[Effects of microRNA-106b on migration and invasion of human malignant pleural mesothelioma cell NCI-H2452]

Objective: To investigate the inhibitory effect of microRNA-106b in the process of migration and invasion of human malignant pleural mesothelioma cell NCI-H2452. Methods: In April 2017, the expression level of miRNA-106b in malignant pleural mesothelioma cells (NCI-H2452, MSTO-211H, NCI-H2052) and normal mesothelial cells MeT-5A was detected and analyzed. Using NCI-H2452 cells as a model, the NCI-H2452 cell model with miRNA-106b overexpression was established by transfecting miRNA-106b mimics. The expression level of miRNA-106b in the cells was detected by real-time fluorescent quantitative PCR. The effect of miRNA-106b on the migration and invasion ability of NCI-H2452 cells was analyzed. The gene expression data of malignant mesothelioma and the downstream target gene data of miRNA-106b in public databases were analyzed to screen the downstream target genes of miRNA-106b in mesothelioma cells that affect cell migration and invasion ability, and to verify the expression of this gene in NCI-H2452 cells with miRNA-106b overexpression. Results: The expression of miRNA-106b in three MPM cells was decreased compared with MeT-5A cells (P<0.001) . The expression level of miRNA-106b was significantly increased after transfection of miRNA-106b mimics (P<0.001) . The scratch migration levels of the experimental group were 28.45%±4.37%, 38.12%±4.82% and 50.06%±8.92% at 24h, 31h and 48h, respectively. Compared with the control group, the migration level decreased by 37.48%±2.65%, 49.21%±3.45% and 68.14%±3.81% (P<0.01) . The number of cell migration and invasion decreased in the experimental group compared with the control group (P<0.001) . Public databases were used to screen and analyze the possibility that TCF21 gene, as a downstream target gene, could affect the migration and invasion ability of MPM cells. The expression level of TCF21 gene was increased after transfection of miRNA-106b mimics in NCI-H2452 cells (P=0.009) . Conclusion: MiRNA-106b can inhibit the migration and invasion of NCI-H2452 cells and increase the expression of TCF21 gene.

[Incremental value of epicardial fat volume on predicting obstructive coronary artery disease with myocardial ischemia]

Objective: This study aimed to investigate the association between epicardial fat volume (EFV) and obstructive coronary artery disease (CAD) with myocardial ischemia, and evaluate the incremental value of EFV on top of traditional risk factors and coronary artery calcium (CAC) in predicting obstructive CAD with myocardial ischemia. Methods: This study was a retrospective cross-sectional study. Patients with suspected CAD who underwent coronary angiography (CAG) and single photon emission computerized tomography-myocardial perfusion imaging (SPECT-MPI) at the Third Affiliated Hospital of Soochow University from March 2018 to November 2019 were consecutively enrolled. EFV and CAC were measured by non-contrast chest computed tomography (CT) scan. Obstructive CAD was defined as coronary artery stenosis≥50% in at least one of the major epicardial coronary arteries, and myocardial ischemia was defined as reversible perfusion defects in stress and rest MPI. Obstructive CAD with myocardial ischemia was defined in patients with coronary stenosis severity≥50% and reversible perfusion defects in the corresponding areas of SPECT-MPI. Patients with myocardial ischemia bot without obstructive CAD were defined as none-obstructive CAD with myocardial ischemia group. We collected and compared the general clinical data, CAC and EFV between the two groups. Multivariable logistic regression analysis was performed to identify the relationship between EFV and obstructive CAD with myocardial ischemia. ROC curves were performed to determine whether addition of EFV improved predictive value beyond traditional risk factors and CAC for obstructive CAD with myocardial ischemia. Results: Among the 164 patients with suspected CAD, 111 patients were males, and average age was (61.4±9.9) years old. 62 (37.8%) patients were included into the obstructive CAD with myocardial ischemia group. 102 (62.2%) patients were included into the none-obstructive CAD with myocardial ischemia group. EFV was significantly higher in obstructive CAD with myocardial ischemia group than in none-obstructive CAD with myocardial ischemia group ((135.63±33.29)cm³ and (105.18±31.16)cm³, P<0.01). Univariate regression analysis showed the risk of obstructive CAD with myocardial ischemia increased by 1.96 times for each SD increase in EFV(OR 2.96; 95%CI, 1.89-4.62; P<0.01). After adjustment for traditional risk factors and CAC, EFV remained as an independent predictor for obstructive CAD with myocardial ischemia (OR, 4.48, 95%CI, 2.17-9.23; P<0.01). Addition of EFV to CAC and traditional risk factors was related to larger AUC for predicting obstructive CAD with myocardial ischemia (0.90 vs. 0.85, P=0.04, 95%CI: 0.85-0.95) and the global chi-square increased by 21.81 (P<0.05). Conclusions: EFV is an independent predictor for obstructive CAD with myocardial ischemia. Addition of EFV to traditional risk factors and CAC has incremental value for predicting obstructive CAD with myocardial ischemia in this patient cohort.

Identification of hub genes correlated with diabetic retinopathy via bioinformatics methods

OBJECTIVE

The aim of this study was to identify the hub genes and uncover the molecular mechanisms of diabetic retinopathy (DR).

MATERIALS AND METHODS

We used the Gene Expression Omnibus (GEO) dataset GSE60436 in our study. After screening for differentially expressed genes (DEGs), we performed gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analysis. Subsequently, a protein-protein interaction (PPI) network was constructed using the Search Tool for Retrieval of Interacting Genes (STRING) database and visualized using the Cytoscape software. Finally, we identified 10 hub genes by cytoHubba plugin.

RESULTS

A total of 592 DEGs were identified, including 203 up-regulated genes and 389 downregulated genes. The DEGs were mainly enriched in visual perception, photoreceptor outer segment membrane, retinal binding, and PI3K-Akt signaling pathway. By constructing a protein-protein interaction (PPI) network, 10 central genes were finally identified, including CNGA1, PDE6G, RHO, ABCA4, PDE6A, PDE6B, NRL, RPE65, GUCA1B and AIPL1.

CONCLUSIONS

CNGA1, PDE6G, RHO, ABCA4, PDE6A, PDE6B, NRL, RPE65, GUCA1B, and AIPL1 may be potential biomarkers and therapeutic targets for DR.

[The clinical characteristics of functional hypothalamic amenorrhea with hyperandrogenism]

Objective: To explore the clinical and biochemical discriminants of hyperandrogenism in functional hypothalamic amenorrhea (FHA). Methods: From January to September 2022, a total of 56 patients with FHA group in the Obstetrics and Gynecology Hospital of Fudan University outpatient clinic were included in this retrospective cross-sectional analysis. According to the clinical or biochemical features of hyperandrogenism, FHA patients can be divided into two subgroups, namely hyperandrogenic FHA and non-hyperandrogenic FHA. Explore the differences and its significances between hyperandrogenic FHA and non-hyperandrogenic FHA by comparing anthropometry, reproductive hormones, AMH, ultrasonic manifestation, the scores of eating attitude test, depression questionnaire and anxiety scale respectively and analyzing their correlations. Results: The age of 56 FHA patients was 15-32(23.36±4.90) years, and body mass index(BMI) was (18.91±2.49) kg/m². The age of hyperandrogenic FHA and non-hyperandrogenic FHA was (21.76±4.40) and (24.05±5.00) (P=0.109) years old respectively, and BMI was (19.14±3.15 )and (18.81±2.18) kg/m² (P=0.702). Compared to the non-hyperandrogenic FHA, the AMH (6.46 and 3.63 ng/ml, P=0.025) and PRL (278.78 and 149.46 mU/ml, P=0.002) levels were higher in hyperandrogenic FHA group. There was no significant difference between the hyperandrogenic and non-hyperandrogenic FHA group in body composition.GAD-7 (r=0.455, P=0.005) and PHQ-9 (r=0.664, P<0.001) were correlated with EAT-26 scores in non-hyperandrogenic FHA group, but no significant correlation was shown between PHQ-9 (r=0.091, P=0.766)、GAD-7 (r=0.304, P=0.313) and EAT-26 in hyperandrogenic FHA group. Conclusions: Some patients with FHA had clinical manifestations of hyperandrogenism and mildly elevated AMH and PRL, with underlying PCOS endocrine characteristics.

[Association between inflammation activity of left atrial epicardial adipose tissue measured by 18F-FDG PET/CT and atrial fibrillation]

Objective: To explore the association between inflammation activity of left atrial epicardial adipose tissue (LA-EAT) measured by ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) and atrial fibrillation (AF). Methods: A total of 78 patients with AF, who underwent ¹⁸F-FDG PET/CT in the Nuclear Medicine Department of the Third Affiliated Hospital of Soochow University due to abnormally elevated levels of tumor indicators or malignant tumors from March 2018 to December 2019, were enrolled in this retrospective study. According to the examination date of PET/CT and basic characteristics of AF patients (gender, age), a 1∶1 propensity score matching was used to enroll a non-AF control group (78 patients). The maximum standard uptake value of left atrial epicardial tissue (LA-EAT FDG SUV_max) and total EAT volume (V-EAT) were measured by ¹⁸F-FDG PET/CT. Left ventricular ejection fraction (LVEF) and left atrial diameter (LAD) were obtained by echocardiography. Blood lipids and biomarkers of inflammation were measured. The differences of clinical data and EAT-related indicators were compared between the AF group and control group. Logistic multivariate regression analysis was used to determine the related factors of AF. Then the receiver operating characteristic (ROC) curve was used to determine the cutoff value of LA-EAT FDG SUV_max on the diagnosis of AF. Univariate and multivariate logistic regression analysis were used to analyze the relationship between the increase of LA-EAT FDG SUV_max and AF. Results: The age was (66.9±10.2) years and there were 55 males (70.5%) in the AF group. The age was (66.9±8.0) years, and there were 52 males (66.7%) in the control group (both P>0.05). The LAD ((44.2±5.8) mm vs. (35.4±4.4) mm), V-EAT ((122.1±42.0) cm³ vs. (91.6±34.5) cm³), and LA-EAT FDG SUV_max ((1.6±0.3) vs. (1.4±0.2)) values were significantly higher, while LVEF ((60.1±4.7)% vs. (63.9±2.9)%) was lower in the AF group than in the control group (P all<0.001). Multivariate logistic regression analysis showed that LAD (OR=1.340, 95%CI 1.195-1.502), V-EAT (OR=1.016, 95%CI 1.001-1.031), and LA-EAT FDG SUV_max (OR=1.375, 95%CI 1.095-1.723) were positively correlated with AF, LVEF (OR=0.781, 95%CI 0.659-0.926) was negatively correlated with AF(P all<0.05). The area under the ROC curve of LA-EAT FDG SUV_max for diagnosis of AF was 0.680 (95%CI 0.597-0.764, P<0.001), and the best cut-off value was 1.415 with a sensitivity of 65.4% and specificity of 61.5%. After adjusting for high-density lipoprotein cholesterol, LVEF, LAD and V-EAT, LA-EAT FDG SUV_max≥1.415 was independently associated with AF (OR=2.982, 95%CI 1.122-7.926, P=0.010). Conclusions: The inflammatory activity of LA-EAT measured by ¹⁸F-FDG PET/CT is an independent risk factor of AF, and the increased inflammatory activity of LA-EAT is positively correlated with AF.

[microRNA-30d can inhibit the proliferation, migration and invasion of human mesothelial cell MSTO-211H]

Objective: To investigate the inhibitory effect and molecular mechanism of microRNA-30d (miR-30d) in the process of proliferation, migration and invasion of malignant mesothelioma cell line MSTO-211H. Methods: In April 2017, the human MSTO-211H cells was used to establish miR-30d overexpressed MSTO-211H cell model by transfection of miR-30d mimics. The qRT-PCR was performed to detect the expression level of miR-30d in the cells transfected miR-30d mimics. The effects of miR-30d on the proliferation, apoptosis, migration and invasion of MSTO-211H cells were analyzed by CCK-8 experiment, flow cytometry, cell scratch experiment and Transwell method. Results: After transfection of miR-30d, the expression level of miR-30d in the MSTO-211H+miR-30d cells group was significantly higher than MSTO-211H+miR NC cells group (P<0.01) . The cell activity of MSTO-211H+miR-30d group (105.13%±2.35%) was significantly lower than MSTO-211H+miR NC cells group (115.40%±1.35%) , and the level of apoptosis (3.97%±0.36%) was significantly higher than MSTO-211H+miR NC cells group (1.47%±0.10%) (P<0.01) . The relative migration areas at 12 and 24 h of MSTO-211H+miR-30d cells group (9.35±3.16 μm(2) and 58.19±1.82 μm(2)) were significantly lower than MSTO-211H+miR NC cells group (54.42±5.26 μm(2) and 88.32±1.96 μm(2)) (P<0.01) . Compared with the MSTO-211H+miR NC cells group, the numbers of cell migration and cell invasion were reduced in the MSTO-211H+miR-30d cells group (P<0.01) . Conclusion: miR-30d can regulate the progression of malignant pleural mesothelioma by inhibiting the proliferation, apoptosis, migration and invasion of MSTO-211H cells.

Influence of miR-34a on preeclampsia through the Notch signaling pathway

OBJECTIVE

The aim of this study was to investigate the influence of micro-ribonucleic acid-34a (miR-34a) on preeclampsia through the Notch signaling pathway.

PATIENTS AND METHODS

The expressions of miR-34a, Notch-1, Notch-2, and Notch-3 in the placenta of 39 preeclampsia patients and 42 normal patients were detected by immunohistochemistry and Reverse Transcription-Polymerase Chain Reaction (RT-PCR). The correlations between miR-34a expression with the expressions of Notch-1, Notch-2 and Notch-3 were analyzed, respectively. Besides, placental trophoblasts were isolated from preeclampsia patients and cultured in vitro. The expressions of miR-34a, Notch-1, Notch-2 and Notch-3 in placental trophoblasts were analyzed. Furthermore, the influences of miR-34a on the protein expressions of Notch-1, Notch-2, Notch-3, and hairy and enhancer of split-1 (Hes-1) in the Notch signaling pathway were analyzed by Luciferase reporter gene assay and Western blotting. The role of Notch in trophoblast invasion was investigated through the Notch inhibitors. In addition, its influence on the expression of urokinase-type plasminogen activator (uPA) was studied by miR-34a overexpression.

RESULTS

The expressions of miR-34a and Notch-1 were correlated with preeclampsia in the placentas of preeclampsia patients and normal patients to a certain degree. The expression of miR-34a in preeclamptic placenta was significantly higher than that of the normal placenta (p<0.05). However, Notch-1 expression was markedly lower in preeclamptic placenta (p<0.05). No significant differences were found in the expressions of Notch-2 and Notch-3 between the two types of placentas (p>0.05). MiR-34a had a remarkable negative correlation with Notch-1 expression in the Notch family (p<0.001, r=-0.5775). RT-PCR results revealed that the mRNA expression of miR-34a in placental trophoblasts of patients with preeclampsia was notably higher than that of normal people (p<0.01). However, Western blotting demonstrated that the protein expressions of Notch-1, Notch-2 and Notch-3 exhibited the opposite results. Additionally, the protein expression of Notch-1, Notch-2, Notch-3 and Hes-1 in trophoblasts transfected with pre-miR-34a was significantly decreased. The treatment with Notch inhibitors markedly reduced the trophoblast invasion. Furthermore, miR-34a overexpression or intracellular domain of Notch (ICN) overexpression regulated uPA expression.

CONCLUSIONS

MiR-34a regulates uPA system through the Notch signal transduction, thereby regulating the invasion of placental trophoblasts in patients with preeclampsia.

[The correlation between left atrial sphericity and thromboembolic events in patients with atrial fibrillation]

Objective: To study the correlation between left atrial sphericity (LASP) and thromboembolic events (TE) in patients with atrial fibrillation (AF). Methods: This study was conducted in patients with AF underwent radiofrequency ablation in the Department of Cardiology of First Affiliated Hospital of Zhengzhou University from January 2011 to October 2018. The AF patients with TE (study group, n=157) and the AF patients without TE (control group, n=157) were matched for age and gender. The differences of LASP and other related indexes between the two groups were compared, and the correlation between LASP and TE was analyzed by conditional logistic regression. The receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of LASP for TE. Results: (1) The LASP in the study group was significantly higher than that in the control group [ (87.5±7.1) % vs. (82.8±6.1) %, P=0.001]. (2) Conditional logistic regression analyses showed that LASP (OR=1.10, 95%CI 1.05-1.16, P=0.001), left atrial volume index (OR=1.01, 95%CI 1.00-1.02, P=0.016) and CHA(2)D-VASc score (OR=1.77, 95%CI 1.30-2.41, P=0.001) were independently and positively correlated with TE. (3) The ROC curve analysis showed that the area under the curve (AUC) of left atrial sphericity (AUC=0.712, 95%CI 0.656-0.768, P=0.001) was larger than the AUC of either left atrial volume index (AUC=0.650, 95%CI 0.589-0.710, P=0.001) or CHA(2)D-VASc score (AUC=0.612, 95%CI 0.550-0.674, P=0.001). (4) CHA(2)D-VASc-LASP(2) score was positively correlated with TE (OR=1.95, 95%CI 1.55-2.42, P=0.001). Conclusion: LASP is independently and positively correlated with TE in patients with AF.

[Prevalence of thyroid function in pregnant and lactating women in areas with different iodine levels of Shanxi province]

Objective: To investigate the effects of high iodine intake on thyroid function in pregnant and lactating women. Methods: A cross sectional epidemiological study was conducted among 130 pregnant women and 220 lactating women aged 19-40 years in areas with high environment iodine level (>300 μg/L) or proper environment iodine level (50-100 μg/L) in Shanxi in 2014. The general information, urine samples and blood samples of the women surveyed and water samples were collected. The water and urine iodine levels were detected with arsenic and cerium catalysis spectrophotometric method, the blood TSH level was detected with electrochemiluminescence immunoassay, and thyroid stimulating hormone (FT(4)), antithyroid peroxidase autoantibody (TPOAb) and anti-thyroglobulin antibodies (TGAb) were detected with chemiluminescence immunoassay. Results: The median urine iodine levels of the four groups were 221.9, 282.5, 814.1 and 818.6 μg/L, respectively. The median serum FT(4) of lactating women in high iodine area and proper iodine area were 12.96 and 13.22 pmol/L, and the median serum TSH was 2.45 and 2.17 mIU/L, respectively. The median serum FT(4) of pregnant women in high iodine area and proper iodine area were 14.66 and 16.16 pmol/L, and the median serum TSH was 2.13 and 1.82 mIU/L, respectively. The serum FT(4) levels were lower and the abnormal rates of serum TSH were higher in lactating women than in pregnant women in both high iodine area and proper iodine area, the difference was statistically significant (FT(4): Z=-6.677, -4.041, P<0.01; TSH: Z=8.797, 8.910, P<0.01). In high iodine area, the abnormal rate of serum FT(4) in lactating women was higher than that in pregnant women, the difference was statistically significant (Z=7.338, P=0.007). The serum FT(4) level of lactating women in high iodine area was lower than that in proper iodine area, the difference was statistically significant (Z=-4.687, P=0.000). In high iodine area, the median serum FT(4) in early pregnancy, mid-pregnancy and late pregnancy was 16.26, 14.22 and 14.80 pmol/L, respectively, and the median serum TSH was 1.74, 1.91 and 2.38 mIU/L, respectively. In high iodine area, the serum FT(4) level in early pregnancy was higher than that in mid-pregnancy and late pregnancy, and the serum TSH level was lower than that in mid-pregnancy and late pregnancy, the difference was statistically significant (FT(4): Z=-2.174, -2.238, P<0.05; TSH: Z=-2.985, -1.978, P<0.05). There were no significant differences in the positive rates of serum thyroid autoantibodies among the four groups of women and women in different periods of pregnancy (P>0.05). The morbidity rates of subclinical hyperthyroidism in pregnant women and lactating women in high iodine area were obviously higher than those in proper iodine areas, the difference was statistically significant (χ(2)=5.363, 5.007, P<0.05). Conclusions: Excessive iodine intake might increase the risk of subclinical hypothyroidism in pregnant women and lactating women. It is suggested to strengthen the iodine nutrition and thyroid function monitoring in women, pregnant women and lactating women in areas with high environmental iodine.

[Study on the change of optical zone after femtosecond laser assisted laser in situ keratomileusis]

Objective: To explore the change of optical zone after femtosecond laser assisted laser in sitn keratomileusis(FS-LASIK) so as to provide the reference for measurement and design of clinical optical zone. Methods: This retrospective case series study covers 41 eyes of 24 patients (7 males and 17 females, aged from 18 to 42 years old) with myopia and myopic astigmatism who have received FS-LASIK surgery at Corneal Refractive Department of Qingdao Eye Hospital and completed over 6 months of clinical follow-up. Pentacam system (with the application of 6 corneal topographic map modes including: the pure axial curvature topographic map, the pure tangential curvature topographic map, the axial curvature difference topographic map, the tangential curvature difference topographic map, the postoperative front elevation map and the corneal thickness difference topographic map), combined with transparent concentric software (a system independently developed by Qingdao Eye Hospital) was used to measure the optical zone at 1, 3 and 6 months postoperatively, the optical zone diameters measurement results among different follow-up times in group were analyzed with the repeated measures analysis of variance, and the actual measured values and the theoretical design values of the optical zone were analyzed with independent-samples t-testing. Spearman correlation coefficient (r(s)) have been applied to evaluate the relationship between postoperative optical zone measurement values and the potential influencing factors. Results: The optical zone diameters measured by pure axial curvature topographic map at 1, 3 and 6 months after FS-LASIK showed (6.55±0.50)mm, (6.50±0.53)mm and (6.48±0.53)mm respectively. The differences between values are of no statistical significance (F=1.60, P=0.21), the optical zone diameter measured by pure tangential curvature topographic map at 1, 3 and 6 months after FS-LASIK showed (5.44±0.46)mm, (5.46±0.52)mm and (5.44±0.50)mm respectively, the differences between values are of no statistical significance (F=0.17, P=0.85). The optical zone diameters measured by postoperative front elevation map at 1, 3 and 6 months after FS-LASIK showed (5.06±0.28)mm, (5.12±0.32)mm and (5.17±0.28)mm respectively. The differences between the values of 3 and 6 months postoperatively are of no statistical significance (F=6.14, P=0.15), the optical zone diameters measured by axial curvature difference topographic map at 1, 3 and 6 months after FS-LASIK showed (6.51±0.37)mm, (6.45±0.41)mm and (6.41±0.40)mm respectively, and the differences between the values of 3 and 6 months postoperatively are of no statistical significance (F=7.25, P=0.05). The optical zone diameters measured by tangential curvature difference topographic map at 1, 3 and 6 months after FS-LASIK showed (5.21±0.23)mm, (5.16±0.19)mm and (5.17±0.20) mm respectively, and the differences between the values of 1 and 3 months postoperatively are of statistical significance (F=1.75, P=0.04). The optical zone diameters measured by corneal thickness difference topographic map at 1, 3 and 6 months after FS-LASIK showed (6.53±0.40)mm, (6.39±0.43)mm and (6.41±0.47)mm respectively, and the differences between the values of 1 and 3 months postoperatively are of statistical significance (F=1.67, P=0.032). The actual measured optical zone values from the 6 different modes of Pentacam system are less than the theoretical design values (7.75 mm), and the differences were statistical significance (t=-15.42, -29.39, -59.27, -21.47, -81.69, -18.22, P<0.01). Conclusions: The optical zone measurement values tend to be stable at 3 months after FS-LASIK. The actual measured values from all the 6 different modes of Pentacam system were less than the theoretical design values. The results from pure tangential curvature topographic map, the tangential curvature difference topographic map and the postoperative front elevation map showed greater variation with clear border, which was beneficial for eccentric research. The results from pure axial curvature topographic map, the axial curvature difference topographic map and the corneal thickness difference topographic map were close to the theoretically designed values. Furthermore, the axial curvature difference topographic map showed clearer border and less variation thus maybe more favorable for measuring optical zone in clinical application.(Chin J Ophthalmol, 2018, 54: 39-47).

[Nested case-control study on associated factors for anemia during pregnancy]

Objective: To explore the related factors of anemia during pregnancy and provide scientific evidence for the primary prevention of anemia during pregnancy. Methods: The pregnant women (≤12 pregnant weeks) who received the first pregnancy care in a local medical institution in Hunan province from June 2013 to November 2014 were included in this cohort study, and for them anemia had been excluded by physical examination. Baseline survey and follow up till childbirth were conducted for them. A queue-based nested case-control study (1 ∶ 2) was conducted (380 pregnant women with anemia detected in this study as case group, 760 pregnant women without anemia randomly selected and matched by age, habitual residence during pregnancy as control group. And t test, χ(2) test and logistic regression analysis were conducted to identify related factors of anemia during pregnancy. Results: Multivariate logistic regression analysis indicated that low family annual income level (net income) (OR=2.08, 95%CI: 1.22-3.59), low educational level (OR=2.09, 95%CI: 1.22-3.59), pre-pregnancy perm/hair dye (OR=2.23, 95%CI: 1.63-3.05), early pregnancy vomiting (OR=2.51, 95%CI: 1.56-4.03) were the risk factors for anemia during pregnancy. Intake of vitamin and trace element supplements (OR=0.69, 95%CI: 0.50-0.94), frequent meat, fish, shrimp, egg intakes (OR=0.68, 95%CI: 0.49-0.92), frequent soy milk, milk intakes (OR=0.51, 95%CI: 0.27-0.95) were the protective factors for anemia during pregnancy. Conclusion: A number of factors, such as family annual income level, education level, poisonous and harmful material contact, pregnancy reaction, nutrition, are related to the incidence of anemia during pregnancy, it is necessary to take preventive measures to reduce the incidence of anemia during pregnancy.

[An adolescent with Hashimoto's encephalopathy after surgery and ¹³¹I radiotherapy for papillary thyroid carcinoma: one case report]

Hashimoto's encephalopathy is a rare brain disease. Its etiology is still unknown. In this paper, we reported a 15-year-old female patient underwent total thyroidectomy and lymph node dissection, due to a multifocal papilliferous carcinoma of the right lobus. Forty-two days after surgery, the patient was treated by ¹³¹I radiotherapy in another hospital and begun to have a headache after 48 hours. At last, the patient was diagnosed by HE on the basis of all considerations. She recovered from by i.v. Immunoglobulin. Till now, the patient has not relapsed for more than 4 years follow-up.

[Features of peripheral nerve injuries in workers exposed to vibration: an analysis of 197 cases]

Objective: To investigate the features of peripheral nerve injuries in workers exposed to vibration. Methods: A total of 197 male workers [median age: 34 years (21-50 years) ; median working years of vibration exposure: 7.3 years (1-20 years) ] engaged in grinding in an enterprise were enrolled. Their clinical data and electromyography results were analyzed to investigate the features of peripheral nerve impairment. Results: Of all workers, 96 (48.73%) had abnormal electromyography results. Of all workers, 88 (44.7%) had simple mild median nerve injury in the wrist, who accounted for 91.7% (88/96) of all workers with abnormal electromy-ography results. Six workers had ulnar nerve injury, superficial radial nerve injury, or/and superficial peroneal nerve injury and accounted for 6.3% of all workers with abnormal electromyography results. Of all workers, 88 had a reduced amplitude of median nerve sensory transduction, and 28 had slowed median nerve sensory transduction. A total of 46 workers were diagnosed with occupational hand-arm vibration disease and hospitalized for treatment. They were followed up for more than 4 months after leaving their jobs, and most of them showed improvements in neural electromyography results and returned to a normal state. Conclusion: Workers exposed to vibration have a high incidence rate of nerve injury in the hand, mainly sensory function impairment at the distal end of the median nerve, and all injuries are mild peripheral nerve injuries. After leaving the vibration job and being treated, most workers can achieve improvements and return to a normal state.

The influence of testicular microlithiasis on the outcomes of in vitro fertilisation in a Chinese Han population

To investigate the influence of testicular microlithiasis (TM) on the outcomes of in vitro fertilisation (IVF), we retrospectively reviewed the ultrasonography results of the TM patients who underwent IVF treatment in our hospital. They were classified as classic-TM (CTM) or limited-TM (LTM) comparing with patients without TM (Non-TM). Semen parameters, rates of fertilisation, normal fertilisation, good embryos and clinical pregnancy were analysed. The Non-TM group showed higher percentage of morphologically normal spermatozoa than the CTM or LTM group (4.08 ± 2.07 versus 3.40 ± 2.00 versus 3.04 ± 1.66, p = .003) while the other general semen parameters were comparable. The LTM group showed higher rate of fertilisation than the CTM group (85.10% versus 81.12%, p = .044). Moreover, the rates of normal fertilisation of Non-TM (62.47%) and LTM (66.32%) group were significantly higher than the CTM (58.02%) group (p = .027 and p = .001 respectively). There were 333 embryo transfer cycles in total (including 222 fresh and 111 frozen). The overall clinical pregnancy rate was 54.95%, 58.33% and 64.12% in the group of CTM, LTM and Non-TM respectively. However, no statistically significant difference was obtained (p = .326). Our results suggest that TM may have influence on the IVF outcomes. The extent of microlithiasis correlates inversely with the rates of fertilisation and normal fertilisation.

0.95 W high-repetition-rate, picosecond 335 nm laser based on a frequency quadrupled, diode-pumped Nd:YVO(4) MOPA system

An efficient all-solid-state picosecond (ps) ultraviolet (UV) laser at 335 nm was demonstrated based on frequency quadrupling of a mode-locked 1342 nm MOPA system. An output power of 0.95 W was obtained under a fundamental wave power of 16.38 W, corresponding to a conversion efficiency of 5.8% from infrared to UV. The repetition rate and pulse duration were 77 MHz and 20.2 ps, respectively. The beam quality factor M(2) was measured to be 1.56. This is, to the best of our knowledge, the highest output power at 335 nm.

Safety and effectiveness of intravenous thrombolysis with recombinant tissue plasminogen activator in eighty years and older acute ischemic stroke patients

OBJECTIVE

To explore the safety and efficacy of intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) in elderly (≥ 80 years old) acute ischemic stroke (AIS) patients.

PATIENTS AND METHODS

The clinical data of patients who were treated in Tianjin Huanhu Hospital from June 2012 to November 2013 were retrospectively analyzed; amongst them 404 patients had received IVT with rt-PA and 200 patients had not received IVT. Among ≥ 80 years' old patients, 204 had received IVT and 200 had not. And, the 404 patients who had received IVT, they were divided into two subgroups: elderly (≥ 80 years of age; n = 204) and controls (< 80 years old; n = 200). The incidence of intracranial hemorrhage (ICH) and symptomatic intracranial hemorrhage (sICH), case-fatality rate, and other prognostic indicators were compared.

RESULTS

Among all ≥ 80 years' old patients, the IVT subgroup had significantly superior good outcome rates than the non-IVT subgroup at 24-h and 3-month, along with significantly lower case-fatality rate. But for the patients those who had received IVT, the incidence of ICH and the 7-day case-fatality rate were not significantly increased in both the elderly and control subgroups. The 24-h and 3-month good outcome rates were not significantly different between these two subgroups as well.

CONCLUSIONS

IVT with rt-PA is a safe and effective treatment for ≥ 80 year's old AIS patients.

Study on the effect of urinary kallidinogenase after thrombolytic treatment for acute cerebral infarction

OBJECTIVE

To evaluate the safety and efficacy of urinary kallidinogenase for recombinant tissue-type plasminogen activator (rt-PA) intravenous thrombolytic treatment in patients with acute cerebral infarction.

PATIENTS AND METHODS

All 200 patients with acute cerebral infarction were randomized 1:1 into an experimental group (100 cases) and a control group (100 cases). Patients in the control group were administrated rt-PA (0/9 mg/kg) while patients in the experimental group were given urinary kallidinogenase by intravenous drip (0.15 PNAU/d, for 7 days) after rt-PA intravenous thrombolytic treatment (0.9 mg/kg). The main evaluation index was NIHSS and BI.

RESULTS

Compared to the control group, the NIHSS scores were significantly lower 7 and 90 days after thrombolytic therapy (t = 2.391, 2.714; p < 0.05). BI scores were obviously higher at 90 days after thrombolytic therapy in the experimental group (t = 2.675, p < 0.05).

CONCLUSIONS

Urinary kallidinogenase may improve the treatment effect for rt-PA intravenous thrombolytic treatment in patients with acute cerebral infraction.

Amitriptyline up-regulates connexin43-gap junction in rat cultured cortical astrocytes via activation of the p38 and c-Fos/AP-1 signalling pathway

BACKGROUND AND PURPOSE

Intercellular communication via gap junctions, comprised of connexin (Cx) proteins, allow for communication between astrocytes, which in turn is crucial for maintaining CNS homeostasis. The expression of Cx43 is decreased in post-mortem brains from patients with major depression. A potentially novel mechanism of tricyclic antidepressants is to increase the expression and functioning of gap junctions in astrocytes.

EXPERIMENTAL APPROACH

The effect of amitriptyline on the expression of Cx43 and gap junction intercellular communication (GJIC) in rat primary cultured cortical astrocytes was investigated. We also investigated the role of p38 MAPK intracellular signalling pathway in the amitriptyline-induced expression of Cx43 and GJIC.

KEY RESULTS

Treatment with amitriptyline for 48 h significantly up-regulated Cx43 mRNA, protein and GJIC. The up-regulation of Cx43 was not monoamine-related since noradrenaline, 5-HT and dopamine did not induce Cx43 expression and pretreatment with α- and β-adrenoceptor antagonists had no effect. Intracellular signalling involved p38 MAPK, as amitriptyline significantly increased p38 MAPK phosphorylation and Cx43 expression and GJIC were significantly blocked by the p38 inhibitor SB 202190. Furthermore, amitriptyline-induced Cx43 expression and GJIC were markedly reduced by transcription factor AP-1 inhibitors (curcumin and tanshinone IIA). The translocation of c-Fos from the cytosol and the nucleus of cortical astrocytes was increased by amitriptyline, and this response was dependent on p38 activity.

CONCLUSION AND IMPLICATION

These findings indicate a novel mechanism of action of amitriptyline through cortical astrocytes, and further suggest that targeting this mechanism could lead to the development of a new class of antidepressants.

Primary cultures of rat cortical microglia treated with nicotine increases in the expression of excitatory amino acid transporter 1 (GLAST) via the activation of the α7 nicotinic acetylcholine receptor

Although the clearance of glutamate from the synapse under physiological conditions is performed by astrocytic glutamate transporters, their expression might be diminished under pathological conditions. Microglia glutamate transporters, however, might serve as a back-up system when astrocytic glutamate uptake is impaired, and could have a prominent neuroprotective function under pathological conditions. In the current study, the effect of nicotine, well known as a neuroprotective molecule, on the function of glutamate transporters in cultured rat cortical microglia was examined. Reverse transcription polymerase chain reaction and pharmacological approaches demonstrated that, glutamate/aspartate transporter (GLAST), not glutamate transporter 1 (GLT-1), is the major functional glutamate transporter in cultured cortical microglia. Furthermore, the α7 subunit was demonstrated to be the key subunit comprising nicotinic acetylcholine (nACh) receptors in these cells. Treatment of cortical microglia with nicotine led to a significant increase of GLAST mRNA expression and (14)C-glutamate uptake in a concentration- and time-dependent manner, which were markedly inhibited by pretreatment with methyllycaconitine, a selective α7 nACh receptor antagonist. The nicotine-induced expression of GLAST mRNA and protein is mediated through an inositol trisphosphate (IP3) and Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) depend intracellular pathway, since pretreatment with either xestospongin C, an IP3 receptor antagonist, or KN-93, a CaMKII inhibitor, blocked GLAST expression. Together, these findings indicate that activation of nACh receptors, specifically those expressing the α7 subunit, on cortical microglia could be a key mechanism of the neuroprotective effect of nACh receptor ligands such as nicotine.

The association between RhEPO and FN expression in glomerular mesangial cells

AIM

Erythropoietin (rhEPO) is increasingly being used in the treatment of anemia caused by miscellaneous reasons. The aim of our research is to investigate the effects of recombinant human erythropoietin (rhEPO) on cellular growth and fibronectin (FN) expression in glomerular mesangial cells.

METHODS

Western blot was used to detect the expression of FN induced by rhEPO (1, 10, 100 and 1000U/mL). In vivo studies, male CD-1 mice were administered rhEPO subcutaneously at a single dose of 1000U/Kg. The cellular hypertrophy was quantified by counting cell number and calculating the ratio of cell protein to cell number.

RESULTS

1) Compared with the control group, the results of mesangial cells' growth stimulated by rhEPO were not significantly different; 2) RhEPO lead to hypertrophy of mesangial cells; 3) rhEPO induced FN expression of mesangial cell in a dose-dependent way. Compared to control, 100U/mL rhEPO enhanced the expression of FN significantly; 4) indirect immunofluorescence showed that rhEPO induced large amount deposition of FN in the intercellular space of mesangial cells; 5) in vivo studies, there were markedly increase of FN expression in mice received the injection of rhEPO.

CONCLUSION

RhEPO could up-regulated the expression of FN and induced glomerular mesangial cells hypertrophy. These results suggested rhEPO could induce dysfunction of renal glomerulus through its influence on the function of mesangial cells.

Expression of Toll-like receptor 4 in the brain in a rabbit experimental subarachnoid haemorrhage model

OBJECTIVE

To investigate the expression of the Toll-like receptor (TLR) 4 in the brain after experimental subarachnoid haemorrhage (SAH) in rabbits.

METHODS

A total of 52 rabbits were randomly divided into four groups: control group; day 3, day 5, and day 7 groups. Day 3, day 5, and day 7 groups were all SAH groups in which the rabbits were killed on day 3, 5, and 7, respectively. In SAH groups, autologous arterial blood was injected into cisterna magna twice on day 0 and day 2. Immunostaining and immunoblotting experiments were performed to detect the expression of TLR4 protein. Reverse-transcriptase polymerase chain reaction was used to analyze the presence and quantity of TLR4 mRNA.

RESULTS

The expressions of TLR4 protein and mRNA were increased remarkably in SAH groups compared with the control group. The immunohistochemical staining demonstrated high level expression of TLR4 was present mainly in the endothelial cells of capillaries in the brain.

CONCLUSION

Our results indicate that TLR4 expression is upregulated in the brain after experimental SAH.

History of medical screening: from concepts to action

The objective of medical screening is to identify disease in its preclinical, and therefore hopefully still curable, phase. This may have been an old quest in medicine but it became historically possible when at least four conditions were met: the availability of simple, valid and acceptable forms of tests, the discovery of effective treatments, the establishment of a theory of screening, and the wide access to health care. Five selected examples that illustrate the history of medical screening are reviewed: screening for psychiatric disorders in the United States army as it is one of the oldest screening programmes; screening for syphilis as it used one of the earliest screening tests; screening for diabetes as one of the first modern forms of mass screening; screening for cervical cancer using the Pap test as one of the greatest successes of screening; and screening for breast cancer by mammography as this offers a good opportunity to discuss the development of modern evaluation of screening programmes. The evaluation of the impact of screening on human health slowly progressed, from obvious changes in the vital statistics such as the decline in incidence of syphilis, to less obvious changes such as the decline in mortality of cancer of the uterus, to finally more subtle changes, such as the impact of mammographic screening on breast cancer mortality. Methods of evaluation had therefore to adapt, evolving from simple surveys to case-control studies and randomised trials. The history of screening is short, but very rich and mostly still to be written.

Topology of the Na(+)/dicarboxylate cotransporter: the N-terminus and hydrophilic loop 4 are located intracellularly

The current secondary structure model of the Na(+)/dicarboxylate cotransporter, NaDC-1, contains 11 transmembrane domains. The model is based on hydropathy analysis and the extracellular location of the carboxy terminus, which contains an N-glycosylation site. In this study, the model was further tested using indirect immunofluorescence of COS-7 cells. The Flag epitope tag (DYKDDDDK) was fused to the amino terminus of NaDC-1 (Flag-NaDC-1), and a monoclonal antibody against the Flag epitope was used to determine the location of the N-terminus. Hydrophilic loop 4 of NaDC-1 was identified using polyclonal antibodies raised against a fusion protein containing amino acids 164--233 of NaDC-1. The expression of NaDC-1 and Flag-NaDC-1 in COS-7 cells was confirmed by functional assays of succinate transport and by Western blots of cell surface biotinylated proteins. Immunofluorescent labeling of cells expressing both NaDC-1 and Flag-NaDC-1 required permeabilization of the plasma membranes with digitonin whereas no immunofluorescence was visible in intact cells. The results of this study show that both the N-terminus and hydrophilic loop 4 of NaDC-1 are located intracellularly, which supports the current model of NaDC-1 structure.

Simultaneous detection of multiple genetic aberrations in single cells by spectral fluorescence in situ hybridization

Spectral fluorescence in situ hybridization (S-FISH) is a novel molecular cytogenetic approach that detects multiple disease-specific chromosomal aberrations in interphase nuclei using combinatorial fluorescence and digital imaging microscopy. A panel of six centromeric probes for chromosomes 7, 8, 9, 10, X, and Y, using a unique two-dye combination of four fluorophores, was developed to assess ploidy in breast tumors, bladder washings, and leukemia. Validation of S-FISH was performed by classic cytogenetics when metaphases were available or by standard fluorescence in situ hybridization (FISH) analyses. S-FISH identified clonal aberrations in newly diagnosed breast tumors and recurrent bladder cancer and revealed minimal residual disease in hyperdiploid acute lymphocytic leukemia, providing "proof of concept." Like standard FISH, aberrations were identified in poor growth/no growth specimen at the single cell level; however, S-FISH provided increased sensitivity over standard FISH by surveying six genetic targets instead of one or two. Disadvantages of the current assay include labor intensive screening and interpretative challenges with signal overlap in highly aneuploid samples and focal plane distortions. S-FISH appears to be a sensitive oncology assay with significant clinical application for early detection of new or reemerging clones, allowing for earlier therapeutic intervention and development of probe panels for individualized therapy.

Twenty-four-color spectral karyotyping reveals chromosome aberrations in cytogenetically normal acute myeloid leukemia

Multicolor spectral karyotyping allows simultaneous visualization of all human chromosomes and screening for chromosomal rearrangements without a priori knowledge of any abnormalities involved. Based on this potentially increased sensitivity, we investigated, in a preliminary manner, whether spectral karyotyping could detect cytogenetic aberrations in karyotypically normal leukemia. The test population was comprised of 28 cryopreserved, cytogenetically normal acute myeloid leukemia (AML) samples from patients registered to a randomized trial for previously untreated AML (SWOG 9031). Two normal and 12 samples with known cytogenetic aberrations were used to validate and establish the diagnostic accuracy of the spectral karyotyping assay and instrumentation in a clinical setting. Enumeration and region-specific DNA fluorescence in situ hybridization (FISH) probes verified discrepant results. In the validation data set, spectral karyotyping refined complex karyotypic rearrangements in six cases and defined the chromosomal origin of a "jumping" homogeneously staining region; however, the technology was less sensitive in the detection of subtelomeric rearrangements and double minute chromosomes. In the test population, spectral karyotyping identified previously undetected cytogenetic aberrations in two cases (7%) of karyotypically normal AML: a cryptic 11q23 translocation in 20/20 cells and a minor monosomy 7 clone in 3/21 cells (FISH, 10.5%). Both of these abnormalities are considered to confer a poor prognosis when based on classical cytogenetic prognostic criteria. As an adjunct to classical cytogenetics and standard FISH analyses, the additive resolution of spectral karyotyping, in particular, with chromosome paints spiked with subtelomeric and/or locus-specific probes, may allow significant gains to be made in diagnostic accuracy and recognition of genotype/phenotype prognostic relationships, and in defining underlying biologic mechanisms in cancer. Genes Chromosomes Cancer 28:318-328, 2000.

Toward the validation of aneusomy detection by fluorescence in situ hybridization in bladder cancer: comparative analysis with cytology, cytogenetics, and clinical features predicts recurrence and defines clinical testing limitations

Fluorescence in situ hybridization (FISH) is regarded as a potential new tool for the clinical management of bladder cancer that works by detecting cytogenetic aberrations in noncycling, exfoliated cells from bladder irrigations. However, clinical validation steps must be addressed to define the true predictive potential in a clinical setting. Toward the validation of FISH with the use of bladder washings and prior to incorporation into a large, prospective clinical trial, a pilot study was designed to determine its clinical potential, define testing limitations, optimize a panel of probes specific for bladder cancer detection, and outline protocol/data collection parameters. Correlations with standard cytogenetics and clinicopathological features of bladder cancer were investigated. Exfoliated cells obtained from benign bladder washings served as normal controls. The results of this pilot study suggest the following: (a) FISH and cytology are complementary testing procedures; however, the FISH data provided valuable ploidy and specific genotypic information for recurrent tumors in "suspicious" cases; (b) chromosomal aberrations defined by FISH are associated with tumor grade and stage (i.e., simple numerical aberrations were associated with low-grade tumors, and high-grade and invasive tumors exhibited multiple, nonrandom chromosomal aberrations and vast intratumor heterogeneity); (c) somatic pairing or homologous centromeric association can give a false-positive result and appears to be linked to prior therapy; (d) dual hybridization with reference gene-specific probes must be used to control for somatic pairing; and (e) focal, deep muscle invasive lesions, with no surface exposure, may yield false-negative results. The data suggest that FISH analysis, with the use of cells isolated from bladder washings, is a powerful technique holding promise for early cancer detection, monitoring treatment outcome, and predicting recurrence of disease.