T2* relaxation time in the detection and assessment of aggressiveness of peripheral zone cancer in comparison with diffusion-weighted imaging

AIM

To investigate the feasibility of T2* relaxation time for distinguishing benign from malignant regions, as well as tumour aggressiveness, within the peripheral zone (PZ) of the prostate in comparison with diffusion-weighted imaging (DWI).

MATERIALS AND METHODS

Fifty-eight patients with prostate cancer underwent 3 T magnetic resonance imaging using multi-echo T2* and DWI (maximum b-value, 2000 s/mm(2)). Parametric maps were obtained for apparent diffusion coefficient (ADC) and T2* values. Two radiologists reviewed these maps and measured ADC and T2* values in sextants positive for cancer at biopsy. Data were analysed using mixed-model analysis of variance and receiver operating characteristic curves.

RESULTS

Ninety-three sextants exhibited a Gleason score of 6; 59 exhibited a Gleason score of 7 or 8. The T2* value was significantly lower in cancerous sextants than in the benign PZ (48.69+0.60 versus 74.14+0.56, p<0.001), as well as in cancerous sextants with higher rather than lower Gleason scores (43.18+0.89 versus 52.18+0.55, p<0.001). The T2* value showed significantly greater specificity for differentiating cancerous sextants from benign PZ than ADC (93.1% versus 89.7%, p<0.001), with equal sensitivity (82.8% versus 81%, p>0.05). The T2* value exhibited significantly greater sensitivity and specificity for differentiating sextants with low- and high-grade cancer than ADC (79.6% versus 64.5% and 81.4% versus 72.9%, respectively; p<0.05). The T2* value had a significantly greater area under the receiver operating characteristic curve for differentiating sextants with low- and high-grade cancer than ADC (0.77 versus 0.71, p<0.01).

CONCLUSION

Preliminary findings suggest that the T2* relaxation time has increased diagnostic value compared with DWI in prostate PZ cancer assessment.

Ultrasound assessment of lung consolidation and reaeration after pleural effusion drainage in patients with Acute Respiratory Distress Syndrome: a pilot study

PURPOSE

The aim of the pilot study was to assess by ultrasound changes in dimensions of lung consolidation and reaeration after drainage of large pleural effusion in patients with acute respiratory distress syndrome (ARDS).

METHODS

Lung ultrasound and blood gas were performed before, 2 hours (H2) and 24 hours (H24) after drainage of pleural effusion. Lung ultrasound aeration score was calculated. Cephalocaudal dimension and diaphragmatic transversal area of lung consolidation were measured.

RESULTS

Ten patients were studied. Median volume of drained effusion was 675 ml at H2 and 895 at H24. Two hours after drainage, dimension of cephalocaudal consolidation and diaphragmatic transversal area decreased significantly. Lung reaeration after drainage occurred mainly in latero-inferior and postero-superior regions. PaO2/FiO2 increased significantly at H24.

CONCLUSIONS

Ultrasound is a useful method to assess lung consolidation after pleural effusion drainage. Drainage of pleural effusion may lead to a decrease of lung consolidation and improvement of lung reaeration.

Akt inhibition attenuates rasfonin-induced autophagy and apoptosis through the glycolytic pathway in renal cancer cells

Rasfonin is a fungal secondary metabolite with demonstrated antitumor effects. However, the underlying mechanism of the regulatory role in autophagy initiated by rasfonin is largely unknown. Moreover, the function of Akt to positively mediate the induced autophagy remains elusive. In the present study, we observed that rasfonin induced autophagy concomitant with the upregulation of Akt phosphorylation. Both the inhibition of Akt by small molecule inhibitors and genetic modification partially reduced rasfonin-dependent autophagic flux and PARP-1 cleavage. The overexpression of myrAkts (constant active form) promoted rasfonin-induced apoptosis and autophagy in a cell type- and Akt isoform-specific manner. Using quantitative PCR and immunoblotting, we observed that rasfonin increased the expression of glycolytic gene PFKFB3, and this increased expression can be suppressed in the presence of Akt inhibitor. The inhibition of PFKFB3 suppressed rasfonin-activated autophagy with enhanced PARP-1 cleavage. In the case of glucose uptake was disrupted, which mean the glycolytic pathway was fully blocked, the rasfonin-induced autophagy and PARP-1 cleavage were downregulated. Collectively, these results demonstrated that Akt positively regulated rasfonin-enhanced autophagy and caspase-dependent apoptosis primarily through affecting the glycolytic pathway.

Design of Silk-Vaterite Microsphere Systems as Drug Carriers with pH-responsive Release Behavior

Improving the therapeutic efficacy of chemotherapy remains a key goal for cancer therapy. Various passive and active targeting strategies have been developed to facilitate drug release targeted to cancer lesions, but actively designing tunable drug release behavior for these needs remains a challenge. As a step towards this need, silk-vaterite microspheres were fabricated and utilized as carriers to tune drug release. Doxorubicin (DOX) was loaded on the microspheres with high efficiency and the release behavior was regulated by tuning the microspheres via thermal processing. In vitro cell inhibition results showed that the drug-loaded microspheres had different cytotoxic efficiencies depending on the DOX release rates. Better efficacy at lower drug doses suggests options to optimize anticancer effects while minimizing toxic side effects. The tunable drug release capacity combined with the inherent passive targeting property of vaterite-based carriers based on pH sensitivity suggests a promising system for enhanced efficacy of chemotherapy.

Recent advances in massage therapy--a review

Massage therapy is one of the most widely accepted alternative form of medicine helping patients suffering from varied pathological states including arthritis, anxiety, sleep problems, pain management and injury repair. Besides this, it is one of the safest forms of alternative medicine and has become favorite among various health care professionals. However, there is still a lot of debate is going in medical world pertaining to its certain use in modern medicine. So, the present review shall enlighten all the latest aspects of massage therapy in current medicine.

Virtual Touch quantification using acoustic radiation force impulse (ARFI) technology for the evaluation of focal solid renal lesions: preliminary findings

AIM

To evaluate potential value of Virtual Touch quantification (VTQ) of acoustic radiation force impulse (ARFI) imaging for characterising focal solid renal lesions.

MATERIALS AND METHODS

Two independent operators performed 10 and five measurements of each lesion and adjacent renal cortex, respectively. Mean shear wave velocity (SWV) and shear wave velocity ratio (SWR) of histotypes were compared.

RESULTS

One hundred and ninety-seven renal lesions were evaluated, including 155 renal cell carcinomas (RCCs; 129 clear-cell RCCs [ccRCCs], 14 papillary RCCs [pRCCs], and 12 chromophobe RCCs [cRCCs]) and 42 angiomyolipomas (AMLs). The interoperator reproducibility of SWV of renal tumours and renal cortex were good (ICC=0.852, and 0.903, respectively). SWV of the renal cortex at a depth of <4 cm was significant higher than that at a depth of >4 cm. Regardless of the subtypes of RCC, SWV and SWR of RCCs differed significantly from those of AMLs (2.28±0.85 versus 1.98±0.85; 1.09±0.56 versus 0.78±0.34; p=0.045 and p<0.001, respectively). At cut-off points of SWV >1.87 m/s or SWR >0.84 to differentiate RCCs from AMLs, the sensitivity and specificity were 47.5%, 33.2% or 47.5%, 30.2%, respectively. When the subtypes of RCCs were taken into account, SWV and SWR of ccRCCs were significantly higher than those of pRCCs, cRCCs, and AMLs, while there was no significant difference among the latter. With SWV >1.98 m/s or SWR >0.80 as the cut-off point to differentiate ccRCCs from other renal tumours, the sensitivity and specificity were 69.8%, 65% or 76.8%, 73.4%, respectively.

CONCLUSION

The ARFI technique offers additional information regarding renal tumour elasticity with good reproducibility. SWV and SWR are potential biomarkers in this setting, helping to differentiate ccRCC from other renal tumour histotypes.

Key pathway to prevent the collapse of femoral head in osteonecrosis

OBJECTIVE

Osteonecrosis of the femoral head (ONFH) is a multifactorial disease, with unclear pathogenesis. The collapse of the femoral head is an important turning point in ONFH, especially for young patients. Many methods have been proposed, but the best treatment lacks consensus among orthopedic surgeons. Thus, understanding the collapse mechanism of the femoral head in ONFH is the key to a successful outcome of joint preservation. This review aims to provide an update of the collapse mechanism of the femoral head in ONFH and to focus on the most appropriate therapeutic strategies to adopt in clinical practice.

MATERIALS AND METHODS

We reviewed the international literature to identify studies focusing on ONFH and therapeutic options. PubMed, Medline and Cochrane Library databases were searched for English language papers.

RESULTS

An imbalance between bone resorption and bone formation as well as stress distribution on insufficient trabecular bone may be the most important collapse mechanism in ONFH.

CONCLUSIONS

Treatment to avoid femoral head collapse should focus on local effective mechanical support with modification of bone remodeling in the femoral head.

PAR1-stimulated platelet releasate promotes angiogenic activities of endothelial progenitor cells more potently than PAR4-stimulated platelet releasate

BACKGROUND

Endothelial progenitor cells (EPCs) are important for endothelial regeneration and angiogenesis. Thrombin protease-activated receptor 1 (PAR1) PAR1 and PAR4 stimulation induces selective release of platelet proangiogenic and antiangiogenic regulators.

OBJECTIVE

To investigate if PAR1-stimulated platelet releasate (PAR1-PR) and PAR4-PR regulate angiogenic properties of EPCs in different manners.

METHODS AND RESULTS

EPCs were generated from peripheral mononuclear cell culture. Washed platelets (2 × 10(9) mL(-1)) were stimulated by PAR1-activating peptide (PAR1-AP; 10 μmol L(-1)) or PAR4-AP (100 μmol L(-1)) to prepare PAR1-PR and PAR4-PR, respectively. PAR1-PR or PAR4-PR had little influence on EPC proliferation. EPC migration experiments using a modified Boyden chamber showed that both platelet releasates facilitated EPC migration. As for in vitro tube formation on Matrigel, PAR1-PR and PAR4-PR similarly enhanced capillary-like network formation of EPCs in the complete EPC medium containing 10% FBS and a cocktail of growth factors, while PAR1-PR more profoundly increased EPC tube formation in basal culture medium supplemented with only 0.5% FBS than did PAR4-PR. The latter was confirmed in the murine angiogenesis model of subcutaneous Matrigel implantation. Moreover, blockade of vascular endothelial growth factor, stromal cell-derived factor 1α, or matrix metalloproteinases attenuated EPC migration and tube formation, suggesting a cooperation of these factors in the enhancements.

CONCLUSIONS

PAR1-PR enhances vasculogenesis more potently than PAR4-PR, and the enhancements require a cooperation of multiple platelet-derived angiogenic regulators.

Independent risk factors for massive ascites after living donor liver transplantation in adults

OBJECTIVES

This study sought to define the perioperative recipient and donor factors that contribute to the occurrence of massive ascites after living donor liver transplantation (LDLT) in adults.

METHODS

A retrospective review of medical records and computerized databases was performed, and 105 adult patients who underwent LDLT from 2005 to 2011 in the West China Hospital, Sichuan University, were included. Patients were divided into group 1 (n = 27, massive ascites defined as >7000 mL of ascitic fluid produced during the first 7 days after LDLT) or group 2 (n = 78, no massive ascites). Perioperative recipient and donor factors were assessed using a univariate analysis followed by 2 logistic regression analyses.

RESULTS

The recipients' median age was 44 years (range, 27 to 69 years), and the male-to-female ratio was 92:13. Massive ascites developed in 27 patients (25.7%). The average amount of ascites in group 1 and group 2 patients within the first 7 postoperative days was 11,285 mL and 3311 mL, respectively. The univariate analysis showed that recipient's age, primary liver disease, preoperative MELD score, Child-Pugh score, operating time, postoperative sequential organ failure assessment (SOFA) score, postoperative total bilirubin, right hepatic vein graft diameter, and hepatic portal vein graft diameter were significantly different between the 2 groups (P < .05). The 2 logistic regressions showed that the Child-Pugh score, operating time, and right hepatic vein graft diameter were independent risk factors for massive ascites after LDLT.

CONCLUSION

It is important to improve the perioperative liver function and portal hypertension and to shorten operating time to reduce massive ascites after LDLT.

Mycophenolic acid upregulates miR-142-3P/5P and miR-146a in lupus CD4+T cells

BACKGROUND

Mycophenolic acid (MPA), the active metabolite of mycophenolate mofetil (MMF), is a noncompetitive inhibitor of inosine monophosphate dehydrogenase, and is now widely used for the treatment of systemic lupus erythematosus (SLE). Dysregulated expression of microRNA has been reported to be associated with the pathogenesis of SLE. However, it is unexplored whether altering microRNA expression in SLE patients is one of the therapeutic effects of MPA.

OBJECTIVES

This study thus aims to investigate the effect of MPA on microRNAs expression in lupus CD4(+)T cells and its underlying mechanisms.

RESULTS

According to our microarray data, 101 upregulated microRNAs and 77 downregulated microRNAs were identified in MPA-treated lupus CD4(+)T cells. Among these microRNAs, miR-142-3p/5p and miR-146a expression was found to be significantly increased in MPA-treated lupus CD4(+)T cells compared to untreated controls. Furthermore, we observed that MPA-treated CD4(+)T cells from patients with SLE showed enriched levels of H4 acetylation in the putative miRNA-142 regulatory region and enhanced levels of H3 acetylation in the putative miRNA-146a regulatory region compared to untreated cells.

CONCLUSION

Data from this study suggest that MPA activates miR-142 and miR-146a expression through histone modification at the promoter region, which may partially explain the pharmacological mechanisms of MPA for SLE.

Clinical study on gastric cancer susceptibility genes IL-10-1082 and TNF-α

TNF 308 gene polymorphism and IL-10 polymorphism provided evidence in diagnosing some types of cancer. We aimed to explore the relation of gene polymorphism with gastric cancer. A total of 360 cases of gastric cancer patients were included in the study. The genotypes GG, GA, and AA of the interleukin-10-1082 gene (IL-10-1082) and the tumor necrosis factor-alpha gene (TNF-α) 308 polymorphism were examined by chromogenic detection. Three hundred healthy individuals' gene as control group were also examined. The GA 308 genotype of TNF-α differed significantly between the control group and the gastric cancer group (X(2) = 9.32, P < 0.05). Genotype frequencies of A/A (17.2%), A/G (26.2%), and G/G (9.1%) of the IL-10-1082 gene polymorphism in the gastric cancer group differed significantly compared to those of the control group (X(2) = 20.32, P < 0.05). The IL-10-1082 gene and the GA 308 genotype of the TNF-α gene were found to be susceptibility genes for gastric cancer.

Liver injury attenuation by curcumin in a rat NASH model: an Nrf2 activation-mediated effect?

AIM

Nuclear factor-erythroid 2-related factor-2 (Nrf2) acts as a defense system in the development of nonalcoholic steatohepatitis (NASH). Curcumin is a phenolic compound with lipid regulatory, anti-oxidative, anti-inflammatory and anti-tumorigenic properties that is beneficial in defending against NASH and was recently proved to be an Nrf2 activator. The aim of this study was to evaluate whether Nrf2 activation could be involved in NASH mitigation by curcumin.

METHODS

Hepatic, metabolic, and inflammatory parameters, along with hepatic Nrf2 protein expression were explored in adult Sprague-Dawley rats developing high-fat-diet-induced NASH and submitted to curcumin gavage for 6 weeks.

RESULTS

Curcumin administration led to lower degrees of hepatic steatosis and inflammation; lower levels of serum aminotransferases, lipids, and homeostasis model assessment of insulin resistance; and lower serum and hepatic contents of tumor necrosis factor-α (TNF-α), interleukin-6, and malondialdehyde. In contrast, higher hepatic contents of glutathione, heme oxygenase-1 and superoxide dismutase were observed in rats with curcumin. Moreover, Nrf2 expression in liver cell nuclei was significantly higher in rats with curcumin.

CONCLUSIONS

Curcumin can prevent and ameliorate NASH via lipid reduction, improve insulin resistance, improve anti-inflammatory, and have antioxidant effects, possibly related to its activation of Nrf2.

Promoter demethylation contributes to TSLP overexpression in skin lesions of patients with atopic dermatitis

BACKGROUND

Thymic stromal lymphopoietin (TSLP) plays an important role in promoting T-cell homeostasis, and appears to be a central player in the development of allergic symptoms, especially in asthma and atopic dermatitis (AD). Human TSLP is overexpressed in keratinocytes of patients with acute and chronic AD. However, the mechanism of TSLP overexpression remains unclear.

AIM

To investigate whether TSLP expression is regulated by aberrant DNA methylation modification of the TSLP promoter in keratinocytes of patients with AD.

METHODS

mRNA and protein levels of TSLP in lesional skin samples from 10 children with AD and 10 healthy controls were measured by real-time quantitative reverse transcriptase-PCR and immunohistochemistry. Bisulfite sequencing was performed to determine the methylation status of the TSLP promoter, and 5-azacytidine (5-aza), a DNA methyltransferase inhibitor, was used to determine the influence of DNA methylation on TSLP expression.

RESULTS

TSLP mRNA and protein expression levels were increased in skin lesions from patients with AD compared with healthy controls. Moreover, promoter hypomethylation of the TSLP gene was identified in skin lesions from patients with AD, and treating keratinocytes with 5-aza reduced the methylation level of the TSLP promoter and increased TSLP transcription.

CONCLUSIONS

DNA demethylation of a specific regulatory region of the TSLP gene may contribute to TSLP overexpression in skin lesions in patients with AD.

KCNQ/Kv7 channel activator flupirtine protects against acute stress-induced impairments of spatial memory retrieval and hippocampal LTP in rats

Spatial memory retrieval and hippocampal long-term potentiation (LTP) are impaired by stress. KCNQ/Kv7 channels are closely associated with memory and the KCNQ/Kv7 channel activator flupirtine represents neuroprotective effects. This study aims to test whether KCNQ/Kv7 channel activation prevents acute stress-induced impairments of spatial memory retrieval and hippocampal LTP. Rats were placed on an elevated platform in the middle of a bright room for 30 min to evoke acute stress. The expression of KCNQ/Kv7 subunits was analyzed at 1, 3 and 12 h after stress by Western blotting. Spatial memory was examined by the Morris water maze (MWM) and the field excitatory postsynaptic potential (fEPSP) in the hippocampal CA1 area was recorded in vivo. Acute stress transiently decreased the expression of KCNQ2 and KCNQ3 in the hippocampus. Acute stress impaired the spatial memory retrieval and hippocampal LTP, the KCNQ/Kv7 channel activator flupirtine prevented the impairments, and the protective effects of flupirtine were blocked by XE-991 (10,10-bis(4-Pyridinylmethyl)-9(10H)-anthracenone), a selective KCNQ channel blocker. Furthermore, acute stress decreased the phosphorylation of glycogen synthase kinase-3β (GSK-3β) at Ser9 in the hippocampus, and flupirtine inhibited the reduction. These results suggest that the KCNQ/Kv7 channels may be a potential target for protecting both hippocampal synaptic plasticity and spatial memory retrieval from acute stress influences.

Physical activity, body mass index and mental health in Chinese adolescents: a population based study

AIM

The aim of the present study was to examine the association between physical activity, BMI level and mental health among Chinese adolescents.

METHODS

Three thousand ninety-six adolescents aged 11 to 13 were analyzed from 6 middle schools of Xuzhou. Physical activity level was measured using self-designed questionnaires. BMI was calculated according to the results of these students' physical examinations. Anxiety symptoms were assessed by using the Screen for Child Anxiety Related Emotional Disorder, depression via the Children's Depression Inventory. Data were analyzed using chi-square test and logistic regression.

RESULTS

Adolescents' self-reported rate of insufficient physical activity was 58.1%. The overweight and obesity rates were 18.4%, 16.0%. The point prevalence rates on anxiety and depression were 15.2%, 11.5%. Insufficient physical activity was positively associated with anxiety and depression (OR [95%CI]: 1.31 [1.06-1.63]; 1.33 [1.04-1.70]). Obesity was positively associated with depression (OR [95%CI]: 1.48 [1.10-2.00]). IS-OB was positively associated with anxiety and depressive (OR [95%CI]: 1.71 [1.19-2.45]; 1.99 [1.33-2.97]).

CONCLUSION

Physical inactivity and overweight/obesity were negatively association with mental health of adolescents, respectively. Meanwhile, to explore the combined effects of physical inactivity and obesity would increase the risk of anxiety and depression in adolescents.

Transbrachial and femoral artery approach endovascular therapy for flush infrarenal aortic occlusion

OBJECTIVE

The purpose of this study is to report the efficacy of transbrachial and femoral artery approach endovascular therapy with catheter-directed thrombolysis (CDT) and adjunctive therapy for flush infrarenal aortic occlusion (FIAO).

MATERIALS AND METHODS

From March 2012 to December 2013, 11 consecutive patients (9 males; mean age 68 years; range 54-80 years) were submitted to endovascular therapy for FIAO. All patients were treated with CDT initially and then adjunctive endovascular treatments were performed to correct the underlying lesions.

RESULTS

Complete reconstruction of occluded aortoiliac arteries was successfully achieved in 81.8% (9/11) of patients. Left brachial and bilateral femoral arterial accesses were obtained in nine patients, and brachial and unilateral femoral in two patients. The residual lesions after CDT were corrected in nine patients and concomitant endovascular recanalization of superficial femoral artery was performed in two patients. Self-expandable stents were implanted in the all aortoiliac lesions with pre- and post-dilation. No renal or distal runoff embolization was seen during intraoperative angiography. Seven (7/9) patients with rest pain or tissue loss showed significant improvements in symptoms and two (2/9) patients with intermittent claudication gained an improved walking distance. The ABI rose significantly between pre- and post-procedure (0.84 ± 0.18 vs. 0.44 ± 0.13 on the right leg, p < .01; 0.89 ± 0.23 vs. 0.48 ± 0.16 on the left, p < .01).

CONCLUSIONS

Transbrachial and femoral artery approach endovascular therapy for FIAO offers an alternative to surgical reconstruction with immediate outcomes.

Doppler study of the effects of inhaled nitric oxide and intravenous almitrine on regional pulmonary blood flows in patients with acute lung injury

BACKGROUND

Lung ultrasound can be used at bedside to assess initial lung morphology in hypoxemic patients. We hypothesized that blood flow in consolidated lung and therefore effects of inhaled nitric oxide (iNO) and intravenous almitrine could be directly assessed using Doppler transesophageal echocardiography (TEE).

METHODS

We conducted a prospective study including 13 ALI patients with consolidated left lower lobe (LLL). Regional arterial and venous flow signals within the consolidation were recorded with TEE using Doppler at baseline, after iNO (5 ppm), almitrine (4 μg/kg/min) and their combination. Pulmonary shunt (Qs/Qt) was measured using a Swan-Ganz catheter. Arterial and venous velocity time integral (VTI), peak velocity (Vmax) and mean velocity (Vmean) were measured. Patients were responders if PaO2 basal value increased by 20% after iNO or almitrine.

RESULTS

In 7 NO responders, iNO decreased regional arterial VTI (8.1±1.9 vs. 6.7±1.6, P<0.05). In 8 almitrine responders, almitrine decreased regional arterial and venous VTI (from 6.7±2.0 to 4.5±2.3 cm and from 12.3±5.4 to 7.5±3.8 cm, respectively, P<0.05). For all patients, combination of iNO and almitrine decreased regional arterial and venous VTI (from 7.3±0.3 to 4.1±0.3 cm and from 12.6±0.7 to 6.7±0.8 cm, respectively, P<0.05). Arterial and venous Vmean and Vmax significantly decreased. Variations of arterial VTI and venous Vmean were correlated to variations of Qs/Qt (r=.71, P<.001 and r=.62, P<.01, respectively).

CONCLUSION

Doppler of consolidated LLL allows assessment of regional pulmonary circulation in ICU settings. It detects changes in flow profiles resulting from the administration of NO and/or almitrine. Further applicability remains to be determined.

δ-Catenin, a Wnt/β-catenin modulator, reveals inducible mutagenesis promoting cancer cell survival adaptation and metabolic reprogramming

Mutations of Wnt/β-catenin signaling pathway has essential roles in development and cancer. Although β-catenin and adenomatous polyposis coli (APC) gene mutations are well established and are known to drive tumorigenesis, discoveries of mutations in other components of the pathway lagged, which hinders the understanding of cancer mechanisms. Here we report that δ-catenin (gene designation: CTNND2), a primarily neural member of the β-catenin superfamily that promotes canonical Wnt/β-catenin/LEF-1-mediated transcription, displays exonic mutations in human prostate cancer and promotes cancer cell survival adaptation and metabolic reprogramming. When overexpressed in cells derived from prostate tumor xenografts, δ-catenin gene invariably gives rise to mutations, leading to sequence disruptions predicting functional alterations. Ectopic δ-catenin gene integrating into host chromosomes is locus nonselective. δ-Catenin mutations promote tumor development in mouse prostate with probasin promoter (ARR2PB)-driven, prostate-specific expression of Myc oncogene, whereas mutant cells empower survival advantage upon overgrowth and glucose deprivation. Reprogramming energy utilization accompanies the downregulation of glucose transporter-1 and poly (ADP-ribose) polymerase cleavage while preserving tumor type 2 pyruvate kinase expression. δ-Catenin mutations increase β-catenin translocation to the nucleus and hypoxia-inducible factor 1α (HIF-1α) expression. Therefore, introducing δ-catenin mutations is an important milestone in prostate cancer metabolic adaptation by modulating β-catenin and HIF-1α signaling under glucose shortage to amplify its tumor-promoting potential.

Safe and efficient local gene delivery into skeletal muscle via a combination of Pluronic L64 and modified electrotransfer

Efficient DNA electrotransfer into muscles can be achieved by combining two types of electronic pulses sequentially: short high-voltage (HV) pulse for the cell electropermeabilization and long low-voltage (LV) pulse for the DNA electrophoresis into cells. However, the voltages currently applied can still induce histological and functional damages to tissues. Pluronic L64 has been considered as a molecule possessing cell membrane-disturbing ability. For these reasons, we hope that L64 can be used as a substitute for the HV pulse in cell membrane permeabilization, and a safe LV pulse may still keep the ability to drive plasmid DNA across the permeabilized membrane. In this work, we optimized the electrotransfer parameters to establish a safe and efficient procedure using a clinically applied instrument, and found out that the critical condition for a successful combination of electrotransfer with L64 was that the injection of plasmid/L64 mixture should be applied 1 h before the electrotransfer. In addition, we revealed that the combined procedure could not efficiently transfer plasmid into solid tumor because the uncompressed plasmid may rapidly permeate the leaky tumor vessels and flow away. Altogether, the results demonstrate that the combined procedure has the potential for plasmid-based gene therapy through safe and efficient local gene delivery into skeletal muscles.

Woven silk fabric-reinforced silk nanofibrous scaffolds for regenerating load-bearing soft tissues

Although three-dimensional (3-D) porous regenerated silk scaffolds with outstanding biocompatibility, biodegradability and low inflammatory reactions have promising application in different tissue regeneration, the mechanical properties of regenerated scaffolds, especially suture retention strength, must be further improved to satisfy the requirements of clinical applications. This study presents woven silk fabric-reinforced silk nanofibrous scaffolds aimed at dermal tissue engineering. To improve the mechanical properties, silk scaffolds prepared by lyophilization were reinforced with degummed woven silk fabrics. The ultimate tensile strength, elongation at break and suture retention strength of the scaffolds were significantly improved, providing suitable mechanical properties strong enough for clinical applications. The stiffness and degradation behaviors were then further regulated by different after-treatment processes, making the scaffolds more suitable for dermal tissue regeneration. The in vitro cell culture results indicated that these scaffolds maintained their excellent biocompatibility after being reinforced with woven silk fabrics. Without sacrifice of porous structure and biocompatibility, the fabric-reinforced scaffolds with better mechanical properties could facilitate future clinical applications of silk as matrices in skin repair.

Impact of cold ischemia on cytokines after partial liver transplantation in rats

To study the impact of cold ischemia on tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) expression after liver transplantation, a stable model of partial liver transplantation in rats was established. The experimental animals were divided into the following groups: a partial hepatectomy control group, a group that received partial liver transplantation after 30 min of cold ischemia (experimental group A), and a group that received a partial liver transplantation after 10 h of cold ischemia (experimental group B). The survival rate was observed in each group. The liver tissue was sampled 1, 2, and 4 days after surgery, and immunohistochemical detection of proliferating cell nuclear antigen TNF-α and IL-10 was performed. The correlation between liver regeneration and TNF-α and IL-10 expression was analyzed, and the impact of the 2 cytokines on rat liver regeneration after liver transplantation was evaluated. The survival rates of rats in the partial hepatectomy control group, in the group that received a partial liver transplantation after 30 min of cold ischemia, and the group that received a partial liver transplantation after 10 h of cold ischemia were 100, 70, and 33.3%, respectively. The expression of proliferating cell nuclear antigen and TNF-α was decreased (P < 0.05), and IL-10 expression was increased (P < 0.05) in animals that received a partial liver transplant after 10 h of cold ischemia compared with that in the animals that received a partial liver transplant after 30 min of cold ischemia. We conclude that with the extension of cold ischemic time, liver regeneration and survival rate after liver transplantation decreased. TNF-α and IL-10 play important regulatory roles in the regeneration process of transplanted livers.

Affect as a mediator between self-efficacy and quality of life among Chinese cancer survivors in China

Previous studies have shown that self-efficacy influences cancer survivors' quality of life. As most of the relevant findings are based on Caucasian cancer survivors, whether the same relationship holds among Asian cancer patients and through what mechanism self-efficacy influences quality of life are unclear. This study examined the association between self-efficacy and quality of life among Chinese cancer survivors, and proposed affect (positive and negative) as a mediator between self-efficacy and quality of life. A sample of 238 Chinese cancer survivors (75% female, mean age = 55.7) were recruited from Beijing, China. Self-efficacy, affect (positive and negative) and quality of life were measured in a questionnaire package. Self-efficacy was positively associated with quality of life and positive affect, and negatively associated with negative affect. Path analyses revealed the direct effect from self-efficacy to quality of life and the indirect effects from self-efficacy to quality of life through positive affect and negative affect. The beneficial role of self-efficacy in Chinese cancer survivors' quality of life and the mediating role of affect in explaining the relationship between self-efficacy and quality of life are supported. Future interventions should include self-care and affect regulation skills training to enhance cancer survivors' self-efficacy and positive affect, as this could help to improve Chinese cancer survivors' quality of life.

Meta-analysis of temporary ileostomy versus colostomy for colorectal anastomoses

BACKGROUND/AIMS

Defunctioning stoma is a common surgical procedure, it is now generally acknowledged that defunctioning stoma significantly reduce the rates of complications in colorectal surgery, but the choice of temporary ileostomy or temporary colostomy for defunctioning colorectal anastomoses remains controversial. This meta-analysis evaluated two types of defunctioning stoma to determine whether one is superior to the other.

METHODOLOGY

Studies and relevant literatures comparing temporary ileostomy with temporary colostomy for defunctioning colorectal anastomoses were searched though PubMed, Embase and The Cochrane Library. The rates of complications were pooled and compared using a meta-analysis. The risk ratios were calculated with 95% confidence intervals to evaluate the safety and efficacy of each technique.

RESULTS

Five randomized controlled trials and seven non-randomized studies were included, with 1687 patients in total. The meta-analysis of the RCTs demonstrated a lower risk of stoma prolapse (RR 0.15; 95% CI: 0.04-0.48, p = 0.001) in the temporary ileostomy group. Meta-analysis of the non-randomized studies showed a lower risk of stoma prolapse (RR 0.26; 95% CI 0.10-0.67, p = 0.005) and wound infection after stoma closure (RR 0.28; 95% CI 0.5-0.52, p < 0.0001) in the temporary ileostomy group. No other statistically significant difference was observed for complications.

CONCLUSIONS

Each type of defunctioning stoma has its advantages and disadvantages, and there is not a strong evidence for the superiority of one temporary stoma over another for colorectal anastomoses. According to this, large scale RCTs and high quality studies are needed to conduct.

Controllable transition of silk fibroin nanostructures: an insight into in vitro silk self-assembly process

Silk fiber is one of the strongest and toughest biological materials with hierarchical structures, where nanofibril with size <20nm is a critical factor in determining its excellent mechanical properties. Although silk nanofibrils have been found in natural and regenerated silk solutions, there is no way to actively control nanofibril formation in aqueous solution. This study shows a simple but effective method of preparing silk nanofibrils by regulating the silk self-assembly process. Through a repeated drying-dissolving process, a silk fibroin solution composed of metastable nanoparticles was first prepared and then used to reassemble nanofibrils with different sizes and secondary conformations under various temperatures and concentrations. These nanofibrils have a similar size to that of natural fibers, providing a suitable unit to further assemble the hierarchical structure in vitro. Several important issues, such as the relationships between silk nanofibrils, secondary conformations and viscosity, are also investigated, giving a new insight into the self-assembly process. In summary, besides rebuilding silk nanofibrils in aqueous solution, this study provides an important model for furthering the understanding of silk structures, properties and forming mechanisms, making it possible to regenerate silk materials with exceptional properties in the future.

Morphological and Molecular Identification of Cytospora germanica Causing Canker on Populus spp. in China

Species of Cytospora Ehrenb. cause canker and dieback on many genera of hardwoods. During surveys of forest trees in 2004 and 2008, some hardwoods such as Populus spp. with symptoms of canker and dieback were found in Liaoning and Xinjiang provinces, respectively. In these trees, the canker pathogen discolored the sapwood. During wet weather, the conidia were exuded from the fruiting bodies in gelatinous matrices, usually as yellow or orange tendrils. In the spring, the affected trees were wilting and the diffuse cankers spread rapidly and extensively during the period when trees began active spring growth. For saplings, sometimes the death rate of the pathogen has exceeded 50%. Conidiomatal stromata immersed in bark, prominent, circular to ovoid, 1.10 ± 0.23 mm in diameter (n = 10). Discs were white, nearly flat, circular, 0.44 ± 0.04 mm in diameter (n = 10), with one or two ostioles per disc. Ostioles were gray. Locules were subdivided by invaginations into chambers. Conidia were hyaline and lelongate-allantoid shaped, 4 to 5.4 μm long and 1 to 1.4 μm wide. Pieces (5 × 5 mm²) of the junction of affected and healthy tissues were surface sterilized with 1% NaOCl for 30 s and then rinsed twice in sterile distilled water. The fragments were placed on potato dextrose agar (PDA) plates incubated at 25°C for 7 days. The obtained isolates were cultured on PDA at 25°C in diffuse fluorescent light for 30 days, and then were deposited in the culture collection of the Chinese Academy of Forestry. According to these morphological features we initially thought that this pathogen was Cytospora chrysosperma (Pers.) Fr. However, BLAST analysis showed 98% and 99% homology with ITS sequence of isolate CBS118560 (GenBank Accession No. DQ243793), 99% and 100% homology with LSU gene of isolate AR3427 (AF362561) when we amplified ITS-rDNA gene and LSU gene of the isolates. The sequences were submitted to GenBank with the following accession numbers: JQ086563, JQ086564, JX524617, and JX524618. Pathogenicity tests were conducted in the greenhouse by inoculating 20 disinfected (70% ethanol) Populus tomentosa cuttings. Another two cuttings were treated with water agar as controls. The cuttings were incubated at 25°C for 30 days. In 18 of the 20 cuttings, the cambium became brown and appeared water soaked 20 days later, whereas controls did not show any symptoms. C. germanica was reisolated from symptomatic tissues. Inoculations were later repeated two times with similar results. Hubbes (1) and Spielman (2) considered V. germanica (teleomorph of C. germanica) a synonym of V. sordida (teleomorph of C. chrysosperma) based on morphological studies. We almost regarded these isolates as C. chrysosperma too. Morphological identification has been a weak and often inadequate means of identifying Cytospora species (1,2); the present study based on ITS-rDNA gene and LSU gene has substantially elevated identifications. To our knowledge, this is the first report of C. germanica on Populus spp. in China. Populus species are economically important trees in forests of North China and C. germanica has the potential to cause significant economic losses. References: (1) M. Hubbes. Phytopathol. Z. 39:65, 1960. (2) L. J. Spielman. Can. J. Bot. 63:1355, 1985.

Functional analysis of DNA methylation in lung cancer

OBJECTIVES

We aimed to explore the DNA methylation difference between lung cancer samples and non-cancer lung samples, and to investigate the role of DNA methylation in the mechanism of lung cancer development. Besides, we analyzed the transcriptional regulation network of DNA methylation and the miRNAs regulated by DNA methylation. This study provides a framework for DNA methylation in other tumors or diseases.

MATERIALS AND METHODS

DNA methylation and gene expression profiles used were obtained from Gene Expression Omnibus. Firstly, we identified differentially methylated genes (DMGs) by Student's t-test. Then we detected the biological processes and pathways changed in lung cancer by Gene Ontology (GO) and KEGG pathway enrichment analysis. The transcriptional factors in differential genes were identified and the microRNAs regulated by them were also obtained in TransmiR.

RESULTS

We obtained 108 DMGs between lung cancer samples and non-cancer samples. Besides development related biological processes and pathways were dramatically disordered. For the DMGs, we identified 11 transcriptional factors regulating them. Moreover, we screened out 21 relationships between DMGs and their transcriptional targets. Five microRNAs are reported to be regulated by DNA methylation genes. Finally a regulation network of DNA methylation was constructed.

CONCLUSIONS

DNA methylation participates in carcinogenesis at the transcriptional and post-transcriptional level. Aberrant DNA methylation will prevent its binding with the upstream regulatory proteins, inhibit the function of downstream target genes and regulate the expression of downstream miRNA, and consequently affect cell development, immunoresponse and apoptosis.

Conservative Treatment of Complicated Oblique Crown-root Fractures of Molars: A Report of Five Representative Cases

The five cases presented here describe a conservative treatment procedure for complicated crown-root fractures of molars with extensive loss of tooth structure. After the mobile crown-root fragments were extracted, the remaining crowns were restored at the juxtagingival level. The follow-up time ranged from two years, seven months, to four years. At the follow-up examinations, all of the teeth were asymptomatic and had healthy clinical appearances. There was no evidence of pockets related to fractures. The results of these cases show that complete periodontal healing is possible with conservative treatment of complicated crown-root fracture of molars.

Endovascular repair of the aortic arch in pigs by improved double-branched stent grafts

INTRODUCTION

This study aimed to evaluate the feasibility of total endovascular repair of the aortic arch in pigs using improved integrated double-branched stent grafts.

METHODS

Improved self-expandable stent grafts with a main body and two integrated branches were prepared for the repair of the aortic arch in six pigs. The feasibility of using these stent grafts was evaluated with arteriography, computed tomography (CT), computed tomography angiography (CTA) and autopsy three months following the procedure.

RESULTS

The double-branched stent grafts were placed successfully in the aortic arch in all six pigs. All pigs survived for at least three months and their biological behaviour was normal. Arteriography, CTA and animal necropsy revealed good fixation in all cases. Aortic valve function and coronary ostia remained intact, and CT of the head did not detect any lesion of cerebral infarction.

CONCLUSIONS

Endovascular repair of the aortic arch with an integrated double-branched stent graft is safe and feasible in animal studies.

First Report of Branch Canker Caused by Cytospora atrocirrhata on Populus sp. and Salix sp. in China

Cytospora Ehrenb. species and their related teleomorphs are common inhabitants on over 85 species of plants throughout the world, and some of these pathogens have been associated with stem canker and dieback diseases. In July to August of 2011, samples of Cytospora canker were collected from Populus and Salix trees in Aershan City of Xingan League (46.51° N, 120.21° E) and Genhe (50.54° N, 120.30° E) (Inner Mongolia, China), the northeast part of the Chinese mainland, where the forests were frequently stressed by drought and cold springs and seriously suffered from Cytospora canker outbreaks, causing over 150,000 infected trees to die in 1999 (4). Symptoms observed included discoloration of the inner bark, cambium, and sapwood and sunken lesions at the site of active canker growth. The discrete erumpent ostiolar beaks of condimata were visible on the bark. The red spiral tendrils exuded from fruiting bodies when the relative humidity rose above 80%. All isolates were deposited into the China Forestry Culture Collection Center, strain numbers CXY1401, CXY1402, and CXY1403. The colony of single spore isolates on PDA medium was white and conidiomata were produced on autoclaved leaves and segments of Populus tomentosa Carr. and Salix babylonica Linn. The cultural characteristics of the isolates were conidiomatal stromata immersed in bark, discrete, erumpent, leucotorsellioid, and 0.5 to 1.1 × 0.4 to 0.9 mm. Discs were light grey, nearly flat, circular to ovoid, and 0.4 to 0.5 mm diameter, with one central dark grey ostiole. Locules were multi-chambered, subdivided by invaginations into chambers with seperate walls. Conidia were hyaline, eguttulate, elongate-allantoid, aseptate, and 5.5 to 7.0 × 0.8 to 1.2 μm. The ribosomal ITS1-5.8S-ITS2 region was amplified with primers ITS1 and ITS4 from gDNA. BLAST alignments of the consensus sequences of the ITS1 and ITS2 amplicons (JX534242, JX534243, JX534244) revealed 99% identical to the analogous 'Cytospora atrocirrhata Gvrit.' sequences reported from Populus spp. and Salix spp. in Iran (EF447305 and EF447306) (2). Pathogenicity tests were carried out using mycelium discs of isolates placed on disinfected 2-year-old P. tomentosa twigs, while the control were inoculated with sterile potato dextrose agar (PDA) discs. Cuttings were incubated at 25°C for 30 days. For 16 of the 20 cuttings, symptoms of brown spot and inner bark discoloration were similar to those observed in the field. Controls did not develop any symptoms, and Koch's postulates were fulfilled with the reisolation of the pathogen from symptomatic tissues. C. atrocirrhata was first reported in the former Soviet Union in 1973 (3) and more recently in Iran (1). To our knowledge, this is the first report of branch canker caused by C. atrocirrhata on Populus sp., and Salix sp. in China. The result provides new information on the geographic distribution of C. atrocirrhata. The appearance of C. atrocirrhata in China seriously threatens the Populus and Salix species, which are widely cultivated for wood production in flat areas. Control measures are needed to prevent further spread of the fungus to new areas. References: (1) K. B. Fotouhifar et al. Rostaniha. 8:129, 2007. (2) K. B. Fotouhifar et al. Mycol. 102:1369, 2010. (3) M. N. Gvritishvili. Miko. Fitopatol. 7:544, 1973. (4) C. L. Wu. China Forest Pest and Disease (in Chinese). 2:36, 1999.

Unique roles of Schistosoma japonicum protein Sj16 to induce IFN-γ and IL-10 producing CD4(+)CD25(+) regulatory T cells in vitro and in vivo

Various proteins are expressed during different stages of schistosome development that are essential for cercarial penetration of vertebrate skin and evasion of host immune response. CD4(+)CD25(+) regulatory T cells are important in modulating immune responses towards helminth infections. Schistosoma japonicum protein Sj16 present in the secretions of schistosomula has been shown to have anti-inflammatory effects; however, it is uncertain whether Sj16 can induce CD4(+)CD25(+) regulatory T cells to participate in the regulation of early infection. In this study, we demonstrate a relationship between recombinant Sj16 (rSj16) and the induction of CD4(+)CD25(+) Foxp3(+) regulatory T cells. An increase in CD4(+)CD25(+) T cells was observed both in splenic cells from mice injected with rSj16 and the cells pretreated with rSj16, respectively. The induced CD4(+)CD25(+) T cells suppressed CD4(+)CD25(-) T-cell proliferation; furthermore, IFN-γ and IL-10 released from rSj16-stimulated cells contribute to this suppression. Additionally, rSj16-treated bone marrow dendritic cells (BMDCs) demonstrate an immature phenotype and play a role in the conversion of CD4(+)CD25(-) T cells into suppressive CD4(+)CD25(+) regulatory T cells. Our study identified a new CD4(+)CD25(+) T-cell population that induced by rSj16 and suggests that an IFN-γ-biased microenvironment during early infection of schistosome may favour the establishment of infection.