The effect of previous orbital decompression on outcomes of rectus muscle recession surgery in patients with thyroid ophthalmopathy

PURPOSE

To evaluate the effect of previous orbital decompression on outcomes of rectus muscle recession surgery in patients with thyroid-associated ophthalmopathy.

METHODS

This retrospective study enrolled 55 eyes of 33 patients treated in our hospital for restrictive strabismus caused by thyroid-associated ophthalmopathy. We performed muscle recession for the obviously restricted extraocular muscles, with 6 weeks of follow-up. Surgical outcomes were compared between the orbital decompression group (DG, n=15) and non-orbital decompression group (NDG, n=18).

RESULTS

A total of 33 patients with Graves' ophthalmopathy who underwent rectus muscle recession surgery were included. Of these, 15 patients had undergone orbital decompression prior to strabismus surgery, and 18 had not. The two groups did not differ in terms of the preoperative horizontal or vertical ocular deviation, degree of restriction of eye movement, degree of diplopia, or mean number of muscles that underwent surgery (P>0.05). There was no significant difference in the preoperative horizontal or vertical ocular deviation, level of eye movement restriction, degree of diplopia and the success rate of the surgery (P>0.05).

CONCLUSION

Rectus muscle recession surgery in patients with thyroid-associated ophthalmopathy during the quiescent period could improve the ocular deviation and diplopia, and orbital decompression performed before strabismus surgery had no significant effect on surgical technique or outcomes of rectus muscle recession surgery.

PKCβII activation requires nuclear trafficking for phosphorylation and Mdm2-mediated ubiquitination

PKCβII, a conventional PKC family member, plays critical roles in the regulation of a variety of cellular functions. Here, we employed loss-of-function approaches and mutants of PKCβII with altered phosphorylation and protein interaction behaviors to identify the cellular mechanisms underlying the activation of PKCβII. Our results show that 3-phosphoinositide-dependent protein kinase-1 (PDK1)-mediated constitutive phosphorylation of PKCβII at the activation loop (T500) is required for phorbol ester-induced nuclear entry and subsequent Mdm2-mediated ubiquitination of PKCβII, whereas ubiquitination of PKCβII is required for the PDK1-mediated inducible phosphorylation of PKCβII at T500 in the nucleus. After moving out of the nucleus, PKCβII interacts with actin, undergoes inducible mTORC2-mediated phosphorylation at the turn motif (T641), interacts with clathrin, and then translocates to the plasma membrane. This overall cascade of cellular events intertwined with the phosphorylation at critical residues and Mdm2-mediated ubiquitination in the nucleus and along with interactions with actin and clathrin plays roles that encompass the core processes of PKC activation.

Consensus on diagnostic criteria for deficiency syndrome in hypertension: a modified Delphi study

OBJECTIVE

To reach consensus on the diagnostic criteria for deficiency syndrome in hypertension (YDSH) patients by a modified Delphi method.

METHODS

Our study was consistent with T/CACM 1032-2017. The methodology of RAND/UCLA appr-opriateness was used to develop consensus guidance statements. A nationwide panel of experienced clinical experts from 19 provinces was constructed. These experts were all prominent in Traditional Chinese Medicine (TCM) of cardiovascular diseases. This con-sensus process consisted of two rounds of ques-tionnaires and a final round of consultation to analyze the weight score of each item. Moreover, the data extraction process is carried out independently by third-party researchers (LIANG Junya, SUN Yang, and DU Xiaona). When there is disagreement in all three rounds, the expert panel group (odd number) are invited to vote, and the one with more votes wins. In the questionnaires, participants were asked to rate the appropriateness of each syndrome item using a nine-point Likert scale. The consensus was defined as a panel median rating 1-3 or 7-9 without disagreement. And then the diagnostic criteria of YDSH were formed according to the weight score in the final round.

RESULTS

Twenty-eight experts (84.8%) participated in the first round, and thirty-one (93.9%) finished the second round. After two rounds, the consensus of YDSH was reached on 11 items (25.6%), including symptoms, signs, and pulse condition. Twenty-one experts (63.6%) com-pleted the final round in which they used a grading system for each item. Red tongue with scanty fur had the highest weighting (22.8%), followed by heat in the palms and soles (20.1%).

CONCLUSIONS

The consensus-based diagnostic criteria for YDSH, formed by a modified Delphi method, can be widely incorporated in TCM. A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our YDSH criteria.

Sequestration of Gβγ by deubiquitinated arrestins into the nucleus as a novel desensitization mechanism of G protein-coupled receptors

BACKGROUND

Desensitization of G protein-coupled receptors (GPCRs) refers to a rapid attenuation of responsiveness that occurs with repeated or continuous exposure to agonists. GRK-mediated phosphorylation and subsequent binding with arrestins in the activated receptor cytoplasmic cavity in competition with G proteins has been suggested as the conventional mechanism of desensitization. Along with widely accepted conventional mechanism of desensitization, studies of various GPCRs including dopamine D2-like receptors (D₂R, D₃R, D₄R) have suggested the existence of another desensitization mechanism. In this study, loss-of-function approaches and D2-like receptor mutants that display different desensitization properties were used to elucidate the molecular mechanisms responsible for desensitization.

RESULTS

Desensitization development entailed the signaling cascade composed of Src, PDK1, and Akt, the latter of which in turn interacted with USP33, an arrestin deubiquitinase, to promote arrestin deubiquitination. The deubiquitinated arrestin subsequently formed a complex with Gβγ and translocated to the nucleus via an importin complex, wherein it sequestered Gβγ from the receptor and Gα, thereby attenuating receptor signaling. As in D2-like receptors, both USP33 and importin β1 were involved in the desensitization of the β₂ adrenoceptor.

CONCLUSIONS

In addition to the conventional mechanism of desensitization, which occurs on the plasma membrane and in the cytosol, this study provides a new insight that another desensitization pathway in which nuclear trafficking plays a critical role is operating. It is plausible that multiple, complementary desensitization measures are in place to properly induce desensitization depending on receptor characteristics or the surrounding environment. Video Abstract.

Activation of PKCβII through nuclear trafficking guided by βγ subunits of trimeric G protein and 14-3-3ε

AIMS

Conventional members of protein kinase C (PKC) family, including PKCβII, are constitutively phosphorylated on three major motifs and located in the cytosol in a primed state. In response to cellular stimuli, PKCβII is activated through inducible phosphorylation and Mdm2-mediated ubiquitination. In this study, we aimed to identify the activation mechanism of PKCβII, focusing on the signaling cascade that regulate the phosphorylation and ubiquitination.

MATERIALS AND METHODS

Loss-of-function approaches and mutants of PDK1/PKCβII that display different regulatory properties were used to identify the cellular components and processes responsible for endocytosis.

KEY FINDINGS

Phorbol 12-myristate 13-acetate (PMA)-induced phosphorylation and ubiquitination of PKCβII, which are needed for its translocation to the plasma membrane, required the presence of both Gβγ and 14-3-3ε. Gβγ and 14-3-3ε mediated the constitutive phosphorylation of PKCβII by scaffolding PI3K and PDK1 in the cytosol, which is an inactive but required state for the activation of PKCβII by subsequent signals. In response to PMA treatment, the signaling complex translocated to the nucleus with dissociation of PI3K from it. Thereafter, PDK1 stably interacted with 14-3-3ε and was dephosphorylated; PKCβII interacted with Mdm2 along with Gβγ, leading to its ubiquitination at two lysine residues on its C-tail. Finally, PDK1/14-3-3ε and ubiquitinated PKCβII translocated to the plasma membrane.

SIGNIFICANCE

As PKCβII mediates a wide range of cellular functions and plays important roles in the pathogenesis of various diseases, our results will provide clues to understand the pathogenesis of PKCβII-related disorders and facilitate their treatment.

Design, Synthesis, and Functional Evaluation of 1, 5-Disubstituted Tetrazoles as Monoamine Neurotransmitter Reuptake Inhibitors

Tetrazoles were designed and synthesized as potential inhibitors of triple monoamine neurotransmitters (dopamine, norepinephrine, serotonin) reuptake based on the functional and docking simulation of compound 6 which were performed in a previous study. The compound structure consisted of a tetrazole-linker (n)-piperidine/piperazine-spacer (m)-phenyl ring, with tetrazole attached to two phenyl rings (R1 and R2). Altering the carbon number in the linker (n) from 3 to 4 and in the spacer (m) from 0 to 1 increased the potency of serotonin reuptake inhibition. Depending on the nature of piperidine/piperazine, the substituents at R1 and R2 exerted various effects in determining their inhibitory effects on monoamine reuptake. Docking study showed that the selectivity of tetrazole for different transporters was determined based on multiple interactions with various residues on transporters, including hydrophobic residues on transmembrane domains 1, 3, 6, and 8. Co-expression of dopamine transporter, which lowers dopamine concentration in the biophase by uptaking dopamine into the cells, inhibited the dopamine-induced endoctytosis of dopamine D₂ receptor. When tested for compound 40 and 56, compound 40 which has more potent inhibitory activity on dopamine reuptake more strongly disinhibited the inhibitory activity of dopamine transporter on the endocytosis of dopamine D₂ receptor. Overall, we identified candidate inhibitors of triple monoamine neurotransmitter reuptake and provided a theoretical background for identifying such neurotransmitter modifiers for developing novel therapeutic agents of various neuropsychiatric disorders.

Structural Requirements for Modulating 4-Benzylpiperidine Carboxamides from Serotonin/Norepinephrine Reuptake Inhibitors to Triple Reuptake Inhibitors

In this study, we determined the effect of 24 different synthetic 4-benzylpiperidine carboxamides on the reuptake of serotonin, norepinephrine, and dopamine (DA), and characterized their structure–activity relationship. The compounds with a two-carbon linker inhibited DA reuptake with much higher potency than those with a three-carbon linker. Among the aromatic ring substituents, biphenyl and diphenyl groups played a critical role in determining the selectivity of the 4-benzylpiperidine carboxamides toward the serotonin transporter (SERT) and dopamine transporter (DAT), respectively. Compounds with a 2-naphthyl ring were found to exhibit a higher degree of inhibition on the norepinephrine transporter (NET) and SERT than those with a 1-naphthyl ring. A docking simulation using a triple reuptake inhibitor 8k and a serotonin/norepinephrine reuptake inhibitor 7j showed that the regions spanning transmembrane domain (TM)1, TM3, and TM6 form the ligand binding pocket. The compound 8k bound tightly to the binding pocket of all three monoamine reuptake transporters; however, 7j showed poor docking with DAT. Co-expression of DAT with the dopamine D₂ receptor (D₂R) significantly inhibited DA-induced endocytosis of D₂R probably by reuptaking DA into the cells. Pretreatment of the cells with 8f, which is one of the compounds with good inhibitory activity on DAT, blocked DAT-induced inhibition of D₂R endocytosis. In summary, this study identified critical structural features contributing to the selectivity of a molecule for each of the monoamine transporters, critical residues on the compounds that bound to the transporters, and the functional role of a DA reuptake inhibitor in regulating D₂R function.

In-air self-reduction synthesis and luminescence properties from Mg21 Ca4 Na4 (PO4 )18 :Eu2+ -Eu3+ excited using ultraviolet light

A series of Mg₂₁ Ca₄ Na₄ (PO₄ )₁₈ :Eu²⁺ -Eu³⁺ phosphors was successfully synthesized using a high-temperature solid-state method in an air atmosphere. The phase structures and luminescence properties of the samples were studied in detail. The phosphors exhibited strong visible light emission under different wavelengths of ultraviolet light excitation. By harmonizing the doping concentration of Eu³⁺ to adjust the relative luminescence intensity of Eu²⁺ and Eu³⁺ , a colourful emission of phosphors could be achieved. In addition, the colour coordinates of the International Commission on lighting indicated that Mg₂₁ Ca₄ Na₄ (PO)₁₈ :Eu²⁺ -Eu³⁺ could be considered as a potential blue, orange and red phosphor for white light-emitting diode applications.

Self-reduction synthesis and luminescence properties of Eu, Dy co-doped SrMg2 (PO4 )2 phosphor

A series of SrMg₂ (PO₄ )₂ :Eu²⁺ -Eu³⁺ ,Dy³⁺ phosphors was synthesized successfully using a high-temperature solid-state method in an air atmosphere. The structures were studied in detail using X-ray diffraction (XRD) and the luminescence properties of the samples. SrMg₂ (PO₄ )₂ :Eu²⁺ -Eu³⁺ samples can emit adjustable blue-violet light by controlling the proportion of dopant concentration of europium and dysprosium under 340 nm excitation. Dy³⁺ exhibits typical blue and yellow emission under 350 nm excitation. The energy transferred from Eu³⁺ to Dy³⁺ in Dy and Eu co-doped system was determined by comparing the fluorescence spectra of single-doped system. In addition, the colour coordinates of the International Commission on lighting (CIE) indicated that SrMg₂ (PO₄ )₂ :Eu²⁺ -Eu³⁺ ,Dy³⁺ could be considered as a potential blue-purple phosphor for white light-emitting diode applications.

[Yijing Prescription regulates the PI3K/Akt/mTOR signaling pathway and autophagy and inhibits the apoptosis of Leydig cells: An experimental study in vitro]

OBJECTIVE

To explore the mechanism of Yijing Prescription (YJP) improving sperm quality in oligozoospermia patients.

METHODS

Mouse Leydig (TM3) cells were divided into five groups: normal control, acrolein-induced oxidative stress (ACR) model control, and low-, medium- and high-dose YJP. The ACR model was established in the latter four groups with 100 μmol/L acrolein, and the TM3 cells in the latter three groups were treated with the serum containing 5%, 10% and 20% YJP, respectively. After modeling, the viability of the cells and the contents of MDA, T-AOC and SOD were determined by CCK-8, and the relative expressions of PI3K/Akt/mTOR, Beclin-1, Bcl-2 and LC3-II detected by real-time PCR and Western blot. The results obtained were analyzed and compared among different groups.

RESULTS

Compared with the normal control cells, the TM3 cells in the ACR model control group showed a dramatically inhibited survival rate (54%), increased content of MDA, decreased levels of T-AOC and SOD (P < 0.01), down-regulated expressions of p-PI3K/p-Akt protein (P < 0.01), and Bcl-2 protein (P < 0.05) and Bcl-2 mRNA (P < 0.01), and up-regulated mRNA and protein expressions of Beclin-1 and LC3II (P < 0.01). After administration of YJP, all the above-mentioned parameters were reversed in different degrees and improved in a dose-dependent manner.

CONCLUSIONS

Yijing Prescription acts against oxidative stress, mediates the regulation of the PI3K/Akt/mTOR signaling pathway and autophagy and inhibition of the apoptosis of Leydig cells, and thus improves the sperm quality of oligozoospermia patients.

Observer-Based Adaptive Fuzzy Tracking Control for Strict-Feedback Nonlinear Systems With Unknown Control Gain Functions

This article investigates the adaptive fuzzy output-feedback backstepping control design problem for uncertain strict-feedback nonlinear systems in the presence of unknown virtual and actual control gain functions and unmeasurable states. A fuzzy state observer is designed via fuzzy-logic systems, thus the unmeasurable states are estimated based on the designed fuzzy state observer. By constructing the logarithm Lyapunov functions and incorporating the property of the fuzzy basis functions and bounded control design technique into the adaptive backstepping recursive design, a novel observer-based adaptive fuzzy output-feedback control method is developed. The proposed fuzzy adaptive output-feedback backstepping control scheme can remove the restrictive assumptions in the previous literature that the virtual control gains and actual control gain functions must be constants. Furthermore, it can make the control system be semiglobally uniformly ultimately boundedness (SGUUB) and keep the observer and tracking errors to remain in a small neighborhood of the origin. The numerical simulation example is presented to validate the effectiveness of the proposed control scheme and theory.

Cytoplasmic recruitment of Mdm2 as a common characteristic of G protein-coupled receptors that undergo desensitization

Desensitization of G protein-coupled receptors (GPCRs) represents a gradual attenuation of receptor responsiveness by continuous or repeated exposure to agonists. The most widely accepted molecular mechanism responsible for desensitization is that of GRK2-mediated receptor phosphorylation followed by association with β-arrestins. However, in most cases, this mechanism cannot explain the desensitization of GPCRs. In this study, we investigated whether there exists a direct correlation between desensitization and certain cellular events that commonly observed with desensitizing receptors. Our study showed that constitutive ubiquitination of β-arrestin, accompanied by nuclear to cytoplasmic translocation of Mdm2, was observed in cells expressing desensitizing GPCRs (dopamine D₃ receptor, K149C-dopamine D₂ receptor, β₂ adrenoceptor, and lysophosphatidic acid receptor 1). In contrast, Mdm2 was observed in the nucleus in cells expressing non-desensitizing GPCRs (dopamine D₂ receptor, C147K-dopamine D₃ receptor, and dopamine D₄ receptor). Molecular manipulation to convert the characteristics of the dopamine D₄ receptor from non-desensitizing to desensitizing changed the status of subcellular localization of Mdm2 from nuclear to cytoplasmic. With repeated agonist treatments of desensitizing receptors, Mdm2 translocated from cytoplasm to nucleus, resulting in the deubiquitination of β-arrestins. This study suggests that the property of a receptor that causes a change in subcellular localization of Mdm2, from the nuclear to cytoplasmic, could be used as a biomarker to predict the desensitization of a receptor.

A novel molecular mechanism responsible for phosphorylation-independent desensitization of G protein-coupled receptors exemplified by the dopamine D3 receptor

GRK-mediated receptor phosphorylation followed by association with β-arrestins has been proposed to be the molecular mechanism involved in the desensitization of G protein-coupled receptors (GPCRs). However, this mechanism does not explain the desensitization of some GPCRs, such as dopamine D₃ receptor (D₃R), which does not undergo GRK-mediated phosphorylation. Loss-of-function approaches and mutants of dopamine D₂ receptor and D₃R, which exhibit different desensitization properties, were used to identify the cellular components and processes responsible for desensitization. D₃R mediated the recruitment of Mdm2 to the cytosol, which resulted in the constitutive ubiquitination of β-arrestin2 in the resting state. Under desensitization conditions, cytosolic Mdm2 returned to the nucleus, resulting in the deubiquitination of cytosolic β-arrestins. Deubiquitinated β-arrestins formed a tight complex with Gβγ, thereby sequestering it, causing interference in D₃R signaling. In conclusion, this study shows that β-arrestins, depending on their ubiquitination status, control the G protein cycling by regulating their interactions with Gβγ. This is a novel mechanism proposed to explain how certain GPCRs can undergo desensitization without receptor phosphorylation.

Mdm2-mediated ubiquitination of β-arrestin2 in the nucleus occurs in a Gβγ- and clathrin-dependent manner

The fate and activity of β-arrestin2, a key player in the regulation of desensitization and endocytosis of G protein-coupled receptors (GPCRs), are regulated by mouse double minute 2 homolog (Mdm2)-mediated ubiquitination. However, details of the molecular mechanisms of β-arrestin2 ubiquitination remain unclear. Studies on β-arrestin2 and Mdm2 mutants with modified nucleocytoplasmic shuttling properties have revealed that β-arrestin2 ubiquitination occurs in the nucleus in a Gβγ- and clathrin-dependent manner. The nuclear entry of both β-arrestin2 and Mdm2 commonly relies on the presence of importin complex but can occur independently of each other. Gβγ and clathrin regulated the nuclear entry of β-arrestin2 by mediating the interaction between β-arrestin2 and importin β1. In contrast, Akt-mediated phosphorylation of two serine residues of Mdm2 partly regulated the nuclear entry of Mdm2. Ubiquitinated β-arrestin2 along with Mdm2 translocated to the cytoplasm where they play various functional roles including receptor endocytosis and ubiquitination of other cytoplasmic proteins. The nuclear export of Mdm2 required nuclear entry and interaction of β-arrestin2 with Mdm2. Ubiquitination was required for the translocation of β-arrestin2 toward activated receptors on the plasma membrane and for its endocytic activity. The current study revealed the cellular components and processes involved in the ubiquitination of β-arrestin2, and these findings could be quintessential for providing directions and detailed strategies for the manipulation of GPCR functions and development of GPCR-related therapeutics.

Mitogenome of the little owl Athene noctua and phylogenetic analysis of Strigidae

New advances in molecular approaches for DNA analysis have enhanced our understanding of the phylogenetic relationship of birds. The Little Owl (Athene noctua) is of great significance for the integrated management of forest diseases and control of regional pests. Here, we sequenced and annotated the 17,772 bp complete mitogenome of A. noctua. The mitogenome encoded 37 typical mitochondrial genes: 13 protein-coding genes, two ribosomal RNA genes, 22 transfer RNA, and one non-coding control region (D-loop). The organization and location of genes in the A. noctua mitogenome were consistent with those reported for other Strigidae birds. Phylogenetic relationships based on Bayesian inference and Maximum likelihood methods showed that A. noctua has close relationships with Athene brama and Glaucidium cuculoides, confirming that A. noctua belongs to the Strigidae family. The phylogenetic relationships among seven genera of the Strigidae family used in this study were: Ninox and the other six genera were far apart, Otus and the clade ((Bubo + Strix) + Asio) were clustered into one branch, and Athene and Glaucidium were clustered into one branch. This phylogenetic classification is consistent with prior taxonomic studies on the Strigidae family. Our results provide new mitogenomic data to support further phylogenetic and taxonomic studies of Strigidae.

[Evaluation of the role of melatonin in the metastasis of papillary thyroid carcinoma]

Objective:To evaluate the level of melatonin and the role of melatonin in the metastasis of papillary thyroid carcinoma in patients with papillary thyroid carcinoma. Method:We measured serum melatonin levels in 81 patients with papillary thyroid carcinoma（PTC） ,20 patients with multinodular goiter（MNG） and 20 healthy adults using ELISA. The relationship between melatonin and clinicopathological features of PTC were analyzed.The expression of MT1 and MT2 in two subtypes of melatonin receptor in 81 cases of papillary thyroid carcinoma and adjacent tissues were detected by immunohistochemical SP method, and its the mean optical density（MOD） image was analyzed by Image Pro Plusversion（IPP） image processing software. Result:Serum melatonin concentration in patients with PTC was significantly higher than that in MNG patients and normal controls（P<0.05）. The level of melatonin in the primary tumor T≥2 cm group was significantly higher than that in the T<2 cm group. Patients with positive cervical lymph nodes（N≥1） had significantly higher melatonin levels than lymph node negatives（N=0）（P<0.05）. The MT1 and MT2 receptors were expressed in both PTC and paracancerous tissues, mainly in the cell membrane and cytoplasm. The expression of MT1 receptor was low in the two groups, and there was no statistical difference. The expression of MT2 receptor in PTC tissues Significantly higher than the adjacent tissues（P<0.05）, further studies showed that the expression of MT2 receptor in PTC tissues was associated with cervical lymph node metastasis, and the expression of MT2 receptor in PTC tissues with cervical lymph node metastasis was significantly lower than that without metastasis （P<0.05）. Conclusion:Serum melatonin levels in PTC patients were higher than those in MNG and control groups, which may be associated with low malignancy of PTC; melatonin inhibits PTC metastasis, which exerts anti-PTC metastasis mainly through MT2 receptors.

The complete mitochondrial genome of Asian brown flycatcher Muscicapa latirostris (Passeriformes: Muscicapidae)

We report the mitochondrial genome of Muscicapa latirostris. The overall base composition of the Asian brown flycatcher mitogenome is 24.31% T, 31.62% C, 29.62% A, and 14.44% G, with an A + T content of 53.93%. The total length of the sequence is 18,026 bp (13 protein-coding genes, 22 transfer RNA genes, 2 ribosomal RNA genes, and 2 control regions). Phylogenetic analysis was performed based on the concatenated nucleotide sequences of cytochrome c oxidase subunit I and cytochrome b using the neighbor-joining method and the Kimura 2-parameter model in MEGA 7.0 with 1000 bootstrap replicates.

[Clinical study about anatomical and functional reconstruction for frontolateral vertical partial laryngectomy with ultrathin titanium mesh and fascia flap from the strap muscles]

Objective:To investigate the effect of laryngeal reconstruction in functional and anatomical aspect with ultrathin titanium mesh and myofascial flap in patients underwent frontolateral vertical partial laryngectomy with T2 and T3 glottic laryngeal carcinoma. Method:Ten patients with T2 and T3 glottic laryngeal carcinoma underwent frontolateral vertical partial laryngectomy in different range. The ultrathin titanium mesh was shaped up according to the form of thyroid cartilage in operation while the thyroid perichondrium membrane combined with straped myofascial flap was lined under the titanium mesh to restore the laryngeal cavity space. The pronunciation, swallowing capability and extubation rate were observed after surgery. Result:Nine patients underwent extubation within 2 to 4 weeks after surgery, one patients remove metal tube in two-stage after laryngeal dilation surgery with the Montgomery tube. Swallowing and voice function in these patients recovered well and no deglutition disorder was found. CT scan showed that the Titanium meshs were fixed well without displacement and deformity. Electronic laryngoscopy showed that the mucosa of laryngeal lumen was smooth without laryngeal stenosis, keloid contraction, tissue necrosis or titanium mesh exposure. Conclusion:In the cases of T2, T3 glottic laryngeal cancer patients, laryngeal framework reconstruction with the new type of ultrathin titanium mesh, thyroid cartilage membrane and pedicled fascia plap of strap muscles is a good choice after the vertical frontolateral partial laryngectomy. Even some elective T4 cases with the former part invasion in supra-glottic or infra-glottic region can receive this operation. It can reconstruct the physiological and anatomical structure of the larynx, restore laryngeal function with a sound decanulization rate.

[The anatomic characteristics and surgical treatment of congenital pyriform sinus fistula]

Objective:To discuss the clinical anatomic characteristics of congenital pyriform sinus fistula and summarize the experiences of open neck surgery. Method：The clinical data of 12 patients with congenital pyriform sinus fistula were retrospectively analyzed.Result:During the operation, all lesions were located below of superior laryngeal nerve. All fistulas were closely related with the supperior part of thyroid gland and laterally passed over the left recurrent laryngeal nerve just before merging into the apex of piriform sinus or beginning of aesophagus. Follow-up periods were ranging between 8 to 65 months. Two months after surgery,one patient showed lateral neck abscess again. After open drainage procedures and antibiotics treatment, there was no recurrence signs during 3 years of follow-up.Conclusion:We found that the congenital pyriform sinus fistula was closely related to the superior thyroid gland and recurrent laryngeal nerve,which was different from the popular theory.We had not encountered types descending into mediastinum and thoracic cavity or ascending along common carotid artery sheath. All fistulas passed over the left recurrent laryngeal nerve，and then merged into the apex of pyriform sinus or beginning of aesophagus.The key point for successful resection of fistulas in block was to remove the superior involvement part of the thyroid gland and exposure the recurrent laryngeal nerve. Based on our practical findings, the neck dissection procedure should not be taken in some patients that the anatomical structure is not clear for repeated infections.

Fragment-growing guided design of Keap1-Nrf2 protein-protein interaction inhibitors for targeting myocarditis

Small-molecule inhibitors that block the Keap1-Nrf2 protein-protein interactions are being intensely pursued as a new therapeutic strategy for oxidative stress-related diseases, such as cancer, diabetes, Alzheimer's disease, arteriosclerosis, inflammation and myocarditis. However, there are not enough studies on antioxidant treatments using small molecules in myocarditis. We herein provided a series of novel hydronaphthoquinones as the Keap1-Nrf2 interaction inhibitors targeting LPS-induced myocarditis both in vitro and in vivo. These compounds were designed through an in-silico fragment growing approach based on our previous reported compound, S47 (1). The new compounds were predicted to form additional hydrogen bonds with the S363 residue, leading to higher inhibitory activity. Among these new derivatives, compounds S01 and S05 emerged as inhibitors with significant biochemical potency, as determined by fluorescent anisotropy assay and confirmed by surface plasmon resonance (SPR) and differential scanning fluorimetry (DSF) assays. These inhibitors can dose-dependently protect the H9c2 cardiac cells against LPS-induced injury (100% at 2 μM and 4 μM) and effectively prolong survival or save the life of LPS-injured mice. Mechanistic studies showed that these inhibitors could release Nrf2 in H9c2 cells and LPS-inflammatory mouse models and translocate into the nucleus in a dose-response manner, which significantly increased the downstream genes (HO-1, NQO-1) and the pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), while ROS production dramatically decreased. Their protective effects and the mechanism of action were further confirmed by siNrf2 transfected experiment. Collectively, the novel hydronaphthoquinones can be used as promising lead compounds for the study of Keap1-Nrf2 protein-protein interactions and further anti-myocarditis drug development.

Effect of fructo-oligosaccharides on nutrient digestibility and digesta retention time in adult guinea pigs

A previous study suggested that addition of fructo-oligosaccharides (FOS) to the diet improved nitrogen (N) utilization and decreased acid detergent fiber (ADF) digestibility in guinea pigs. The present study was conducted to clarify the relationship between ADF digestibility and gastrointestinal mean retention time (MRT) in guinea pigs under FOS supplementation. Adult male guinea pigs were fed a commercial diet (50 g/day) with either 5% glucose (glucose group) or 5% FOS (FOS group) for 12 days in individual metabolism cages. Unlike the glucose group, N utilization improved, but ADF digestibility significantly (P < 0.05) decreased in the FOS group. MRT of solid digesta also significantly (P < 0.05) decreased in the FOS group compared with that in the glucose group. We concluded that reduction of MRT of solid digesta containing FOS decreased ADF digestibility in guinea pigs.

[Primary malignant tumor of uvula: report of 3 cases and review of the literature]

We retrospectively analyzed 3 middle-aged male patients of primary malignant tumor of uvula. There was a long history of smoking and drinking for the patients. All of them came to the hospital with the syptoms of pharyngeal foreign body sensation and two of them had pharyngeal sore. The patients appeared well, new neoplasm at the apex of the uvula. Diameter of 2 cases were less than 1 cm without invading the midline of the soft palate. Another patient's diameter was more than 1 cm with invading the midline of the soft palate. Preoperative pathology diagnosis of 3 patients was squamous cell carcinoma of uvula. The pharyngeal CT of the patient with invading the midline of the soft palate showed nodules at the end of the soft palate, obviously enhancement and small lymph node in left neck.

Triple reuptake inhibitors: Design, synthesis and structure-activity relationship of benzylpiperidine-tetrazoles

Monoamine transporters are important targets in the treatment of various central nervous disorders. Several limitations of traditional reuptake inhibitors, like delayed onset of action, insomnia, and sexual dysfunction, have compelled the search for safer, more effective compounds. In this study, we have sought to identify novel monoamine reuptake inhibitors. Based upon the docking study of compounds that we had reported previously, aromatic rings (A1) were modified to generate a novel series of benzylpiperidine-tetrazoles. Thirty-one compounds were synthesized and evaluated for their triple reuptake inhibition of serotonin, norepinephrine and dopamine. Triple reuptake inhibitor, compound 2q, in particular, showed potent serotonin reuptake inhibition, validating our design approach.

[Establishment of rat models with altered anterior guidance and observation of histological changes in temporomandibular joint synovium]

OBJECTIVE

This study aims to establish a stable animal model with altered anterior guidance and investigate histological changes on temporomandibular joint (TMJ) synovium in rats.

METHODS

Thirty-two rats were divided into four groups, namely, control group, anterior-guidance-deficient group (T1), and anterior guidance inclined up to 15 degree (T2) and 30 degree (T3) groups. Metal crowns that add 15 and 30 degrees to the palatal side were cemented to the incisors of maxilla to increase the inclination of anterior guidance. The low-speed diamond wheel shorts for both upper and lower incisors of rats were applied to avoid contact between anterior teeth in all direction, thus establishing an anterior guidance deletion model. TMJ joints on one side of two animals in each group were harvested after 3, 7, 14, and 28 days. Pathological changes were investigated in the TMJ synovium using hematoxylin-eosin (HE) staining.

RESULTS

The weight of T1 decreased briefly at first, and then increased slightly (P<0.05). The weight of T3 obviously reduced and then slowly increased, but remained below the initial weight (P<0.05). T3 manifested obvious synovial lining proliferation and vascular dilation (P<0.05).

CONCLUSIONS

The rat model of anterior guidance inclined up to 30 degree could imitate the pathological features of TMJ synovium with excessive increase in anterior guidance. A higher inclination of anterior guidance might cause more damage of TMJ synovium. The effect of anterior guidance deletion on TMJ synovium is yet to be determined.
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Anatomical structure of the coracohumeral ligament and its effect on shoulder joint stability

BACKGROUND

In this study, coracohumeral ligament (CHL) specimens were carefully dissected to observe its length, width, thickness and tension at different positions of the shoulder joint, thereby elucidating its effects on shoulder joint stability.

MATERIALS AND METHODS

Fresh frozen shoulder joints from 40 normal adult cadaveric specimens were dissected to reveal the CHL. With the shoulder joints placed at different positions, the length of the CHL and the width and thickness of the middle part of the ligament were measured. The changes in tension of the CHL were also observed. When the shoulder joint maintained the neutral position, the length of the CHL was 52.23 ± 1.02 mm and the width and thickness of the middle part of the ligament were 15.95 ± 0.59 mm and 1.46 ± 0.06 mm, respectively.

RESULTS

When the shoulder joint moved from the neutral position to 90° external rotation, from the neutral position to 30° adduction or from the neutral position to 30° flexion/extension or when the shoulder joint is pulled down with a 5 kg weight, the CHL was elongated and thinned, maintaining a strained state. When the shoulder joint moved from the neutral position to 90° internal rotation, from the neutral position to 90° abduction or from the neutral position to 30° flexion/ extension, the CHL was shortened and thickened, maintaining a relaxed state.

CONCLUSIONS

The CHL may limit the external rotation, adduction and downward movement of the shoulder joint and the process from the neutral position to the 30° flexion/extension, maintaining shoulder joint stability.

Therapy of tacrolimus combined with corticosteroids in idiopathic membranous nephropathy

We evaluated the efficacy and safety of tacrolimus (TAC) combined with corticosteroids in treating patients with idiopathic membranous nephropathy (IMN). One hundred seventy-seven biopsy-proven IMN patients were recruited in this retrospective clinical study. Sixty patients received TAC (target blood concentration of 4–8 ng/mL) and 117 patients received daily cyclophosphamide (CYC, 100 mg) combined with prednisone. Remission rates at the end of the first, second and third month in the TAC group were significantly higher than that in the CYC group (1st: 35.0 vs 19.7%, P<0.05; 2nd: 56.7 vs 38.5%, P<0.05; 3rd: 76.7 vs 59.0%, P<0.05). In the first 3 months, daily urinary protein and serum albumin in the TAC group obtained a better improvement than that in the CYC group (P<0.05). At the end of the sixth and the twelfth month, the remission rates, daily urinary protein and serum albumin were all comparable between the two groups (P>0.05). No significant difference of relapse rate between the groups was found (16.3 vs 12.0%, P>0.05). Patients were more likely to develop glucose intolerance in the TAC group. The TAC regimen obtained more benefits in treating IMN patients, especially in the first 3 months, than the CYC regimen.

Environmental context for the terminal Ediacaran biomineralization of animals

In terminal Ediacaran strata of South China, the onset of calcareous biomineralization is preserved in the paleontological transition from Conotubus to Cloudina in repetitious limestone facies of the Dengying Formation. Both fossils have similar size, funnel-in-funnel construction, and epibenthic lifestyle, but Cloudina is biomineralized, whereas Conotubus is not. To provide environmental context for this evolutionary milestone, we conducted a high-resolution elemental and stable isotope study of the richly fossiliferous Gaojiashan Member. Coincident with the first appearance of Cloudina is a significant positive carbonate carbon isotope excursion (up to +6‰) and an increase in the abundance and (34) S composition of pyrite. In contrast, δ(34) S values of carbonate-associated sulfate remain steady throughout the succession, resulting in anomalously large (>70‰) sulfur isotope fractionations in the lower half of the member. The fractionation trend likely relates to changes in microbial communities, with sulfur disproportionation involved in the lower interval, whereas microbial sulfate reduction was the principal metabolic pathway in the upper. We speculate that the coupled paleontological and biogeochemical anomalies may have coincided with an increase in terrestrial weathering fluxes of sulfate, alkalinity, and nutrients to the depositional basin, which stimulated primary productivity, the spread of an oxygen minimum zone, and the development of euxinic conditions in subtidal and basinal environments. Enhanced production and burial of organic matter is thus directly connected to the carbon isotope anomaly, and likely promoted pyritization as the main taphonomic pathway for Conotubus and other soft-bodied Ediacara biotas. Our studies suggest that the Ediacaran confluence of ecological pressures from predation and environmental pressures from an increase in seawater alkalinity set the stage for an unprecedented geobiological response: the evolutionary novelty of animal biomineralization.

Association of CYP1A1 MspI polymorphism with oral cancer risk in Asian populations: a meta-analysis

Numerous studies regarding the association between the CYP1A1 MspI polymorphism and oral cancer risk in Asian populations have shown controversial results. To get a more precise estimation of this relationship, we conducted a comprehensive meta-analysis. PubMed, the Cochrane Library, Elsevier Science Direct, Web of Knowledge, the Chinese National Knowledge Infrastructure, VIP, and Wan Fang Med Online were searched. Pooled odds ratios (ORs) with 95% confidence intervals (95%CIs) were calculated using fixed-effects or random-effects models. Heterogeneity among studies was assessed using the Cochran Q test and I(2) statistics. Twelve articles including 1925 oral cancer patients and 2335 controls were ultimately included in the meta-analysis. Overall, the meta-analysis showed that the CYP1A1 MspI polymorphism was associated with oral cancer risk in Asians (m1/m1 vs m2/m2: OR = 0.46, 95%CI = 0.30-070, POR = 0.000; m1/m1 vs m1/m2+m2/m2: OR = 0.70, 95%CI = 0.51-0.98, POR = 0.037; m1/m1+m1/m2 vs m2/m2: OR = 0.48, 95%CI = 0.35-0.65, POR = 0.000). Subgroup analyses showed that the control source (hospital-based or population-based), the genotyping method [polymerase chain reaction (PCR) or PCR-restriction fragment length polymorphism], the country in which the study was conducted, and Hardy-Weinberg equilibrium (Yes or No) were positively related to the association. Sensitivity analysis suggested that the overall results showed no significant change in three genetic models when any one study was removed, and publication bias was undetected by the Egger test. The CYP1A1 MspI polymorphism may be associated with oral cancer risk in Asian populations.

Discovery of 7-Methyl-10-Hydroxyhomocamptothecins with 1,2,3-Triazole Moiety as Potent Topoisomerase I Inhibitors

Homocamptothecin is emerging as an important topoisomerase I inhibitor originating in natural product camptothecin. We report the modifications and SAR of homocamptothecin on position C10 to develop potent topoisomerase I inhibitors for anticancer drug discovery. Based on click chemistry, twenty-one 1,2,3-triazole-substituted homocamptothecin derivatives were readily synthesized in two steps. For A549, cycloalkyl- and alkyl-substituted compounds 6j, 6l, and 6o revealed highly antiproliferative inhibitory activities with IC50 value of 30, 30, and 50 nm, respectively. In addition, cyclopropyl 6j exhibited greater Topo I inhibitory activity than 20(S)-Camptothecin, which indicated suitability for further drug development.

[The resection of a giant recurrent parotid gland tumor]

This paper report a case of a giant recurrent tumor arising in the parotid gland. The patient presents as a tumor for 20 years on her left parotid region showing a rapid increase in the dimensions during the latest 3 months. The computed tomography scan and fine needle aspiration cytology (FNAC) showed it most likely to be a pleomorphic adenoma. The tumor was completely resected with preservation of the facial nerve under general anesthesia. Macroscopically, the excised tumor was measured 21 cm×13 cm×10 cm in scale, and weighed 1.730 kg. Histopathological examination of the excised tumor revealed a recurrent pleomorphic adenoma. Postoperatively, the facial nerve function was normal with an excellent aesthetic outcome.

Effect of oral contraceptive use on the incidence of dry socket in females following impacted mandibular third molar extraction: a meta-analysis

The aim of this comprehensive meta-analysis was to provide evidence-based data to test whether oral contraceptive (OC) use can promote the incidence of dry socket (DS) in females following impacted mandibular third molar extraction. PubMed, the Cochrane Library, and Elsevier Science Direct databases were searched. The pooled risk ratio (RR) with 95% confidence interval (CI) was calculated using fixed-effects or random-effects model analysis. Heterogeneity among studies was evaluated with the Cochran test and I(2) statistic. Study quality was assessed with the Newcastle-Ottawa scale. Of 70 articles identified in the search, 12 reporting 16 clinical controlled trials were included in this study. The incidence of DS was significantly greater in the OC groups than in the control groups (RR 1.80, 95% CI 1.33-2.43). Subgroup analyses showed that the unit assessed (tooth or patient), the region in which the study was conducted, and the intervention were not related to the incidence of DS in females taking OC after impacted mandibular third molar extraction. The sensitivity analysis showed no significant change when any one study was excluded. Publication bias was also not detected. This study suggests that OC use may promote the incidence of DS in females following impacted mandibular third molar extraction.

Expression and clinical role of TCTP in epithelial ovarian cancer

The aim of this study is to investigate the potential role and prognostic significance of translationally controlled tumor protein (TCTP) in human epithelial ovarian cancer (EOC). Western blot was used to evaluate the expression of TCTP in eight fresh EOC tissues. Immunohistochemistry was performed on formalin-fixed paraffin-embedded sections of 119 cases of ovarian cancers. Kaplan-Meier method indicated the relation between TCTP and EOC patients' overall survival rate. Starvation and re-feeding was used to assess cell cycle. Knocking down of TCTP and CCK8 assay showed the role of TCTP in HO8910 cell cycle. We found that TCTP was overexpressed in carcinoma tissues compared with normal tissues. Immunohistochemistry revealed that TCTP expression was significantly associated with clinicopathologic variables. Kaplan-Meier analysis revealed that high TCTP expression was significantly related to poor prognosis of the patients. Starvation and re-feeding suggested TCTP played a critical role in HO8910 cell proliferation. Interference of TCTP and CCK8 assay showed that the TCTP-siRNA treated HO8910 cells grew more slowly than the control group. CCK-8 assays and terminal-deoxynucleoitidyl transferase mediated nick end labeling assays were also performed to demonstrate the cisplatin could inhibit the survival of HO8910 cells and promote their apoptosis. All the experiments we have done showed that TCTP could promote the progression of EOC and reduce the sensitiveness of HO8910 cells to cisplatin.

Involvement of chromosome region maintenance 1 (CRM1) in the formation and progression of esophageal squamous cell carcinoma

Chromosome region maintenance 1 (CRM1) has been related to several malignancies. The predictive value of CRM1 in the malignance and prognosis of esophageal squamous cell carcinoma (ESCC), however, is not clear yet. In this study, we displayed that CRM1 expression was up-regulated in ESCC using immunohistochemistry and Western blot. Statistical analysis demonstrated that patients with high CRM1 levels indicated shorter survival period. We further found that silencing CRM1 caused apoptosis in ESCC cell lines. Moreover, knockdown of CRM1 disturbed the expression of tumor suppressor proteins and inhibited NF-κB activity in ESCC cell lines, especially if the cell line was treated with 5-fluorouracil. In consequence, our results for the first time indicated that CRM1 was dysregulated in ESCC, and suppression of CRM1 expression which resulted in inhibiting of NF-κB signaling might be developed into a new strategy in ESCC therapy.

Design, synthesis and biological activity of piperlongumine derivatives as selective anticancer agents

In an effort to expand the structure-activity relationship of the natural anticancer compound piperlongumine, we have prepared sixteen novel piperlongumine derivatives with halogen or morpholine substituents at C2 and alkyl substituents at C7. Most of 2-halogenated piperlongumines showed potent in vitro activity against four cancer cells and modest selectivity for lung normal cells. The highly active anticancer compound 11h exhibited obvious ROS elevation and excellent in vivo antitumor potency with suppressed tumor growth by 48.58% at the dose of 2 mg/kg. The results indicated that halogen substituents as electrophilic group at C2 played an important role in increasing cytotoxicity.

Transfer of blood urea nitrogen to cecal microbial nitrogen is increased by fructo-oligosaccharide feeding in guinea pigs

The present study was conducted to determine the mechanism by which nitrogen (N) availability is improved by fructo-oligosaccharide (FOS) in guinea pigs. Adult male guinea pigs were fed a commercial pellet diet (50 g/day) with either 5% glucose or 5% FOS for 7 days in individual metabolism cages. After 7 days of feeding the diet, (15) N-urea was administered intravenously 1 h before slaughter under anesthesia. The amount and concentration of total, protein, bacterial, ammonia and urea N and the (15) N atom % excess were measured in blood, liver, gut contents and urine. The (15) N atom % excess of total and protein N, and the amount of total, protein and bacteria N and (15) N in the cecum were significantly increased by the consumption of FOS. Furthermore, the concentration and amount of short-chain fatty acids were significantly increased by the consumption of FOS. In contrast, the amount of urinary (15) N was significantly decreased by the consumption of FOS. These results suggest that consumption of FOS increases transfer of blood urea N into the large intestine for bacterial N synthesis, which is subsequently re-absorbed by cecotrophy, and contributes to the increase of N utilization in guinea pigs.