Severe spontaneous acute arterial subdural hematoma as an initial symptom of chronic myeloid leukemia

Acute subdural hematoma (SDH) is a rare occurrence in chronic myeloid leukemia (CML) patients with only two cases reported in literature. However, sudden severe acute SDH caused by CML has not been reported on. Our patient was admitted for 'sudden unconsciousness for more than 1 hour'. Computed tomography (CT) angiography revealed a large amount of acute SDH on the left side. Physical exam showed the patient's left pupil was dilated and signs of cerebral herniation were present. The preoperative coagulation profile was normal. Emergency craniotomy for hematoma clearance and decompression was performed. During the surgery, a ruptured cerebral artery was located in the perisylvian region and hemostasis was achieved through electrocautery. Pre-operative white blood count was 58,100 cell/µl, with post-operative bone marrow examination、cytogenetic analysis and RT-PCR detection revealing a diagnosis of CML, for which hydroxyurea chemotherapy was initiated. Leukocyte count of the patient gradually returned to normal. After 24 days, the patient regained consciousness and on day 30, repeat CT scan showed no SDH recurrence. The patient recovered with no neurological deficits and achieved a good prognosis.

Chronic subdural hematoma caused by excessive drainage in a patient with ventriculoperitoneal shunt valve breakdown in brain injury: a case report

INTRODUCTION

Chronic subdural hematoma (CSDH) often occurs 3 weeks to 3 months after brain injury, which is mainly caused by bleeding of the bridging vein. For patients with ventriculoperitoneal (V-P) shunt, excessive drainage can also cause CSDH. We present a rare case of CSDH caused by shunt valve breakdown in brain injury.

CASE REPORT

We report a 68-year-old man with V-P shunt for 8 years. He presented with bilateral CSDH with disappearance of lateral ventricles nearly 1 month after a brain injury caused by being hit with a stick. After burr hole drainage (BHD), the patient's symptoms improved and lateral ventricles reappeared, but disappeared rapidly with CSDH recurrence within a short time. We considered the cause to be medium pressure shunt valve breakdown caused by hitting with a stick, which was confirmed by the engineer's test after the operation and excessive drainage of cerebrospinal fluid. BHD replaced the adjustable pressure shunt valve, and the patient recovered.

CONCLUSION

V-P shunt is a common operation in neurosurgery, and postoperative shunt valve breakdown may lead to poor outcome. We report a rare case of CSDH caused by shunt valve breakdown due to excessive external forces, suggesting that patients after V-P shunt should pay attention to the protection of the shunt valve.

[Effects of caloric restriction and rope-skipping exercise on cardiometabolic risk factors in overweight or obese college students]

Objective: To explore the effect of three interventions including caloric restriction, rope-skipping exercise and caloric restriction combined with rope-skipping exercise on cardiometabolic risk factors in overweight or obese college students. Methods: This study was a pilot randomized controlled trial. Overweight or obese students who met the inclusion criteria were recruited at Sun Yat-sen University in September 2019 and were randomly divided into four groups: caloric restriction group (CR), rope-skipping group (RS), combined group (CR-RS) and control group (CT). The intervention in each group lasted 8 weeks, specifically: the daily energy intake of CR was 100% to 110% of the basal metabolic energy; RS was instructed to rope three times a week, and CR-RS combined caloric restriction with rope-skipping. At the baseline and end of 8-week intervention, basic information, anthropometric indicators and fasting vein blood of students were collected. Paired t test and Wilcoxon paired-samples signed rank test were used for comparison before and after intervention, and analysis of covariance was used for comparison between groups after intervention. Results: A total of 29 students completed the trial and were included in the final analysis (7, 9, 7 and 6 students in CR, RS, CR-RS and CT, respectively). The mean age of students were (19.00±1.00) years, including 11 males and 18 females. The baseline characteristics of four groups were comparable. After 8 weeks of intervention, compared with CT, there was an increase in the body fat percentage and fat mass index in CR and CR-RS (P<0.05). Insulin level decreased in CR-RS (P<0.05). Systolic blood pressure in CR and diastolic blood pressure in CR-RS were higher (P<0.05). Compared with baseline, fat mass index decreased in CR (P<0.05), while body weight, BMI, and fat mass index decreased in CR-RS (P<0.05). Conclusion: It is suggested that the caloric restriction alone and calorie restriction combined with rope-skipping exercise can benefit overweight or obese college students with cardiometabolic risk factors.

Scratching damages tight junctions through the Akt-claudin 1 axis in atopic dermatitis

BACKGROUND

Atopic dermatitis (AD) is a common, chronic, severely pruritic, eczematous skin disease that seriously deteriorates the quality of life of patients. Scratching is a cardinal symptom of AD. Although the vicious itch-scratch cycle continues and aggravates skin barrier dysfunction in AD, how scratching induces skin barrier dysfunction through tight junctions remains unclear.

AIM

To study the effect of scratching on tight junctions in the itch-scratch cycle.

METHODS

Scratching behaviour and skin barrier dysfunction on the neck and back in an AD mouse model were assessed. The expression of tight junction proteins was compared between the neck and back mice, and the mechanisms underlying the involvement of Akt/CLDN1 pathways in this process were explored.

RESULTS

We used oxazolone to induce AD on the neck or back of mice. There was significantly more scratching behaviour and more pronounced skin barrier dysfunction with the neck than with the back. Downregulation of claudin-1 (CLDN1) and upregulation of Akt phosphorylation in skin were well correlated with scratching behaviour in this AD model. Furthermore, SC79, an agonist of Akt phosphorylation, could downregulate CLDN1 expression in HaCaT cells. An antagonist of Akt phosphorylation (LY294002) was used to treat the AD mice; this treatment rescued CLDN1 expression through inhibiting Akt phosphorylation in skin, and importantly, also inhibited the scratching behaviour induced by AD.

CONCLUSION

The results reveal the underlying mechanism of tight junction damage promoted by scratching in the itch-scratch cycle of AD, and opens a new avenue to pruritus management in AD, through Akt antagonists.

Acute communicating hydrocephalus caused by extravasation of digital subtraction angiography contrast medium: a case report and literature review

With the increasing use of endovascular technology in the treatment of various conditions, there has been an inevitable rise in cases with extravasation of contrast medium. We present a case in which extravasation of a large quantity of contrast medium resulted in acute communicating hydrocephalus. A 78-year-old woman came to the hospital because of abnormal right-sided limb movement, and was diagnosed with occlusion of the left internal carotid artery. The patient underwent timely intra-arterial mechanical thrombectomy. Postoperative computed tomography (CT) examination revealed a high-density shadow of the left basal ganglia and left frontal lobe. Twelve hours later, the patient fell into a coma. Repeat head CT indicated acute hydrocephalus with no evidence of obstruction. The patient underwent emergency external ventricular drainage, and the drainage fluid was observed to be clear. The patient regained consciousness after the procedure and the drainage tube was removed 4 days later. The patient had no recurrence of hydrocephalus. The mechanisms and treatment of this condition are discussed.

Effect of different early nutritional support programs on serum protein, inflammatory cytokines, and Glasgow Coma Scale score in patients with severe craniocerebral injury

AIM

To compare the effect of different nutritional support programs on serum protein, inflammatory cytokines, and Glasgow Coma Scale (GCS) score in patients with severe craniocerebral injury (SCCI).

METHODS

The clinical data of 150 patients with SCCI treated from April 2012 to April 2017 were retrospectively analyzed. Among them, 70 patients were given general enteral nutrition support in the early stage (control group), and 80 patients were given early enteral nutrition support program containing probiotics (observation group). The two groups of patients were compared in serum protein levels, inflammatory cytokines, GCS score, and other indicators.

RESULTS

At weeks 1 and 2 after treatment, serum protein levels (39.22 ± 2.58 vs 35.03 ± 1.91, 41.31 ± 2.61 vs 36.92 ± 1.93, P < 0.05) and hemoglobin levels (103.68 ± 11.56 vs 94.19 ± 10.81, 107.32 ± 11.41 vs 95.12 ± 10.87, P < 0.05) were significantly higher and the levels of IL-6, TNF-α, D-lactate, and PCT (week 1: 87.33 ± 18.61 vs 113.76 ± 20.35, 6.28 ± 1.06 vs 8.22 ± 1.58, 1.25 ± 0.21 vs 2.39 ± 0.46, 4.15 ± 0.86 vs 7.12 ± 1.01; week 2: 85.35 ± 17.32 vs 110.91 ± 18.93, 5.92 ± 1.01 vs 8.31 ± 1.61, 1.09 ± 0.19 vs 2.28 ± 0.37, 4.105 ± 0.71 vs 7.08 ± 1.22; P < 0.05) were significantly lower in the observation group than in the control group. GCS scores at weeks 1 and 2 were significantly higher in the observation group than in the control group (12.08 ± 1.52 vs 10.28 ± 1.37, 13.26 ± 1.72 vs 11.31 ± 1.41, P < 0.05). The hospitalization time, hospitalization cost, enteral nutrition time, and in-hospital mortality were significantly lower in the observation group than in the control group (21.28 ± 7.16 vs 27.43 ± 8.23, 8.38 ± 1.96 vs 11.65 ± 2.67, 17.66 ± 5.71 vs 23.19 ± 7.33, 16.25% vs 28.57%, P < 0.05). The GOS score at 6 mo after discharge was significantly higher in the observation group than in the control group (4.32 ± 1.25 vs 3.11 ± 0.91, P < 0.05).

CONCLUSION

The early use of probiotics-containing enteral nutrition regimens in patients with SCCI can significantly improve nutritional status, reduce inflammatory response, and improve GCS score.

Proteome analysis of tobacco leaves reveals dynamic changes in protein expression among different cultivation areas

The leaves of tobacco plants were used to analyze differences in protein content of tobacco grown in the four main flue-cured tobacco-producing areas of Sichuan Province, China. An improved protein extraction method, isoelectric focusing/sodium dodecyl sulfate-polyacrylamide gel electrophoresis two-dimensional gel electrophoretic separation, was used to extract and separate total protein from tobacco leaves. Proteomic maps with relatively high resolution and repeatability were produced. At isoelectric points 4 to 7 and molecular weight ranging from 20-100 kDa, we detected 1032, 1030, 1019, and 1011 clearly visible protein spots in tobacco leaves from the four study areas. Proteome comparison between these protein spots showed that 119 spots with a greater than 2-fold change in expression quantity contributed to the variation in expression. Of which, 115 were successfully identified and annotated. According to the annotation results, these proteins participate in photosynthesis, energy metabolism, mineral nutrition, terpene metabolism, defensive reaction, and other physiological and biochemical processes. This study preliminarily explains the effects of ecological conditions on the physiological metabolism of tobacco leaves and how such effects directly or indirectly contribute to tobacco leaf quality.

Dynamic QTL analysis of protein content and glutamine synthetase activity in recombinant inbred wheat lines

Protein content (PC) is a crucial factor that determines the end-use and nutritional quality of wheat (Triticum aestivum). Glutamine synthetase (GS), which is a major participant in nitrogen metabolism, can convert inorganic nitrogen into organic nitrogen. Although many studies have been conducted on PC and GS, a dynamic analysis of all of the filling stages has not been conducted. Therefore, 115 F9-10 recombinant inbred wheat lines of 'R131/R142' were used to analyze PC and GS activity during different developmental stages, using the conditional quantitative trait loci (QTL) mapping method. Twenty-two and six conditional QTL were detected for PC and GS activily, respectively. More QTL in leaf PC were detected during the early filling stages than in the later filling stages. Grain PC QTL displayed different dynamic variations to leaf PC QTL during the entire grain-filling stages. All of the QTL were expressed differently over time, and nine conditional QTL were detected across two filling stages. QTL with similar functions may have tended to group in specific locales. This study provides dynamic genetic information on protein accumulation during grain-filling stages.

Spontaneous thoracic ventral spinal subdural hematoma mimicking a tumoral lesion: a case report

Introduction

Spinal subdural hematoma is rare and can cause serious neurological symptoms. Sometimes, idiopathic spinal subdural hematoma can spontaneously occur without any identifiable underlying etiologies. In this report, we present such an uncommon case of paraplegia caused by idiopathic spinal subdural hematoma that was successfully managed by laminectomy.

Case presentation

A 45-year-old Chinese woman presented with sudden onset of progressive asthenia and numbness in both lower extremities, accompanied by difficulty in micturition. An initial non-contrast spinal magnetic resonance imaging at a local hospital suggested a spinal subdural tumoral hematoma at the T9 level. She was referred to our hospital and an emergency laminectomy from T8 to T10 was performed 22 hours after onset of her initial symptoms. However, nothing but a hematoma was identified during the operation, and a final diagnosis of spontaneous acute spinal subdural hematoma was concluded. She had partial return of sensations and voluntary movement after the operation.

Conclusions

On imaging findings, spinal subdural hematoma could manifest as focal and independent from the dura matter, and, therefore, it should be included in the differential diagnosis of medullary compressive lesions.

Major quality trait analysis and QTL detection in hexaploid wheat in humid rain-fed agriculture

Humid rain-fed agriculture is a special environment for wheat (Triticum aestivum) culture that tends to negatively affect wheat yield and quality. To identify quality characters of wheat in a humid environment, we conducted quality analysis and quantitative trait loci (QTL) detection in a recombinant inbred line whose parent had a high level of quality for several years. We found that high-quality wheat had less gluten content and lower protein content. Apparently, wheat quality and associated quantity traits were in a dynamic state of equilibrium. We detected 83 QTL for 10 wheat quality traits in this recombinant inbred line population. Nine QTL were detected in both evaluation years; Q.DT.scau-2A, linked to Xwmc522-2A, was detected at the same genetic location in both years. Other QTL for different traits were detected simultaneously in more than one location. Consequently, there appeared to be pleiotropic genes that control wheat quality. Based on previous studies and our research on QTL analysis of grain protein content, we conclude that there must be one or more genes for grain protein content on chromosome 6B, whose expression was little affected by environment. We constructed a consensus map and projected the QTL on it. It was useful for choosing optimal markers for marker-assisted breeding and map-based cloning.

The maternal cytoplasmic environment may be involved in the viability selection of gametes and zygotes

Segregation distortion is the phenomenon whereby the observed genotypic frequencies of a locus fall outside the expected Mendelian segregation ratio, and it is increasingly recognised as a potentially powerful evolutionary force. The main reason for segregation distortion is a difference in the viability of gametes and zygotes caused by viability loci in the segregating progeny. However, the maternal cytoplasm may also be involved in the viability selection of gametes and zygotes. The objectives of this study were to map the segregation distortion loci (SDL) in maize and to test the hypothesis that the viability of gametes and zygotes may also be associated with the maternal cytoplasmic environment. In the present study, a reciprocal mating design was conducted to generate an F2-segregating population. A linkage map was constructed with 126 microsatellite markers. A whole-genome scan was performed to detect the SDL in segregating populations with different maternal cytoplasm environments. Altogether, 14 SDL with strong LOD (logarithm (base 10) of odds) supports were identified in the specifically designed F2 populations. Interestingly, we found dramatic changes in the genotypic frequencies of the SDL in the two maternal cytoplasmic backgrounds, which indicated a change in the viability of gametes and zygotes in different cytoplasmic environments. Furthermore, in the JB cytoplasmic background, most of the detected SDL and complete distortion markers exhibited similar bias patterns favouring the Y53 alleles. These results suggested that selfish cytoplasmic elements may have an important role in shaping the patterns of segregation distortion in F2 populations through selective viability of gametes and zygotes.

Chloroplast ultrastructure regeneration with protection of photosystem II is responsible for the functional 'stay-green' trait in wheat

CN17 is a functional stay-green wheat variety that exhibits delayed leaf senescence and enhanced photosynthetic competence. To better understand these valuable traits, levels of chlorophyll a and b, soluble proteins, unsaturated fatty acids, and other components of CN17 were assayed. In addition, chloroplast ultrastructure, chloroplast number, and differences in gene expression between CN17 and a control variety, MY11, were examined. By 21 d post-anthesis (DPA), CN17 leaves exhibited a significantly higher maximal photochemical efficiency for photosystem II (PSII) (F(v) /F(m) ) and a significantly higher efficiency of excitation capture by open PSII reaction centres (F(v) '/F(m) '). In addition, chlorophyll degradation in CN17 was delayed by approximately 14 d, and was not blocked as observed in cosmetic stay-green phenotypes. The soluble protein content (Ps) of CN17 was higher than MY11 at all timepoints assayed, and the ratio of unsaturated to saturated fatty acids was significantly higher. CN17 also exhibited isolated granal lamellae associated with vesicles and diminished peroxidation, and between 35 and 42 DPA, a sharp decrease in chloroplast number was detected. Taken together, these results strongly support the hypothesis that chloroplast ultrastructure regeneration is responsible for the functional stay-green trait of CN17, and gene expression data provide insight into the mechanistic details.

Variation of genomic DNA methylation in the nitrate reductase gene of sibling tobacco (Nicotiana tabacum) cultivars

To better understand genomic DNA methylation in sibling plant cultivars, methylation-sensitive amplification polymorphism analysis was used to investigate two sibling tobacco cultivars, Yunyan85 and Yunyan87, and their two parents, K326 and Yunyan No. 2. Differences in the degree of genomic DNA methylation were found among the four tobacco cultivars. Compared with parents, the two sibling cultivars had fewer methylated sites. Twenty-nine methylation-sensitive amplification polymorphism fragments that exhibited methylation alteration in the four tobacco cultivars were recovered and sequenced. BLAST (nucleotide BLAST) searches showed that two of the 29 sequences have 99% similarity with nucleotides 1442-1694 of the nia-1 gene and the other 27 sequences contain GC, CAAT or TATA box. The nitrate reductase genes from Yunyan87, K326 and Yunyan No. 2 were found to be identical; however, the third intron of the nitrate reductase gene from Yunyan85 was different compared to the third introns of Yunyan87, K326 and Yunyan No. 2. We conclude that methylation alteration of promoter regions could be responsible for the different phenotypes in tobacco and that introns of the nitrate reductase gene can vary as a result of intra-species crossing in tobacco.

Compromised liver mitochondrial function and complex activity in low feed efficient broilers are associated with higher oxidative stress and differential protein expression

Variations in broiler growth and efficiency have been explained in part by differences in mitochondrial function and biochemistry in broilers. To further our knowledge in this regard, 2 experiments were carried out to determine the relationships of a) mitochondrial function and activities of various electron transport chain (ETC) complexes; b) production of H2O2, a reactive oxygen species (ROS), and its association with protein oxidation; and c) mitochondrial protein expression in liver of a single line male broilers with low or high feed efficiency (FE, n = 5 to 8 per group). Mitochondrial function and complex activities were measured polarographically and spectrophotometrically, respectively. H2O2 was measured fluorimetrically, whereas oxidized protein (carbonyls) and specific mitochondrial proteins were analyzed using Western blots. Mitochondrial function (ETC coupling) and activities of ETC complexes (I, II, III, and IV) were higher in high FE compared with low FE broilers. H2O2 and protein carbonyls were higher in the livers of low FE broilers than in high FE broilers. Whereas the expression of 4 immunoreactive proteins [NAD3 (complex I), subunit VII (complex III), cytochrome c oxidase subunits (COX) II, and COX IVb (complex IV)] were higher in low FE liver mitochondria and 2 proteins [subunit 70 (complex II) and a-ATP synthase (complex V)] were higher in high FE birds, there were no differences between groups in the expression of 18 other mitochondrial proteins. In conclusion, increases in oxidative stress in low FE broilers were caused by or may contribute to differences in mitochondrial function (ETC coupling and complex activities) or the differential expression of steady-state levels of some mitochondrial proteins in the liver. Understanding the role of oxidative stress in Low FE broilers will provide clues in understanding the cellular basis of feed efficiency.

Low Feed Efficient Broilers Within a Single Genetic Line Exhibit Higher Oxidative Stress and Protein Expression in Breast Muscle with Lower Mitochondrial Complex Activity

The objectives of this study were to determine the effects of low or high feed efficiency (FE) on a) protein oxidation, b) the activities of various respiratory chain complexes, and c) expression of various mitochondrial proteins in male broilers within a single genetic line. Tissue homogenate or mitochondria were isolated from breast muscle of broilers with high (0.80 +/- 0.01) and low FE (0.62 +/- 0.02). The complex activities were measured spectrophotometrically, and the levels of oxidized protein (carbonyl) and immunoreactive mitochondrial proteins were analyzed using Western blots. Protein carbonyl levels were higher in low FE compared with high FE broilers breast muscle, which indicated enhanced protein oxidation in low FE mitochondria. Activities of all respiratory chain complexes (I, II, III, IV) were higher in high FE compared with low FE broilers for breast mitochondria. Whereas the expression of immunoreactive proteins was higher in low FE muscle mitochondria for 5 mitochondrial proteins [core I, cyt c1, cyt b (complex III), COX II (cytochrome c oxidase subunit II, complex IV), and adenine nucleotide translocator (ANT1)], there were no differences between groups in the expression of 9 other respiratory chain protein subunits associated with complexex I, II, III, IV, and V. SDS-PAGE revealed a protein band of 47 kDa that was expressed at a higher level in low FE compared with high FE mitochondria. The differential expression of certain mitochondrial proteins and the 47-kDa band might be a compensatory response either to the lower complex activities or increased protein oxidation observed in low FE birds.

Association of mitochondrial function with feed efficiency within a single genetic line of male broilers

Studies were conducted to determine relationships between feed efficiency and mitochondrial function and biochemistry. After feed efficiency (FE; gain:feed) was determined in broiler breeder males between 6 and 7 wk of age, mitochondria were isolated from breast and leg muscle from birds with high FE (0.83+/-0.01, n = 6) and low FE (0.64+/-0.01, n = 7). Respiratory chain coupling, assessed by the respiratory control ratio (RCR), was greater in high FE breast, and leg mitochondria provided NADH-linked, but not FADH-linked, energy substrates. There were no differences, however, in the adenosine diphosphate to oxygen (ADP:O) ratio (an index of oxidative phosphorylation) when mitochondria were provided either energy substrate. Electron leak, as determined by generation of H202, was greater in the low FE than in high FE breast mitochondria. Electron leak increased following inhibition of electron transport at Complex I (with rotenone) and Complex III (with antimycin A) in low FE but not in high FE breast mitochondria. There were no differences in basal electron leak in leg mitochondria between groups, but H202 generation was elevated (P < 0.07) compared to basal values in low FE leg mitochondria after Complex I inhibition. The activities of Complexes I and II were greater in high FE breast and leg muscle mitochondria compared to those in low FE mitochondria. The results indicate that lower respiratory chain coupling in low FE muscle mitochondria may be due to lower activities of Complexes I and II and defects in electron leak and provide insight into cellular mechanisms associated with the phenotypic expression of feed efficiency in broilers.

[Acute toxicity testing (LD50) of Chinese mineral drugs]

Acute toxicity and LD50 of 62 mineral drugs were determined by ig, ip or iv in mice, in order to provide some guidelines for safety in clinical use, as well as for pharmacological and toxicological studies. In the present investigation, the difference in the acute toxicity and LD50 between raw drugs and medicines prepared by roasting is explained.