Plumbagin Regulates Snail to Inhibit Hepatocellular Carcinoma Epithelial-Mesenchymal Transition in vivo and in vitro

Background/Aims

Plumbagin (PL) has been shown to effe ctively inhibit autophagy, suppressing invasion and migration of hepatocellular carcinoma (HCC) cells. However, the specific mechanism remains unclear. This study aimed to investigate the effect of PL on tumor growth factor (TGF)-β-induced epithelial-mesenchymal transition (EMT) in HCC.

Methods

Huh-7 cells were cultured, and in vivo models of EMT and HCC-associated lung metastasis were developed through tail vein and in situ injections of tumor cells. In vivo imaging and hematoxylin and eosin staining were used to evaluate HCC modeling and lung metastasis. After PL intervention, the expression levels of Snail, vimentin, E-cadherin, and N-cadherin in the liver were evaluated through immunohistochemistry and Western blot. An in vitro TGF-β-induced cell EMT model was used to detect Snail, vimentin, E-cadherin, and N-cadherin mRNA levels through a polymerase chain reaction. Their protein levels were detected by immunofluorescence staining and Western blot.

Results

In vivo experiments demonstrated that PL significantly reduced the expression of Snail, vimentin, and N-cadherin, while increasing the expression of E-cadherin at the protein levels, effectively inhibiting HCC and lung metastasis. In vitro experiments confirmed that PL up-regulated epithelial cell markers, down-regulated mesenchymal cell markers, and inhibited EMT levels in HCC cells.

Conclusion

PL inhibits Snail expression, up-regulates E-cadherin expression, and down-regulates N-cadherin and vimentin expression, preventing EMT in HCC cells and reducing lung metastasis.

[The significance of preoperative evaluation for atlantoaxial reducibility should be reevaluated]

For treatment of atlantoaxial dislocation, the evaluation of reducibility used to be the main basis for its classification. In recent years, with the development of posterior reduction techniques, the treatment paradigm for atlantoaxial dislocation is gradually changing from a combined anterior and posterior approach to a direct posterior approach. Through posterior intra-articular release and distraction, part of atlantoaxial dislocation which is irreducible in traditional concept can become reducible. With the new proposed strategy based on posterior reduction techniques, the significance and necessity of preoperative evaluation for atlantoaxial reducibility should be reevaluated. Based on our clinical experience, we put forward our views on this hot topic for peer reference and criticism.

[Surgical treatment strategy for difficult-reducible atlantoaxial dislocation]

Objective: To discuss the surgical strategy for difficult-reducible atlantoaxial dislocation. Methods: Clinical data of 82 patients with difficult-reducible atlantoaxial dislocation underwent surgical treatment in the Department of Neurosurgery, Xuanwu Hospital from January 2018 to February 2019 were retrospectively reviewed. Total of 32 men and 50 women were included, with a mean age of (41.8±12.9) years. Most cases (n=80) were treated with one-staged posterior atlantoaxial joint distraction and cage implantation, a few (n=2) underwent ventral decompression. All cases were followed up, postoperative improvement of clinical symptoms and radiology parameters were analyzed. Results: Of the patients, 80 cases (97.6%) received one-staged posterior atlantoaxial joint distraction and cage implantation; lateral facet joint bony fusion was found in 4 patients and was cut off with an osteotome. Transoral odontoidectomy was performed in 2 cases (2.4%) with fused atlanto-odontoid joint. All the patients were followed-up for (18.6±7.3) months. Postoperative CT showed complete reduction of ADI was achieved in 60 patients (75.0%). The ADI decreased significantly after the operation [(2.1±1.4) mm vs (5.0±1.5) mm, P<0.05]. The postoperative vertical distance between odontoid process and the Chamberlain line decreased significantly when compared with that before the operation [(3.9±3.8) mm vs (10.2±5.2) mm, P<0.05]. The mean JOA score at 6 months post operation improved significantly than that before the operation (13.7±1.5 vs 11.2±1.7, P<0.05). Seventy-five patients (93.8%) had atlantoaxial intra-articular bony fusion at 1 year follow-up. Conclusion: Most difficult-reducible atlantoaxial dislocations can be managed well by posterior one-staged atlantoaxial joint distraction and Cage implantation.

Rare leptin in non-alcoholic fatty liver cirrhosis: A case report

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD)-related cirrhosis is mainly caused by NAFLD by causing inflammation which leads to fibrosis. The role of leptin in NAFLD-related cirrhosis has been rarely reported.

CASE SUMMARY

This study presents the case of a 65-year-old male patient who was referred to The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi, China, for diagnosis and treatment for liver cirrhosis. Initially, the cause of liver cirrhosis was unknown. After radiology, laboratory examination, pathological results and analysis of the patient’s signs and symptoms, the case was finally diagnosed with final NAFLD-related cirrhosis. Although this study reports a single case, the findings might expand the understanding of leptin’s role in NAFLD-related cirrhosis and might provide a basis for the clinical diagnostic criteria, pathological features and treatment of NAFLD-related cirrhosis.

CONCLUSION

Although the occurrence of marasmus NAFLD-related cirrhosis is rare, it needs to be distinguished from other liver diseases, including viral hepatitis, drug-induced liver disease, Wilson's disease and autoimmune liver disease. Aggressive treatment is needed to prevent the progression of NAFLD-related cirrhosis.

[Evaluation of the effectiveness of malaria control health education among overseas enterprise employees]

OBJECTIVE

To evaluate the effectiveness of health education on knowledge, attitude and practice (KAP) relating to malaria control among overseas enterprise employees.

METHODS

In September 2019, on-site malaria control health education was conducted among all Chinese employees of a China-funded mining enterprise in the Democratic Republic of Congo. The KAP questionnaire for malaria control was generated on the Questionstar website, and the participants were subjected to two questionnaire surveys prior to and 14 months after health education. After the questionnaires were recovered, all valid questionnaires were divided into 4 groups, including the baseline group (the questionnaires filled out by respondents who received health education and participated in two questionnaire surveys before health education), the loss-to-follow-up group (the questionnaires filled out by respondents who received health education but only participated in the questionnaire survey after health education), the retest group (the questionnaires filled out by respondents who received health education and participated in two questionnaire surveys after health education) and the new group (questionnaires filled out by respondents who did not receive health education and only participated in the questionnaire survey after health education) according to subjects' receiving health education and participation in two questionnaire surveys. The correct rate of malaria control knowledge, the proportion to good attitudes towards malaria control and the proportion of good practices towards malaria control were compared between the baseline group and the loss-to-follow-up group, between the baseline group and the retest group, and between the retest group and the new group.

RESULTS

A total of 110 and 142 valid questionnaires were recovered during the two surveys, and the recovery rates were 90.9% and 70.3%, respectively. There were 77, 77, 33, and 65 valid questionnaires recovered from the baseline group, the loss-to-follow-up group, the retest group, and the new group, respectively. There were no significant differences in respondents' gender, age and educational levels between the baseline group and the loss-to-follow-up group (all P values > 0.05), and there were no significant differences between the two groups in terms of the mean score of malaria control knowledge (Z = 2.011, P > 0.05), the mean score of attitudes towards malaria control (t = -0.787, P > 0.05) and the mean score of practices towards malaria control (t = -0.787, P > 0.05). There were significant differences between the retest group and the baseline group in terms of the mean score of malaria control knowledge (10.83 vs. 9.79; Z = -4.017, P < 0.05), the mean score of attitudes towards malaria control (29.48 vs. 28.61; Z = -1.981, P < 0.05) and the mean score of practices towards malaria control (6.43 vs. 5.91; Z = -2.499, P < 0.05). There were no significant differences between the retest group and the new group in terms of gender, age or education levels (all P values > 0.05), and a higher mean score of malaria control knowledge was found in the retest group than in the new group (10.83 vs. 9.81; Z = -2.962, P < 0.05), while no significant differences were seen in the mean score of attitudes towards malaria control (29.48 vs. 30.17; Z = -1.158, P > 0.05) and the mean score of practices towards malaria control (6.43 vs. 6.37; Z = -0.048, P > 0.05) between the two groups.

CONCLUSIONS

Malaria control health education may significantly improve the understanding of malaria control knowledge, positive attitudes towards malaria control and the compliance of practices towards malaria control among overseas enterprise employees.

[The Chinese guidelines for the diagnosis and treatment of pancreatic neuroendocrine neoplasms (2020)]

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

[Advances in liver immunology in 2018]

The mechanism of innate and adaptive immune responses to chronic infections with hepatotropic viruses (HBV, HCV) was studied in 2018. Its mechanism elucidated the dysregulation of natural killer (NK) cells, monocytes, B cells and T cells. In addition, a new target for immune regulation of HBV infection (TLR3/OX40L) was introduced. The discovery of new NK cell immune checkpoints, the involvement of mononuclear macrophages in liver failure and inflammation, sex hormone affecting intrahepatic-resistant bacterial infection through the regulation of humoral immunity, and the communication mechanism between liver and other immune organs have enriched people's understanding of liver immunology and its clinical significance.

[Research progress of dyskeratosis congenita]

Dyskeratosis congenita (DC) is a rare disease and a genetic heterogeneity of bone marrow failure, characterized by muco-cutaneous triad of mucosal leukoplakia, abnormal skin pigmentation, nails dystrophy and often involving multiple organs or systems. The inheritance patterns of DC include X-linked recessive, autosomal dominant and recessive patterns. However, the inheritance patterns in 30%-40% of DC patients remained unknown. Dyskeratosis congenita is difficult to diagnose because of its genetic and clinical heterogeneity. This article will review and discuss the state-of-the-art progresses in genetics, clinical manifestation, diagnosis, differential diagnosis, treatment and prognosis of DC.

Optofluidic system based on electrowetting technology for dynamically tunable spectrum absorber

An optofluidic system that uses the electrowetting technology to dynamically control the local surface plasmon resonance of the silver nanoparticle is invented. The silver nanoparticle is initially suspended at the interface of the polar liquid and the non-polar liquid. As the interface morphology changes with the applied voltage, the media distribution surrounding particle is changed accordingly, thus realizing the resonance absorption peak's modulation. The investigation result shows that a wide range of the spectral colors from red to blue can be selectively absorbed just by a single device. Specifically, when the radius of the particle is 50 nm, the wavelength of the absorption peak can be dynamically modulated from 460 nm to 607 nm. This proposed method can be used to design and prepare rapidly adjustable optical elements.

[Liver sinusoidal endothelial cells regulate adaptive immune tolerance in the liver]

Liver sinusoidal endothelial cells are a major group of nonparenchymal cells in the liver and are involved in immunological surveillance of the liver through the expression of various scavenger receptors and pattern recognition receptors. However, in case of several physiological states, viral infections, and tumor environment, liver sinusoidal endothelial cells maintain immune tolerance in the liver through various mechanisms and cause persistent viral infection and tumor metastasis. This article reviews the mechanisms of immune tolerance of CD4 + T cells and CD8 + T cells in the liver induced by liver sinusoidal endothelial cells.

[Effects of trabecular metal augments for the reconstruction of Paprosky type Ⅲ acetabulum bone defects]

Objective: To investigate the methods and short-time clinical results of reconstruction of Paprosky type Ⅲ acetabulum bone defects by using tantalum augments. Methods: A total of 17 patients (17 hips) with Paprosky type Ⅲ acetabulum bone defects, treated with tantalum augments in revision of total hip arthroplasty at Department of Orthopedics Surgery in General Hospital of Chinese People's Liberation Army were retrospectively analyzed from March 2014 to May 2016.There were 6 males and 11 females aged from 23 to 74 years with an average of (50.2±16.3) years. Tantalum augments or TM-Cup augment (the cup-on-cup technique) were used to reconstruct the defects.The TM-Cup augment was the tantalum revision cup which was removed titanium ring. The cup-on-cup technique combined TM-Cup augment and biological acetabulum cup. Augments were served as the nonresorptive structural allograft in revision of total hip arthroplasty. Harris hip score was used to evaluate clinical effects. The vertical position of the rotation center was measured and analyzed. Radiographic assessments of the acetabular components were performed by DeLee-Charnley and the Anderson criteria and recorded postoperative complications. Results: All the patients were followed up from 3 to 29 months with an average of (16.2±5.4) months, tantalum augments and biological acetabulum cup were used in 13 patients, the TM-Cup augment and biological acetabulum cup were used in 4 patients. At the time of the latest follow-up, the mean Harris hip score increased compared to preoperatively (86.8±8.3 vs. 30.0±12.0) (t=12.78, P<0.01), the average vertical location of the center of rotation was decreased ((25.3±9.8) mm vs.(47.6±10.5)) mm (t=4.95, P<0.01). All the tantalum augments and biological acetabulum cups were stable, there were no infection, dislocation and other complications. Conclusions: The use of tantalum augments could be considered as an effective management of Paprosky type Ⅲ defects providing good clinical and radiographic outcomes in the short term.The cup-on-cup technique which was used in reconstruction of severe superior-invagination acetabular bone defects and restoration relatively normal center of rotation had special application value.

Output characteristics of actively Q-switched Ho:LuVO₄ laser at room temperature

A compact continuous wave (CW) and actively Q-switched (AQS) Ho:LuVO4 laser pumped by a 1.94 μm Tm: YAP laser is demonstrated. The performance of the laser was investigated by changing the output coupler. The maximum output power of 4.1 W at 2058.43 nm in CW regime is obtained at the maximum absorbed pump power of 12.3 W. The minimum pulse width of 29.3 ns was obtained at Pulse Repetition Frequency (PRF) of 20 kHz with the same output coupler corresponding to a peak power of 6.9 kW. The maximal output power is 4.1 W with center wavelength of 2058.43 nm at PRF of 40 kHz, corresponding to slope efficiency of 43.0% with respect to absorbed pump power. The M2 factors measured by the traveling knife-edge method are 1.04 in parallel a-axis and 1.08 in parallel c-axis with diffraction limited beam quality.

Resonantly pumped room temperature Ho:LuVO₄ laser

Spectroscopic characterization of a Ho:LuVO4 crystal grown by the Czochralski method has been performed, including the absorption and emission spectra. We demonstrate a 2 μm room temperature Ho:LuVO4 laser, resonantly pumped by a 1.94 μm Tm:YAP laser. By use of an output coupler with T=10% transmission, the Ho:LuVO4 laser generated continuous-wave output power of 2.5 W at 2074.18 nm, with a beam quality factor of Mx2=My2=1.3, for a total incident pump power of 19.4 W. The slope efficiency with respect to the pump power was 17.6%, and the optical-to-optical efficiency was 12.9%. Moreover, we obtained a Ho:LuVO4 laser that operated at 2073.77 and 2055.27 nm, by using different output couplers with transmissions of T=15 and 30%.

Therapeutic mechanism of treating SMMC-7721 liver cancer cells with magnetic fluid hyperthermia using Fe₂O₃ nanoparticles

This study aimed to investigate the therapeutic mechanism of treating SMMC-7721 liver cancer cells with magnetic fluid hyperthermia (MFH) using Fe₂O₃ nanoparticles. Hepatocarcinoma SMMC-7721 cells cultured in vitro were treated with ferrofluid containing Fe₂O₃ nanoparticles and irradiated with an alternating radio frequency magnetic field. The influence of the treatment on the cells was examined by inverted microscopy, MTT and flow cytometry. To study the therapeutic mechanism of the Fe₂O₃ MFH, Hsp70, Bax, Bcl-2 and p53 were detected by immunocytochemistry and reverse transcription polymerase chain reaction (RT-PCR). It was shown that Fe₂O₃ MFH could cause cellular necrosis, induce cellular apoptosis, and significantly inhibit cellular growth, all of which appeared to be dependent on the concentration of the Fe₂O₃ nanoparticles. Immunocytochemistry results showed that MFH could induce high expression of Hsp70 and Bax, decrease the expression of mutant p53, and had little effect on Bcl-2. RT-PCR indicated that Hsp70 expression was high in the early stage of MFH (<24 h) and became low or absent after 24 h of MFH treatment. It can be concluded that Fe₂O₃ MFH significantly inhibited the proliferation of in vitro cultured liver cancer cells (SMMC-7721), induced cell apoptosis and arrested the cell cycle at the G₂/M phase. Fe₂O₃ MFH can induce high Hsp70 expression at an early stage, enhance the expression of Bax, and decrease the expression of mutant p53, which promotes the apoptosis of tumor cells.

Sequential intravenous/oral moxifloxacin monotherapy for complicated skin and skin structure infections: a meta-analysis of randomised controlled trials

OBJECTIVES

The presumed superiority of moxifloxacin for the treatment of complicated skin and skin structure infections (cSSSIs) is based on laboratory data, but has not yet been established on clinical grounds. The aim of this meta-analysis was to evaluate the efficacy and safety of sequential intravenous (i.v.)/oral (p.o.) moxifloxacin monotherapy for the treatment of cSSSIs.

METHODS

Randomised controlled trials (RCTs) published prior to November 2012 were systematically retrieved from PubMed, MEDLINE, EMBASE, ScienceDirect, ClinicalTrials.gov and the Cochrane Central Register of Controlled Trials. Finally, a meta-analysis of all RCTs eligible for inclusion criteria was performed.

RESULTS

Three studies that enrolled 2255 patients were included in the meta-analysis. There were no statistically significant differences between patients given moxifloxacin and those given other antibiotics with regard to clinical success rate [1667 patients, odds ratio (OR) = 0.83, 95% confidence interval (CI) 0.63 to 1.09, p = 0.18], bacteriological success rate (bacteriological success rates: 1502 patients, OR = 0.90, 95% CI 0.68-1.18, p = 0.45) or mortality (2207 patients, OR = 1.96, 95% CI 0.79-4.88, p = 0.15). Significantly, more overall adverse events (AEs) were associated with the use of moxifloxacin than with other antibiotics (2207 patients, OR = 1.21, 95%CI 1.00-1.45, p = 0.04). However, there was no statistically significant difference in the occurrence of drug-related AEs, serious AEs or serious drug-related AEs between patients given moxifloxacin and those given other antibiotics.

CONCLUSION

Sequential i.v./p.o. moxifloxacin monotherapy is an effective and relatively safe option for the treatment of cSSSIs. Other benefits of moxifloxacin may make it a more viable option compared with the currently used regimens.

Molecular characterization, expression and association analysis of the porcine CMYA4 gene with carcass traits

CMYA4 (cardiomyopathy-associated 4) gene plays an important role in thick filament assembly. In this study, we obtained the mRNA sequence including the full coding sequence and the partial 5' untranslated region of the porcine CMYA4 gene by using the rapid amplification of cDNA ends and reverse transcriptase polymerase chain reaction (RT-PCR) and the sequence was deposited in the GenBank nucleotide database (DQ_286571). The human (NM_173167) and mouse (NM_178680) homologues have a 91% and 87% identity with the porcine CMYA4 gene, respectively. The sequence contains an open reading frame encoding 930 amino acid residues, and the amino terminus of the predicted CMYA4 protein contains three tandem repeats belonging to the tetratricopeptide repeat family. Semi-quantitative RT-PCR results showed that the porcine CMYA4 gene is expressed exclusively in striated muscle tissue. An A558G single nucleotide polymorphism in the CMYA4 intron 15 detected as an MspI PCR-restriction fragment length polymorphism showed allele frequency differences among 225 unrelated pigs from six breeds. Association of the genotypes with growth and carcass traits showed that different genotypes of the CMYA4 gene were significantly associated with the backfat thickness of the area between sixth and seventh ribs (p < 0.05) and backfat thickness at the shoulder (p < 0.05).

[Genetic effects of mineral elements of Fe, Zn, Mn and P in black pericarp rice grains]

Complete diallel crosses with seven varieties of black pericarp rice were conducted in one year to analyze the genetic effects on main mineral elements of Fe, Zn, Mn and P contents in kernels of parents and their F1S and F2S, using the full genetic model including triploid endosperm, cytoplasmic and maternal effects on quantitative traits of seeds in cereal crops. The results indicated that the contents of all the four mineral elements were controlled by seed direct genetic effects, maternal genetic effects as well as by cytoplasmic effects. The seed direct genetic effects were more important than the maternal genetic effects for Fe, Zn, Mn contents, and seed direct additive effects constituted a major part of their genetic effects, whereas seed direct additive, maternal additive and dominant effects formed the main part in the inheritance of P content. The heritabilities of seed direct effects of the 4 mineral element contents were all highly significant. The estimate values of narrow heritabilites of seed direct genetic effects were high for Fe, Zn and Mn contents, while those of seed and maternal effects were intermediate for P content. Therefore, more attention should be paid to the single plant selection and single grain selection based on the seed mineral element contents of hybrid offspring.

[Clinical study on the piweiping capsule in treating patients with metaplasia of gastric mucosa]

One hundred and forty-three patients were diagnosed as chronic superficial atrophic gastritis of gastric antrum or with metaplasia by means of gastroscopic observation with pathological biopsy examination. They were divided into 4 types (the Spleen-Stomach Cold-Deficiency type, Disharmonious of Liver and Stomach type, Spleen-Stomach Yin Deficiency type and Spleen Deficiency with Qi-Stagnation type) and subdivided according to treatment into two groups, 75 patients of treatment group of above-mentioned 4 types were treated with Piweiping capsule (PWPC) I, II, III, IV respectively, 68 patients of control group were all treated with Sanjiu Weitai (SJWT). After 3-6 months of treatment, the improvement of gastric mucosa cyclic adenosine monophosphate, deoxyribonucleic acid, 3H-thymopyrimidine nucleoside and lymphocyte transformation of treatment group were all superior to that of control group, P < 0.05-0.001. The curative rate and total effective rate of symptomatic effect of treatment group were 49.3% and 92.0%, while at intestinal metaplasia of treatment group were 45.3% and 62.7%. As in control group, they were 29.4%, 67.6%, 10.3% and 29.4% respectively. The difference between two groups was significant, P < 0.001. These results suggested that the PWPC could reverse the intestinal metaplasia through improving the gastric cAMP, DNA and strengthening the cellular immunity and the effect would be enhanced when the treatment was based on syndrome differentiation.