[Further understanding and paying attention to normoalbuminuric diabetic kidney disease]

Diabetes mellitus (DM) has grown up to be an important issue of global public health because of its high incidence rate. Diabetic kidney disease (DKD) is the main cause of end-stage kidney disease (ESKD). Therefore, early diagnosis and timely prevention and treatment of DKD are essential for the progress of DM. The clinical diagnosis and staging of DKD are mostly based on the urinary albumin excretion rate (UAER) and estimated glomerular filtration rate (eGFR). However, clinically, DKD patients show normoalbuminuric diabetic kidney disease (NADKD) instead of clinical proteinuria. The old NADKD concept is no longer suitable and should be updated accordingly with the redefinition of normal proteinuria by NKF/FDA (National Kidney Foundation/Food and Drug Administration). Based on the relevant guidelines of DM and chronic kidney disease (CKD) and combined with the current situation of clinical research, the review described NADKD from the aspects of epidemiology, pathological mechanism, disease diagnosis, clinical characteristics and biomarkers, to arouse the new understanding of NADKD in the medical profession and pay attention to it.

Anesthetic management for the peripartum care of women with Fontan physiology

BACKGROUND

As outcomes for surgical palliation have improved, women with single ventricle congenital heart disease are surviving into their reproductive years and may become pregnant. The cardiovascular changes of pregnancy may stress the Fontan circulation and pose significant risk to the mother and fetus.

METHODS

Pregnant women with Fontan physiology were identified from the Ahmanson/UCLA Adult Congenital Heart Disease Center database. A total of 37 pregnancies were identified between 2000 and 2019. Twenty live births from 19 patients were reviewed and compared for cardiac history, obstetric history, anesthetic management and cardiovascular outcomes.

RESULTS

Median gestational age at delivery was 35 weeks. Ten of 20 births were by cesarean delivery. An epidural technique was used as the primary anesthetic for 19 deliveries and general anesthesia was used for one cesarean delivery. An arterial line was placed in the peripartum period for three deliveries. Central venous access was established in the peripartum period for one patient. The mean blood loss for cesarean deliveries was 626 mL (range 240-1200 mL). The mean net peri-operative intake/output was positive 93.5 mL. Three patients were briefly transferred to the intensive care unit postpartum for higher level monitoring and care.

CONCLUSION

Epidural anesthesia is safe and effective for both vaginal and cesarean deliveries. Judicious fluid management is critical in minimizing postpartum cardiovascular complications. Many patients do not require a higher level of care, invasive monitoring or central venous access during the peripartum period.

Exogenous 6-benzyladenine application affects root morphology by altering hormone status and gene expression of developing lateral roots in Malus hupehensis

Malus hupehensis is an extensively used apple rootstock in China. In the current study, M. hupehensis seedlings were treated with exogenous 2.2 µm 6-benzyladenine (6-BA) so as to investigate the mechanism by which 6-BA affects lateral root development. The results indicate that 6-BA treatment promotes elongation and thickening of both root and shoot in M. hupehensis, but reduces the number of lateral roots, as well as reducing the auxin level after 6-BA treatment. Moreover, MhAHK4, MhRR1 and MhRR2 were also significantly up-regulated in response to 6-BA treatment. Expression levels of auxin synthesis- and transport-related genes, such as MhYUCCA6, MhYUCCA10, MhPIN1 and MhPIN2, were down-regulated, which corresponds with lower auxin levels in the 6-BA-treated seedlings. A negative regulator of auxin, MhIAA3, was induced by 6-BA treatment, leading to reduced expression of MhARF7 and MhARF19 in 6-BA-treated seedlings. As a result, expression of MhWOX11, MhWOX5, MhLBD16 and MhLBD29 was blocked, which in turn inhibited lateral root initiation. In addition, a lower auxin level decreased expression of MhRR7 and MhRR15, which repressed expression of key transcription factors associated with root development, thus inhibiting lateral root development. In contrast, 6-BA treatment promoted secondary growth (thickening) of the root by inducing expression of MhCYCD3;1 and MhCYCD3;2. Collectively, the changes in hormone levels and gene expression resulted in a reduced number of lateral roots and thicker roots in 6-BA-treated plants.

[Droplets and aerosols in dental clinics and prevention and control measures of infection]

Spraying during dental practices can generate a large number of droplets, which may transform into droplet nuclei and suspend in the air of clinic in the form of aerosol. Either droplets or aerosols may carry microorganisms and cause air contamination in the hospital, posing potential threat to the health of clinical healthcare staff and patients. The present article summarizes some basic concepts involved in bio-aerosol research and reviews literatures on intervention measures of dental clinic droplet/aerosols to clarify whether there is experimental evidence of aerosol-carrying bacteria in the existing literatures. The aim of the present review article is to provide evidence for the formulation of guidelines for infection control in dental healthcare practices during the pandemic period of infectious diseases, as well as to provide reference and scientific basis for the management and implementation of infection control measures in daily dental clinical work.

[Surgical technique and mid-and-long curative effect analysis of primary repair of chronic Achilles tendon rupture]

Objective: To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture. Methods: From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same doctor at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years), the follow-up period was (45.6±17.2) months(range:17-82 months). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right.The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment-Achilles(VISA-A), the Achilles tendon Total Rupture Score(ATRS)and the Tegner Activity Score of patients were collected and compared by paired-t test. Results: Among 47 patients with chronic Achilles tendon rupture, 35 patients were followed up for (45.6 ± 17.2)months(range: 17-28 months). No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow-up,the VAS decreased from 1.0(2.0) (M(Q(R))) preoperative to 0.0(0.8)(Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359,P<0.001), VISA-A increased from 51.3± 9.8 to 87.8±18.0(t=- 17.656, P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=- 12.524, P=0.00)and ATRS increased from 40.0±3.5 to 97.9±3.9(t=-64.133,P=0.00). Twenty-eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner-Lindholm curative effect evaluation criteria, 32 cases(91.4%)gained the excellent results, 1 case(2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%. All except 2 patients with bad results could perform a single-limb heel rise painlessly. Conclusions: Primary repair is an efficient approach for chronic Achilles tendon rupture. The mid-and-long curative effect is satisfactory and stable.Compared with other surgical techniques, operation is relatively simple and economical. The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.

Establishment of a Quantitative Polymerase Chain Reaction Assay for Monitoring Chimeric Antigen Receptor T Cells in Peripheral Blood

BACKGROUND

The chimeric antigen receptor (CAR) consists of an antigen recognition moiety from a monoclonal antibody fused to an intracellular signalling domain capable of activating T cells. The specific structure of the CAR molecule has been used in various basic research and clinical settings to detect CAR expression, but it is necessary to develop more specific and simpler monitoring methods to observe real-time changes.

MATERIALS AND METHODS

To develop a quantitative assay for the universal detection of DNA from anti-CD19 CAR-T cells, a TaqMan real-time quantitative polymerase chain reaction (qPCR) assay was developed using primers based on FMC63-28Z gene sequences. We identified the numbers of copies of CAR gene on T cells transduced with the CAR gene that were obtained from peripheral blood.

RESULTS

The assay had a minimum detection limit of 10 copies/μL and a strong linear standard curve (y = -3.3682x + 38.594; R² = 0.999) within the range of the input CAR gene (10-10⁷ copies/μL). The reproducibility test showed a coefficient of variation ranging from 0.63%-1.65%. Real-time qPCR is a highly sensitive, specific, reproducible, and universal method that can be used to detect anti-CD19 CAR-T cells in peripheral blood.

Microdomain elements of airway smooth muscle in calcium regulation and cell proliferation

Airway remodeling manifested by hyperplasia of airway smooth muscle cells (ASMCs) and other structural and functional changes is a pathological condition in asthma not addressed by current treatment. Ca²⁺ signaling is crucial for ASMC proliferation. Inositol-1,4,5-trisphosphate receptor (IP3R) and ryanodine receptor (RyR) mediate Ca²⁺ release from endoplasmic reticulum/sarcoplasmic reticulum (ER/SR). Upon sensing the depletion of Ca²⁺ in ER/SR, stromal interaction molecule 1 (STIM1) aggregates and redistributes at the microdomain of ER/SR-plasma membrane (PM) and activates Orai1, a component of the store-operated Ca²⁺ (SOC) channels, to initiate Ca²⁺ influx. The STIM1/Orai1-mediated SOC entry is the main cause of a sustained intracellular calcium ([Ca²⁺]_i) elevation, which is different from a transient rise of [Ca²⁺]_i mediated by IP₃R and RyR. Extended-synaptotagmin 1 (E-Syt1) is recruited to the ER/SR-PM junction and anchors to the PM lipid phosphatidylinositol-4,5-bisphosphate (PI(_4,5)P₂) in a SOC-dependent manner. The subsequent strengthening of the ER/SR-PM connection by E-Syt1 facilitates the phosphatidylinositol (PI) transfer protein, Nir2, to supplement PI, a PI(_4,5)P₂ substrate, for the generation of IP3 and the propagation of Ca²⁺ signaling. Calcineurin and nuclear factor of activated T cells are the downstream signaling factors of elevated [Ca²⁺]_i contributing to ASMC proliferation. Mitochondrial Ca²⁺ uptake/efflux, mitochondrial fission/fusion and mitochondrial-ER/SR coupling also play important roles in modulating [Ca²⁺]_i and ASMC proliferation. Together, these pathways and mechanisms represent new therapeutic targets for airway remodeling. The present review provides an overview of our current understanding of the mechanisms of ASMC proliferation involving Ca²⁺ and highlights potential directions to control airway remodeling in asthma.

[Expression of osteoprotegerin and receptor activator of nuclear factor kappa-B ligand in mandibular ramus osteotomy healing with administration of different doses of parathyroid hormone]

Objective: To investigate the effect of parathyroid hormone (PTH) on the bone healing of mandibular ramus osteotomy. Methods: The mandibular ramus osteotomy model was established in sixty rabbits and these rabbits were randomly divided into experimental group A, experimental group B and control group. In the experimental group A and experimental group B, the rabbits were given PTH (20 and 40 μg/kg respectively) every other day after operation. In the control group, 1 ml saline was given. The animals were sacrificed at 1 week, 2 weeks, 3 weeks and 4 weeks postoperatively. The new bone formation was observed by histology and cone bone CT. The expression of osteoprotegerin and receptor activator of nuclear factor kappa-B (RANKL) in the new bone was detected by real-time quantitative PCR. Results: The experimental groups has better osteogenesis and the bone mineral density than the control group in osteotomy area. The experimental group B showed the best osteogenesis.Osteoprotegerin mRNA expression in experimental group A (1.127±0.035, 1.742±0.049, 1.049±0.062, 1.063±0.036) was significantly higher than that in the control group in each period (0.965±0.082, 1.254±0.071, 0.793±0.061, 0.684±0.055) (P=0.010, P=0.000, P=0.001, P=0.020), while group B (1.416±0.205, 2.648±0.168, 1.652±0.091, 1.712±0.070) was significantly higher than group A (P=0.000, P=0.010, P=0.023, P=0.003). RANKL mRNA expression in control group (1.666±0.086, 1.058±0.105, 0.885±0.124, 0.972±0.136) was significantly higher than that of the group A (0.788±0.036, 0.585±0.017, 0.692±0.017, 0.527±0.051) (P=0.001, P=0.006, P=0.003, P=0.028) in each period, while group A was significantly higher than group B(0.247±0.022, 0.240±0.034, 0.134±0.011, 0.103±0.050) (P=0.000, P=0.001, P=0.002, P=0.012). Conclusions: PTH can upregulate the expression of osteoprotegerin and reduce expression of RANKL, thus promoting new bone formation. Intermittent administration of high dose of parathyroid hormone can further promote the healing process after mandibular ramus osteotomy.

[A clinical evaluation of periodontal treatment effect using periodontal endoscope for patients with periodontitis: a split-mouth controlled study]

Objective: To compare the clinical effects of periodontal treatment using periodontal endoscope with that of conventional treatment method for patients with periodontitis. Methods: Eleven periodontal patients with moderate to advanced periodontal destruction were recruited and treated with scaling and root planing in a split-mouth design randomly with (test group) or without (control group) periodontal endoscope. Changes of such clinical parameters as plaque index (PLI), bleeding index (BI), probing depth (PD) and attachment loss (AL) before and after treatments as well as the difference between test and control groups were examined and compared. Results: Both groups showed significant reductions in PD, BI and AL values at 6 weeks and 3 months after treatment (P <0.001). Only in the test group, for sites with PD≥6 mm at baseline, PD value ([4.0±1.2] mm) and AL value ([3.8±0.9] mm) at the end of 3 months were significantly lower than that at the end of 6 weeks (PD[4.4±1.3] mm, P<0.001; AL[4.1±1.1] mm, P< 0.05). There were no significant differences between two groups at the baseline, at the end of 6 weeks and 3 months, respectively. However, for the sites with PD≥6 mm in anterior teeth, PD value in test group at the end of 3 months was significantly lower than that in control group ([3.2±0.9] mm vs [3.7±0.9] mm, P <0.05), while AL value tend to be lower ([2.9 ± 1.2] mm vs [3.6 ± 1.3] mm, P=0.061). Conclusions: Periodontal treatment using endoscope is obviously effective, especially for the medium and long term prognosis of deep pockets and single rooted teeth.

[Role of vitamin K-dependent protein Gas6 in the expression of endothelial cell adhesion molecule-1 and chemokines induced by Porphyromonas gingivalis lipopolysaccharide]

OBJECTIVE

Growth-arrest-specific protein 6 (Gas6) is a vitamin K-dependent protein and involved in cell proliferation, survival, adhesion and migration . Also it has been shown to play an important role in the inflammatory response .The aim of present study was to investigate the role of Gas6 in the process of the expression of adhesion molecules and chemokines of human umbilical vein endothelial cells (HUVECs) induced by Porphyromonas gingivalis lipopolysaccharide(P.g-LPS).

METHODS

After up-regulation and down-regulation of the expression of Gas6, the vascular endothelial cells were stimulated with 1 mg/L P.g-LPS for 3 h and 24 h. Real-time quantitative polymerase chain reaction(real-time PCR) was taken to detect the expression of the cell adhesion molecules:intercellular adhesion molecule-1 (ICAM-1) and E-selectin, as well as chemokines:interleukin-8 (IL-8) and monocyte chemoattractant protein 1 (MCP-1). Wound healing assay was taken to observe the migration ability of endothelium cells in different groups.

RESULTS

After 3 h of P.g-LPS stimulation, the expression of adhesion molecules and chemokine in the down-regulation group was not significantly different from that in the control group,while in the up-regulation group the decrease of E-selectin, ICAM-1, IL-8 and MCP-1 was 81%±0%, 47%±3%, 76% ± 3%, 26% ± 6% respectively. After 24 h of P.g-LPS stimulation, the expression of adhesion molecules and chemokine in down-regulation group was significantly higher than that in control group (2.06±0.07, 1.99±0.11, 3.14±0.15, 1.84±0.03 flod), while these molecules in the down-regulation group was significantly lower than in the control group (29%±1%, 62%±3%, 69%±1%, 41%±2%). Differences were statistically significant (P<0.01). Wounding healing assay showed that down-regulation of Gas6 enhanced migration ability of endothelial cells while up-regulation of Gas6 weakened this ability,which was consistent with the trend of real-time PCR result.

CONCLUSION

Down-regulation of the Gas6 gene enhanced the expression of ICAM-1, E-selectin, IL-8 and MCP-1 in HUVECs after P.g- LPS stimulating, while up-regulaiton of the Gas6 gene weakened the expression of ICAM-1, E-selectin, IL-8 and MCP-1 in HUVECs after P.g-LPS stimulating,suggesting that Gas6 may play a role in the process of endothelial cell adhesion.

A new water-soluble polythiophene derivative as a probe for real-time monitoring adenosine 5'-triphosphatase activity in lysosome of living cells

Detection of the adenosine 5'-triphosphatase (ATPase) activity in lysosome of living cells is of great importance for clinical diagnosis of many related diseases, including cancer. In this work, a new water-soluble polythiophene derivative named ZnPT bearing both quaternary ammonium salt groups and dipicolylamine-Zn²⁺ (DPA-Zn²⁺) complexes in its side chain, was designed and synthesized for this propose. The probe mainly localized to lysosome with good biocompatibility and membrane penetration. The real-time, continuous, direct, and label-free assays were achieved through a fluorescence "turn-on" mode by taking advantages of the reaction specificity of ATPase with ATP and the high binding selectivity of ZnPT toward ATP substrate over its hydrolysis product (ADP). This well designed strategy should provide a facile and effective way for investigating ATPase-relevant biological processes.

[Clinical analysis of multiple myeloma-associated amyloidosis]

Objective: To investigate the clinical features and survival of multiple myeloma-associated amyloidosis patients. Methods: Twenty three multiple myeloma-associated amyloidosis patients were retrospectively analyzed from January 2009 to December 2016. Results: The overall response rate(ORR)was 65.2% and the remission rate (sCR+ CR) was 21.7%. The median progression-free survival(PFS) was fourteen months(1-63), and the median overall survival(OS)was fifteen months(3-63). The early death rate (death rate within one year)was 33.3%. The median OS of patients(n=9)with the performance status(PS) score >2 was seven months(1-15), and the median OS of patients(n=14)with the PS score ≤2 was thirty months(10-63). There was a statistically significant difference in OS(P<0.05); the median PFS and OS of the patients (n=15) who responded to inductive treatment were seventeen months(2-63) and twenty four months (4-63)respectively, and the median PFS and OS of the patients (n=8)who did not respond to inductive treatment were three months(1-8) and eleven months (3-15) respectively. There was a statistically significant difference in PFS and OS(P<0.05). There was a statistically significant difference in PFS and OS between patients treated with remission (n=5)and those who did not(n=18) (P<0.05). Conclusions: The multiple myeloma-associated amyloidosis patients had a high early death rate and short survival time. Early identification and effective treatment are the preconditions for improving the poor prognosis.

[The prognostic significance of plasma Epstein-Barr virus DNA in patients with diffuse large B cell lymphoma]

To retrospectively analyze the prognostic significance of plasma Epstein-Barr virus (EBV) DNA in 122 patients with diffuse large B cell lymphoma (DLBCL). Plasma EBV DNA positivity was related to advanced disease stage (P=0.030), B symptoms (P=0.004) and elevated serum lactic dehydrogenase (LDH) (P=0.001). Furthermore, univariate analysis indicated that plasma EBV DNA level was associated with worse overall survival (OS) (HR=0.223, 95%CI 0.096-0.518, P<0.001) and worse progression free survival (PFS) (HR=4.417, 95%CI 1.911-10.208, P<0.001), whereas multivariate analysis showed plasma EBV DNA as a probable independent prognostic factor of clinical outcome(HR=0.409, 95%CI 0.166-1.008, P=0.052).

Naringenin regulates production of matrix metalloproteinases in the knee-joint and primary cultured articular chondrocytes and alleviates pain in rat osteoarthritis model

Inflammation of cartilage is a primary symptom for knee-joint osteoarthritis. Matrix metalloproteinases (MMPs) are known to play an important role in the articular cartilage destruction related to osteoarthritis. Naringenin is a plant-derived flavonoid known for its anti-inflammatory properties. We studied the effect of naringenin on the transcriptional expression, secretion and enzymatic activity of MMP-3 in vivo in the murine monosodium iodoacetate (MIA) osteoarthritis model. The assessment of pain behavior was also performed in the MIA rats. The destruction of knee-joint tissues was analyzed microscopically. Moreover, the effect of naringenin was also studied in vitro in IL-1β activated articular chondrocytes. The transcriptional expression of MMP-3, MMP-1, MMP-13, thrombospondin motifs (ADAMTS-4) and ADAMTS-5 was also studied in primary cultured chondrocytes of rats. Naringenin caused significant reduction in pain behavior and showed marked improvement in the tissue morphology of MIA rats. Moreover, a significant inhibition of MMP-3 expression in MIA rats was observed upon treatment with naringenin. In the in vitro tests, naringenin caused a significant reduction in the transcriptional expression, secretion and enzymatic activity of the studied degradative enzymes. The NF-κB pathway was also found to be inhibited upon treatment with naringenin in vitro. Overall, the study suggests that naringenin alleviated pain and regulated the production of matrix-metalloproteinases via regulation of NF-κB pathway. Thus, naringenin could be a potent therapeutic option for the treatment of osteoarthritis.

[Workplace social capital and intention to stay among Chinese nurses: a structural equation model]

Objective: To explore a model that workplace social capital is associated with intention to stay (ITS) in the nursing profession and that this association is partially mediated by organizational commitment, job satisfaction, and job stress among Chinese nurses. Methods: A cross-sectional, observationalstudy was conducted in Shanghai, China between September and December 2014. Two thousandforty-two nurses from 23 healthcare organizations were recruited for the current study using a two-stage sampling process.Intention to stay, workplace social capital, job satisfaction, organizational commitment, and job stress was measured by validated scale. Measured variable path analysis (MVPA) was used to test their hypothesized relationships. Results: There were significant positive direct effects from workplace social capital (β=0.11, P<0.01) , organizational commitment (β=0.81, P<0.01) and job satisfaction (β=0.03, P<0.01) to ITS, and a negative direct effects from job strain to ITS (β=-0.03, P<0.01) . The model explained 84% of the variability in ITS. Additionally, workplace social capital had significant positive direct effects on organizational commitment (β=0.65, P<0.01) , job satisfaction (β=0.44, P<0.01) and negative direct effects on job strain (β=-0.35, P<0.01) . The indirect effect of social capital to ITS was 0.55. Job satisfaction was positively associated with organizational commitment (r=0.47, P<0.01) , and negtively associated with job stress (r=-0.12, P<0.01) . Job stress was negtively associated with organizational commitment (r=-0.20, P<0.01) . Conclusion: This study suggests that greater workplace social capital may lead to higher ITS in nursing primarily by increasing commitment to the nursing occupation and their job satisfaction and by reducing their sense of job stress.

Propofol inhibits carbachol-induced chloride secretion by directly targeting the basolateral K+ channel in rat ileum epithelium

BACKGROUND

Propofol is a widely used intravenous general anesthetic. Acetylcholine (ACh) is critical in controlling epithelial ion transport. This study was to investigate the effects of propofol on ACh-evoked secretion in rat ileum epithelium.

METHODS

The Ussing chamber technique was used to investigate the effects of propofol on carbachol (CCh)-evoked short-circuit currents (Isc).

KEY RESULTS

Propofol (10^-2 -10^-6  mol/L) attenuated CCh-evoked Isc of rat ileum mucosa in a dose-dependent manner. The inhibitory effect of propofol was only evident after application to the serosal side. Pretreatment with tetrodotoxin (TTX, 0.3 μmol/L, n=5) had no effect on propofol-induced inhibitory effect, whereas serosal application of K⁺ channel inhibitor, glibenclamide, but not, an ATP-sensitive K⁺ channel inhibitor, largely reduced the inhibitory effect of propofol. In addition, pretreatment with either hexamethonium bromide (HB, nicotinic nACh receptor antagonist) or Cl^- channel blockers niflumic acid and cystic fibrosis transmembrane conductance regulator (inh)-172 did not produce any effect on the propofol-induced inhibitory effect.

CONCLUSIONS & INFERENCES

Propofol inhibits CCh-induced intestinal secretion by directly targeting basolateral K⁺ channels.

A new FRET-based ratiometric probe for fluorescence and colorimetric analyses of adenosine 5′-triphosphate

A new ratiometric probe for ATP was designed based on the binding-induced modulation of FRET coupled with the ACQ sensing mechanism.

[A clinical analysis of 69 newly diagnosed multiple myeloma patients with renal insufficiency]

Objective: To investigate the efficacy and outcome in newly diagnosed multiple myeloma (MM) patients with renal insufficiency using bortezomib- or thalidomide-based regimens as front line treatment. Method: Sixty-nine newly diagnosed MM patients with renal insufficiency were retrospectively analyzed from August 2006 to August 2014. Results: ① Among thirty-nine patients with bortezomib based regimens (the bortezomib group), the overall response rate (ORR) was 89.7% and complete response (CR) plus near CR(nCR) rate was 41.0%. By contrast, among thirty patients with thalidomide based regimens (the thalidomide group), the ORR was 83.3% and CR+ nCR rate was 26.7%. There was no significant difference of either ORR or CR+ nCR rate between bortezomib and thalidomide groups. ② The improvement rate of renal function in bortezomib group and thalidomide group were 87.2% and 60.0% respectively (P=0.012). The median duration time of renal injury was 45 days in 52 patients with renal function improved, which was significantly shorter compared with 222 days in 17 patients without improvement (P<0.05). There was no difference of median serum creatinine and creatinine clearance rate between the two groups.③ The median progression-free survival (PFS) and the overall survival (OS) were 18 and 33.5 months, respectively in all patients. The three-year and five-year OS rates were 57% and 17%, respectively. The median PFS was 19 months in bortezomib group, while it was only 12 months in thalidomide group (P=0.023). The median OS were 36.5 months and 25.5 months respectively, which was no difference (P=0.285). Conclusions: The newly diagnosed MM patients with renal insufficiency could get higher ORR and the longer PFS using bortezomib-containing regimens as initial therapy. Meanwhile the improvement rate of renal function and the living quality in patients with bortezomib are better compared with those with thalidomide based treatment.

A novel pathway for the production of H2 S by DAO in rat jejunum

BACKGROUND

Hydrogen sulfide (H2 S) is endogenously generated from L-cysteine (L-Cys) by the enzymes cystathionine-β-synthase (CBS) and cystathionine-γ-Lyase (CSE). Hydrogen sulfide is also produced from D-cysteine (D-Cys) by D-Amino acid oxidase (DAO).

METHODS

The H2 S production was measured by the methylene blue assay. The expression of DAO was investigated by Western blotting and immunohistochemistry. The short-circuit current (Isc) was recorded using the Ussing chamber technique.

KEY RESULTS

The epithelium in rat jejunum possesses DAO, and generates H2 S. D-cysteine, originally used as a negative control for L-Cys, significantly increases the H2 S release, which is inhibited by I2CA, an inhibitor of DAO. In vitro study by Ussing chamber technique reveals that D-Cys decreases the Isc across the epithelium of the rat jejunum and enhances the Na(+) -coupled L-alanine transport.

CONCLUSIONS & INFERENCES

A novel pathway for the production of H2 S by DAO exists in rat jejunum.

Growth inhibitive effect of betulinic acid combined with tripterine on MSB-1 cells and its mechanism

Marek's disease (MD), a highly infectious lymphoproliferative disease in chickens, is caused by a cell-associated oncogenic herpesvirus, Marek's disease virus (MDV). MSB-1 is a MD-derived lymphoblastoid cell line and can induce tumors when inoculated into susceptible chickens. Betulinic acid, which is present as one of the major effective components in many traditional Chinese medicines, has recently been reported to inhibit growth of cancer cells and employed as a potential anticancer agent. Tripterine, a major active compound extracted from the Chinese herb Tripterygium wilfordii Hook F, has now also shown anti-tumor activities in various cancers. The aim of this study was to investigate the synergistic growth-inhibitive effect of betulinic acid combined with tripterine on MSB-1 cells and its mechanism. Viability of MSB-1 cells was assessed by 3-(4,5-dimethylthiazol-2-y1)-2,5-diphenyltetrazolium bromide (MTT) method. Cell apoptotic analysis was performed by fluorescence detection. NF-κB transcription activity was detected by measuring luciferase activity. Western blotting was used to analyze the expression of p65, IκB and Meq. Our results showed that the proliferation in the combination group was significantly decreased as compared with that of monotherapy using betulinic acid or tripterine, accompanied by an induction of apoptosis, inhibition of NF-κB transcriptional activity and its targeting oncogenic gene Meq. The results suggest that the combination of betulinic acid and tripterine at lower concentration may produce a synergistic inhibitive effect on MSB-1 cells that warrants further investigation for its potential clinical applications.

Fluorescence turn-on detection of Fe3+in pure water based on a cationic poly(perylene diimide) derivative

A water-soluble PDIs-based polymeric chemosensor L displays a turn-on response selective to Fe³⁺, which allows facile monitoring of the Fe³⁺/Fe²⁺transition and intracellular Fe³⁺imaging.

Clinical and cytogenetic results of a series of amniocentesis cases from Northeast China: a report of 2500 cases

The aims of this study were to demonstrate the clinical and cytogenetic results of amniocentesis (AS) cases in Northeast China, to compare the incidence of different kinds of chromosomal abnormalities, and to study the association between the detection rate of chromosomal abnormalities and different indications for prenatal diagnosis. Cytogenetic analysis was performed on long-term tissue cultures of 2500 second-trimester amniotic fluid samples. The most common indication for genetic AS was abnormal maternal serum-screening test (69.56%), followed by advanced maternal age (15.04%). Chromosomal abnormality was detected in 206 (8.24%) of the 2500 samples. The detection rate of abnormal karyotypes was 62.5% in the group in which one member of the couple was a carrier of a chromosome abnormality; in the group having a positive result from noninvasive prenatal testing, the frequency was 50%. To determine the origin of fetal chromosome abnormal karyotype, 45 fetuses were analyzed. Of these, 20 were found to be de novo abnormalities and 25 were familial. The frequency and proportion of abnormal karyotypes varied substantially across different maternal AS indications. Knowing the origin and type of chromosomal abnormality would help determine termination or continuation of the pregnancy.

Case Report Diffuse large B-cell lymphoma in the primary bone marrow

This study aimed to improve understanding of the diagnosis, treatment, and prognosis of primary bone marrow (PBM) diffuse large B-cell lymphoma (DLBCL), a rare illness. We report a 56-year-old man with pancytopenia and hyperbilirubinemia but without lymphadenopathy, hepatomegaly, or splenomegaly. Bone marrow aspiration, flow cytometry, biopsy, and immunohistochemistry confirmed DLBCL. Two cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone were administered. Blood cell numbers and hyperbilirubinemia improved. Although the patient did not completely recover, he survived for at least 3 years after chemotherapy and receiving blood transfusions. PBM DLBCL is a distinct, aggressive lymphoma characterized by lymphoma cells only in the bone marrow and effectively treated via chemotherapy. Prognoses for PBM DLBCL vary.

Sperm aneuploidy and implications for genetic counseling in a pedigree of three t(1;3) balanced translocation carriers

A reciprocal translocation between the short arm of chromosome 1 and the long arm of chromosome 3 was observed in a pedigree of three carriers (proband, and his brother and mother). In this study, the three carriers had different clinical manifestations: the proband with infertility, his brother with spousal miscarriages, and his mother with no adverse reproductive history. Cytogenetic analysis of metaphase chromosomes was performed, and triple-color fluorescence in situ hybridization was applied to the detection of aneuploidy sperm related to the interchromosomal effect (ICE). An increase of aneuploidy of chromosome 21 in the proband and aneuploidy of chromosomes 13, 21, and Y in the brother were observed. Since patients with reciprocal translocations and spermatogenetic impairment are candidates, with their partners, for intracytoplasmic sperm injection, the study of the level of sperm aneuploidy rates would provide useful information for couples at risk, as well as contributing to a better understanding of the ICE.

Immobilization of imidazolium ionic liquids on hydrotalcites using silane linkers: retardation of memory effect

We report a new covalent surface immobilization of silane-modified imidazolium ionic liquids on hydrotalcite-like materials (HTs) and provide detailed characterization of the resulting surface chemistry using PXRD, CP-MAS, TGA and FT-IR.

Identification of novel kinase inhibitors by targeting a kinase-related apoptotic protein-protein interaction network in HeLa cells

OBJECTIVES

Protein kinases orchestrate activation of signalling cascades in response to extra- and intracellular stimuli for regulation of cell proliferation. They are directly involved in a variety of diseases, particularly cancers. Systems biology approaches have become increasingly important in understanding regulatory frameworks in cancer, and thus may facilitate future anti-cancer discoveries. Moreover, it has been suggested and confirmed that high-throughput virtual screening provides a novel, effective way to reveal small molecule protein kinase inhibitors. Accordingly, we aimed to identify kinase targets and novel kinase inhibitors.

MATERIALS AND METHODS

A series of bioinformatics methods, such as network construction, molecular docking and microarray analyses were performed.

RESULTS

In this study, we computationally constructed the appropriate global human protein-protein interaction network with data from online databases, and then modified it into a kinase-related apoptotic protein-protein interaction network. Subsequently, we identified several kinases as potential drug targets according to their differential expression observed by microarray analyses. Then, we predicted relevant microRNAs, which could target the above-mentioned kinases. Ultimately, we virtually screened a number of small molecule natural products from Traditional Chinese Medicine (TCM)@Taiwan database and identified a number of compounds that are able to target polo-like kinase 1, cyclin-dependent kinase 1 and cyclin-dependent kinase 2 in HeLa cervical carcinoma cells.

CONCLUSIONS

Taken together, all these findings might hopefully facilitate discovery of new kinase inhibitors that could be promising candidates for anti-cancer drug development.

Molecular mechanisms of Lycoris aurea agglutinin-induced apoptosis and G2 /M cell cycle arrest in human lung adenocarcinoma A549 cells, both in vitro and in vivo

OBJECTIVES

Lycoris is aurea agglutinin (LAA) has attracted rising attention due to its remarkable bioactivities. Here, we aimed at investigating its anti-tumor activities.

MATERIAL AND METHODS

In vitro methods including MTT, cellular morphology observation, FCM and immunoblotting were performed. In vivo methods like detection of tumor volume, body weight and survival ratio, as well as TUNEL staining were performed.

RESULTS AND CONCLUSION

LAA triggers G2 /M phase cell cycle arrest via up-regulating p21expression as well as down-regulating cdk-1cyclinA singling pathway, and induces apoptotic cell death through inhibiting PI3K-Akt survival pathway in human lung adenocarcinoma A549 cells. While LAA has no significant cytotoxic effect toward normal human embryonic lung fibroblast HELF cells, and moreover, LAA could amplify the antineoplastic effects of cisplatin toward A549 cells. Lastly LAA also bears anti-cancer and apoptosis-inducing effects in vivo, and it could decrease the volume and weight of subcutaneous tumor mass obviously as well as expand lifespan of mice. These findings may provide a new perspective for elucidating the complicated molecular mechanisms of LAA-induced cancer cell growth-inhibition and death, providing a new opportunity of LAA as a potential candidate anti-neoplastic drug for future cancer therapeutics.

In silico analysis of molecular mechanisms of legume lectin-induced apoptosis in cancer cells

OBJECTIVES

The legume lectin family, one of the most extensively studied plant lectin families, has received increasing attention for the remarkable anti-tumor activities of its members for binding specific cancer cell surface glycoconjugates. MicroRNAs, a class of small, non-coding RNAs, control translation and stability of mRNAs at post-transcriptional and translational levels. To date, accumulating evidence has revealed that microRNAs are involved in progression of a number of human diseases, especially cancers. However, the molecular manners of microRNA-modulated apoptosis in legume lectin-treated cancer cells are still under investigation.

MATERIALS AND METHODS

We performed in silico analyses to study the interactions between three typical legume lectins (ConA, SFL and SAL) and some specific sugar-containing receptors (for example, EGFR, TNFR1, HSP70 and HSP90). Additionally, we predicted some relevant microRNAs which could significantly regulate these aforementioned targetreceptors and thus inhibiting down-stream cancer-related signaling pathways.

RESULTS

The results showed that these three legume lectins could competitively bind sugar-containing receptors such as EGFR, TNFR1, HSP70 and HSP90 in two ways, via anti-apoptotic or survival pathways. On the one hand, the legume lectins could induce cancer cell death through triggering receptor-mediated signaling pathways, which resulted from indirect binding between legume lectins and mannoses resided in receptors. On the other hand, direct binding between legume lectins and receptors could lead to steric hindrance, which would disturb efficient interactions between them, and thus, the legume lectins would induce cancer cell death by triggering receptor-mediated signaling pathways. In addition, we identified several relevant microRNAs that regulated these targeted receptors, thereby ultimately causing cancer cell apoptosis.

CONCLUSIONS

These findings provide new perspectives for exploring microRNA-modulated cell death in legume lectin-treated cancer cells, which could be utilized in combination therapy for future cancer drug development.

Diarylheptanoids from Alpinia officinarum

A new diarylheptanoid, along with five known diarylheptanoids, was isolated from the rhizomes of Alpinia officinarum (Zingiberaceae). The structure of the new compound was determined to be trans,trans-1(3'-methoxy-4'-hydroxyphenyl)-7-phenyl-5-ol-4,6-dien-3-heptanone on the basis of spectral and chemical evidence.

Fluorescence-based functional assay for Wnt/beta-catenin signaling activity

Aberrant activation of beta-catenin signaling has been implicated in the development of human cancers. As a Wnt signal transducer, beta-catenin forms a complex with the lymphocyte enhancer-binding factor/T cell factor transcription factor and activates downstream targets that promote cell proliferation. Here we developed a Wnt-dependent beta-catenin-mediated heterologous transactivation system, which consisted of a chimeric transcription factor constructed by fusing the GAL4 DNA-binding domain with the full-length beta-catenin, and a GAL4-responsive reporter expressing GFP. The chimeric transcription factor was highly unstable and exerted no detectable transactivating effect on the GAL4-responsive reporter. However, lithium and Wnt1 significantly stabilized this chimeric transactivator, indicating that this transactivation system is regulated by beta-catenin in a Wnt-responsive fashion. Thus, this transactivation system could be used as a functional reporter to identify potential upstream factors that deregulate beta-catenin signaling during tumorigenesis, as well as to screen for potential anti-cancer agents that specifically inhibit beta-catenin signaling in human tumors.

[Cloning and expression of human TNFR (P55)-IgG Fc fusion protein in eukaryotic cells]

OBJECTIVE

To express soluble biologically active TNF receptor protein in eukaryotic cells, which can inhibit cytotoxic activity of TNF.

METHODS

PCR amplified the extra-cellular region of TNF receptor P55 and IgG Fc gene. Then the two were linked through an oligomer encoding a thrombin-sensitive peptide linker and cloned into eukaryotic expression vector pcDNA3.1 (+). The eukaryotic expression plasmid pcDNA3. 1/TI was then transfected to the mammalian cell line COS7 and BHK. Using the G418 system, BHK cell clones were selected and can continuously secrete biological protein in large amount.

RESULTS

The expressed protein was fused with IgG Fc and secreted into the cell culture supernatant. It has good antigenicity and binding ability to TNF. It can also inhibit the cytotoxic activity of TNF on L929 cell.

CONCLUSION

The TNFR-IgG Fc fusion protein expressed in eukaryotic cells has biological activities of human TNF receptor P55.

[Generation of monoclonal antibody Fab fragments to parathyroid hormone related protein by phage display technology]

OBJECTIVE

To develop monoclonal antibody Fab fragments using display technique.

METHODS

The mouse IgG Fab genes of heavy and light chains were amplified from spleen cells of a parathyroid hormone-related protein (PTHrP) immunized mouse. The combinatorial phage antibody library was prepared by inserting both heavy and light chain Fab genes into phagemid vector pComb3 and followed by infection of helper phage. The library was selected by purified recombinant PTHrP.

RESULTS

The combinatorial phage antibody library was constructed successfully and the specific mouse Fabs to PThrP were selected and expressed in E. coli.

CONCLUSIONS

The selected specific mouse Fabs can recognize PTHrP with high specificity.

Cloning and expression of truncated PTHrP receptor in Escherichia coli

To evaluate the effects of recombinant soluble parathyroid hormone related protein receptor(sPTHrPR), the RNA prepared from renal cell carcinoma was reverse-transcribed and amplified by a polymerase chain reaction(PCR). A 543 base pair fragment corresponding to extracellular domain of PTHrPR was obtained and cloned. Sequencing was performed by the dideoxy chain-termination method. Comparison of the nucleic acid sequence with the published data revealed that only one nucleotide had changed. A high level expression vector referred to as pET-3a/sPTHrPR was constructed. The binding specificity of the expression products was proved by indirect ELISA. Our preliminary experiment also showed that the expression products can block the biological activity of PTHrP.

Inhibition of the induction of the inducible nitric oxide synthase in murine brain microglial cells by sodium salicylate

The induction of the inducible nitric oxide synthase (iNOS) has been proposed to play a role in a variety of inflammatory diseases. Sodium salicylate (NaSal) is the most commonly used anti-inflammatory agent. We investigated whether NaSal can diminish the induction of iNOS in murine brain microglial cells. In primary cultures, interferon-gamma (IFN-gamma) or lipopolysaccharide (LPS) separately did not stimulate nitric oxide (NO) production, whereas IFN-gamma combined with LPS synergistically induced iNOS. NaSal inhibited both the production of NO and expression of iNOS in microglial cells. Synergy between IFN-gamma and LPS was mainly dependent on tumour necrosis factor-alpha (TNF-alpha) secretion as the increase of the induction of the iNOS by IFN-gamma plus LPS was associated with the increase of TNF-alpha secretion and IFN-gamma plus LPS-induced TNF-alpha secretion by microglial cells was decreased by the treatment with NaSal. These results suggest a possible use of NaSal in managing inflammation of the central nervous system through inhibition of the iNOS induction.

Inhibition of immediate type allergic reactions by the aqueous extract of Kum-Hwang-San

We studied the effect of aqueous extract of Kum-Hwang-San (KHS) on mast cell-mediated immediate type allergic reactions. KHS (1-100 microg/site) inhibited concentration-dependently mast cell-dependent ear swelling response induced by compound 48/80 (200 microg/site) in mice by both topical and intradermal application. KHS (0.1-100 microg/site) inhibited concentration-dependently passive cutaneous anaphylaxis induced by anti-dinitrophenyl (DNP) IgE in rats by both topical and intradermal application. KHS also inhibited concentration-dependently the histamine release from the rat peritoneal mast cells (RPMC) by compound 48/80 and anti-DNP IgE. Moreover, KHS had a significant inhibitory effect on anti-DNP IgE-induced tumor necrosis factor-alpha (TNF-alpha) secretion from RPMC. These results indicate that KHS inhibits immediate type allergic reactions by inhibition of histamine release and TNF-alpha secretion from mast cells in vivo and in vitro.

Dynamic changes of lung lymph flow and the release of lysosomal enzyme from the lungs after severe steam inhalation injury in goats

Chronic lung lymph fistulae were produced in six goats according to Winn's and Stothert's methods with our modification to define the pathophysiology of pulmonary oedema after severe steam inhalation injury. Arterial blood gas, lung lymph flow (QLym), lymph/plasma total protein concentration ratio (L/P), and beta-glucuronidase (beta-G) in plasma and lung lymph were monitored for 24 h post-injury. The pathological changes in the lung tissues were also determined at the end of the study. It was found that directly after injury, QLym increased steadily to a peak value at 6 h, followed by declining values at 18 and 24 h. L/P decreased promptly during the 60 min after injury and then also steadily increased to a peak value at 4 h (P less than 0.05). A significant increase in plasma beta-G was only observed at 4 h post-burn. However, lung lymph beta-G activities and lymph beta-G transport increased immediately after injury, reaching a peak at 4 h (5 and 12 times above baseline values, respectively, P less than 0.01). Significant hypoxaemia and hypocapnia occurred at 2 h post-burn and deteriorated progressively throughout the study. There were obvious pulmonary interstitial and alveolar oedema microscopically. This study demonstrates that the increase in transvascular fluid and protein flux after steam inhalation injury is mainly due to increased pulmonary microvascular permeability. Nevertheless, a hydrostatic pressure effect can not be completely excluded, especially in the first hour post-burn. Lysosomal enzyme release is considered to be one of the important factors which damage lung microvascular elements and induce an increase in their permeability.