Texture analysis of CT images in predicting malignancy risk of gastrointestinal stromal tumours

AIM

To explore the role of texture analysis of computed tomography (CT) images in predicting the malignancy risk of gastrointestinal stromal tumours (GISTs).

MATERIALS AND METHODS

Seventy-eight patients with histopathologically confirmed GISTs underwent preoperative CT. Texture analysis was performed on unenhanced and contrast-enhanced CT images, respectively. Fourteen CT texture parameters were obtained and compared among GISTs at different malignancy risks with one-way analysis of variance or independent-samples Kruskal-Wallis test. Correlations between CT texture parameters and malignancy risk were analysed with Spearman's correlation test. Diagnostic performance of CT texture parameters in differentiating GISTs at low/very low malignancy risk was tested with receiver operating characteristic (ROC) analysis.

RESULTS

Three parameters on unenhanced images (r=-0.268-0.506), four parameters on arterial phase (r=-0.365-0.508), and six parameters on venous phase (r=-0.343-0.481) imaging correlated significantly with malignancy risk of GISTs, respectively (all p<0.05). For identifying GISTs at low/very low malignancy risk, three parameters on unenhanced images (area under ROC curve [AUC], 0.676-0.802), four parameters on arterial phase (AUC, 0.637-0.811), and six parameters on venous phase (AUC, 0.636-0.791) imaging showed significant diagnostic performance, respectively (all p<0.05), especially maximum frequency on both unenhanced and contrast-enhanced images (AUC, 0.791-0.811).

CONCLUSION

Texture analysis of CT images holds great potential to predict the malignancy risk of GISTs preoperatively.

miR-214 modulates cisplatin sensitivity of osteosarcoma cells through regulation of anaerobic glycolysis

Osteosarcoma is the most frequent primary bone tumor originating from adolescents and young adults. Despite improvements in the chemo- or radio- therapy of osteosarcoma patients, survival rate has not increased and drug resistance becomes a major factor that limits the effectiveness. Therefore, investigation of new treatment modalities is urgently required to optimize therapeutic options. Our previous study described an oncogenic role of miR-214 through promotion of osteosarcoma cells proliferation. In this study, we report miR-214 contributes to cisplatin resistance in osteosarcoma cells. Overexpression of miR-214 decreased the cisplatin sensitivity. By establishing an osteosarcoma cisplatin resistant cell line, we find miR-214 is significantly upregulated in cisplatin resistant cells. Moreover, we show miR-214 promotes anaerobic glycolysis rates of osteosarcoma cells but suppresses mitochondrial oxidative phosphorylation. Consistently, cisplatin resistant cells exhibit upregulated glycolysis but decreased mitochondrial oxidative phosphorylation, a phenotype called "Warburg effect". Finally, we demonstrate inhibition of glycolysis by either glycolysis inhibitor or miR-214 inhibition significantly re-sensitizes cisplatin resistant osteosarcoma cells. In summary, this study illustrates a miRNA-involved chemosensitivity of osteosarcoma and will contribute to the developments of therapeutic agents for the anti-chemoresistance treatments.

Quantitative imaging of Candida utilis and its organelles by soft X-ray Nano-CT

Soft X-ray microscopy has excellent characteristics for imaging cells and subcellular structures. In this paper, the yeast strain, Candida utilis, was imaged by soft X-ray microscopy and three-dimensional volumes were reconstructed with the SART-TV method. We performed segmentation on the reconstruction in three dimensions and identified several types of subcellular architecture within the specimen cells based on their linear absorption coefficient (LAC) values. Organelles can be identified by the correlation between the soft X-ray LAC values and the subcellular architectures. Quantitative analyses of the volume ratio of organelles to whole cell in different phases were also carried out according to the three-dimensional datasets. With such excellent features, soft X-ray imaging has a great influence in the field of biological cellular and subcellular research.

Correlation between diffusion tensor imaging parameters and clinical assessments in patients with cervical spondylotic myelopathy with and without high signal intensity

STUDY DESIGN

A cross-sectional observational study.

OBJECTIVES

The aim of this study is to compare the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) between patients with cervical spondylotic myelopathy (CSM) with and without high T2-weighted signal intensity, and to correlate each parameter with clinical assessments.

SETTING

CSM is a common cause of spinal cord dysfunction. The significance of T2 high signal intensity in the prognosis of CSM remains controversial.

METHODS

Diffusion tensor imaging was performed at the cervical spinal cord in 40 patients with CSM and 42 healthy subjects. Patients with high signal intensity were separated from those without high signal intensity. ADC and FA values were compared among different groups, and the correlation between each parameter and the modified Japanese Orthopedic Association (mJOA) score was examined.

RESULTS

The ADC and FA values of C2/3 differed significantly from those of C5/6 and C6/7 in healthy subjects. Patients with CSM had a higher ADC but a lower FA value than did healthy subjects. In all patients with CSM, there was a negative linear correlation between ADC and mJOA score, but FA value correlated positively with mJOA score. Secondary analysis suggested that FA value in patients with high signal intensity was lower than that in patients without high signal intensity. FA value showed a positive linear correlation with mJOA score in the patients with high signal intensity but not in the patients without high signal intensity.

CONCLUSIONS

Patients with high signal intensity may have more severe spinal cord injury than patients without high signal intensity, and FA may be a useful indicator of functional status in patients with CSM with high signal intensity.

Association between bone mineral density, muscle strength, and vitamin D status in patients with myasthenia gravis: a cross-sectional study

Myasthenia gravis (MG) patients had low proximal hip BMD, which could be explained by reduced muscle strength, elevated bone resorption markers, vitamin D deficiency, and increased PTH levels in those with MG compared to controls.

INTRODUCTION

Muscle strength is closely correlated with bone mineral density (BMD) and vitamin D status. Here, we evaluated muscle strength, BMD, and vitamin D status in a large sample of Chinese patients with MG.

METHODS

In this cross-sectional survey, 86 patients with MG without glucocorticoid treatment and 86 healthy controls were included. Serum levels of 25-hydroxyvitamin D [25OHD], parathyroid hormone (PTH), bone turnover markers (BTMs), and BMD were measured and compared between the two groups. Grip strength and one-leg standing time (OLST) were also assessed in MG patients.

RESULTS

Low grip strength and short OLST were found in 11 (12.8%) and 12 (14.0%) MG patients, respectively. There were 3 (3.5%) MG patients with low bone mass for chronological age. Serum beta C-terminal telopeptide and PTH levels were higher (p < 0.001 and p = 0.001, respectively), and BMD at the femoral neck and trochanter were lower in MG patients (p < 0.001 and p < 0.001, respectively) compared to healthy controls. In patients with MG, grip strength was positively correlated with BMD. Serum 25OHD levels were lower in MG patients than in healthy controls (17.36 ± 6.64 vs. 22.11 ± 7.28 ng/ml, p < 0.001).

CONCLUSION

Grip strength was positively correlated with BMD in Chinese patients with MG. MG patients tended to have low proximal hip BMD, which may partially be explained by reduced muscle strength, vitamin D deficiency, increased PTH levels, and elevated bone resorption markers compared to controls.

Intra-aortic balloon pumping and thrombocytopenia in patients with acute coronary syndrome : Incidence, risk factors, and prognosis

BACKGROUND

Thrombocytopenia is a frequently encountered phenomenon during intra-aortic balloon pumping (IABP), which may limit its prolonged utilization. The aim of the study was to explore the risk factors and clinical implications of IABP-associated thrombocytopenia in patients with acute coronary syndrome (ACS).

METHODS

We retrospectively analyzed the data of 222 patients with ACS undergoing invasive treatment strategy supported by IABP. The incidence and risk factors of IABP-associated thrombocytopenia, and the association between thrombocytopenia and relevant clinical endpoints (in-hospital death, bleeding according to the TIMI scale, and thromboembolic events), were analyzed.

RESULTS

IABP-associated thrombocytopenia was observed in 54.5% (121/222) of the patients. The incidence of thrombocytopenia was higher and the magnitude of reduction in platelet count was greater in the Arrow balloon group (n = 89) compared with the Datascope balloon group (n = 133; 68.5% vs. 45.1%, p = 0.001; 48.7% vs. 33.2%, p < 0.001; respectively). Independent predictors of thrombocytopenia included older age and Arrow balloon utilization (odds ratio [OR]: 1.054; 95% confidence interval [CI]: 1.028-1.080; p<0.001; OR: 2.468; 95%CI: 1.375-4.431; p = 0.002; respectively). The incidence of in-hospital death was higher in patients who developed thrombocytopenia than those who did not (9.1% vs. 2.0%, p = 0.041), and thrombocytopenia was correlated with in-hospital death (OR: 5.932; 95%CI: 1.221-28.822; p = 0.027). However, the rates of TIMI bleeding and thromboembolic events were similar between the two groups (5.8% vs. 5.0%, p = 1.000; 3.2% vs. 6.0%, p = 0.518; respectively), and thrombocytopenia was not associated with TIMI bleeding or thromboembolic events (OR: 0.940; 95%CI: 0.267-3.307; p = 0.923; OR: 0.541, 95%CI: 0.148-1.974, p = 0.352; respectively).

CONCLUSION

IABP-associated thrombocytopenia occurred in 54.5% of patients with ACS undergoing an invasive strategy and it was correlated with increased in-hospital mortality. Older age and use of the Arrow balloon may predict IABP-associated thrombocytopenia.

[The impact of red blood cell distribution width on outcome of elective percutaneous coronary intervention in non-anemia patients]

Objective: Previous studies have revealed that the red blood cell distribution width (RDW) was associated with long-term prognosis in patients undergoing percutaneous coronary intervention (PCI). However, they did not exclude patients with anemia. This study, thus, investigated the association between RDW and prognosis in non-anemia patients. Methods: A total of 2 732 patients underwent elective PCI from July 2009 to September 2011 were enrolled in the study. These patients were divided into two groups based on their baseline median RDW levels: low RDW group (RDW<12.1%) and high RDW group (RDW≥12.1%). All the subjects were followed up for an average period of 18 months and the associations between baseline RDW levels and postoperative mortality were analyzed. Results: Patients in the high RDW group were elder and had more women than those in low RDW group. Most of them had prior history of hypertension, stroke, myocardial infarction, but few of them were current smokers. Subjects in the high RDW group had higher systolic blood pressure and total cholesterol levels, and lower erythrocyte mean corpuscular volume, hemoglobin level, estimated glomerular filtration rate level, and left ventricular ejection fraction. Moreover, more subjects in the high RDW group were combined with left main, ostial and chronic total occlusion lesion, and had a lower complete revascularization rate. The postoperative mortality was significantly higher in the high RDW group than that in the low RDW group (2.4% vs 0.6%, P<0.001). Multivariate Cox regression analysis revealed that preoperative high RDW level was an independent risk factor for postoperative mortality after adjustment of other factors (HR 3.930, 95%CI 1.600-9.656, P=0.003). Conclusion: High RDW might be a marker for the postoperative mortality in non-anemic patients undergoing elective PCI.

Uncovering potential key genes associated with the pathogenesis of asthma: A microarray analysis of asthma-relevant tissues

BACKGROUND

The present study aimed to discover more potential genes associated with the pathogenesis of asthma.

METHODS

The microarray data of GSE67940 was downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified in bronchial alveolar lavage cells from patients with mild-moderate asthma (notSA) and severe asthma (SA) compared with normal controls (NC), respectively. Functional and pathway enrichment analysis, protein-protein interaction (PPI) network analysis were performed upon the identified up- and down-regulated DEGs. Besides, the gene association network based on the common up-regulated and down-regulated genes was generated and transcriptional regulatory pairs of overlapping DEGs in the PPI network were identified.

RESULTS

A total of 104 DEGs (30 up- and 74 down-regulated genes) were identified in notSA vs. NC. Additionally, 2796 DEGs were screened out in SA vs. NC group, including 320 up-regulated DEGs, and 135 down-regulated DEGs. Specially, 41 overlapping DEGs were screened out in notSA vs. NC and SA vs. NC, including 16 common up-regulated genes and 25 common down-regulated genes. No pathways were enriched by the DEGs in notSA vs. NC. DEGs in SA vs. NC were associated with cytokine-cytokine receptor interaction. VEGFA was a hub protein in both the PPI networks of DEGs in notSA vs. NC and SA vs. NC. Gene association network showed that signalling pathways and cytokine-cytokine receptor interaction were involved in. The overlapping VEGFA, and IFRD1, and ZNF331 were regulated by more TFs.

CONCLUSION

Genes such as VEGFA, and IFRD1, and ZNF331 may be associated with pathogenesis of asthma.

[Relative analysis of platelet activation with bleeding risk in patients with primary immune thrombocytopenia]

目的

研究原发免疫性血小板减少症（ITP）患者血小板活化状态和出血程度的相关性。

方法

采用ITP特异性出血评价工具（ITP-BAT）对43例ITP患者进行出血评分及出血程度分级，应用流式细胞术检测二磷酸腺苷（ADP）激活前后血小板膜糖蛋白（GP）Ⅰb、Ⅱb/Ⅲa和P选择素表达。分析GPⅠb、GPⅡb/Ⅲa、P选择素表达与血小板计数、未成熟血小板比例的相关性；分析GPⅠb、GPⅡb/Ⅲa、P选择素表达与ITP患者出血程度的相关性，以及对中度以上出血患者风险评估的应用价值。

结果

ITP患者激活前血小板GPⅡb/Ⅲa、P选择素表达均高于正常对照组（65.69±10.73对7.16±0.99，t=4.130，P<0.001；15.43±1.41对12.55±1.03，t=2.070，P=0.043），GPⅠb表达低于正常对照组（240.11±24.93对295.11±22.15，t=2.417，P=0.020）。ITP患者ADP激活后血小板GPⅡb/Ⅲa表达高于正常对照组（133.96±12.17对39.67±4.99，t=5.256，P<0.001），而P选择素、GPⅠb表达低于正常对照组（37.09±3.94对109.77±23.66，t=3.901，P<0.001；149.06±19.14对205.73±21.00，t=2.070，P=0.043）。ADP激活后GPⅠb表达、ADP激活前后P选择素表达及ADP激活前后GPⅠb、P选择素表达比值与血小板计数相关（P<0.05）。ADP激活后P选择素表达、ADP激活前后P选择素表达比值与未成熟血小板比例相关（P<0.05）。ITP患者ADP激活后GPⅠb表达、ADP激活前后P选择素表达及ADP激活前后P选择素、GPⅡb/Ⅲa、GPⅠb表达比值在不同出血程度之间差异有统计学意义（P<0.05）。ADP激活前后GPⅠb表达比值是ITP患者中度以上出血的正性影响因素（OR=3.05，P=0.011），ADP激活前后P选择素、GPⅡb/Ⅲa表达比值是ITP患者中度以上出血的负性影响因素（OR=0.32，P=0.023；OR=0.04，P=0.006）。

结论

血小板活化指标能较准确地评估ITP患者出血程度，可以作为治疗参考指标和疗效观察指标。

Tumor-associated immune factors are associated with recurrence and metastasis in non-small cell lung cancer

Dynamic interaction between tumor cells and the microenvironment is critical for tumorigenesis, and cancer immunosurveillance plays an important role in the tumor evolution. In some tumors (such as esophageal cancer, pancreatic cancer and colorectal cancer), studies have shown that the number of tumor-infiltrating lymphocytes (TILs) has a significant relationship with the prognosis, but there is little research on the prognosis of TILs and non-small cell lung cancer (NSCLC) has been performed. Therefore, it is necessary to discover the relationship between the TILs and cytokines with NSCLC prognosis and metastasis in patients. Tumor samples were carefully examined for tissue preservation and complete follow-up. A total of 107 tumor samples from NSCLC patients with radical surgical resection were enrolled for the analysis. All samples were subjected to immunohistochemistry for detection of CD3, CD4, CD8, CD28, forkhead box protein P3 (Foxp3), cytotoxic T lymphocyte-associated protein-4, cyclooxygenase2 (COX-2), transforming growth factor β 1, interleukin-2 (IL-2), interleukin-6, interleukin-10, interleukin-12 receptor and hypoxia inducible factor 1a (HIF-1a). The number, function and location of the targets were analyzed to determine their correlation with disease-free survival (DFS) and overall survival (OS). Immunhistochemical results from 107 samples indicated that the FoxP3+ regulatory TIL (HR=1.336, P=0.031), IL-2 (HR=0.595, P=0.007) and HIF-1a (HR=1.510, P=0.002) levels in tumor cells closely correlated with DFS in a COX analysis model. FoxP3+ regulatory TILs (HR=1.566, P=0.002) significantly correlated with OS and tumor node metastasis staging. The patients were divided into two groups due to the coexpression pattern of the IL-2, FoxP3+ and HIF-1a. The high-risk group had an overall worse survival than those at low risk. We confirmed that Foxp3 expression in lymphocyte and IL-2 expression in tumor cells were associated with recurrence or transfer. Furthermore, we also observed that HIF-1a expression significantly correlated with DFS and OS.

High-Dose Linoleic Acid Activated JAK2-STAT3 Signaling Pathway Involved in Cytokine Production and Lipogenesis in Pancreatic Exocrine Cells

BACKGROUND

Linoleic acid has been implicated in the pathogenesis of acute pancreatitis. However, molecular mechanisms underlying adverse effects of large-dose linoleic acid remain unclear. Current study aimed to explore the impact of high-dose linoleic acid on the activation of Janus kinase 2 (JAK2)-signal transducers and activators of transcription 3 (STAT3) pathway, cytokine production, and lipogenesis in pancreatic exocrine cells.

METHODS

MTT assay was used to detect the viability of AR42J rat pancreatic exocrine cells, and lactate dehydrogenase assay was utilized to detect cytotoxicity. Concentrations of interleukin (IL)-6 and tumor necrosis factor (TNF)-α were detected by ELISA, and protein expression of JAK2, p-JAK2, STAT3, p- STAT3, and fatty acid synthase (FAS) was examined by Western Blot. The impact of highdose linoleic acid on JAK2-STAT3 pathway was also examined when JAK2 was inhibited by AG490, and STAT3 expression was interrupted by siRNA.

RESULTS

The cell viability of AR42J rat pancreatic exocrine cells was inhibited, and cytotoxicity was increased by high-dose linoleic acid. JAK2 and STAT3 proteins in pancreatic exocrine cells were activated by high-dose linoleic acid via phosphorylation and nuclear localization of phosphorylated STAT3. Moreover, the expression of downstream proteins in JAK2-STAT3 pathway (IL-6, TNF-α and FAS) was up-regulated by high-dose linoleic acid. The increased levels of IL-6 and TNF-α caused by high-dose linoleic acid were attenuated by JAK2 inhibitor AG490. p-JAK2 protein was up-regulated, whereas p-STAT3, STAT3 and FAS proteins were down-regulated by high-dose linoleic acid in the presence of STAT3-siRNA.

CONCLUSION

The cytotoxicity was increased and JAK2-STAT3 signaling pathway was activated by high-dose linoleic acid through cytokine production and lipogenesis in rat pancreatic exocrine cells.

[Pathology and differential diagnosis of immunotactoid glomerulopathy]

Objective: To study the morphologic changes of immunotactoid glomerulopathy and to investigate the clinical pathological features and differential diagnosis. Methods: Renal biopsy was observed under the light microscope, immunofluorescence and electron microscopy in a case of newly diagnosed immunotactoid glomerulopathy. Results: This patient clinically presented with nephrotic syndrome and hypertension, without family history of renal diseases. Light microscopy showed that diffusely massive and specific protein deposition in the glomerulus in Masson staining. Immunofluorescence revealed IgG, C3 and κ were deposited along the capillary walls and mesangial regions. Electron microscopic examination showed that a large amount of microtubule like substances and a small amount of long bar-shaped and dense crystal-like substances were deposited in the subendothelial spaces and mesangial areas. Conclusions: Light microscopy and immunofluorescence of immunotactoid glomerulopathy show no specifically pathological changes. Under electron microscope, a large amount of microtubule like substances is deposited in the glomerulus, which is the key point to distinguish this disease from other glomerular diseases. Except for the microtubule-like substances, the present case is accompanied by the deposition of long bar-shaped and dense crystal-like substance, which has not been reported in previous studies.

Correlation of the TCF7L2 (rs7903146) polymorphism with an enhanced risk of type 2 diabetes mellitus: a meta-analysis

Increasing evidence has demonstrated that a transcription factor 7-like 2 (TCF7L2) polymorphism (rs7903146) is significantly associated with type 2 diabetes mellitus (T2DM); however, limited sample size and variance of ethnicity in the studies investigating this association have led to conflicting reports regarding its role. Therefore, a comprehensive meta-analysis was conducted to quantitatively assess the association between the TCF7L2 polymorphism (rs7903146) and T2DM including published case-control studies in global populations. We searched the PubMed, EMbase, CNKI, and Wanfang databases for publications that studied correlation between TCF7L2 polymorphism (rs7903146) and risk of T2DM. Thirty-six studies from 30 eligible papers were identified. After data extraction and reference quality assessment, summary odds ratio and 95% confidence intervals (95%CI) of the TCF7L2 (rs7903146) polymorphism were calculated and combined using the fixed-effect model. Hardy-Weinberg equilibrium was evaluated to determine selection bias of the control subjects. Heterogeneity among studies was examined using the Q-test and the I² test. Publication bias in studies was assessed using Begg's plots and the Egger test. The results showed that the rs7903146 T allele of the TCF7L2 gene was positively correlated with an enhanced risk of T2DM in the allelic, heterozygote, homozygote, dominant, and recessive models, with odds ratios of 1.35 (T vs C, 95%CI = 1.31-1.39), 1.32 (CT vs CC, 95%CI = 1.27-1.38), 1.74 (TT vs CC, 95%CI = 1.63-1.87), 1.40 (TT+CT vs CC, 95%CI = 1.35-1.46), and 1.59 (TT vs CT+CC, 95%CI = 1.49-1.69), respectively. No obvious publication bias was observed using the Egger linear test.

Characterization and identification of ISSR markers associated with oil content in sea buckthorn berries

Bioactive oils extracted from sea buckthorn (Hippophae rhamnoides) berries contain highly nutritional and medicinal compounds; however, the oil contents of sea buckthorn berries are very low. Thirteen inter-simple sequence repeat (ISSR) primers were used to identify markers associated with oil content of dry pulp in 51 cultivars and lines, which clustered into three major groups based on 137 polymorphic markers. Dry pulp oil contents in 45 cultivars and lines in Group I ranged from 6.6 to 33.1%; these accessions belonged to H. rhamnoides ssp mongolica and its hybrids with H. rhamnoides ssp sinensis. Three lines (H. rhamnoides ssp mongolica) in Group II had high dry pulp oil contents (33.7 to 37.5%), whereas three lines of hybrids in Group III had low dry pulp oil contents (10.9 to 17.5%). The dry pulp oil content of H. rhamnoides ssp mongolica (27.2 ± 0.9%) was higher than that of hybrids (12.0 ± 1.2%) (P < 0.01). Four ISSR markers (881₃₄₀, 825₁₀₀₀, 817₃₈₀, and 807₁₁₀₀) had positive association with high dry pulp oil content (P < 0.01) using stepwise multiple regression analysis. The use of these ISSR markers is a potential strategy to select genotypes with high dry pulp oil content and suitable parental combinations for improvement of sea buckthorn berries.

Cardiomyocyte-specific TβR2 knockout mice are more susceptible to cardiac hypertrophy induced by adrenergic agonist stimulation

TGF-β signaling is shown to be involved in cardiac remodeling, but the detailed function and underlying mechanism are still incompletely understood. In this study, we generated cardiomyocyte-specific TGF-β type 2 receptor (TβR2) knockout mice to study the function of TGF-β signaling in cardiac hypertrophy. Although the mutant mice displayed no obvious physiological abnormality, they developed severer cardiac hypertrophy in response to isoproterenol (ISO) stimulation than control mice did. The expression of p-Smad2 was markedly reduced, while the concentration of p-ERK was increased in the hearts of mutant mice. In addition, we also found that cardiomyocyte-specific Smad2 knockout mice did not demonstrate cardiac phenotype as observed on TβR2 knockout mice, while inhibition of MEK-1-mediated activation of MAPK using PD98059 partially rescued the phenotype of TβR2-deleted cardiomyocytes, indicating that activation of TGF- noncanonical signaling might contribute to cardiac phenotype observed in TβR2 knockout mice. Thus, our data provided the first in vivo genetic evidence to show that TβR2 may function as an anti-hypertrophic factor of cardiac hypertrophy subjected to adrenergic stimulation, suggesting the complex role of TβR2 in cardiac hypertrophy under stimulation of different stresses.

Adolescent exposure to cocaine increases anxiety-like behavior and induces morphologic and neurochemical changes in the hippocampus of adult rats

Repeated exposure to cocaine during adolescence may affect both physical and psychological conditions in the brain, and increase the risk of psychiatric disorders and addiction behaviors in adulthood. Adolescence represents a critical development period for the hippocampus. Moreover, different regions of the hippocampus are involved in different functions. Dorsal hippocampus (dHP) has been implicated in learning and memory, whereas ventral hippocampus (vHP) plays an important role in emotional processing. In this study, the rats that were exposed to cocaine during adolescence (postnatal days, P28-P42) showed higher anxiety-like behavior in the elevated plus maze test in adulthood (P80), but displayed normal spatial learning and memory in the Morris water maze test. Furthermore, repeated exposure to cocaine during adolescence lead to alterations in morphology of pyramidal neurons, activities of astrocytes, and levels of proteins that involved in synaptic transmission, apoptosis, inflammation and addiction in both dHP and vHP of adult rats. These findings suggest that repeated exposure to cocaine during adolescence in rats may elicit morphologic and neurochemical changes in the hippocampus when the animals reach adulthood. These changes may contribute to the increased susceptibility for psychiatric disorders and addiction seen in adults.

Socioeconomic inequalities in dental caries among 5-year-olds in four Chinese provinces

OBJECTIVE

To explore socioeconomic inequalities in dental caries among 5-year-olds in four Chinese provinces.

METHODS

This study used data from 1,732 children living in Guangxi, Hubei, Jilin and Shanxi who participated in the Third National Oral Health Survey in 2005. Questionnaires were completed by parents to collect information on family socioeconomic position (parental education and household income) and children's dental behaviours (toothbrushing frequency, sugar intake frequency and last dental visit). Children were clinically examined for dental caries, which was reported using the dmft index. Socioeconomic inequalities in children's caries experience were assessed in negative binomial regression models.

RESULTS

There were significant gradients in children's dmft by household income. Children's dmft increased from 2.63 in the highest income group to 4.70 in the lowest income group. However, parental education was not significantly related to childhood dental caries.

CONCLUSION

Clear social gradients in caries experience of deciduous teeth were found by household income but not parental education.

Impairment of Endothelial Cell Function Induced by Hemoglobin A(1c) and the Potential Mechanisms

OBJECTIVE

Hemoglobin A(1c) (HbA(1c)) concentrations reflect glycemic control and diabetic complications. However, there is little evidence supporting the pathological role of HbA(1c) in the development and progression of diabetic complications. We investigated the impact of HbA(1c) on endothelial cell function and the potential mechanisms.

METHODS

The effects of HbA(1c) on the viability and migration of human umbilical vein endothelial cells (HUVECs) were measured by the Cell Counting Kit-8 and a wound healing scratch assay, respectively. Production of nitric oxide (NO) and reactive oxygen species was measured by the nitrate reductase colorimetric method and flow cytometry, respectively. The expression of endothelial nitric oxide synthase (eNOS) mRNA was quantitated by reverse-transcriptase PCR. The expression of eNOS, p-AMPK, and NOX4 proteins was detected by Western blot.

RESULTS

High concentrations of HbA(1c) reduced the viability and migration of HUVECs in a dose- and time-dependent manner. High concentrations of HbA(1c) inhibited production of NO but increased production of ROS. Incubation with increasing concentrations of HbA(1c) downregulated the expression of eNOS mRNA, decreased expression of eNOS and p-AMPK, and upregulated expression of NOX4.

CONCLUSION

These findings provide direct evidence that HbA(1c) is involved in the development and progression of the cardiovascular complications of diabetes.

The inhibition of high-voltage-activated calcium current by activation of MrgC11 involves phospholipase C-dependent mechanisms

High-voltage-activated (HVA) calcium channels play an important role in synaptic transmission. Activation of Mas-related G-protein-coupled receptor subtype C (MrgC; mouse MrgC11, rat homolog rMrgC) inhibits HVA calcium current (ICa) in small-diameter dorsal root ganglion (DRG) neurons, but the intracellular signaling cascade underlying MrgC agonist-induced inhibition of HVA ICa in native DRG neurons remains unclear. To address this question, we conducted patch-clamp recordings in MrgA3-eGFP-wild-type mice, in which most MrgA3-eGFP(+) DRG neurons co-express MrgC11 and can be identified for recording. We found that the inhibition of HVA ICa by JHU58 (0.001-100nM, a dipeptide, MrgC-selective agonist) was significantly reduced by pretreatment with a phospholipase C (PLC) inhibitor (U73122, 1μM), but not by its inactive analog (U73343) or vehicle. Further, in rats that had undergone spinal nerve injury, pretreatment with intrathecal U73122 nearly abolished the inhibition of mechanical hypersensitivity by intrathecal JHU58. The inhibition of HVA ICa in MrgA3-eGFP(+) neurons by JHU58 (100nM) was partially reduced by pretreatment with a Gβγ blocker (gallein, 100μM). However, applying a depolarizing prepulse and blocking the Gαi and Gαs pathways with pertussis toxin (PTX) (0.5μg/mL) and cholera toxin (CTX) (0.5μg/mL), respectively, had no effect. These findings suggest that activation of MrgC11 may inhibit HVA ICa in mouse DRG neurons through a voltage-independent mechanism that involves activation of the PLC, but not Gαi or Gαs, pathway.

Activation of p38 MAPK in the rostral ventromedial medulla by visceral noxious inputs transmitted via the dorsal columns may contribute to pelvic organ cross-sensitization in rats with endometriosis

Whether visceral organ cross-sensitization is involved in endometriosis-associated pain remains elusive. Previous studies have shown that visceral noxious stimuli may trigger a cascade of signal transductions in the rostral ventromedial medulla (RVM) via the spinal dorsal column (DC) pathway and the RVM plays a critical role in the descending control of visceral nociception. In the current study, we hypothesized that the p38 mitogen-activated protein kinase (MAPK) activation in the RVM by noxious visceral inputs from ectopic growths via the DC was involved in the development of pelvic organ cross-sensitization in established endometriosis. A rat model of experimental endometriosis was established. To examine ectopic growths-to-colon cross-sensitization, graded colorectal distention (CRD) was performed and abdominal withdrawal reflex (AWR) scores were recorded in female rats at 8weeks after the uterine or fat (control) auto-transplantation. Western blot study was carried out to examine the phosphorylated form and the total level of p38 MAPK protein in the RVM. Our results showed that lesions of bilateral DCs immediately following uterine or fat auto-transplantation in female rats significantly attenuated the later development of ectopic growths-to-colon cross-sensitization and the increased p38 MAPK activation in the RVM, as compared to sham DC lesions. Furthermore, intra-RVM microinjection of a p38 MAPK inhibitor (SB 203580), but not vehicle, in female rats with established endometriosis significantly attenuated ectopic growths-to-colon cross-sensitization and the increased activation of p38 MAPK in the RVM. These findings suggest that the noxious inputs from ectopic growths may activate p38 MAPK in the RVM via the DC, which may contribute to the development of ectopic growths-to-colon cross-sensitization in established endometriosis.

Blood versus crystalloid cardioplegia for pediatric cardiac surgery: a meta-analysis

OBJECTIVE

Blood and crystalloid cardioplegia are the main myocardial protective solutions used in pediatric cardiac surgery. However, the effectiveness of these two solutions on myocardial metabolism, reperfusion injury and clinical outcomes in pediatric patients is still under debate. The purpose of this meta-analysis was to compare the efficacy of these two cardioplegia solutions in pediatric cardiac surgery.

METHODS

Keyword searches were performed on PUBMED, EMBASE and The Cochrane Library for randomized, controlled, clinical studies which were primarily comparing blood and crystalloid cardioplegia in pediatric cardiac surgery and provided data of postoperative cardiac troponin I (cTnI), lactate, mechanical ventilation time, length of intensive care unit (ICU) stay and inotropic support. Databases were searched from 1966 to June 2013 and were restricted to peer-reviewed English language publications of human subjects. We summarized the combined results of the data as mean difference (MD, when outcome measurements were made on the same scale) or standard mean difference (SMD, when the studies assess the same outcome with different scales), with 95% confidence intervals.

RESULTS

Five studies were identified, with a total of 323 patients. Lactate level after cardiopulmonary bypass (CPB) was significantly lower after blood cardioplegia compared with crystalloid cardioplegia (SMD 1.09, 95%CI 0.12 to 2.06, p=0.03); cTnI release postoperatively at 4-6 h (MD 0.92 ng/ml, 95%CI -0.13 to 1.97, p=0.09), 12 h (MD 0.2 ng/ml, 95% CI -0.43 to 0.84, p=0.53) and 24 h (MD 0.98 ng/ml, 95%CI -0.26 to 2.22, p=0.12) was not significantly different between the groups; ventilation duration (MD 5.15 hours, 95%CI -7.51 to 17.81, p=0.42) and length of ICU stay (SMD -0.3, 95%CI -0.80 to 0.21, p=0.25) were not significantly different between the groups either.

CONCLUSION

Myocardial metabolism was better in the blood cardioplegia group compared with the crystalloid cardioplegia group. However, there was no evidence of improvement in myocardial damage or clinical outcome for either cardioplegia solution.

Genetic tuning of the novel avian influenza A(H7N9) virus during interspecies transmission, China, 2013

A novel avian influenza A(H7N9) virus causing human infection emerged in February 2013 in China. To elucidate the mechanism of interspecies transmission, we compared the signature amino acids of avian influenza A(H7N9) viruses from human and non-human hosts and analysed the reassortants of 146 influenza A(H7N9) viruses with full genome sequences. We propose a genetic tuning procedure with continuous amino acid substitutions and reassorting that mediates host adaptation and interspecies transmission. When the early influenza A(H7N9) virus, containing ancestor haemagglutinin (HA) and neuraminidase (NA) genes similar to A/Shanghai/05 virus, circulated in waterfowl and transmitted to terrestrial poultry, it acquired an NA stalk deletion at amino acid positions 69 to 73. Then, receptor binding preference was tuned to increase the affinity to human-like receptors through HA G186V and Q226L mutations in terrestrial poultry. Additional mammalian adaptations such as PB2 E627K were selected in humans. The continual reassortation between H7N9 and H9N2 viruses resulted in multiple genotypes for further host adaptation. When we analysed a potential association of mutations and reassortants with clinical outcome, only the PB2 E627K mutation slightly increased the case fatality rate. Genetic tuning may create opportunities for further adaptation of influenza A(H7N9) and its potential to cause a pandemic.