[Prognosis analysis of 310 patients with pathological stage pN3 gastric cancer]

OBJECTIVE

To investigate the clinicopathological characteristics and prognostic factors of patients with pathological stage pN3 gastric cancer.

METHODS

A retrospective study of 310 patients with histologically confirmed pN3 stage gastric cancer undergoing radical gastrectomy from January 2000 to December 2006 in our department was performed. The Kaplan-Meier method was used to analyze the survival. Log-rank test and Cox regression model were carried out for univariate and multivariate analyses.

RESULTS

All the patients were followed up for 2 to 103 (mean 35.7) months. The overall 5-year survival rate was 14.6%. There were 201 cases with stage pN3a and 109 cases with stage pN3b, and the 5-year survival rates were 16.8% and 10.3% respectively (P=0.013). Univariate analysis showed that tumor location, Borrmann type, depth of tumor invasion, surgical method, metastatic lymph node ratio, and pN stage were associated with postoperative survival (all P<0.05). The multivariate analysis revealed that depth of tumor invasion, surgical method and metastatic lymph node ratio were independent prognostic factors, while the pN stage was not. The difference of 5-year survival rate between pN3a and pN3b subgroups was significant in pT4a patients (16.1% vs. 12.8%, P=0.001), while such difference was not significant in pT4b patients (8.6% vs. 3.1%, P=0.137).

CONCLUSIONS

Prognosis of patients with pN3 stage gastric cancer after radical resection is poor. Depth of tumor invasion and surgical method are independent prognostic factors for pN3 stage gastric cancer. Metastatic lymph node ratio is valuable to predict the prognosis of pN3 stage patients. The pN3 staging of the 7th UICC provides a more accurate prediction of prognosis.

[Effects of linggui zhugan decoction combined calorie restriction on the insulin resistance of model rats and mechanisms research]

OBJECTIVE

To explore the effects of Linggui Zhugan Decoction (LZD) combined calorie restriction on fasting plasma glucose (FPG), the insulin resistance (IR), and the peroxisome proliferator-activated receptor gamma (PPAR-gamma) of IR model rats.

METHODS

Totally 48 male Wistar rats were randomly divided into the control group, the model group, the calorie restriction group, and the TCM + calorie restriction group, 12 in each group. Ordinary forage was given to those in the control group, and high fat diet was fed to those in the rest 3 groups for 12 weeks to establish the IR model. After successful modeling, rats in the control group and the model group were continually fed with the original farage for 4 days. The normal saline at the daily dose of 20 mL/kg was given to them by gastrogavage. The normal saline at the daily dose of 20 mL/kg was given to rats in the calorie restriction group by gastrogavage after 4-day calorie restriction. LZD at the daily dose of 20 mL/kg was given to rats in the TCM +calorie restriction group by gastrogavage after 4-day calorie restriction. The body weight, FPG, serum fasting insulin (FINS), insulin resistance index (IRI), and the protein expression of PPAR-y in the omental adipose tissue were compared.

RESULTS

After 4-day calorie restriction, the body weight obviously decreased in the calorie restriction group and the TCM +calorie restriction group, when compared with the model group (P <0.01). There was no statistical difference between the former two groups (P >0.05). The FINS and IRI obviously decreased in the calorie restriction group (P <0.01, P <0.05). The FPG, FINS, and IRI significantly decreased in the TCM + calorie restriction group (P <0. 05, P <0.01). The protein expression of PPAR-gamma obviously decreased in the calorie restriction group and the TCM + calorie restriction group (P <0.01).The phlegm dampness state was alleviated, with more significant effects shown in the TCM + calorie restriction group.

CONCLUSIONS

LZD combined calorie restriction could reduce the body weight, FPG, and IRI of IR rats. Besides, it showed better effects than calorie restriction alone. Its effects in improving IR might be correlated with inhibiting the activities of PPAR-gamma. Meanwhile, it might play a role in inhibiting the differentiation of fat cells.

Protective effects of modified linggui zhugan decoction combined with short-term very low calorie diets on cardiovascular risk factors in obese patients with impaired glucose tolerance

OBJECTIVE

To observe the protective effects of modified Linggui Zhugan decoction combined with short-term very low calorie diets (VLCDs) on cardiovascular risk factors in obese patients with impaired glucose tolerance (IGT).

METHODS

Eighty-five obese patients with IGT of spleen hypofunction and dampness accumulation type were randomly divided into treated group (n=45)and control group (n=40). The treated group was given Linggui Zhugan decoction combined short-term VLCDs. The control group was given basic weight-reduction treatment. The total course was 6 months. Changes of fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS), lipid metabolism, blood pressure, body mass index (BMI) and waist circumference (WC) were observed, and the outcomes were reviewed after the treatment.

RESULTS

Compared with the control group, the levels of FPG, 2 hPG, HbA1c, FINS, HOMA-IR decreased significantly (P < 0.05), and the indexes of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI and WC were improved significantly (P < 0.05) in the treated group. The transformation rate of normal glucose tolerance (NGT) was higher in treatment group than control group (P < 0.01). No severe adverse reaction was found in the therapeutic course.

CONCLUSION

The modified Linggui Zhugan decoction combined with short-term VLCDs has good protective effects on cardiovascular risk factors as a treatment intervention for IGT with obesity, as it could improve glycometabolism, significantly decrease the levels of blood pressure, blood lipids, BMI, WC and effectively cut-off and reverse the development of diabetes mellitus.

Disruption of Type-I IFN pathway ameliorates preservation damage in mouse orthotopic liver transplantation via HO-1 dependent mechanism

Ischemia/reperfusion injury (IRI) remains unresolved problem in clinical organ transplantation. We analyzed the role of Type-I interferon (IFN) pathway in a clinically relevant murine model of extended hepatic cold preservation followed by orthotopic liver transplantation (OLT). Livers from Type-I IFN receptor (IFNAR) knockout (KO) or wild-type (WT) mice (C57/BL6) were harvested, preserved at 4°C in UW solution for 20 h and transplanted to groups of syngeneic IFNAR KO or WT recipients. Liver graft but not recipient IFNAR deficiency was required to consistently ameliorate IRI in OLTs. Indeed, disruption of Type-I IFN signaling decreased serum alanine aminotransferase (sALT) levels (p < 0.001), diminished Suzuki's score of histological OLT damage (p < 0.01) and improved 14-day survival (from 42%[5/12] in WT to 92%[11/12] in IFNAR KO; p < 0.05). Unlike in WT group, IFNAR deficiency attenuated OLT expression of TNF-α, IL-1β, IL-6, MCP-1, CXCL-10, ICAM-1; diminished infiltration by macrophages/PMNs; and enhanced expression of antioxidant HO-1/Nrf2. The frequency of TUNEL+ apoptotic cells and caspase-3 activity/expression selectively decreased in IFNAR KO group. Small interfering (si)RNA-directed targeting of HO-1 restored cardinal features of liver IRI in otherwise resistant IFNAR-deficient OLTs. Thus, intact Type-I IFN signaling is required for hepatic IRI, whereas HO-1 is needed for cytoprotection against innate immunity-dominated organ preservation damage in IFNAR-deficient liver transplants.

Sotrastaurin, a protein kinase C inhibitor, ameliorates ischemia and reperfusion injury in rat orthotopic liver transplantation

Sotraustaurin (STN), a small molecule, targeted protein kinase C (PKC) inhibitor that prevents T-lymphocyte activation via a calcineurin-independent pathway, is currently being tested in Phase II renal and liver transplantation clinical trials. We have documented the key role of activated T cells in the inflammation cascade leading to liver ischemia/reperfusion injury (IRI). This study explores putative cytoprotective functions of STN in a clinically relevant rat model of hepatic cold ischemia followed by orthotopic liver transplantation (OLT). Livers from Sprague-Dawley rats were stored for 30 h at 4°C in UW solution, and then transplanted to syngeneic recipients. STN treatment of liver donors/recipients or recipients only prolonged OLT survival to >90% (vs. 40% in controls), decreased hepatocellular damage and improved histological features of IRI. STN treatment decreased activation of T cells, and diminished macrophage/neutrophil accumulation in OLTs. These beneficial effects were accompanied by diminished apoptosis, NF-κB/ERK signaling, depressed proapoptotic cleaved caspase-3, yet upregulated antiapoptotic Bcl-2/Bcl-xl and hepatic cell proliferation. In vitro, STN decreased PKCθ/IκBα activation and IL-2/IFN-γ production in ConA-stimulated spleen T cells, and diminished TNF-α/IL-1β in macrophage-T cell cocultures. This study documents positive effects of STN on liver IRI in OLT rat model that may translate as an additional benefit of STN in clinical liver transplantation.

[Prognostic factors in 138 patients with node-negative gastric cancer]

OBJECTIVE

To investigate the risk factors for the prognosis in patients with node-negative gastric cancer.

METHODS

Clinicopathological characteristics of 138 patients with node-negative gastric carcinoma undergoing curative gastrectomy from January 2000 to December 2005 were retrospectively analyzed.

RESULTS

The overall 5-year survival rate was 62.4%. The univariate analysis revealed that tumor size, tumor location, cell differentiation, invasive depth, operative type and Lauren histologic type had significant effects on the survival. The independent prognostic factors of these patients were tumor size, cell differentiation, and serosal involvement in multivariate analyses.

CONCLUSION

For node-negative gastric cancer patients, tumor size, poor differentiation and serosal involvement are important markers to evaluate prognosis.

[Prognostic significance of preoperative serum albumin level in patients with gastric cancer]

OBJECTIVE

To evaluate the prognostic significance of preoperative serum albumin in patients with gastric cancer undergoing radical resection.

METHODS

A total of 146 patients with gastric cancer underwent radical resection from January 2001 to December 2003. Clinicopathological data were analyzed retrospectively. Patients were divided into two groups, including patients with a normal preoperative serum albumin level(>35 g/L, n=115) and patients with hypoalbuminemia (≤35 g/L, n=31).

RESULTS

Patients with a low albumin level were associated with a higher postoperative recurrence rate(90.3% vs. 43.5%, P<0.01). The overall 5-year survival rate in patients with a normal serum albumin level was significantly higher than that in patients with a low serum level(57.4% vs. 9.7%, P<0.01). On multivariate analysis, preoperative serum albumin level was an independent factor associated with survival(P<0.01). When stratified by nodal metastasis, normal serum albumin level was still associated with higher survival rate(P<0.05). Prognostic significance was found in patients with lower stomach cancer(P<0.01), but not in patients with cancer in the upper and middle stomach(P>0.05).

CONCLUSION

Hypoalbuminemia is associated with worse survival in patients with cancer in the lower stomach and adjuvant therapy should be considered.

[Analysis of treatment and prognosis in 132 patients with gastric gastrointestinal stromal tumors]

OBJECTIVE

To investigate the clinicopathological characteristics, diagnosis, treatment and prognostic factors of gastric gastrointestinal stromal tumors(GIST) in the stomach.

METHODS

The clinicopathological data of 132 patients with gastric GIST between January 1998 and December 2008 were analyzed retrospectively, and the prognostic factors were evaluated.

RESULTS

Tumor locations were the cardia or fundus (50, 37.9%), the stomach body (62, 47%),the antrum (13, 9.8%), and two regions were found in 6 cases (4.5%), three regions in 1 cases (0.8%). Tumor size ranged from 1.0 to 27.0 cm with an average of 9.4 cm. All the patients underwent complete tumor resection, including multi-organ resection in 41 cases. Thirty-four cases underwent lymph node dissection. All the lymph nodes were negative. The positive rate was 93.2% (23/132) for CD 117 and 82.6% (109/132) for CD34. The 1-,3- and 5-year survival rates of the 118 cases with follow up were 94.7%, 80.2%, and 56.6%, respectively. Univariate analysis revealed that the differences in Fletcher classification, tumor size, infiltration to surrounding tissue, preoperative metastasis, and adjuvant postoperative therapy with imatinib were related to the survival rates. Multivariate analysis demonstrated that Fletcher classification, preoperative metastasis and adjuvant postoperative therapy with imatinib were independent poor prognostic factors for survival.

CONCLUSIONS

Preoperative metastasis is an independent factor predicting poor prognosis of gastric GIST. Fletcher classification can be used to evaluate the biological behaviors and prognosis, while surgery is the main therapy and targeted therapy can improve survival of gastric GIST.

Interaction between the intermediary electron acceptor (pheophytin) and a possible plastoquinone-iron complex in photosystem II reaction centers

Photoreduction of the intermediary electron acceptor, pheophytin (Pheo), in photosystem II reaction centers of spinach chloroplasts or subchloroplast particles (TSF-II and TSF-IIa) at 220 K and redox potential E(h) = -450 mV produces an EPR doublet centered at g = 2.00 with a splitting of 52 G at 7 K in addition to a narrow signal attributed to Pheo([unk]) (g = 2.0033, DeltaH approximately 13 G). The doublet is eliminated after extraction of lyophilized TSF-II with hexane containing 0.13-0.16% methanol but is restored by reconstitution with plastoquinone A (alone or with beta-carotene) although not with vitamin K(1). TSF-II and TSF-IIa are found to contain approximately 2 nonheme Fe atoms per reaction center. Incubation with 0.55 M LiClO(4) plus 2.5 mM o-phenanthroline (but not with 0.55 M LiClO(4) alone) decreases this value to approximately 0.6 and completely eliminates the EPR doublet, but photoreduction of Pheo is not significantly affected. Partial restoration of the doublet (about 25%) was achieved by subsequent incubation with 0.2 mM Fe(2+), but not with either Mn(2+) or Mg(2+). The Fe removal results in the development of a photoinduced EPR signal (g = 2.0044 +/- 0.0003, DeltaH = 9.2 +/- 0.5 G) at E(h) = 50 mV, which is not observed after extraction with 0.16% methanol in hexane. It is ascribed to plastosemiquinone no longer coupled to Fe in photosystem II reaction centers. The results show that a complex of plastoquinone and Fe can act as the stable "primary" electron acceptor in photosystem II reaction centers and that the interaction of its singly reduced form with the reduced intermediary acceptor, Pheo([unk]), is responsible for the EPR doublet.

Redox titration of fluorescence yield of photosystem II

The variable fluorescence yield of photosystem II is dependent on the redox state of the fluorescence quencher molecule or the primary electron acceptor of the system. We have carried out redox titrations of fluorescence yield of a photochemically active photosystem-II reaction-center particle and have measured the redox potential of the photosystem-II primary acceptor.During reductive titrations using dithionite as the reductant, only a single quenching transition was observed. For instance, at pH 7.0, the midpoint potential of the fluorescence transition is -325 mV, and those at a pH between 6.0 and 7.5 are consistent with a pH dependence of about 60 mV/pH unit. At a given pH, the midpoint potential of the transition closely corresponds to that of the most negative transition previously measured in unfractionated chloroplasts (both by chemical reductive titration). Oxidative titrations using ferricyanide as the oxidant yielded hysteresis in the titration curves.Similar changes in fluorescence yield were observed in redox titrations by electrochemical reduction or oxidation. Electrochemical reductive and oxidative titrations yielded reversible transitions, contrary to the hysteresis observed during chemical oxidative titration. From coulometric-titration data, we have estimated that most likely one electron is involved in the redox transition of the fluorescence-quencher or primary-electron-acceptor molecule of photosystem II. These findings are consistent with the current proposal that a membrane-bound plastoquinone functions as the primary acceptor of photosystem II.

Spectral and kinetic evidence for two early electron acceptors in photosystem I

Triton-fractionated photosystem-I particles poised at -625 mV, where the two bound iron-sulfur proteins are reduced, have been studied by optical and electron paramagnetic resonance spectroscopies from 293 to 5 K. At 5-9 K, these particles exhibit two decay components with lifetimes of 1.3 and 130 msec in the laser pulse-induced absorption and electron paramagnetic resonance signal changes. Spectral properties of the 130-msec decay component reflect the charge separation between P-700 and some iron-sulfur center having a broad optical absorbance in the 400- to 550-nm region and a previously reported electron paramagnetic resonance signal with g = 1.78, 1.88, and 2.08. Spectral properties of the 1-msec decay component indicate photoinduced charge separation between P-700 and a chlorophyll a dimer having absorption bands at 420, 450, and 700 nm. It is assumed that these two acceptors participate in the electron transfer from P-700(*) to the bound iron-sulfur proteins.

Oxidation-reduction potentials of bound iron-sulfur proteins of photosystem I

Digitonin - fractionated photosystem - I subchloroplasts were titrated potentiometrically between -450 and -610 mV at pH 10. Examination of the titrated subchloroplasts by low-temperature (13 degrees K) electron paramagnetic resonance spectroscopy revealed resonances centered at values of 2.05, 1.94, 1.92, 1.89, and 1.86 on the g-factor scale. The peak heights depended on the potentials at which the chloroplasts were poised. The resonances of at least three iron-sulfur centers can be recognized: one with lines at g = 2.05 and 1.94; one with lines at g = 2.05, 1.92, and 1.89; and one for which only a line at g = 1.86 has been resolved. The midpoint potentials of the iron-sulfur species fall into two distinctly separate regions: the titration profile of the g = 1.94 signal, the first segment of the g = 2.05 plot, and the rise phase of the g = 1.86 signal had a value of -530 +/- 5 mV; the upper segment of the g = 2.05 plot, the decrease phase of the g = 1.86 signal, and the g = 1.89 profile had a midpoint potential estimated to be [unk] -580 mV. The oxidation-reduction reaction of each of the bound iron-sulfur species, as represented by the changes of the electron paramagnetic resonance spectra, was reversible and apparently involved a two-electron change.Titration at pH 9 could only be carried to -560 mV, and essentially only the first half of the titration behavior as found at pH 10 was seen. At any given potential more positive than -560 mV, the part of the iron-sulfur protein that was not reduced electrochemically could be reduced photochemically, but only to the maximum extent reduced electrochemically at -560 mV. Whereas, chloroplasts illuminated at room temperature and then frozen while still being illuminated developed a signal similar to that produced by electrochemical reduction at -610 mV, illumination at 77 degrees K did not bring about photoreduction beyond that accomplished electrochemically at about -560 mV.Dithionite alone in the dark and under anaerobic conditions brought about a partial reduction to the extent of the first electrochemical reduction step. Dithionite plus illumination at room temperature or dithionite plus methyl viologen in the dark produced the maximum signal. Electron paramagnetic resonance spectra due to either light or electrochemically reduced iron-sulfur proteins showed no detectable decay for at least 3 days when samples were stored in the dark at 77 degrees K.

[Prognostic analysis on primary duodenal adenocarcinoma]

OBJECTIVE

To investigate the prognostic factors of primary duodenal adenocarcinoma.

METHODS

The medical records of 67 patients with primary duodenal adenocarcinoma treated in our hospital from January 1990 to December 2005 were retrospectively analyzed. Prognostic factors were analyzed by univariable and multivariable analysis.

RESULTS

Of the 67 patients, 38 underwent curative resection and 29 underwent palliative resection. The overall 5-year survival rate was 22.4%. The survival was significantly higher in patients who underwent curative resection (5-year survival 39.5%) than that in those who underwent palliative resection(5-year survival 0) (P<0.05). Univariable analysis showed that T-stage, nodal metastasis and tumor stage had significant negative effects on the survival of patients who underwent curative resection. However, multivariable analysis revealed that T-stage and nodal metastasis were significantly associated with survival.

CONCLUSIONS

Curative resection may improve the survival. T-stage and lymph nodes metastasis are associated with decreased survival.

The parameters of electron cyclotron resonance/radio-frequency hybrid hydrogen plasma adjusted by substrate arrangements

Hybrid hydrogen plasma was formed by biasing 13.56 MHz radio-frequency (rf) power on a substrate immersed in 2.45 GHz microwave electron cyclotron resonance (ECR) plasma. The influences of the substrate configuration on plasma characteristics were investigated. With increasing rf self-bias voltage, electron temperature, T(e), increases obviously in the case of the single-electrode substrate, whereas a slight change in T(e) was observed with the double-electrode substrate condition. Electron density rises almost with a same magnitude under both two substrate conditions. It exhibited that electron energy and density in ECR-rf hybrid mode could be adjusted independently by controlling rf discharge with favorable substrate configurations.

The antioxidant drink “effective microorganism-X (EM-X)” pre-treatment attenuates the loss of nigrostriatal dopaminergic neurons in 6-hydroxydopamine-lesion rat model of Parkinson’s disease

There is continued interest in the assessment and potential use of antioxidants as neuroprotective agents in diseases associated with increased oxidative stress, such as Parkinson's disease. The neuroprotective effect of a natural antioxidant drink, EM-X (a ferment derivative of unpolished rice, papaya and seaweeds with effective microorganisms), was investigated using the 6-hydroxydopamine (6-OHDA)-lesion rat model of Parkinson's disease. The nigrostriatal dopaminergic neurons were unilaterally lesioned with 6-OHDA (8 μg) in rats that were treated with a 10-times diluted EM-X drink (dilEM-X), standard EM-X drink (stdEM-X) or tap water for 4 days. Seven days post lesion, the integrity (no. of tyrosine hydroxylase positive cells (TH+ cells) in the substantia nigra pars compacta (SNpc)) and functionality (dopamine and its metabolites DOPAC and HVA content in the striata) of nigrostriatal dopaminergic neurons were assessed. In the vehicle-treated rats, infusion of 8 μg of 6-OHDA significantly reduced the number of TH+ cells in the SNpc as well as the levels of dopamine, DOPAC and HVA in the striata on the lesion side. The loss of TH+ cells, dopamine and HVA, but not the DOPAC levels, was significantly attenuated by stdEM-X pretreatment, but not by the dilEM-X pretreatment. There were no significant changes in the TH+ cells, or in the monoamine levels with the EM-X pretreatment per se, except for a small but significant fall in the levels of dopamine with the stdEM-X. The evidence presented supports the potential neuroprotective effects of stdEM-X drink, although its effect on dopamine levels needs further investigation.

Intestinal ischemia/reperfusion injury triggers activation of innate toll-like receptor 4 and adaptive chemokine programs

BACKGROUND

Ischemia/reperfusion injury (IRI) is a major problem in intestinal transplantation. Toll-like receptor 4 (TLR4) has been implicated as a possible link between the innate and adaptive immune systems, however little data exists regarding TLR4 in intestinal IRI. The goal of this study is to evaluate the involvement of TLR4 in intestinal IRI and to assess the effect on T cell related chemokine programs.

METHODS

C57BL6 mice underwent 100 minutes of warm intestinal ischemia by SMA clamping. Control WT mice underwent laparotomy without vascular occlusion. Separate survival and analysis groups were performed, and intestinal tissue was harvested at 1 hour, 2 hours, 4 hours, and 24 hours post-reperfusion. Analysis included histology, CD3 immunostaining, myeloperoxidase activity, Western blot, and PCR.

RESULTS

Survival was significantly worse in the IRI group vs control (50% vs. 100%). IRI caused severe histopathological injury including mucosal erosions and villous congestion and hemorrhage. Myeloperoxidase activity increased in a time-dependent manner after IRI (2.71 0.25 at 1 hour, 2.92 0.25 at 2 hours, 4 0.16 at 4 hours, 5.1 0.25 at 24 hours vs 0.47 0.11 controls, P < .05). Protein expression of TLR4 followed by NF-kappaB was increased after IRI. Additionally, mRNA production of IP-10, MIP-2, MCP-1, and RANTES was increased at all time-points, as was mRNA for ICAM-1 and E-selectin.

CONCLUSION

This study is the first to demonstrate increased expression of TLR4 and NF-kappaB after warm intestinal IRI. This detrimental cascade may be initiated by TLR4 via NF-kappaB signaling pathways, implicating TLR4 as a potential therapeutic target for the prevention of intestinal IRI.

Diannexin, a novel annexin V homodimer, protects rat liver transplants against cold ischemia-reperfusion injury

Ischemia/reperfusion injury (IRI) remains an important problem in clinical transplantation. Following ischemia, phosphatidylserine (PS) translocates to surfaces of endothelial cells (ECs) and promotes the early attachment of leukocytes/platelets, impairing microvascular blood flow. Diannexin, a 73 KD homodimer of human annexin V, binds to PS, prevents attachment of leukocytes/platelets to EC, and maintains sinusoidal blood flow. This study analyzes whether Diannexin treatment can prevent cold IRI in liver transplantation. Rat livers were stored at 4 degrees C in UW solution for 24 h, and then transplanted orthotopically (OLT) into syngeneic recipients. Diannexin (200 microg/kg) was infused into: (i) donor livers after recovering and before reperfusion, (ii) OLT recipients at reperfusion and day +2. Controls consisted of untreated OLTs. Both Diannexin regimens increased OLT survival from 40% to 100%, depressed sALT levels, and decreased hepatic histological injury. Diannexin treatment decreased TNF-alpha, IL-1beta, IP-10 expression, diminished expression of P-selectin, endothelial ICAM-1, and attenuated OLT infiltration by macrophages, CD4 cells and PMNs. Diannexin increased expression of HO-1/Bcl-2/Bcl-xl, and reduced Caspase-3/TUNEL+ apoptotic cells. Thus, by modulating leukocyte/platelet trafficking and EC activation in OLTs, Diannexin suppressed vascular inflammatory responses and decreased apoptosis. Diannexin deserves further exploration as a novel agent to attenuate IRI, and thereby improve OLT function/increase organ donor pool.

Antiangiogenic activity of a concentrated effective microorganism fermentation extract

We have previously demonstrated the possible growth inhibitory activity of both first generation of the effective microorganism fermentation extract (EM-X) as well as the second generation (EM-X2) on cancer cell lines in vitro. The possible anti-angiogenic potential of EM-X has not been reported. Herein we show that using the concentrated EM-X, the growth of human umbilical cord endothelial cells (HUCE) was significantly inhibited in vitro. Enzyme linked immunosorbent assay suggested that the concentrated EM-X is able to reduce the level of vascular endothelial growth factor (VEGF) from Hep3B hepatocellular carcinoma (HCC) cells. The conditioned culture medium obtained from the concentrated EM-X incubated Hep3B HCC cells possessed significant antiproliferative effect on the HUCE cells. Moreover, in vivo chick chorioallantoic membrane assay further demonstrated that the concentrated EM-X is able to greatly inhibit the basic fibroblast growth factor induced angiogenesis from chick embryo experiment. We speculate that the anti-cancer potential of this concentrated EM-X involved growth inhibition on cancer cell and antiangiogenic effect on HUCE cells.

Apoptotic potential of the concentrated effective microorganism fermentation extract on human cancer cells

The effective microorganism fermentation extract (EM-X, the first generation) was claimed to possess strong anti-oxidation property. On the other hand, we have shown that the second generation of the effective microorganism fermentation extract (EM-X2) possessed growth inhibition on human cancer cells involving MDA-MB231 breast cancer and K-562 chronic myelogenous leukaemia cells. Elevation of super oxide dismutase activity from EM-X2 treated cancer cell extract was observed. However, the possible anti-cancer activity of the first generation of the EM-X was not reported. Here we demonstrate that the concentrated form of the EM-X from its original fluid also possess antiproliferation ability together with induction of apoptosis on the human cancer cell lines including Hep3B hepatocellular carcinoma (HCC) and KG1a acute myelogenous leukaemia (AML). Similar effect could also be demonstrated on primary cultured bone marrow samples isolated from patients with AML. Morphological inspection revealed that common apoptotic feature was found on these concentrated EM-X treated cancer cells. Both the anchorage-dependent clonogenicity assay on Hep3B HCC and methyl-cellulose colony formation assay on KG1a cells and bone marrow cells from AML patients further revealed the ability of the concentrated EM-X on reducing their colony formation ability. Incubating KG1a with concentrated EM-X readily induced apoptosis as demonstrated by flow cytometric analysis. Interestingly, few growth inhibition effect of the concentrated EM-X was observed on both the SV40 transformed THLE-2 liver epithelial cells and primary cultured non-malignant haematological disordered bone marrow. Collectively, this concentrated EM-X is effective in inducing cell death and reducing the regeneration potential of both Hep3B HCC and KG1a AML cells in vitro.

Evaluation of the toxicity and safety of the antioxidant beverage effective microorganisms-X (EM-X) in animal models

The acute and chronic toxicity tests and the mutagenic test of the extracts from the fermentation of plants with effective microorganisms (EM-X) were performed in the mouse and the rat. In acute toxicity test, mice were orally treated three times per day with 20-fold of concentrated EM-X for 7 days. For chronic toxicity test, the rats were orally treated with original EM-X once a day for 90 days at the dosages of 180, 120 or 60ml/kg. At the levels tested EM-X did not lead to significant changes in food consumption, body weight, behaviors and stools. Hematological assays on red blood, white blood cell, hemoglobin, platelets, lymphocyte, granulocyte, middle cell and coagulation time and the biochemical assays on aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, blood urea nitrogen, total protein, albumin, glucose, total bilirubin, creatinine and total cholesterol did not show abnormal changes. The histological inspection of principal organs of the heart, liver, spleen, lung and kidney did not show significant pathological changes. The delaying toxic reactions were detected 2 weeks after administration of EM-X was stopped. The mutagenic test showed that EM-X did not cause mutagenesis and tests of micronucleus of bone marrow cell and sperm shape abnormality upon EM-X were negative. The maximal tolerance dose of EM-X was calculated to be 1800ml/kg BW in the mouse and rat. Thus, oral administration of EM-X does not present acute and chronic toxicity and mutagenic effects in the animals.

P-selectin knockout mice have improved outcomes with both warm ischemia and small bowel transplantation

AIM

To analyze the role of P-selectin in intestinal ischemia and reperfusion injury (IRI) using murine models.

METHODS

A model of warm IRI wherein the SMA was occluded for 100 minutes was undertaken in the following groups (10 mice per group): Group 1 (control) wild-type (WT) C57BL6, no treatment; Group 2: 0.4 mg/kg of r-PSGL1-lg 10 minutes before and after clamping; Group 3: PSGL KO mice. Survival was assessed at 7 days; the intestine was assayed for histopathology, apoptosis, myeloperoxidase (MPO), IL1, and TNF. A second model of cold IRI followed by intestinal transplantation (IT) was undertaken in the following groups (two mice per group): Group A WT --> WT: Group B PSGL KO --> WT (1-hour ischemia); Group C: PSGL KO --> WT (2 hour ischemia). Survival only was assessed.

RESULTS

Survival was 50% in group 1, 90% in group 2, and 100% in group 3. Graded histopathology and crypt apoptosis demonstrated significantly less injury in groups B and C. MPO was not different between groups. IL1 and TNF were significantly reduce in groups 2 and 3. Following IT, survival was <12 hours in group A, >7 days in group B, and <72 hours in group C.

CONCLUSION

This study clearly demonstrates the importance of P-selectin in warm and cold IRI in that the blockade of P-selectin using rPSGL1-lg or the absence of P-selectin using KO mice confers a survival advantage and reduction in tissue injury. The mechanism is unclear but appears to be independent of neutrophil infiltration.