Sofosbuvir Monotherapy for Asymptomatic and Noncirrhotic Hepatitis C Infection in a Renal Retransplantation Recipient: A Case Report

Renal transplant recipients infected with hepatitis C virus (HCV) have a high risk of progressing to cirrhosis, end-stage liver diseases, and hepatocellular carcinoma. It is also considered as an independent risk for graft loss and is correlated with proteinuria, transplant glomerulopathy, HCV-associated glomerulonephritis, and chronic rejection. Previous therapy involving interferon alfa and ribavirin led to treatment complications, including toxicity, anemia, sepsis, and drug-drug interactions with calcineurin inhibitors, as well as reduced tolerability and efficacy. New direct-acting antiviral drugs simplify and shorten the treatment along with increasing tolerability and efficacy. Nevertheless, limited data and no specific regimen with direct-acting antiviral drugs have been described in the literature for renal transplant recipients with chronic HCV. We describe here the case of a 52-year-old Chinese man who diagnosed with chronic renal failure in 1997 and underwent renal transplantation the same year. In 2012, he was diagnosed with renal graft failure and again underwent hemodialysis. The patient then underwent his second renal transplantation and was administered an immunosuppressive cyclosporine-based regimen in 2015. During hemodialysis, he acquired asymptomatic genotype 1b HCV infection. Serologic test results reflecting liver cirrhosis were all negative, and ultrasound showed no abnormalities in the liver. The patient later required oral sofosbuvir monotherapy for 12 weeks after the second kidney transplantation. Curing HCV in renal transplant recipients is necessary. Although our treatment did not successfully result in a sustained virologic response, it suggests that genotype 1b HCV may have a poor response to a sofosbuvir monotherapy regimen. Specific and effective regimens for renal transplant recipients with HCV infection need to be confirmed in the future.

[Efficacy of intravenous thrombolysis in acute ischemic stroke with hyperdense middle cerebral artery sign]

Objective: To observe the efficacy and safety of recombinant tissue-type plasminogen activator (rtPA) intravenous thrombolysis (IVT) in the treatment of acute cerebral infarction with hyperdense middle cerebral artery sign (HMCAS). Methods: Acute cerebral infarction patients with HMCAS from July 2010 to November 2015 at the First Affiliated Hospital of Dalian Medical University were collected.These patients were divided into two groups depending on whether they received IVT or not.The Nation Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to evaluate early and long-time therapeutic effects.Efficacy and safety were compared between the two groups. Results: A total of 93 patients were eligible for the analysis, with 45 cases in IVT group and 48 cases in non-IVT group.As time went by, NIHSS score in IVT group showed significant downward trend than the non-IVT group.The rate of patients with good outcome in IVT group was higher than that in non-IVT group (P<0.05). The rate of hemorrhage transformation (HT) in IVT group and non-IVT group was 35.6% (16/45) and 10.4% (11/48), respectively, and the difference was statistically significant (P<0.05). While no statistically significant difference was found about the rate of symptomatic intracranial hemorrhage (sICH) (8.9% vs 2.1%, P>0.05) and mortality (33.3% vs 27.1%, P>0.05) between these two groups.Logistic regression analysis identified relativity between IVT treatment and good outcome (P<0.05), hemorrhage transformation (P<0.05), rather than mortality (P>0.05). Conclusions: Intravenous thrombolysis with rt-PA is an effective and safe treatment for most acute ischemic stroke patients with HMCAS and can promote early neurologic improvement and significantly improve long-term functional prognosis.Although Ⅳ thrombolysis can increase the risk of overall HT, it does not add risk in sICH and mortality.

The culture of HaCaT cells on liquid substrates is mediated by a mechanically strong liquid–liquid interface

The mechanical properties of naturally-derived matrices and biomaterials are thought to play an important role in directing cell adhesion, spreading, motility, proliferation and differentiation. However, recent reports have indicated that cells may respond to local nanoscale physical cues, rather than bulk mechanical properties. We had previously reported that primary keratinocytes and mesenchymal stem cells did not seem to respond to the bulk mechanical properties of poly(dimethyl siloxane) (PDMS) substrates. In this study, we examine the mechanical properties of weakly crosslinked PDMS substrates and observe a liquid-like behaviour, with complete stress relaxation. We then report the observation that HaCaT cells, an epidermal cell line, proliferate readily at the surface of uncrosslinked liquid PDMS, as well as on low viscosity (0.77 cSt) fluorinated oil. These results are surprising, considering current views in the field of mechanotransduction on the importance of bulk mechanical properties, but we find that strong mechanical interfaces, presumably resulting from protein assembly, are formed at liquid–liquid interfaces for which cell adhesion and proliferation are observed. Hence our results suggest that cells sense the nanoscale mechanical properties of liquid–liquid interfaces and that such physical cues are sufficient to sustain the proliferation of adherent cells.

Downregulated ECRG4 is correlated with lymph node metastasis and predicts poor outcome for nasopharyngeal carcinoma patients

OBJECTIVE

Esophageal cancer-related gene 4 (ECRG4) is a new candidate tumor suppressor gene. In this retrospective study, we evaluated ECRG4 protein expression in patients with nasopharyngeal carcinoma (NPC) under curative treatment and examined its association with pathological features and clinical outcomes as a possible biomarker for diagnosis and prognosis of NPC.

METHODS

We enrolled 122 patients with a first diagnosis between January 2001 and December 2003. Tumor tissue and control tissue from biopsies underwent immunohistochemical staining for ECRG4. ECRG4 expression was analyzed by clinicopathological variables. After Kaplan-Meier survival analysis, we used Cox proportional hazards regression to estimate the predictive effect of ECRG4 expression on overall survival.

RESULTS

ECRG4 protein level was lower in NPC than control tissue (P < 0.01). It was inversely related to node status (P < 0.001) and clinical stage (P = 0.027). ECRG4 expression was associated with overall survival, and downregulated ECRG4 expression was an independent prognostic factor of poor survival (hazard ratio = 0.677, 95 % confidence interval 0.463-0.989, P = 0.044).

CONCLUSIONS

A significant NPC patients showed downregulated ECRG4 expression, which is correlated with lymph node metastasis. The marker could be an independent prognostic factor for NPC patients. The precise function of ECRG4 in the progression of NPC, especially for lymphatic metastasis, deserves further investigation, which would bring a new target for personalized therapy.

Erythropoietin Receptor Activation Protects the Kidney From Ischemia/Reperfusion-Induced Apoptosis by Activating ERK/p53 Signal Pathway

BACKGROUND

Apoptosis plays an important role in renal ischemia/reperfusion (IR) injury. Evidence has shown that erythropoietin (EPO) has an antiapoptotic effect. Therefore, this study aimed to explore the effect and potential mechanism of EPO in renal IR injury.

METHODS

Kidney IR injury in rats was established by clamping the left renal artery for 30 minutes followed by 24 hours of reperfusion, along with contralateral nephrectomy. Renal function, renal histology, and expression of EPOR, p-EPOR, ERK, p-ERK, p-p53, p53, Bcl-2, Bcl-xl, Bad, and Bax were examined.

RESULTS

Pretreatment with EPO significantly reduced renal dysfunction, pathologic change, and expression of Bad and Bax. Furthermore, EPO treatment enhanced the expression of p-ERK, p-p53, Bcl-2, and Bcl-xl with no influence on the expression of EPOR, ERK, and p53.

CONCLUSIONS

These findings demonstrated that EPO pretreatment can attenuate renal IR injury by inhibiting apoptosis by promoting activation of the ERK/p53 signaling.

MiR-204 regulates HMGA2 expression and inhibits cell proliferation in human thyroid cancer

BACKGROUND

Analysis using publicly available algorithms has found that high mobility group AT-hook 2 (HMGA2), a key transcriptional regulatory factor, is a potential target of microRNA-204 (miR-204). Some studies have shown that both miR-204 and HMGA2 are associated with cancer development.

OBJECTIVE

We examined the possible relationship between miR-204 and HMGA2 in the development of thyroid cancer.

METHODS

We assessed miR-204 expression in thyroid cancer specimens and cell lines using real-time polymerase chain reaction (PCR). Luciferase reporter assay was used to confirm the target associations. The effect of miR-204 on cell proliferation was confirmed with tetrazolium and colony formation assays. Gene and protein expression were examined using real-time PCR and western blotting, respectively.

RESULTS

MiR-204 was downregulated in the thyroid cancer specimens and cell lines, and targeted the 3^\prime untranslated region of HMGA2 directly. MiR-204 overexpression decreased cyclin D1 and Ki67 expression and increased P21 expression, which subsequently inhibited thyroid cancer cell proliferation.

CONCLUSIONS

Our findings suggest that miR-204 plays a protective role by inhibiting thyroid cancer cell proliferation, and may identify new targets for anti-cancer treatment.

TMEM2 inhibits hepatitis B virus infection in HepG2 and HepG2.2.15 cells by activating the JAK-STAT signaling pathway

We have previously observed the downregulation of TMEM2 in the liver tissue of patients with chronic hepatitis B virus (HBV) infection and in HepG2.2.15 cells with HBV genomic DNA. In the present study, we investigated the role and mechanism of TMEM2 in HepG2 and HepG2.2.15 during HBV infection HepG2 and HepG2.2.15. HepG2 shTMEM2 cells with stable TMEM2 knockdown and HepG2 TMEM2 and HepG2.2.15 TMEM2 cells with stable TMEM2 overexpression were established using lentivirus vectors. We observed reduced expression of TMEM2 in HBV-infected liver tissues and HepG2.2.15 cells. HBsAg, HBcAg, HBV DNA, and HBV cccDNA levels were significantly increased in HepG2 shTMEM2 cells but decreased in HepG2 TMEM2 and HepG2.2.15 TMEM2 cells compared with naive HepG2 cells. On the basis of the western blotting results, the JAK-STAT signaling pathway was inhibited in HepG2 shTMEM2 cells but activated in HepG2 TMEM2 and HepG2.2.15 TMEM2 cells. In addition, reduced and increased expression of the antiviral proteins MxA and OAS1 was observed in TMEM2-silenced cells (HepG2 shTMEM2 cells) and TMEM2-overexpressing cells (HepG2 TMEM2 and HepG2.2.15 TMEM2 cells), respectively. The expression of Interferon regulatory factor 9 (IRF9) was not affected by TMEM2. However, we found that overexpression and knockdown of TMEM2, respectively, promoted and inhibited importation of IRF9 into nuclei. The luciferase reporter assay showed that IRF9 nuclear translocation affected interferon-stimulated response element activities. In addition, the inhibitory effects of TMEM2 on HBV infection in HepG2 shTMEM2 cells was significantly enhanced by pre-treatment with interferon but significantly inhibited in HepG2.2.15 TMEM2 cells by pre-treatment with JAK1 inhibitor. TMEM2 inhibits HBV infection in HepG2 and HepG2.2.15 by activating the JAK-STAT signaling pathway.

[The diagnosis and treatment of esophageal perforation and neck abscess induced by esophageal foreign body]

Objective:To explore the clinical characteristics and treatment methods of esophageal perforation and neck abscess induced by esophageal foreign body. Method:Twenty-six cases with esophageal perforation and neck abscess caused by esophageal foreign body treated in our department were performed surgery under general anesthesia. Result:The foreign bodies were removed via esophagoscope in 24 cases, no foreign bodies were found in 2 cases. Twenty-five case cured and one case was sent to the department of thoracic surgery. Conclusion:For the patients with esophageal perforation and neck abscess, regular perfect preoperative CT scan, timely take out foreign body; meanwhile indwelling nasal-stomach tube, the vacancy of the esophagus, avoid food spillage through the perforation and aggravating infection; adequate antibiotics and nutritional support can improve the cure rate.

Nanoparticle shape, thermodynamics and kinetics

Nanoparticles can be beautiful, as in stained glass windows, or they can be ugly as in wear and corrosion debris from implants. We estimate that there will be about 70,000 papers in 2015 with nanoparticles as a keyword, but only one in thirteen uses the nanoparticle shape as an additional keyword and research focus, and only one in two hundred has thermodynamics. Methods for synthesizing nanoparticles have exploded over the last decade, but our understanding of how and why they take their forms has not progressed as fast. This topical review attempts to take a critical snapshot of the current understanding, focusing more on methods to predict than a purely synthetic or descriptive approach. We look at models and themes which are largely independent of the exact synthetic method whether it is deposition, gas-phase condensation, solution based or hydrothermal synthesis. Elements are old dating back to the beginning of the 20th century-some of the pioneering models developed then are still relevant today. Others are newer, a merging of older concepts such as kinetic-Wulff constructions with methods to understand minimum energy shapes for particles with twins. Overall we find that while there are still many unknowns, the broad framework of understanding and predicting the structure of nanoparticles via diverse Wulff constructions, either thermodynamic, local minima or kinetic has been exceedingly successful. However, the field is still developing and there remain many unknowns and new avenues for research, a few of these being suggested towards the end of the review.

Decreased miR-134 expression and its tumor-suppressive function in human osteosarcoma

Dysregulation of microRNA (miR) is often associated with cancer development and progression. Aberrant expression of miR-134 has been found in some types of cancer. However, its expression and function in osteosarcoma remain unclear. The aim of this study was to explore the effects of miR-134 in osteosarcoma tumorigenesis and development. The expression level of miR-134 was quantified by real-time reverse transcription-polymerase chain reaction in human osteosarcoma cell lines and tissues. The effects of miR-134 on MG-63 cell phenotypes and tumorigenicity in vivo were observed using flow cytometry, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, transwell invasion, migration, and scratch migration assays. MiR-134 was significantly downregulated in osteosarcoma cell lines and clinical specimens. Decreased miR-134 expression was significantly associated with large tumor size, positive distant metastasis, and advanced clinical stage. Low miR-134 expression in osteosarcoma was an independent predictor of poor survival. Overexpression of miR-134 inhibited MG-63 cell proliferation, invasion, and migration, promoted cell apoptosis in vitro, and suppressed tumorigenicity in vivo. These findings indicate that miR-134 may act as a tumor suppressor in osteosarcoma and could serve as a novel therapeutic agent for miRNA-based therapy.

Treatment of tibia avulsion fracture of posterior cruciate ligament with high-strength suture fixation under arthroscopy

Aim

To evaluate the outcome of arthroscopy treatment using high-strength line in the treatment of tibial avulsion fracture of posterior cruciate ligament.

Methods

Both the avulsed bone block and the tibia bone bed were refreshed. The procedure was completed with the assistance of PCL director drill guide. The reduction and fixation using high-strength line were used to fix the avulsed bone by from posterior middle portal. Rehabilitation began early postoperatively.

Results

From January 2010 to June 2012, a total of 18 arthroscopically treated cases of PCL tibial avulsion fracture were retrospectively evaluated. Reduction of the avulsion fragment was obtained in all cases. 16 cases were followed up for 7–30 months (average 13.6), and 2 cases were out of follow-up. In the 16 followed patients, flexion and extension were back to normal within 6 weeks, and return to normal walk in 12 weeks. The bone healing was good without any vascular or nerve complications. All the patients regained the preinjury activity level. The mean score (and standard deviation) increased from 38.9 ± 4.9 points to 95.2 ± 3.8 points with the system of Lysholm, from 57.1 ± 10.3 points to 94.3 ± 4.4 points with the system of IKDC. Post-test displacement of KT3000 declined from 3.6 ± 0.39 to 1.1 ± 0.27 mm.

Conclusion

Arthroscopic vertical fixation by high-strength line is a simple, safe, reliable, and micro-invasive treatment to PCL tibial avulsion fracture. It is a kind of real all arthroscopic technique, and good for early postoperative rehabilitation. The total stability of the knee could be gained, and the second operation to remove the internal fixation is avoided.

Development of a nano-particle-assisted PCR assay for detection of duck tembusu virus

Duck tembusu virus (DTMUV) has caused significant economic losses to the poultry industry in China since the spring of 2010. In this study, a nano-PCR assay targeting E gene of DTMUV was developed and their sensitivities and specificities were investigated. Under the optimized conditions of nano-PCR assay for detection of DTMUV, the nano-PCR assay was 10-fold more sensitive than a conventional PCR assay. The lower detection limit of the nano-PCR assay was 1·8 × 10(2)  copies μl(-1) of DTMUV RNA, as no cross-reaction was observed with other viruses. This is the first report to demonstrate the application of a nano-PCR assay for the detection of DTMUV. The sensitive, and specific nano-PCR assay developed in this study can be applied widely in clinical diagnosis and field surveillance of DTMUV-infection.

SIGNIFICANCE AND IMPACT OF THE STUDY

A nanoparticle-assisted polymerase chain reaction (nano-PCR) assay was developed in this study for the rapid detection of duck tembusu virus (DTMUV) with high sensitivity and specificity. This technique has potential application in both clinical diagnosis and field surveillance of DTMUV-infection.

Incidence and risk of peripheral neuropathy with nab-paclitaxel in patients with cancer: a meta-analysis

Nab-paclitaxel, a Cremophor EL-free formulation of paclitaxel, is used to treat various malignancies. Peripheral neuropathy is one of its major toxicities, although the overall incidence remains unclear. We performed a meta-analysis to calculate the incidence of peripheral neuropathy in cancer patients treated with nab-paclitaxel and to compare the relative risk (RR) with conventional taxanes. The electronic databases were searched for relevant clinical trials. Eligible studies included phase II and III prospective clinical trials of cancer patients treated with nab-paclitaxel with toxicity profile on peripheral neuropathy. Statistical analyses were done to calculate summary incidences, RRs and 95% confidence intervals (CI), using fixed-effects or random-effects models based on the heterogeneity of the included studies. Nineteen trials were selected for the meta-analysis, yielding a total of 2878 cancer patients. The overall incidences of peripheral neuropathy (all-grade) was 51.0% (95% CI: 45.1-57.6%), and that of high-grade peripheral neuropathy was 12.4% (9.8-15.7%). The RRs of peripheral neuropathy of nab-paclitaxel compared to taxanes were not increased for all-grade and high-grade peripheral neuropathy. Nab-paclitaxel is associated with an increased risk of developing peripheral neuropathy. Future clinical studies are still needed to investigate the risk reduction and possible use of nab-paclitaxel.

Satisfactory Usage of a Lacerated Kidney for Transplantation: A Case Report

BACKGROUND

Organ shortage is the main bottleneck in the wait-list for transplantation; therefore, expanding the donor pool is an effective way to solve the problem. Usage of the traumatized liver for transplantation has been applied, but the use of lacerated kidneys for transplant donor is rarely reported.

METHODS

We reported a successful case of donation after brain death. The donor committed suicide by jumping from a campus dormitory building. One of the donated kidneys was severely injured. Two lacerations measured 4 × 1 × 1 cm in the medial margin of the graft and 1 × 1 × 1.5 cm in the front side of the graft, respectively. After repair with continuous absorbable suture, the lacerated kidney was transplanted to a recipient.

RESULTS

The post-transplantation renal function gradually recovered. Furthermore, serious complications, such as large amounts of hemorrhage, delayed graft function, or urinary fistula did not occur. The serum creatinine dropped from 1232 μmol/L to 120 μmol/L and maintained normal range after surgery. In addition, the daily urine output was normal. At day 12 after operation, the patient was discharged.

CONCLUSIONS

Our case shows that the use of a lacerated donor kidney appears to be feasible, but long-term effects need further observation.

Genetic diversity in intraspecific hybrid populations of Eucommia ulmoides Oliver evaluated from ISSR and SRAP molecular marker analysis

Eucommia ulmoides Oliver, the only extant species of Eucommiaceae, is a second-category state-protected endangered plant in China. Evaluation of genetic diversity among some intraspecific hybrid populations of E. ulmoides Oliver is vital for breeding programs and further conservation of this rare species. We studied the genetic diversity of 130 accessions from 13 E. ulmoides intraspecific hybrid populations using inter-simple sequence related (ISSR) and sequence-related amplified polymorphism (SRAP) markers. Of the 100 ISSR primers and 100 SRAP primer combinations screened, eight ISSRs and eight SRAPs were used to evaluate the level of polymorphism and discriminating capacity. A total number of 65 bands were amplified using eight ISSR primers, in which 50 bands (76.9%) were polymorphic, with an average of 8.1 polymorphic fragments per primer. Alternatively, another 244 bands were observed using eight SRAP primer combinations, and 163 (66.8%) of them were polymorphic, with an average of 30.5 polymorphic fragments per primer. The unweighted pair-group method (UPGMA) analysis showed that these 13 populations could be classified into three groups by the ISSR marker and two groups by the SRAP marker. Principal coordinate analysis using SRAP was completely identical to the UPGMA-based clustering, although this was partly confirmed by the results of UPGMA cluster analysis using the ISSR marker. This study provides insights into the genetic background of E. ulmoides intraspecific hybrids. The progenies of the variations "Huazhong-3", "big fruit", "Yanci", and "smooth bark" present high genetic diversity and offer great potential for E. ulmoides breeding and conservation.

Ammonium increases Ca(2+) signalling and upregulates expression of Cav1.2 gene in astrocytes in primary cultures and in the in vivo brain

AIM

The primary aim of this study was to identify the effects of hyperammonaemia on functional expression of Cav1.2 L-type Ca(2+) channels in astroglia.

METHODS

Primary cultures of mouse astrocytes were used to study effects of chronic treatment (1-5 days) with ammonium chloride, at 1, 3 and 5 mm on depolarization-induced increases in free cytosolic Ca(2+) concentration ([Ca(2+)]i , measured with Fura-2 based microfluorimetry) in control conditions and following treatment with the L-type Ca(2+) channel inhibitor, nifedipine, or with ryanodine receptor inhibitor, ryanodine. Expression of Cav1.2 mRNA was identified with RT-PCR, whereas protein content was determined by Western blotting. Sustained hyperammonaemia in vivo was induced by daily injections of urease (33 units kg body weight(-1), i.p.) for 3 days.

RESULTS

Depolarization-induced [Ca(2+)]i transients sensitive to nifedipine (peak of the response) and to ryanodine (plateau phase) were significantly increased in astrocytes chronically exposed to ammonium. The ammonium-induced increase in Ca(2+) influx in astrocytes resulted from an upregulation of Cav1.2 channel's expression detected at mRNA and protein levels. Increase in Cav1.2 expression was prevented by ouabain antagonist canrenone. Similar upregulation of Cav1.2 gene expression was found in the brains of adult mice subjected to intraperitoneal injection of urease. In transgenic mice tagged with an astrocyte-specific or neurone-specific markers and treated with intraperitoneal injections of urease, the fluorescence-activated cell sorting of neurones and astrocytes demonstrated that Cav1.2 mRNA expression was upregulated in astrocytes, but not in neurones.

CONCLUSIONS

Ammonium-induced deregulation of astroglial Ca(2+) signalling, is, in part, associated with upregulation of Cav1.2 L-type calcium channels.