Uterine rupture during pregnancy

BACKGROUND

Despite great advances in modern obstetrics, uterine rupture (UR) remains one of the most frightening complications with high morbidity and mortality.

OBJECTIVE

To improve the diagnosis and management of UR.

RESULTS

We report two cases of UR. Case 1 was spontaneous UR and case 2 was associated with a scar in the patient's uterus. Interestingly, the ruptured scar was not a scar from a previous cesarean section; it was a scar that was associated with placenta accreta. The fetal heart rates in both cases were below 80 beats per minute after UR. The newborn in case 1 died soon after delivery, while the newborn in case 2 survived. Both women were healthy and were discharged from hospital two to three weeks after surgery.

CONCLUSION

UR can occur in a previously unscarred uterus or from a scar of a cesarean section or scars caused by other pathologic lesions in the uterus. Severe fetal bradycardia might be a strong indicator for UR. Such study will help obstetricians provide more careful measures to manage UR, so that its morbidity and mortality can be decreased.

Randomised clinical trial: the effects of perioperative probiotic treatment on barrier function and post-operative infectious complications in colorectal cancer surgery - a double-blind study

BACKGROUND

Infection following abdominal operation remains a major factor affecting the morbidity of patients after surgery.

AIM

To determine the effects of perioperative administration of probiotics on the gut barrier function and the surgical outcome in patients undergoing elective colorectal surgery.

METHODS

One hundred patients with colorectal carcinoma were randomly divided into the control group (n = 50) and the probiotics group (n = 50). The probiotics were given orally for 6 days preoperatively and 10 days post-operatively. Outcomes were measured by bacterial translocation, gut permeability, the effect on the faecal microbiota, and the clinical outcomes such as infectious-related complications and gut defecation function.

RESULTS

Compared with the control group, probiotics group had increased transepithelial resistance (P < 0.05), reduced transmucosal permeation of horseradish peroxidase and lactulose/mannitol ratio, reduced bacterial translocation (P < 0.05), decreased ileal-bile acid binding protein (P < 0.05) and positive rate of blood bacterial DNA (P < 0.05) and an enhanced mucosal tight junction protein expression. They had decreased blood enteropathogenic bacteria and increased faecal bacterial variety. The post-operative recovery of peristalsis, incidence of diarrhoea, and infectious-related complications were also improved.

CONCLUSION

Probiotics can improve the integrity of gut mucosal barrier by benefiting the faecal microbiota, and decreasing infectious complications in patients with colorectal cancer undergoing colorectomy.

Therapeutic effect of norisoboldine, an alkaloid isolated from Radix Linderae, on collagen-induced arthritis in mice

The alkaloid fraction of Radix Linderae, the main active component of this herb drug, has been proven to exhibit anti-inflammatory, analgesic and antimicrobial activities. The present study was undertaken to investigate the therapeutic potential of norisoboldine, the major isoquinoline alkaloid present in Radix Linderae, in collagen II -induced arthritis (CIA) of mice as well as the possible mechanisms. CIA was induced in mice by immunization with chicken type II collagen (II). After boosted on day 21, mice were treated with norisoboldine (10, 20, 40 mg/kg) for twenty consecutive days. The clinical scores, body weight changes and joint histopathology were evaluated. Norisoboldine treatment significantly alleviated the severity of the disease, based on the reduced clinical scores and elevated the lowered body weights of model mice. Meanwhile, this alkaloid dose-dependently reduced the infiltration of inflammatory cells, synovial hyperplasia and protected joint from destruction. Additionally, the serum level of anti-CII IgG and the CII-stimulated lymphocyte proliferation were remarkably decreased in the groups administered with norisoboldine. An assessment of Th1 function using the delayed-type hypersensitivity model confirmed that norisoboldine also significantly suppressed the enhanced T cell responses in vivo. These findings suggest that norisoboldine might be a potential therapeutic agent for rheumatoid arthritis, and it functions through protecting joint destruction as well as regulating the abnormal immune responses.

The Arabidopsis gene SIGMA FACTOR-BINDING PROTEIN 1 plays a role in the salicylate- and jasmonate-mediated defence responses

The chloroplast-localized SIB1 protein was previously identified by its interaction with SIGMA FACTOR 1 (SIG1), a component of the RNA polymerase machinery responsible for transcription of plastid genes. The physiological function of SIB1 is little known. We found that expression of SIB1 is induced by infection with Pseudomonas syringae, suggesting its possible involvement in the defence response. The sib1 loss-of-function mutation compromises induction of some defence-related genes triggered by pathogen infection and the treatments with salicylic acid (SA) and jasmonic acid (JA), two key signalling molecules in the defence response. Conversely, constitutive over-expression of SIB1 causes the plants to hyper-activate defence-related genes following pathogen infection or the SA and JA treatments, leading to enhanced resistance to infection by P. syringae. SIB1 is a member of the large plant-specific VQ motif-containing protein family, and might act as a link to connect defence signalling with chloroplast function.

Abdominal compartment syndrome associated with capillary leak syndrome after liver transplantation

Orthotopic liver transplantation was performed in a 49-year-old man with metastatic liver sarcoma. After surgery, both abdominal compartment syndrome (ACS) and capillary leak syndrome (CLS) developed. Exploratory laparotomy and colon exteriorization were performed. Five days later, a diagnosis of severe CLS was established, and hydroxyethyl starch was infused to prevent leakage of albumin. The patient gradually recovered over 3 weeks. Awareness of ACS and CLS is important to improve outcome because early diagnosis and immediate therapy are essential. Bladder pressure is a key factor in diagnosing ACS, and pressure of 35 mm Hg is an indication for decompressive laparotomy. During the early stage of CLS, hydroxyethyl starch but not albumin should be used to alleviate edema and hypoalbuminemia.

Mesenchymal stem cells inhibition of chronic ethanol-induced oxidative damage via upregulation of phosphatidylinositol-3-kinase/Akt and modulation of extracellular signal-regulated kinase 1/2 activation in PC12 cells and neurons

It is well known that chronic ethanol consumption damages CNS through oxidative stress which results in many dysfunctions. Recently, it has been demonstrated that as a promising strategy to treat several neurological diseases, transplanted bone marrow-derived mesenchymal stem cells (MSCs) can secrete lots of protective factors that in turn promote function recovery. In the present study, we assessed the potential effects of MSCs conditioned medium (MSC-CM) against chronic ethanol-associated damage on PC12 cells and primary cortical neurons. We found that pretreatment with MSC-CM notably improved cell survival, prevented chronic ethanol-associated apoptosis and abolished the robust deterioration in oxidative status. In addition, we also discovered that chronic ethanol exposure induced an inactivation of phosphatidylinositol-3-kinase (PI3K)/Akt and a lasting activation of extracellular signal-regulated kinase 1/2 (ERK1/2) in both PC12 cells and primary cortical neurons which were able to be reversed by MSC-CM. The PI3K inhibitor (LY294002) was able to reduce the antioxidative and cytoprotective effects conferred by MSC-CM, in part, and the ERK1/2 inhibitor (PD98059) was able to elicit significant protection from chronic ethanol cytotoxicity but not rescue the deterioration in oxidative status induced by chronic ethanol. Taken together, these findings provide the first evidence that MSCs might have potent antioxidant action to shield the apoptotic impairment from chronic ethanol exposure in PC12 cells and neurons, which is involved in upregulation of PI3K/Akt and modulation of ERK1/2 activation, at least partially.

Differential actions of urocortins on neurons of the myenteric division of the enteric nervous system in guinea pig distal colon

BACKGROUND AND PURPOSE

Urocortins (Ucns) 1, 2 and 3 are corticotropin-releasing factor (CRF)-related neuropeptides and may be involved in neural regulation of colonic motor functions. Nevertheless, details of the neural mechanism of action for Ucns have been unclear. We have, here, tested the hypothesis that Ucns act in the enteric nervous system (ENS) to influence colonic motor behaviour.

EXPERIMENTAL APPROACH

We used intracellular recording with 'sharp' microelectrodes, followed by intraneuronal injection of biocytin, and immunohistochemical localization of CRF(1) and CRF(2) receptors in guinea pig colonic tissue.

KEY RESULTS

Application of Ucn1 depolarized membrane potentials and elevated excitability in 58% of AH-type and 60% of S-type colonic myenteric neurons. In most of the neurons tested, depolarizing responses evoked by Ucn-1 were suppressed by the CRF(1) receptor antagonist NBI 27914, but were unaffected by the CRF(2) receptor antagonist antisauvagine-30. The selective CRF(2) receptor agonists, Ucn2 and Ucn3, evoked depolarizing responses in 12 and 8% of the AH-type myenteric neurons, respectively, and had no effect on S-type neurons. Antisauvagine-30, but not NBI 27914, suppressed these Ucn2- and Ucn3-evoked responses. Immunohistochemical staining identified CRF(1) as the predominant CRF receptor subtype expressed by ganglion cell somas, while CRF(2)-immunoreactive neuronal somas were sparse. Ucns did not affect excitatory synaptic transmission in the ENS.

CONCLUSIONS AND IMPLICATIONS

The results suggest that Ucns act as neuromodulators to influence myenteric neuronal excitability. The excitatory action of Ucn1 in myenteric neurons was primarily at CRF(1) receptors, and the excitatory action of Ucn2 and Ucn3 was at CRF(2) receptors.

Observation of time-reversal-protected single-dirac-cone topological-insulator states in Bi2Te3 and Sb2Te3

We show that the strongly spin-orbit coupled materials Bi2Te3 and Sb2Te3 and their derivatives belong to the Z2 topological-insulator class. Using a combination of first-principles theoretical calculations and photoemission spectroscopy, we directly show that Bi2Te3 is a large spin-orbit-induced indirect bulk band gap (delta approximately 150 meV) semiconductor whose surface is characterized by a single topological spin-Dirac cone. The electronic structure of self-doped Sb2Te3 exhibits similar Z2 topological properties. We demonstrate that the dynamics of spin-Dirac fermions can be controlled through systematic Mn doping, making these materials classes potentially suitable for topological device applications.