Glipizide blocks renal interstitial fibrosis by inhibiting AKT signaling pathway

OBJECTIVE

Diabetes affects the renal function at a certain stage. Oral medication glipizide plays a hypoglycemic effect mainly through releasing insulin, while more insulin is derived from islet β cells. It is still controversy whether antidiabetics. This study mainly intends to investigate the role of glipizide in inhibiting renal interstitial fibrosis.

MATERIALS AND METHODS

A total of 93 SD rats were purchased from Guangdong animal monitoring and established unilateral ureteral obstruction (UUO) model to simulate renal interstitial fibrosis. Forty rats in the experimental group received glipizide intraperitoneal injection for a week at 30 days after modeling, while another 40 rats in the control group received a normal saline injection. The last 10 rats were treated as blank group. Hematoxylin and eosin (HE) staining was applied to test renal interstitial fibrosis. Immunohistochemistry was used to detect fibronectin expression in glomerular and renal tubules. AKT signaling pathway related factors expression was measured by Western blot to determine AKT signal activation.

RESULTS

HE staining showed that the entire kidney cytoplasm red dye becomes shallow, renal medulla gradually disappears, renal tubular epithelial cells enlarge, vacuoles degeneration, renal tubule and collecting tube expansion, inflammatory cells infiltration after UUO modeling. Glipizide treatment decreased dilated renal tubule number, improved glomerulus integrity, and reduced inflammatory infiltration. Fibronectin level in the experimental group was significantly lower than that in control (p<0.05). Western blot revealed that p-AKT expression downregulated after glipizide treatment.

CONCLUSIONS

Glipizide blocks renal interstitial fibrosis by inhibiting AKT signaling pathway.

The incidence and economic burden of injuries in Jiangxi, China

OBJECTIVES

This study estimated the incidence, direct medical and non-medical costs, and productivity losses due to morbidity and mortality across multiple strata for injuries that occurred in Jiangxi, China.

STUDY DESIGN

Cross-sectional study.

METHODS

Data came from the Jiangxi injury survey, a provincially-representative, population-based sample of 100,010 households. The major economic costs of injuries were divided into direct costs and indirect costs. Direct costs encompass medical costs and direct non-medical costs. Indirect costs refer to the productivity losses due to injury-related morbidity and mortality.

RESULTS

In 2005, about one of 18 residents in Jiangxi, China, experienced an injury. Overall, fall, animal bite, and road traffic crash (RTC) injuries accounted for more than 66% of all injuries, while fall, RTC, drowning, and self-harm injuries accounted for 80% of fatal injuries. Average cost per case for a fatal injury was 163,389 RMB ($20,171) for lost productivity and 2800 RMB ($346) in direct medical & non-medical costs. A non-fatal injury resulting in hospitalisation or permanent disability on average caused 5221 RMB ($643) in direct costs and 18,437 RMB ($2276) in lost productivity and, an additional loss of three school days. A non-hospitalised non-fatal injury on average caused 303 ($37) RMB in direct costs and 491 RMB ($61) in lost productivity and, an additional loss of 0.5 school days.

CONCLUSIONS

The unequivocal evidence of the substantial health and financial burden of injuries indicates to Chinese policy makers that more research and efforts are needed to find efficacious and cost-effective interventions targeting injury.

Commercially available immunoglobulins contain virus neutralizing antibodies against all major genotypes of polyomavirus BK

Neutralizing antibodies (NAbs) form the basis of immunotherapeutic strategies against many important human viral infections. Accordingly, we studied the prevalence, titer, genotype-specificity, and mechanism of action of anti-polyomavirus BK (BKV) NAbs in commercially available human immune globulin (IG) preparations designed for intravenous (IV) use. Pseudovirions (PsV) of genotypes Ia, Ib2, Ic, II, III, and IV were generated by co-transfecting a reporter plasmid encoding luciferase and expression plasmids containing synthetic codon-modified VP1, VP2, and VP3 capsid protein genes into 293TT cells. NAbs were measured using luminometry. All IG preparations neutralized all BKV genotypes, with mean EC50 titers as high as 254 899 for genotype Ia and 6,666 for genotype IV. Neutralizing titers against genotypes II and III were higher than expected, adding to growing evidence that infections with these genotypes are more common than currently appreciated. Batch to batch variation in different lots of IG was within the limits of experimental error. Antibody mediated virus neutralizing was dose dependent, modestly enhanced by complement, genotype-specific, and achieved without effect on viral aggregation, capsid morphology, elution, or host cell release. IG contains potent NAbs capable of neutralizing all major BKV genotypes. Clinical trials based on sound pharmacokinetic principles are needed to explore prophylactic and therapeutic applications of these anti-viral effects, until effective small molecule inhibitors of BKV replication can be developed.

Component-Resolved Diagnostic Study of Dermatophagoides Pteronyssinus Major Allergen Molecules in a Southern Chinese Cohort

BACKGROUND AND OBJECTIVE

Little is known about component-resolved diagnosis (CRD) for Dermatophagoides pteronyssinus (Der p) sensitization in the Chinese population. We aimed to evaluate sensitization to Der p components in southern China.

METHODS

Two-hundred immunotherapy-naïve patients with asthma and/or rhinitis positive to specific IgE (sIgE) against Der p extract, along with 20 Der p-negative nonallergic healthy controls, were tested for sIgE against Der p 1, Der p 2, and Der p 10 using ImmunoCAP 100. Seventy-five were further examined with the ImmunoCAP Immuno Solid-phase Allergen Chip (ISAC). Der p 10-positive patients were also tested for sIgE against crude extracts of cockroach, moth, and shrimp.

RESULTS

In total, 183 (91.5%) of the 200 patients were sensitized to Der p 1 and/or Der p 2. The proportion of positive results and the median level of s1gE against Der p 1 were higher in children than in adults. Der p 1 and Der p 2 correlated with Der p in sIgE levels. ImmunoCAP ISAC demonstrated 100% specificity and 84% sensitivity in detecting Der p 1, Der p 2, and Der p 10 compared with ImmunoCAP 100. Sensitization to Der p 10 correlated well with sIgE to shrimp, moths, cockroaches, Pen m 1, Bla g 7, and Ani s 3.

CONCLUSIONS

The detection of Der p 1 and Der p 2 provided a good reflection of atopy to Der p in a Chinese cohort. Sensitization to Der p 10 may result from cross-reactivity with seafood and cockroaches in coastal southern China. ImmunoCAP ISAC may be a useful tool for CRD, with comparable performance to ImmunoCAP 100.

Microbial synthesis of functional homo-, random, and block polyhydroxyalkanoates by β-oxidation deleted Pseudomonas entomophila

Functional polyhydroxyalkanoates (PHAs) allow chemical modifications to widen PHA diversity, promising to increase values of these biodegradable and biocompatible polyesters. Among functional PHAs, unsaturated PHA site chains can be easily grafted to add chemical groups, and to cross-link with other PHA polymer chains. However, it has been very difficult to obtain structurally controllable functional homo-, random, or block PHA. For the first time, a β-oxidation deleted Pseudomonas entomophila was used to successfully synthesize random copolymers of 3-hydroxydodecanoate (3HDD) and 3-hydroxy-9-decenoate (3H9D). Compositions of the random copolymers P(3HDD-co-3H9D) can be adjusted by ratios of dodecanoic acid (DDA) to 9-decenol (9DEO) fed to the culture of P. entomophila. Homopolymer P3H9D was formed when only 9DEO was added to the culture. Diblock copolymers of P3HDD-b-P3H9D were produced by feeding DDA as the first precursor to form a P3HDD block followed by adding 9DEO as the second precursor to form a second P3H9D block. It was demonstrated that random copolymers P(3HDD-co-3H9D) could be crossed-linked under UV-radiation due to the presence of the unsaturated bonds. Thermal and mechanical characterizations of the above homo-, random, and diblock PHA polymers were conducted. It was found that the diblock polymer P3HDD-b-P3H9D increased at least 2-fold on Young's modulus compared with its random copolymers consisting of similar 3HDD/3H9D ratios. This study demonstrates that PHA functionality could be controlled to meet various requirements.

PKM2 and ACVR 1C are prognostic markers for poor prognosis of gallbladder cancer

PURPOSE

To identify biological markers related to the progression and prognosis of GBC.

METHODS

The expressions of pyruvate kinase isoenzyme type M2 (PKM2) and activin A receptor type IC (ACVR 1C) in 46 squamous cell/adenosquamous carcinomas (SC/ASC) and 80 adenocarcinomas (AC) were examined using immunohistochemistry.

RESULTS

Positive PKM2 and negative ACVR 1C expressions were significantly associated with lymph node metastasis, invasion and TNM stage of SC/ASCs and ACs. Univariate Kaplan-Meier analysis showed that either elevated PKM2 or loss of ACVR 1C expression significantly correlated with shorter average survival times in both SC/ASC and AC patients. Multivariate Cox regression analysis showed that positive PKM2 expression and loss of ACVR 1C expression were poor prognosis biomarkers in both SC/ASC and AC patients.

CONCLUSIONS

Our study suggested that PKM2 overexpression is a marker of metastasis, invasion and poor prognosis of GBC. ACVR 1C is a tumor suppressor, and lowered ACVR 1C expression is an important marker for the metastasis, invasion, and prognosis of GBC.

The application of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) scaffolds for tendon repair in the rat model

Tendon injuries and defects present a substantial burden to global healthcare economies. There are no synthetic/biosynthesised implants available which can restore full function or match the mechanical properties of native tendon. Therefore, poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) was investigated for its utility as a scaffold in a rat Achilles tendon repair model. Porous PHBHHx tubes and fibres were prepared with particle leaching and extrusion methods, respectively. Collagen gels reinforced by polymer fibres were inserted into the lumen of scaffold tubes to create the operational scaffold unit. Mechanical testing demonstrated that PHBHHx scaffolds had comparable mechanical properties to rat tendon, with maximal loads of 23.73 ± 1.08 N, compared to 17.35 ± 1.76 N in undamaged rat Achilles tendon. Sprague-Dawley (SD) rats were split into four experimental groups: control, PHBHHx scaffold only, PHBHHx scaffold and collagen, PHBHHx scaffold, collagen and tenocyte compositions for implantation to repair an induced Achilles tendon defect. No secondary immune response to PHBHHx was observed over a 40 days period of implantation. Movement was restored in PHBHHx scaffold-collagen-tenocyte recipient rats at an earlier time point than in other experimental groups, with complete load-bearing and function returning 20 days post-surgery as determined by the Achilles Functional Index. In vitro testing of tendon constructs after 40 days demonstrated reductions in PHBHHx molecular weight and polydispersity index accompanied by an increase in mean chain length indicating degradation of smaller polymer chain subunits. Similarly a reduction in PHBHHx tube ultimate tensile strength and elastic modulus was observed. Histological analysis provided evidence of tissue remodelling and cell alignment. In summary, PHBHHx scaffolds have been successfully applied in an in vivo tendon repair model raising promise for future utility in tissue engineering applications.

What is the correct distance measurement metric when measuring carotid ultrasound intima-media thickness automatically?

AIM

The aims of this study were: 1) to analyze the interobserver carotid intima-media thickness (CIMT) variability using three different measurement metrics on large multi-institutional databases; 2) to evaluate the three kinds of metrics when comparing completely automated CIMT measurement (Auto Edge CIMT) to two manually derived CIMT (manual CIMT).

METHODS

Two expert sonographers manually analyzed 665 carotid B-Mode ultrasound images collected from five institutions and using four different scanners. The two readers traced the lumen-intima (LI) and media-adventitia (MA) interfaces. The manual CIMT was computed from the LI/MA tracings by using three different distance measurement metrics: the Hausdorff, the PolyLine, and the Centerline distance metrics. The LI/MA tracings of a completely automated method we previously developed were then compared to manual CIMT.

RESULTS

The average CIMT values of Readers 1 and 2 were 1.904±0.650 mm and 1.421±0.394 using Hausdorff, 0.808±0.269 mm and 0.790±0.227 mm using Polyline, and 0.762±0.266 mm and 0.782±0.228 mm using Centerline, respectively. The correlation coefficients were 0.14 (0.07-0.22) for Hausdorff, 0.77 (0.74-0.80) for Polyline, and 0.82 (0.79-0.84) for Centerline. The variation coefficients (CV) were equal to 46.4% (Hausdorff), 2.6 % (Polyline), and 14.1% (Centerline). The Auto Edge CIMT values were: 1.655±0.676 mm using Hausdorff, 0.808±0.282 mm using Polyline, and 0.776±0.275 mm using Centerline.

CONCLUSION

Centerline and Polyline yield very close results and are clinically suitable distance measurement techniques for computing the CIMT from LI/MA profiles.

Poster - Thur Eve - 54: A software solution for ongoing DVH quality assurance in radiation therapy

PURPOSE

A program has been developed in MATLAB for use in quality assurance of treatment planning of radiation therapy. It analyzes patient DVH files and compiles dose volume data for review, trending, comparison and analysis.

MATERIAL AND METHODS

Patient DVH files are exported from the Eclipse treatment planning system and saved according to treatment sites and date. Currently analysis is available for 4 treatment sites; Prostate, Prostate Bed, Lung, and Upper GI, with two functions for data report and analysis: patient-specific and organ-specific. The patient-specific function loads one patient DVH file and reports the user-specified dose volume data of organs and targets. These data can be compiled to an external file for a third party analysis. The organ-specific function extracts a requested dose volume of an organ from the DVH files of a patient group and reports the statistics over this population. A graphical user interface is utilized to select clinical sites, function and structures, and input user's requests.

RESULTS

We have implemented this program in planning quality assurance at our center. The program has tracked the dosimetric improvement in GU sites after VMAT was implemented clinically. It has generated dose volume statistics for different groups of patients associated with technique or time range.

CONCLUSION

This program allows reporting and statistical analysis of DVH files. It is an efficient tool for the planning quality control in radiation therapy.

A comparative investigation of methods for longitudinal data with limits of detection through a case study

The statistical analysis of continuous longitudinal data may be complicated since quantitative levels of bioassay cannot always be determined. Values beyond the limits of detection (LOD) in the assays may not be observed and thus censored, rendering complexity to the analysis of such data. This article examines how both left-censoring and right censoring of HIV-1 plasma RNA measurements, collected for the study on AIDS-related Non-Hodgkin’s lymphoma (AR-NHL) in East Africa, affects the quantification of viral load and explores the natural history of viral load measurements over time in AR-NHL patients receiving anticancer chemotherapy. Data analyses using Monte Carlo EM algorithm (MCEM) are compared to analyses where the LOD or LOD/2 (left censoring) value is substituted for the censored observations, and also to other methods such as multiple imputation, and maximum likelihood estimation for censored data (generalized Tobit regression). Simulations are used to explore the sensitivity of the results to changes in the model parameters. In conclusion, the antiretroviral treatment was associated with a significant decrease in viral load after controlling the effects of other covariates. A simulation study with finite sample size shows MCEM is the least biased method and the estimates are least sensitive to the censoring mechanism.

Automated carotid IMT measurement and its validation in low contrast ultrasound database of 885 patient Indian population epidemiological study: results of AtheroEdge™ Software

AIM

The aim of this paper was to demonstrate the usage of an automated computer-based IMT measurement system called - CALEX 3.0 (a class of patented AtheroEdge™ software) on a low contrast and low resolution image database acquired during an epidemiological study from India. The image contrast was very low with pixel density of 12.7 pixels/mm. Further, to demonstrate the accuracy and reproducibility of the AtheroEdge™ software system we compared it with the manual tracings of a vascular surgeon--considered as a gold standard.

METHODS

We automatically measured the IMT value of 885 common carotid arteries in longitudinal B-Mode images. CALEX 3.0 consisted of a stage for the automatic recognition of the carotid artery and an IMT measurement modulus made of a fuzzy K-means classifier. Performance was assessed by measuring the system accuracy and reproducibility against manual tracings by experts.

RESULTS

CALEX 3.0 processed all the 885 images of the dataset (100% success). The average automated obtained IMT measurement by CALEX 3.0 was 0.407±0.083 mm compared with 0.429 ± 0.052 mm for the manual tracings, which led to an IMT bias of 0.022±0.081mm. The IMT measurement accuracy (0.022 mm) was comparable to that obtained on high-resolution images and the reproducibility (0.081 mm) was very low and suitable to clinical application. The Figure-of-Merit defined as the percent agreement between the computer-estimated IMT and manually measured IMT for CALEX 3.0 was 94.7%.

CONCLUSION

CALEX 3.0 had a 100% success in processing low contrast/low-resolution images. CALEX 3.0 is the first technique, which has led to high accuracy and reproducibility on low-resolution images acquired during an epidemiological study. We propose CALEX 3.0 as a generalized framework for IMT measurement on large datasets.

Simpson's paradox - aggregating and partitioning populations in health disparities of lung cancer patients

It is well known that non-small cell lung cancer (NSCLC) is a heterogeneous group of diseases. Previous studies have demonstrated genetic variation among different ethnic groups in the epidermal growth factor receptor (EGFR) in NSCLC. Research by our group and others has recently shown a lower frequency of EGFR mutations in African Americans with NSCLC, as compared to their White counterparts. In this study, we use our original study data of EGFR pathway genetics in African American NSCLC as an example to illustrate that univariate analyses based on aggregation versus partition of data leads to contradictory results, in order to emphasize the importance of controlling statistical confounding. We further investigate analytic approaches in logistic regression for data with separation, as is the case in our example data set, and apply appropriate methods to identify predictors of EGFR mutation. Our simulation shows that with separated or nearly separated data, penalized maximum likelihood (PML) produces estimates with smallest bias and approximately maintains the nominal value with statistical power equal to or better than that from maximum likelihood and exact conditional likelihood methods. Application of the PML method in our example data set shows that race and EGFR-FISH are independently significant predictors of EGFR mutation.

Age-related changes in the default mode network are more advanced in Alzheimer disease

OBJECTIVE

To investigate age-related default mode network (DMN) connectivity in a large cognitively normal elderly cohort and in patients with Alzheimer disease (AD) compared with age-, gender-, and education-matched controls.

METHODS

We analyzed task-free-fMRI data with both independent component analysis and seed-based analysis to identify anterior and posterior DMNs. We investigated age-related changes in connectivity in a sample of 341 cognitively normal subjects. We then compared 28 patients with AD with 56 cognitively normal noncarriers of the APOE ε4 allele matched for age, education, and gender.

RESULTS

The anterior DMN shows age-associated increases and decreases in fontal lobe connectivity, whereas the posterior DMN shows mainly age-associated declines in connectivity throughout. Relative to matched cognitively normal controls, subjects with AD display an accelerated pattern of the age-associated changes described above, except that the declines in frontal lobe connectivity did not reach statistical significance. These changes survive atrophy correction and are correlated with cognitive performance.

CONCLUSIONS

The results of this study indicate that the DMN abnormalities observed in patients with AD represent an accelerated aging pattern of connectivity compared with matched controls.