High-resolution anorectal manometry in newborns: normative values and diagnostic utility in Hirschsprung disease

BACKGROUND

Conventional methods of screening for Hirschsprung disease (HD) in newborns (barium enema, BE; anorectal manometry, ARM; rectal suction biopsy, RSB) have limitations and/or are invasive. High-resolution anorectal manometry (HR-ARM) is a minimally invasive technique that has potential to overcome most of these limitations, but normative data and performance characteristics have not been reported in newborns. The aims of our study were to assess anorectal sphincter metrics including resting pressure (RP), anal canal length (ACL), and rectoanal inhibitory reflex (RAIR) in healthy and asymptomatic newborns, and to explore the role of HR-ARM in the diagnosis of HD using these normal parameters.

METHODS

All procedures were performed using solid state HR-ARM equipment (Medical Measurement Systems, Enchede, The Netherland) by a single operator. In the first phase, 180 asymptomatic newborns (term newborns 95, preterm newborns 85) were studied, and anal RP, ACL, and RAIR were measured. In the second phase, 16 newborns with clinical manifestations of HD were studied (9 of whom had histopathologic confirmation), and parameters compared to asymptomatic newborns.

KEY RESULTS

Normative RP values were higher in term newborns compared with preterm newborns (p < 0.05), and correlated with age. Progressive maturation of the anal sphincter was evident with chronologic age, both in preterm and term newborns. RAIR was present in all normal subjects. Using absent RAIR as indicative of HD, HR-ARM had a sensitivity 89% and specificity of 83% compared to RSB; these performance characteristics were better than BE (sensitivity 78%, specificity 17%), with significantly higher diagnostic accuracy (80% vs 53%, respectively, p = 0.009).

CONCLUSIONS & INFERENCES

Anorectal sphincter pressure progressively matures with incremental increase in RP during the first months of life. HR-ARM is an effective and safe method that complements the diagnosis of HD in newborns.

Expression of the apoptosis inhibitor livin in colorectal adenoma-carcinoma sequence: correlations with pathology and outcome

The inhibitor of apoptosis family member livin is expressed in several types of cancer but not in most benign tissues, and it has been considered to be a poor prognostic mark in various malignancies. However, livin expression and its prognostic relevance have not been evaluated in colorectal adenoma-carcinoma sequence. In this study, we analyzed the difference of livin expression among normal mucosa, adenoma, and adenocarcinoma and investigated the relationship of livin expression in carcinomas with clinicopathological variables using immunohistochemistry and real-time reverse transcription-PCR. We observed that the expression of livin protein was mainly present on base of colorectal crypts in adenoma and throughout the epithelium in carcinoma, whereas did not present in accompanying normal mucosa, and the expression of livin messenger RNA (mRNA) in adenocarcinomas was significantly higher than in adenomas and in normal mucosa (P = 0.001, respectively), whereas, compared with normal mucosa, the expression level of livin mRNA was up-regulated in adenomas but no significant difference (P = 0.196). We also found that the expression levels of livin mRNA in rectal cancer was significantly higher than those in colonic cancer, and livin mRNA expression was strongly related to colorectal cancer invasive depth but not to clinical tumor stage, differentiation, lymph node metastasis, tumor morphological category and pathological type, and patient's age and gender. These findings support the possibility that the livin gene may play a role in colorectal tumorigenesis, and increased expression of livin mRNA may serve as a new target for colorectal cancer treatment.

Search for a light sterile neutrino at Daya Bay

A search for light sterile neutrino mixing was performed with the first 217 days of data from the Daya Bay Reactor Antineutrino Experiment. The experiment's unique configuration of multiple baselines from six 2.9 GW(th) nuclear reactors to six antineutrino detectors deployed in two near (effective baselines 512 m and 561 m) and one far (1579 m) underground experimental halls makes it possible to test for oscillations to a fourth (sterile) neutrino in the 10(-3) eV(2)<|Δm(41)(2) |< 0.3 eV(2) range. The relative spectral distortion due to the disappearance of electron antineutrinos was found to be consistent with that of the three-flavor oscillation model. The derived limits on sin(2) 2θ(14) cover the 10(-3) eV(2) ≲ |Δm(41)(2)| ≲ 0.1 eV(2) region, which was largely unexplored.

Vision-based endoscope tracking for 3D ultrasound image-guided surgical navigation

This work introduces a self-contained framework for endoscopic camera tracking by combining 3D ultrasonography with endoscopy. The approach can be readily incorporated into surgical workflows without installing external tracking devices. By fusing the ultrasound-constructed scene geometry with endoscopic vision, this integrated approach addresses issues related to initialization, scale ambiguity, and interest point inadequacy that may be faced by conventional vision-based approaches when applied to fetoscopic procedures. Vision-based pose estimations were demonstrated by phantom and ex vivo monkey placenta imaging. The potential contribution of this method may extend beyond fetoscopic procedures to include general augmented reality applications in minimally invasive procedures.

Roles of tumor suppressors in regulating tumor-associated inflammation

Loss or silencing of tumor suppressors (TSs) promotes neoplastic transformation and malignant progression. To date, most work on TS has focused on their cell autonomous effects. Recent evidence, however, demonstrates an important noncell autonomous role for TS in the control of tumor-associated inflammation. We review evidence from clinical data sets and mouse model studies demonstrating enhanced inflammation and altered tumor microenvironment (TME) upon TS inactivation. We discuss clinical correlations between tumor-associated inflammation and inactivation of TS, and their therapeutic implications. This review sets forth the concept that TS can also suppress tumor-associated inflammation, a concept that provides new insights into tumor-host interactions. We also propose that in some cases the loss of TS function in cancer can be overcome through inhibition of the resulting inflammatory response, regardless whether it is a direct or an indirect consequence of TS loss.

Roles of tumor suppressors in regulating tumor-associated inflammation

Loss or silencing of tumor suppressors (TSs) promotes neoplastic transformation and malignant progression. To date, most work on TS has focused on their cell autonomous effects. Recent evidence, however, demonstrates an important noncell autonomous role for TS in the control of tumor-associated inflammation. We review evidence from clinical data sets and mouse model studies demonstrating enhanced inflammation and altered tumor microenvironment (TME) upon TS inactivation. We discuss clinical correlations between tumor-associated inflammation and inactivation of TS, and their therapeutic implications. This review sets forth the concept that TS can also suppress tumor-associated inflammation, a concept that provides new insights into tumor-host interactions. We also propose that in some cases the loss of TS function in cancer can be overcome through inhibition of the resulting inflammatory response, regardless whether it is a direct or an indirect consequence of TS loss.

An apparatus to manipulate and identify individual Ba ions from bulk liquid Xe

We describe a system to transport and identify barium ions produced in liquid xenon, as part of R&D towards the second phase of a double beta decay experiment, nEXO. The goal is to identify the Ba ion resulting from an extremely rare nuclear decay of the isotope (136)Xe, hence providing a confirmation of the occurrence of the decay. This is achieved through Resonance Ionization Spectroscopy (RIS). In the test setup described here, Ba ions can be produced in liquid xenon or vacuum and collected on a clean substrate. This substrate is then removed to an analysis chamber under vacuum, where laser-induced thermal desorption and RIS are used with time-of-flight mass spectroscopy for positive identification of the barium decay product.

Effect of texture and grain shape on ultrasonic backscattering in polycrystals

An ultrasonic backscattering model is developed for textured polycrystalline materials with orthotropic or trigonal grains of ellipsoidal shape. The model allows us to simulate realistic microstructures and orthotropic macroscopic material textures resulting from thermomechanical processing for a broad variety of material symmetries. The 3-D texture is described by a modified Gaussian orientation distribution function (ODF) of the crystallographic orientation of the grains along the macroscopic texture direction. The preferred texture directions are arbitrary relative to the axes of the ellipsoidal grains. The averaged elastic covariance and the directional anisotropy of the backscattering coefficient are obtained for a wave propagation direction arbitrary relative to the texture and grain elongation directions. One particular application of this analysis is the backscattering solution for cubic crystallites with common textures such as Cube, Goss, Brass and Copper. In our analysis, in the texture-defined coordinates the matrix of elastic constants for cubic crystallites takes the form of orthotropic or trigonal symmetry. Numerical results are presented, discussed and compared to the experimental data available in the literature illustrating the dependence of the backscattering coefficient on texture and grain shape.

Platelet P2Y₁₂ receptors are involved in the haemostatic effect of notoginsenoside Ft1, a saponin isolated from Panax notoginseng

BACKGROUND AND PURPOSE

Saponins isolated from Panax notoginseng (Burk.) F.H. Chen have been shown to relieve thrombogenesis and facilitate haemostasis. However, it is not known which saponin accounts for this haemostatic effect. Hence, in the present study we aimed to identify which saponins contribute to its haemostatic activity and to elucidate the possible underlying mechanisms.

EXPERIMENTAL APPROACH

Platelet aggregation was analysed using a platelet aggregometer. Prothrombin time, activated partial thromboplastin time and thrombin time were measured using a blood coagulation analyser, which was further corroborated with bleeding time and thrombotic assays. The interaction of notoginsenoside Ft1 with the platelet P2Y₁₂ receptor was determined by molecular docking analysis, cytosolic Ca(2+) and cAMP measurements, and phosphorylation of PI3K and Akt assays.

KEY RESULTS

Among the saponins examined, Ft1 was the most potent procoagulant and induced dose-dependent platelet aggregation. Ft1 reduced plasma coagulation indexes, decreased tail bleeding time and increased thrombogenesis. Moreover, it potentiated ADP-induced platelet aggregation and increased cytosolic Ca(2+) accumulation, effects that were attenuated by clopidogrel. Molecular docking analysis suggested that Ft1 binds to platelet P2Y₁₂ receptors. The increase in intracellular Ca(2+) evoked by Ft1 in HEK293 cells overexpressing P2Y₁₂ receptors could be blocked by ticagrelor. Ft1 also affected the production of cAMP and increased phosphorylation of PI3K and Akt downstream of P2Y₁₂ signalling pathways.

CONCLUSION AND IMPLICATIONS

Ft1 enhanced platelet aggregation by activating a signalling network mediated through P2Y₁₂ receptors. These novel findings may contribute to the effective utilization of this compound in the therapy of haematological disorders.

Common polymorphisms in the HIF-1α gene confer susceptibility to digestive cancer: a meta-analysis

Recent evidence suggests that common functional polymorphisms in the hypoxia inducible factor-1α (HIF-1α) gene may play an important role in the development and progression of digestive cancer, but individually published results are inconclusive. Our meta-analysis is aimed to derive a more precise estimation of the relationships between HIF-1α gene polymorphisms and digestive cancer risk. An extensive literature search for relevant studies was conducted on Pubmed, Embase, Web of Science, Cochrane Library, and CBM databases from their inception through May 1, 2013. This meta-analysis was performed using the STATA 12.0 software. The crude odds ratios (OR) with 95% confidence interval (CI) were calculated. Eight case-control studies were included with a total of 1276 digestive cancer patients and 3392 healthy controls. Our meta-analysis revealed that the A variant of HIF-1α G1790A polymorphism might be associated with increased risk of colorectal, esophageal, gastric, and liver cancers, especially among Asian populations. However, no statistically significant associations were found between HIF-1α C1772T polymorphism and susceptibility to digestive cancer. No publication bias was detected in this meta-analysis. The current meta-analysis suggests that the HIF-1α G1790A polymorphism may increase the risk of colorectal, esophageal, gastric, and liver cancers, especially among Asian populations.

First Report of Leptosphaeria biglobosa Causing Black Leg on Brassica campestris ssp. chinensis var. purpurea in Central China

Purple cai-tai (Brassica campestris ssp. chinensis var. purpurea) is a traditional vegetable widely grown in southern China. In 2012 and 2013, black leg disease was observed on purple cai-tai in three surveyed cities (Jingzhou, Qianjiang, and Huanggang) in Hubei Province of China. Disease incidence ranged from 5 to 88% in eight surveyed fields. White cankers occurred on basal stems and numerous black pycnidia and pink conidia were present on the stem surface. Surface-sterilized (5% NaOCl for 90 s, rinsed in sterilized water three times) stem pieces were plated on potato dextrose agar (PDA) and incubated at 20°C and 12 h light/12 h dark for 7 days. A total of 22 isolates were obtained. All of the isolates appeared similar in colony morphology on PDA (20°C, 7 to 10 days), producing yellow pigment and black-brown, globose pycnidia containing cylindrical hyaline conidia (4 to 5 × 2 μm). These characteristics matched the description for Phoma lingam, the anamorph Leptosphaeria maculans and L. biglobosa (2). Species-specific primers LbigF, LmacF, and LmacR (1) were used in PCR-based identification of the isolates. A 444-bp DNA fragment characteristic of L. biglobosa was amplified from DNA extracted from all of the collected isolates. DNA amplification from the isolate UK-1 of L. maculans from B. napus in Hertfordshire of the United Kingdom yielded a 331-bp fragment. Two isolates, HGHCT2-1 and HGHCT2-2, were further identified by cloning and analysis of the ITS sequences and the partial sequences encoding β-tubulin and actin (3,4). The ITS sequences (586 bp, GenBank Accession. Nos. KF371660 and KF371661) were 100% identical to L. biglobosa 'brassicae' strain UK28 (DQ133893). The DNA sequences for β-tubulin (479 bp, KF307760 and KF307761) and actin (899 bp, KF307758 and KF307759) were 99 and 100% identical to the partial β-tubulin gene sequence (AY748997) and the partial actin gene sequence (AY748949) of the L. biglobosa 'brassicae' strain 2379-4, respectively. Pathogenicity of six randomly selected isolates was determined on two purple cai-tai cvs. Wanzi Qianhong and Jiu Yue Xian. Cotyledons of 10-day-old seedlings grown in potting mix in pots were pricked with a sterilized needle, and each wound was inoculated with 10 μl of conidial suspension (1 × 10⁷ conidia/ml) of an isolate or 10 μl sterilized water (control). There were 12 cotyledons for each isolate and control. The experiment was repeated once. The treated seedlings were incubated at 20°C in an incubator under 12 h light/12 h dark for 12 days. The control cotyledons were healthy, but necrotic lesions were developed on the cotyledons that were inoculated with L. biglobosa and formation of pycnidia was observed on some lesions. Fungi re-isolated from the lesions were similar to the original L. biglobosa isolates both in colony morphology on PDA and in species-specific PCR testing. No fungi were isolated from the control cotyledons. This is the first report of L. biglobosa causing black leg on B. campestris ssp. chinensis var. purpurea in central China. The finding will be useful for understanding of the epidemiology of black leg on cruciferous crops and for management of this disease. References: (1) S. Y. Liu et al. Plant Pathol. 55:401, 2006. (2) R. A. Shoemaker and H. Burn. Can J Bot. 79:412, 2001. (3) L. Vincenot et al. Phytopathology 98:321, 2008. (4) T. J. White et al. PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.

Time-series analysis on human brucellosis during 2004-2013 in Shandong Province, China

Human brucellosis is a re-emerging bacterial anthropozoonotic disease, which remains a public health concern in China with the growing number of cases and more widespread natural foci. The purpose of this study was to short-term forecast the incidence of human brucellosis with a prediction model. We collected the annual and monthly laboratory data of confirmed cases from January 2004 to December 2013 in Shandong Diseases Reporting Information System (SDRIS). Autoregressive integrated moving average (ARIMA) model was fitted based on the monthly human brucellosis incidence from 2004 to 2013. Finally, monthly brucellosis incidences in 2014 were short-term forecasted by the obtained model. The incidence of brucellosis was increasing from 2004 to 2013. For the ARIMA (0, 2, 1) model, the white noise diagnostic check (x(2) = 5.58 P = 0.35) for residuals obtained was revealed by the optimum goodness-of-fit test. The monthly incidences that fitted by ARIMA (0, 2, 1) model were closely consistent with the real incidence from 2004 to 2013. And forecasting incidences from January 2014 to December 2014 were, respectively, 0.101, 0.118, 0.143, 0.166, 0.160, 0.172, 0.169, 0.133, 0.122, 0.105, 0.103 and 0.079 per100 000 population, with standard error 0.011-0.019 and mean absolute percentage error (MAPE) of 58.79%.

A critical review of traditional Chinese medicine use amongst women with menopausal symptoms

OBJECTIVES

To provide the first critical review of traditional Chinese medicine (TCM) use amongst symptomatic menopausal women, drawing upon work examining the perspectives of both TCM users and TCM practitioners.

METHODS

A search was conducted in three English-language databases (MEDLINE, CINAHL and AMED) and three Chinese-language databases (CNKI, VIP and CBM Disc) for 2002-2013 international peer-reviewed articles reporting empirical findings of TCM use in menopause.

RESULTS

A total of 25 journal articles reporting 22 studies were identified as meeting the review inclusion criteria. Chinese herbal medicine appears to be the most common therapy amongst symptomatic menopausal women, and vasomotor symptoms and emotional changes are the most frequent symptoms for which TCM is sought. However, evidence regarding the prevalence of TCM use and users' profile in menopause is limited. Existing studies are of varied methodological quality, often reporting low response rate, extensive recall bias and a lack of syndrome differentiation.

CONCLUSIONS

This review provides insights for practitioners and health policy-makers regarding TCM care to symptomatic menopausal women. More nationally representative studies are required to rigorously examine TCM use for the management of menopausal symptoms. Syndrome differentiation of menopausal women is an area which also warrants further attention.