Fibronectin Enhances Cartilage Repair by Activating Progenitor Cells Through Integrin α5β1 Receptor

This study aimed to determine the effect of fibronectin (FN) on cartilage regeneration through the activation of chondrogenic progenitor cells (CPCs). Cells were isolated from the knee cartilage of mice and cultured in the presence of various concentrations of FN. Proliferation, migration, and chondrogenic differentiation assays were performed in vitro. In some experiments, CPCs were preincubated with anti-integrin α5β1 antibody for 60 min before FN treatment to block the integrin α5β1 receptor. Soluble FN was mixed with Pluronic F-127 and injected into the joint cavity in an early-stage osteoarthritis model. Cartilage repair was evaluated histologically, biochemically, and biomechanically. In vitro, we observed that the isolated CPCs, which exhibited stem cell-relevant markers, proliferated most at a concentration of 20 μg/mL FN (p < 0.05). In addition, FN enhanced the proliferation, migration, and chondrogenic differentiation capacity of CPCs, and the enhancement was significantly decreased by blockade of the integrin α5β1 receptor (p < 0.05). In vivo, FN also significantly promoted cartilage repair along with increased CPC activation and integrin α5β1 expression (p < 0.05). These findings suggest that FN enhances CPC proliferation, migration, and chondrogenic differentiation through the integrin α5β1-dependent signaling pathway. Based on these results, a novel and promising therapy focused on targeted activation of CPCs by FN could be developed for the treatment of cartilage injuries in a clinical setting.

The impact of neurally adjusted ventilatory assist mode on respiratory severity score and energy expenditure in infants: a randomized crossover trial

OBJECTIVE

Examine respiratory severity scores (RSS) (mean airway pressure × fraction of inspired oxygen) and resting energy expenditure (REE) on neurally adjusted ventilatory assist (NAVA) compared with synchronized intermittent mandatory ventilation with pressure controlled and supported breath (SIMV (PC)PS).

STUDY DESIGN

A randomized, crossover trial in a level IV neonatal intensive care unit. Twenty-four patients were ventilated with NAVA or SIMV (PC) PS for 12 h and then crossed over to the alternative mode for 12 h. The primary outcome (RSS) and additional secondary respiratory outcomes were analyzed.

RESULTS

RSS and measured REE were not different between modes. On NAVA, peak inspiratory pressures were lower (17.8 vs 19.9 cmH₂O (P<0.05)) without higher oxygen requirements. Respiratory rates were higher on NAVA (52 vs 39 (P<0.05)), estimated work of breathing (WOB) (0.01 vs 0.04 J l^-1 (P<0.05)) was improved.

CONCLUSION

NAVA mode can be safe without increase in RSS or REE. Although respiratory rates were higher, this was offset by lower peak inspiratory pressures and WOB during NAVA.

CDKN2B deletion is essential for pancreatic cancer development instead of unmeaningful co-deletion due to juxtaposition to CDKN2A

Pancreatic cancer is among the deadliest malignancies; however, the genetic events that lead to pancreatic carcinogenesis in adults remain unclear. In vivo models in which these genetic alterations occur in adult animals may more accurately reflect the features of human cancer. In this study, we demonstrate that inactivation of Cdkn2b (p15ink4b) is necessary for induction of pancreatic cancer by oncogenic KRAS^G12D expression and inactivation of Tp53 and Cdkn2a in adult mouse pancreatic ductal cells (P60 or older). KRAS^G12D overexpression in these cells activated transforming growth factor-β signaling and expression of CDKN2B, which, along with CDKN2A, led to cellular senescence and protected cells from KRAS-mediated transformation via inhibition of retinoblastoma phosphorylation. These results show a critical role of CDKN2B inactivation in pancreatic carcinogenesis, and provide a useful adult animal model by genetic engineering via lentiviral delivery.

Associations between benign cutaneous nevi and risk of Type 2 diabetes mellitus in men and women: results from two prospective cohort studies

AIM

To examine the association of cutaneous nevi with Type 2 diabetes risk.

METHODS

We prospectivly examined the associations between nevus count and risk of Type 2 diabetes among 26 240 men (1988-2010) from the Health Professionals Follow-up Study and 67 050 women (1986-2010) from the Nurses' Health Study. Information on the numbers of cutaneous nevi on arms at baseline and incident cases of Type 2 diabetes was collected using validated questionnaires.

RESULTS

During 1 879 287 person-years of follow-up, we documented 9040 incident cases of Type 2 diabetes. After adjustment for age, BMI and other diabetes risk factors, greater number of nevi was associated with higher risk of Type 2 diabetes. Multivariable-adjusted hazard ratios for <1, 1-5, 6-14 and ≥15 nevi were 1.00 (reference), 1.02 (95% CI 0.93, 1.13), 1.08 (95% CI 0.88, 1.34) and 1.57 (95% CI 1.15, 2.15), respectively, for men (P for linear trend = 0.01), and 1.00 (reference), 1.07 (95% CI 1.02, 1.13), 0.98 (95% CI 0.87, 1.10), and 1.25 (1.01, 1.54), respectively, for women (P for linear trend = 0.05). This positive association remained consistent across subgroups stratified by age, BMI, multivitamin use, smoking status, alcohol, physical activity, history of hypercholesterolaemia, family history of diabetes, history of hypertension and menopausal status (in women).

CONCLUSIONS

Cutaneous nevus count may represent a novel marker for development of Type 2 diabetes, suggesting a possible unique melanocytic nevus-related mechanism in the pathogenesis of Type 2 diabetes. Further studies are warranted to confirm the findings and to investigate the underlying mechanisms.

Factors leading to rehospitalization for tracheostomized and ventilator-dependent infants through 2 years of age

OBJECTIVE

To identify factors leading to readmission for tracheostomized, ventilator-dependent infants <2 years of age.

STUDY DESIGN

Retrospective cohort study of 117 tracheostomized, ventilator-dependent infants followed through 2 years of age.

RESULTS

Home ventilator use (at hospital discharge, 6 and 12 months of age), inhaled steroid use (at 12 and 24 months of age), oxygen dependence (at 6 and 12 months of age) and tracheostomy (at discharge, 6 and 12 months of age) were increased risks for rehospitalization. Equipment malfunction throughout the first 2 years also contributed to readmissions. Viral infection, with rhinovirus/enterovirus the most commonly identified pathogen, was the most common etiology for rehospitalization. Diuretic use and initial comorbid diagnoses were not associated with increased risk of rehospitalization.

CONCLUSION

The risk for rehospitalization for infants requiring tracheostomy and ventilator support was affected by prolonged oxygen use, prolonged ventilator dependence, inhaled steroid use and equipment malfunction, and was equally distributed throughout the first 2 years of life.

A comparison of 7-day versus 10-day course of low-dose dexamethasone for chronically ventilated preterm infants

OBJECTIVE

The objective of the study was to compare the effect of two different dexamethasone regimens on respiratory outcomes of ventilator-dependent preterm infants.

STUDY DESIGN

Retrospective study of ventilated preterm infants <29 weeks gestational age treated with either 7-day or 10-day dexamethasone course. Primary outcome was days to successful extubation. Other outcomes included rate of successful extubation and need for repeat steroid therapy.

RESULTS

Fifty-nine infants were identified; 32 (54%) received 7 days of dexamethasone and 27 (46%) received 10 days of dexamethasone. Both groups had comparable baseline demographics and clinical characteristics. Mean time to successful extubation was similar between the two groups (5.1±2.7 days in 7-day group and 6.0±3.7 days in 10-day group, P=0.42). Successful extubation by end of treatment (56% versus 67%, P=0.44) and need for repeat steroid therapy (47% versus 33%, P=0.43) were also similar.

CONCLUSION

7-day and 10-day course of dexamethasone have comparable efficacy in facilitating extubation of ventilator-dependent preterm infants.

FBXL4 defects are common in patients with congenital lactic acidemia and encephalomyopathic mitochondrial DNA depletion syndrome

Mutations in FBXL4 have recently been recognized to cause a mitochondrial disorder, with clinical features including early onset lactic acidosis, hypotonia, and developmental delay. FBXL4 sequence analysis was performed in 808 subjects suspected to have a mitochondrial disorder. In addition, 28 samples from patients with early onset of lactic acidosis, but without identifiable mutations in 192 genes known to cause mitochondrial diseases, were examined for FBXL4 mutations. Definitive diagnosis was made in 10 new subjects with a total of 7 novel deleterious variants; 5 null and 2 missense substitutions. All patients exhibited congenital lactic acidemia, most of them with severe encephalopathic presentation, and global developmental delay. Overall, FBXL4 defects account for at least 0.7% (6 out of 808) of subjects suspected to have a mitochondrial disorder, and as high as 14.3% (4 out of 28) in young children with congenital lactic acidosis and clinical features of mitochondrial disease. Including FBLX4 in the mitochondrial diseases panel should be particularly important for patients with congenital lactic acidosis.

[Rheumatoid arthritis involving tibialis posterior tendon: study on the early diagnostic value of power Doppler ultrasonography and comparison with surgery]

Objective: To explore the value of power Doppler ultrasonography (PDUS) in the early diagnosis of tibialis posterior tendon injury induced by rheumatoid arthritis (RA). Method: From January 2014 to December 2015, a total of 48 cases (60 feet) of RA tendinopathy group were selected as the research subjects from Guanghua Hospital; 12 cases(20 feet) of non-RA tendinopathy group and 10 cases (20 feet) of healthy volunteers were selected as control group.The blood flow signals of pannus were observed by PDUS to determine whether the tendon was injured or the degree of the injury. The following indexes were compared and analyzed by Chi-square testing: (1)positive rate of blood flow signal; (2)grade of blood flow signal; (3)spatial distribution of blood flow signal: diffusibility or local. Results: Of 70 cases(100 feet) in the study, the positive blood flow signals were only in the RA(88.3%) and non-RA group(40.0%) .Grade Ⅲ in RA was 20.0%, while this was not observed in non-RA . Grade Ⅱ in RA and non-RA was 36.7% and 10.0% , respectively. There were significant differences in the positive rate and grades between RA and non-RA group (P<0.01). The spatial distribution of blood flow signal in RA was significantly different from that in non-RA. In RA, they can be detected in the whole tendon.However, they were mainly distributed around the scaphoid in non-RA. In this study, three patients with grade Ⅲwere treated with surgery. The intraoperative findings were consistent with the preoperative ultrasound results. Conclusions: PDUS can be used to detect the neovascular formation of tendon synovitis. It can detect the early tendon injury before the appearance of foot deformity induced by RA, which can guide clinical early intervention treatment and prevent the occurrence of deformity and other serious consequences.

Selecting optimal surgical procedures for intraductal papillary mucinous neoplasm (IPMN): An analysis based on the Surveillance, Epidemiology, and End Result registry database

INTRODUCTION

Intraductal papillary mucinous neoplasm (IPMN) is a field defect disease of pancreas that has malignant potential. Many studies have recommended surgery as the preferred treatment. We investigated whether a total pancreatectomy (TP) can improve patient prognosis compared to a pancreatoduodenectomy (PD) and the indications for each approach.

PATIENTS AND METHODS

We obtained data of 548 malignant IPMN patients who underwent either a TP or a PD from SEER database. The survival rates were analyzed using the Kaplan-Meier method and a Cox regression model. Cases were subdivided to investigate the advantages of each procedure.

RESULTS

The surgical procedures (PD and TP) did not significantly affect either cancer-specific survival (CSS) times or overall survival (OS) times in both Kaplan-Meier analysis and Cox regression (Kaplan-Meier: PCSS = 0.919, POS = 0.996; Cox: PCSS = 0.735, POS = 0.820). In the subgroup analyses, patients in stage T4 and AJCC stage III in the TP group had a longer survival time than did those in the PD group (33 months vs 14 months), but not significant (T4: PCSS = 0.124, AJCC III: PCSS = 0.102). In addition, PD had the trend to be better for poorly differentiated patients (Pos = 0.055) and older patients.

CONCLUSION

TP did not offer any significant OS and CSS benefits as compared to PD. However, for patients in stage T4 and AJCC stage III, TP may extend survival time in some degree. In older or histologically poorly differentiated patients, PD may be preferable to TP. The results are rational, but still warrant further verification due to limited sample volumes of specific subgroups.

Synthesis and Assay of SIRT1-Activating Compounds

The NAD(+)-dependent deacetylase SIRT1 plays key roles in numerous cellular processes including DNA repair, gene transcription, cell differentiation, and metabolism. Overexpression of SIRT1 protects against a number of age-related diseases including diabetes, cancer, and Alzheimer's disease. Moreover, overexpression of SIRT1 in the murine brain extends lifespan. A number of small-molecule sirtuin-activating compounds (STACs) that increase SIRT1 activity in vitro and in cells have been developed. While the mechanism for how these compounds act on SIRT1 was once controversial, it is becoming increasingly clear that they directly interact with SIRT1 and enhance its activity through an allosteric mechanism. Here, we present detailed chemical syntheses for four STACs, each from a distinct structural class. Also, we provide a general protocol for purifying active SIRT1 enzyme and outline two complementary enzymatic assays for characterizing the effects of STACs and similar compounds on SIRT1 activity.

Spotlight on ultrasonic fracture behaviour of nanowires: their size-dependent effect and prospect for controllable functional modification

A ‘bubble-jet impacted’ model reveals the specific fragmentation evolution behaviors of nanowires.

Serum lipid profile in gynecologic tumors: a retrospective clinical study of 1,550 patients

BACKGROUND

The study was performed to characterize and compare the serum lipid profile in gynecologic cancers and benign diseases.

MATERIALS AND METHODS

A total of 1,550 age-matched females were included in this study: 760 patients with gynecologic cancers and 790 patients with benign diseases. Serum levels of triglycerides (TG), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c), total cholesterol (TC), and lipoprotein (a) were measured.

RESULTS

Compared to gynecologic benign disease group, gynecologic cancer group was associated with higher level of TG (p = 0.0002), as well as lower level of HDL-c (p < 0.0001), LDL-c (p = 0.004) and TC (p = 0.003). Compared to benign ovarian tumor group, ovarian cancer group had significantly lower levels of HDL-c (p < 0.0001), LDL-c (p = 0.0009), and TC (p < 0.0001), as well as a trend of higher level of lipoprotein (a) (p = 0.10). Compared to endometriosis group, endometrial cancer group showed higher levels of TG (p < 0.0001) and lower levels of HDL-c (p = 0.002). There was no significant difference in any lipid parameters between cervical cancer group and uterine leiomyomas group.

CONCLUSION

In conclusion, compared with benign diseases, gynecologic cancers are associated with a disordered lipid profile characterized by higher TG and lipoprotein (a) levels, and lower HDL-c, LDL-c, and TC levels. The association is most conspicuous in ovarian cancers. Endometrial cancer is accompanied by alterations only in TG and HDL-c levels, while cervical cancer does not appear to be associated with disordered lipid profile.

Upregulation of mitogen-inducible gene 6 triggers antitumor effect and attenuates progesterone resistance in endometrial carcinoma cells

Researches regarding mitogen-inducible gene 6 (Mig-6) have confirmed its role as a tumor suppressor and progesterone resistance factor in endometrium. In this study, after confirming the downregulation of Mig-6 protein in endometrial carcinoma (EC) tissues, the expression of Mig-6 was upregulated in Ishikawa cells by pCMV6-Mig-6 plasmid. We observed the increased apoptosis, decreased proliferation and invasion potential of Ishikawa cells after upregulation of Mig-6. The proapoptosis ability of P4 significantly enhanced by 39.36%, the antiproliferation ability increased by 37.90% and the anti-invasion ability increased by 48.89%, suggesting the antiprogesterone resistance potential of Mig-6 in endometrium. In addition, the results suggested that Mig-6 may induce Ishikawa cell apoptosis through the mitochondrial pathway, inhibit cell proliferation via the extracellular signal-regulated kinase pathway and the anti-invasion potential may associate with matrix metalloproteinase (MMP)-2 and MMP-9 downexpression. Therefore, upregulation of Mig-6 may add a new strategy to suppress endometrial tumorigenesis and attenuate the progesterone resistance during P4 treatment.

Satisfactory Usage of a Lacerated Kidney for Transplantation: A Case Report

BACKGROUND

Organ shortage is the main bottleneck in the wait-list for transplantation; therefore, expanding the donor pool is an effective way to solve the problem. Usage of the traumatized liver for transplantation has been applied, but the use of lacerated kidneys for transplant donor is rarely reported.

METHODS

We reported a successful case of donation after brain death. The donor committed suicide by jumping from a campus dormitory building. One of the donated kidneys was severely injured. Two lacerations measured 4 × 1 × 1 cm in the medial margin of the graft and 1 × 1 × 1.5 cm in the front side of the graft, respectively. After repair with continuous absorbable suture, the lacerated kidney was transplanted to a recipient.

RESULTS

The post-transplantation renal function gradually recovered. Furthermore, serious complications, such as large amounts of hemorrhage, delayed graft function, or urinary fistula did not occur. The serum creatinine dropped from 1232 μmol/L to 120 μmol/L and maintained normal range after surgery. In addition, the daily urine output was normal. At day 12 after operation, the patient was discharged.

CONCLUSIONS

Our case shows that the use of a lacerated donor kidney appears to be feasible, but long-term effects need further observation.

Comparison of plain radiography and CT in postoperative evaluation of ankle fractures

AIM

To compare postoperative plain radiographs with computed tomography (CT) post-processing images in evaluating the quality of anatomical reduction and internal fixation of ankle fractures.

MATERIALS AND METHODS

A total of 168 patients who sustained closed ankle fracture and were treated with open reduction and internal fixation in East Hospital were reviewed. Postoperative plain radiographs and CT post-processing images were evaluated. The observation was performed under volume-rendering mode and multiplanar reconstruction mode. The assessment was performed by two independent orthopaedic surgeons. The inter- and intra-observer variations were analysed by kappa statistics. The differences between plain radiographs and CT post-processing images were compared using χ(2) test (McNemar's test).

RESULTS

Inter- and intra-observer agreement was almost perfect (0.813-1.000) using CT post-processing images, which was higher than that using plain radiographs (0.323-0.848). More non-anatomical reduction could be recognised in the supination-external rotation (SER), supination-adduction (SAD), pronation-external rotation (PER), and overall groups (p<0.05) and more poor internal fixation could be recognised in the SER, SAD, and overall groups (p<0.05) using CT post-processing images than using radiographs.

CONCLUSION

More residual articular step, fracture fragment displacement, and poor internal fixation could be detected by CT post-processing images than plain radiographs.

MLN4924 induces Noxa upregulation in acute myelogenous leukemia and synergizes with Bcl-2 inhibitors

MLN4924 (pevonedistat), an inhibitor of the Nedd8 activating enzyme (NAE), has exhibited promising clinical activity in acute myelogenous leukemia (AML). Here we demonstrate that MLN4924 induces apoptosis in AML cell lines and clinical samples via a mechanism distinct from those observed in other malignancies. Inactivation of E3 cullin ring ligases (CRLs) through NAE inhibition causes accumulation of the CRL substrate c-Myc, which transactivates the PMAIP1 gene encoding Noxa, leading to increased Noxa protein, Bax and Bak activation, and subsequent apoptotic changes. Importantly, c-Myc knockdown diminishes Noxa induction; and Noxa siRNA diminishes MLN4924-induced killing. Because Noxa also neutralizes Mcl-1, an anti-apoptotic Bcl-2 paralog often upregulated in resistant AML, further experiments have examined the effect of combining MLN4924 with BH3 mimetics that target other anti-apoptotic proteins. In combination with ABT-199 or ABT-263 (navitoclax), MLN4924 exerts a synergistic cytotoxic effect. Collectively, these results provide new insight into MLN4924-induced engagement of the apoptotic machinery that could help guide further exploration of MLN4924 for AML.

Health-related quality of life and related factors among elderly people in Jinzhou, China: a cross-sectional study

OBJECTIVES

With rapid reductions in fertility and mortality, China has to face the dramatic ageing of its population. Although an ageing population is associated with greater life expectancy, and reflects a huge improvement in people's living standards and health care services, it also means that more elderly people suffer from non-communicable diseases (NCDs). The prolonged course of illness and disability associated with chronic diseases may significantly reduce health-related quality of life (HRQoL) among elderly people. The aims of this study were to evaluate HRQoL of elderly people living in Jinzhou, and to identify the predictors of HRQoL.

STUDY DESIGN

Cross-sectional study with stratified sampling.

METHODS

A cross-sectional survey was conducted among 1015 elderly people (≥60 years) living in the three administrative regions (Linghe, Guta and Taihe) of Jinzhou. A demographic questionnaire and Short Form-36 were employed to collect demographic variables and evaluate HRQoL, respectively. Multiple stepwise linear regression analysis was performed to estimate factors related to HRQoL of the subjects.

RESULTS

Lowest HRQoL scores were obtained in the following dimensions: general health (65.44), role-emotional (69.74) and role-physical (70.20). Multiple stepwise regression showed that factors associated with HRQoL of elderly people were medical health checks, age, socio-economic status, NCDs, and various unhealthy lifestyle behaviours such as smoking, excessive drinking and insufficient exercise.

CONCLUSIONS

This study described overall HRQoL of elderly people in Jinzhou, and found that medical health checks, age, socio-economic status, NCDs, smoking, excessive drinking and insufficient exercise affected HRQoL. These findings will provide a basis for recommendations regarding health management of elderly people, and will also help local government to devise appropriate health intervention strategies for promoting the health status of elderly people in this region.