[Clinical observation on the treatment of intractable otomastoiditis with reconstruction of external auditory canal wall]

Objective:To observe the clinical effect on the treatment of intractable tympanitis with reconstruction of external auditory canal wall.Method:Five cases underwent radical removel of residual lesion and reconsruction of external auditory posterior canal wall using hydroxyapatite ceramic wall with transferred pedicle temporalis fascia covering on it were analyzed. The implement of ossicular chain reconstruction depends on the probing for tympanic cavity intraoperatively. Periodic review were conducted in the 1st, 3rd, 6th, 12th month after surgery.Result:All 5 cases gained dryears within 3 months after surgery, in which hearing of 3 cases improved and ABG were within 20 dB. 1 cases showed no improvement compared to preoperation, and 1 case gained a worse audiology result. Central part of the transplant of 1 case was naked, while peripheral part had been epithelization and external auditory canal gained no accessible to mastoid cavity, the patient were also found recurrence of cholesteatom inside the mastoid cavity when received CT examination during outpatient follow-up one year postoperatively, and underwent correction surgery. 1 case underwent revision operation for a fistula between the reconstructed wall and the skin of the outer auditory canal. No surgical complications like infection or facial paralysis occurred, all patients were satisfied with surgery effect.Conclusion:HA with transferred vascularized temporalis fascia pedicle for the reconstructon of the external auditory canal wall is an effective method for the treatment of intractable tympanitis, and worth promoting.

Fertiloscopy improves in vitro fertilization for women with repeated implantation failure

OBJECTIVE

To assess the effects of fertiloscopy procedure on the outcomes of subsequent in vitro fertilization cycles in patients with repeated implantation failure (RIF).

METHODS

A retrospective study was performed on 50 patients underwent fertiloscopy and 41 controls with RIF. Pelvic and intrauterine pathologies related to infertility, clinical pregnancy rate (CPR) and ongoing pregnancy rate (OPR) of subsequent IVF cycles were assessed.

RESULTS

Twenty-six out of 50 patients (52%) had abnormal fertiloscopic findings. The women who underwent fertiloscopy exhibited significantly increased CPRs (46.8% vs. 24.4%) and OPRs (36.2% vs. 12.2%) compared with the control subjects who did not undergo fertiloscopy.

CONCLUSION

The incidence of pathologic findings on fertiloscopy is high among patients with RIF. Fertiloscopy is valuable in subsequent cycles among patients with RIF.

[Clinical comparative analysis of comprehensive laparoscopic and laparotomic staging of early-stage epithelial ovarian cancer]

Objective: To investigate the value of laparoscopy in comprehensive early ovarian cancer staging by comparing the feasibility and safety of laparoscopy and laparotomy in surgical staging of early-stage epithelial ovarian cancer (EOC). Methods: A total of 102 patients with EOC who underwent comprehensive laparoscopic (LPS group, n=71) or laparotomic (LPT group, n=31) staging at Southwest Hospital from November 2007 to November 2014 were retrospectively analyzed. The perioperative parameters, postoperative complication rate and the long-term curative effect were compared between the two groups. Results: (1) LPS group had less intra-operative blood loss [(288±239) vs (631±463) ml], lower rate of blood transfusion (14% vs 58%) , larger number of pelvic dissected lymph nodes (18.1±5.6 vs 15.5±4.6), lower vasual analogue scalescore (VAS) pain score (2.1±1.6 vs 3.0±1.1), shorter gastrointestinal recovery time [(2.6±0.8) vs (3.5±0.9) days] and shorter hospital stay [(9.9±2.9) vs (11.3±5.0) days] when compared with LPT group (all P<0.01). No significant difference were found in operation time, number of para-aortic lymph nodes, rate of postoperative upstaging and adjuvant chemotherapy between the two groups (all P>0.05). (2) No significant difference was found in postoperative rate of complications [11%(8/71) vs 19% (6/31), χ(2)=1.192, P=0.275]. (3) No significant difference was found in recurrence rate [17%(11/66) vs 14%(4/29), χ(2)=0.125, P=0.724] and 5-year overall survival (86.7% vs 86.8%, P=0.874) . Conclusion: Compared with LPT group, there are no significance differences in recurrence rate and mortality between two groups, laparoscopic staging, which could be recommended as a choice of surgical treatment of early ovarian cancer, shows more favorable operative outcomes including minimally invasive, less intra-operative blood loss, less postoperative pain and quicker recovery.

Immunotolerant indoleamine-2,3-dioxygenase is increased in condyloma acuminata

BACKGROUND

The tryptophan-depleting enzyme indoleamine-2,3-dioxygenase (IDO) is critical for the regulation of immunotolerance and plays an important role in immune-associated skin diseases.

OBJECTIVES

To analyse the level of IDO in condyloma acuminata (CA) and its role in this condition.

METHODS

IDO expression was assessed in the skin and peripheral blood of healthy controls and patients with CA. To assess the role of skin IDO in immunity, the ability of isolated epidermal cells to metabolize tryptophan and the influence on polyclonal T-cell mitogen (PHA)-stimulated T-cell proliferation were explored.

RESULTS

IDO median fluorescence intensities in peripheral blood mononuclear cells from patients with CA were similar to those from healthy controls. Immunohistochemistry showed that IDO⁺ cells were rare in normal skin and the control skin of patients with CA, but were greatly accumulated in wart tissue. Most fluorescence signals of IDO⁺ cells did not overlap with those of CD1a⁺ Langerhans cells. Human papillomavirus (HPV) DNA probe in situ hybridization showed a large number of IDO⁺ cells in the HPV^- site. Keratinocytes in the skin of healthy controls and the circumcised skin of patients with CA could minimally transform tryptophan into kynurenine, but IDO-competent epidermal cells from warts could transform tryptophan. In addition, these IDO-competent epidermal cells could inhibit PHA-stimulated T-cell proliferation. The addition of an IDO inhibitor, 1-methyl-d-tryptophan, restored the inhibited T-cell proliferation.

CONCLUSIONS

Abnormally localized high IDO expression might be involved in the formation of a local immunotolerant microenvironment.

Comparison of outcomes between off-pump versus on-pump coronary artery bypass surgery in elderly patients: a meta-analysis

The aim of this study was to analyze if off-pump coronary artery bypass surgery (CABG) is associated with better treatment outcomes in elderly patients (>70 years of age) than on-pump CABG, using meta-analysis. Medline, PubMed, Cochrane and Google Scholar databases were searched until September 13, 2016. Sensitivity and quality assessment were performed. Twenty-two studies, three randomized control trials (RCTs) and 20 non-RCTs were included with 24,127 patients. The risk of death associated with on-pump or off-pump CABG in the RCTs were similar (pooled OR=0.945, 95%CI=0.652 to 1.371, P=0.766). However, in the non-RCTs, mortality risk was lower in patients treated with off-pump CABG than on-pump CABG (pooled OR=0.631, 95%CI=0.587 to 0.944, P=0.003). No differences were observed between the two treatment groups in terms of the occurrence of 30-day post-operative stroke or myocardial infarction (P≥0.147). In the non-RCTs, off-pump CABG treatment was associated with a shorter length of hospital stay (pooled standardized difference in means=-0.401, 95%CI=-0.621 to -0.181, P≤0.001). The meta-analysis with pooled data from non-RCTs, but not RCTs, found that mortality was lower with off-pump compared with on-pump CABG, and suggested that there may be some benefit of off-pump CABG compared with on-pump CABG in the risk of mortality and length of hospital stay.

Genetic analysis of PITX3 variants in patients with essential tremor

BACKGROUND

A clinical overlap between essential tremor (ET) and Parkinson's disease (PD) has prompted investigation whether these disorders share common genetic factors. The paired-like homeodomain transcription factor 3 gene (PITX3) has been shown to play an important role for the differentiation and survival of midbrain dopaminergic neurons in the substantia nigra pars compacta. The preferential degeneration of those dopaminergic neurons is the pathological hallmark in PD.

AIMS OF THE STUDY

The purpose of this study was to evaluate whether PITX3 variants are related to susceptibility of ET in Chinese Han population.

METHODS

Genetic analysis of two variants rs3758549 and rs4919621 of the PITX3 gene was conducted in 200 Chinese Han patients with ET and 426 controls.

RESULTS

We did not identify any statistically significant difference in either genotypic or allelic frequencies of variants between the ET patients and control cohort (all P > 0.05). Haplotype analysis of two variants in the PITX3 gene showed no potential association between the haplotypes and risk of ET (all P > 0.05).

CONCLUSIONS

Our data suggest that PITX3 variants rs3758549 and rs4919621 are not associated with ET in Chinese Han population.

A stabilized laser continuously tunable over a range of 1.5 GHz

We demonstrate a method to stabilize laser frequency which can be continuously tuned over a range of 1.5 GHz. It is based on saturated absorption spectroscopy (SAS) generated by an external-cavity diode laser (ECDL) which is modulated by an electro-optic amplitude modulator (EO-AM). The spectra consist of not only the original peaks corresponding to resonant and crossover lines of ¹³³Cs D₂ line, but also signals introduced by sidebands from an EO-AM. Thus, the laser frequency can be locked to any point within the range of the spectra. Furthermore, the tuning range of the laser can be doubled compared to the coverage of common SAS by fixing the frequency of the pumping laser. The best stability of the locked laser induced by the EO-AM is 1.27 × 10^-11 over an integrating time of 125 s. This method may be applied for more precise and flexible manipulation of atoms and molecules.

Identification of a PRX variant in a Chinese family with congenital cataract by exome sequencing

BACKGROUND

Congenital cataract is a common cause of childhood vision impairment or blindness with genetic and clinical heterogeneity. The aim of this study was to identify the disease-associated gene in a Chinese family with congenital cataract.

METHODS

A four-generation Chinese family with three enrolled patients suffering from congenital cataract was studied. Detailed family history and clinical data of all the members were collected and recorded. Exome sequencing was applied in the proband to screen potential genetic variants, and then Sanger sequencing was used to verify the variant within the family.

RESULTS

A heterozygous variant, c.3673G > A (p.V1225M), in the periaxin gene (PRX) was identified in three patients and two asymptomatic individuals of the family. The variant was absent in the other three unaffected family members and in 3290 ethnically matched in-house controls from BGI-Shenzhen.

CONCLUSIONS

By utilizing both exome sequencing and Sanger sequencing, we identified a missense variant in the PRX gene that is possibly associated with disease in this family. Our finding may broaden the spectrum of genes associated with congenital cataract, and may provide insights into lens development, pathogenic mechanism, future clinical genetic diagnosis and therapy of congenital cataract.

[The role of PACAP protein in chronic sinusitis with or without nasal polyps]

Objective:To investigate the expression of PACAP protein in chronic rhinosinusitis without/with nasal polyps and refractory chronic rhinosinusitis.Method: Fifty-three patients with nasal polyps,70 cases with chronic sinusitis, 28 patients with refractory chronic rhinosinusitis and 20 control cases were enrolled for this study. The expression of PACAP protein was detected by immunochemistry.Result: ①PACAP protein were expressed in nasal epithelium，glandular epithelium and goblet cells；②The positive intensity of PACAP was" +", " +++", "－-+",and " ++" in nasal polyps, chronic rhinosinusitis, refractory chronic rhinosinusitis, and control group, respectively.Conclusion:PACAP protein mainly locates in nasal epithelium，glandular epithelium and goblet cells. Reduced expression of PACAP may be related with onset of chronic rhiniosinusitis without/with nasal polyps.

[Role of CMKLR1 on mouse vascular smooth muscle cells proliferation and related mechanism]

OBJECTIVE

To explore the proliferation property of vascular smooth muscle cells (VSMCs) in the stable CMKLR1 gene knock-down mouse VSMCs line and explore related mechanism.

METHODS

The short hairpin RNA sequence targeting to knockdown the coding regions of mouse CMKLR1 mRNA was synthesized and subsequently employed to construct recombinant lentivirus vector.Mouse VSMCs were cultured and infected with the recombinant lentivirus (knockdown VSMCs). mRNA and protein CMKLR1 expression in Knockdown VSMCs was measured by real-time PCR and Western blot and compared with those in normal VSMCs (vehicle VSMCs) and lentivirus control VSMCs (control VSMCs). The proliferation of normal, knockdown and control VSMCs was induced by platelet-derived growth factor-BB (PDGF VSMCs) and measured by cell number counting and BrdU.The phosphorylated c-Jun N-terminal kinase (p-JNK) protein was investigated by Western blot.

RESULTS

The relative level of CMKLR1 mRNA in knockdown VSMCs (0.23±0.04) was significantly downregulated compared with which in vehicle VSMCs (1.05±0.05) as well as control VSMCs (0.99±0.04) (P<0.01). The relative level of CMKLR1 protein in knockdown VSMCs (0.29±0.04) was also significantly decreased, compared with which in vehicle VSMCs (1.06±0.04) as well as control VSMCs (0.95±0.02) (P<0.01). The VSMCs number ((50.33±1.20)×10(3)/cm(2)) and BrdU A450 nm value (1.80±0.05) in PDGF VSMCs were significantly increased in vehicle VSMCs ((42.02±1.53)×10(3)/cm(2,) 1.55±0.04) (both P<0.05). Compared with those in vehicle VSMCs, the VSMCs number ((23.33±2.03)×10(3)/cm(2)) and BrdU A450 nm value (1.32±0.02) in knockdown VSMCs were significantly decreased.The proliferation property between PDGF VSMCs and control VSMCs was similar(P>0.05). Compared with the relative level of p-JNK protein (1.03±0.03) in vehicle VSMCs, the p-JNK protein level was significantly increased in PDGF VSMCs (1.36±0.02, P<0.05) and significantly downregulated in knockdown VSMCs (0.79±0.05, P<0.05).

CONCLUSION

Knockdowning CMKLR1 gene can reduce the proliferation of mouse vascular smooth muscle cells, which was related with the down-regulation of p-JNK expression.

Regulation of size and uniformity of In2O3 nanooctahedra

Rational regulation of the size and uniformity of nanoparticles has drawn great interests and shown widespread application, but this cannot be simply achieved by the vapor route. In this work, by adopting a chemical vapor deposition approach, the growth process was intricately regulated to guide the reagent supersaturation, and the large-scale growth of uniform-sized In2O3 nanooctahedra was realized. A one-time nucleation and synchronous growth mode controlled by the reagent supersaturation ratio is proposed to be responsible for the uniformity of size. Furthermore, a series of comparative experiments were conducted to study the size dependence on reaction duration, and temperature difference between the heating and depositing zones. This study demonstrates a feasible approach to prepare uniform-sized nanoparticles through precisely controlling the crystal growth process, and the developed growth strategy could be generalized to synthesize uniform-sized nanostructures of other material systems.

miR-141 is involved in BRD7-mediated cell proliferation and tumor formation through suppression of the PTEN/AKT pathway in nasopharyngeal carcinoma

Bromodomain containing 7 (BRD7) was identified as a nuclear transcriptional regulatory factor. BRD7 functions as a tumor suppressor in multiple cancers, including nasopharyngeal carcinoma (NPC). In this study, we reported a novel mechanism of BRD7 in NPC progression. We demonstrated that the expression of miR-141 was remarkably increased in NPC tissues and was negatively correlated with the expression of BRD7 and the survival rate of NPC patients. Decreased expression levels of miR-141, including the primary, the precursor and the mature forms of miR-141, were found in BRD7-overexpressing HEK293, 5-8F and HNE1 cells compared the control cells, while there was no obvious effect on the expression levels of the two critical enzymes Drosha and Dicer. BRD7 can negatively regulate the promoter activity of miR-141, while no obvious binding site of BRD7 was found in the potential promoter region of miR-141. Moreover, ectopic expression of miR-141 can significantly promote cell proliferation and inhibit apoptosis in NPC, and rescuing the expression of miR-141 in BRD7-overexpressing NPC cells could partially reverse the tumor suppressive effect of BRD7 on cell proliferation and tumor growth in vitro and in vivo. Furthermore, the activation of the PTEN/AKT pathway mediated by the overexpression of BRD7 could be inhibited by rescuing the expression of miR-141, which accordingly results in the partial restoration of cell proliferation and tumor growth. Our findings demonstrate that the BRD7/miR-141/PTEN/AKT axis has critical roles in the progression of NPC and provide some promising targets for the diagnosis and treatment of NPC.

An let-7 KRAS rs712 polymorphism increases hepatocellular carcinoma risk

KRAS, also known as V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog, acts as an intracellular signal transducer. The oncogenic KRAS mutation is an essential step in the development of many types of human cancers, including hepatocellular carcinoma. Here we aimed to investigate the relationship between KRAS rs712 polymorphisms and hepatocellular carcinoma susceptibility. Five-hundred-and-fourteen participants were enrolled in a case-control study (262 cases and 252 normal subjects). The variants were distinguished using polymerase chain reaction-restriction fragment length polymorphism. Significantly increased HCC risk was observed to be associated with the T allele of the rs712 locus (P = 0.049, OR = 1.35, 95%CI = 1.01-1.78). Further, HCC risk with the GT genotype (P = 0.015, OR = 1.64, 95%CI = 1.08-2.50) and the TT genotype (P = 0.015, OR = 2.56, 95%CI = 1.05-6.25) in a codominant model was significantly higher than that with the GG genotype. In a dominant model, significantly increased HCC susceptibility was also associated with T allele carriers (P = 0.006, OR = 1.75, 95%CI = 1.16-2.63). Moreover, we found that the frequency of the KRAS rs712 TT genotype was significantly higher in HBV-positive HCC patients than in HBV-negative HCC patients.

Regulation of the expression of zinc finger protein genes by microRNAs enriched within acute lymphoblastic leukemia-derived microvesicles

Microvesicles (MVs) are submicrometric membrane fragments that can "engulf" cytoplasmic contents such as microRNAs (miRNAs) from their cellular origin. The study of miRNAs carried within MVs might provide insights into the roles that miRNAs play in the underlying pathophysiologic processes of acute lymphoblastic leu-kemia (ALL). We identified numerous dysregulated MV miRNAs in patients with B- and T-cell ALL by using Agilent microarray analysis. Selected miRNAs obtained by microarray profiling were validated us-ing quantitative reverse transcription-polymerase chain reaction. Us-ing bioinformatic tools, we found that 118 and 116 miRNAs from B- and T-ALL MVs, respectively, regulated the expression of zinc finger protein (ZFP) genes. For example, zinc finger protein 238 (ZNF238), known as a tumor suppressor, was regulated by miR-20b over-expres-sion. Conversely, ZNF267, a cancer-promoting factor, was mediated by downregulated miR-23a and miR-23b. Considering that miRNAs are generally believed to repress gene expression, antineoplastic ZNF238 was likely inhibited while the level of oncogenic ZNF267 was likely increased by miRNA dysregulation, leading to modifica-tion of the ALL microenvironment. In addition, gene ontology and sig-naling pathway analysis demonstrated that a subset of the ZFP genes targeted by altered MV miRNAs are involved in cellular biological processes including proliferation, differentiation, apoptosis, and cell cycle regulation. These findings indicated that cancer-associated MV miRNAs and their target ZFP genes might be novel pathogenic factors in ALL. However, the specific roles exerted by MV miRNAs and their target ZFP genes on the pathological mechanisms of ALL remain to be further understood.

A randomized clinical trial of the effects of ultra-low-dose naloxone infusion on postoperative opioid requirements and recovery

BACKGROUND

Tolerance to remifentanil during sevoflurane anesthesia may increase postoperative analgesic requirements. Low-dose naloxone not only has been shown to block the development of acute opioid tolerance but also to ameliorate undesired opioid-induced side effects. We hypothesized that naloxone prevents the acute opioid tolerance produced by a large dose of remifentanil, and reduces the incidence of opioid-induced side effects.

METHODS

Seventy-two patients undergoing open colorectal surgery were randomly assigned to receive intraoperative remifentanil (1) small dose at 0.1 μg/kg/min; (2) large dose at 0.30 μg/kg/min; or (3) large dose at 0.30 μg/kg/min combined with low-dose naloxone at 0.25 μg/kg/h just after the induction. Cumulative morphine consumption, postoperative pain scores, incidence of opioid-related side effects, time to recovery of bowel function, and length of hospital stay were recorded.

RESULTS

Cumulative morphine consumption at 24 h after surgery was higher in the large-dose remifentanil group (28 ± 12 mg) compared with the small-dose remifentanil group (17 ± 12 mg), and large-dose remifentanil-naloxone group (18 ± 9 mg), (P < 0.001). The median time to return of bowel function was shorter in the large-dose remifentanil-naloxone group than the other two groups (P < 0.05). The median length of hospital stay was lower in the large-dose remifentanil-naloxone group (8 [interquartile range: 8-12] days) compared with the small-dose remifentanil group (12 [interquartile range: 9-15] days) and large-dose remifentanil group (12 [interquartile range: 10-13] days), (P < 0.001).

CONCLUSION

Naloxone infusion prevented the acute opioid tolerance, provided a quicker recovery of bowel function, and reduced the length of hospital stay after open colorectal surgery.

Suppression of Inflammatory Responses by Dihydromyricetin, a Flavonoid from Ampelopsis grossedentata, via Inhibiting the Activation of NF-κB and MAPK Signaling Pathways

Ampelopsis grossedentata, an indigenous plant in southern China, has been used for treating pharyngitis in traditional Chinese medicine for hundreds of years. In this study, we explored the anti-inflammatory activity of dihydromyricetin (1), its major bioactive component, and the underlying mechanism of this action. We demonstrated that 1 suppressed the levels of pro-inflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) as well as increased the level of the anti-inflammatory cytokine interleukin-10 (IL-10) in lipopolysaccharide (LPS)-treated mice. Moreover, 1 was found to markedly inhibit the production of nitric oxide (NO) and the levels of TNF-α, IL-1β, and IL-6, whereas it increased the level of IL-10 in LPS-induced RAW 264.7 macrophage cells. Compound 1 also reduced the protein expression of inducible nitric oxide synthase (iNOS), TNF-α, and cyclooxygenase-2 (COX-2) in macrophage cells. Furthermore, 1 suppressed the phosphorylation of NF-kappa B (NF-κB) and IκBα as well as the phosphorylation of p38 and JNK but not ERK1/2 in LPS-stimulated macrophages. Taken together, the present results suggest that 1 exerts its topical anti-inflammatory action through suppressing the activation of NF-κB and the phosphorylation of p38 and JNK. Thus, 1 may be a potentially useful therapeutic agent for inflammatory-related diseases.