Two-step retrograde closed stenting: a novel method for treating canalicular lacerations in Chinese patients

PURPOSE

To evaluate the efficacy of two-step retrograde closed stenting for treating canalicular laceration. methods: Forty-eight consecutive canalicular laceration cases (48 eyes) were randomised and divided into two groups: a one-step group and a two-step group. In the two-step group (23 cases), the first step was performed in the outpatient department and included identifying the medial cut end of the canaliculus and probing under a slit-lamp microscope, followed by a retrograde canalicular stenting assisted by a memory titanium stylet. The second step was canalicular anastomosis, which was performed in the operating room. In the one-step group (25 cases), all of the surgical procedures were performed when preoperative preparations were simultaneously available.

RESULTS

The time elapsed from the doctor visit to the treatment was 4.3 ± 2.4 h in the two-step group and 18.8 ± 6.3 h in the one-step group (P<0.01). The canalicular medial cut ends were found in all cases, but 8.6 ± 3.5 min was needed in the two-step group, and 51.4 ± 24.2 min was needed in the one-step group (P<0.01). The numerical rating scale for pain during surgery was 1.8 ± 1.2 in the two-step group and 5.4 ± 2.2 in the one-step group (P<0.01). One case (2.63%) in the two-step group and nine cases (36%) in the one-step group required other assisted methods to locate the medial cut end (P=0.007). Twenty-one cases (91.3%) in the two-step group and 20 cases (80%) in the one-step group achieved patent lacrimal drainage systems during a 12-month follow-up (P=0.528).

CONCLUSIONS

The two-step canalicular anastomosis method allows an early search for the medial cut end of the canaliculus and improves the chances of finding it; it is also a quicker, less invasive method for treating canalicular lacerations.

Induced maturation of hepatic progenitor cells in vitro

Hepatic progenitor cells (HPCs) are a potential cell source for liver cell transplantation but do not function like mature liver cells. We sought an effective and reliable method to induce HPC maturation. An immortalized HP14.5 albumin promoter-driven Gaussian luciferase (ALB-GLuc) cell line was established from HPCs isolated from fetal mouse liver of post coitus day 14.5 mice to investigate the effect of induction factors on ALB promoter. HP14.5 parental cells were cultured in DMEM with different combinations of 2% horse serum (HS), 0.1 µM dexamethasone (DEX), 10 ng/mL hepatic growth factor (HGF), and/or 20 ng/mL fibroblast growth factor 4 (FGF4). Trypan blue and crystal violet staining were used to assess cell proliferation with different induction conditions. Expression of hepatic markers was measured by semi-quantitative RT-PCR, Western blot, and immunofluorescence. Glycogen storage and metabolism were detected by periodic acid-Schiff and indocyanine green (ICG) staining. GLuc activity indicated ALB expression. The combination of 2% HS+0.1 µM Dex+10 ng/mL HGF+20 ng/mL FGF4 induced the highest ALB-GLuc activity. Cell proliferation decreased in 2% HS but increased by adding FGF4. Upon induction, and consistent with hepatocyte development, DLK, AFP, and CK19 expression decreased, while ALB, CK18, and UGT1A expression increased. The maturity markers tyrosine aminotransferase and apolipoprotein B were detected at days 3 and 6 post-induction, respectively. ICG uptake and glycogen synthesis were detectable at day 6 and increased over time. Therefore, we demonstrated that HPCs were induced to differentiate into functional mature hepatocytes in vitro, suggesting that factor-treated HPCs may be further explored as a means of liver cell transplantation.

HES1 inhibits adipogenesis of porcine mesenchymal stem cells via transcriptional repression of FAD24

Adipogenesis, the development from preadipocytes or mesenchymal stem cells (MSCs) to mature adipocytes, is regulated by a network of signaling pathways and transcription factors. The involvement of Notch signaling and its effector HES1 in adipogenesis has been investigated in several studies with conflicting results. The underlying mechanisms remain unclear because of the lack of information about HES1 target genes during adipocyte differentiation. As a novel gene transiently up-regulated in early adipogenesis, FAD24 functions as a positive regulator of adipocyte differentiation in both preadipocytes and MSCs. In the present study, we report that the expression level of FAD24 is inversely associated with that of HES1 in porcine MSCs after adipogenic induction. Enforced overexpression of HES1 in MSCs during the early stage of adipogenesis significantly repressed the transcription of FAD24 (P < 0.01) and the other pro-adipogenic genes (P < 0.05), resulting in reduced intracellular lipid accumulation. Sequence analysis showed that porcine FAD24 harbors an evolutionarily conserved HES1 binding site in its proximal promoter region. Functional HES1, but not its dominant-negative mutant, markedly reduced the promoter activity of FAD24 (P < 0.01). Site-directed mutation and chromatin immunoprecipitation further confirmed that HES1 inhibits FAD24 transcription by direct binding to the promoter. Taken together, we identified FAD24 as a novel downstream target of HES1 during adipogenesis. Our data suggest that HES1-mediated repression of FAD24 transcription at the early stage of adipocyte differentiation may contribute to the impaired adipogenesis induced by the Notch-HES1 signaling pathway.

Yersinia pestis versus Yersinia pseudotuberculosis: effects on host macrophages

Yersinia pestis, the causative agent of plague, is proved to be a recently emerged clone from Y. pseudotuberculosis. However, the diseases they cause and their patterns of transmission are very different. People always focus on the genetic changes between Y. pestis and Y. pseudotuberculosis to reveal their pathogenic differences, and little is known about host defence differences to these two Yersinia. In this study, the effects of Y. pestis and Y. pseudotuberculosis on macrophages were analysed. Cell apoptosis showed significant difference after the macrophages were infected by these two strains, and caspase-3 activity also demonstrated a similar tendency. Further, macrophage function activities were evaluated. We found during the early infection of Y. pestis, several basic functions of macrophages, including phagocytosis, secretion of cytokine tumour necrosis factor-α and nitric oxide, macrophage polarity and antigen presenting, were significantly interrupted. In comparison, Y. pseudotuberculosis infection showed lower inhibition on macrophages. Especially, Y. pestis infection might cause macrophage to polarize to M2 macrophages in the early phase, compared with Y. pseudotuberculosis infection, which was different from the common acute infection. These results clearly indicated even in the early stage of infection, different host macrophage defence patterns could help us to understand the obvious virulence differences between Y. pestis and Y. pseudotuberculosis.

Correlated increase of omentin-1 and adiponectin by exenatide, avandamet and dietary change in diet-induced obese rats

Adipokines omentin-1 and adiponectin have been reported to improve insulin resistance. It is known that insulin sensitizers exenatide, avandamet, or diet change from high-fat to normal chow ameliorate metabolic disorders. However, whether these treatments increase omentin-1 levels in high fat-diet animals and the relationship between omentin- 1 and adiponectin remain largely unknown. We investigated the effect of insulin sensitizers exenatide and avandamet, and of dietary change on these adipokine levels, body weight, and insulin sensitivity in diet-induced obese rats. Obesity was induced in rats by high-fat diet feeding for 8 weeks, and then the rats were given exenatide, avandamet and diet change to normal chow, respectively, for additional 8 weeks. Compared to the high-fat control group, exenatide and avandamet treatment significantly induced adipose gene expression and elevated the circulation levels of omentin-1 and adiponectin, whereas they decreased the leptin gene expression and circulation level, which is associated with improvement of systemic insulin sensitivity and the glucose and lipid profile. Notably, there was a significant positive correlation between omentin-1 and adiponectin in the above regimens, suggesting that omentin-1 and adiponectin may contribute to the insulin-sensitizing effect of exenatide and avandamet.

Performance of a modified rabbit model of abdominal aortic aneurysm induced by topical application of porcine elastase: 5-month follow-up study

OBJECTIVES

To modify the method for creating an abdominal aortic aneurysm in rabbits, and to study its performance.

MATERIALS AND METHODS

A total of 24 New Zealand white rabbits were induced topically with 10 μl of porcine elastase (0, 0.1, 5 and 10 units μl(-1)) to define the optimal concentration (groups A-D). Twelve aneurysms were induced with 10 units μl(-1) of 10 μl elastase to serve as a follow-up group (group E) to serve as a follow-up. A 1.5-cm aortic segment was isolated and induced with elastase solution for 30 min.

RESULTS

All animals in groups D and E developed AAA by day 5. Aneurysms in Group E were stable over 100 days. Partial destruction to disappearance of elastic lamellae and smooth muscle cells (SMCs) was seen in elastase-treated animals by day 5. Regenerated elastin and proliferated SMCs were present in group E. Matrix metalloproteinases 2 and 9 and RAM11 showed strong expression in group D, but expression decreased in group E after day 15.

CONCLUSIONS

The rabbit AAA model induced via topical application of porcine elastase at 10 units μl(-1) for 30 min appears easy and simple, with shorter induction and more rapid aortic dilation. The model is stable over 100 days and is useful to study the formation and progress of AAAs.

First Report of Raspberry leaf blotch virus in Raspberries in Finland

Raspberry (Rubus idaeus L.) is a valuable and widely grown softfruit that is a host for 40 viruses and virus-like agents, of which many are not characterized at the molecular level. Recently, Raspberry leaf blotch virus (RLBV, putative emaravirus species) was described from raspberries (cv. Glen Ample) in the United Kingdom and Serbia. Plants displayed conspicuous yellow blotches on leaves and abnormal development of leaf hairs in the corresponding areas of the abaxial side (3). Similar symptoms were observed in 'Glen Ample' grown in protective plastic tunnels and open fields in the main berry growing area in eastern Finland in June 2011. In three farms, leaves were sampled from symptomatic and symptomless plants of 'Glen Ample' and also cv. Polka displaying no symptoms. Total RNA was extracted using CTAB reagent. Equal amounts of RNA were pooled from 13 samples and subjected to small-RNA (sRNA) deep sequencing (Fasteris SA, Plan-les-Ouates, Switzerland) to detect viruses without advance information (2). Contigs were built on 21- to 24-nt sRNA reads using Velvet. Contigs larger than 50 nt were used to search homologous sequences in GenBank by BLAST and significant similarity (up to 99%) was observed with RLBV RNA3 and RNA4. Mapping sRNA reads to the genome of RLBV (1) by MAQ resulted in significant coverage of RNA1 (16%), RNA2 (37%), RNA3 (46%), RNA4 (65%), and RNA5 (27%). cDNA was synthesized on RNA of one symptom-expressing plant using random hexamer primers and the cDNA tested by PCR with a forward primer (RLBV-F 5'-TCAAATCCACTTGCATAGAACC-3', nt 723 to 744) and reverse primer (RLBV-R1 5'-CCTCAAACCTTGCAAACACA-3', nt 1,318 to 1,337) designed according to the nucleocapsid (NP) gene of the Scottish RLBV isolate (3). The sequence of the amplified partial NP gene (576 nt; GenBank Accession No. JQ684678) was 92.8% and 94.8% identical to the Scottish isolate at nt and amino acid levels, respectively. The forward primer RLBV-F and a new reverse primer (RLBV-R2 5'-GCCGAAAGTCAAACCTGGTG-3', nt 943 to 962) were used to test additional plants for RBLV and to make a probe (198 nt) to detect RLBV using digoxigen-labeled sense and antisense RNA probes, as described for European mountain ash ringspot associated virus (1). RLBV was detected in all tested plants of 'Glen Ample' with yellow leaf blotch symptoms in the three farms, but not in any symptomless plants of 'Glen Ample' and 'Polka.' The sense probes gave strong signals, in contrast to the antisense probes, which gave only weak or no detectable signals in the virus-positive plants, consistent with the negative RNA strand of RLBV being encapsidated in virus particles. The results show RLBV is associated with severe, distinct, and characteristic symptoms in raspberries of cv. Glen Ample grown in plastic tunnels and open fields in Finland and has an apparent negative impact on plant growth and yield. Our observations in 2011 also suggest that the incidence of diseased plants is much higher in plastic tunnels than in open fields, perhaps because the conditions for the vector of RLBV (raspberry leaf and bud mite, Phyllocoptes gracilis Nalepa) (1) are more favorable in plastic tunnels. These results clarify the etiology of raspberry leaf blotch disease in Finland and emphasize the need to inspect raspberry planting materials for RLBV for better control of the disease. References: (1) A. K. Kallinen et al. Phytopathology 99:344, 2009. (2) J. F. Kreuze et al. Virology 388:1, 2009. (3) W. J. McGavin et al. J. Gen. Virol. 93:430, 2012.

Direct and indirect regulatory mechanisms in TH17 cell differentiation and functions

T helper 17 (TH17) cells have well-described roles in autoimmune diseases. The immune modulations of development and function of TH17 have become a key issue. In this review, we summarize the recent findings regarding the direct and indirect signalling regulatory mechanisms of TH17 cells in the general mouse model of autoimmune diseases and other human diseases.

The Yangtze-Hydro Project: a Chinese-German environmental program

Water of good quality is one of the basic needs of human life. Worldwide, great efforts are being undertaken for an assured water supply. In this respect, one of the largest water technology projects worldwide is the Yangtze Three Gorges Dam in China. There is a need for extensive scientific and technical understanding of the challenges arising from this large hydrological engineering project. German and Chinese groups from various scientific fields are collaborating to provide knowledge for the sustainable management of the reservoir. In this project description, the Yangtze Three Gorges Dam Project, its goals and challenges, are described in brief, and the contributions of the German research projects are presented.

Association of β-cell function and insulin sensitivity with fasting and 2-h plasma glucose in a large Chinese population

AIM

Our aim was to provide a quantitative analysis of the changes in the principal determinants of insulin sensitivity and secretion in relation to fasting plasma glucose (FPG) or 2-h plasma glucose (2h PG) in a Chinese population with a wide range of glucose tolerance.

METHODS

A total of 5728 adults spanning the entire range of glucose tolerance were included. Insulin sensitivity was measured by Matsuda insulin sensitivity index (ISI(M)) and homeostasis model assessment of 1/homeostasis model assessment of insulin resistance (HOMA-IR). β-Cell function adjusted by insulin sensitivity was assessed from disposition index (DI) at early-phase DI(30) and total DI(120). The exponential curve was established as the best fit for the relationship between insulin sensitivity or β-cell function and FPG or 2h PG.

RESULTS

Relative to the trend classified as increasing 2h PG, hepatic insulin sensitivity and insulin secretion showed a decreasing trend to a substantial degree as FPG increased. A 1 mmol/l increase in FPG and 2h PG concentration was associated with a -22 and -21% decline in ISI(M), -16 and -4% in 1/HOMA-IR, -38 and -35% in DI(30) and -36 and -26% in DI(120). The decay constant of ISI(M) and DI(30) in IFG or ISI(M), 1/HOMA-IR, DI(30) and DI(120) in IGT was lower than that in normal glucose tolerance. Significant interactions between sex and glucose levels determining DI were found.

CONCLUSIONS

We conclude that impairment of insulin sensitivity and insulin secretion contributes to both FPG or 2h PG hyperglycaemia in a Chinese population, but that the decline in insulin secretion is more pronounced with increasing fasting than 2h PG.

P1-03-09: Significance of FAP, SMA and CD31 Expression in the Stroma of Breast Cancer

Breast cancer stroma heterogeneity has been demonstrated in various gene expression profile analyses. Whether there is any association between stroma heterogeneity and the molecular phenotype of breast cancer has yet to be established. Therefore, we performed immunohistochemical analyses (IHC) to evaluate the expression of the following stromal cell markers (fibroblast activation protein (FAP), smooth muscle actin (SMA), and CD31, an endothelial cell marker) in tumor tissues from a contemporary cohort of 52 patients comprising of all four molecular subtypes (luminal A (n=25); luminal B (n=2); Her2-neu (+) (n=5); and basal (n=20)). We hypothesize that stroma heterogeneity as reflected by the proportion of stromal cells staining (+) for FAP and SMA may correlate with their molecular epithelial phenotype. Furthermore, studying the distribution of these stromal cell markers in IHC sections may evaluate their spatial relationship with tumor cells, immune cells, and tumor microvasculature which may have strategic significance within the tumor/microenvironment.

Survival time of cardiac allografts prolonged by isogeneic BMT in mice

To find an approach to prolong the survival time of cardiac allografts in a BALB/c-to-C57/BL6 heterotopic heart transplant model and to try to figure out related chemokines and cytokines, isogeneic and allogeneic BM cells were obtained from pregnant C57/BL6 (♀C57/BL6 × ♂BALB/c) and regular BALB/c mice and injected to the half lethally irradiated C57/BL6 mice 1 day before heart transplantation. Recipients were treated with CsA or phosphate-buffered saline for 7 days. Isogeneic BMT (iBMT) from pregnant C57/BL6 mice was observed to significantly prolong the survival of BALB/c allografts and reduce the lymphocyte infiltration. Allogeneic BMT (aBMT) and iBMT both exhibited signicantly less T-cell proliferation reactivity and the similar degree of chimerism. There was no significant difference in these groups of IFN-γ and IL-4 production. The level of chemokine MIG (CXCL9) dramatically decreased in aBMT and iBMT groups compared with the control group. But there were no significant differences between aBMT and iBMT group. IL-17 and RORγ(t) (receptor-related orphan receptor) production were downregulated in iBMT recipients. These results indicate that iBMT can prolong the survival of cardiac allografts. IL-17 production downregulated in iBMT recipients. This means that iBMT may have important therapeutic implications.

Role of subchondral bone during early-stage experimental TMJ osteoarthritis

Temporomandibular joint osteoarthritis (TMJ OA) is a degenerative disease that affects both cartilage and subchondral bone. We used microarray to identify changes in gene expression levels in the TMJ during early stages of the disease, using an established TMJ OA genetic mouse model deficient in 2 extracellular matrix proteins, biglycan and fibromodulin (bgn(-/0)fmod(-/-)). Differential gene expression analysis was performed with RNA extracted from 3-week-old WT and bgn(-/0)fmod(-/-) TMJs with an intact cartilage/subchondral bone interface. In total, 22 genes were differentially expressed in bgn(-/0)fmod(-/-) TMJs, including 5 genes involved in osteoclast activity/differentiation. The number of TRAP-positive cells were three-fold higher in bgn(-/0)fmod(-/-) TMJs than in WT. Quantitative RT-PCR showed up-regulation of RANKL and OPG, with a 128% increase in RANKL/OPG ratio in bgn(-/0)fmod(-/-) TMJs. Histology and immunohistochemistry revealed tissue disorganization and reduced type I collagen in bgn(-/0)fmod(-/-) TMJ subchondral bone. Early changes in gene expression and tissue defects in young bgn(-/0)fmod(-/-) TMJ subchondral bone are likely attributed to increased osteoclast activity. Analysis of these data shows that biglycan and fibromodulin are critical for TMJ subchondral bone integrity and reveal a potential role for TMJ subchondral bone turnover during the initial early stages of TMJ OA disease in this model.

SLC30A8 polymorphism and type 2 diabetes risk: evidence from 27 study groups

BACKGROUND AND AIMS

Intense research has been performed to identify the genetic risk factors in type 2 diabetes, and a single nucleotide polymorphism (SNP) in SLC30A8 (rs13266634) was reported to be associated with type 2 diabetes mellitus. However, published data on the association between SLC30A8 polymorphism and the risk of type 2 diabetes were inconsistent. Therefore, we conducted this meta-analysis to derive a more precise estimation of the relationship.

METHODS AND RESULTS

We searched PubMed through October 2009 to identify all relevant papers. Odds ratios (ORs) and 95% confidence intervals (CIs) were extracted under an additive genetic model. In the current meta-analysis, we identified a total of 27 groups including 42,609 cases and 69,564 controls. In analyses of the case-control studies by ethnicity, the results indicated that SLC30A8 polymorphism was related to elevate risks of type 2 diabetes both in Europeans (OR=1.15, 95% CI 1.11-1.18, P<0.001) and Asians (OR=1.15, 95% CI 1.11-1.19, P<0.001). Next, we separated hospital-based case-control studies from population-based case-control studies, however, there was no apparent difference between population-based case-control study groups (OR=1.15, 95% CI 1.12-1.17, P<0.001) and hospital-based case-control study groups (OR=1.16, 95% CI 1.07-1.25, P<0.001).

CONCLUSION

Our present meta-analysis provided evidence that SLC30A8 (rs13266634) C allele carriers could elevate the risk of type 2 diabetes, especially in Europeans and Asians.

The inhibitory effects of PKCθ on adiponectin expression is mediated by ERK in 3T3-L1 adipocytes

The research suggests that adiponectin plays an important role in sensitizing insulin action. It is interesting to find that the lower levels of adiponectin exist in the plasma of obese and Type 2 diabetes subjects and in the adipose tissue of obese, db/db mice, and insulin-resistant individuals. However, the underlying mechanism by which adiponectin expression is inhibited remains largely unknown. In this study, we reported that adipogenesis was inhibited by the stable over-expression of protein kinase C θ (PKCθ) in 3T3-L1 pre - adipocytes. The prolonged treatment of mature 3T3-L1 adipocytes with palmitate, a kind of saturated free fatty acid, reduced adiponectin expression at both mRNA level and protein level, accompanied with the enhanced phosphorylation of PKCθ and extracellular signal-regulated kinase (ERK), and the impaired expression of peroxisome proliferator-activated receptor γ2 (PPARγ2) mRNA. Either PD98059, an ERK inhibitor or PKCθ pseudosubstrate, a specific PKCθ inhibitor, restored palmiate-inhibited PPARγ2 mRNA expression and subsequent adiponectin expression. In addition, the over-expression or activation of PKCθ resulted in the enhanced phosphorylation of ERK in the mature 3T3-L1 adipocytes. PKCθ pseudosubstrate significantly reduced the phorbol 3-myristate 12-acetate (PMA)-induced phosphorylation of ERK. The data suggested that PKCθ-dependent activity of ERK resulted in the impaired expression of PPARγ2 mRNA leading to the reduction of adiponectin expression in the mature 3T3-L1 adipocytes.

Synthetic evaluation of the effect of health promotion: impact of a UNICEF project in 40 poor western counties of China

OBJECTIVE

To synthetically evaluate the effects of a health promotion project launched by the Ministry of Health of China and the United Nations Children's Fund (UNICEF) in 40 poor western counties of China.

STUDY DESIGN

The two surveys were cross-sectional studies. Stratified multistage random sampling was used to recruit subjects.

METHODS

Data were collected through two surveys conducted in the 40 'UNICEF project counties' in 1999 and 2000. After categorizing the 27 evaluation indicators into four aspects, a hybrid of the Analytic Hierarchy Process, the Technique for Order Preference by Similarity to Ideal Solution, and linear weighting were used to analyse the changes. The 40 counties were classified into three different levels according to differences in the synthetic indicator derived. Comparing the synthetic evaluation indicators of these two surveys, issues for implementation of the project were identified and discussed.

RESULTS

The values of the synthetic indicators were significantly higher in 2000 than in 1999 (P=0.02); this indicated that the projects were effective. Among the 40 counties, 11 counties were at a higher level in 2000, 10 counties were at a lower level, and others were in the middle level. Comparative analysis showed that 36% of village clinics were not licensed to practice medicine, nearly 50% of village clinics had no records of medicine purchases, nearly 20% of village clinics had no pressure cooker for disinfection, and 20% of pregnant women did not receive any prenatal care.

CONCLUSIONS

The health promotion projects in the 40 counties were effective. Health management, medical treatment conditions, maternal health and child health care have improved to some extent. However, much remains to be done to improve health care in these 40 poor counties. The findings of this study can help decision makers to improve the implementation of such improvements.