Severe brain damage in premature infants associated with postnatal infection

AIM

This study examined clinical features and neuroimaging characteristics of severe brain damage in premature infants with postnatal infection.

METHODS

We retrospectively analyzed clinical data of two preterm infants who developed extensive encephalomalacia secondary to postnatal infection.

RESULTS

Two premature boys experienced serious postnatal infection at about 3 weeks after birth; the infection was characterized by lethargy, apnea, increased CRP, severe bilateral pneumonia, positive sputum culture for multidrug-resistant bacteria, and mild changes of cerebrospinal fluid. Both infants required ventilation and antibiotic therapy. While both infants survived, a very extensive encephalomalacia was documented by serial cranial ultrasound, MRI and CT scans 3 to 4 weeks after postnatal infection. Their mothers had no premature ruptures of membranes and no signs of antenatal infection, suggesting potential postnatal infection in the infants.

CONCLUSION

More studies are needed to better understand the underlying mechanism of encephalomalacia associated with postnatal infection. To facilitate early diagnosis and effective treatment, cranial ultrasound scans should be done routinely in premature infants with serious postnatal infection.

Multifocal multiphoton microscopy based on a spatial light modulator

We present a new multifocal multiphoton microscope that employs a programmable spatial light modulator to generate dynamic multifocus arrays which can be rapidly scanned by changing the incident angle of the laser beam using a pair of galvo scanners. Using this microscope, we can rapidly select the number and the spatial density of focal points in a multifocus array, as well as the locations and shapes of arrays according to the features of the areas of interest in the field of view without any change to the hardware.

Antineoplastic therapy combined with whole brain radiation compared with whole brain radiation alone for brain metastases: a systematic review and meta-analysis

BACKGROUND

The standard treatment for brain metastases is whole brain radiation, but the medium survival is about 3-10 months and hadn't be improved for years.

AIM

This study was to evaluate the effect of antineoplastic therapy combined with whole brain radiation for brain metastases.

MATERIALS AND METHODS

We searched PubMed, EMBASE, Cochrane Library, Chinese Biomedical Literature Database, China Journal Full Text Database and references of the included studies up to May 2011. Randomized controlled trials involving antineoplastic combined with whole brain radiation compare with whole brain radiation alone for brain metastases were analysed. Study selection, data collection and quality assessment of studies were performed by two individual reviewers according to the Cochrane Handbook for systematic reviews of interventions 5.0.2. Statistic analyses were calculated using RevMan5.0.17 software. 9 randomized controlled trails, a total of 1582 patients were included.

RESULTS

There were no significant differences in overall survival, six to twenty-four months survival rate and death from central nervous system (CNS) cause, only the objective response rate was statistically higher in the combined group. (RR = 1.47, 95% CI: 1.10, 1.97; p = 0.009) Subgroup analysis of lung cancer got the same result, except that death from central nervous system (CNS) cause was higher in the combined therapy group, it was statistical significant (RR = 0.70, 95% CI: 0.53, 0.93; p = 0.01).

CONCLUSIONS

The benefit of antineoplastic combined with whole brain radiation for brain metastases was not concerned, either in the brain metastases from unselected primary tumors or lung cancer.

Impaired natural killer cell-induced antibody-dependent cell-mediated cytotoxicity is associated with human immunodeficiency virus-1 disease progression

This study evaluates the correlation between natural killer (NK) cell function and human immunodeficiency virus (HIV)-1 disease progression in 133 untreated HIV-1 positive Chinese subjects, including 41 former plasma donors (FPDs) and 92 men who have sex with men, and 35 HIV-negative controls. Flow cytometry was used to determine the abundance of NK cell subsets, the expression levels of receptor species, human leucocyte antigen (HLA) genotyping and the antibody-dependent cell-mediated cytotoxicity (ADCC) responses of NK cells. We observed a decreased expression of CD56(dim) CD16(+) NK cell subsets and an increased expression of CD56(-) CD16(+) with HIV-1 infection. As well, the expression of activating and inhibitory receptors increased significantly in NK cells, but CD16 receptor levels and the NKG2A/NKG2C ratio were down-regulated with HIV-1 infection. ADCC responses were higher in elite controllers than in all other groups, and were correlated inversely with HIV-1 viral load but correlated positively with CD4 count only in FPDs. Furthermore, individuals infected for < 1 year have lower ADCC responses than those infected for > 1 year. We also observed a negative association between ADCC responses and viral load in those who carry the HLA-A*30/B*13/Cw*06 haplotype. The positive correlation between CD16 expression and ADCC responses and a negative correlation trend between CD158a and ADCC responses were also observed (P = 0·058). Our results showed that the ADCC response is associated with patients' disease status, receptor expression levels, infection time and specific HLA alleles, which indicates that ADCC may offer protective effects against HIV-1 infection.

Lactogenic hormones stimulate expression of lipogenic genes but not glucose transporters in bovine mammary gland

During the onset of lactation, there is a dramatic increase in the expression of glucose transporters (GLUT) and a group of enzymes involved in milk fat synthesis in the bovine mammary gland. The objective of this study was to investigate whether the lactogenic hormones mediate both of these increases. Bovine mammary explants were cultured for 48, 72, or 96 h with the following hormone treatments: no hormone (control), IGF-I, insulin (Ins), Ins + hydrocortisone + ovine prolactin (InsHPrl), or Ins + hydrocortisone + prolactin + 17β-estradiol (InsHPrlE). The relative expression of β-casein, α-lactalbumin, sterol regulatory element binding factor 1 (SREBF1), fatty acid synthase (FASN), acetyl-CoA carboxylase α (ACACA), stearyol-CoA desaturase (SCD), GLUT1, GLUT8, and GLUT12 were measured by real-time PCR. Exposure to the lactogenic hormone combinations InsHPrl and InsHPrlE for 96 h stimulated expression of β-casein and α-lactalbumin mRNA by several hundred-fold and also increased the expression of SREBF1, FASN, ACACA, and SCD genes in mammary explants (P < 0.01). However, those hormone combinations had no effect on GLUT1 or GLUT8 expression and inhibited GLUT12 expression by 50% after 72 h of treatment (P < 0.05). In separate experiments, the expression of GLUTs in the mouse mammary epithelial cell line HC11 or in bovine primary mammary epithelial cells was not increased by lactogenic hormone treatments. Moreover, treatment of dairy cows with bovine prolactin had no effect on GLUT expression in the mammary gland. In conclusion, lactogenic hormones clearly stimulate expression of milk protein and lipogenic genes, but they do not appear to mediate the marked up-regulation of GLUT expression in the mammary gland during the onset of lactation.

Importance of circulating IGF-1 for normal cardiac morphology, function and post infarction remodeling

IGF-1 plays an important role in cardiovascular homeostasis, and plasma levels of IGF-1 correlate inversely with systolic function in heart failure. It is not known to what extent circulating IGF-1 secreted by the liver and local autocrine/paracrine IGF-1 expressed in the myocardium contribute to these beneficial effects on cardiac function and morphology. In the present study, we used a mouse model of liver-specific inducible deletion of the IGF-1 gene (LI-IGF-1 -/- mouse) in an attempt to evaluate the importance of circulating IGF-I on cardiac morphology and function under normal and pathological conditions, with an emphasis on its regulatory role in myocardial phosphocreatine metabolism. Echocardiography was performed in LI-IGF-1 -/- and control mice at rest and during dobutamine stress, both at baseline and post myocardial infarction (MI). High-energy phosphate metabolites were compared between LI-IGF-1 -/- and control mice at 4 weeks post MI. We found that LI-IGF-1 -/- mice had significantly greater left ventricular dimensions at baseline and showed a greater relative increase in cardiac dimensions, as well as deterioration of cardiac function, post MI. Myocardial creatine content was 17.9% lower in LI-IGF-1 -/- mice, whereas there was no detectable difference in high-energy nucleotides. These findings indicate an important role of circulating IGF-1 in preserving cardiac structure and function both in physiological settings and post MI.

Asymmetric dimethylarginine and carotid atherosclerosis in Type 2 diabetes mellitus

BACKGROUND

Circulating asymmetric dimethylarginine (ADMA) concentration is elevated in patients with Type 2 diabetes mellitus (T2DM).

AIM

To assess the relationship between plasma ADMA concentration and carotid atherosclerosis in patients with T2DM.

SUBJECTS AND METHODS

A total of 72 newly diagnosed and untreated T2DM individuals and 72 healthy controls were studied. Carotid atherosclerosis was determined by ultrasonographically evaluated intima- media thickness (IMT) and plaque score. Plasma concentration of ADMA was measured by high-performance liquid chromatography.

RESULTS

Plasma ADMA, mean IMT, and plaque score were higher in diabetic patients compared with controls. Univariate and multivariate analyses demonstrated an independent association between ADMA and mean IMT in diabetic patients. On a multiple logistic regression analysis, ADMA was the sole predictor of carotid plaque formation (plaque score ≥1.1) (odds ratio 2.43, 95% confidence interval 1.19 to 4.94, p<0.05).

CONCLUSION

Our results suggest that increased levels of ADMA might be involved in the development of carotid atherosclerosis in T2DM.

Characterization of bovine glucose transporter 1 kinetics and substrate specificities in Xenopus oocytes

Glucose is an essential substrate for lactose synthesis and an important energy source in milk production. Glucose uptake in the mammary gland, therefore, plays a critical role in milk synthesis. Facilitative glucose transporters (GLUT) mediate glucose uptake in the mammary gland. Glucose transporter 1 (GLUT1) is the major facilitative glucose transporter expressed in the bovine mammary gland and has been shown to localize to the basolateral membrane of mammary epithelial cells. Glucose transporter 1 is, therefore, thought to play a major role in glucose uptake during lactation. The objective of this study was to determine the transport kinetic properties and substrate specificity of bovine GLUT1 using the Xenopus oocyte model. Bovine GLUT1 (bGLUT1) was expressed in Xenopus oocytes by microinjection of in vitro transcribed cRNA and was found to be localized to the plasma membrane, which resulted in increased glucose uptake. This bGLUT1-mediated glucose uptake was dramatically inhibited by specific facilitative glucose transport inhibitors, cytochalasin B, and phloretin. Kinetic analysis of bovine and human GLUT1 was conducted under zero-trans conditions using radio-labeled 2-deoxy-D-glucose and the principles of Michaelis-Menten kinetics. Bovine GLUT1 exhibited a Michaelis constant (K(m)) of 9.8 ± 3.0mM for 2-deoxy-d-glucose, similar to 11.7 ± 3.7 mM for human GLUT1. Transport by bGLUT1 was inhibited by mannose and galactose, but not fructose, indicating that bGLUT1 may also be able to transport mannose and galactose. Our data provides functional insight into the transport properties of bGLUT1 in taking up glucose across mammary epithelial cells for milk synthesis.

WE-C-217BCD-10: Development of High Performance PET for Animal Imaging and Therapy Applications

PURPOSE

A prototype small animal PET is developed with several novel technologies to measure 3D gamma-interaction positions and to substantially improve imaging performance.

METHODS

Each new detector has an 8×8 array of 1.95×1.95×30 mm̂3 LYSO scintillators, with each end optically connected to a solid-state photo multiplier (SSPM) array through a light guide. This dual-ended-readout enables the depth-of-interaction (DOI) measurement. Each SSPM array has 16 SSPMs arranged in a 4×4 matrix. Each SSPM has active area about 3×3 mm̂2, with its output read by an ASIC electronics that directly converts analog signals to digital timing pulses which encode the interaction information for energy, timing, crystal of interaction, and DOI calculations. These digital pulses are transferred to and decoded by FPGA-based TDC for coincident event selection and data acquisition. This independent readout of each SSPM and parallel signal process significantly improve signal-to-noise ratio and permit applying flexible data processing algorithms. The current prototype system consists of two rotating detector panels on a portable gantry, with 4 detectors linearly packed together in each panel to provide ∼16 mm axial and variable trans- axial FOV with adjustable panel-to-panel distance. List-mode OSEM-based image reconstruction with resolution modeling was implemented. Both Na- 22 point source and phantom were used to evaluate the system performance.

RESULTS

The measured energy, timing, spatial and DOI resolutions for each crystal were around 16%, 2.6 ns, 2.0 mm and 5.0 mm, respectively. The measured spatial resolutions with DOI were ∼1.7 mm across the entire FOV in all direction, while those without DOI were much worse and non-uniform across the FOV, in the range predominately around 3.0 to 4.0 mm. In addition, images from a F-18 hot-rod phantom with DOI show significantly improved quality compared to those without DOI.

CONCLUSIONS

DOI- measurable PET shows substantially improved image performance for a compact system. National Institute of Health. University of Texas MD Anderson Cancer Center.

Study on reconstruction of rectal sensation based on wavelet packet analysis and SVM strategy

To control anal incontinence, we have developed an artificial anal sphincter system with sensor feedback. The artificial anal sphincter system is a novel hydraulic-electric muscle which mainly comprises an artificial anal sphincter, a wireless power supply subsystem, and a rectal sensation reconstruction subsystem. To investigate the features of the patients' rectal sensation, we have developed an in vitro experimental platform of artificial anal sphincter. In vitro experiments have been performed, and demonstrate that the traditional threshold method is not suitable for predicting the time for defecation. The traditional threshold method only uses single-dimensional pressure time series which may contain a few interdependent components simultaneously. A wavelet packet analysis algorithm is employed to extract the feature vector of the rectal pressure signal, then the rectal sensation prediction model is constructed based on a support vector machine for defecation pattern recognition. The results show that the proposed method is an effective approach for the reconstruction of patients' rectal sensation.

Identify the association between polymorphisms of BLK and systemic lupus erythematosus through unlabelled probe-based high-resolution melting analysis

Systemic lupus erythematosus (SLE) is a complex immune disease. The genetic variation in the B lymphoid tyrosine kinase (BLK) gene was found to associate with SLE in Caucasian population. However, the association of rs13277113 and rs4840568 with SLE was not extensively studied in Chinese population. In this study, we aim to test the association of SNP rs13277113 and rs4840568 with the disease risk of SLE in Chinese mainland population. A total of 532 patients with SLE and 576 controls were recruited. Unlabelled probe-based high-resolution melting analysis (HRMA) was used in genotyping. HRMA with unlabelled probe successfully distinguished all genotypes. Significant differences were observed in both genotype and allele frequencies for rs13277113 and rs4840568. Minor alleles of rs13277113 (P = 4.2E-05, odds ratio [OR] 0.66, [95% CI 0.54-0.81]) and rs4840568 (P = 7.1E-05, OR 0.67, [95% CI 0.55-0.82]) were found to be protective against SLE. Polymorphisms of rs13277113 and rs4840568 in BLK gene were associated with SLE in Chinese population.

Are there adverse consequences of quizzing during informed consent for HIV research?

INTRODUCTION

While quizzing during informed consent for research to ensure understanding has become commonplace, it is unclear whether the quizzing itself is problematic for potential participants. In this study, we address this issue in a multinational HIV prevention research trial enrolling injection drug users in China and Thailand.

METHODS

Enrolment procedures included an informed consent comprehension quiz. An informed consent survey followed.

RESULTS

525 participants completed the informed consent survey (Heng County, China¼255, Xinjiang, China¼229, Chiang Mai, Thailand¼41). Mean age was 33 and mean educational level was 8 yrs. While quizzing was felt to be a good way to determine if a person understands the nature of clinical trial participation (97%) and participants did not generally find the quiz to be problematic, minorities of respondents felt pressured (6%); anxious (5%); bored (5%); minded (5%); and did not find the questions easy (13%). In multivariate analysis, lower educational level was associated with not minding the quizzing (6e10 yrs vs 0e5 yrs: OR¼0.27, p¼0.03; more than 11 yrs vs 0e5 yrs: OR¼0.18, p¼0.03). There were also site differences (Heng County vs Xinjiang) in feeling anxious (OR¼0.07; p¼<0.01), not minding (OR¼0.26; p¼0.03), being bored (OR¼0.25; p¼0.01) and not finding the questions easy (OR¼0.10; p¼<0.01).

CONCLUSIONS

Quizzing during the informed consent process can be problematic for a minority of participants. These problems may be associated with the setting in which research takes place and educational level. Further research is needed to develop, test and implement alternative methods of ensuring comprehension of informed consent.

TRIAL REGISTRATION

clinicaltrials.gov number NCT00270257.

Loss of balance between T helper type 17 and regulatory T cells in chronic human immunodeficiency virus infection

The aim of this study is to characterize the changes of CD4(+) CD25(high) forkhead box P3 (FoxP3(+) ) regulatory T cells (T(reg) ), interleukin (IL)-17 secreting T helper type 17 (Th17) cell frequencies and the balance of these two subsets in a cohort of chronic human immunodeficiency virus type 1 (HIV-1)-infected patients in China. A total of 115 untreated chronic HIV-infected individuals and 32 healthy donors were recruited in this study. Peripheral blood mononuclear cells were isolated from ethylenediamine tetracetic acid (EDTA) anti-coagulated fresh whole blood and stained to characterize the frequencies of T(reg) and Th17. Of a total 115 patients, 42 individuals including 10 elite controllers were followed-up for more than 1 year, and changes of T(reg) and Th17 frequencies were analysed over time. The continuous loss of Th17 cells was accompanied by a concomitant rise in the frequency of T(reg) cells, resulting in a loss of Th17/T(reg) balance during the progressive HIV infection. Meanwhile, the T(reg) levels, Th17 levels and Th17/T(reg) ratios of the elite controller group were comparable to those of the HIV-1 negative controls in the follow-up study. Additionally, we demonstrated that loss of balance between Th17 and T(reg) is associated with an earlier CD4 T cell decline during the course of HIV infection. Our results indicate that a loss of immune-balance of Th17 to T(reg) during HIV-1 disease progression and the persistence of such an immune-balance in the elite controllers may have a critical role in HIV-1 infection and further shed new light into understanding the pathogenesis of HIV-1.

Keratinocytes play a role in the immunity to Herpes simplex virus type 2 infection

Herpes simplex virus type 2 (HSV-2) infection is the most common cause of genital ulcerative disease in the developed world. Keratinocytes are the primary cells involved in clinical lesions caused by HSV-2. In our study, we intensively examined cytokine expression in the HSV-2-infected keratinocytes. We observed upregulation of a series of cytokines including early-induced antiviral cytokines as interferons α, β (IFN-α, β), tumor necrosis factor α (TNF-α), colony stimulating factors (CSFs) as G-CSF, GM-CSF, interleukin 3 (IL-3), growth factors (EGF, KGF, and IGF-β1), defensins, selectins, leukocyte function-associated antigens (LFAs,) and toll-like receptors (TLR-2, 3, 4, and 9). More importantly, we found that HSV-2-infected keratinocytes stimulated the proliferation of lymphocytes in co-cultivation system. These data suggest that keratinocytes participate in the immune response to HSV-2 infection in two ways. They secrete inflammatory cytokines to resist the HSV-2 infection directly and recruit the immune cells to eliminate the primary infection indirectly and enhance the adaptive immunity to prevent subsequent infections.

A laparoscopic approach to ventriculoperitoneal shunt placement with a novel fixation method for distal shunt catheter in the treatment of hydrocephalus

BACKGROUND

The laparoscopically assisted ventriculoperitoneal (VP) shunt has been widely used in the clinical treatment of hydrocephalus for its simplicity and reliability. Despite significant improvements in shunt procedures, shunt complications remain common. Our clinical experiences suggest that the fixation of the distal (peritoneal) shunt catheter using threads and hemoclips may partially contribute to complications of the distal shunt including obstruction of the shunt and infection. In this study, we explored a novel fixation method in the laparoscopically assisted VP shunt with use of the liver falciform ligament as a natural support for fixation of the distal shunt catheter.

METHODS

10 patients with hydrocephalus underwent laparoscopically assisted VP shunt and the distal shunt catheter was placed into the hepatodiaphragmatic space and the catheter was traversed through 2-3 drilled holes in the liver falciform ligament without using any artificial material for fixation.

RESULTS

In all the patients who received surgery with the adopted new procedure the clinical symptoms were alleviated. The size of cerebral ventricles returned to normal after 1 week. The distal catheters were in the hepatodiaphragmatic space in 9 of 10 patients, while in 1 patient it migrated to the peritoneal cavity underneath the liver. All the 9 patients were followed up for 1 year and no surgery-related catheter obstructions and infections were observed.

CONCLUSIONS

The modified laparoscopically assisted VP shunt in the treatment of hydrocephalus with fixation of the distal shunt catheter to a natural anatomic structure could potentially reduce the necessity of repeat surgery for addressing the complications caused by catheter obstruction and infections, reduce the chance of adhesions, and would be of benefit to those patients who need future revisions.

Feasibility study of a smart pen for autonomous detection of concentration lapses during reading

We implemented a portable smart pen system capable of detecting lapses in concentration during reading. An accelerometer and a microcontroller are embedded within a pen casing to record data as a user reads sections of text using the pen as a pointer. When a substantial pause in reading is detected, the system generates an appropriate warning or alarm. An accompanying software program can communicate with the pen through a USB interface to customize system parameters, record relevant data, and graph collected data over time. The overall effectiveness of a prototype system was tested on 11 normal volunteers and 3 persons with attention deficit disorder (ADD). The prototype system had probability of false alarm of 19%, and sensitivity of 82%. With further refinement, this system could enable patients with attention deficit/hyperactivity disorder maintain concentration during reading in a variety of environments.

Scientific Approaches to AIDS Prevention and Control in China

The HIV epidemic in China started among intravenous drug users in the late 1980s. The second wave of the epidemic was caused by an outbreak in the paid plasma donors in central China in the mid-1990s. Sexually transmitted HIV cases have steadily increased and comprised more than half the reported HIV/AIDS infections since 2007. In the last 5 years, there has been a sharp increase of HIV infection in men who have sex with men. The HIV epidemic in China has expanded from high-risk groups to the general population and from rural regions to urban areas. This brief article discusses the history of HIV epidemics in China and the challenges facing the current AIDS control efforts in the country. It explains that only scientific approaches can sustain the national AIDS control programs and introduce the type of research needed to address those challenges. The selected research areas include molecular epidemiology, drug resistance surveillance, and the Chinese HIV vaccine research.

Gastrointestinal toxicities following radiation therapy for localized prostate cancer

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Background: Radiation therapy (RAD) is commonly employed to treat localized prostate cancer; however, representative data regarding treatment related toxicities compared to conservative management (CM) is sparse.

Methods: We performed a population-based cohort study, using Medicare claims data linked to the Surveillance, Epidemiology, and End Results data, to evaluate gastrointestinal (GI) toxicities in men aged 65-85 years treated with either primary RAD or CM for T1-T2 prostate cancer diagnosed in 1992-2005. In this study, only GI toxicities requiring interventional procedures occurring after 6 months of cancer diagnosis were included. Competing risk models were used with the following covariates: year of diagnosis, comorbidity, age, tumor stage, cancer grade, hormone use within 1 year of diagnosis, region, race, poverty and marital status.

Results: Among 41,859 patients in this study, 28,021 patients received radiation therapy, 19,287 with external beam radiation therapy (EBRT) alone, and 5,138 with brachytherapy alone. The most common GI toxicity was GI bleeding or ulceration. GI toxicity rates were 6.1% after 3D-conformal therapy (3D-CRT), 2.8% after intensity modulated radiation therapy (IMRT), 2.6% after brachytherapy, 8.2% after proton therapy and 1.1% for CM patients. In the multivariate models, RAD group was associated with a higher hazard of GI toxicities (hazard ratio [HR] 4.68; 95% CI, 3, 93-5.58) than CM. Comparing to 3D-CRT, brachytherapy (HR 0.62; 95% CI, 0.51-0.75) and IMRT (HR 0.67; 95% CI, 0.55-0.82) are associated with a lower hazard of GI toxicities, while proton therapy is associated with a higher hazard of GI toxicities (HR 2.15; 95% CI, 1.45-3.17).

Conclusions: Radiation therapy is associated with a higher risk of GI toxicities than CM. Among different modalities of radiation therapy, protons therapy is associated with the highest risk of GI toxicities, followed by 3D-CRT, IMRT, and brachytherapy. The increased GI toxicities for patients with proton therapy may reflect a learning curve in the early years.

No significant financial relationships to disclose.

Association study of tryptophan hydroxylase-2 gene in schizophrenia and its clinical features in chinese han population

Introduction

Schizophrenia is a chronic and severe mental illness which is characterized by the development of various detrimental clinical features, and its etiology still remains unknown. Based on the evidence from neurobiological and pharmacological research, dysfunctions in central serotonergic transmission may be involved in the development of schizophrenia. Tryptophan hydroxylase 2 (TPH2), a newly identified isoform of tryptophan hydroxylase (the rate limiting enzyme in the biosynthesis of serotonin), regulates the brain-specific serotonin synthesis.

Objectives

To further clarify the role of TPH2 in the development of schizophrenia.

Aim

We performed a case-control study to examine the association of the TPH2 gene with schizophrenia and its clinical features.

Methods

We genotyped three putative functional polymorphisms (rs4570625, rs7305115 and rs4290270) within the gene and carried out a case-control study consisting of 304 schizophrenia patients and 362 healthy subjects. The severity of psychotic symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS).

Results

The frequencies of genotypes and alleles of rs4570625, rs7305115 and rs4290270 did not differ significantly between schizophrenic patients and controls. However, the PANSS positive symptom subcore was significantly associated with rs4570625 (P = 0.022).

Conclusion

These results suggest that rs4570625 of TPH2 may play an important role in the development of positive symptoms in Han Chinese schizophrenic patients.

Use of plasma angiogenesis-related factors to investigate the association of interleukin 8 and interleukin 6 levels with efficacy of sorafenib-based antiangiogenic therapy in patients with advanced hepatocellular carcinoma (HCC)

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Background: Anti-angiogenic agents have become the most important class of therapy for patients (pts) with advanced HCC. However, biomarkers predictive of the efficacy of anti-angiogenic therapy remain lacking.

Methods: Advanced HCC pts, enrolled in a phase II study (Hsu et al: J Hepatol 2010) and its extended cohort, were treated with sorafenib plus metronomic oral tegafur/uracil until disease progression. Plasma samples were collected before treatment and 4 weeks after the start of treatment. The levels of IL-6, IL-8, IL-13, CXCL10, PDGF and VEGF-A were analyzed by multiplexed bead suspension arrays (Bio-Rad, Hercules, CA, US). Levels of VEGF-C, VEGF-D, PlGF, fibroblast growth factor 2 (FGF2), SDF1-alpha and soluble VEGF receptor 2 were determined by ELISA. The baseline levels and post-treatment changes of these plasma factors were analyzed for their associations with treatment outcomes.

Results: Among 68 pts treated with the protocol treatment, 64 were enrolled to this study. There were 4 partial responder (PR) and 33 patients with stable disease (SD) according to RECIST 1.0. The disease control rate (PR+SD) was 58%. The median PFS and OS were 3.7 and 7.4 months, respectively. Patients with progressive disease, compared to those with disease control, had significant increase of post- treatment IL-6 (p = 0.016) and IL-8 (p = 0.021), borderline significant increase of post-treatment FGF2 (p = 0.078) and significant decrease of post-treatment CXCL-10 (p = 0.046). High baseline IL-8 was significantly associated with poorer PFS and OS (p = 0.002 and 0.001, respectively). More increase of post-treatment IL-6 was associated with poorer PFS and OS (p = 0.087 and 0.018, respectively). By multivariate analysis, high baseline IL-8 and more post-treatment increase of IL-6 remained independent predictors for poorer PFS and OS.

Conclusions: High baseline IL-8 and more post-treatment increase of IL-6 in plasma were associated with poor treatment outcomes in advanced HCC pts treated with sorafenib-based anti-angiogenic therapy. This study was supported by the grant of NSC 98-3112-B-002-038.

No significant financial relationships to disclose.

Copy number variations of the human histamine H4 receptor gene are associated with systemic lupus erythematosus

BACKGROUND

Systemic lupus erythematosus (SLE) is a complex genetic disease; the histamine H4 receptor (HRH4) has been shown to be related to different kinds of autoimmune disorders; and copy number variations (CNVs) have been found to be associated with various types of diseases.

OBJECTIVES

To explore a possible association between HRH4 (formerly H4R) CNVs and the risk of SLE.

METHODS

Genomic DNA and RNA from 340 patients with SLE and 392 healthy controls were extracted, and CNVs and mRNA levels of HRH4 were examined.

RESULTS

The expression of HRH4 mRNA was significantly increased in patients with SLE compared with controls. Amplification of HRH4 copy numbers significantly increased the risk of SLE [P < 0·001, odds ratio (OR) 2·26, 95% confidence interval (CI) 1·50-3·40]. HRH4 amplifications also positively correlated with the incidence of arthritis (P = 0·019, OR 1·96, 95% CI 1·11-3·47), and proteinuria (P < 0·001, OR 2·95, 95% CI 1·73-5·00) and antinuclear antibody abnormalities (P < 0·001, OR 2·97, 95% CI 1·66-5·33). Deletions of HRH4 copy numbers were protective against proteinuria (P = 0·03, OR 0·50, 95% CI 0·26-0·94).

CONCLUSION

CNVs of the HRH4 gene are associated with SLE.

Examination of AKAP12 promoter methylation in skin cancer using methylation-sensitive high-resolution melting analysis

BACKGROUND

A kinase anchor protein 12 (AKAP12/gravin) belongs to a family of scaffold proteins and organizes protein kinase (PK)A and PKC. DNA hypermethylation in the AKAP12 promoter region has been reported in a variety of human cancers with the exception of skin cancer. Methylation-specific high-resolution melting (MS-HRM) analysis is a novel tool for analysis of promoter methylation.

AIM

To use MS-HRM analysis to detect the methylation levels of the AKAP12 gene in skin samples.

METHODS

In total, 195 samples, including basal cell carcinoma, squamous cell carcinoma and actinic keratosis were examined. MS-HRM analysis was used to detect methylation levels of the AKAP12 gene in these samples.

RESULTS

MS-HRM analysis successfully detected the methylation of AKAP12 in skin samples. The frequencies of AKAP12 methylation in all three types of skin abnormalities were significantly higher than in normal tissues.

CONCLUSIONS

Application of MS-HRM analysis proved to be a fast and high-throughput method to investigate the epigenetic status of AKAP12. Methylation of AKAP12 can be detected in different skin abnormalities.

Polymorphisms of PXK are associated with autoantibody production, but not disease risk, of systemic lupus erythematosus in Chinese mainland population

Systemic lupus erythematosus (SLE) is a complex immune disease. The genetic variation in the PXK gene was found to associate with SLE in Caucasian populations. However, the association of rs6445975 with SLE has not been extensively studied in a Chinese mainland population. A total of 288 SLE patients and 357 controls were recruited. Unlabeled probe-based high-resolution melting analysis (HRMA) was used in genotyping. HRMA with unlabeled probe successfully distinguished all genotypes. Neither genotype nor allele frequencies of SNP rs6445975 showed statistically significant differences between SLE patients and controls. The association of SNP rs6445975 with the diagnostic criteria of SLE was also examined. No obvious association was observed between rs6445975 and the incidence of clinical symptoms. However, the minor allele (G) of rs6445975 was found to significantly associate with increased abnormalities of anti-Smith (p = 0.004, odds ratio (OR) = 1.95, 95% confidence interval (CI) = 1.22-3.09), anti-Ro (p = 0.015, OR = 1.69, 95% CI = 1.10-2.58), anti-La (p = 0.008, OR = 1.86, 95% CI = 1.17-2.93) and C3C4 (p = 0.007, OR = 1.79, 95% CI = 1.17-2.74). Polymorphisms of rs6445975 in the PXK gene were associated with autoantibody production, but not disease risk, of systemic lupus erythematosus in a Chinese population.

Hyperactivation of MEK-ERK1/2 signaling and resistance to apoptosis induced by the oncogenic B-RAF inhibitor, PLX4720, in mutant N-RAS melanoma cells

Activating mutations in B-RAF and N-RAS occur in ∼60 and ∼15% of melanomas, respectively. The most common mutation in B-RAF is V600E, which activates B-RAF and the downstream MEK-ERK1/2 pathway. Thus, B-RAF(V600E) is a viable therapeutic target. PLX4720 is a selective inhibitor of mutant B-RAF and its analog, PLX4032, is currently undergoing clinical trials in melanoma. However, the effects of PLX4720 across the genotypic spectrum in melanoma remain unclear. Here, we describe that PLX4720 treatment rapidly induces hyperactivation of the MEK-ERK1/2 pathway in mutant N-RAS melanoma cells. Furthermore, we demonstrate that C-RAF is the major RAF isoform involved in this process. Importantly, PLX4720-induced hyperactivation of the MEK-ERK1/2 pathway promotes resistance to apoptosis in both non-invasive and invasive mutant N-RAS melanoma cells but does not enhance cell cycle properties. These findings underscore the need to genotypically stratify melanoma patients before enrollment on a mutant B-RAF inhibitor trial.

Enhanced tumor suppression in vitro and in vivo by co-expression of survivin-specific siRNA and wild-type p53 protein

The development of malignant prostate cancer involves multiple genetic alterations. For example, alterations in both survivin and p53 are reported to have crucial roles in prostate cancer progression. However, little is known regarding the interrelationships between p53 and survivin in prostate cancer. Our data demonstrate that the expression of survivin is inversely correlated with that of wtp53 protein (r(s)=0.548) in prostate cancer and in normal prostate tissues. We have developed a therapeutic strategy, in which two antitumor factors, small interfering RNA-survivin and p53 protein, are co-expressed from the same plasmid, and have examined their effects on the growth of PC3, an androgen-independent prostate cancer cell line. When p53 was expressed along with a survivin-specific short hairpin RNA (shRNA), tumor cell proliferation was significantly suppressed and apoptosis occurred. In addition, this combination also abrogated the expression of downstream target molecules such as cyclin-dependent kinase 4 and c-Myc, while enhancing the expression of GRIM19. These changes in gene expression occurred distinctly in the presence of survivin-shRNA/wtp53 compared with control or single treatment groups. Intratumoral injection of the co-expressed construct inhibited the growth and survival of tumor xenografts in a nude mouse model. These studies revealed evidence of an interaction between p53 and survivin proteins plus a complex signaling network operating downstream of the wtp53-survivin pathway that actively controls tumor cell proliferation, survival and apoptosis.

Research on a novel artificial anal sphincter for human incontinence

This paper discusses a novel artificial anal sphincter with sensor feedback for controlling anal incontinence. The artificial anal sphincter system is a novel hydraulic-electric muscle which mainly comprises an artificial anal sphincter, a wireless power supply subsystem, and a communication subsystem. High integration of all functional components and no wire linking to the outer device make surgical implantation easier and lower risk. The wireless power supply subsystem employs a Class-E power amplifier based on adaptive control technique, and the electromagnetic compatibility in biological tissue is analysed. With the goal of designing a reliable and safe instrument, the models of human colonic blood flow and rectum motion are developed, the biomechanical material properties of human rectum and tissue ischaemia are analysed. The results show that the deformation of the artificial anal sphincter can be controlled by the press of reservoir below the upper limit of human tissue ischaemia. In vitro experiments demonstrate the artificial anal sphincter system is a good cure for human anal incontinence problems.