The change of C-fos expression in ovariectomized rats following electroacupuncture treatment--an immunohistochemistry study

The roles of electroacupuncture (EA) in regulating the function of ovulation in rat have been investigated; however, the systematic study for the involvement of neural population of central nervous system (CNS) in acupuncturing the ovariectomized rat for promoting functional recovery has not been well understood. The present research was designed to examine, by C-fos immunocytochemistry, the distribution of Fos labelled neuron in CNS after acupuncturing the point of "Zhong-Ji (RN3)", "Guan-Yuan (RN4)", "San-Ying-Jiao (SP6)" and "Zi-Gong (EXCA1)" in ovariectomized rat. The area occupied by Fos protein labelled neuron, two hours after ovariotomy, was detected in medial preoptic nucleus (MPN), lateral preoptic nucleus (LPN), suprachiasmatic nucleus (SCN), paraventricular nucleus of the hypothalamus (PANH), medial amygdala nucleus (MAN), periventricular nucleus of the hypothalamus (PVNH), ventromedial nucleus of the hypothalamus (VNH), and arcuate nucleus (AR). The C-fos immunoreactive labelled neurons disappeared two weeks later following ovariotomy. The rat, recovering for two weeks after ovariotomy, received EA, and many specific Fos labelled cell were observed in LPN, PVNH, VNH, SCN and especially in AR, PANH and MPN, but not any labelled neuron could be found in MAN. No obvious C-fos expression was shown in these areas in the control group and EA group without ovariotomy. These results indicate that the above structures involved in regulating the function of hypothalamus-pituitary-ovarian axis and EA could modulate this function through effects on the above nuclei.

Failure of an uncemented acetabular prosthesis - a case study

Severe wear and aseptic loosening in an uncemented acetabular prosthesis have been observed in a revision surgery carried out at King Edwards VII hospital by L. Taylor and P. Heaton-Adegbile, twelve years following the primary total hip replacement operation. The superior-lateral wall of the polyethylene liner and part of the titanium cup were found to be completely worn out, such that the ceramic head was in direct articulation with the titanium cup.A three-dimensional finite element model was developed. The polyethylene liner was modelled with the outer surface of the liner fully constrained to represent the much stiffer metal cup. Contact analyses were performed between the articulating surfaces under physiological loading conditions, including normal walking, climbing upstairs and downstairs, using the finite element software ANSYS. The results show high initial contact pressure along the periphery of the liner due to the oversize of the femoral head. The maximum contact pressure was found in the superior-posterior quadrant, which correlates well with the location and the direction of the wear. Both wear particles and stress shielding may have contributed to the periprosthetic bone loss and ultimately the late loosening. Reduction of the interference between the liner and the femoral head seems to be effective in the reduction of the initial contact pressure.

In patients receiving dopamine infusions for treatment of shock do free radicals convert dopamine to 6-hydroxydopamine?

Free hydroxyl radicals react with dopamine in vitro to produce the neurotoxin 6-hydroxydopamine (6-OHDA). If 6-OHDA were produced in vivo it could destroy central and/or peripheral neurons. Free radicals are produced in patients with cardiovascular or toxic shock. These patients are often treated with intravenous dopamine infusions. Using a newly developed method for measuring 6-OHDA in biological samples, we have examined blood from 15 patients receiving dopamine infusions for treatment of shock. 6-OHDA neither binds to nor elutes from either alumina or ion-exchange resins; therefore we used ODA-silica (Sep-Pak) to prepare samples for HPLC analysis with electrochemical detection. 6-OHDA disappeared rapidly from whole blood or serum at room temperature but was stable at -70 degrees C in an HClO4 extract. Recovery from Sep-Pak was 95% and detection limit 10 nmol/L. We repeated the experiments that showed in vitro hydroxyl radical conversion of dopamine to 5- and 6-OHDA. We detected neither 5- nor 6-OHDA in plasma samples from patients receiving dopamine infusions at 10-28 micrograms kg-1 min-1. Plasma dopamine in these patients was 1-5 mumol/L. We conclude that any 6-OHDA produced by hydroxyl radical attack in vivo is rapidly scavenged by endogenous substances containing sulfhydryl groups.

[Comparison of intensified myeloablative conditioning regime without antithymocytic globulin (ATG) with myeloablative conditioning regime for single-unit unrelated umbilical cord blood transplantation in hematological malignancies]

OBJECTIVE

To campare the effect and tolerance beween intensified myeloablative conditioning regime (IMCR) without antithymocyte globulin (ATG) and myeloablative conditioning regime (MCR) for single-unit unrelated umbilical cord blood transplantation (sUCBT) in hematological malignancies.

METHODS

The clinical data of 190 patients with hematological malignancies undergoing sUCBT between April 2000 and December 2013 at Department of Hematology, Anhui Provincial Hospital were retrospectively analyzed, of whom 156 received IMCR without ATG (IMCR group), including 79 patient receiving total body irradiation (TBI)/cytosine arabinoside (Ara-C)/cyclophosphamide (CY) regime, 47 receiving fludarabine (Flu)/busulfan (Bu)/CY regime, and 30 receiving Ara-C/Bu/CY regime, and all of the 156 received a combination of cyclosporine A (CsA) and mycophelonate mofetil (MMF) for the prophylaxis of graft-versus-host disease (GVHD); the remaining 34 patients received MCR (MCR group), 30 patients receiving Bu/CY regime, and 4 receiving TBI/CY regime, all using CsA/MMF±ATG or methotrexate (MTX) for the prophylaxis of GVHD. The two groups were compared in disease status at the time of transplantation, characteristics of graft, transplantation effect, and transplantation-related complications.

RESULTS

There were no statistically significant differences between the two groups in gender, disease type, human leukocyte antigen match, ABO blood type match, and disease status at the time of transplantation (all P>0.05). The median age and body weight at transplantation in the IMCR group were significantly higher than those in the MCR group (13 years vs 9 years, P=0.003; 44 kg vs 26 kg, P=0.000). The median doses of infused total nucleated cells (×10(7)/kg) and CD34(+) cells (×10(5)/kg) in the IMCR group were significantly lower than in the MCR group (3.87 vs 4.99, P=0.002; 2.00 vs 3.17, P=0.000). The cumulative incidence of myeloid engraftment on the 42th day and platelet engraftment on the 120th day in the IMCR group were remarkably higher than in the MCR group [96.33%(95%CI: 96.27%-96.39%)vs 82.30%(95%CI: 80.67%-83.93%), P=0.000; 86.44%(95%CI: 86.28%-86.60%)vs 51.17%(95%CI: 49.02%-53.32%), P=0.002]. There were no statistically significant differences in the incidences of grade Ⅱ to Ⅳ acute GVHD, grade Ⅲ to Ⅳ acute GVHD, and 2-year chronic GVHD(P=0.482, 0.928, 0.579). The incidence of pre-engraftment syndrome in the IMCR group was higher than in the MCR group(82.70% vs 47.06%, P=0.000). And 180-day transplantation-related mortality (TRM) in the IMCR group was lower than that in the MCR group [20.50%(95%CI: 20.28%-20.71%)vs 42.20% (95%CI: 41.32%-45.09%), P=0.004]. Up to October 2015, with a median follow-up of 44.2(22.7-188.9)months, the estimated 3-year overall survival and disease-free survival in the IMCR group were both significantly higher than those in the MCR group (62.90% vs 34.10%, P=0.000; 58.60% vs 34.10%, P=0.001).

CONCLUSION

IMCR without ATG may improve the engraftment without increasing complications, reduce early transplantation-related mortality, and improve survival.

Mitochondrial Aconitase ACO2 Links Iron Homeostasis with Tumorigenicity in Non-Small Cell Lung Cancer

The ability of a patient tumor to engraft an immunodeficient mouse is the strongest known independent indicator of poor prognosis in early-stage non-small cell lung cancer (NSCLC). Analysis of primary NSCLC proteomes revealed low-level expression of mitochondrial aconitase (ACO2) in the more aggressive, engrafting tumors. Knockdown of ACO2 protein expression transformed immortalized lung epithelial cells, whereas upregulation of ACO2 in transformed NSCLC cells inhibited cell proliferation in vitro and tumor growth in vivo. High level ACO2 increased iron response element binding protein 1 (IRP1) and the intracellular labile iron pool. Impaired cellular proliferation associated with high level ACO2 was reversed by treatment of cells with an iron chelator, whereas increased cell proliferation associated with low level ACO2 was suppressed by treatment of cells with iron. Expression of CDGSH iron-sulfur (FeS) domain-containing protein 1 [CISD1; also known as mitoNEET (mNT)] was modulated by ACO2 expression level and inhibition of mNT by RNA interference or by treatment of cells with pioglitazone also increased iron and cell death. Hence, ACO2 is identified as a regulator of iron homeostasis and mNT is implicated as a target in aggressive NSCLC.

IMPLICATIONS

FeS cluster-associated proteins including ACO2, mNT (encoded by CISD1), and IRP1 (encoded by ACO1) are part of an "ACO2-Iron Axis" that regulates iron homeostasis and is a determinant of a particularly aggressive subset of NSCLC.

A myeloablative conditioning regimen with fludarabine demonstrates good results in UCBT for 30 pediatric patients with hematologic malignancies, especially acute lymphoblastic leukemia

We retrospectively analyzed the safety and efficacy of a myeloablative conditioning regimen with fludarabine (FLU) in unrelated cord blood transplantation (UCBT) of 30 pediatric patients with hematologic malignancies. The conditioning regimen consisted of FLU, busulfan (BU) and cyclophosphamide (CY). All of the patients received Cyclosporine (CSA) and mycophenolate mofetil (MMF) as graft versus host disease (GVHD) prophylaxis. We achieved high engraftment rates (96.7%) and rapid hematopoietic reconstitution. Acute GVHD occurred in 12 cases of the 29 engraftment patients (41.4%), and 6 cases (20.7%) were of grade III-IV. Chronic GVHD only occurred in 1 of 28 evaluable patients (3.6%). Twenty-three patients (76.7%) became infected, and 3 cases (10.0%) died of severe infections. Cytomegalovirus (CMV) reactivation occurred in 70.0% of the patients, but no CMV diseases were observed, nor did any patients die of CMV infection. The cumulative incidence of relapse (6.7%) was significantly reduced, and none of the acute lymphoblastic leukemia (ALL) patients relapsed. The 3-year overall survival (OS) and event-free survival (EFS) rates were 73.3% and 70.0%, respectively. The 3-year OS and EFS of the ALL patients was 75.0%. This conditioning regimen demonstrates good results and security in UCBT, especially in acute lymphoblastic leukemia.

[Comparison of unrelated cord blood transplantation and HLA-identical sibling peripheral blood stem cell transplantation for the treatment of adult hematological malignancies]

Objective: To compare the efficacy of unrelated cord blood transplantation (UCBT) and HLA-identical sibling peripheral blood stem cell transplantation (PBSCT) for the treatment of adult hematological malignancies. Methods: From April 2011 to December 2015, a total of 81 patients receiving single-unit UCBT and 57 patients receiving HLA-identical sibling PBSCT were enrolled in this study. All of the patients received myelablative conditioning. Cyclosporine combined with mycophenolate mofetil was adopted for GVHD prophylaxis. Results: The cumulative incidence of neutropil engraftment at day-42 was 95.0% and 100% in UCBT and sibling PBSCT groups, respectively (P=0.863) . Platelet engraftment at day 100 was 87.3% (95%CI 76.8%-93.1%) in UCBT group, which was significantly lower than that of sibling PBSCT group[98.2% (95%CI 87.3%-99.7%) ] (P=0.005) . There were no significant differences in terms of Ⅱ-Ⅳ acute GVHD or Ⅲ-Ⅳ acute GVHD in two groups (P=0.142, 0.521) . The 3-year chronic GVHD and extensive chronic GVHD were 14.9% (95%CI 5.2%-23.5%) and 11.2% (95%CI 2.9%-18.7%) , respectively in UCBT group, which was significantly lower than that of sibling PBSCT group[35.2% (95%CI 19.4%-47.8%) , 31.4% (95%CI 16.2%-43.9%) ] (P=0.008, 0.009) . The 3-year transplant-related mortality (TRM) was similar between two groups (30.1% vs 23.2%, P=0.464) . The relapse rate at 3-year in UCBT group[12.9% (95%CI 6.6%-21.5%) ]was significantly lower than that in sibling PBSCT group[24.3% (95%CI 13.5%-36.8%) ] (P=0.039) . There were no significant differences in terms of overall survival (OS) and disease-free survival (DFS) between two groups (58.6% vs 54.8%, P=0.634; 57.0% vs 52.4%, P=0.563) . But GVHD-free and relapse-free survival (GRFS) in UCBT group [55.7% (95%CI 44.1%-65.8%) ]was significantly higher than that of sibling PBSCT group[42.9% (95%CI 29.8%-55.3%) ] (P=0.047) . Conclusions: For adult hematological malignancies, the incidences of acute GVHD and TRM were similar between UCBT and sibling PBSCT recipients, and the incidences of chronic GVHD and relapse were lower in UCBT recipients. UCBT recipients had higher GRFS rate although OS and DFS were similar between two groups, which may reflect the real recovery and better quality of life following UCBT.