Erythropoietin Ameliorates Lung Injury by Accelerating Pulmonary Endothelium Cell Proliferation via Janus Kinase-Signal Transducer and Activator of Transcription 3 Pathway After Kidney Ischemia and Reperfusion Injury

BACKGROUND/AIMS

Kidney ischemia and reperfusion injury could cause microvascular barrier dysfunction, lung inflammatory cascades activation, and programmed cell death of pulmonary endothelium, leading to acute lung injury. Our study aimed at determining whether erythropoietin (EPO) can ameliorate lung dysfunction following renal ischemia and reperfusion (IR) injury and explored the underlying mechanisms.

METHODS

In vivo, C57BL/6 mice received EPO (6000 U/kg) before right renal vascular pedicles clamping for 30 minutes, followed by 24 hours of reperfusion. The lung histopathologic changes and inflammatory cytokines expression were assessed. In vitro, cultured human umbilical vein endothelial cells were treated with EPO, and apoptosis rate, proliferation capacity, and phosphorylation status of the Janus kinase-signal transducer and activator of transcription 3 (Jak-STAT3) pathway were measured respectively in the presence or absence of lipopolysaccharide stimulation.

RESULTS

In vivo, EPO remarkably attenuated pulmonary interstitial and alveolar epithelial edema caused by renal IR injury. In vitro, the proliferation capacity of human umbilical vein endothelial cells was significantly increased under EPO stimulation, which correlated with changes in Jak-STAT3 signaling.

CONCLUSION

Our data indicated that EPO is able to ameliorate acute lung tissue damage induced by renal IR, and at least in part, via the Jak-STAT3 pathway.

Synergistic O2-/Li+ Dual Ion Transportation at Atomic Scale

The ion migration during electrochemical process is a fundamental scientific issue for phase transition behavior and of technical importance for various functional devices, where cations or anions are active under electrical bias. Usually only one type of functional ion, O^2- or Li⁺, is activated due to their different migration energy barriers, cooperated by the valence change of other immobile ions in the host lattice matrix, e.g., Co²⁺/Co³⁺ and Mn³⁺/Mn⁴⁺ redox couples, owing to the charge neutralization. Here we select spinel Li₄Ti₅O₁₂ as anode and construct an all-solid-state battery under a transmission electron microscope; a synergistic transportation of O^2- and Li⁺ driven by an electrical bias was directly observed at the atomic scale. A small amount of oxygen anions was extracted firstly as a result of its lowest vacancy formation energy under 2.2 V, leading to the vertical displacement of oxygen. Up to 2.7 V, an ordered phase with both Li- and O- deficiency formed. The Li⁺ and O^2- ions are simultaneously extracted out from the [LiO₄] tetrahedra due to the electroneutrality principle. The migration paths of O and Li have been proposed and verified by first-principles calculations. These results reveal a brand new synergistic ion migration manner and may provide up-to-date insights on the transportation process of lithium ion conductors.

Surgical management and outcomes of duodenal gastrointestinal stromal tumors

BACKGROUND AND STUDY AIMS

This retrospective study purports to examine these characteristics and compare the surgical procedures available and appropriate for the treatment of patients affected by duodenal GISTs.

PATIENTS AND METHODS

A retrospective examination of reports and studies carried out between May 2012 and March 2017, and covering patients with primary GISTs of the duodenum was performed using modules from the SPSS package. Comparisons of treatment effects resulting from the administration of two differential methods of surgical treatment namely pancreaticoduodenectomy (PD), and limited resection (LR), were effected on the reports of the GIST patients thus selected.

RESULTS

Out of these 62 patients who had undergone resection of duodenal GISTs, 47 (76%) had limited resection (LR) and 15 (24%) underwent pancreaticoduodenectomy (PD). In Multivariate analyses, tumor size was an independent predictive factor for recurrence (p=0.008). ASA, tumor size, and PD were independent and significant prognostic factors on OS (p=0.021, p=0.024, and p=0.030, respectively). In the very low and low risk group, and high-risk group, there were no significant differences in the RFS (recurrence-free survival) and OS (overall survival) between the LR and PD groups.

CONCLUSIONS

When technically feasible, LR should be given due consideration as a reliable and curative option for duodenal GISTs achieving satisfactory RFS and OS.

[Prognostic influence of preoperative Nutritional Risk Screening -2002 (NRS-2002) score for patients with thoracic esophageal squamous cell carcinoma receiving surgery]

Objective: To apply Nutritional Risk Screening-2002(NRS-2002) to perform nutritional status score for the patients with thoracic esophageal squamous cell carcinoma (ESCC) receiving surgery, and to explore the prognostic impact of long-term survival. Methods: A total of 117 patients who were diagnosed with ESCC from 2010 to 2012 were retrospectively analyzed. They recieved standard curative esophagectomy in the Yangzhou University Affiliated Taixing People's Hospital. The nutritional status and risk score for recruited patients were assessed according to the standard of NRS-2002 tool prior to surgery, and these patients were grouped for further analysis according to the median values of NRS-2002 score. Finally, the relationship between NRS-2002 score and prognosis was analyzed. Results: Patients were classified into two groups, with 45 in the NRS-2002<2.0 group, and 72 cases in the NRS-2002≥2.0, respectively. In the NRS-2002<2.0 group, the 1-, 3-, and 5-year progression-free survival (PFS) rates were 75.6%, 44.4% and 40.0% separately, while in the NRS-2002≥2.0 group, the PFS rates were 61.1%, 6.9% and 4.2% respectively, and the differences were statistically significant (P<0.001). Correspondingly, in the NRS-2002< 2.0 group, the 1-, 3-, and 5-year overall survival (OS) rates were 97.8%, 66.7% and 57.8% separately, while in the NRS-2002≥2.0 group, the OS rates were 91.7%, 33.3% and 16.7% respectively, and the differences were also statistically significant (P<0.001). Univariate analysis showed that N stage, TNM stage and NRS-2002 score were closely related to PFS and OS (P<0.05), and T stage was only associated with OS in patients with thoracic esophageal squamous cell carcinoma (P<0.05). Furthermore, multivariate Cox regression analysis showed that N stage (RR=1.640, 95% CI 1.049-2.565, P=0.030) and NRS-2002 (RR=3.154, 95% CI 1.946-5.113, P<0.001) were independent prognostic factors for PFS in patients with ESCC after surgery. Additionally, pathological differentiation (RR=1.556, 95% CI 1.004-2.440, P=0.041), N stage (RR=1.624, 95% CI 1.017-2.593, P=0.042) and NRS-2002 (RR=3.906, 95% CI2.245-6.795, P<0.001) were independent prognostic factors for OS in ESCC patients following surgery. Conclusion: Preoperative nutritional risk screening NRS-2002 score is an independent prognostic factor in patients with ESCC receiving surgery and could be used as a tool for primary screening for nutritional risk.

MAGE-A is frequently expressed in triple negative breast cancer and associated with epithelial-mesenchymal transition

Epithelial-mesenchymal transition (EMT) is a crucial step in tumor metastasis. Triple negative (TN) breast cancer, a high metastasis phenotype, has been verified to be associated with EMT. Melanoma associated antigen-A (MAGE-A) is exclusively expressed in cancers with high aggressiveness as well as unfavorable prognosis and likely to be associated with EMT of triple negative breast cancer (TNBC). The aim of the study is to analyze the expression profile of MAGE-A in breast cancer and the correlation between MAGE-A and EMT of TNBC. Immunohistochemistry (IHC) was performed to assess the prevalence of MAGE-A, vimentin, E-cadherin and β-catenin in breast cancer tissues and correlate them with clinical pathological parameters. The association between MAGE-A and EMT markers was also evaluated. Scratch assay and transwell invasion assay were carried out to evaluate the impact of MAGE-A down-regulation on migration and invasion of the breast cancer cells. Real-time PCR was also conducted to evaluate alterations in EMT markers with decrease in MAGE-A. The results showed that MAGE-A was absent in normal tissue but expressed in tumor samples with the incidence of 49.17% (P=0.008). MAGE-A staining was higher in TNBC (76.47%, 13/17), followed by HER-2(+) (53.85%, 7/13) and Luminal set (43.33%, 39/90), and it was significantly correlated with ER (-), PR (-), HER-2 (-), lymph nodes involvement and higher histological grade (P<0.05). E-cadherin-positivity was frequent in Luminal set (94.44%, 85/90) and linked to ER (+), negative lymph nodes and lower histological grade (P<0.05). Vimentin expression was often observed in TNBC (70.56%, 12/17) and ER (-), PR (-), lymph nodes (+) groups (P<0.05). Expression of β-catenin was prevalent in Luminal set (93.33%, 84/90) and correlated with ER (+), PR (+) and lower histological grade (P<0.05). MAGE-A was inversely associated with E-cadherin (P=0.011) and β-catenin (P=0.048) but expressed in the same trend with vimentin (P=0.000). Migration and invasion of MDA-MB-231 were inhibited when MAGE-A decreased. Increase in epithelial markers and decline in mesenchymal indicators were also seen with MAGE-A reduction. Snail, Slug, ZEB1 and ZEB2 were also down-regulated. In conclusion, MAGE-A may be responsible for high aggressiveness and EMT of TNBC and can be a new choice for targeted therapy.

[Epidemiological investigation and analysis of an outbreak of mycoplasma pneumoniae pneumonia in adult]

Objective: To conduct an epidemiological investigation and analysis of an outbreak of mycoplasma pneumonia in adults. Methods: The first case was a 23-year-old male came from the Third Military Medical University, who served as an intern in the Fuzhou General Hospital of PLA and presented on July 16, 2015 with a history of low-grade fever, dizziness, fatigue and chest tightness. Chest CT revealed pulmonary nodules shadow. It was found that other 11 individuals who had been in close contact with the first patient also had similar pulmonary nodules shadow after chest CT examination. Immediately, the health and epidemic prevention department of the ministry of health of Nanjing Military Command and the disease prevention and control center of the Nanjing Military Command received a phone call from Fuzhou General Hospital of PLA. Upon arrival, the prevention and control team conducted a series of epidemiological investigations and on-site prevention, control and disposal of the event, and conducted chest CT screening for other 289 students and staff who volunteered to be examined living in the same area. After the patients with similar pulmonary nodules shadow were screened out, mycoplasma antibody titer detection and chest CT re-scanning were performed for compliance patients. Results: There were 301 students living in the dormitories (Building A and B) of the student living area, and they were screened by chest CT, and it was found that 27 of them had pulmonary nodules shadow, including single pulmonary nodules shadow (48.1%, 13 out of 27) and multiple pulmonary nodules shadow (51.9%, 14 out of 27). And halo sign was observed in 25 of 27 patients (92.6%). The majority of the 27 patients were asymptomatic, only 2 patients got cough, a few of them had systemic symptoms such as fever, dizziness, fatigue. The positive rate of pulmonary nodules shadow was 32.8% (22/67) in building A (poor environmental hygiene), 2.14% (5/234) in building B, and the total incidence rate was 8.97%. Four-fold increase in the mycoplasma pneumoniae (MP) antibody titer in the paired sera was observed in first 12 patients. Measures such as disinfection, isolation and sanitation were taken to control the spread of the epidemic. There was no serious and death cases on the basis of active treatment on the affected patients. Conclusions: The outbreak of mycoplasma pneumoniae pneumonia often occur in crowded places. And the clinical and imaging features of mycoplasma pneumoniae pneumonia are atypical. Standard epidemiological intervention should be adopted for the sudden onset of respiratory diseases with unknown causes.

Similar Effect of P16 Hydroxymethylation and True Methylation on Prediction of Malignant Transformation of Oral Epithelial Dysplasia: A Prospective Study

Background: Total P16 methylation (P16M), including P16 hydroxymethylation (P16H) and true-P16M, correlates with malignant transformation of oral epithelial dysplasia (OED). Both true-P16M and P16H are early events in carcinogenesis. Aim: The aim of this study is to prospectively determine if discrimination of true-P16M from P16H similarly is necessary for prediction of cancer development from OEDs. Methods: Patients (n = 265) with mild or moderate OED were recruited into the double-blind 2-center cohort. Total-P16M and P16H were analyzed using the 115-bp MethyLight, TET-assistant bisulfite (TAB) methylation-specific PCR (MSP), and TAB-sequencing. Total-P16M-positive and P16H-negative samples were defined as true-P16M-positive. Progression of OEDs was monitored for a minimum 24 months follow-up period. Results: P16H was detected in 23 of 73 (31.5%) total-P16M-positive OEDs. Follow-up information was obtained from 247 patients with an ultimate compliance of 93.2%. OED-derived squamous cell carcinomas were observed in 13.0% (32/247) patients during the follow-up (median, 41.0 months). The cancer progression rate for total-P16M-positive patients was significantly increased when compared with total-P16M-negative patients (23.3% vs 8.6%; adjusted odds ratio = 2.67 [95% CI: 1.19-5.99]). However, the cancer progression rate was similar between P16H- and true-P16M-positive OEDs (26.1% [6/23] vs 22.0% [11/50]; odds ratio = 0.80 [95% CI: 0.22-2.92]). The progression-free survival was also similar for these patients. Conclusion: P16H and true-P16M are similar biomarkers for determining malignant potential of OEDs. Discrimination of P16H from true-P16M, at least in OED, may be not necessary in clinical applications.

Ureteral tunnel length versus ureteral orifice configuration in the determination of ureterovesical junction competence: A computer simulation model

INTRODUCTION

The long-held belief that a ureteral re-implant tunnel should be five times the diameter of the ureter, as proposed by Paquin in 1959, ignores the effect of the orifice on the occurrence of reflux. In 1969, Lyon proposed that the shape of the ureteral orifice (UO) is more important than the intravesical tunnel. However, both theories missed quantitative evidence from principles of physics. The goal of the current study was to test Lyon's theory through numerical models (i.e. to quantify the sensitivity of ureterovesical junction (UVJ) competence to intravesical tunnel length and to the UO).

MATERIALS AND METHODS

The closure of a three-dimensional spatial configuration of ureter, constrained within a bladder, was simulated. Two common UO shapes (i.e. golf type vs 2-mm volcano type (Summary Fig.)), and two different intravesical ureteral tunnel length/diameter ratios (3:1 and 5:1) were examined. The required closure pressures were then compared.

RESULTS

The UO was a significant factor in determining closure pressure. Given the same intravesical ureteral tunnel length/diameter ratio, the required closure pressure for the volcanic orifice was 78% less than that for the golf orifice. On the other hand, the intravesical ureteral tunnel length/diameter ratio had minimal effect on the required closure pressure. As the intravesical ureteral tunnel length/diameter ratio changed from 3:1 to 5:1, the required closure pressure was reduced by less than 7%, regardless of the orifice shape.

CONCLUSIONS

The simulation results showed that UVJ competence was more sensitive to a 2-mm protrusion of the UO compared to an increase in the intravesical tunnel length from 3:1 to 5:1. This agrees with Lyon's theory, and at the same time challenges Paquin's 5:1 rule. Researchers could use this information to consider the UO configuration in further animal, human, computer or material models.

OCO-2 advances photosynthesis observation from space via solar-induced chlorophyll fluorescence

Quantifying gross primary production (GPP) remains a major challenge in global carbon cycle research. Spaceborne monitoring of solar-induced chlorophyll fluorescence (SIF), an integrative photosynthetic signal of molecular origin, can assist in terrestrial GPP monitoring. However, the extent to which SIF tracks spatiotemporal variations in GPP remains unresolved. Orbiting Carbon Observatory-2 (OCO-2)'s SIF data acquisition and fine spatial resolution permit direct validation against ground and airborne observations. Empirical orthogonal function analysis shows consistent spatiotemporal correspondence between OCO-2 SIF and GPP globally. A linear SIF-GPP relationship is also obtained at eddy-flux sites covering diverse biomes, setting the stage for future investigations of the robustness of such a relationship across more biomes. Our findings support the central importance of high-quality satellite SIF for studying terrestrial carbon cycle dynamics.

Genome-wide association analysis identifies potential regulatory genes for eumelanin pigmentation in chicken plumage

Plumage color in chicken is determined by the proportion of eumelanin and pheomelanin pigmentation. As the main ingredient in plumage melanin, eumelanin plays a key role in the dark black, brown and grey coloration. However, very few studies have been performed to identify the related genes and mutations on a genome-wide scale. Herein, a resource family consisting of one backcross population and two F2 cross populations between a black roster and Yukou Brown I parent stockbreed was constructed for identification of genes related to eumelanin pigmentation. Chickens with eumelanin in their plumage were classified as the case group, and the rest were considered the control group. A genome-wide association study of this phenotype and genotypes using Affymetrix 600K HD SNP arrays in this F2 family revealed 13 significantly associated SNPs and in 10 separate genes on chromosomes 1, 2, 3 and 5. Based on previous studies in model species, we inferred that genes, including NUAK family kinase 1 (NUAK1) and sonic hedgehog (SHH), may play roles in the development of neural crest cells or melanoblasts during the embryonic period, which may also affect the eumelanin pigmentation. Our results facilitate the understanding of the genetic basis of eumelanin pigmentation in chicken plumage.

The Effect of Apolipoprotein E ɛ4 (APOE E4) on Visuospatial Working Memory in Healthy Elders and Amnestic Mild Cognitive Impairment Patients: An Event-related Potentials Study

Introduction

Previous studies provided inconsistent evidences for the effect of apolipoprotein E ɛ4 (APOE ɛ4) status on the visuospatial working memory (VSWM). Our study was the first investigation with event-related potential (ERP) to explore the effect of APOE ɛ4 on VSWM in healthy elders and aMCI patients.

Objective

The aim was to investigate the effect of APOE ɛ4 on VSWM with event-related potential (ERP) study in healthy elders and aMCI patients.

Methods

Thirty-nine aMCI patients (27 APOE ɛ4 non-carriers and 12 APOE ɛ4 carriers) and 43 their matched control (25 APOE ɛ4 non-carriers and 18 APOE ɛ4 carriers) performed an N-back task, a VSWM paradigm that manipulated the number of items to be stored in memory.

Results

Our study detected reduced accuracy and delayed mean correct response time in aMCI patients than healthy elders. P300 was elicited by VSWM and its amplitude was lower in aMCI patients at the central-parietal and parietal electrodes than healthy controls. In healthy elders, P300 amplitude declined prior to task performance change in APOE ɛ4 carriers than non-carriers. Regarding aMCI patients, P300 amplitude result revealed exacerbated VSWM deficits in APOE ɛ4 carriers than APOE ɛ4 non-carriers. Additionally, standardized low-resolution brain electromagnetic tomography analysis (s-LORETA) result showed enhanced brain activation in right parahippocampal gyrus during P300 time range in APOE ɛ4 carriers than non-carriers in aMCI patients (Fig. 1, Tables 1 and 2).

Conclusions

It demonstrated that P300 amplitude might serve as a biomarker for recognizing aMCI patients and contribute to early detection of worse VSWM in APOE ɛ4 carriers than non-carriers.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.

Fast Surface Dynamics of Metallic Glass Enable Superlatticelike Nanostructure Growth

Contrary to the formation of complicated polycrystals induced by general crystallization, a modulated superlatticelike nanostructure, which grows layer by layer from the surface to the interior of a Pd_{40}Ni_{10}Cu_{30}P_{20} metallic glass, is observed via isothermal annealing below the glass transition temperature. The generation of the modulated nanostructure can be solely controlled by the annealing temperature, and it can be understood based on the fast dynamic and liquidlike behavior of the glass surface. The observations have implications for understanding the glassy surface dynamics and pave a way for the controllable fabrication of a unique and sophisticated nanostructure on a glass surface to realize the properties' modification.

FKBP12 enhances sensitivity to chemotherapy-induced cancer cell apoptosis by inhibiting MDM2

The FK506-binding protein 12 (FKBP12) is a cytoplasmic protein and has been reported to possess multiple functions in signaling transduction based on its interaction with different cellular targets. Here, we report that FKBP12 interacts with oncoprotein MDM2 and induces MDM2 degradation. We demonstrate that FKBP12 degrades MDM2 through binding to MDM2 protein, disrupting MDM2/MDM4 interaction and inducing MDM2 self-ubiquitination. The FKBP12-mediated MDM2 degradation was significantly enhanced when the transfected MDM2 was localized in the cytoplasm. The endogenous MDM2, when it was induced by p53 subjecting to DNA-damaging stimuli such as treatment with doxorubicin, was also significantly inhibited by FKBP12. This is due to translocation of p53-induced MDM2 from the nucleus to the cytoplasm, which facilitates interaction with cytoplasmic FKBP12. Furthermore, the enhanced level of MDM2 following p53 activation in nutlin-3 treated cells was also inhibited by FKBP12. The FKBP12-mediated downregulation of MDM2 in response to doxorubicin or nutlin-3 results in continuing and constitutive activation of p53, inhibition of XIAP and sensitization of cancer cells to apoptosis. These results identify a novel function for FKBP12 in downregulating MDM2, which directly enhances sensitivity of cancer cells to chemotherapy and nutlin-3 treatment.

Randomised clinical trial: prucalopride, a colonic pro-motility agent, reduces the duration of post-operative ileus after elective gastrointestinal surgery

BACKGROUND

Previous studies have shown that recovery of colonic transit is a major determinant of post-operative ileus and clinical recovery after gastrointestinal surgery. Prucalopride is a highly selective 5-hydroxytryptamine receptor-4 agonist with colonic pro-motility effects.

AIM

To evaluate the effect and safety of prucalopride on post-operative ileus and surgical outcomes after elective gastrointestinal surgery.

METHODS

In this phase II randomised clinical trial, 110 patients undergoing elective gastrointestinal surgery were randomised to either oral prucalopride (2 mg/day) (n = 55) or placebo (n = 55). Intervention was started 24 h after surgery and stopped after defecation or maximally at 7 days. The primary outcome was time to defecation. Secondary outcomes included time to first passage of flatus, tolerance of solid food, nasogastric tube reinsertion, post-operative length of stay, hospital readmission, overall cost, time to walk independently, surgical complications and inflammatory parameters.

RESULTS

Patients who received prucalopride had a shorter time to defecation (65.0 vs. 94.5 h, P = 0.001), passage of flatus (53.0 vs. 73.0 h, P < 0.001), and post-operative length of stay (7.0 vs. 8.0 days, P = 0.001) than controls. The number of patients with prolonged ileus (>5 days) (16.4% vs. 34.5%, P = 0.026) and the C-reactive protein level on post-operative day 5 (35.67 vs. 59.07 mg/L, P = 0.040) were lower in the prucalopride group. There was no significant difference in post-operative Clavien-Dindo grade III and IV complications (P = 0.606) between the groups.

CONCLUSION

Prucalopride is a safe and effective treatment to reduce post-operative ileus and systemic inflammation without affecting post-operative complications in patients undergoing elective gastrointestinal surgery. ClinicalTrials.gov: NCT02004652.

USP4 inhibits p53 and NF-κB through deubiquitinating and stabilizing HDAC2

Histone deacetylases (HDACs) are major epigenetic modulators involved in a broad spectrum of human diseases including cancers. As HDACs are promising targets of cancer therapy, it is important to understand the mechanisms of HDAC regulation. In this study, we show that ubiquitin-specific peptidase 4 (USP4) interacts directly with and deubiquitinates HDAC2, leading to the stabilization of HDAC2. Accumulation of HDAC2 in USP4-overexpression cells leads to compromised p53 acetylation as well as crippled p53 transcriptional activation, accumulation and apoptotic response upon DNA damage. Moreover, USP4 targets HDAC2 to downregulate tumor necrosis factor TNFα-induced nuclear factor (NF)-κB activation. Taken together, our study provides a novel insight into the ubiquitination and stability of HDAC2 and uncovers a previously unknown function of USP4 in cancers.

Treatment of patients with diabetic peripheral neuropathic pain in China: a double-blind randomised trial of duloxetine vs. placebo

BACKGROUND

Duloxetine has been approved in the United States, European Union and some Asian countries for the treatment of diabetic peripheral neuropathic pain (DPNP). We assessed the efficacy and safety of duloxetine (60 mg once daily) compared with placebo in Chinese patients suffering from DPNP.

METHODS

This was a phase 3, multicenter, randomised, double-blind, parallel, placebo-controlled, 12-week trial of the treatment of DPNP with duloxetine. Subjects were male and female outpatients ≥ 18 years of age with DPNP, as assessed by the Michigan Neuropathy Screening Instrument, and had a rating of ≥ 4 on the Brief Pain Inventory-Modified Short Form-Severity weekly average pain item. The primary efficacy measure was the reduction in pain severity from baseline to 12 weeks, as measured by the weekly mean of 24-h average pain ratings recorded in the patient's diary. Mean changes from baseline in efficacy measures were analysed by a restricted maximum likelihood-based, mixed-effects model repeated measures approach and by analysis of covariance.

RESULTS

Of the 405 patients randomised, 203 patients were assigned to duloxetine 60 mg once daily and 202 patients were assigned to placebo. Duloxetine-treated patients showed significantly greater pain relief on 24-h average pain ratings compared with placebo-treated patients each week of the 12-week study period [week 12: least squares (LS) mean change duloxetine: -2.40, placebo: -1.97; LS mean change difference (95% confidence interval) = -0.43 (-0.82, -0.04), p = 0.030]. Compared with placebo, patients treated with duloxetine experienced higher rates of nausea (p = 0.010), somnolence (p < 0.001) and asthenia (p = 0.002).

CONCLUSIONS

Duloxetine-treated patients showed significantly greater pain relief compared with placebo-treated patients over the 12-week study period. Duloxetine was shown in Chinese patients to have a safety profile similar to that found in previous duloxetine trials.

Magnetism-Driven Ferroelectricity in Double Perovskite Y₂NiMnO₆

We report the discovery of multiferroic behavior in double perovskite Y2NiMnO6. X-ray diffraction shows that the material has a centrosymmetric crystal structure of space group P2(1)/n with Ni(2+)/Mn(4+) ordering. This result is further confirmed by aberration-corrected scanning transmission electron microscopy combined with atomic resolution electron energy loss spectroscopy. The appearance of ferroelectric polarization coincides with the magnetic phase transition (∼67 K), which indicates that the ferroelectricity is driven by magnetism, and this is further confirmed by its strong magnetoelectric (ME) effect. We proposed the origin of the ferroelectricity is associated with the combination of Ni(2+)/Mn(4+) charge ordering and the ↑↑↓↓ spin ordering. When compared with other known magnetic multiferroics, Y2NiMnO6 displays several attractive multiferroic properties, including high polarization (∼145 μC/m(2)), a high multiferroic transition temperature (∼67 K), and strong ME coupling (∼21%).

Combined transplantation of autologous hematopoietic stem cells and allogenic mesenchymal stem cells increases T regulatory cells in systemic lupus erythematosus with refractory lupus nephritis and leukopenia

Autologous hematopoietic stem cell (HSC) and mesenchymal stem cell (MSC) transplantation is currently being evaluated as a novel treatment for autoimmune diseases, such as systemic lupus erythematosus (SLE). Here we report a case of autologous HSC transplantation combined with MSCs in a 25-year-old severe SLE patient with multiple life-threatening complications and refractory to conventional cyclophosphamide (CYC) therapy. After being pretreated with CYC, fludarabine and antithymocyte globulin, the patient was transplanted with autologous CD34+HSCs and MSCs by intravenous infusion. Hematopoietic regeneration was observed on day 12 thereafter. After HSC and MSC transplantation, the patient's clinical symptoms caused by SLE were remitted, and the SLEDAI score decreased. Moreover, CD4+CD25+FoxP3+Treg cells increased in peripheral blood mononuclear cells (PBMCs) after transplantation. This result suggests that the combined transplantation of HSCs and MSCs may reset the adaptive immune system to re-establish self-tolerance in SLE. A 36-month follow-up showed that the clinical symptoms remained in remission. Although a longer follow-up is required for assessing the long-term efficacy, our present results suggest that the combined transplantation of HSCs and MSCs may be a novel and effective therapy for refractory SLE.

Visceral fat area is associated with a high risk for early postoperative recurrence in Crohn's disease

AIM

Mesenteric hypertrophy has been recognized as an indicator of the complicated course of Crohn's disease. The aim of this study was to investigate whether the visceral fat area (VFA) is associated with postoperative clinical and endoscopic recurrence.

METHOD

Computed tomography was used to measure the subcutaneous fat area and VFA, and the mesenteric fat index (MFI) was defined as the ratio of the VFA to the subcutaneous fat area. Associations between body mass index, subcutaneous fat area, VFA and MFI and postoperative clinical and endoscopic recurrence were investigated.

RESULTS

The factors associated with postoperative endoscopic recurrence at 6 months after surgery were a high VFA value (P = 0.019) and MFI values above the median (P = 0.008). VFA values were significantly correlated with endoscopic recurrence (r = 0.895, P = 0.040) and endoscopic lesions (r = 0.617, P < 0.0001). Additionally, MFI values correlated well with endoscopic recurrence (r = 0.918, P = 0.02) and endoscopic scores (r = 0.584, P < 0.0001). Multivariate analysis indicated that VFA values above the median (hazard ratio 2.63, 95% CI 1.03-6.74) were predictive of postoperative clinical recurrence in Crohn's disease.

CONCLUSION

A high VFA value is associated with postoperative recurrence of Crohn's disease and has clinical implications with respect to optimizing prophylaxis for each individual. However, further studies are needed to confirm the predictive role of this biomarker in a different data set.

An ecosystem-scale perspective of the net land methanol flux: synthesis of micrometeorological flux measurements

Methanol is the second most abundant volatile organic compound in the troposphere and plays a significant role in atmospheric chemistry. While there is consensus about the dominant role of living plants as the major source and the reaction with OH as the major sink of methanol, global methanol budgets diverge considerably in terms of source/sink estimates reflecting uncertainties in the approaches used to model, and the empirical data used to separately constrain these terms. Here we compiled micrometeorological methanol flux data from eight different study sites and reviewed the corresponding literature in order to provide a first cross-site synthesis of the terrestrial ecosystem-scale methanol exchange and present an independent data-driven view of the land-atmosphere methanol exchange. Our study shows that the controls of plant growth on the production, and thus the methanol emission magnitude, and stomatal conductance on the hourly methanol emission variability, established at the leaf level, hold across sites at the ecosystem-level. Unequivocal evidence for bi-directional methanol exchange at the ecosystem scale is presented. Deposition, which at some sites even exceeds methanol emissions, represents an emerging feature of ecosystem-scale measurements and is likely related to environmental factors favouring the formation of surface wetness. Methanol may adsorb to or dissolve in this surface water and eventually be chemically or biologically removed from it. Management activities in agriculture and forestry are shown to increase local methanol emission by orders of magnitude; they are however neglected at present in global budgets. While contemporary net land methanol budgets are overall consistent with the grand mean of the micrometeorological methanol flux measurements, we caution that the present approach of simulating methanol emission and deposition separately is prone to opposing systematic errors and does not allow taking full advantage of the rich information content of micrometeorological flux measurements.

An ecosystem-scale perspective of the net land methanol flux: synthesis of micrometeorological flux measurements

Methanol is the second most abundant volatile organic compound in the troposphere and plays a significant role in atmospheric chemistry. While there is consensus about the dominant role of living plants as the major source and the reaction with OH as the major sink of methanol, global methanol budgets diverge considerably in terms of source/sink estimates reflecting uncertainties in the approaches used to model, and the empirical data used to separately constrain these terms. Here we compiled micrometeorological methanol flux data from eight different study sites and reviewed the corresponding literature in order to provide a first cross-site synthesis of the terrestrial ecosystem-scale methanol exchange and present an independent data-driven view of the land-atmosphere methanol exchange. Our study shows that the controls of plant growth on the production, and thus the methanol emission magnitude, and stomatal conductance on the hourly methanol emission variability, established at the leaf level, hold across sites at the ecosystem-level. Unequivocal evidence for bi-directional methanol exchange at the ecosystem scale is presented. Deposition, which at some sites even exceeds methanol emissions, represents an emerging feature of ecosystem-scale measurements and is likely related to environmental factors favouring the formation of surface wetness. Methanol may adsorb to or dissolve in this surface water and eventually be chemically or biologically removed from it. Management activities in agriculture and forestry are shown to increase local methanol emission by orders of magnitude; they are however neglected at present in global budgets. While contemporary net land methanol budgets are overall consistent with the grand mean of the micrometeorological methanol flux measurements, we caution that the present approach of simulating methanol emission and deposition separately is prone to opposing systematic errors and does not allow taking full advantage of the rich information content of micrometeorological flux measurements.

AAV-mediated and pharmacological induction of Hsp70 expression stimulates survival of retinal ganglion cells following axonal injury

We evaluated the effect of AAV2- and 17-AAG (17-N -allylamino-17-demethoxygeldanamycin)-mediated upregulation of Hsp70 expression on the survival of retinal ganglion cells (RGCs) injured by optic nerve crush (ONC). AAV2-Hsp70 expression in the retina was primarily observed in the ganglion cell layer. Approximately 75% of all transfected cells were RGCs. RGC survival in AAV2-Hsp70 injected animals was increased by an average of 110% 2 weeks after the axonal injury compared to the control. The increase in cell numbers was not even across the retinas with a maximum effect of approximately 306% observed in the inferior quadrant. 17-AAG-mediated expression of Hsp70 has been associated with cell protection in various models of neurodegenerative diseases. We show here that a single intravitreal injection of 17-AAG (0.2 ug/ul) results in an increased survival of ONC injured RGCs by approximately 49% compared to the vehicle-treated animals. Expression of Hsp70 in retinas of 17-AAG-treated animals was upregulated approximately by 2-fold compared to control animals. Our data support the idea that the upregulation of Hsp70 has a beneficial effect on the survival of injured RGCs, and the induction of this protein could be viewed as a potential neuroprotective strategy for optic neuropathies.

Stapled vs hand suture closure of loop ileostomy: a meta-analysis

AIM

Loop ileostomies are widely used in colorectal surgery to reduce the consequences of distal anastomotic failure. The optimal surgical technique for their closure has yet not been defined. A meta-analysis was performed to compare the outcome after stapled or hand sutured ileostomy closure.

METHOD

An electronic literature search of EMBASE, PubMed and the Cochrane Library was undertaken to identify studies reporting stapled and hand sutured ileostomy closure. End-points included postoperative small bowel obstruction (SBO), anastomotic leakage, wound infection, overall postoperative complications, operation time, hospital stay and surgery-related cost.

RESULTS

Fourteen studies including 5084 patients were identified. Meta-analysis showed that stapled closure was associated with a lower rate of SBO overall (OR = 0.56, P < 0.00001) and early (within 30 days of closure) SBO (OR = 0.51, P < 0.00001). This difference persisted for direct ileostomy closure (OR = 0.62, P = 0.02) or closure with bowel resection and hand sewn anastomosis (OR = 0.44, P < 0.00001). Stapled closure required a shorter inpatient stay (mean difference -1.22, P < 0.0001) and operating time (mean difference -11.21, P = 0.01). No significant difference was noted between the two techniques in terms of anastomotic leakage, wound infection, overall complications or cost.

CONCLUSION

Stapled side-to-side anastomosis is associated with fewer complications, especially SBO, than hand sewn ileostomy closure by direct suture or resection and anastomosis. It is quicker to perform and associated with fewer postoperative bowel obstructions.

Oral treatment with SEW2871, a sphingosine-1-phosphate type 1 receptor agonist, ameliorates experimental colitis in interleukin-10 gene deficient mice

SEW2871, a selective sphingosine-1-phosphate type 1 receptor (S1P1) agonist, has been shown to be effective in protecting kidneys against ischaemia-reperfusion injury by reducing CD4(+) T cell infiltration in mice. However, the effects of SEW2871 on colitis remain unclear. The aim of this study was to investigate the effects of SEW2871 on established colitis in interleukin (IL)-10 gene-deficient (IL-10(-/-)) mice, a murine model of Crohn's disease (CD). SEW2871 was administered by gavage at a dose of 20 mg/kg/day for 2 weeks to IL-10(-/-) mice. Severity of colitis, serum amyloid A, tissue myeloperoxidase (MPO), T cells in blood and colon lamina propria (LP) and proinflammatory cytokine productions were evaluated. Furthermore, the phospho-signal transducer and activator of transcription (STAT)-3 (p-STAT-3) expression in lymphocytes isolated from colon LP was also assessed. The 2-week administration of SEW2871 ameliorated established colitis in IL-10(-/-) mice, associated with a reduction of serum amyloid A concentration, a decreased colon MPO concentration, a depletion of the peripheral CD4(+) CD45(+) T cells and a reduction of the homing of T cells into colon LP. Moreover, typical cytokines of T helper type 1 (Th1) and Th17 cells and p-STAT-3 expression were also suppressed by SEW2871 treatment. SEW2871 treatment ameliorates established experimental colitis in IL-10(-/-) mice, which may provide a new therapeutic approach for human CD therapy.

Intestinal dysbacteriosis contributes to decreased intestinal mucosal barrier function and increased bacterial translocation

The purpose of this study was to determine the effect of colistin-induced intestinal dysbacteriosis on intestinal mucosal barrier function and bacterial translocation in a mouse model. Colistin or saline was administered orally for 7 days, and populations of viable organisms from the caecal mucosa and its content, the ileal segments, the mesenteric lymph nodes (MLNs) and the internal organs were prepared for examination. In the intestinal dysbacteriosis model, intestinal barrier dysfunction was observed and associated with increased bacterial translocation to extraintestinal sites. The extent of bacterial translocation to the MLNs and internal organs in the colistin group was significantly higher than in the saline group. Colistin-induced intestinal dysbacteriosis was shown to injure the intestinal mucosa barrier function and increase bacterial dislocation.

SIGNIFICANCE AND IMPACT OF THE STUDY

Colistin has been reported to be effective in selective digestive decontamination (SDD), which is an infection prevention measure used in the treatment of certain patients in intensive care. We are the first to report that colistin-induced intestinal dysbacteriosis can injure intestinal mucosal barrier function and increase bacterial translocation, whereas a high dose of colistin does not damage the intestinal mucosal barrier in germ-free (GF) mice raised in a GF environment. These results may indicate that prolonged use of a high dose of a SDD medication should be carefully considered.

H19 DMR methylation correlates to the progression of esophageal squamous cell carcinoma through IGF2 imprinting pathway

BACKGROUND

H19 gene has been proved to be essential for human tumor growth which contains CpG rich regions. Imprinted gene expression in many cancers is usually associated with the function of methylation. We performed this study to better understand wether H19 DMR methylation correlates to the progression of esophageal squamous cell carcinoma through IGF2 imprinting pathway.

METHODS

LOI of IGF2 was detected in 276 samples, which were determined as heterozygote with ApaI polymorphism in exon 9 of IGF2 by PCR-RFLP and RT-PCR-RFLP. Methylation status of H19 DMR in informative samples was analyzed by bisulfite sequencing PCR. IGF2 expression was examined by real-time PCR and IHC.

RESULTS

208 ESCC patients were informative for ApaI polymorphism. 92 tumor and 30 normal tissues showed IGF2 LOI. Methylation status of H19 CBS6 was higher in patients with IGF2 LOI compared to patients with IGF2 MOI (p < 0.05). IGF2 expression in patients with IGF2 LOI was higher than patients with IGF2 MOI (p < 0.05) which was correlated with lymph node involvement, neoplastic grade and metastasis (p < 0.05).

CONCLUSIONS

Our results suggested that H19 CBS6 hypermethylation is related to the LOI of IGF2 which usually leads to an overexpression of IGF2, playing important roles in the occurrence, development as well as metastasis of ESCC. Therefore, H19 CBS6 methylation potentially represents a novel clinically relevant epigenetic marker to identify individuals at increased risk for the occurrence, progression and prognosis of ESCC.

Anisomycin induces apoptosis of glucocorticoid resistant acute lymphoblastic leukemia CEM-C1 cells via activation of mitogen-activated protein kinases p38 and JNK

Glucocorticoids (GCs) resistance is frequently encountered in children with acute lymphoblastic leukemia (ALL), especially in T-ALL, which usually results in failure of treatment. To find new agent to overcome GC resistance of ALL is an urgent problem. Here we investigated potential effect of anisomycin on GC-resistant T-ALL CEM-C1 cells and explored involved molecular mechanisms. Dramatic growth inhibition and apoptosis in GC resistant CEM-C1 cells and GC-sensitive CEM-C7 cells induced by anisomycin were observed, which presented in a concentration- and time-dependent manner. Correspondingly, anisomycin induced cleaved caspase-3 and up-regulation of pro-apoptotic proteins (BimEL and Bad), meanwhile down-regulation of anti-apoptotic proteins (Mcl-1 and Bcl-2), both in a dose- and time-dependent manner in GC resistant CEM-C1 cells. Anisomycin also induced cell cycle arrest at G0/G1 phase in CEM-C1 cells through increasing expressions of p21 and p27, and attenuating the expression of cyclinA. The rapid up-regulation of phosphorylated mitogen-activated protein kinases (MAPKs) p38 and Jun N-terminal kinase (JNK) were observed after CEM-C1 cells were incubated with anisomycin. The activation of p38 and JNK could be blocked by respective inhibitors (SB203580 for p38 and SP600125 for JNK) accompanied with the inhibition of apoptosis and changes of apoptosis associated proteins in CEM-C1 cells. These results suggested that anisomycin induced apoptosis of CEM-C1 cells via activation of p38 and JNK, and might be an attractive new agent for treatment of GC-resistant ALL.

Fiber-optic two-photon optogenetic stimulation

Optogenetic stimulation of genetically targeted cells is proving to be a powerful tool in the study of cellular systems, both in vitro and in vivo. However, most opsins are activated in the visible spectrum, where significant absorption and scattering of stimulating light occurs, leading to low penetration depth and less precise stimulation. Since we first (to the best of our knowledge) demonstrated two-photon optogenetic stimulation (TPOS), it has gained considerable interest in the probing of cellular circuitry by precise spatial modulation. However, all existing methods use microscope objectives and complex scanning beam geometries. Here, we report a nonscanning method based on multimode fiber to accomplish fiber-optic TPOS of cells.

Resveratrol attenuates hydrogen peroxide-induced apoptosis in human umbilical vein endothelial cells

BACKGROUND AND OBJECTIVES

  Vascular endothelium injury caused by reactive oxygen species (ROS) plays an initial role in the pathogenesis of atherosclerosis. Resveratrol, a natural polyphenolic compound, is well known to possess a variety of cardioprotective activities. In this study we first investigated the effects of resveratrol against apoptosis of human umbilical vein endothelial cells (HUVECs) induced by hydrogen peroxide (H2O2) in vitro and the possible mechanisms.

MATERIALS AND METHODS

HUVECs were pre-incubated with resveratrol (0.5-10 microM) for 120 min, and then challenged with 100 microM H2O2 for 30 min. The cell viability was evaluated by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) assay. The superoxide dismutase (SOD) activities and the reduced glutathione (GSH) contents were measured spectrophotometrically by using commercially available kits. The apoptosis of HUVECs was detected by Hoechst 33258 and Annexin-V/PI staining by flow cytometry staining using Fluorescence microscope. We also measured the mitochondrial membrane potential with the fluorescent probe JC-1 through Fluorescence microscope.

RESULTS

The study showed that incubation with resveratrol caused significant increase of the viability of HUVECs and the SOD activities and GSH contents, and decrease of cell apoptosis induced by H2O2, which was accompanied with the restoration of the mitochondrial membrane potential.

CONCLUSIONS

Our data suggested that resveratrol protected HUVECs against apoptosis induced by H2O2 through enhancing the antioxidant defenses, and inhibiting the degression of the mitochondrial membrane potential.  

Epigenetic screen identifies genotype-specific promoter DNA methylation and oncogenic potential of CHRNB4

Genome-wide association studies have highlighted three major lung cancer susceptibility regions at 15q25.1, 5p15.33 and 6p21.33. To gain insight into the possible mechanistic relevance of the genes in these regions, we investigated the regulation of candidate susceptibility gene expression by epigenetic alterations in healthy and lung tumor tissues. For genes up- or downregulated in lung tumors the influence of genetic variants on DNA methylation was investigated and in vitro studies were performed.

We analyzed 394 CpG units within 19 CpG islands in the susceptibility regions in a screening set of 34 patients. Significant findings were validated in an independent patient set (n=50) with available DNA and RNA. The most consistent overall DNA methylation difference between tumor and adjacent normal tissue on 15q25 was tumor hypomethylation in the promoter region of CHRNB4 with a median difference of 8% (p<0.001) which resulted in overexpression of the transcript in tumors (p<0.001). Confirming previous studies we also found hypermethylation in CHRNA3 and TERT with significant expression changes. Decitabine treatment of H1299 cells resulted in reduced methylation levels in gene promoters, elevated transcript levels of CHRNB4 and CHRNA3 and a slight downregulation of TERT demonstrating epigenetic regulation of lung cancer cells. SNPs rs421629 on 5p15.33 and rs1948, rs660652, rs8040868 and rs2036527 on 15q25.1, previously identified as lung cancer risk or nicotine addiction modifiers were associated with tumor DNA methylation levels in the promoters of TERT and CHRNB4 (p<0.001) respectively in two independent sample sets (n=82; n=150). In addition, CHRNB4 knock down in two different cell lines (A549 and H1299) resulted in reduced proliferation (p_A549<0.05;p_H1299L<0.001) and propensity to form colonies in H1299 cells.

These results suggest epigenetic deregulation of nicotinic acetylcholinereceptor subunit (nAChR) genes which in the case of CHRNB4 is strongly associated with genetic lung cancer susceptibility variants and a functional impact on tumorigenic potential.