[Effect of sedation weaning pattern on withdrawal syndrome in pediatric intensive care unit]

Objective: To investigate the sedation weaning strategies in critically ill patients with mechanical ventilation in pediatric intensive care unit (PICU) and to explore the effect of different sedative weaning patterns on withdrawal syndrome. Methods: A single-center prospective cohort study was conducted from April 1, 2016 to April 30, 2017. One hundred and twelve patients who required mechanical ventilation and benzodiazepines and (or) opioids for at least 5 consecutive days in PICU of Shanghai Children's Medical Center were enrolled. Twenty patients (17.9%) had an intermittent weaning pattern, defined as a 50% or greater increase in daily benzodiazepine and (or) opioid dose after the start of weaning, and the remaining 92 cases (82.1%) had a steady weaning pattern. The demographic and clinical features, duration and dose of sedative and analgesics, and the incidence of withdrawal syndrome were evaluated. Mann-Whitney U test was used for comparison about clinical features between different weaning pattern groups and children with withdrawal syndrome or not. Logistic regression was used to explore the risk factors of withdrawal syndrome. Results: Among the 112 patients, 46 (41.1%) had withdrawal syndrome. The patients with the intermittent weaning pattern had a high score of pediatric risk of mortality Ⅲ (PRISM-Ⅲ) (10.0 (3.5, 12.0) vs. 6.0 (2.0, 10.0), U=654.50, P=0.043) and were prone to re-intubation (35.0% (7/20) vs. 7.6% (7/92), P=0.003). The patients with withdrawal syndrome had longer duration of sedation (19.5 (16.8, 24.3) vs. 10.0 (7.0, 17.3) days, U=743.50, P<0.01), higher incidence of intermittent weaning pattern (32.6% (15/46) vs. 7.6% (5/66),χ(2)=11.58, P=0.001), longer PICU hospitalization (19.0 (15.8, 25.3) vs. 12.0 (8.8, 17.0) days, U=755.00, P<0.01) and higher cost (89 (57,109) vs. 53 (32, 79) thousand yuan, U=804.00, P<0.01). Logistic regression showed that intermittent weaning pattern (odds ratio (OR)=4.85, 95% confidence interval (CI) 1.39-16.91, P=0.013), perioperative period of liver transplantation (OR=6.97, 95%CI 1.25-39.04, P=0.027) and a cumulative dose of midazolam ≥ 34.7 mg/kg (OR=8.12, 95%CI 3.09-21.37, P<0.01) were risk factors of withdrawal syndrome. Conclusions: Withdrawal syndrome is more likely to occur in children who are intermittently weaned from sedation. Steady weaning strategy may help prevent iatrogenic withdrawal syndrome.

Maternal exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin suppresses male reproductive functions in their adulthood

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a ubiquitous environmental contaminant in the environment. The developmental period is more sensitive to TCDD and there is a possibility that maternal exposure to TCDD may affect in adulthood. Adult female Wistar rats were exposed to 0.5, 1.0, and 2.0 µg/kg TCDD during the critical stage of organogenesis, that is, on GD15. The results revealed a significant decrease in indices of reproductive organ weight in adult male rats exposed to prenatal TCDD, and dose-dependent reduction in epididymal sperm reserves, percent motile, and viable sperm with an increase in percent morphological abnormal sperm. Polymerase chain reaction analysis revealed downregulated expression levels of steroidogenic markers such as steroidogenic acute regulatory, cholesterol side-chain cleavage, and 3β- and 17β-hydroxysteroid dehydrogenase (HSDs) in experimental rats. Immunofluorescence sections portrayed reduced distribution of 3β- and 17β-HSD proteins in testes of experimental rats. Furthermore, spermatogenic markers (acid phosphatase, alkaline phosphatase, lactate dehydrogenase, and sorbitol dehydrogenase) were significantly altered in the testes. Serum levels of testosterone, follicle stimulating hormones, and luteinizing hormone were significantly decreased. Testicular levels of hydrogen peroxide and lipid peroxidation were significantly elevated with a decline in superoxide dismutase, catalase, glutathione peroxidase activities, and total thiol levels. Moreover, histological and morphometric examination of testicular cross-sections depicted degenerative changes. Male fertility assessment in adult rats revealed a significant decrease in mating index, fertility index, and mean number of pre- and postimplantations with an increase in pre- and postimplantation losses in rats cohabited with in utero TCDD-exposed adult males. In conclusion, the findings of this study provided clear evidence that maternal exposure to TCDD during the critical stage of development results in suppressed reproductive health in adulthood.

Influenza a virus and Streptococcus pneumonia coinfection potentially promotes bacterial colonization and enhances B lymphocyte depression and reduction

Influenza has frequently been epidemic in recent years. However, the mechanisms of severe pneumonia with postinfluenza Streptococcus pneumoniae (SP) secondary infection have not been fully understood. In this study, we explored the mechanisms of pneumonia in postinfluenza A virus (IAV) infection via a mouse model. Mice were intranasally inoculated with SP three days after IAV inoculation. We then collected samples at three time points to dynamically observe the pathological progression. In IAV infection alone, lymphocyte infiltration and widened alveolar intervals were observed. In the blood, levels of the CD19+, CD19+CD21+ and CD19+CD79β+B lymphocyte subpopulations were reduced, and IFN-γ and IL-10 were elevated. Slight atrophy was seen in the spleen, which was due to splenic B lymphocyteinitiated apoptosis through the mitochondrial pathway. When SP infection occurred after IAV infection, the pulmonary inflammation was significantly aggravated; a fair number of lymphocytes and neutrophils infiltrated simultaneously with exfoliated bronchial epithelial cells, vascular endothelial cells, widened alveolar septum and hemorrhaging. Increasing edema fluid and bacteria accumulated in the alveolar cavity. Decreased CD19+, CD19+CD21+ and CD19+CD79β+B lymphocyte subpopulations and increased interferon gamma (IFN-γ) or interleukin 10 (IL-10) were more prominent compared to those with viral infection alone. Spleen atrophy resulting from coinfection was more obvious because of massive splenic B lymphocyte apoptosis through the mitochondrial pathway compared to viral infection alone. This study shows that although inflammation caused by SP infection alone was temporary, preceding IAV infection provided favorable conditions for SP colonization and multiplication by destroying lung structure and suppressing humoral immunity. Synergistic IAV-SP coinfection is likely to facilitate more SP colonization and promote B lymphocyte-suppression and reduction. Eventually, the pneumonia worsened.

A Y1 receptor ligand synergized with a P-glycoprotein inhibitor improves the therapeutic efficacy of multidrug resistant breast cancer

Multidrug resistance (MDR) is one of the main reasons for the inefficiency of cancer chemotherapy. As a consequence of MDR, the expression level of membrane proteins might be changed, which can thus be used to develop a novel strategy for its treatment. Based on the high overexpression of Y1 receptor (Y1R) protein and P-glycoprotein (P-gp) in the multidrug resistant breast cancer cell line, a selective Y1R ligand [Asn6, Pro34]-NPY (AP) was employed to stabilize the chemotherapeutic drug doxorubicin (DOX) and P-gp inhibitor tariquidar (Tar) co-loaded nanomicelles at the physiological level. This also improved the targeted delivery of DOX and Tar into MCF-7/ADR cells. Co-delivered Tar further impedes the efflux of DOX and enhances its accumulation in the nuclei of drug resistant cancer cells, thereby inducing significant inhibition of cell growth. The synergistic effect of AP and Tar generates an excellent in vivo tumor targeting and antitumor efficacy of DOX with prolonged survival and minimized side effects, especially for liver metastasis. In general, Y1R as a novel target site and its selective ligand AP synergized with the P-gp inhibitor can be used for a more precise MDR breast cancer treatment.

[Correlation between endogenous EPO levels and electrocardiogram scatter plot changes in patients with coronary heart disease and autonomic nerve function injury]

Objective: To analyze the correlation between endogenous EPO levels and electrocardiogram scatter plot changes in patients with coronary heart disease and autonomic nerve function injury. Methods: Forty-eight patients who underwent coronary arteriography (CAG) inspection due to chronic coronary heart diseases were selected from July 2015 to October 2015. All of them were evaluated by the Ewing standard autonomic nervous function test, and were divided into Ewing(+) group and Ewing(-) group according to the results of the test. The clinical data of the patients was collected and venous blood was extracted to detect EPO level. Results: The EPO level of Ewing (+) group ((13±3) mIU/ml) was significantly higher than that of Ewing (-) group ((10±3) mIU/ml). The Lorenz scatter plot comet shapes between the two groups had a significant difference. As for the quantitative indicators of Lorenz scatterplot, length of the Ewing (+) group ((147±22) ms) was shorter than that of the Ewing (-) group ((164±24) ms) and there was no significant differences in the width between the two groups. EPO level was negatively correlated with length in both groups (r=-0.427, P=0.002), but not with width (r=0.091, P=0.539). Binary logistic regression analysis showed that EPO (OR=1.394) and diastolic blood pressure (OR=1.091) were risk factors for autonomic nervous function damage. Length (OR=0.934) was a protective factor for autonomic nervous function. ROC curve analysis showed that the area under the EPO curve was 0.737 and that under the length curve was 0.719. Conclusions: The endogenous EPO levels are associated with the changes of electrocardiogram scatter plot in patients with coronary heart disease and autonomic nerve function injury. EPO and length of scatter plot have the similar diagnostic value on predicting of autonomic nerve function injury.

Apical U-shape splitting technique for undercut areas of the anterior alveolar ridge: a prospective non-randomized controlled study

The aim of this study was to investigate a novel apical U-shape splitting technique for horizontal bone augmentation in undercut areas and to compare its efficacy with that of guided bone regeneration (GBR). This was a prospective non-randomized controlled clinical trial. A total of 36 patients, who presented with a labial undercut that was not able to house a normally inclined implant, underwent the new technique or GBR. Radiographic and clinical data were obtained preoperatively, immediately after surgery, and 12 months after surgery. Pairwise comparisons of changes in ridge width gain, marginal bone loss, and pink aesthetic score were performed; correlations with pristine ridge morphology were investigated. The results showed similar marginal bone loss in the two groups. The overall ridge width gains in the new technique group (2.56±1.92mm) and GBR group (0.73±1.21mm) differed significantly (P<0.05). The pink aesthetic score was higher for the new technique group (11.75±1.22) than for the GBR group (9.25±1.86) (P<0.01). The morphology of the concavity had different impacts on regeneration in the two groups. The apical U-shape splitting technique, as a safe and effective alternative to GBR, provided a significant increase in bone volume gain where labial fenestration was inevitable during implant placement.

Epithelial Cdc42 Deletion Induced Enamel Organ Defects and Cystogenesis

Cdc42, a Rho family small GTPase, regulates cytoskeleton organization, vesicle trafficking, and other cellular processes in development and homeostasis. However, Cdc42's roles in prenatal tooth development remain elusive. Here, we investigated Cdc42 functions in mouse enamel organ. Cdc42 showed highly dynamic temporospatial patterns in the developing enamel organ, with robust expression in the outer enamel epithelium, stellate reticulum (SR), and stratum intermedium layers. Strikingly, epithelium-specific Cdc42 deletion resulted in cystic lesions in the enamel organ. Cystic lesions were first noted at embryonic day 15.5 and progressively enlarged during gestation. At birth, cystic lesions occupied the bulk of the entire enamel organ, with intracystic erythrocyte accumulation. Ameloblast differentiation was retarded upon epithelial Cdc42 deletion. Apoptosis occurred in the Cdc42 mutant enamel organ prior to and synchronously with cystogenesis. Transmission electron microscopy examination showed disrupted actin assemblies, aberrant desmosomes, and significantly fewer cell junctions in the SR cells of Cdc42 mutants than littermate controls. Autophagosomes were present in the SR cells of Cdc42 mutants relative to the virtual absence of autophagosome in the SR cells of littermate controls. Epithelium-specific Cdc42 deletion attenuated Wnt/β-catenin and Shh signaling in dental epithelium and induced aberrant Sox2 expression in the secondary enamel knot. These findings suggest that excessive cell death and disrupted cell-cell connections may be among multiple factors responsible for the observed cystic lesions in Cdc42 mutant enamel organs. Taken together, Cdc42 exerts multidimensional and pivotal roles in enamel organ development and is particularly required for cell survival and tooth morphogenesis.

[Interventional treatment of symptomatic intracranial in-stent restenosis]

Objective: To assess the feasibility and safety of interventional treatment of symptomatic intracranial in-stent restenosis (SISR). Methods: Clinical data of 21 patients with SISR who underwent interventional treatment in the General Hospital of the PLA Rocket Force from January 2012 to May 2018 were retrospectively analyzed. Perioperative complications, angiographic and clinical follow-up results were recorded. Results: The success rate of treatment was 100%, including 21 lesions of SISR (7 at the V4 segment of the vertebral artery, 7 at the basilar artery, 5 at the M1 segment of middle cerebral artery, 2 at the internal carotid artery). The residual stenosis rate was preoperative 84±7, postoperative 30±14 respectively. Balloon angioplasty and stent implantation were performed in 10 patients (48.6%) and 11 patients (52.4%), respectively. After treatment, 1 patient experienced perforating event without neurological sequelae. Of the 11 patients (52.4%) completed angiography follow-up, 3 (3/11, 27.3%) ocurred restenosis and 1 was retreated. During clinical follow-up, 1 patients received intravenous thrombolysis for the symptom of acute cerebral infarction in territory of stenting artery, in-stent restenosis or occlusion was not demonstrated by emergency cerebral angiography. Conclusion: Interventional treatment of SISR is feasible and safe, however, further studies need to warrant the long-term effects.

A Flexible Caterpillar-Like Gold Nanoparticle Assemblies with Ultrasmall Nanogaps for Enhanced Dual-Modal Imaging and Photothermal Therapy

Gold nanoparticle (AuNP) assemblies (GNAs) have attracted attention since enhanced coupling plasmonic resonance (CPR) emerged in the nanogap between coupling AuNPs. For one dimensional GNAs (1D-GNAs), most CPR from the nanogaps could be easily activated by electromagnetic waves and generate drastically enhanced CPR because the nanogaps between coupling AuNPs are linearly distributed in the 1D-GNAs. The reported studies focus on the synthesis of 1D-GNAs and fundamental exploration of CPR. There are still problems which impede further applications in nanomedicine, such as big size (>500 nm), poor water solubility, and/or poor stability. In this study, a kind of 1D flexible caterpillar-like GNAs (CL-GNAs) with ultrasmall nanogaps, good water solubility, and good stability is developed. The CL-GNAs have a flexible structure that can randomly move to change their morphology, which is rarely reported. Numerous ultrasmall nanogaps (<1 nm) are linearly distributed along the structure of CL-GNAs and generate enhanced CPR. The toxicity assessments in vitro and vivo respectively demonstrate that CL-GNAs have a low cytotoxicity and good biocompatibility. The CL-GNAs can be used as an efficient photothermal agent for photothermal therapy, a probe for Raman imaging and photothermal imaging.

A Ultrasensitive Near-Infrared Fluorescent Probe Reveals Pyroglutamate Aminopeptidase 1 Can Be a New Inflammatory Cytokine

Previous study showed that pyroglutamate aminopeptidase 1 (PGP-1) has a relationship with the immune response in cells. However, whether PGP-1 is involved in inflammatory response in vivo and can serve as a new inflammatory cytokine are still unclear. To address these issues, a new near-infrared fluorescent probe, which exhibits high selectivity and super sensitivity, is developed. With this probe, the up-regulation of PGP-1 (evidenced by western blot) in BALB/c mice legs and livers under the stimulation of two main immunopotentiators is revealed for the first time. The occurrence of inflammatory process (including tissue necrosis) in mice is determined by up-regulation of tumor necrosis factor-α and hematoxylin-eosin staining. Interestingly, it is revealed for the first time that knocking down PGP-1 leads to the weakness of inflammatory process in RAW264.7 cells. These new findings suggest that PGP-1 is indeed involved in inflammatory response in vivo and can be a new inflammatory cytokine.

A novel fibroblast activation protein-targeted near-infrared fluorescent off-on probe for cancer cell detection, in vitro and in vivo imaging

A new hemicyanine-based fibroblast activation protein-targeted near-infrared fluorescent probe is designed and it shows high selectivity and sensitivity to cancer cell detection, and in vitro and in vivo imaging. This probe is successfully applied in fluorescence detection of living cells (with a detection limit of 1500 cells per mL). It is believed that many new functions or distributions of FAP could be discovered by this new probe later.

Sodiation-based in-source collision for profiling of pyranocoumarins in Radix Peucedani (Qianhu): utility of sodium adducts' stability with in-source collision

Full scan mode of liquid chromatography-mass spectrometry equipped with an electrospray ionization source offers a chance on global detection of complicated components; however, the scan mode carries significant challenges in rapidly capturing information of analysts. Sodiation-based in-source collision was proposed here, as a technique for rapid detecting untargeted analytes in full scan analysis, which was based on the stability of sodium adducts and the nonselectivity of in-source collision. Then the technique was applied to profile of angular-type pyranocoumarins (APs) in Radix Peucedani, with full scan analysis performed at two specific in-source collision energy: a high energy 50 V that is tolerated by the sodium adducts of APs, and a low energy 10 V, at which abundant adducts were offered. The spectra list of two average mass spectra was exported, and stable ions were selected based on the intensity ratio of standards at the two collision energy. Then 27 plausible [M + Na]⁺ m/z values of APs were acquired after filtering the fragment ion and isotope ions and validating with [M + NH₄ ]⁺ . Eighty-two APs finally were tentatively identified based on their accurate spectral data of MSⁿ , fragmentation rules, and elution order regardless of their absolute configuration, which included 25 reported APs from Peucedanum praeruptorum Dunn. The technique provided a novel application of sodium adduct in qualitative analysis. And it was valuable for rapidly capturing information of analytes in full scan analysis, not only for APs but also for other compounds that could form sodium adducts. Copyright © 2017 John Wiley & Sons, Ltd.

Neuropeptide Y Y1 receptor-mediated biodegradable photoluminescent nanobubbles as ultrasound contrast agents for targeted breast cancer imaging

Targeted molecular imaging has attracted great attention in cancer diagnosis and treatment. However, most clinically used ultrasound contrast agents (UCAs) are non-targeted microbubbles seldom used for cancer imaging. Here, we fabricated fluorescent nanobubbles (NBs) by encapsulation of liquid tetradecafluorohexane (C₆F₁₄) within biodegradable photoluminescent polymers (BPLPs) through an emulsion-evaporation process and conjugation of PNBL-NPY ligand for specific targeting of Y₁ receptors overexpressed in breast tumors. The developed PNBL-NPY modified NBs were uniform in size with good dispersibility and photostability, presenting good ultrasound enhancement. Further, in vitro and in vivo results indicated that the fabricated NBs exhibit high affinity and specificity to Y₁ receptor-overexpressing breast cancer cells and tumors with minimal toxicity and damage to organs. Our developed PNBL-NPY-modified NBs are novel targeted UCAs for safe, efficient and specific targeted breast cancer imaging, and may provide a new nanoplatform for early cancer diagnosis and treatment in the future.

Prospective cohort study of laparoscopic and open hepatectomy for hepatocellular carcinoma

BACKGROUND

The safety and feasibility of laparoscopic hepatectomy for hepatocellular carcinoma (HCC) with a diameter of 5 cm or less is well recognized. The role of laparoscopy in treating large HCC (5-10 cm) remains controversial. This prospective cohort study was undertaken to assess the short- and long-term outcomes of laparoscopic hepatectomy for large HCC and to compare this approach with open hepatectomy.

METHODS

Patients with a solitary HCC (diameter 5-10 cm) who underwent open or laparoscopic hepatectomy were enrolled in a prospective observational study from January 2012 to April 2015. Perioperative and follow-up data were analysed.

RESULTS

Some 128 patients underwent laparoscopic hepatectomy and 207 had an open hepatectomy. One and two perioperative deaths were reported in the laparoscopic and open groups respectively. Laparoscopic hepatectomy was converted to an open procedure in 12 (9·4 per cent) of 128 patients. More patients in the laparoscopic group underwent an anatomical hepatectomy than in the open group (45·3 versus 21·7 per cent; P = 0·001). The postoperative complication rate was 20·3 per cent for the laparoscopic group versus 35·7 per cent for the open group (P = 0·003). Mean(s.d.) duration of hospital stay was 11·4(3·1) and 15·8(7·7) days respectively (P < 0·001). One- and 3-year overall survival rates in the laparoscopic and open groups were 94·4 versus 93·6 per cent (P = 0·875), and 81·4 versus 82·2 per cent (P = 0·802), respectively. One- and 3-year disease-free survival rates were 89·4 versus 88·7 per cent (P = 0·825), and 67·3 versus 66·7 per cent (P = 0·902), respectively.

CONCLUSION

Laparoscopic hepatectomy is safe and feasible for the treatment of patients with large HCC.

Vasculogenic mimicry and hypoxia-inducible factor-1α expression in cervical squamous cell carcinoma

In this study, the existence of vasculogenic mimicry (VM) in cervical squamous cell carcinoma was investigated. To this end, the relationship between hypoxia-inducible factor 1α (HIF-1α) and the development, infiltration, and metastasis of cervical squamous cell carcinoma was studied. Between January 2010 and December 2010, 67 human cervical squamous carcinoma tissue samples were collected and stained by CD34/periodic acid-Schiff double staining to detect the existence of VM. HIF-1α expression was analyzed by immunohistochemistry. The relationship between VM and HIF-1α was also analyzed. Normal cervical tissues (20 cases) from patients who had uterine surgeries in the same period were collected as controls. In the cervical squamous carcinoma tissues, positive rates of VM and HIF-1α were 38.81% (26/67) and 64.18% (43/67), respectively. This was significantly higher than those in the normal cervical tissues [0 (0/20); P < 0.05]. VM rates in cervical squamous carcinoma tissues from patients with different pathological grades, Federation of Gynecology and Obstetrics (FIGO) stages, and lymph node metastasis states were also significantly different (P < 0.05). In addition, significant differences in HIF-1α positivity rates were observed among patients with varying tumor sizes and lymph node metastasis states (P < 0.05). Positive correlation was found between VM and HIF-1α (r = 0.339, P < 0.05). To summarize, we found VM in cervical squamous carcinoma; high expression of HIF-1α may promote VM formation, as well as cervical squamous cell infiltration and metastasis.

Timing of antiretroviral therapy initiation after diagnosis of recent human immunodeficiency virus infection and CD4(+) T-cell recovery

We retrospectively examined the timing of antiretroviral therapy (ART) initiation and CD4(+) T-cell recovery over 36 months among recent human immunodeficiency virus (HIV) infections using BED (HIV-1 subtypes B, E and D) immunoglobulin G capture enzyme immunoassay (BED-CEIA). Regardless of baseline CD4(+) counts, individuals (n = 393) who initiated ART >2 months after diagnosis had significantly decreased probability and rate of achieving CD4(+) counts ≥900 cells/μL or ≥600 cells/μL than those individuals (n = 135) who started ART earlier (≤2 months). But the mean CD4(+) counts in two groups converged after 30 months of treatment. Early ART initiation leads to accelerated CD4(+) recovery, but does not offer a long-term advantage in CD4(+) counts.

The effects of nerve growth factor on endothelial cells seeded on different titanium surfaces

Angiogenesis is critical for peri-implant bone regeneration and osseointegration. Endothelial cells (ECs) play an important role in angiogenesis during the early stage of bone formation. Nerve growth factor (NGF) is also reported to function as an angiogenic growth factor. The effects of NGF on ECs seeded on titanium surfaces are unclear. This study was done to investigate the influence of NGF on peri-implant angiogenesis in vitro and in vivo. We used two different titanium surfaces. ECs seeded on these surfaces were treated with indicated concentrations of NGF or vascular endothelial growth factor (VEGF). Proliferation, differentiation, morphological features, and amounts attached were assessed. Chicken embryo chorioallantoic membrane (CAM) was adopted to evaluate the effect of NGF in vivo. The results showed that NGF could promote EC proliferation on both titanium surfaces (F1d=2.083, P=0.156; F3d=30.857, P=0.0002; F5d=4.440, P=0.041; F7d=11.065, P=0.001). NGF and the SLA surface upregulated mRNA of NGF, TrkA, and p75 expression (FNGF=11.941, P=0.003; FTrkA=28.514, P=0.004; Fp75=7.725, P=0.01). In vivo, the supernatants of the NGF-treated group could promote neovascularization in CAM (F=17.662, P=0.009). This study demonstrated that NGF could enhance EC proliferation, gene expression on different titanium surfaces, and neovascularization in CAM. This provides novel information in relation to the promotion of early dental implant osseointegration.

Silica-coated super-paramagnetic iron oxide nanoparticles (SPIONPs): a new type contrast agent of T1 magnetic resonance imaging (MRI)

Magnetic resonance imaging (MRI), a sophisticated promising three-dimensional tomographic noninvasive diagnostic technique, has an intrinsic advantage in safety compared with radiotracer and optical imaging modalities; however, MRI contrast agents are less sensitive than complexes used in other imaging techniques. Usually the clinically used Gd-based complexes MRI-T₁ contrast agents are toxic; therefore, the demand for nontoxic novel T₁-weighted MRI candidates with ultrasensitive imaging and advanced functionality is very high. In this research, silica-coated ultra-small monodispersed super-paramagnetic iron oxide nanoparticles were synthesized via a thermal decomposition method, which demonstrated themselves as a high performance T₁-weighted MRI contrast agent for heart, liver, kidney and bladder based on in vivo imaging analyses. Transmission electron microscopy (TEM) results illustrated that the diameter of the SPIONPs was in the range of 4 nm and the average size of Fe₃O₄@SiO₂ was about 30-40 nm. X-ray diffraction (XRD) and Raman spectroscopy analyses revealed the phase purity of the prepared SPIONPs. These magnetite nanoparticles exhibited a weak magnetic moment at room temperature because of the spin-canting effect, which promoted a high positive signal enhancement ability. MTT assays and histological analysis demonstrated good biocompatibility of the SPIONPs in vitro and in vivo. In addition, the silica-coated ultra-small (4 nm sized) magnetite nanoparticles exhibited a good r₁ relaxivity of 1.2 mM^-1 s^-1 and a low r₂/r₁ ratio of 6.5 mM^-1 s^-1. In vivo T₁-weighted MR imaging of heart, liver, kidney and bladder in mice after intravenous injection of nanoparticles further verified the high sensitivity and biocompatibility of the as-synthesized magnetite nanoparticles. These results reveal silica-coated SPIONPs as a promising candidate for a T₁ contrast agent with extraordinary capability to enhance MR images.

Neuropeptide Y Y1 receptors mediate [corrected] targeted delivery of anticancer drug with encapsulated nanoparticles to breast cancer cells with high selectivity and its potential for breast cancer therapy

By enabling nanoparticle-based drug delivery system to actively target cancer cells with high selectivity, active targeted molecules have attracted great attention in the application of nanoparticles for anticancer drug delivery. However, the clinical application of most active targeted molecules in breast cancer therapy is limited, due to the low expression of their receptors in breast tumors or coexpression in the normal and tumor breast tissues. Here, a neuropeptide Y Y1 receptors ligand PNBL-NPY, as a novel targeted molecule, is conjugated with anticancer drug doxorubicin encapsulating albumin nanoparticles to investigate the effect of Y1 receptors on the delivery of drug-loaded nanoparticles to breast cancer cells and its potential for breast cancer therapy. The PNBL-NPY can actively recognize and bind to the Y1 receptors that are significantly overexpressed on the surface of the breast cancer cells, and the drug-loaded nanoparticles are delivered directly into the cancer cells through internalization. This system is highly selective and able to distinguish the breast cancer cells from the normal cells, due to normal breast cells that express Y2 receptors only. It is anticipated that this study may provide a guidance in the development of Y1 receptor-based nanoparticulate drug delivery system for a safer and more efficient breast cancer therapy.

Supersaturation-induced hydrothermal formation of α-CaSO4·0.5H2O whiskers

Supersaturation-induced fast transformation from CaSO₄·2H₂O to α-CaSO₄·0.5H₂O was observed and the process followed the dissolution–precipitation and homogeneous nucleation mechanism according to classical nucleation theory.

Plasma metabolic signatures reveal the regulatory effect of exercise training in db/db mice

Regulatory effect of moderate exercise training on fatty acid oxidation.

Osteogenic differentiation of human periodontal ligament cells after transfection with recombinant lentiviral vector containing follicular dendritic cell secreted protein

BACKGROUND AND OBJECTIVE

Follicular dendritic cell secreted protein (FDC-SP), has been identified in human periodontal ligament (PDL) in a recent study. It is suggested that the expression of FDC-SP might be associated with the osteogenic differentiation and mineralization of human periodontal ligament cells (hPDLCs). However, the intrinsic mechanism regarding this is still unclear. The aim of this study was to establish hPDLCs with safe and efficient overexpression of FDC-SP and to elucidate the influence of FDC-SP transfection on hPDLC osteogenesis in periodontal regeneration.

MATERIAL AND METHODS

We first applied a recombinant lentiviral vector containing FDC-SP to transfect hPDLCs via different multiplicity of infection (MOI) levels (1, 10, 20, 50 and 100). Western blot was performed to confirm the expression of FDC-SP. MTT assay was employed to evaluate the proliferation status of transfected cells. Then, the extent of osteogenic differentiation was investigated by simultaneous monitoring of alkaline phosphatase (ALP) activity assessment, immunofluorescent staining, the expression patterns of osteoblastic markers and mineralization staining.

RESULTS

We found that hPDLCs transfected via MOI 20, 50 and 100 exhibited expression of FDC-SP protein compared with MOI 1 and 10. There was no significant effect of FDC-SP transfection (at different MOI levels of 1, 10 and 20) on the proliferation of hPDLCs, whereas higher MOI levels (50 and 100) inhibited cell proliferation ability. In addition, ALP activity decreased significantly in FDC-SP-transfected hPDLCs at day 7. When stained with alizarin red, cells overexpressing FDC-SP formed less mineralized nodules at 21 d post-induction of differentiation, compared with the control cultures. Osteogenic inhibition was also confirmed by ALP immunostaining. Moreover, mRNA expression levels of osteoblastic markers decreased after FDC-SP transfection, which were in accordance with western blot results.

CONCLUSION

Our data suggest that MOI 20 is optimal to transfect hPDLCs, which achieves safe and efficient overexpression of FDC-SP in transfected cells. Moreover, FDC-SP overexpression inhibits osteogenic differentiation of hPDLCs. The present study contributes to a better understanding of the biological functions governing FDC-SP-induced hPDLC differentiation.

Time-shift homotopic connectivity in mesial temporal lobe epilepsy

BACKGROUND AND PURPOSE

Voxel-mirrored intrinsic functional connectivity allows the depiction of interhemispheric homotopic connections in the human brain, whereas time-shift intrinsic functional connectivity allows the detection of the extent of brain injury by measuring hemodynamic properties. We combined time-shift voxel-mirrored homotopic connectivity analyses to investigate the alterations in homotopic connectivity in mesial temporal lobe epilepsy and assessed the value of applying this approach to epilepsy lateralization and the prediction of surgical outcomes in mesial temporal lobe epilepsy.

MATERIALS AND METHODS

Resting-state functional MR imaging data were acquired from patients with unilateral mesial temporal lobe epilepsy (n=62) (31 left- and 31 right-side) and healthy controls (n=33). Dynamic interhemispheric homotopic architecture seeding from each hemisphere was individually calculated by 0, 1, 2, and 3 repetition time time-shift voxel-mirrored homotopic connectivity. Voxel-mirrored homotopic connectivity maps were compared between the patient and control groups by using 1-way ANOVA for each time-shift condition, separately. Group comparisons were further performed on the laterality of voxel-mirrored homotopic connectivity in each time-shift condition. Finally, we correlated the interhemispheric homotopic connection to the surgical outcomes in a portion of the patients (n=20).

RESULTS

The patients with mesial temporal lobe epilepsy showed decreased homotopic connectivity in the mesial temporal structures, temporal pole, and striatum. Alterations of the bihemispheric homotopic connectivity were lateralized along with delays in the time-shift in mesial temporal lobe epilepsy. The patients with unsuccessful surgical outcomes presented larger interhemispheric voxel-mirrored homotopic connectivity differences.

CONCLUSIONS

This study showed whole patterns of dynamic alterations of interhemispheric homotopic connectivity in mesial temporal lobe epilepsy, extending the knowledge of abnormalities in interhemispheric connectivity in this condition. Time-shift voxel-mirrored homotopic connectivity has the potential for lateralization of unilateral mesial temporal lobe epilepsy and may have the capability of predicting surgical outcomes in this condition.

Serum uric acid is associated with arterial stiffness in men with newly diagnosed type 2 diabetes mellitus

BACKGROUND

Increased serum uric acid levels and vascular atherosclerosis are very common in diabetes. However, few studies focused on the relationship between serum uric acid and aortic or peripheral arterial stiffness in newly diagnosed diabetic patients. This study investigated the association between serum uric acid levels and carotid-femoral pulse wave velocity (cfPWV) or carotid-radial (cr) PWV in male patients with newly diagnosed type 2 diabetes mellitus (T2DM).

METHODS

106 male patients with newly diagnosed T2DM were recruited. cfPWV and crPWV as well as anthropometric parameters, blood pressure, serum uric acid, blood glucose, fasting insulin, C-reactive protein and blood lipids were measured.

RESULTS

The subjects were divided into low uric acid (UA) subgroup and high UA subgroup according to uric acid median. cfPWV and crPWV were significantly higher in high UA subgroup. Serum uric acid significantly correlated with cfPWV (r = 0.533, P < 0.001), crPWV (r = 0.334, P = 0.001), waist circumference (r = 0.350, P < 0.001), waist-to-hip ratio (r = 0.254, P = 0.009), fasting insulin (r = 0.432, P < 0.001), HOMA-IR (r = 0.173, P = 0.042), fasting blood glucose (r = -0.271, P = 0.005), haemoglobin A1c (r = -0.202, P = 0.038), and HDL-cholesterol (r = -0.267, P = 0.006) after correction for age. Stepwise multiple regressions showed that the independent determinants of cfPWV were serum uric acid, age, C-reactive protein, HDL-cholesterol, and smoking status. And the independent determinants of crPWV were serum uric acid, age, diastolic blood pressure, and HDL-cholesterol.

CONCLUSIONS

Serum uric acid is significantly associated with increased aortic and peripheral arterial stiffness in men with T2DM at the early stage.

The treatment of severe and multiple injuries in intensive care unit: report of 80 cases

OBJECTIVE

To summarize our case load in managing severe and multiple injuries (SMI) in the Intensive Care Unit (ICU).

PATIENTS AND METHODS

The clinical data of 80 SMI patients treated in our ICU from January 2009 to June 2013 were analyzed.

RESULTS

Results of these 80 SMI patients, 60 (75%) were salvaged and 15 (18.75%) died. The causes of death included severe head injury (n=7), severe chest injury (n=3), destruction of injured abdominal organs (n=2), and multiple organ dysfunction syndrome (n=3). Five patients (7.50%) gave up treatment and were discharged upon their own requests. Early application of continuous renal replacement therapy (CRRT) and enteral nutrition (EN) improved outcomes.

CONCLUSIONS

The key interventions during the ICU treatment of SMI include: adequate analgesia and appropriate sedation; timely management of hypoxemia; reasonable fluid resuscitation and CRRT.