1), thereby forming the Twist-MBD1-SIRT1 complex on the CDH1 promoter, which resulted in reduced E-cadherin transcription activity and increased cell EMT ability. Significantly, targeting MBD1 reversed the EMT phenotype of PC and restored sensitivity to chemotherapy. Taken together, the results of our study revealed a novel function of MBD1 in PC invasion and metastasis by providing a molecular mechanism underlying MBD1-promoted EMT. Thus MBD1 may serve as a potential therapeutic target for PC.

[Continuous cultivation of a large number of Plasmodium falciparum gametocytes in carbon dioxide incubator]

AIM

To establish a method for continuously cultivating a large number of P. falciparum gametocytes in vitro using carbon dioxide incubator.

METHODS

The number of gametocytes produced in experimental and control groups was compared after the addition of various concentrations of NaHCO3 to the culture medium.

RESULTS

The gametocytes began to rise on day 5 of cultivation and reached a peak on day 11-13. The peak gametocyte loads were 1.9% +/- 0.6% and 1.3% +/- 0.4% (P < 0.05) in experimental and control group, respectively, indicating that the complete medium with 30 mmol/L sodium bicarbonate was beneficial to gametogenesis. The numbers of stages I-V gametocytes rose to a peak on d5, d7, d11, d13 and d15, respectively. On day 15 the percentage of stage V gametocytes was 7.1%-52.6% with an average of 24.3%. The ratio of macrogametocyte to microgametocyte was 12.8:1. The parasites were able to produce high gametocytaemia up to 24th subculture after thawing. Laboratory reared Anopheles stephensi fed through membrane on blood infected with P. falciparum were dissected, no oocyst was found in the midgut.

CONCLUSION

A culture system which could consistently and stably produce a large number of gametocytes of P. falciparum was established.

Preparation of a novel core-shell nanostructured gold colloid-silk fibroin bioconjugate by the protein in situ redox technique at room temperature

A novel core-shell gold colloid-silk fibroin (SF) bioconjugate was prepared by the protein in situ redox technique at room temperature, in which the tyrosine (Tyr) residue of the SF, having strong electron donating properties, in situ reduced Au(III) ions to Au colloids showing a stable and highly monodispersed nature.

[Surgical treatment of elderly patients with pancreatic neoplasm]

OBJECTIVE

To further elucidate the clinical feature, treatment and prognosis of pancreatic cancer in elderly patients.

METHODS

Data of 180 elderly patients with pancreatic cancer operated upon during 1990-2000 were analyzed. Postoperative complications and 30-day mortality rates were recorded among the 46 cases subjective to Whipple procedure, including 22 cases undergoing regional pancreatoduodenectomy after intervention therapy. 78 patients received palliative surgery and 50 patients received laparotomy. Follow-up was made for 6 months to 10 years.

RESULTS

All the patients were operated upon successfully. 48 patients underwent radical pancreatectomy with a mortality rate of 6.2 per cent, a complication rate of 20.8 per cent, and a mean survival period of 26 months. The 78 cases undergoing palliative surgery survived for 6 months on average. 54 patients undergoing laparotomy only survived for 3 months on average.

CONCLUSION

Aggressive surgical management helps prolong the survival period and improve the life quality of elderly patients with pancreatic cancer.

[Apoptosis of pancreatic acinar and expression of TNF-alpha mRNA, IL-10 mRNA in rats with acute pancreatitis]

OBJECTIVE

To investigate the apoptosis of pancreatic acinar and the expression of TNF-alpha mRNA, IL-10 mRNA in pancreatic tissue of rats with acute pancreatitis.

METHODS

The model of acute edematous pancreatitis(AEP) was established in 20 rats and that of acute necrotizing pancreatits(ANP) in another 20 by injection of sodium taurocholate into the pancreatic duct. Another 10 normal rats were used as controls. At 12 hours after the induction of pancreatitis, 10 rats in each group were sacrificed. Serum and pancreatic TNF-alpha and IL-10 levels were measured. The expression of TNF-alpha and IL-10 mRNA in pancreas was detected and the apoptotic rate of pancreatic acinar determined.

RESULTS

The apoptotic rate of pancreatic acinar in normal, AEP and ANP groups was 2.98%, 17.29% and 8.39%, respectively. TNF-alpha and IL-10 levels increased after the induction of acute pancreatitis. The level of TNF-alpha was lower while that of IL-10 higher in AEP group than in ANP group. Transcription level of TNF-alpha mRNA in ANP group and that of IL-10 mRNA in AEP group were upregulated.

CONCLUSIONS

The transcription levels of TNF-alpha and IL-10 mRNA in pancreatic tissue of rats with acute pancreatitis are positively correlated with their levels in serum and pancreas, suggesting that the pancreas is the organ to release cytokines. The apoptotic rate of pancreatic acinar is negatively correlated with the severity of disease and apoptosis may be a benign response to pancreatic injury.

Mechanisms of multiple organ damages in acute necrotizing pancreatitis

OBJECTIVE

To determine the role of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS), and evaluate the progress from SIRS to MODS and the therapeutic strategies for acute necrotizing pancreatitis (ANP).

METHODS

Rat ANP models were made by retrograde injection of 3.5% sodium taurocholate 2.5 ml/kg into the pancreatic duct. Serum interleukin-8 (IL-8), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF alpha), amylase, endotoxin, and albumin were examined. The morphology and pathology of the pancreas, liver, lung, kidney and heart after ANP were observed. Finally, TNF alpha mRNA in the liver, lung, kidney and heart after ANP were observed by reverse transcriptase-polymerase chain reactions, and the efficiency of somatostatin and growth hormone were also observed in this experiment.

RESULTS

ANP led to remarkable elevation of the inflammatory mediators which were positively correlated with the development of ANP and MODS. Somatostatin and growth hormone inhibited inflammatory mediators and TNF alpha mRNA overexpressions, reduced the risk of MODS, corrected hypoalbuminemia, reversed negative nitrogen balance, and controlled the reduction of cell groups with functions and reasonably intervened SIRS caused by ANP.

CONCLUSION

TNF alpha mRNA plays an important role in ANP progression. The amelioration of ANP by combination treatment with somatostatin and growth hormone leads to the reduction of complications and marked increase in survival.

Computing and visualizing electric potentials and current pathways in the thorax

The long-term goal of electrocardiography is to relate electric potentials on the body surface with activities in the heart. Many previously reported studies have focused on direct links between heart and body surface potentials. The goals of this study were first to validate computational methods of determining volume potentials and currents with high-resolution experimental measurements and then to use interactive visualization of thoracic currents to understand features of the electrocardiographic fields from measured cardiac sources. We developed both simulation and experimental studies based on a realistic shaped torso phantom containing an isolated, perfused dog heart. Interventions included atrial pacing, single pacing and simultaneously pacing at multiple locations on the ventricles. Simulated torso volume potentials closely matched measured potentials in the torso-tank preparation (mean correlation coefficients of 0.95). Simulation further provided a means of estimating the current field in the torso from the computed torso volume potentials and the local geometric and conductive properties of the medium. Applying these techniques to the torso electric fields under a variety of pacing conditions, we have further demonstrated that thoracic current can provide many insights into the relationship between heart surface potential and body surface potentials. Specifically, we have shown that geometric factors including cardiac source configuration and location play an important role in determining to what extent electric activity in the heart is directly visible on the body surface electrocardiogram. The computation and visualization toolkit we developed in this study to explore current fields associated with cardiac events may provide new insights into electrocardiology.

Effects of heart position on the body-surface electrocardiogram

Previous studies have examined the influence of body position, respiration, and habitus on body surface potentials. However, the authors could only estimate the sources of the effects they documented. Among the proposed origin of changes in body surface potentials from those studies were the position of the heart, alterations in autonomic tone, differences in ventricular blood volume, and variations in torso resistivity. The goal of this study was to investigate specifically the role of geometric factors in altering body surface potentials and the electrocardiogram. For this, we used experiments with an isolated, perfused dog heart suspended in a realistically shaped electrolytic torso tank. The experimental preparation allowed us to measure epicardial and tank surface potentials simultaneously, and then reconstruct the geometry of both surfaces. Our results mimicked some of the features described by previous investigators. However, our results also showed differences that included considerably larger changes in the peak QRS and T-wave amplitudes with heart movement than those reported in human studies. We detected smaller values of root-mean-squared variability from heart movements than those reported in a human study comparing body surface potentials during change in inspiration and body position. There was better agreement with relative variability, which in these studies ranged from 0.11 to 0.42, agreeing well with an estimate from human studies of 0.40. Our results suggest that the isolated heart/torso tank preparation is a valuable tool for investigating the effects of geometric variation. Furthermore, the geometric position of the heart appears to be a large source of variation in body surface potentials. The size of these variations easily exceeded thresholds used to distinguish pathologic conditions and thus such variations could have important implications on the interpretation of the standard electrocardiogram.

[Clinical study on tangweikang capsule in treating diabetic nephropathy]

OBJECTIVE

To observe the effect of Tangweikang capsule (TWKC) in treating diabetic nephropathy (DN).

METHODS

The 119 patients enrolled were divided into 2 groups, 78 patients in the TWKC group treated with TWKC and 41 patients in the control group treated with Captopril. The changes of symptom score, urinary microprotein series (urinary albumin excretion rate, Tamm-horsfall protein and beta 2-microglobulin), blood glucose, kidney function, blood lipid, angiotensin I (A I) and II (A II), atrial natriuretic polypeptide (ANP), thromboxane B2(TXB2), 6-keto-prostaglandin F1 alpha, endothelin 1 (ET-1) and collagen IV in patients after treatment were observed.

RESULTS

The total effective rate in the TWKC group was 84.62%, which was superior to that in the control group (70.73%, P < 0.05). TWKC also showed better effects in improving clinical symptoms, lowering blood glucose, urinary microprotein series, blood lipid, A I, A II, ANP, ET-1 and collagen IV, ameliorating kidney function, and adjusting dynamic equilibrium of thromboxane-prostacyclin system, as compared with the control group (P < 0.05 or P < 0.01).

CONCLUSION

TWKC could lower the levels of blood glucose and lipid, improve the glucose and lipid metabolism, regulate the microcirculation, ameliorate the degree of kidney damage, therefore, it showed a better effect in treating diabetic nephropathy.