Mean peak systolic velocity of the superior thyroid artery is correlated with radioactive iodine uptake in untreated thyrotoxicosis

OBJECTIVE

To evaluate the correlation between mean superior thyroid artery peak systolic velocity (STA-PSV) and radioactive iodine uptake (RAIU) in Chinese patients with untreated thyrotoxicosis, using retrospectively and prospectively collected data.

METHODS

Patients with untreated thyrotoxicosis (n = 220) and euthyroid control subjects (n = 30) underwent thyroid function, thyroid autoantibody and thyroid ultrasonography tests. Mean STA-PSV was measured by ultrasonography. RAIU tests identified 168 patients with Graves' disease and 52 with destructive thyroiditis. Linear correlation of mean STA-PSV with 3-h and 24-h RAIU, and sensitivity, specificity and receiver operating characteristic (ROC) curves for mean STA-PSV in the differential diagnosis of Graves' disease and destructive thyroiditis were calculated.

RESULTS

Mean STA-PSV was significantly higher in Graves' disease than in destructive thyroiditis. Mean STA-PSV correlated positively and significantly with 3-h and 24-h RAIU. Area under the ROC curve of mean STA-PSV for the differential diagnosis of Graves' disease and destructive thyroiditis was 0.825 (optimum cut-off value of mean STA-PSV, 45.25 cm/s; sensitivity, 80.4%; specificity, 81.4%).

CONCLUSIONS

Detection of mean STA-PSV by ultrasonography agrees with RAIU and is useful for the differential diagnosis of thyrotoxicosis in Chinese patients.

Scanning assay of beta-galactosidase activity

Beta-galactosidase, encoded by the lacZ gene in E. coli, can cleave lactose and structurally related compounds to galactose and glucose or structurally related products. Its activity can be measured using an artificial substrate, o-nitrophenyl-beta-D-galactopyranoside (ONPG). Miller firstly described the standard quantitative assay of beta-galactosidase activity in the cells of bacterial cultures by disrupting the cell membrane with the permeabilization solution instead of preparing cell extracts. Therefore, beta-galactosidase became one of the most widely used reporters of gene expression in molecular biology to reflect intracellular gene expression difference. But the Miller assay procedure could not monitor the beta-galactosidase reaction in real time and its results were greatly influenced by some operations in the Miller procedure, such as permeabilization time, reaction time and concentration of the cell suspension. A scanning method based on the Miller method to determine the intracellular beta-galactosidase activity in E. coli Tuner (DE3) expressing -galactosidase in real time was developed and the permeabilization time of cells was optimized for that. The comparison of 3 assays of beta-galactosidase activity (Miller, colorimetric and scanning) was made. The results proved that scanning method for the determination of enzyme activity with using ONPG as substrate is simple, fast and reproducible.

Scalp EEG-based discrimination of cognitive deficits after traumatic brain injury using event-related Tsallis entropy analysis

Traumatic brain injury (TBI) is the leading cause of death and disability in children and adolescents in the U.S. This is a pilot study, which explores the discrimination of chronic TBI from normal controls using scalp EEG during a memory task. Tsallis entropies are computed for responses during an old-new memory recognition task. A support vector machine model is constructed to discriminate between normal and moderate/severe TBI individuals using Tsallis entropies as features. Numerical analyses of 30 records (15 normal and 15 TBI) show a maximum discrimination accuracy of 93% (p-value = 7.8557E-5) using four features. These results suggest the potential of scalp EEG as an efficacious method for noninvasive diagnosis of TBI.

Identification of microRNA-regulated autophagic pathways in plant lectin-induced cancer cell death

OBJECTIVES

Plant lectins, carbohydrate-binding proteins of non-immune origin, have recently been reported to induce programmed cell death (including apoptosis and autophagy) in many types of cancer cells. MicroRNAs (miRNAs), small, non-coding endogenous RNAs, ~22 nucleotides (nt) in length, have been well characterized to play essential roles in regulation of the autophagy process in cancer; however, how these miRNAs regulate autophagic pathways in plant lectin-induced cancer cells, still remains an enigma.

MATERIALS AND METHODS

Identification of microRNA-regulated autophagic pathways was carried out using a series of elegant systems - biology and bioinformatics approaches, such as network construction, hub protein identification, targeted microRNA prediction, microarray analyses and molecular docking.

RESULTS

We computationally constructed the human autophagic protein-protein interaction (PPI) network, and further modified this network into a plant lectin-induced network. Subsequently, we identified 9 autophagic hub proteins and 13 relevant oncogenic and tumour suppressive miRNAs, that could regulate these aforementioned targeted autophagic hub proteins, in human breast carcinoma MCF-7 cells. In addition, we confirmed that plant lectins could block the sugar-containing receptor EGFR-mediated survival pathways, involved in autophagic hub proteins and relevant miRNAs, thereby ultimately culminating in autophagic cell death.

CONCLUSIONS

These results demonstrate that network-based identification of microRNAs modulate autophagic pathways in plant lectin-treated cancer cells, which may shed new light on the discovery of plant lectins as potent autophagic inducers, for cancer drug discovery.

Stem cell transplantation in cardiovascular disease: an update

Despite the development of novel therapeutic strategies, cardiovascular diseases remain the main cause of morbidity and mortality worldwide. Many phase 1 and 2 clinical trials have reported the safety, feasibility and promising potential of stem cell transplantation, however, the optimal cell types, timing of infusion, cell dosage and routes of administration remain to be determined. This paper reviews the findings of various clinical studies and discusses the challenges facing the delivery of stem cell therapy in cardiovascular diseases.

Meta analysis of angiotensin-converting enzyme I/D polymorphism as a risk factor for preeclampsia in Chinese women

Preeclampsia affects 3-8% of pregnancies and is a major cause of maternal and perinatal morbidity and mortality worldwide. Inappropriate activation of the renin-angiotensin system may play a role in the development of preeclampsia. An insertion/deletion polymorphism in the angiotensin-converting enzyme gene (ACE-I/D) has been associated with differences in ACE activity. However, there are controversies in reports on the association of ACE-I/D with preeclampsia. Data were analyzed using Review Manager Version 5.0 and a random effects model was applied irrespective of between studies heterogeneity, which was evaluated via sensitivity and subgroup analyses. Publication bias was evaluated using the fail-safe number. A systematic search was performed based on published case control studies up to October 1, 2011, and 11 studies were included, involving 800 patients and 949 controls. Significant association of the ACE D allele with increase risk of preeclampsia was found (odds ratio = 1.93, 95% confidence interval = 1.19-3.12; P = 0.008). Sensitivity analysis showed that no individual study had an undue influence on the summary odds ratios for all contrasts. An analysis stratified by study size showed an attenuated odds ratio towards a null effect as study size increased. Based on our meta-analysis, we suggest that the D allele of the ACE gene is related with increased risk for preeclampsia in the Chinese population. Considering the potential existence of small study bias, further research should be performed with a larger dataset.

Developing vaccines in the era of genomics: a decade of reverse vaccinology

Vaccines have a significant impact on public health, and vaccinology in the era of genomics is taking advantage of new technologies to tackle diseases for which vaccine development has so far been unsuccessful. Almost all existing vaccines were developed based on traditional vaccinology methods, which relied on empirical screening of a few candidates at a time, based on known features of the pathogen. However, the ability to sequence a pathogen's genome provides access to its entire antigenic repertoire. As such, genomics has catalysed a shift in vaccine development towards sequence-based 'Reverse Vaccinology' approaches, which use high-throughput in silico screening of the entire genome of a pathogen to identify genes that encode proteins with the attributes of good vaccine targets. Furthermore, the increasing availability of genome sequences has led to the development and application of additional technologies to vaccine discovery, including comparative genomics, transcriptomics, proteomics, immunomics and structural genomics. Vaccine candidates identified from a pathogen's genome or proteome can then be expressed as recombinant proteins and tested in appropriate in vitro or in vivo models to assess immunogenicity and protection. The process of reverse vaccinology has been applied to several pathogens, including serogroup B Neisseria meningitidis, Streptococcus agalactiae, Streptococcus pyogenes, Streptococcus pneumoniae and pathogenic Escherichia coli, and has provided scores of new candidate antigens for preclinical and clinical investigation. As novel genome-based technologies continue to emerge, it is expected that new vaccines for unmet diseases will be within reach.

LPS induces IL-8 expression through TLR4, MyD88, NF-kappaB and MAPK pathways in human dental pulp stem cells

AIM

To evaluate the effects of lipopolysaccharide (LPS) on interleukin-8 (IL-8) and related intracellular signalling pathways in human dental pulp stem cells (hDPSCs).

METHODOLOGY

Human pulp tissues were isolated from human impacted third molars, and the hDPSCs were cultured and characterized. The effects of LPS on IL-8 and Toll-like receptor 4 (TLR4) gene expression in hDPSCs were investigated using real-time quantitative RT-PCR and ELISA. Whether TLR4/MyD88/NF-кB was involved in the LPS-induced up-regulation of IL-8 in hDPSCs was determined using transient transfection, luciferase assay and ELISA. The involvement of MAPKs in the LPS-induced up-regulation of IL-8 in hDPSCs was investigated via transient transfection, luciferase assay, ELISA and western blot. The data were statistically analysed using Student's t-test or one-way anova followed by the Student-Neumann-Keuls test.

RESULTS

Cells exposed to LPS not only displayed an enhanced expression of TLR4 but also showed an elevated IL-8 gene expression; exposure to LPS also resulted in the induction of IL-8 gene transcription via promoter activation. The LPS-induced IL-8 promoter activation was inhibited through dominant-negative mutations in TLR4 and MyD88, but not in TLR2. The LPS-induced IL-8 protein release was attenuated through the administration of TLR4-neutralizing antibody or MyD88 inhibitory peptide and a dominant-negative mutation in IκBα. In contrast, IL-8 protein release was enhanced through the expression of NF-κB p65. Treatment with PDTC, TPCK or Bay117082 effectively antagonized LPS-induced IL-8 protein release. Moreover, both the promoter activity and the LPS-induced release of IL-8 were diminished upon the administration of U0126 and SB203580, but not SP600125. Moreover, the exposure to LPS activated ERK1/2 and p38 MAPK phosphorylation in cells.

CONCLUSIONS

This study reports the LPS-mediated transcriptional and post-translational up-regulation of IL-8, which is a process that also involves TLR4, MyD88, NF-κB and MAPK.

Effect of Ischaemic Postconditioning on Recovery of Left Ventricular Contractile Function after Acute Myocardial Infarction

OBJECTIVE: This study investigated whether ischaemic postconditioning can improve recovery of myocardial contractile function in acute myocardial infarction patients 1 week and 6 months after angioplasty. METHODS: A total of 62 patients undergoing direct percutaneous coronary intervention after acute myocardial infarction were randomly assigned to receive four episodes of inflation and deflation of the angioplasty balloon in the early reperfusion period (postconditioned group, n = 32), or no additional intervention (control group, n = 30). Two-dimensional size and left ventricular (LV) global and regional contractile functions were then evaluated by echocardiography at 1 week and 6 months after angioplasty. RESULTS: At 1 week, there were no significant differences in left atrial diameter, LV end-diastolic diameter, LV end-diastolic volume, cardiac output, LV ejection fraction or wall motion score index between the two groups. At 6 months, LV ejection fraction was significantly increased and the wall motion score index significantly reduced in the postconditioned group compared with the control group. CONCLUSION: Ischaemic postconditioning can improve long-term LV contractile function 6 months after reperfusion following acute myocardial infarction.

Feedback effect on high-energy magnetic fluctuations in the model high-temperature superconductor HgBa2CuO(4+δ) observed by electronic Raman scattering

We use electronic Raman scattering to study the model single-layer cuprate superconductor HgBa(2)CuO(4+δ). In an overdoped sample, we observe a pronounced amplitude enhancement of a high-energy peak related to two-magnon excitations in insulating cuprates upon cooling below the critical temperature T(c). This effect is accompanied by the appearance of the superconducting gap and a pairing peak above the gap in the Raman spectrum, and it can be understood as a hitherto-undetected feedback effect on the high-energy magnetic fluctuations due to the Cooper pairing interaction. This implies a direct involvement of the high-energy magnetic fluctuations in the pairing mechanism. All of these effects occur already above T(c) in two underdoped samples, demonstrating a related feedback mechanism associated with the pseudogap.

Renal tubular dysfunction during long-term adefovir or tenofovir therapy in chronic hepatitis B

BACKGROUND

Adefovir and tenofovir are nucleotide analogues used as long-term therapy of chronic hepatitis B. Side effects are few, but prolonged and high-dose therapy has been associated with proximal renal tubular dysfunction (RTD).

AIM

To assess the incidence of RTD during long-term nucleotide therapy of chronic hepatitis B.

METHODS

A total of 51 patients being treated at the Clinical Center, National Institutes of Health were studied. Diagnosis of RTD required de novo appearance of at least three of five features: hypophosphataemia, hypouricaemia, serum creatinine elevation, proteinuria or glucosuria.

RESULTS

Among 51 patients treated for 1-10 (mean 7.4) years with adefovir (n = 42), tenofovir (n = 4) or adefovir followed by tenofovir (n = 5), 7 (14%) developed RTD. Time to onset ranged from 22 to 94 (mean 49) months with an estimated 10-year cumulative rate of 15%. All seven had low urinary percent maximal tubular reabsorption of phosphate (<82%). Patients with RTD were older (58 vs. 44 years; P = 0.01) and had lower baseline glomerular filtration rates (82 vs. 97 cc/min; P = 0.08) compared to those without; but did not differ in other features. Six patients with RTD were switched to entecavir, all subsequently had improvements in serum phosphate (2.0-3.0 mg/dL), creatinine (1.6-1.1 mg/dL), uric acid (2.7-3.8 mg/dL) and proteinuria.

CONCLUSIONS

Renal tubular dysfunction develops in 15% of patients treated with adefovir or tenofovir for 2-9 years and is partially reversible with change to other antivirals. Monitoring for serum phosphate, creatinine and urinalysis is prudent during long-term adefovir and tenofovir therapy.

MicroRNA-7 functions as an anti-metastatic microRNA in gastric cancer by targeting insulin-like growth factor-1 receptor

Metastasis is a major clinical obstacle in the treatment of gastric cancer (GC) and it accounts for the majority of cancer-related mortality. MicroRNAs have recently emerged as regulators of metastasis by acting on multiple signaling pathways. In this study, we found that miR-7 is significantly downregulated in highly metastatic GC cell lines and metastatic tissues. Both gain-of-function and loss-of-function experiments showed that increased miR-7 expression significantly reduced GC cell migration and invasion, whereas decreased miR-7 expression dramatically enhanced cell migration and invasion. In vivo metastasis assays also demonstrated that overexpression of miR-7 markedly inhibited GC metastasis. Moreover, the insulin-like growth factor-1 receptor (IGF1R) oncogene, which is often mutated or amplified in human cancers and functions as an important regulator of cell growth and tumor invasion, was identified as a direct target of miR-7. Silencing of IGF1R using small interefering RNA (siRNA) recapitulated the anti-metastatic function of miR-7, whereas restoring the IGF1R expression attenuated the function of miR-7 in GC cells. Furthermore, we found that suppression of Snail by miR-7, through targeting IGF1R, increased E-cadherin expression and partially reversed the epithelial-mesenchymal transition (EMT). Finally, analyses of miR-7 and IGF1R levels in human primary GC with matched lymph node metastasis tissue arrays revealed that miR-7 is inversely correlated with IGF1R expression. The present study provides insight into the specific biological behavior of miR-7 in EMT and tumor metastasis. Targeting this novel miR-7/IGF1R/Snail axis would be helpful as a therapeutic approach to block GC metastasis.

A missense mutation in AGTPBP1 was identified in sheep with a lower motor neuron disease

A type of lower motor neuron (LMN) disease inherited as autosomal recessive in Romney sheep was characterized with normal appearance at birth, but with progressive weakness and tetraparesis after the first week of life. Here, we carried out genome-wide homozygosity mapping using Illumina Ovine SNP50 BeadChips on lambs descended from one carrier ram, including 19 sheep diagnosed as affected and 11 of their parents that were therefore known carriers. A homozygous region of 136 consecutive single-nucleotide polymorphism (SNP) loci on chromosome 2 was common to all affected sheep and it was the basis for searching for the positional candidate genes. Other homozygous regions shared by all affected sheep spanned eight or fewer SNP loci. The 136-SNP region contained the sheep ATP/GTP-binding protein 1 (AGTPBP1) gene. Mutations in this gene have been shown to be related to Purkinje cell degeneration (pcd) phenotypes including ataxia in mice. One missense mutation c.2909G>C on exon 21 of AGTPBP1 was discovered, which induces an Arg to Pro substitution (p.Arg970Pro) at amino-acid 970, a conserved residue for the catalytic activity of AGTPBP1. Genotyping of this mutation showed 100% concordant rate with the recessive pattern of inheritance in affected, carrier, phenotypically normal and unrelated normal individuals. This is the first report showing a mutant AGTPBP1 is associated with a LMN disease in a large mammal animal model. Our finding raises the possibility of human patients with the same etiology caused by this gene or other genes in the same pathway of neuronal development.

Targeted therapy via oral administration of attenuated Salmonella expression plasmid-vectored Stat3-shRNA cures orthotopically transplanted mouse HCC

The development of RNA interference-based cancer gene therapies has been delayed due to the lack of effective tumor-targeting delivery systems. Attenuated Salmonella enterica serovar Typhimurium (S. Typhimurium) has a natural tropism for solid tumors. We report here the use of attenuated S. Typhimurium as a vector to deliver shRNA directly into tumor cells. Constitutively activated signal transducer and activator of transcription 3 (Stat3) is a key transcription factor involved in both hepatocellular carcinoma (HCC) growth and metastasis. In this study, attenuated S. Typhimurium was capable of delivering shRNA-expressing vectors to the targeted cancer cells and inducing RNA interference in vivo. More importantly, a single oral dose of attenuated S. Typhimurium carrying shRNA-expressing vectors targeting Stat3 induced remarkably delayed and reduced HCC (in 70% of mice). Cancer in these cured mice did not recur over 2 years following treatment. These data demonstrated that RNA interference combined with Salmonella as a delivery system may offer a novel clinical approach for cancer gene therapy.

Perceived parenting and risk for major depression in Chinese women

BACKGROUND

In Western countries, a history of major depression (MD) is associated with reports of received parenting that is low in warmth and caring and high in control and authoritarianism. Does a similar pattern exist in women in China?

METHOD

Received parenting was assessed by a shortened version of the Parental Bonding Instrument (PBI) in two groups of Han Chinese women: 1970 clinically ascertained cases with recurrent MD and 2597 matched controls. MD was assessed at personal interview.

RESULTS

Factor analysis of the PBI revealed three factors for both mothers and fathers: warmth, protectiveness, and authoritarianism. Lower warmth and protectiveness and higher authoritarianism from both mother and father were significantly associated with risk for recurrent MD. Parental warmth was positively correlated with parental protectiveness and negatively correlated with parental authoritarianism. When examined together, paternal warmth was more strongly associated with lowered risk for MD than maternal warmth. Furthermore, paternal protectiveness was negatively and maternal protectiveness positively associated with risk for MD.

CONCLUSIONS

Although the structure of received parenting is very similar in China and Western countries, the association with MD is not. High parental protectiveness is generally pathogenic in Western countries but protective in China, especially when received from the father. Our results suggest that cultural factors impact on patterns of parenting and their association with MD.

Prevalence, awareness, treatment, and control of hypertension among herdsmen living at 4,300 m in Tibet

BACKGROUND

Studies on blood pressure (BP) in high-altitude areas are scarce and the results are controversial. Tibetans live in regions at high altitudes, and data on the prevalence of hypertension in this population is not currently well known.

METHODS

All Tibetans aged 40 years and older living in the township of Yangbajing (4,300 m) in Tibet, China were invited to participate in the 2009 survey. BP was measured with electronic sphygmomanometers (calibrated by the results of a previous study). Histories of hypertension and medication use were collected through face-to-face interviews. Hypertension was defined as systolic BP (SBP) ≥140 mm Hg and/or diastolic BP (DBP) ≥90 mm Hg, or antihypertensive medication use in the past 2 weeks.

RESULTS

A total of 701 adults (aged 40-89, 42.9% male, 94.9% herdsmen) were recruited. The mean (s.d.) SBP/DBP was 146.6 (31.3)/92.0 (15.7) mm Hg and the prevalence of hypertension was 55.9%. Of note, 61.2% of those with hypertension had stage 2 hypertension (SBP ≥160 or DBP ≥100 mm Hg). At age 70 years and older, the mean (s.d.) SBP/DBP were 182.8 (30.9)/102.6 (13.4) mm Hg. Among those with hypertension (n = 392), only 19.9% were aware of their condition, 2.6% were taking medication, and only one participant had controlled BP.

CONCLUSION

According to our survey in Yangbajing, Tibetan adults aged 40 years and older living at high altitudes had high BP and prevalence of hypertension with low awareness, treatment, and control. Future studies are needed to clarify the association between BP, altitude, and other possible causes.

Randomised clinical trial: the benefit of combination therapy with adefovir and lamivudine for chronic hepatitis B

BACKGROUND

Combination antiviral therapy holds the promise of increasing response rates while decreasing antiviral resistance, but has yet to be shown to be beneficial or necessary in chronic hepatitis B.

AIM

To evaluate the benefit of combination therapy with adefovir and lamivudine versus adefovir alone in maintaining virological, biochemical and histological responses.

METHODS

Patients with chronic hepatitis B with and without previous lamivudine therapy were randomised to receive adefovir alone (10 mg/daily) or adefovir and lamivudine (100 mg/daily) for up to 192 weeks. Study endpoints were (i) maintained virological (HBV DNA <500 copies/mL), biochemical and histological response, (ii) loss of HBeAg and (iii) loss of HBsAg.

RESULTS

A total of 41 patients were enrolled, including 31 HBeAg -positive and 31 treatment-naïve subjects. 30 patients remained on assigned therapy at 192 weeks. The percentage of patients achieving a combined maintained response was higher in the combination than the monotherapy arm, both at week 48 (59% vs. 26%, P = 0.06) and 192 (68% vs. 31%, P = 0.03). At week 192, 76% of the combination vs. 36% of the monotherapy group had loss of HBeAg (P = 0.03). One patient receiving adefovir cleared HBsAg. Adefovir resistance developed in 6 of 19 (32%) monotherapy but none of 22 combination treated patients (P = 0.03).

CONCLUSIONS

Extended combination therapy with lamivudine and adefovir is associated with a high rate of long-term virological and biochemical response. Adefovir monotherapy appears to be less effective mainly because of poor initial response and the ultimate development of antiviral resistance (www.Clinical. Trials.gov NCT00023309).