Impact of chemotherapy on thrombin generation and on the protein C pathway in breast cancer patients

Although thromboembolism is a problematic complication of chemotherapy, the pathogenic mechanisms by which chemotherapeutic agents exert prothrombotic effects in vivo are unclear.The objective of this study was to examine the effects of adjuvant chemotherapy on thrombin generation, the protein C anticoagulant pathway, and microparticle tissue factor (MP TF) activity in 26 breast cancer patients (stages I to III). The patients received cyclophosphamide, 5-fluorouracil, and methotrexate, epirubicin, or doxorubicin. Plasma samples were collected on day 1 (baseline), day 2, and day 8 for the first 2 cycles of chemotherapy. Levels of thrombin-antithrombin (TAT) complexes, MP TF activity, and components of the protein C anticoagulant pathway, including protein C, activated protein C (APC), soluble thrombomodulin (sTM), and soluble endothelial protein C receptor (sEPCR), were measured. Compared to prechemotherapy baseline levels, plasma TAT, protein C, and APC were significantly different following the administration of chemotherapy (p < 0.01 for each). Plasma TAT was higher in cycle 1, day 2, and cycle 2, day 8, compared to baseline. Plasma protein C levels were lower in cycle 2, day 8, whereas plasma APC levels were lower in cycle 2, day 1, and cycle 2, day 8. No significant changes were found in plasma sEPCR, sTM, or MP TF activity. This study suggests that adjuvant chemotherapy in women with breast cancer increases thrombin generation and impairs the endothelium-based protein C anticoagulant pathway.

(E)-1-(2,4-Dihy-droxy-phen-yl)-3-(4-hydroxy-phen-yl)prop-2-en-1-one monohydrate

In the title compound, C(15)H(12)O(4)·H(2)O, the two benzene rings are not coplanar, making a dihedral angle of 7.24 (16)°. An intra-molecular hy-droxy-carbonyl O-H⋯O hydrogen bond occurs. In the crystal, four inter-molecular O-H⋯O hydrogen bonds involving the hy-droxy residues, the carbonyl group and the water mol-ecule lead to the formation of a three-dimensional network. The supra-molecular structure is further stabilized by weak C-H⋯O inter-actions.

Integrating molecular docking, DFT and CoMFA/CoMSIA approaches for a series of naphthoquinone fused cyclic α-aminophosphonates that act as novel topoisomerase II inhibitors

Since they are potential topoisomerase II (Topo II) inhibitors, naphthoquinone fused cyclic α-aminophosphonates display anticancer activity. In order to explore the inhibitory mechanisms of these compounds, they were docked into the active site of Topo II structure, which allowed their probable binding modes to be predicted. Some meaningful results concerning their structure-activity relationships were obtained from density functional theory calculations. Models based on quantitative comparative molecular field analysis and comparative molecular similarity index analysis were derived for the steric, electrostatic, hydrophobic and H-bonding features of the compounds. The present study provides valuable results that enhance our understanding of the anticancer activities of these inhibitors and will aid the rational drug design of novel Topo II inhibitors in the future.

Elevated tissue factor expression contributes to exacerbated diabetic nephropathy in mice lacking eNOS fed a high fat diet

BACKGROUND

 Human eNOS (NOS3) polymorphisms that lower its expression are associated with advanced diabetic nephropathy (DN), and the lack of eNOS accelerates DN in diabetic mice. Diabetes is associated with fibrin deposition. Lack of nitric oxide and fatty acids stimulates the NF-kB pathway, which increases tissue factor (TF).

OBJECTIVES

 To test the hypothesis that TF contributes to the severity of DN in the diabetic eNOS(-/-) mice fed a high-fat diet (HF).

METHODS

 We made eNOS(-/-) and wild-type mice diabetic with streptozotocin. Half of them were placed on HF.

RESULTS

 Blood glucose levels were not affected by either the diet or eNOS genotype. Lack of eNOS in the diabetic mice increased urinary albumin excretion, glomerulosclerosis, interstitial fibrosis, and glomerular basement membrane thickness. HF by itself did not affect DN in the wild-type mice, but significantly enhanced DN in eNOS(-/-) mice. More than half of diabetic eNOS(-/-) mice on HF died prematurely with signs of thrombotic complications. Diabetic kidneys contained fibrin and TF, and their levels were increased by the lack of eNOS and by HF in an additive fashion. The HF diet increased the kidney expression of inflammatory genes. The increase in TF preceded DN, and administration of an anti-mouse TF antibody to diabetic mice reduced the expression of inflammatory genes.

CONCLUSION

 Together, these data indicate a causal link between TF and the exacerbation of DN in eNOS(-/-) mice. The condition is significantly worsened by enhanced inflammatory responses to an HF diet via TF.

Infection of Myxobolus turpisrotundus sp. n. in allogynogenetic gibel carp, Carassius auratus gibelio (Bloch), with revision of Myxobolus rotundus (s. l.) Nemeczek reported from C. auratus auratus (L.)

Infection of a Myxobolus species, previously identified as Myxobolus rotundus, was detected in 182 of 7892 (2.31%) allogynogenetic gibel carp, Carassius auratus gibelio, in a closed pond culture system in China. Morphological and molecular data showed that this myxosporean is a different species from M. rotundus parasitizing Abramis brama in Europe and is thus designated as a new species, Myxobolus turpisrotundus. M. rotundus (s.l.) ex C. auratusauratus is a synonym of M. turpisrotundus. Plasmodia of M. turpisrotundus develop in the subepidermal tissues of the body surface resulting in an unaesthetic appearance and causing severe economic losses. Prevalence of infection with the myxosporean plasmodia varied seasonally, increasing in winter and decreasing in spring. Prevalence was positively correlated to host size, but no host sex-specificity was found. No infection was observed in other fish species (grass carp, bighead carp and yellow catfish) reared in the same pond, suggesting that the parasite has a relatively strict host specificity. Plasmodia grew gradually as the parasite developed, and reached up to a maximum 5.6 mm in diameter. Plasmodia ruptured naturally to release the mature spores and host fish completely recovered with no mortality. Release of spores and regeneration of lesions were not correlated with water temperature. Histology showed that plasmodia developed sub-epidermally, and that the wall of the plasmodia was composed of a multiple complex structure, including layers of fibroblasts, a collagenous membrane, melanophores and a layer of cup-like cells of unknown derivation and function. The cup-like cells are in direct contact with pre-sporogonic stages located in the peripheral parts of the large plasmodia. No severe host inflammatory response was seen.

Rapid detection of clonal expansion of T-cell receptor-beta gene in patients with HBV using the real-time PCR with DNA melting curve analysis

AIM

The gene melting spectral pattern (GMSP) of PCR products from 24 T-cell receptor beta chain variable (TCRBV) gene families was developed to determine sequence bias and feature of TCRBV CDR3 gene family.

METHODS

The assay was based on reverse transcript quantitative polymerase chain reaction and their DNA melting curves.

RESULTS

We discovered that the relatively conserved amino acid sequences X-Q and X-G are present in TCRBV CDR3 from patients with HBV. Further, the X of the X-Q motif is preferentially E (glutamic acid), P (proline) or T (threonine) when accompanied by the BJ2.7, BJ1.5, or BJ2.3, respectively. The frequency of sequence bias in the TCRBV gene family showed a positive correlation with the T cell receptor excision circles (TRECs) content, and an inverse correlation with the HBV DNA loading.

CONCLUSION

These results suggest that the GMSP assay could be used to monitor the features of TCRBV gene distribution quickly, and facilitate the further study of HBV-specific T cell in patients with HBV.

Laggera alata extract prevents acetamidophenol-induced liver damage in mice

AIM: To investigate the protective effects of Laggera alata against acetamidophenol-induced liver damage.

METHODS: The main components of Laggera alata extract (LAE) were quantitatively analyzed by the Folin-Ciocalteu method and high-pressure liquid chromatography (HPLC). Before mice were intragastrically given high-dosage acetamidophenol (1000 mg/kg), different doses of LAE (50, 100 and 200 mg/kg) was intragastrically administered to investigate its preventive effect against acetamidophenol-induced liver damage.

RESULTS: Quantitative analysis of LAE by the Folin Ciocalteu method showed that LAE contains a high content of phenolic compounds (52.6 g GAE/100 g extract). The HPLC analysis indicated that dicaffeoylquinic acids are the major components of LAE, whose content amounts to 53%. LAE at a dose of 100 mg/kg could obviously protect mice from acetamidophenol-induced death. LAE at doses of 50, 100 and 200 mg/kg (especially 100 and 200 mg/kg) significantly reduced serum AST and ALT levels in mice treated with acetamidophenol. Furthermore, LAE at all doses could improve acetamidophenol-induced hepatic injury.

CONCLUSION: LAE has potent protective effect against acetamidophenol-induced liver injury in mice. Dicaffeoylquinic acids may be the active ingredients in LAE that are responsible for the hepatoprotective effects of LAE.

Screening efficient siRNAs in vitro as the candidate genes for chicken anti-avian influenza virus H5N1 breeding

The frequent disease outbreaks caused by avian influenza virus (AIV) not only affect the poultry industry but also pose a threat to human safety. To address the problem, RNA interference (RNAi) has recently been widely used as a potential antiviral approach. Transgenesis, in combination with RNAi to specifically inhibit AIV gene expression, has been proposed to make chickens resistant to avian influenza. For the transgenic breeding, screening the efficient siRNAs in vitro as the candidate genes is one of the most important tasks. Here, we combined an online search tool and a series of bioinformatics programs with a set of rules for designing the siRNAs targeting different mRNA regions of AIV H5N1 subtype. By this method we chose five rational siRNAs, constructed five U6 promoter-driven shRNA expression plasmids contained the siRNA genes, and used these to produce stably transfected Madin-Darby canine kidney (MDCK) cells. Data from virus titration, IFA, PUI-stained flow cytometry, real-time quantitative RT-PCR and DAS-ELISA analyses showed that all five stably transfected cell lines were effectively resistant to viral replication when exposed to 100 CCID50 of AIV, and we finally chose the most effective plasmids (pSi-604i and pSi-1597i) as the candidates for making the transgenic chickens. These findings provide baseline information for breeding transgenic chickens resistant to AIV in combination with RNAi.

A density functional theory study of the one-dimensional alane

The AlH(1-6), Al(2)H(1-7), Al(3)H(1-9), Al(m)H(3m) (m = 4-10), and the periodic helical structure of the one-dimensional (1D) alane are studied by means of density functional theory calculations. The helical isolated structure is more stable than those in the corresponding cyclic and other geometries. A new periodic 1D helical alane structure is predicted for the first time. The stability of this periodic 1D helical alane structure has been confirmed by its large average binding energy based on AlH(3), large energy gap of highest occupied molecular orbital and lowest unoccupied molecular orbital, and the typically double helical pi-orbital which parallels its bone structure.

Utilization of tissue habitats by Myxobolus wulii Landsberg & Lom, 1991 in different carp hosts and disease resistance in allogynogenetic gibel carp: redescription of M. wulii from China and Japan

Myxobolus wulii (=Myxosoma magna) was first described from the gills of goldfish, Carassius auratus auratus, in China. Subsequently, a myxosporean infecting the hepatopancreas of allogynogenetic gibel carp, C. auratus gibelio, was designated as a different species, Myxobolus guanqiaoensis, although the morphological features were almost identical to those of M. wulii. In Japan, an unidentified Myxobolus sp. was found in the gills and hepatopancreas of goldfish. Morphological and molecular analyses in the present study identified these myxosporeans as M. wulii, which was thus shown to use different habitats in the host fish. Phylogenetic analyses of small subunit ribosomal RNA gene sequences showed that M. wulii is closely related to two gill-infecting Myxobolus species, M. ampullicapsulatus and M. longisporus. Fish infected with M. wulii in the hepatopancreas exhibit swollen abdomens and chronic mortality. Hepatopancreas tissues are virtually destroyed and replaced with plasmodia of M. wulii. A remarkable difference in susceptibility to M. wulii between two clones of allogynogenetic gibel carp was observed, suggesting that resistance to the myxosporean infection was established in a clone of fish bred by allogynogenesis.

[Screening efficient siRNAs in vitro as the candidate genes for chicken anti-avian influenza virus H5N1 breeding]

The frequent disease outbreaks caused by avian influenza virus not only affect the poultry industry but also pose a threat to human safety. To address the problem, RNA interference (RNAi) has recently been widely used as a potential antiviral approach. Transgenesis in combination with RNAi to specifically inhibit avian enza virus gene expression has been proposed to make chickens resistant to the infection. For the transgenic breeding, screening in vitro efficient siRNAs as the candidate genes is one of the most important tasks. Here, we combined an online search tool and a series of bioinformatics programs with a set of rules for designing siRNAs targeted towards different mRNA regions of H5N1 avian influenza virus. Five rational siRNAs were chosen by this method, five U6 promoter-driven shRNA expression plasmids containing the siRNA genes were constructed and used for producing stably transfected MDCK cells. The data obtained by virus titration, IFA, PI-stained flow cytometry, real-time quantitative RT-PCR, and DAS-ELISA analyses showed that all five stably transfected cell lines we re resistant to virusreplication when exposed to 100 CCID50 of avian influenza virus H5N1. Finally, most effective plasmids (pSi-604i and pSi-1597i) as the candidates for making the transgenic chickens were chosen. These findings provide baseline information on use of RNAi technique for breeding transgenic chickens resistant to avian influenza virus.

[Evaluation of peripheral pulmonary embolism by different thickness of CTPA imagings]

OBJECTIVE

to evaluate whether there are difference among different thickness of CTPA imagings for detection of emboli in peripheral pulmonary arteries.

METHODS

CTPA Images of 97 patients with acute pulmonary embolism were divided into four series for each patient: 0.625 mm thick original transaxial soure images and 3 series of reconstructed images using the MIP technique with slab thicknesses of 1.25 mm, 2.5 mm, and 5.0 mm. The difference was compared among 4 series of CTPA images for detection of emboli in peripheral pulmonary arteries, and the agreement of 2 observers for detection of emboli in peripheral pulmonary arteries in different thickness images was tested. Chi-Square test was taken for comparison of 4 series of CTPA images for detection of emboli in peripheral pulmonary arteries. Kappa test was taken for the agreement of 2 observers for detection of emboli in peripheral pulmonary arteries.

RESULTS

the average images number of 0.625 mm, 1.25 mm, 2.5 mm, 5.0 mm thickness imaging was 403, 201, 101, and 53, respectively. For detecting clots in segmental pulmonary arteries, there was statistically significant difference between 5.0 mm thick imaging and other 3 series imagings (chi(2) = 60.099, P < 0.01), but agreement of 2 observers in each series imaging was excellent (value of κ from 0.751 to 0.973).For clots in sub-segment pulmonary arteries, no statistical significant difference was observed between 0.625 mm and 1.25 mm thick imagings (chi(2) = 1.051, P > 0.05), and superior to 2.5 mm and 5.0 mm thick images (chi(2) = 151.892, 204.553, respectively, P < 0.01), but agreement of two observers in each series imaging was good (value of kappa from 0.611 to 0.935).

CONCLUSION

compared with 0.625 mm thick transaxial imaging, 1.25 mm thick MIP imaging is equally sensitive for detecting emboli in peripheral pulmonary arteries, but needs fewer images and less time for image reading.

Significance of perihematomal edema in acute intracerebral hemorrhage: the INTERACT trial

BACKGROUND

Uncertainty surrounds the effects of cerebral edema on outcomes in intracerebral hemorrhage (ICH).

METHODS

We used data from the INTERACT trial to determine the predictors and prognostic significance of "perihematomal" edema over 72 hours after ICH. INTERACT included 404 patients with CT-confirmed ICH and elevated systolic blood pressure (BP) (150-220 mm Hg) who had the capacity to commence BP lowering treatment within 6 hours of ICH. Baseline and repeat CT (24 and 72 hours) were performed using standardized techniques, with digital images analyzed centrally. Predictors of growth in edema were determined using generalized estimating equations, and its effects on clinical outcomes were estimated using a logistic regression model.

RESULTS

Overall, 270 patients had 3 sequential CT scans available for analyses. At baseline, there was a highly significant correlation between hematoma and perihematomal edema volumes (r(2) = 0.45). Lower systolic BP and baseline hematoma volume were independently associated with absolute increase in perihematomal edema volume. History of hypertension, baseline hematoma volume, and earlier time from onset to CT were independently associated with relative increase in edema volume. Both absolute and relative increases in perihematomal edema growth were significantly associated with death or dependency at 90 days after adjustment for age, gender, and randomized treatment, but not when additionally adjusted for baseline hematoma volume.

CONCLUSIONS

The degree of, and growth in, perihematomal edema are strongly related to the size of the underlying hematoma of acute intracerebral hemorrhage, and do not appear to have a major independent effect in determining the outcome from this condition.

Clinicopathological features of solid-pseudopapillary tumor of the pancreas: an analysis of 14 cases

AIM: To analyze the clinicopathological and immunohistochemical features of solid-pseudopapillary tumors of the pancreas (SPTP).

METHODS: The clinicopathological and immunohistochemical data of 14 SPTP patients and 5 islet cell tumor patients (including 3 cases of non-functional islet cell tumors and 2 cases of functional islet cell tumors) were analyzed retrospectively.

RESULTS: The ratio of male to female in 14 SPTP patients was 1:6. Their median age was 28 years old. The median diameter of the tumors was 7.25 cm. Histologically, the tumors were composed of pseudopapillary and solid structures. The solid areas were composed of uniform cells. The pseudopapillary structure with a fibrovascular core was remarkable. Immunohistochemically, the tumors were negative for E-cadherin and chromogranin A, but positive for β-catenin and CD10. The positive rates of nuclear and cytoplasmic β-catenin staining in SPTP were 100% and 78.5% (11/14), respectively. In contrast, no membrane β-catenin staining was detected.

CONCLUSION: SPTP is a rare type of tumor that has low malignant potential and remarkable pseudopapillary and is predominantly found in young women. Abnormal E-cadherin and β-catenin expression may be related to the tumorigenesis of SPTP.

[Value of combined wells score and D-dimer test on diagnosing patients with deep venous thrombosis]

OBJECTIVE

To evaluate the value of Wells score or/and D-dimer test on diagnosing or excluding deep venous thrombosis (DVT).

METHODS

Patients with suspected DVT were retrospectively analyzed. All patients underwent clinical assessment, D-dimer assay and bilateral lower extremity compression sonography within 48 hours of admission. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for diagnosing DVT by Wells score, D-dimer test, and combined Wells score and D-dimer were compared.

RESULTS

A total of 274 patients were analyzed. If low probability was defined as negative and moderate and high probabilities were defined as positive, the sensitivity, specificity, PPV and NPV of the Wells score were 78.4%, 66.1%, 52.3% and 86.6%, respectively. At a cut-off of 500 microg/L, the sensitivity, specificity, PPV and NPV of D-dimer test were 73.9%, 66.1%, 50.8% and 84.2%, respectively. If low probability and D-dimer < 500 microg/L were defined as negative, moderate and high probabilities and D-dimer > or = 500 microg/L were defined as positive, the sensitivity, specificity, PPV and NPV of the combined Wells score and D-dimer test were 88.3%, 76.8%, 67.1% and 92.5%, respectively.

CONCLUSION

For clinical suspected DVT patients, DVT diagnosis could be reliably obtained by combined Wells score and D-dimer test.

Retinol-binding protein 4 is associated with impaired glucose regulation and microalbuminuria in a Chinese population

AIMS/HYPOTHESIS

Increased retinol-binding protein 4 (RBP4) has been reported in association with insulin resistance and type 2 diabetes. We aimed to investigate the association of serum RBP4 with impaired glucose regulation and microalbuminuria in Chinese adults aged 40 years or older.

METHODS

Serum RBP4 was measured in 763 individuals with normal glucose regulation, 508 with impaired glucose regulation and 524 newly diagnosed diabetic patients. Serum RBP4 was measured using ELISA and urine albumin/creatinine ratio was used to determine the urinary albumin excretion.

RESULTS

Serum RBP4 concentrations were significantly higher in participants with isolated impaired fasting glucose, isolated impaired glucose tolerance, combined impaired fasting glucose/impaired glucose tolerance and diabetes than in those with normal glucose regulation, whereas serum RBP4 levels were not different in the four groups with dysregulation of glucose metabolism. RBP4 was associated with a higher risk for impaired glucose regulation (OR 1.011 for each 1 microg/ml increase in RBP4, 95% CI 1.000-1.022, p = 0.04) after adjustment for sex, age, BMI, current smoking and alcohol intake, family history of diabetes, insulin resistance, triacylglycerol, total cholesterol, and HDL- and LDL-cholesterol; the corresponding OR of combined impaired glucose regulation and type 2 diabetes was 1.022 (95% CI 1.009-1.035, p = 0.0009). RBP4 was associated with the risk of microalbuminuria (OR 1.023, 95% CI 1.004-1.042, p = 0.01) after adjustment for sex, age, smoking habit and alcohol intake, BMI, waist/hip ratio, homeostasis model assessment of insulin resistance, GFR, triacylglycerol, total cholesterol, and HDL- and LDL-cholesterol.

CONCLUSIONS/INTERPRETATION

Serum RBP4 level is closely associated with impaired glucose regulation and is an independent risk factor for microalbuminuria.