[Some suggestions on improving the capacity of offshore trauma treatment in China]

With the development of national marine strategy, the importance of developing marine medicine and marine medical support capability has been highly regarded. In this paper, the problems regarding improvement on medical support for offshore trauma are discussed. Based on the analysis of the influence of environmental factors on offshore trauma treatment, and positive experience of trauma care practiced in the United States civilian ships and navy, we analyze the problems involving risk control for offshore trauma, establishment of standardized treatment and personnel training project, improvement of mobile rescue forces, and research for rescue technique and equipment, with the purpose to propose some effective and practical suggestions.

The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer: A meta-analysis

BACKGROUND

The clinical value of the prognostic nutritional index (PNI) in gastric cancer (GC) remains controversial. Therefore, we performed the meta-analysis to determine the prognostic and clinicopathological values of PNI in patients with GC.

METHODS

A literature search was performed in the PubMed, Embase, and Web of Science databases. Hazard ratios (HRs) and odds ratios (ORs) were extracted to estimate the association of PNI with survival and clinicopathological characteristics, respectively.

RESULTS

Ten studies involving 3396 patients with GC were analyzed. The pooled results indicated that a low PNI was a significant predictor of poor overall survival (OS) (HR = 1.89, 95% confidence interval [CI] = 1.67-2.13, P < 0.01) and postoperative complications (OR = 1.74, 95% CI = 1.41-2.16, P < 0.01). In the subgroup analysis, a low PNI was significantly associated with poor OS in patients with GC at stage I, II and III, but not at stage IV (HR = 1.14, 95% CI = 0.84-1.55, P = 0.40). Moreover, a low PNI was significantly associated with more advanced tumor features, such as older age, deeper depth of tumor, positive lymph node metastasis, more advanced TNM stages, and positive vessel and lymphatic invasion.

CONCLUSION

PNI was a predictive indicator of survival and postoperative complications, and was associated with clinicopathological features in GC patients. However, a low PNI was not significantly associated with poor OS in patients with GC at stage IV.

Enhanced antitumor effect of combining TRAIL and MnSOD mediated by CEA-controlled oncolytic adenovirus in lung cancer

Lung cancer, especially adenocarcinoma, is one of the leading causes of death in the world. Carcinoembryonic antigen (CEA), a superb non-small-cell lung cancer marker candidate, showed a beneficial effect in cancer therapy with oncolytic adenovirus in recent studies. Cancer-targeting dual gene-virotherapy delivers two therapeutic genes, linked by a connexon, in the replication-deficient vector instead of one gene so that they can work in common. In this study, we constructed a tumor-specific oncolytic adenovirus, CD55-TRAIL-IETD-MnSOD. The virus has the fusion protein complementary DNAs for tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and for manganese superoxide dismutase (MnSOD) complementary DNA linked through a 4-amino acid caspase-8 cleavage site (IETD), and uses a CEA promoter to control virus E1A express. This is the first work to use a CEA promoter-regulated oncolytic adenovirus carrying two therapeutic genes for cancer research. Its targeting and anticancer capacity was evaluated by in vitro and in vivo experiments. The results indicated that CD55-TRAIL-IETD-MnSOD caused more cell apoptosis than CD55-TRAIL or CD55-MnSOD alone, or their combination in vitro, with low cytotoxicity of normal cells. In the A549 tumor xenograft model in nude mice, data showed that CD55-TRAIL-IETD-MnSOD could effectively suppress tumor growth than single gene groups, with no histological damage in liver, spleen or kidney tissues. Thus, the CEA-regulated dual-gene oncolytic virus CD55-TRAIL-IETD-MnSOD may be a novel potential therapy for lung cancer.

Dietary Features and Blood Pressure among 18-88-Year-Old Residents in an Island Population in China

OBJECTIVES

Dietary recommendations to reduce blood pressure (BP) have been widely disseminated and residents who live on islands have unique dietary characteristics. Here, we identified associations between dietary intake and BP levels among island residents in China.

DESIGN

Cross-sectional study.

SETTING

The Changhai islands, which is an important island county in China.

PARTICIPANTS

A total of 876 residents, 18-88 years old, of Changhai county.

MEASUREMENTS

Dietary intake and BP measurements were assessed using standardized questionnaires and protocols, respectively. Dietary intake was compared across BP categories and linear regression analyses were performed between dietary intake and systolic blood pressure (SBP) and diastolic blood pressure (DBP).

RESULTS

Participants previously diagnosed with hypertension consumed less salt than those with undiagnosed high BP (p < 0.01). After exclusion of participants previously diagnosed with hypertension, salt and meat consumption were positively and linearly associated with both SBP (p < 0.01 and < 0.001, respectively) and DBP (p = 0.03 and < 0.01, respectively), whereas consumption of marine products was inversely associated with SBP (p = 0.047). Mixed edible oil and edible oil consumption were associated with SBP (p < 0.01) and DBP (p = 0.021), respectively. In the multiple linear regression model, meat intake was positively associated with both SBP and DBP (β = 0.139, p < 0.001; β = 0.066, p = 0.047, respectively), whereas consumption of marine products was inversely associated with SBP (β = -0.102, p <0.001), while mixed edible oil was associated with SBP (β = 0.062, p = 0.03).

CONCLUSION

Adherence to nutritional recommendations can be improved among hypertensive patients, even those aware of their conditions. In the general island population, eating habits regarding salt, meat, edible oil consumption, and use of mixed edible oil increased the risk of hypertension onset, whereas marine products were found to decrease this risk.

[The differentiation and vicissitude of variety of Aucklandiae Radix]

Aucklandiae Radix is a commonly used Chinese herbal medicine. Historically, the varieties of Aucklandiae Radix for its medicinal use are complicated. Early Radix Aucklandiae was produced domestically, and it began to be imported since the Northern and Southern Dynasties. The two families, four genera, including Saussure Aucklandiae Radix of Compositae, Inula Inulae Radix, Vladimiria Vladimiriae Radix, dali Aucklandiae Radix and Aristolochiaceae Aristolochic aristolochia debilis, are all applied for medicinal purposes. In modern time, there are 3 major classes of crude drugs of Aucklandiae Radix, namely, Aucklandiae Radix, Inulae Radix, root of common Vladimiriae Radix.

Galactosylation of steroidal saponins by β-galactosidase from Lactobacillus bulgaricus L3

The galactosylation of furostanosides and spirostanosides were investigated by using β-galactosidase from Lactobacillus bulgaricus L3 as a catalyst and lactose as a sugar donor. Four novel galactosylated furostanoside products (compounds 1-4) from compound F, compound G, compound I, and compound H were obtained and their structures were identified by HR-ESI-MS, 1D and 2D NMR spectra. The result showed that galactosyl moiety was found to be added to the 6-OH of the 26-O-glucosyl in these four furostanoside substrates.

Perpendicular magnetic anisotropy and magnetization dynamics in oxidized CoFeAl films

Half-metallic Co-based full-Heusler alloys with perpendicular magnetic anisotropy (PMA), such as Co₂FeAl in contact with MgO, are receiving increased attention recently due to its full spin polarization for high density memory applications. However, the PMA induced by MgO interface can only be realized for very thin magnetic layers (usually below 1.3 nm), which would have strong adverse effects on the material properties of spin polarization, Gilbert damping parameter, and magnetic stability. In order to solve this issue, we fabricated oxidized Co₅₀Fe₂₅Al₂₅ (CFAO) films with proper thicknesses without employing the MgO layer. The samples show controllable PMA by tuning the oxygen pressure (P_O2) and CFAO thickness (t_CFAO), large perpendicular anisotropy field of ~8.0 kOe can be achieved at P_O2 = 12% for the sample of t_CFAO= 2.1 nm or at P_O2= 7% for t_CFAO= 2.8 nm. The loss of PMA at thick t_CFAO or high P_O2 results mainly from the formation of large amount of CoFe oxides, which are superparamagnetic at room temperature but become hard magnetic at low temperatures. The magnetic CFAO films, with strong PMA in a relatively wide thickness range and small intrinsic damping parameter below 0.028, would find great applications in developing advanced spintronic devices.

Folic acid supplementation and dietary folate intake, and risk of preeclampsia

BACKGROUND/OBJECTIVES

Folic acid supplementation has been suggested to reduce the risk of preeclampsia. However, results from few epidemiologic studies have been inconclusive. We investigated the hypothesis that folic acid supplementation and dietary folate intake before conception and during pregnancy reduce the risk of preeclampsia.

SUBJECTS/METHODS

A birth cohort study was conducted in 2010-2012 at the Gansu Provincial Maternity & Child Care Hospital in Lanzhou, China. A total of 10,041 pregnant women without chronic hypertension or gestational hypertension were enrolled.

RESULTS

Compared with nonusers, folic acid supplement users had a reduced risk of preeclampsia (OR=0.61, 95% CI: 0.43-0.87). A significant dose-response of duration of use was observed among women who used folic acid supplemention during pregnancy only (P-trend=0.007). The reduced risk associated with folic acid supplement was similar for mild or severe preeclampsia and for early- or late-onset preeclampsia, although the statistical significant associations were only observed for mild (OR=0.50, 95% CI: 0.30-0.81) and late-onset (OR=0.60, 95% CI: 0.42-0.86) preeclampsia. The reduced risk associated with dietary folate intake during pregnancy was only seen for severe preeclampsia (OR=0.52, 95% CI: 0.31-0.87, for the highest quartile of dietary folate intake compared with the lowest).

CONCLUSIONS

Our study results suggest that folic acid supplementation and higher dietary folate intake during pregnancy reduce the risk of preeclampsia. Future studies are needed to confirm the associations.

Transposon variation by order during allopolyploidisation between Brassica oleracea and Brassica rapa

Although many studies have shown that transposable element (TE) activation is induced by hybridisation and polyploidisation in plants, much less is known on how different types of TE respond to hybridisation, and the impact of TE-associated sequences on gene function. We investigated the frequency and regularity of putative transposon activation for different types of TE, and determined the impact of TE-associated sequence variation on the genome during allopolyploidisation. We designed different types of TE primers and adopted the Inter-Retrotransposon Amplified Polymorphism (IRAP) method to detect variation in TE-associated sequences during the process of allopolyploidisation between Brassica rapa (AA) and Brassica oleracea (CC), and in successive generations of self-pollinated progeny. In addition, fragments with TE insertions were used to perform Blast2GO analysis to characterise the putative functions of the fragments with TE insertions. Ninety-two primers amplifying 548 loci were used to detect variation in sequences associated with four different orders of TE sequences. TEs could be classed in ascending frequency into LTR-REs, TIRs, LINEs, SINEs and unknown TEs. The frequency of novel variation (putative activation) detected for the four orders of TEs was highest from the F1 to F2 generations, and lowest from the F2 to F3 generations. Functional annotation of sequences with TE insertions showed that genes with TE insertions were mainly involved in metabolic processes and binding, and preferentially functioned in organelles. TE variation in our study severely disturbed the genetic compositions of the different generations, resulting in inconsistencies in genetic clustering. Different types of TE showed different patterns of variation during the process of allopolyploidisation.

Association between IRF5 polymorphisms and autoimmune diseases: a meta-analysis

In this study, we investigated the association between 5 interferon regulatory factor-5 (IRF5) single nucleotide polymorphisms (SNPs) and autoimmune diseases using the Medline citation index. Twenty-eight studies with 74 comparisons, including 16 rheumatoid arthritis (RA), 43 systemic lupus erythematous (SLE), 2 juvenile idiopathic arthritis (JIA), 6 multiple sclerosis (MS), and 5 systemic sclerosis (SSc) studies, were examined in the meta-analysis. The SNP rs2004640 was significantly associated with SLE, MS, and SSc, but not with JIA [odds ratio (OR)=1.06, 95% confidence interval (CI)=0.90-1.24, P=0.48] or RA (OR=1.03, 95%CI=0.95-1.11, P=0.44). A significant association was observed between rs2280714 and SLE, MS, and SSc, but not RA (OR=1.01, 95%CI=0.94-1.09, P=0.80). Rs10954213 was associated with the pathogenesis of SLE, RA, MS, and SSc. rs2070197 and the exon 6 insertion were significantly associated with SLE. Haplotypes containing rs2004640T and rs2280714T were significantly associated with an increased risk of SLE, but not with RA. This meta-analysis certified that IRF5 polymorphisms confer susceptibility to SLE, MS, and SSc. To further confirm the correlations between polymorphisms of IRF5 and autoimmune disease susceptibility, studies involving a larger number of patients worldwide are necessary.

Mussel-inspired protein-mediated surface functionalization of electrospun nanofibers for pH-responsive drug delivery

pH-responsive drug delivery systems could mediate drug releasing rate by changing the pH values at specific times as per the pathophysiological need of the disease. This paper demonstrates that a mussel-inspired protein polydopamine coating can tune the loading and releasing rate of charged molecules from electrospun poly(ε-caprolactone) (PCL) nanofibers in solutions with different pH values. In vitro release profiles show that the positive charged molecules release significantly faster in acidic than those in neutral and basic environments within the same incubation time. The results of fluorescein diacetate staining and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays show the viability of cancer cells after treatment with doxorubicin-released media at different pH values qualitatively and quantitatively, indicating that the media containing doxorubicin that were released in solutions at low pH values could kill a significantly higher number of cells than those released in solutions at high pH values. Together, the pH-responsive drug delivery systems based on polydopamine-coated PCL nanofibers could have potential application in the oral delivery of anticancer drugs for treating gastric cancer and in vaginal delivery of anti-viral drugs or anti-inflammatory drugs, which could raise their efficacy, deliver them to the specific target and minimize their toxic side effects.

A study comparing three different laser-assisted hatching techniques

PURPOSE OF INVESTIGATION

Laser-assisted hatching (LAH) is recognized as a useful technology to improve clinical pregnancy rates and implantation rates. This study reports the differences between a new LAH method and two conventional LAH techniques.

MATERIALS AND METHODS

The authors studied 151 patients with repeated implantation failure, who were divided into three groups.

RESULTS

In group 1, the zona pellucida (ZP) was opened using LAH (n = 52). In group 2, laser-assisted thinning was performed to dissolve the outer layer of the ZP (n = 49). In group 3, laser-assisted thinning was performed to dissolve the inner layer of the ZP (n = 50). The clinical pregnancy rates and implantation rates among the groups were compared. The results demonstrate that there are significant differences in the clinical pregnancy rates and implantation rates between group 3 and the other two groups.

CONCLUSION

Performing laser-assisted thinning to dissolve the inner layer of the ZP markedly increases the pregnancy rates and implantation rates of patients with repeated implantation failure.

Open reduction and internal fixation versus external fixation for unstable distal radial fractures: a meta-analysis

PURPOSE

To compare the clinical outcomes of open reduction and internal fixation (ORIF) versus the ones of closed reduction and external fixation (EF) in the treatment of distal radial fractures.

METHODS

We performed a meta-analysis of randomized controlled trials that compared the clinical results of ORIF to EF in the treatment of distal radial fractures. A systemic retrieve from PubMed, EMBASE, OVID and Cochrane Collaboration CENTRAL database resulted in 11 studies with 824 patients. We thus performed data synthesis using RevMan (version 5.1).

RESULTS

Superior statistical differences were observed for DASH scores (at 3, 6 and 12 months follow-up) grip strength (at 3 months follow-up), volar tilt (at 12 months follow-up), flexion and supination (at 3 months follow-up), and extension (at 3 and 6 months follow-up) in ORIF patients group, compared with those in EF group. We also found a significantly higher risk of infection associated with EF. There was no significant difference in the incidence of malunion and median nerve dysfunction.

CONCLUSION

Regarding surgical fixation of unstable distal radius fractures, ORIF yields significantly better subjective outcome (DASH scores) the first year after operation, restoration of anatomic volar tilt, and forearm flexion and extension at the end of the follow-up period. However, EF results in higher incidence of infection compared to ORIF. ORIF is equal to EF for either grip strength, or range of motion of the injured wrist, or incidence of malunion or median nerve dysfunction at the end of the follow-up period.

LEVEL OF EVIDENCE

Level II. Therapeutic study.

Inhibition of activin receptor-like kinase 5 induces matrix metallopeptidase 9 expression and aggravates lipopolysaccharide-induced pulmonary injury in mice

BACKGROUND

TGF-β (Transforming Growth Factor-β) mediates its biological effects through members of activin receptor-like kinase (ALK) family and TGF-β/Smad3 signaling link inflammation to pulmonary fibrosis.

AIM

The aim of this study was to evaluate the role of SB431542 as a specific inhibitor of Activin receptor-Like Kinase 5 (ALK5) in pneumonic injury.

MATERIALS AND METHODS

Anesthetized and endo-tracheally intubated C57BL/6 mice were randomized to three groups: the control group with intra-tracheal instillation of 1.5 mg/kg normal saline (NS); LPS stimulation group with intra-tracheal instillation of 3 mg/kg LPS (lipopolysaccharide); and LPS+SB431542 group with intra-peritoneal (i.p.) injection of 4.2 mg/kg SB431542 1 h before intra-tracheal instillation of 3 mg/kg LPS. The lung tissue was obtained 6 h after injury, and the degree of pulmonary injury was evaluated by pathologic scoring. The lung wet/dry weight ratio was measured. TNF-α, IL-1β, and MMP-9 (matrix metallopeptidase-9) mRNA expression levels were assayed by real time PCR (polymerase chain reaction). The content of MMP-9 total protein was measured by Western blotting. The content of active MMP-9 was detected by gelatin zymography. Location of MMP-9 in mouse lung tissue was monitored by immunohistochemistry.

RESULTS

The results showed that (1) pathologic changes including interstitial pulmonary edema, neutrophil infiltration, alveolar edema and hemorrhage were observed 6 h after LPS instillation. The lung wet/dry weight rate and pathologic scores confirmed that SB431542 administration aggravated LPS injury to the mouse lung; (2) the amount of TNF-α and IL-1β mRNA expression in LPS groups was significantly higher than that in the control group, and the highest in LPS+SB431542 group; (3) the amount of MMP-9 mRNA and MMP-9 protein expression and active MMP-9 in the lung tissue of LPS groups was significantly higher than that in the control group 6 h after injury, and the highest in LPS+SB431542 group; and (4) MMP-9 expression was mainly observed in the airway epithelial cells, vascular smooth muscle cells and cytoplasm of inflammatory cells as shown by immunohistochemistry, and brownish yellow uniformed stained areas were also seen in the exudate from part of the alveoli.

CONCLUSIONS

These results indicate that blocking the activity of TGF-β/Smad pathway by specific inhibitor SB431542 of ALK5 promoted the releaser of large amounts of TNF-α, IL-1β and other pro-inflammatory cytokines from the lung tissue of mice sustaining acute lung injury (ALI). At the same time, the amount and activity of MMP-9 expression in the lung were increased, and MMP-9 expression was mainly located in the airway epithelial cells, vascular smooth muscle cells and inflammatory cells, causing increased permeability of the pulmonary blood vessels, degradation of the extracellular matrix and destruction of the normal lung tissue structures, which directly or indirectly promotes the progression of pulmonary inflammatory responses and aggravates ALI.

Gene expression profiling of dedifferentiated human articular chondrocytes in monolayer culture

OBJECTIVE

When primary chondrocytes are cultured in monolayer, they undergo dedifferentiation during which they lose their phenotype and their capacity to form cartilage. Dedifferentiation is an obstacle for cell therapy for cartilage degeneration. In this study, we aimed to systemically evaluate the changes in gene expression during dedifferentiation of human articular chondrocytes to identify underlying mechanisms.

METHODS

RNA was isolated from monolayer-cultured primary human articular chondrocytes at serial passages. Gene expression was analyzed by microarray. Based on the microarray analysis, relevant genes and pathways were identified. Their functions in chondrocyte dedifferentiation were further investigated.

RESULTS

In vitro expanded human chondrocytes showed progressive changes in gene expression. Strikingly, an overall decrease in total gene expression was detected, which was both gradual and cumulative. DNA methylation was in part responsible for the expression downregulation of a number of genes. Genes involved in many pathways such as the extracellular-signal-regulated kinase (ERK) and Bone morphogenetic protein (BMP) pathways exhibited significant changes in expression. Inhibition of ERK pathway did not show dramatic effects in counteracting dedifferentiation process. BMP-2 was able to decelerate the dedifferentiation and reinforce the maintenance of chondrocyte phenotype in monolayer culture.

CONCLUSION

Our study not only improves our knowledge of the intricate signaling network regulating maintenance of chondrocyte phenotype, but also contributes to improved chondrocyte expansion and chondrogenic performance for cell therapy.

Effect of clopidogrel with or without omeprazole in patients with carotid artery stenting

BACKGROUND

Recent concerns have been raised about the potential for proton pump inhibitors (PPIs) to blunt the efficacy of clopidogrel. We observed the effect of clopidogrel plus aspirin with or without omeprazole in patients with carotid stenoses after they received placement of carotid stents.

METHODS

Sixty-four consecutive patients treated with percutaneous carotid artery stenting (CAS) comprised the sample. All enrolled patients underwent the C13 urea breath test (C13 UBT) before CAS. Patients with Helicobacter pylori infection and a history of peptic ulcer were assigned dual antiplatelet combination with omeprazole. Others received dual antiplatelet without omeprazole. Transcranial Doppler and ultrasonography were performed to assess the middle cerebral artery and carotid artery in follow-up at three months and six months.

RESULTS

Eight patients had gastrointestinal bleeding; the event rate was 22.6% without omeprazole and 3.8% with omeprazole. The rate of gastrointestinal bleeding was reduced with omeprazole as compared without omeprazole (p = 0.026, p < 0.05). The two groups did not differ significantly in the rate of in-stent restenosis and thrombus through transcranial Doppler and ultrasonography.

CONCLUSION

Among patients receiving dual antiplatelet therapy, prophylactic use of omeprazole reduced the rate of upper gastrointestinal bleeding. There was no apparent interaction between clopidogrel and omeprazole in patients with carotid artery stenting.

Pennogenin tetraglycoside induces rat myometrial contraction and MLC20 phosphorylation via PLC-IP(3) and RhoA/Rho kinase signaling pathways

BACKGROUND

Total steroidal saponins extracted from the rhizome of Paris polyphylla Sm. var. yunnanensis (TSSPs) have been widely used in China for the treatment of abnormal uterine bleeding. We previously studied the main active constituents of TSSPs and their structure-activity relationships with respect to rat myometrial contractions. Tg (pennogenin tetraglycoside) was identified as one of the active ingredients in TSSPs able to induce rat myometrial contractions. However, the mechanisms underlying the pharmacological actions on uterine activity have not been described clearly.

METHODS

Here Tg was screened for effects on contractile activity in isolated uterine strips from estrogen-primed rats and on MLC20 phosphorylation and related signaling pathways in cultured rat myometrial cells as determined by Western blot. Intracellular calcium ([Ca(2+)](i)) was monitored under a confocal microscope using Fluo-4 AM-loaded myometrial cells.

RESULTS

Tg dose-dependently stimulated rat myometrial contractions as well as MLC20 phosphorylation in vitro, which could be completely suppressed by an inhibitor of myosin light chain kinase (MLCK). Use of Ca(2+) channel blockers and kinase inhibitors demonstrated that Tg-induced myometrial contractions are mediated by activation of the phospholipase C (PLC)-inositol triphosphate (IP3) signaling pathway, resulting in increased MLC20 phosphorylation. Furthermore, Y27632, a specific inhibitor of Rho kinase (ROK), notably suppressed Tg-stimulated myometrial contractions and decreased MLC20 phosphorylation.

CONCLUSIONS

These data provide evidence that rat myometrial contractility induced by Tg results from enhanced MLC20 phosphorylation, while both PLC-IP3 and RhoA/ROK signaling pathways mediate the process. These mechanisms may be responsible for the therapeutic effects of TSSPs on abnormal uterine bleeding.