ARHI (DIRAS3) induces autophagy in ovarian cancer cells by downregulating the epidermal growth factor receptor, inhibiting PI3K and Ras/MAP signaling and activating the FOXo3a-mediated induction of Rab7

The process of autophagy has been described in detail at the molecular level in normal cells, but less is known of its regulation in cancer cells. Aplasia Ras homolog member I (ARHI; DIRAS3) is an imprinted tumor suppressor gene that is downregulated in multiple malignancies including ovarian cancer. Re-expression of ARHI slows proliferation, inhibits motility, induces autophagy and produces tumor dormancy. Our previous studies have implicated autophagy in the survival of dormant ovarian cancer cells and have shown that ARHI is required for autophagy induced by starvation or rapamycin treatment. Re-expression of ARHI in ovarian cancer cells blocks signaling through the PI3K and Ras/MAP pathways, which, in turn, downregulates mTOR and initiates autophagy. Here we show that ARHI is required for autophagy-meditated cancer cell arrest and ARHI inhibits signaling through PI3K/AKT and Ras/MAP by enhancing internalization and degradation of the epidermal growth factor receptor. ARHI-mediated downregulation of PI3K/AKT and Ras/ERK signaling also decreases phosphorylation of FOXo3a, which sequesters this transcription factor in the nucleus. Nuclear retention of FOXo3a induces ATG4 and MAP-LC3-I, required for maturation of autophagosomes, and also increases the expression of Rab7, required for fusion of autophagosomes with lysosomes. Following the knockdown of FOXo3a or Rab7, autophagolysosome formation was observed but was markedly inhibited, resulting in numerous enlarged autophagosomes. ARHI expression correlates with LC3 expression and FOXo3a nuclear localization in surgical specimens of ovarian cancer. Thus, ARHI contributes to the induction of autophagy through multiple mechanisms in ovarian cancer cells.

Global link between deformation and volcanic eruption quantified by satellite imagery

A key challenge for volcanological science and hazard management is that few of the world’s volcanoes are effectively monitored. Satellite imagery covers volcanoes globally throughout their eruptive cycles, independent of ground-based monitoring, providing a multidecadal archive suitable for probabilistic analysis linking deformation with eruption. Here we show that, of the 198 volcanoes systematically observed for the past 18 years, 54 deformed, of which 25 also erupted. For assessing eruption potential, this high proportion of deforming volcanoes that also erupted (46%), together with the proportion of non-deforming volcanoes that did not erupt (94%), jointly represent indicators with ‘strong’ evidential worth. Using a larger catalogue of 540 volcanoes observed for 3 years, we demonstrate how this eruption–deformation relationship is influenced by tectonic, petrological and volcanic factors. Satellite technology is rapidly evolving and routine monitoring of the deformation status of all volcanoes from space is anticipated, meaning probabilistic approaches will increasingly inform hazard decisions and strategic development.

Deformation is often used in volcano monitoring, but the associated hazard is hard to interpret. Biggs et al. analyse 20 years of global satellite data and show a strong statistical link between deformation and eruption, although deformation alone is not necessarily a precursor of imminent eruption.

Population pharmacokinetic modelling to assess clinical drug-drug interaction between AZD7325 and midazolam

WHAT IS KNOWN AND OBJECTIVE

AZD7325 is a selective gamma-amino-butyric acid (GABAA )α2, 3 receptor modulator. The aims of this analysis were to develop population pharmacokinetic (PPK) models of AZD7325 and midazolam and to assess the induction effect of AZD7325 on CYP3A4 with midazolam as a substrate.

METHODS

Drug-drug interaction data of AZD7325 and midazolam from 24 healthy subjects were available for model development. PPK models were developed in a sequential manner using NONMEM. Both AZD7325 and midazolam pharmacokinetics were described by two-compartment models, and a transit compartment absorption model and a first-order absorption model were applied for the absorption of AZD7325 and midazolam, respectively. The induction of CYP3A by AZD7325 was described by a transit enzyme model, where the elimination of midazolam was proportionally linked to the enzyme amount. Simulations were performed to predict dosing regimens to account for the induction of CYP3A4.

RESULTS AND DISCUSSION

The population estimates for AZD7325 clearance, intercompartmental clearance, central and peripheral volume were 36, 29·2 L/h, 169 and 392 L, respectively, with interindividual variability (IIV) of 35% and 24% for clearance and central volume. Midazolam clearance, intercompartmental clearance, central and peripheral volume were estimated to be 62·7, 34·7 L/h, 133 and 146 L, respectively, with 43% IIV for clearance. The estimated mean transit time for induction of the CYP3A4 enzyme was 197 h, with 57% IIV.

WHAT IS NEW AND CONCLUSION

The PPK models developed adequately described the clinical observation of AZD7325-mediated CYP3A4 enzyme induction with midazolam as a probe. The model could provide basis for the rational dosing of AZD7325 in clinical practice.

Increased soluble C5b-9 in CSF of neuromyelitis optica

Neuromyelitis optica (NMO) and multiple sclerosis (MS) are two of the autoimmune inflammatory demyelinating diseases in the central nervous system. Complement is thought to have an important role in pathogenesis of these diseases, especially in NMO. However, the change of terminal complement complex (TCC, C5b-9) in patients with NMO is still unclear. Cerebrospinal fluid (CSF) C3a, C5a, sC5b-9 were measured by enzyme-linked immunosorbent assay in patients with NMO (n = 26), MS (n = 25) and other neurological disease (OND, n = 19). CSF levels of C5a in patients with NMO were higher than patients with OND (P = 0.006). Increased CSF sC5b-9 were found in the patients with NMO compared with patients with MS (P = 0.029) and OND (P = 0.0001). CSF sC5b-9 in patients with MS were also higher than patients with OND (P = 0.030). Patients with NMO revealed a trend to an increased disease disability with increased CSF sC5b-9 during relapse but not in MS (NMO: P = 0.006, MS: P = 0.097). CSF levels of sC5b-9 are increased in patients with NMO and reflect the activation of complement in NMO.

Simvastatin inhibits LPS-induced alveolar bone loss during metabolic syndrome

Studies in recent years have shown a positive relationship between metabolic syndrome (MS) and periodontal disease (PD). Given that patients with MS take statins to reduce cholesterol, and statins also have anti-inflammatory effects, it is important to determine if statin intake hinders the progression of MS-associated PD. In this study, PD was induced in Zucker fat rats (ZFRs), an animal model for MS, and in control lean rats by periodontal injection of Aggregatibacter actinomycetemcomitans lipopolysaccharide (LPS), while simvastatin was given to some of the rats via gavage. After 4 wk of treatment, alveolar bone loss was determined by micro-computed tomography. To explore the underlying mechanisms, we determined the effect of simvastatin on tissue inflammation and the expression of molecules involved in osteoclastogenesis. Results showed that while bone loss was increased by LPS in both ZFRs and the control lean rats, it was significantly more in the former than the latter. Simvastatin effectively alleviated bone loss in both ZFRs and the control rats. Results also showed that LPS stimulated leukocyte tissue infiltration and expression of molecules for osteoclastogenesis, but simvastatin significantly modulated the stimulation. This study demonstrated that simvastatin inhibited LPS-induced alveolar bone loss and periodontal tissue inflammation in rats with MS.

Long non-coding RNA UCA1 promotes breast tumor growth by suppression of p27 (Kip1)

Functional genomics studies have led to the discovery of a large amount of non-coding RNAs from the human genome; among them are long non-coding RNAs (lncRNAs). Emerging evidence indicates that lncRNAs could have a critical role in the regulation of cellular processes such as cell growth and apoptosis as well as cancer progression and metastasis. As master gene regulators, lncRNAs are capable of forming lncRNA–protein (ribonucleoprotein) complexes to regulate a large number of genes. For example, lincRNA-RoR suppresses p53 in response to DNA damage through interaction with heterogeneous nuclear ribonucleoprotein I (hnRNP I). The present study demonstrates that hnRNP I can also form a functional ribonucleoprotein complex with lncRNA urothelial carcinoma-associated 1 (UCA1) and increase the UCA1 stability. Of interest, the phosphorylated form of hnRNP I, predominantly in the cytoplasm, is responsible for the interaction with UCA1. Moreover, although hnRNP I enhances the translation of p27 (Kip1) through interaction with the 5′-untranslated region (5′-UTR) of p27 mRNAs, the interaction of UCA1 with hnRNP I suppresses the p27 protein level by competitive inhibition. In support of this finding, UCA1 has an oncogenic role in breast cancer both in vitro and in vivo. Finally, we show a negative correlation between p27 and UCA in the breast tumor cancer tissue microarray. Together, our results suggest an important role of UCA1 in breast cancer.

The texture quantitative analysis of the normal mammary parenchyma and in breast lesions: acoustic radiation force impulse (ARFI) technology

OBJECTIVE

The purpose of this work is to investigate the feasibility of acoustic radiation force impulse (ARFI) technology in the normal mammary parenchyma and in breast lesions.

MATERIALS AND METHODS

The virtual touch tissue quantification (VTQ) value was measured on a total of 150 cases in the normal mammary parenchyma and a total of 69 cases in breast lesions (19 cases of nodules, 28 cases of fibroadenoma, and 22 cases of cancer). Then the statistic analysis was carried out on the VTQ value combined with mammographic density, ages, menstrual stages, and pathological result.

RESULTS

The VTQ value of mammary parenchyma rose with the increase of the mammographic density, and the value of VTQ had statistical differences in the comparison of group C with group B and in the comparison of group D with group C. The comparison of the VTQ value of the mammary parenchyma in patients with breast cancer and the nodule had statistical difference. The comparison of the VTQ value of the mammary parenchyma in patients with breast cancer, and the fibroadenoma had statistical difference. The value ofVTQ in masses gradually increased in the groups of nodule, fibroadenoma, and breast cancer. There was significant difference in the comparison of VTQ value of the nodule group and the fibroadenoma group with breast cancer group respectively.

CONCLUSION

ARFI-VTQ technology has some reference value in assessing mammographic density. ARFI-VTQ can be used as the quantitative indicater for differentially diagnosing the breast lesions.

Characteristics of unrecognised bipolar disorder in patients treated for major depressive disorder in China: general versus psychiatric hospitals

OBJECTIVES

Bipolar disorder is often misdiagnosed as major depressive disorder. Such misdiagnosis partly depends on the type of treatment setting. This study compared general hospital psychiatric units with psychiatric hospitals in China with respect to basic demographic and clinical characteristics of patients with unrecognised bipolar disorder who are treated for major depressive disorder.

METHODS

Patients treated for major depressive disorder were consecutively examined in 13 health centres (6 general hospital psychiatric units and 7 psychiatric hospitals) in China. Their socio-demographic and clinical features were recorded using a standardised protocol and data collection procedure. The DSM-IV diagnoses were established using the Mini-International Neuropsychiatric Interview.

RESULTS

Of the 1487 patients included in the study, 309 (20.8%) were diagnosed with bipolar disorder. There was no significant difference between general hospital psychiatric units and psychiatric hospitals in the ratio of all types of unrecognised bipolar disorders (χ2 = 0.008, degrees of freedom = 1, p = 0.9) and bipolar II disorders (χ2 = 3.1, degrees of freedom = 1, p = 0.08). The proportions of unrecognised bipolar I disorders (χ2 = 4.1, degrees of freedom = 1, p = 0.04) differed significantly between the 2 types of study site. Multivariate analyses showed that patients with bipolar I disorders with more seasonal depressive episodes were more likely to receive treatment in general hospital psychiatric units (odds ratio = 3.3, 95% confidence interval = 1.1-9.8).

CONCLUSION

Patients with bipolar I disorders receiving treatment in general hospital psychiatric units had different clinical characteristics compared to their counterparts treated in psychiatric hospitals in China.

Simvastatin inhibits lipopolysaccharide-induced osteoclastogenesis and reduces alveolar bone loss in experimental periodontal disease

BACKGROUND AND OBJECTIVE

Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase and have anti-inflammatory effects independent of cholesterol lowering. Recent clinical studies have indicated that statin intake has a beneficial effect on periodontal disease. However, the underlying mechanisms have not been well understood. In the current study, we employed a rat model with lipopolysaccharide (LPS)-induced periodontal disease and determined the effect of simvastatin, a commonly prescribed statin, on osteoclastogenesis, gingival inflammation and alveolar bone loss.

MATERIAL AND METHODS

Sprague-Dawley rats were injected with Aggregatibacter actinomycetemcomitans LPS in periodontal tissue three times per week for 8 wk and part of the rats with LPS injection were also given simvastatin via gavage. After the treatments, the rat maxillae were scanned by microcomputed tomography and the images were analyzed to determine alveolar bone loss. To explore the underlying mechanisms, the effect of simvastatin on osteoclastogenesis and gingival expression of proinflammatory cytokines were also determined by tartrate-resistant acid phosphatase staining and real-time polymerase chain reaction assays, respectively.

RESULTS

Results showed that LPS treatment markedly increased bone loss, but administration of simvastatin significantly alleviated the bone loss. Results also showed that LPS treatment stimulated osteoclastogenesis and the expression of inflammatory cytokines, but simvastatin significantly modulates the stimulatory effect of LPS on osteoclastogenesis and cytokine expression.

CONCLUSION

This study demonstrated that simvastatin treatment inhibits LPS-induced osteoclastogenesis and gingival inflammation and reduces alveolar bone loss, indicating that the intake of simvastatin may hinder the progression of periodontal disease.

Improving methyl parathion hydrolase to enhance its chlorpyrifos-hydrolysing efficiency

Methyl parathion hydrolase (MPH) can degrade a wide range of organophosphorus compounds, but its efficiency in hydrolysing chlorpyrifos, one of the most popular pesticides applied for crop protection, is much lower than that in hydrolysing the preferred substrate methyl parathion. In this study, random mutagenesis was adopted to improve MPH to enhance its efficiency in hydrolysing the poorly hydrolysed substrate chlorpyrifos. Rapid screening of the improved MPH variants was carried out using Bacillus subtilis WB800 secretory expression system to investigate the distribution of improved MPH variants based on the size of clear haloes as a result of chlorpyrifos hydrolysis. Four improved MPH variants were isolated, and one variant K3, in particular, showed a 5-fold increase in kcat value for chlorpyrifos hydrolysis. Furthermore, most of the MPH variants obtained in this study possessed enhanced thermostability and pH stability. The approaches adopted in this study could be extended to create other MPH variants with increased activity for hydrolysing other poorly hydrolysed substrates.

SIGNIFICANCE AND IMPACT OF THE STUDY

Chlorpyrifos is one of the toxic organophosphorus compounds (OP compounds) widely used for insecticides control. Water, soil and foodstuff have been contaminated seriously by chlorpyrifos in some areas. It is urgent to find effective methods to remove its contamination. This work contributes to improve methyl parathion hydrolase (MPH) to enhance its efficiency in hydrolysing the poorly hydrolysed substrate chlorpyrifos. Our study brings new insights for enzymatic strategy for the decontamination of toxic OP compounds.

Investigating univariate temporal patterns for intrinsic connectivity networks based on complexity and low-frequency oscillation: a test-retest reliability study

Intrinsic connectivity networks (ICNs) are composed of spatial components and time courses. The spatial components of ICNs were discovered with moderate-to-high reliability. So far as we know, few studies focused on the reliability of the temporal patterns for ICNs based their individual time courses. The goals of this study were twofold: to investigate the test-retest reliability of temporal patterns for ICNs, and to analyze these informative univariate metrics. Additionally, a correlation analysis was performed to enhance interpretability. Our study included three datasets: (a) short- and long-term scans, (b) multi-band echo-planar imaging (mEPI), and (c) eyes open or closed. Using dual regression, we obtained the time courses of ICNs for each subject. To produce temporal patterns for ICNs, we applied two categories of univariate metrics: network-wise complexity and network-wise low-frequency oscillation. Furthermore, we validated the test-retest reliability for each metric. The network-wise temporal patterns for most ICNs (especially for default mode network, DMN) exhibited moderate-to-high reliability and reproducibility under different scan conditions. Network-wise complexity for DMN exhibited fair reliability (ICC<0.5) based on eyes-closed sessions. Specially, our results supported that mEPI could be a useful method with high reliability and reproducibility. In addition, these temporal patterns were with physiological meanings, and certain temporal patterns were correlated to the node strength of the corresponding ICN. Overall, network-wise temporal patterns of ICNs were reliable and informative and could be complementary to spatial patterns of ICNs for further study.

Neurosurgery for mental disorders: a review

Neurosurgical interventions date back to ancient civilization, 5100 BC through a practice known as trephination. Due to past abuse and ethical considerations, neurosurgical interventions in psychiatry remain a controversial issue. This article aims to review the different surgical techniques and their current application in the treatment of psychiatric disorders. The U.S Food and Drug Administration (FDA) gave its approval for vagal nerve stimulation (VNS) for the management of treatment-resistant depression in 2005 and deep brain stimulation (DBS) for refractory obsessive-compulsive disorders (OCD) in 2009. These invasive but non destructive techniques represent the future of neurosurgery for mental disorder.

Development of a novel adenovirus-alphavirus hybrid vector with RNA replicon features for malignant hematopoietic cell transduction

To improve the expression levels of transgenes in malignant hematopoietic cells, we developed a novel adenoviral-alphavirus hybrid vector Ad5/F11p-SFV-GFP that contains a Semliki Forest Virus (SFV) replicon and chimeric fibers of Ad5 and Ad11p. Ad5/F11p-SFV-GFP infected >95% of K562, U937 or Jurkat cells and 23.65% of HL-60 cells, and led to moderate Enhanced Green Fluorescent Protein (EGFP) transgene expression intensity. The infection efficiency of Ad5/F11p-SFV-GFP in primary human leukemia cells ranged from 9.34-89.63% (median, 28.58%) at a multiplicity of infection (MOI) of 100, compared with only 3.37-44.54% (median, 10.42%) in cells infected by Ad5/F11p-GFP. Importantly, Ad5/F11p-SFV-GFP led to a significantly higher transgene expression level in primary leukemia cells, as indicated by the relative fluorescence intensity, compared to cells infected with Ad5/F11p-GFP. The increased expression of EGFP in Ad5/F11p-SFV-GFP-infected cells was associated with the accumulation of abundant subgenomic mRNA. Additionally, infection of K562, U937 or Jurkat cells by Ad5/F11p-SFV-GFP was significantly inhibited by blocking CD46 receptor; however, other factors may affect the gene-transfer efficiency of Ad5/F11p-SFV-GFP in primary leukemia cells. In conclusion, we successfully developed a novel adenoviral-alphavirus hybrid vector with RNA replicon features, which represents a promising vector for gene modifications during the production of cell-based vaccines for leukemia patients.

Developing topic-specific search filters for PubMed with click-through data

OBJECTIVES

Search filters have been developed and demonstrated for better information access to the immense and ever-growing body of publications in the biomedical domain. However, to date the number of filters remains quite limited because the current filter development methods require significant human efforts in manual document review and filter term selection. In this regard, we aim to investigate automatic methods for generating search filters.

METHODS

We present an automated method to develop topic-specific filters on the basis of users' search logs in PubMed. Specifically, for a given topic, we first detect its relevant user queries and then include their corresponding clicked articles to serve as the topic-relevant document set accordingly. Next, we statistically identify informative terms that best represent the topic-relevant document set using a background set composed of topic irrelevant articles. Lastly, the selected representative terms are combined with Boolean operators and evaluated on benchmark datasets to derive the final filter with the best performance.

RESULTS

We applied our method to develop filters for four clinical topics: nephrology, diabetes, pregnancy, and depression. For the nephrology filter, our method obtained performance comparable to the state of the art (sensitivity of 91.3%, specificity of 98.7%, precision of 94.6%, and accuracy of 97.2%). Similarly, high-performing results (over 90% in all measures) were obtained for the other three search filters.

CONCLUSION

Based on PubMed click-through data, we successfully developed a high-performance method for generating topic-specific search filters that is significantly more efficient than existing manual methods. All data sets (topic-relevant and irrelevant document sets) used in this study and a demonstration system are publicly available at http://www.ncbi.nlm.nih.gov/CBBresearch/Lu/downloads/CQ_filter/

It is not the ride: inter-hospital transport is not an independent risk factor for intraventricular hemorrhage among very low birth weight infants

OBJECTIVE

The purpose of this study was to evaluate the relationship between intraventricular hemorrhage (IVH), inter-hospital transport and known potential risk factors for IVH.

STUDY DESIGN

Very low birth weight (VLBW <1500 g) infants admitted to a large regional neonatal intensive care unit within 48 h of life from 2005 to 2010 were identified. Logistic regression and proportional odds logistic regression models were used to compare inborn versus outborn patients with respect to IVH (any vs none) and IVH grade, respectively. Logistic regression was used to quantify the association between outborn status and mortality.

RESULT

A total of 758 infants were included in the study (inborn=568, outborn=190). Outborn infants were found to have greater IVH severity than inborn (odds ratio (OR): 1.52; P=0.012). After accounting for 20 clinical and demographic variables in a multivariable model, the association between outborn status and IVH lacked statistical significance (OR: 1.14; P=0.56). Significant predictors of IVH grade included vaginal delivery (OR: 2.16; P<0.001), patent ductus arteriosus (OR: 1.65; P=0.005), 5-min Apgar (OR: 0.85; P=0.005) and gestational age (OR: 0.98; P=0.012). Sixty-nine (9.1%) of the infants died. After adjusting for potential confounders, the relationship between mortality and outborn status was not significant (OR:1.26; P=0.516). Significant predictors of mortality included gestational age (OR: 1.03; P=0.04) and 5-min Apgar (OR:1.22; P=0.02).

CONCLUSION

Although VLBW infants transported during the first 2 days of life have higher rates of IVH than infants born at a tertiary care facility, this relationship may be explained by associations with underlying clinical variables rather than transport itself.

Identification of LRP16 as a negative regulator of insulin action and adipogenesis in 3T3-L1 adipocytes

Leukemia related protein 16 (LRP16) was first cloned from acute myeloid leukemia cells in our laboratory. In the present study, we sought to investigate the role of LRP16 in insulin action and sensitivity, using LRP16-depleted and -overexpressing 3T3-L1 cells. LRP16 silencing resulted in a reduction of the expression and secretion of tumor necrosis factor-alpha (TNF-α) and a concomitant increase in the expression of peroxisome proliferator-activated receptor-gamma (PPAR-γ). Moreover, LRP16 depletion promoted insulin-induced glucose uptake and adipocyte differentiation of 3T3-L1 cells. In contrast, LRP16 overexpression increased TNF-α secretion, suppressed glucose uptake, and attenuated 3T3-L1 cell differentiation. The phosphorylation levels of insulin receptor substrate 1 (IRS-1), phosphatidylinositide 3-kinase (PI3-K), and Akt were increased in LRP16-deficient 3T3-L1 cells, and conversely, diminished in LRP16-overexpressing 3T3-L1 cells, when compared to the corresponding control cells. Additionally, LRP16 overexpression raised the phosphorylation level of mammalian target of rapamycin (mTOR). The pretreatment with rapamycin, a specific inhibitor of mTOR, prevented the TNF-α elevation and PPAR-γ reduction and restored the phosphorylation of IRS-1, PI3-K, and Akt in LRP16-overexpressing cells. Our data collectively indicate that LRP16 acts as a negative regulator of insulin action and adipogenesis in 3T3-L1 adipocytes, which involves the activation of the mTOR signaling pathway.

Built to break: the antenna of a primitive insect, Petrobius brevistylis (Archaeognatha)

Jumping bristletails (Archaeognatha) have flagellate antennae with frequent breakpoints, structures destined to break when undue mechanical stress is applied. In natural populations of Petrobius brevistylis at least 67% of animals had broken antennae. In twenty-four trials, all antennae broke at a breakpoint under the animal's weight. Breakpoints consist of two cylinders of laminated cuticle, one stuck inside the other. For half the length of the breakpoint the cylinders are separated by a non-laminated layer of cuticle; thus a tripartite cuticle is formed. During a breakage, the two cylinders slide apart along that non-laminated middle layer that seems to act like a lubricant. While the cylinders pull apart, a thin cuticle unfolds that closes off the new tip of the antenna formed by the outer breakpoint cylinder. Later on, the cylinder is not replaced by a new terminal antennomere. Instead, the antennomere directly proximal to a breakpoint, i.e. the one that after the break forms the last antennomere, already possess the same complement of sensilla as the original terminal antennomere. This includes sensilla basiconica Type A and B found exclusively on these antennomeres and the original terminal antennomere. Breakpoints are common to Archaeognatha and Thysanura, insects that moult throughout their lifetime.

Safety of midazolam for sedation of HIV-positive patients undergoing colonoscopy

OBJECTIVES

Because of concerns regarding interactions between midazolam and antiretroviral therapy (ART), alternative sedatives are sometimes used during procedural sedation. Our objective was to compare outcomes in patients on ART who received intravenous (iv) midazolam vs. iv diazepam, a second-line agent, during colonoscopy.

METHODS

We conducted a retrospective analysis of adult HIV-positive patients who underwent colonoscopy over a 3.5-year period. Primary outcomes were sedation duration, nadir systolic blood pressure (SBP), nadir oxygen saturation, abnormal cardiac rhythm, and change in level of consciousness using a standardized scale. We calculated rates of adverse events according to benzodiazepine use and identified risk factors for complications using univariate and multivariate analyses.

RESULTS

We identified 136 patients for this analysis: 70 received midazolam-based sedation and 66 received a diazepam-based regimen. There were no significant differences between the two groups with respect to sedation duration (mean 48.0 vs. 45.7 minutes for the midazolam and diazepam groups, respectively; P = 0.68), nadir SBP (mean 97.0 vs. 101.6 mmHg; P = 0.06), nadir oxygen saturation (mean 94.6 vs. 94.8%; P = 0.72) or rate of abnormal cardiac rhythm (11.4 vs. 19.7%; P = 0.18). More patients in the midazolam group experienced a depressed level of consciousness (91% vs. 74% in the diazepam group; P = 0.0075), but no patient required reversal of sedation or became unresponsive.

CONCLUSIONS

We did not find evidence that patients who received midazolam for procedural sedation had clinical outcomes statistically different from those who received diazepam. These findings should be confirmed in prospective studies or in a randomized controlled trial.

The "rosette-like" structures in the cuticle of Petrobius brevistylis are the openings of epidermal glands

We examined the "rosette-like" structures (RS), found in Archaeognatha and Thysanura, in the compound eyes and the antennae of the machilid Petrobius brevistylis using SEM and TEM. The nature of the RS was unknown until now, and hypothesized to be either a sensillum or the opening of a gland. Our studies show that RS are the orifices of epidermal glands. A gland consists of a single glandular unit of 4 cells: a duct cell, a secretory cell, a ciliary cell and an enveloping cell. The glands are class 3 epidermal glands as defined by Noirot and Quennedey (1974).

Icariin stimulates the proliferation of rat Sertoli cells in an ERK1/2-dependent manner in vitro

Icariin (ICA), a major constituent of flavonoids from the Chinese medical herb Epimedium brevicornum Maxim, is found to be protective for male reproductive ability, with the underlying mechanism largely unknown. Our study here investigated the effects of ICA on Sertoli cells, which act as nurse cells for the germ cells developing. Icariin was found to stimulate Sertoli cell proliferation in a dose-dependent manner. Further study revealed that Icariin induced an obvious phosphorylation of ERK in Sertoli cells. Inhibition of activation of ERK by the ERK inhibitor U0126 nearly blocked the Icariin-induced proliferation of Sertoli cells. Taken together, our results suggest that Icariin promotes the proliferation of Sertoli cells in vitro by activating the ERK1/2 signal pathway, which might at least partially, explain the protective role of Icariin on male reproductive ability.

[A study on immunity enhancement of frozen human lung cancer cells in vitro.]

BACKGROUND

To investigate the mechanisms of cryo-immunotherapeutic effect.

METHODS

After the mixed culture of human lung cancer cells and autologous lymphocytes was conducted in vitro ,lymphocyte transformation rate (LTR) , soluble interleukin-2 receptor (SIL-2R) and interleukin-6 ( IL-6) in the supernatants of the frozen lung cancer cells and the control were detected. Meanwhile , the effects of the supernatants of the culture of frozen lung cancer cells and the control on the proliferation of autologous lung cancer cells were also determined with FCM measurement.

RESULTS

(1)The levels of SIL-2R , IL-6 and LTR in the group of frozen lung cancer cells were all highly significant higher than those in the group of the control ( P < 0. 01) . (2)The supernatant of the culture of the frozen lung cancer cells could remarkably inhibit the proliferation of the autologous lung cancer cells ( P < 0. 01) .

CONCLUSIONS

(1)Frozen lung cancer cells may improve the immune function of lymphocytes through promoting their activation , proliferation and secretion of cytokines. (2)The activation of immune competent cells by freezing can remarkably inhibit the proliferation of lung cancer cells. Therefore , freezing can irritate the body's anti-tumor immunity.

Advanced or metastatic gastric cancer in elderly patients: clinicopathological, prognostic factors and treatments

PURPOSE

To analyze the clinicopathological features, prognostic factors, treatment efficacy and safety among elderly patients with advanced or metastatic gastric cancer.

METHODS

Three hundred and nineteen patients aged 65 years and older, diagnosed with advanced or metastatic gastric cancer, were followed and data were retrospectively collected, reviewed and analyzed.

RESULTS

The elderly patients carried specific clinicopathological characteristics. Body mass index (BMI), number of metastatic lesions, ascites, Karnofsky performance score (KPS), tumor differentiation grade, lactate dehydrogenase (LDH) level, local treatment, and chemotherapy were the independent prognostic factors. Serum LDH level was superior to the serum CEA level in the prognosis of advanced or metastatic gastric cancer in older patients. Cisplatin-based regimen, chemotherapy cycles, metastatic lesions, LDH level, and supraclavicular lymph node metastasis were the independent prognostic factors in 220 patients receiving chemotherapy. The toxicity was mild and tolerable.

CONCLUSION

KPS, BMI and a well-differentiated histopathology were factors favoring longer survival, whereas elevated serum LDH and a greater number of metastatic lesions were associated with poor prognosis among those elderly patients. Cisplatin-based chemotherapy provided survival benefits and mild toxicity.

Advanced or metastatic gastric cancer in elderly patients: clinicopathological, prognostic factors and treatments

PURPOSE

To analyze the clinicopathological features, prognostic factors, treatment efficacy and safety among elderly patients with advanced or metastatic gastric cancer.

METHODS

Three hundred and nineteen patients aged 65 years and older, diagnosed with advanced or metastatic gastric cancer, were followed and data were retrospectively collected, reviewed and analyzed.

RESULTS

The elderly patients carried specific clinicopathological characteristics. Body mass index (BMI), number of metastatic lesions, ascites, Karnofsky performance score (KPS), tumor differentiation grade, lactate dehydrogenase (LDH) level, local treatment, and chemotherapy were the independent prognostic factors. Serum LDH level was superior to the serum CEA level in the prognosis of advanced or metastatic gastric cancer in older patients. Cisplatin-based regimen, chemotherapy cycles, metastatic lesions, LDH level, and supraclavicular lymph node metastasis were the independent prognostic factors in 220 patients receiving chemotherapy. The toxicity was mild and tolerable.

CONCLUSION

KPS, BMI and a well-differentiated histopathology were factors favoring longer survival, whereas elevated serum LDH and a greater number of metastatic lesions were associated with poor prognosis among those elderly patients. Cisplatin-based chemotherapy provided survival benefits and mild toxicity.

Economic analysis of Mycobacterium avium subspecies paratuberculosis vaccines in dairy herds

Johne's disease, or paratuberculosis, is a chronic infectious enteric disease of ruminants, caused by infection with Mycobacterium avium ssp. paratuberculosis (MAP). Given the absence of a fail-safe method of prevention or a cure, Johne's disease can inflict significant economic loss on the US dairy industry, with an estimated annual cost of over $200 million. Currently available MAP control strategies include management measures to improve hygiene, culling MAP serologic- or fecal-positive adult cows, and vaccination. Although the 2 first control strategies have been reported to be effective in reducing the incidence of MAP infection, the changes in herd management needed to conduct these control strategies require significant effort on the part of the dairy producer. On the other hand, vaccination is relatively simple to apply and requires minor changes in herd management. Despite these advantages, only 5% of US dairy operations use vaccination to control MAP. This low level of adoption of this technology is due to limited information on its cost-effectiveness and efficacy and some important inherent drawbacks associated with current MAP vaccines. This study investigates the epidemiological effect and economic values of MAP vaccines in various stages of development. We create scenarios for the potential epidemiological effects of MAP vaccines, and then estimate economically justifiable monetary values at which vaccines become economically beneficial to dairy producers such that a net present value (NPV) of a farm's net cash flow can be higher than the NPV of a farm using no control or alternative nonvaccine controls. Any vaccination with either low or high efficacy considered in this study yielded a higher NPV compared with a no MAP control. Moreover, high-efficacy vaccines generated an even higher NPV compared with alternative controls, making vaccination economically attractive. Two high-efficacy vaccines were particularly effective in MAP control and NPV maximization. One was a high-efficacy vaccine that reduced susceptibility to MAP infection. The other was a high-efficacy vaccine that had multiple efficacies on the dynamics of MAP infection and disease progress. Only one high-efficacy vaccine, in which the vaccine is targeted at reducing MAP shedding and the number of clinical cases, was not economically beneficial to dairy producers compared with an alternative nonvaccine control, when herds were highly infected with MAP.