[Analysis of types and treatment methods of cervical massive hemorrhage]

Objective: To summarize the classification and clinical treatment experience of cervical massive hemorrhage in multiple centers. Methods: From April 2012 to October 2020, clinical data of 42 patients with cervical massive hemorrhage were retrospectively analyzed, including 27 cases from Shanghai Changzheng Hospital, 7 cases from Hunan Provincial People's Hospital, 4 cases from Longkou People's Hospital and 4 cases from Laizhou People's Hospital. According to bleeding position (P), bleeding vessel (V), cerebral blood supply (C), and the presence or absence of associated injury (A), 42 patients were classified as "PVCA", and summarize the methods of pre-hospital emergency and in-hospital treatment based on the "ABC" treatment principles: airway rebuild (A), effective arterial hemostasis and bleeding stop (B), and cerebral blood flow reconstruction within the time window (C). Results: Within the 42 cases of cervical massive hemorrhage, there were 3 cases of type P1 (below cricoid cartilage), 28 cases of type P2 (cricoid cartilage-mandibular angle), 11 cases of type P3 (mandibular angle-skull base); 22 cases of type V1 (arterial hemorrhage), 11 cases of type V2 (main venous hemorrhage), 7 cases of type V3 (simple superficial vein or small artery hemorrhage), 2 cases of type V4 (mixed arteriovenous hemorrhage); 5 cases of type C0 (no symptoms of cerebral ischemia and neurological dysfunction), 33 cases of type C1 (transient cerebral ischemia without sensory disturbance), 4 cases of type C2 (symptoms of cerebral ischemia and neurological dysfunction); 39 cases of type A0 (no other system damage was involved) and 3 cases of type A1 (combined with other system damage). All 42 patients received operations, 25 patients received open surgery of vascular reconstruction+hematoma/foreign body removal (7 cases of vascular ligation, 14 cases of direct suture repair, 4 cases of vascular interposition), 17 patients received hybrid surgery (carotid angiography+covered stent repair+hematoma/foreign body removal). The surgical technique success rate the was 100%. All the hemorrhagic shock was corrected, hematoma compression was relieved, and the symptoms of cephalic ischemia were improved. There were 4 cases of local cranial nerve injury, 1 case of incision hematoma and 6 cases of postoperative hyper perfusion. During the average 14.3 months follow-up, there was no operation related myocardial infarction, stroke or death, no re-rupture or re-dissection, and 50% asymptomatic restenosis was found in 1 case one year after received covered stent endovascular repair. Conclusion: Based on the "PVCA" classification and "ABC" treatment principle, it is safe and effective to rescue cervical massive hemorrhage.

Effects of spatial variation in water quality and hydrological factors on environmental flows

Environmental flow is the quantity, timing, and quality of water flows required to sustain freshwater and estuarine ecosystems and the human livelihoods and well-being that depend on these ecosystems. Environmental flows (e-flows) are crucial parameters for ecosystem restoration. Understanding the effects of spatial variation in the hydrological and water quality factors on e-flows aids the determination of recovery prior areas and helps to improve the success rate of ecosystem restoration projects. However, few studies have investigated the effects, which severely hinder the restoration of aquatic ecosystems and the sustainable use of water resources in inland waters. This paper therefore presents a framework for studying such effects. Spatial autocorrelation, a geostatistical method, is used to analyze the spatial variation in the hydrological and water quality factors and to further analyze the effects of various factors on the spatial heterogeneity of e-flows. Four different methods including the Tennant method, wetted perimeter method, AEHRA, and integrated water quality method are integrated to comprehensively evaluate e-flows. The former three methods consider the demands of biota on the streamflow, whereas the latter considers the demands on both the streamflow and the water quality. The results show that the Tennant and wetted perimeter methods, which focus on the statistics of only streamflow, result in similar spatial distribution of e-flows; the AEHRA and integrated water quality method, which consider the effects of water quality and other hydrological factors such as flow velocity and water depth on fish, also result in a similar spatial variation. Consideration of both demands on the hydrological factors and the water quality environmental factors makes the integrated water quality method more practical, particularly in developing regions with excessive pollutant discharge into rivers. In addition, spatial variation in the hydrological and water quality factors influenced the presence of principal fish species and consequently affected the e-flows. Of the 37 water quality factors identified, water transparency had a negative impact on e-flow because the increase in transparency could reduce the number of principal fish species. Of the four hydrological factors, flow velocity and river width had positive impacts on fish because the increase in flow velocity can provide breeding sites and habitats for more fish, respectively, both of which result in increases in the numbers of principal fish species. We found that spatial variation in the hydrology and water quality factors had a profound impact on the living environments of aquatic organisms; negative changes in these factors lowered the survival probability of principal species, which changed the hierarchy and structure of the ecosystems and thus led to variation in e-flows. The results can provide priori knowledge for e-flow methods selection and a reference for ecosystem restoration helping improve the success rate of project elsewhere in the world.

Curcumin inhibits hypoxia inducible factor-1α-induced inflammation and apoptosis in macrophages through an ERK dependent pathway

OBJECTIVE

Atherosclerosis, a kind of peripheral arterial disease with chronic inflammation, leads to the dysfunction of the vascular system and many other diseases. Hypoxia has been proven to participate in the progression of atherosclerosis, while curcumin can inhibit hypoxia-inducible factor 1α (HIF-1α). However, the underlying mechanisms are still elusive.

PATIENTS AND METHODS

qRT-PCR was used to examine the expression of HIF-1α, IL-6 and TNFα of macrophages under hypoxic condition. Western blot was applied to examine the changes of HIF-1α, ERK and p-ERK after treatment with curcumin. Oli Red O staining and enzymatic assay were used to examine the lipid and total cholesterol in macrophages, respectively. ELISA was used to examine the release of IL-6 and TNFα by macrophages. FACS and MTT assays were applied to examine the apoptosis and proliferation of macrophages.

RESULTS

Here, we found curcumin inhibited the expression of HIF-1α at the protein level in macrophages under hypoxic condition and curcumin and HIF-1α inhibitors repressed the total cholesterol and lipid level in macrophage under hypoxic condition. Moreover, curcumin also decreased the expression of HIF-1α downstream genes, VEGF, HMOX1, ROS and PDGF. Then, the data show the HIF-1α-induced apoptosis and inflammation of macrophages were inhibited by curcumin. Curcumin also rescued the proliferation defect of macrophages caused by hypoxia. Furthermore, we found it inhibited the expression of HIF-1α via ERK signaling pathway.

CONCLUSIONS

We describe that curcumin inhibited the HIF-1α-induced apoptosis and inflammation of macrophages via ERK signaling pathways. These results suggest curcumin can be used for the treatment of atherosclerosis.

[Effects of long non-coding RNA FLJ37505 on the proliferation and migration of bladder cancer cells]

Objective: To examine the expression of long-chain non-coding RNA (lncRNA) FLJ37505 in bladder cancer tissues and cell lines, and to analyze the molecular mechanism of FLJ37505 to inhibit the proliferation and migration of bladder cancer cells. Methods: Quantitative Real-time PCR(qPCR) was used to analyze the relative expression of FLJ37505 in 63 cases of bladder cancer tissues and bladder cancer cell lines (T24, J82, 5637, BIU-87 and UM-UC-3). The bladder cancer cell lines with the least expression of FLJ37505 were divided into control group (transfected with blank plasmid) and FLJ37505 group (transfected with a plasmid carrying the FLJ37505 sequence) according to random number method. MTS assay and scratch assay were used to detect the effect of up-regulation of FLJ37505 expression on cell proliferation and migration. Bioinformatics predicts the target gene of FLJ37505. The dual luciferase reporter system detects the binding of FLJ37505 to the target gene. qPCR and Western blot were used to detect the effect of FLJ37505 on the expression of target gene. Results: Compared with adjacent tissues, FLJ37505 expression was lower in bladder cancer tissue [(4.90±0.79) vs (0.89±0.28), P<0.05]. Compared with human normal bladder tubular epithelial cells, the expression of FLJ37505 was lower in bladder cancer cell lines (P<0.05), and FLJ37505 has the lowest expression in UM-UC-3 cells (P<0.01). Compared with the control group, the expression of FLJ37505 in UM-UC-3 cells of FLJ37505 group was higher [(0.79±0.04) vs (9.92±1.17), P<0.01]. Compared with the control group, the proliferation ability of UM-UC-3 cells in FLJ37505 group was inhibited (P<0.05), and the cell migration ability was also inhibited (P<0.01). Bioinformatics showed that the target gene of FLJ37505 is miR-203a-3p, and the target gene of miR-203a-3p is inositol polyphosphate 4-phosphatase typeⅡ (INPP4B). The dual luciferase reporter gene system showed that FLJ37505 could complement the miR-203a-3p (P<0.01), and miR-203a-3p could complement the INPP4B mRNA (P<0.01). Compared with the control group, the expression of miR-203a-3p was lower [(1.00±0.05) vs (0.20±0.02), P<0.01], the expression of INPP4B in mRNA and protein levels of UM-UC-3 cells in FLJ37505 group was significantly increased (all P<0.01). Conclusions: The expression of FLJ37505 was significantly decreased in bladder cell carcinoma and bladder cancer cells. Up-regulation of FLJ37505 significantly inhibits the proliferation and migration of bladder cell carcinoma UM-UC-3 cells, and the mechanism might be up-regulating the expression of the INPP4B gene by adsorbing miR-203a-3p.

O-GlcNAcylation promotes malignant phenotypes of bladder cancer cells

O-GlcNAcylation (O-GlcNAc) is a posttranslational modification that is mediated by O-GlcNAc-transferase (OGT) and reversed by O-GlcNAcase (OGA). Increasing evidence indicates that protein O-GlcNAcylation is increased in various types of cancer. In the present study, we aimed to evaluate the expression and function of both OGT and OGA in bladder cancer cells in vitro and in vivo. Expression data of OGT and OGA at the mRNA level was obtained from the Oncomine database. Effects of OGT and OGA on cell proliferate, invasive, and migratory abilities were assessed using MTT, wound healing, cell invasive assay, and cell cycle analysis. In vivo assay was also performed in nude mice. The results revealed that the expression of OGT in bladder cancer tissues was higher than that of normal tissues, while the OGA level was found to be lower in cancer tissues. We also found that knockdown of OGT could inhibit cell proliferation, migration, invasion, and induce cell cycle arrest, while these are reversed when OGA is inhibited. We also observed that O-GlcNAcylation could promote tumor formation in vivo, compared with a negative control. In summary, this study describes the oncogenic role of O-GlcNAcylation in bladder cancer cells.

Central vein sign for multiple sclerosis: A systematic review and meta-analysis

AIMS

To systematically review the diagnostic value of the central vein sign (CVS) in multiple sclerosis (MS) and to meta-analyse the proportion of positive lesions for CVS needed to distinguish MS from non-MS mimics.

MATERIALS AND METHODS

A literature review was performed and a proportion meta-analysis was performed to examine the proportion of the CVS in MS lesions. Studies reporting a threshold of the CVS containing lesions with 100% diagnostic accuracy were included in the meta-analysis. This was compared to MS mimics in order to establish the discriminative value of the CVS.

RESULTS

The CVS was found to be viable at lower field strengths (3 T and 1.5 T) and automated analysis is currently less accurate than manual counting. Five studies were included for the proportional meta-analysis. From the analysis, a proportion of 45% of lesions having the CVS was suggested given that the findings that the weighted proportion was 46.4% (95% confidence interval [CI]: of 40.3%-52.6%) with low heterogeneity (I² = 0.0%; p=0.5).

CONCLUSION

Although the CVS is a clinically relevant and viable sign, further work is needed to integrate this into the existing diagnostic criteria. As manual determination is a time-consuming process, the development of automated methods will be beneficial. With improvements in computational imaging techniques, the CVS will have an important role in the diagnosis and differentiation of MS.

Impact of spatial variations in water quality and hydrological factors on the food-web structure in urban aquatic environments

Global aquatic ecosystems are essential to human existence and have deteriorated seriously in recent years. Understanding the influence mechanism of habitat variation on the structure of the food-web allows the effective recovery of the health of degraded ecosystems. Whereas most previous studies focused on the selection of driving habitat factors, the impact of habitat variation on the food-web structure was rarely studied, resulting in the low success rate of ecosystem restoration projects globally. This paper presents a framework for exploring the effects of spatial variations in water quality and hydrological habitat factors on the food-web structure in city waters. Indices for the evaluation of the food-web structure are first determined by integrating model-parameter extraction via literature refinement. The key water quality and hydrological factors are then determined by coupling canonical correspondence analysis with partial least squares regression. Their spatial variation is investigated using spatial autocorrelation. Finally, fuzzy clustering is applied to analyze the influence of the spatial variations in water quality and hydrological factors on the food-web structure. The results obtained in Ji'nan, the pilot city of water ecological civilization in China, show that the Shannon diversity index, connectance index, omnivory index, and the ratio of total primary production to the total respiration are important indicators of food-web structural change. They show that the driving factors affecting the aquatic food-web structure in Ji'nan are hydrological factors (e.g., river width, water depth, and stream flow), physical aspects of water quality (e.g., air temperature, water temperature, electrical conductivity, and transparency), and chemical aspects (e.g., potassium, dissolved oxygen, calcium, and total hardness). They also show that the stability of the food-web is more prone to spatial variations in water quality than in hydrological factors. Higher electrical conductivity, potassium, total hardness, and air temperature lead to deteriorated food-web structures, whereas better transparency improves structure and stability. We found that water and air temperature are the most important factors in the spatial variation of the food-web structure in the study area, followed by total hardness. Transparency is the least important factor. Large disparities and varied spatial distributions exist in the driving effects of water quality and hydrological factors across regions attributable to differences in geographical environments, water salinity (fresh vs. sea water), and environmental factors (e.g., water pollution). The above methods and results serve as a theoretical and scientific basis for a high success rate of aquatic ecosystem restoration projects in the study area and other cities worldwide.

[Efficacy and safety of domestic dasatinib as second-line treatment for chronic myeloid leukemia patients in the chronic phase]

目的

探讨国产酪氨酸激酶抑制剂（TKI）达沙替尼（商品名：依尼舒）二线治疗慢性髓性白血病慢性期（CML-CP）患者的疗效及安全性。

方法

回顾性分析2016年3月至2018年7月湖北省CML协作组成员医院收治的二线服用国产达沙替尼的CML-CP患者的病例资料，统计患者治疗3、6和12个月时最佳反应率、累积完全细胞遗传学反应（CCyR）率、累积主要分子学反应（MMR）率、无进展生存（PFS）、无事件生存（EFS）情况及不良反应情况。

结果

共纳入83例CML-CP患者，中位随访时间为23（4~45）个月，达沙替尼治疗3、6、12个月最佳反应率分别为77.5%（54/71）、72.6%（61/75）、60.7%（51/69）。至随访截止，累积CCyR率、MMR率分别为65.5%（55/80）、57.1%（48/73），达CCyR和MMR的中位时间均为3个月。随访时间内，PFS率为94.0%（79/83），EFS率为77.4%（65/83）。国产达沙替尼最常见非血液学不良反应为水肿（32.5%），其次为皮疹瘙痒（18.1%）、乏力（13.3%），血液学不良反应主要有血小板减少（31.3%）、白细胞减少（19.3%）和贫血（6.0%）。

结论

国产达沙替尼二线治疗CML-CP患者具有较好的疗效及安全性，可作为CML-CP患者的治疗选择。

Predicting future river health in a minimally influenced mountainous area under climate change

It has been shown that climate change impacts the overall health of a river's ecosystem. Although predicting river health under climate change would be useful for stakeholders to adapt to the change and better conserve river health, little research on this topic exists. This paper presents a methodology predicting river health under different climate change scenarios. First, a multi-source, distributed, time-variant gain hydrological model (MS-DTVGM) was used to predict the runoff from a mountainous river in eastern China using the data from three existing IPCC5 climate change models (RCP2.6, RCP4.5, and RCP8.4). Next, a model was developed to predict the river's water quality under these scenarios. Finally, a multidimensional response model utilizing hydrology, water quality, and biology was used to predict the river's biological status and ascertain the impact of climate change on its overall health. The river is in a mountainous area near Jinan City, one of China's first "pilot" cities recognized as a "healthy water ecological community." Our results predict that the overall health of the Yufu River, which is minimally influenced by human activities, will improve by 2030 due to the increased river flow due to an increase in rainfall frequency and subsequent peak runoff. However, the total nitrogen concentration is predicted to increase, which is a potential eutrophication risk. Therefore, effective control of nitrogen pollutants entering the river will be necessary. The increase in flow velocity (the annual average increase is ~0.5 m/s) is favorable for fish reproduction. Our methods and results will provide scientific guidance for policy makers and river managers and will help people to better understand how global climate change impacts river health.

Abstract P6-03-05: Not presented

This abstract was not presented at the conference.

Citation Format: Guangping L, Wei L, Xiang H, Shidai J, Dengshun M, Ziyi F, Jinhai T, Yongmei Y. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-03-05.

Abstract P1-18-03: Phase I trial to assess the safety, pharmacokinetics and pharmacodynamics of receptor activator of nuclear factor-κB ligand inhibitor (TK006) in patients with bone metastases from breast cancer

Background

Within the bone microenvironment, tumor cells secrete factors that stimulate osteoblasts to express and secrete receptor activator of nuclear factor-κB ligand (RANKL), which binds to its receptor RANK on the surface of osteoclasts, thus enhancing the osteoclast-mediated bone resorption and promoting skeletal complications.TK006 is a fully human monoclonal antibody that binds and inhibits RANKL, thus inhibiting osteoclast-mediated bone destruction.

Objective

To investigate the safety, pharmacokinetics and pharmacodynamics of TK006 in patients with bone metastases from breast cancer.

Patients and methods

In this dose-escalating study, patients were sequentially enrolled into 60 mg, 120 mg, 180 mg single-dosing and 120 multiple-dosing cohorts. Before making dose escalation decision, the safety of TK006 during the 14-day period after dosing in the prior cohort must be confirmed. In the three single-dosing cohorts, patients were followed up for 16 weeks after dosing. In the 120 mg multiple-dosing cohort, patents were treated with 120 mg TK006 every 4 weeks for 3 times totally, and followed up for 20 weeks after the first dosing. The primary outcome was safety profile, and the secondary outcomes were pharmacokinetics, pharmacodynamics and immunogenicity. Pharmacodynamics was measured by level of serum bone alkaline phosphatase (BALP) and urine creatinine corrected cross-linked N-telopeptides of type I collagen (uNTX/Cr).

Patients aged 18 to 65 years with breast cancer related bone metastasis were eligible. It was planned to enroll 10 subjects in each cohort for a total sample size of 40 subjects.

Result

As of May 24 2018, the common adverse events (AEs) related to treatment (≥10%) included: hypocalcemia (25.0%), limbs pain (20.0%), gamma-glutamyl transferase increased (17.5%), lactate dehydrogenase increased (12.5%), alpha-hydroxybutyric dehydrogenase increased (12.5%), aspertate aminotransferase increased (12.5%), alanine aminotransferase (10.0%),osphyalgia (10.0%) toothache (10.0%) and hypertriglyceridemia (10%). Most adverse reactions were mild or moderate except one case of grade 3 hypertriglyceridemia and two cases of grade 3 gamma-glutamyl transferase increasement. No esteonecrosis of the jaw or treatment-related SAE was reported.

In the 60 mg single-dosing cohort, a significant reduction in median uNTX/Cr was observed as early as day 1, the nadir of median uNTX/Cr was reach at day 28 and started to return towards the baseline level at day 112 (Table 1).

Only modest decreasing from baseline in median bone-specific alkaline phosphatase was observed.

Table 1.Effects of 60 mg TK006 therapy on bone turnover markers uNTX/Cr, % change from baseline, medianBALP , % change from baseline, medianD1-38.6-4.7D7-63.01.7D14-55.30.2D28-69.2-0.2D56-57.9-12.1D84-33.4-0.4D1121.3-18.7

Ostalgia was measured by visual analogue scale (VAS). In the 60 mg single-dosing cohort, scores were reduced to 2 from 5 and 3 in two patients individually. No increasing in pain was observed in the remaining 8 patients.

Conclusion

These results suggested a potential therapeutic role for TK006 in patients with bone metastases from breast cancer.

Citation Format: Mei YY, Hai TJ, Wei L, Xiang H, Hao W, Ming ZX, An LX. Phase I trial to assess the safety, pharmacokinetics and pharmacodynamics of receptor activator of nuclear factor-κB ligand inhibitor (TK006) in patients with bone metastases from breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-18-03.

Significant association between paraoxonase 1 rs662 polymorphism and coronary heart disease : A meta-analysis in the Chinese population

BACKGROUND

A growing number of studies have suggested that the single nucleotide polymorphism (SNP) rs662 (G>A) in paraoxonase 1 (PON1) is significantly associated with susceptibility to coronary heart disease (CHD) in the Chinese population. To further evaluate the effects of the PON1 RS662 (G>A) polymorphism on the risk of CHD, we performed a meta-analysis in a Chinese population.

METHODS

PubMed, Embase, Wanfang Data, Chinese National Knowledge Infrastructure (CNKI) were searched to identify eligible studies. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the strength of the associations between RS662 (G>A) and CHD.

RESULT

In the meta-analysis, we identified 14 articles, including a total of 4835 CHD patients and 5111 controls in the Chinese population. Our result showed that overall rs662 (G>A) was significantly associated with susceptibility to CHD in the Chinese population when compared with healthy controls. Furthermore, a G allele suggested an elevated risk of CHD. In the subgroup analyses stratified by ethnicity and geographic areas, significant associations were found in Chinese Han and South China, but not in North China.

CONCLUSION

The present meta-analysis suggests that rs662 (G>A) SNP in PON1 is associated with CHD risk; the G allele might be the risk allele for CHD susceptibility in the Chinese population. However, more research is required to make a definite conclusion.

Widespread white matter microstructural differences in schizophrenia across 4322 individuals: results from the ENIGMA Schizophrenia DTI Working Group

The regional distribution of white matter (WM) abnormalities in schizophrenia remains poorly understood, and reported disease effects on the brain vary widely between studies. In an effort to identify commonalities across studies, we perform what we believe is the first ever large-scale coordinated study of WM microstructural differences in schizophrenia. Our analysis consisted of 2359 healthy controls and 1963 schizophrenia patients from 29 independent international studies; we harmonized the processing and statistical analyses of diffusion tensor imaging (DTI) data across sites and meta-analyzed effects across studies. Significant reductions in fractional anisotropy (FA) in schizophrenia patients were widespread, and detected in 20 of 25 regions of interest within a WM skeleton representing all major WM fasciculi. Effect sizes varied by region, peaking at (d=0.42) for the entire WM skeleton, driven more by peripheral areas as opposed to the core WM where regions of interest were defined. The anterior corona radiata (d=0.40) and corpus callosum (d=0.39), specifically its body (d=0.39) and genu (d=0.37), showed greatest effects. Significant decreases, to lesser degrees, were observed in almost all regions analyzed. Larger effect sizes were observed for FA than diffusivity measures; significantly higher mean and radial diffusivity was observed for schizophrenia patients compared with controls. No significant effects of age at onset of schizophrenia or medication dosage were detected. As the largest coordinated analysis of WM differences in a psychiatric disorder to date, the present study provides a robust profile of widespread WM abnormalities in schizophrenia patients worldwide. Interactive three-dimensional visualization of the results is available at www.enigma-viewer.org.

Impact of Admission Imaging Findings on Neurological Outcomes in Acute Cervical Traumatic Spinal Cord Injury

Variable and unpredictable spontaneous recovery can occur after acute cervical traumatic spinal cord injury (tSCI). Despite the critical clinical and interventional trial planning implications of this tSCI feature, baseline measures to predict neurologic recovery accurately are not well defined. In this study, we used data derived from 99 consecutive patients (78 male, 21 female) with acute cervical tSCIs to assess the sensitivity and specificity of various clinical and radiological factors in predicting recovery at one year after injury. Categorical magnetic resonance imaging parameters included maximum canal compromise (MCC), maximum spinal cord compression (MSCC), longitudinal length of intramedullary lesion (IML), Brain and Spinal Injury Center (BASIC) score, and a novel derived Combined Axial and Sagittal Score (CASS). Logistic regression analysis of the area under the receiver operating characteristic curve (AUC) was applied to assess the differential predictive value of individual imaging markers. Admission American Spinal Injury Association Impairment Scale (AIS) grade, presence of a spinal fracture, and central cord syndrome were predictive of AIS conversion at one year. Both BASIC and IML were stronger predictors of AIS conversion compared with MCC and MSCC (p = 0.0002 and p = 0.04). The BASIC score demonstrated the highest overall predictive value for AIS conversion at one year (AUC 0.94). We conclude that admission intrinsic cord signal findings are robust predictive surrogate markers of neurologic recovery after cervical tSCI. Direct comparison of imaging parameters in this cohort of patients indicates that the BASIC score is the single best acute predictor of the likelihood of AIS conversion.

The haemtrack home therapy reporting system: Design, implementation, strengths and weaknesses: A report from UK Haemophilia Centre Doctors Organisation

INTRODUCTION

Haemtrack is an electronic home treatment diary for patients with inherited bleeding disorders, introduced in 2008. It aimed to improve the timeliness and completeness of patient-reported treatment records, to facilitate analysis of treatment and outcome trends. The system is easy to use, responsive and accessible.

METHODS

The software uses Microsoft technologies with a SQL Server database and an ASP.net website front-end, running on personal computers, android and I-phones. Haemtrack interfaces with the UK Haemophilia Centre Information System and the National Haemophilia Database (NHD). Data are validated locally by Haemophilia Centres and centrally by NHD. Data collected include as follows: treatment brand, dose and batch number, time/date of bleed onset and drug administration, reasons for treatment (prophylaxis, bleed, follow-up), bleed site, severity, pain-score and outcome.

RESULTS

Haemtrack was used by 90% of haemophilia treatment centres (HTCs) in 2015, registering 2683 patients using home therapy of whom 1923 used Haemtrack, entering >17 000 treatments per month. This included 68% of all UK patients with severe haemophilia A. Reporting compliance varied and 55% of patients reported ≥75% of potential usage. Centres had a median 78% compliance overall. A strategy for progressively improving compliance is in place. Age distribution and treatment intensity were similar in Haemtrack users/non-users with severe haemophilia treated prophylactically.

CONCLUSION

The Haemtrack system is a valuable tool that may improve treatment compliance and optimize treatment regimen. Analysis of national treatment trends and large-scale longitudinal, within-patient analysis of changes in regimen and/or product will provide valuable insights that will guide future clinical practice.

Dendritic Cells from Rheumatoid Arthritis Patient Peripheral Blood Induce Th17 Cell Differentiation via miR-363/Integrin αv/TGF-β Axis

Dendritic cells (DCs) are critical regulators of immune responses. This study was to observe the effect of DCs from peripheral blood on the differentiation of Th17 in patients with rheumatoid arthritis (RA). Peripheral blood samples were collected from 30 patients with RA and 20 healthy controls, respectively. Flow cytometry results showed that in contrast to Treg cells, the proportion of Th17 cells in T cells and the Th17/Treg ratio were both increased in patients with RA. The RT-PCR results showed that Foxp3、ROR γt and miR-363 expression in PBMC of patients with RA were reduced, but the ITGAV expression was increased, which was negatively related to miR-363 expression. IL-17, TGF-β and IL-6 levels detected by ELISA were increased in peripheral blood serum of patients with RA. Moreover, we noted that the CD11C⁺ αν⁺ /CD11C⁺ DCs ratio was obvious increased in patients with RA and has positive correlation to the Th17/Treg ratio. In cocultured system, Th17 cell differentiation was significantly inhibited in the presence of ITGF-β suggesting that Th17 cell differentiation was controlled by active TGF-β (aTGF-β). After DCs transfecting with miR-363 mimics and cocultured with T cells, Th17 cell number, IL-17 level and ROR-γt expression were significantly reduced in the presence of latent TGF-β (ITGF-β). In addition, the integrin αv protein expression was both reduced in the presence of aTGF-β or ITGF-β. These data demonstrated that DCs induced Th17 cell differentiation through miR-363/Integrin αv/TGF-β pathway in patients with RA.

[Application of adjacent micro flap in the repair of skin defect in head and face]

Objective:The aim of this study is to sum up the different surgical repair methods and techniques for the skin defect of head and face.Method:A retrospective study on 97 cases of the face and head skin defect caused by trauma and tumor resection in nearly five years, including 37 cases on nasal, 21 cases on cheek, 9 cases on frontal, 13 cases on temporal, and 17 cases on ear. After resecting skin lesion in security boundary, skin defect were repaired by transposition adjacent flap, zone vascular pedicle flap, myocutaneous flap and the mucosal flap.Result:Seventy-one cases of the postoperative flap healed and stitches discharged in a week; 24 cases of flap edge small necrosis in small, one flap occurred most necrosis, and one skin flap occurred infection and necrosis.Conclusion:Facial skin defect can be repaired primarily by various types of micro adjacent flap. Flap survival is closely related to surgical techniques and postoperative treatment. Retroauricular groove flap has been widely used to repair skin defect of multiple regions for ear.

Aspartate β-hydroxylase disrupts mitochondrial DNA stability and function in hepatocellular carcinoma

The mechanism of aberrant mitochondrial genome and function in hepatocellular carcinoma (HCC) remains largely unknown. Our previous study demonstrated an increased expression of aspartate β-hydroxylase (ASPH) in HCC tissues, which was associated with tumor invasiveness and a worse prognosis. Currently, we unexpectedly observed the presence of ASPH in purified mitochondrial protein fraction. In addition, immunostaining of both exogenously and endogenously expressed ASPH showed a colocalization with mitochondrial biomarkers. This study aimed to investigate whether the mitochondrial ASPH is involved in mitochondrial malfunction in HCC. Our results showed that ASPH overexpression in HCC tissues was correlated with decreased copy numbers of displacement loop (D-loop) and NADH dehydrogenase subunit 1 (ND-1) and enhanced D-loop mutation, suggesting the disrupted mitochondrial DNA (mtDNA) stability. The reduced mtDNA copy numbers were associated with aggressive clinicopathological features of HCC. The loss of mtDNA integrity induced by enforced expression of ASPH was accompanied with mitochondrial dysfunction, which was characterized by the aberrant mitochondrial membrane potential, decreased ATP generation and enhanced reactive oxygen species. In contrast, knocking down ASPH by siRNA in HCC cell lines showed the opposite impact on mtDNA integrity and function. Mass spectrometry and co-immunoprecipitation further identified that ASPH interacted with histone H2A member X (H2AX). ASPH overexpression diminished the interaction between H2AX and mitochondrial transcription factor A (mtTFA), an important DNA-binding protein for mtDNA replication, which then reduced the binding of mtTFA to D-loop region. Collectively, our results demonstrate that ASPH overexpression disrupts the mtDNA integrity through H2AX-mtTFA signal, thereby affecting mitochondrial functions in HCC.

Traumatic Brain Injuries Associated With Consumer Products at Home Among US Children Younger Than 5 Years of Age

This study investigated the epidemiology of traumatic brain injuries (TBIs) occurring to young children, associated with consumer products at home in the United States. Data from the National Electronic Injury Surveillance System were analyzed. There were an estimated 2 292 896 (95% CI = 1 707 891-2 877 900) children <5 years of age treated in US emergency departments for a TBI associated with a consumer product at home during 1991-2012, which equals an annual average of 104 223 (95% CI = 77 631-130 814) children. During the 22-year study period, the number and rate of TBIs increased significantly by 283.3% (estimated annual rate of change, m = 7182.6; P < .001) and 266.5% ( m = 0.35; P < .001), respectively. The number of TBIs decreased with increasing age of the child. Falls from household products were the leading mechanism of injury (53.7%). To our knowledge, this is the first nationally representative study of TBIs associated with consumer products at home among young children. These findings underscore the need for increased prevention efforts.

Study on the mechanism of AMPK signaling pathway and its effect on apoptosis of human hepatocellular carcinoma SMMC-7721 cells by curcumin

OBJECTIVE

Liver cancer is a common malignant tumor in the digestive system. Curcumin is a kind of phenolic pigment, which is extracted from herbage and has a plenty of physiological roles in anti-inflammation, anti-oxidation and anti-tumor. In our study, human hepatoma SMMC-7721 cell lines were selected and treated with curcumin to detect its effects on the apoptosis and AMPK signaling pathway.

MATERIALS AND METHODS

Human liver cancer cell strain SMMC-7721 was cultured and treated with different curcumin concentrations for different times followed by measuring the changes of cell proliferation activity and cycle by MTT and flow cytometry, respectively. Protein expression of Bcl-2, Bax and Caspase-3 were tested by Western blot, and the activation level of AMPK was also detected.

RESULTS

Different concentrations of curcumin could inhibit the proliferation of tumor cells in a dose-dependent manner. After 48 h inhibition by curcumin with a concentration of 40 mmol/L, the inhibitory effect was more obvious with statistically significant (p<0.05). The number of human liver cancer SMMC-7721 cells increased in G1 stage and decreased in S stage after treated with different concentrations of curcumin. During the G1 stage to the S stage, inhibition occurred and the effect of curcumin intervention group with 40 mmol/L was more evident than that of 10 mmol/L group, 20 mmol/L group and the control group with statistically significant (p<0.05). SMMC-7721 cell stains had been intervening by curcumin with concentrations of 10 mmol/L, 20 mmol/L and 40 mmol/L for 12 h, 24 h and 48 h, as the drug concentration increased, the reaction time prolonged, the protein expressions of Bcl-2 and Survivin were significantly decreased and Bax protein expression was significantly increased (p<0.05).

CONCLUSIONS

Curcumin decreased the proliferation activity of tumor cells, increased the cell quantities in G1 stage and decreased the cell numbers in S stage in human liver cancer SMMC-7721 cells. The Bcl-2 and Survivin proteins were downregulated and Bax protein was upregulated; furthermore, the AMPK signaling pathway was activated.

Road traffic crashes among farm vehicle drivers in southern China: A cross-sectional survey

OBJECTIVE

The objective of this study was to identify the prevalence and potential risk factors of farm vehicle-related road traffic crashes among farm vehicle drivers in southern China.

METHODS

A cross-sectional study was used to interview 1,422 farm vehicle drivers in southern China. Farm vehicle-related road traffic crashes that occurred from December 2013 to November 2014 were investigated. Data on farm vehicle-related road traffic crashes and related factors were collected by face-to-face interviews.

RESULTS

The prevalence of farm vehicle-related road traffic crashes among the investigated drivers was 7.2%. Farm vehicle-related road traffic crashes were significantly associated with self-reported vision problem (adjusted odds ratio [AOR] = 6.48, 95% confidence interval [CI], 3.86-10.87), self-reported sleep disorders (AOR = 10.03, 95% CI, 6.28-15.99), self-reported stress (AOR = 20.47, 95% CI, 9.96-42.08), reported history of crashes (AOR = 5.40, 95% CI, 3.47-8.42), reported history of drunk driving (AOR = 5.07, 95% CI, 2.97-8.65), and reported history of fatigued driving (AOR = 5.72, 95% CI, 3.73-8.78). The number of road traffic crashes was highest in the daytime and during harvest season. In over 96% of farm vehicle-related road traffic crashes, drivers were believed to be responsible for the crash. Major crash-causing factors included improper driving, careless driving, violating of traffic signals or signs, and being in the wrong lane.

CONCLUSION

Findings of this study suggest that farm vehicle-related road traffic crashes have become a burgeoning public health problem in China. Programs need to be developed to prevent farm vehicle-related road traffic crashes in this emerging country.

Outcomes of standard dose EC-MPS with low exposure to CsA in DCD renal transplantation recipients with DGF

AIMS

The lower limit of exposure to cyclosporine A (CsA) has not yet been established in donation after cardiac death (DCD) renal transplantation recipients with delayed graft function (DGF) receiving enteric-coated mycophenolate sodium (EC-MPS) therapy. Stable and adequate mycophenolic acid (MPA) dosing may facilitate lower CsA exposure after DCD renal transplantation in recipients with DGF without compromising safety.

METHODS

A 12-month, single-centre open-label prospective trial was performed in our centre. According to their DGF risk index using the previous DGF prediction models, we divided up the patients on oral CsA into either a DGF group (n = 26) and no DGF group (n = 48). All of the patients initially received the standard EC-MPS dosing (1440 mg/day). The initial dose of CsA in the low risk of DGF group was 4.5 mg/kg/day and in the high risk of DGF group was 2.5 mg/kg/day. Efficacy parameters, safety and tolerability were assessed over a 12-month study period.

RESULTS

The incidence of DGF was 18.5% in the 162 DCD recipients. Between the DGF group and the no DGF group, the 1-year patient survival and graft survival were not significantly different. The incidence of BPAR was higher in the DGF group (26.9% vs. 8.3%, p = 0.032). Most patients in the DGF group had recovery of renal function after 1 month. The adverse events between the two groups were not significantly different. The daily EC-MPS doses of the DGF group were significantly higher than the no DGF group before the 6-month follow-up period. There were no significant differences between the two groups regarding the mean AUC levels during the follow-up period.

CONCLUSIONS

These results show that low expose CsA with standard dosing of EC-MPS and thymoglobulin was efficacious, safe and well-tolerated in DCD renal transplant recipients with DGF in China. Furthermore, stable and adequate MPA exposure helped to reduce the dose of and exposure to CsA. Thus, this may lead to less-induced nephrotoxicity and better renal function recovery.

Emergency medical services (EMS) versus non-EMS transport among injured children in the United States

OBJECTIVES

This study aimed to assess the proportions of injured children transported to trauma centers by different transportation modes and evaluate the effect of transportation mode on inter-facility transfer rates using the US national trauma registry.

METHODS

We analyzed data from the 2007-2012 National Trauma Data Bank (NTDB) to study trends of EMS versus non-EMS transport. Multivariable logistic regression was used to evaluate the association between transport mode and inter-facility transfer.

RESULTS

There were 286,871 pediatric trauma patients in the 2007-2012 NTDB; 45.8% arrived by ground ambulance, 8.6% arrived by air ambulance, and 37.5% arrived by non-EMS. From 2007 to 2012, there was no significant change in transportation mode. Moderate to severely injured patients (ISS>15) comprised 13.3% of arrivals by ground ambulance, 26.7% of arrivals by air ambulance, and 8.3% of arrivals by non-EMS; those who used EMS were significantly less likely to be transferred to another facility than patients who used non-EMS transport. Moderate and severe pediatric patients arriving by non-EMS to adult trauma centers were more often transferred than those arriving at mixed trauma centers (45.8% and 6.8%, respectively).

CONCLUSIONS

Over one third of US pediatric trauma patients used non-EMS transport to arrive at trauma centers. Moderate to severely injured children benefit from EMS transport and professional field triage to reach the appropriate trauma facility. Our study suggests that national efforts are needed to increase awareness among parents and the general public of the benefits of EMS transportation and care.

Soccer-Related Injuries Treated in Emergency Departments: 1990-2014

OBJECTIVE

To investigate the epidemiology of youth soccer-related injuries treated in emergency departments in the United States.

METHODS

A retrospective analysis was conducted of soccer-related injuries among children 7 through 17 years of age from 1990 through 2014 with data from the National Electronic Injury Surveillance System. Injury rates were calculated from soccer participation data.

RESULTS

An estimated 2 995 765 (95% confidence interval [CI], 2 309 112-3 682 418) children 7 through 17 years old were treated in US emergency departments for soccer-related injuries during the 25-year study period, averaging 119 831 (95% CI, 92 364-147 297) annually. The annual injury rate per 10 000 soccer participants increased significantly, by 111.4%, from 1990 to 2014. Patients 12 to 17 years old accounted for 72.7% of injuries, 55.5% of patients were male, and most injuries occurred in a place of sport or recreation (68.5%) or school (25.7%). Struck by (38.5%) and fell (28.7%) were the leading mechanisms of injury. Injuries most commonly were diagnosed as sprain or strain (34.6%), fracture (23.2%), and soft tissue injury (21.9%), and occurred to the upper extremity (20.7%), ankle (17.8%), and head or neck (17.7%). Concussions or other closed head injuries accounted for 7.3% of the injuries, but the annual rate of concussions/closed head injuries per 10 000 participants increased significantly, by 1595.6%, from 1990 to 2014.

CONCLUSIONS

This study is the first to comprehensively investigate soccer-related injuries and calculate injury rates based on soccer participation data among children at the national level. The increasing number and rate of pediatric soccer-related injuries, especially soccer-related concussions/closed head injuries, underscore the need for increased efforts to prevent these injuries.

Holocord spinal epidural abscess: Case report and literature review

Holocord spinal epidural abscess (SEA) is a rare condition. To our knowledge, five cases of SEA have been reported so far, and no consensus has been made on the treatment yet. In this article, we report a case of holocord SEA and review literature to further understanding of SEA. The advent of antibiotic treatment and the recognition of surgical debridement have been important in searching for alternatives to recovery, so the patient was treated surgically together with systemic antibiotics. The patient remained neurologically stable and continued to be clinically in good condition without any low back pain after 1 year. Surgical drainage, together with systemic antibiotics, is the main treatment choice for extensive SEAs. Although treatment should be considered that highlights the importance of examining the factors related to the health and condition of the patients and the anatomy and extent of the abscess, early surgical treatment associated with prolonged antibiotic treatment is necessary.

Inter-facility transfer of pediatric burn patients from U.S. Emergency Departments

PURPOSE

To describe the epidemiology of pediatric burn patients seen in U.S. emergency departments (EDs) and to determine factors associated with inter-facility transfer.

METHODS

We analyzed data from the 2012 Nationwide Emergency Department Sample. Current American Burn Association (ABA) Guidelines were used to identify children <18 who met criteria for referral to burn centers. Burn patient admission volume was used as a proxy for burn expertise. Logistic models were fitted to examine the odds of transfer from low volume hospitals.

RESULTS

In 2012, there were an estimated 126,742 (95% CI: 116,104-137,380) pediatric burn ED visits in the U.S. Of the 69,003 (54.4%) meeting referral criteria, 83.2% were in low volume hospitals. Only 8.2% of patients meeting criteria were transferred from low volume hospitals. Of the 52,604 (95% CI: 48,433-56,775) not transferred, 98.3% were treated and released and 1.7% were admitted without transfer; 54.7% of burns involved hands.

CONCLUSIONS

Over 90% of pediatric burn ED patients meet ABA burn referral criteria but are not transferred from low volume hospitals. Perhaps a portion of the 92% of patients currently receiving definitive care in low volume hospitals are under-referred and would have improved clinical outcomes if transferred at the time of presentation.

Age-period-cohort analysis of suicide mortality by gender among white and black Americans, 1983-2012

Background

Previous studies suggested that the racial differences in U.S. suicide rates are decreasing, particularly for African Americans, but the cause behind the temporal variations has yet to be determined. This study aims to investigate the long-term trends in suicide mortality in the U.S. between 1983 and 2012 and to examine age-, period-, and cohort-specific effects by gender and race.

Method

Suicide mortality data were collected from the Web-based Injury Statistics Query and Reporting System (WISQARS) and analyzed with the Joinpoint regression and age-period-cohort (APC) analysis.

Results

We found that although age-standardized rate of suicide in white males, white females, black males, and black females all changed at different degrees, the overall situation almost has not changed since these changes offset each other. By APC analysis, while the age effect on suicide demonstrate an obvious difference between white males and females (with the peak at 75 to 79 for white males and 45 to 54 for white females), young black people are predominantly susceptible to suicide (risk peaks in early 20s for black males and late 20s for black females). Cohort effects all showed a descending trend, except that in white males and females which showed an obvious increase peaked in around cohort 1960. There was a similar period effect trend between different genders in the same race group, but between the races, differences were found in the period before 1990 and after 2000.

Conclusion

We confirmed that the distinction in age-specific suicide rate patterns does exist by gender and by race after controlling for period and cohort effects, which suggested that minorities’ age patterns of suicide may have been masked up by the white people in the whole population. The differences of period effects and cohort effects between white and black Americans were likely to be mainly explained by the difference in race susceptibility to economic depression.

Using Geographic Information Systems (GIS) to Characterize Pediatric Pedestrian Motor Vehicle Accidents in the State of Delaware

BACKGROUND

Pediatric pedestrian motor vehicle-associated of injuries correlated with a particular census tract's trauma is a significant public health concern for children. demographic composition. GIS mapping software was used We aimed to use geographic information systems (GIS) to examine the relationship between motor vehicle pedestrian injuries in children and the demographics of the region in which they occurred for the state of Delaware.

METHODS

This is a retrospective analysis of collected data from the Delaware State Trauma Registry form January 1, 2002, to December 31, 2012. The records of all patients younger than 18 years who went to one of the state's six trauma centers during the study were reviewed. For each injury event, patient demographic information was recorded, and latitude/longitude coordinates of the injury site were determined. Median income, minority population, education level, and percentage of males and children in the census tract were obtained from state census data. Analysis of variance was used to characterize how the frequency of injuries correlated with a particular census tract's demographic composition. GIS mapping software was used to identify specific "hot spots" throughout the state where the examine the relationship between motor vehicle pedestrian frequency of traffic crash events was the highest.

RESULTS

Urban and poorer areas had tile highest number of injury events, with Wilmington having the highest frequency Methods: This is a retrospective analysis of collected data of injuries per capita. Census tracts with low median income, from the Delaware State Trauma Registry from January 1, lack of high school degree, and increased percentage of 2002, to December 31, 2012. The records of all patients African Americans and females had significantly higher injury younger than 18 years who went to one of the state's six counts compared with other census tracts.

CONCLUSIONS

In the state of Delaware, children in urban and poor areas are disproportionately affected by motor vehicle-associated pedestrian injuries. Specific risk factors for accidents in these areas need to be identified to facilitate the development of focused prevention strategies.

Concussion Characteristics in High School Football by Helmet Age/Recondition Status, Manufacturer, and Model: 2008-2009 Through 2012-2013 Academic Years in the United States

BACKGROUND

Football helmets used by high school athletes in the United States should meet the National Operating Committee on Standards for Athletic Equipment performance standards. Despite differences in interior padding and exterior shells, all football helmets should provide comparable protection against concussions. Yet, debate continues on whether differences in the rates or severity of concussions exist based on helmet age/recondition status, manufacturer, or model.

PURPOSE

To investigate whether high school football concussion characteristics varied by helmet age/recondition status, manufacturer, and model.

STUDY DESIGN

Descriptive epidemiological study.

METHODS

High school football concussion and helmet data were collected from academic years 2008-2009 through 2012-2013 as part of the National High School Sports-Related Injury Surveillance Study. The certified athletic trainers of participating schools submitted athlete-exposure (AE) and injury information weekly.

RESULTS

Participating schools reported 2900 football concussions during 3,528,790 AEs for an overall rate of 8.2 concussions per 10,000 AEs. Concussion rates significantly increased from 2008-2009 through 2012-2013 overall (P = .006) as well as in competition (P = .027) and practice (P = .023). Characteristics of concussed football players (ie, mean number of symptoms, specific concussion symptoms, symptom resolution time, and time until return to play) were similar among players wearing new helmets when compared with reconditioned helmets. Fewer players wearing an old/not reconditioned helmet had concussion symptoms resolve within 1 day compared with players wearing a new helmet. Despite differences in the manufacturers and models of helmets worn by all high school football players compared with players who sustained a concussion, the mean number of concussion symptoms, specific concussion symptoms, symptom resolution time, and time until return to play were similar for concussions sustained by football players wearing the most common helmet manufacturers and models.

CONCLUSION

Overall, for new and reconditioned football helmets, the most common helmet manufacturers and models on the market today appear to provide high school football players with similar protection against concussions.

CLINICAL RELEVANCE

Concussions can have serious acute and long-term effects. An understanding of concussion patterns in high school athletes can drive targeted preventive measures, including improvements to and/or better use of protective equipment, to reduce the incidence and/or severity of sports-related concussions.

[Co-overexpression of human tissue kallikrein 1 and human metalloproteinase 1 tissue inhibitor inhibits neointima formation in the rat artery after balloon angioplasty]

OBJECTIVE

To investigate the effects of adenovirus-mediated human tissue kallikrein 1(hTK-1) and/or human tissue metalloproteinase inhibitor 1 (hTIMP-1) gene delivery on the neointima formation in balloon-injured rat carotids and related mechanism.

METHODS

Forty-six male Sprague-Dawley rats were randomly assigned into 6 groups with the random number table: (1) sham-operated group(n=6), (2) angioplasty group (n=8), (3) vector virus group (n=8), (4) hTK-1 group (n=8), (5) hTIMP-1 group (n=8), (6) hTK-1-hTIMP-1 group (n=8). Except sham rats, all rats underwent carotid artery balloon injury and local delivery of saline or different recombined adenoviruses respectively. Rats were sacrificed 14 days later. Intima/media area ratio was assessed on hematoxylin-eosin stained tissue section. Immunofluorescence images stained for hTK-1, hTIMP-1 were obtained and analyzed by the confocal microscope for co-localization examination of hTK-1 and hTIMP-1. The protein expression levels of hTK-1, hTIMP-1, matrix metalloproteinases(MMP)-2 and MMP-9 were determined by Western blot. Immune histochemical staining for PCNA was also performed.

RESULTS

(1)Intima area, intima/media area ratio, PCNA, MMP-2 and MMP-9 levels were all significantly increased in rats underwent angioplasty (did or did not receive vector virus) compared with sham-operated rats (all P<0.01) while above parameters were similar between rats underwent angioplasty or vector virus delivery (all P>0.05). (2) The intima area of rats received vector virus, hTK-1, hTIMP-1 or dual gene transfer were (0.160±0.010), (0.110±0.015), (0.121±0.016) or (0.081±0.008) mm(2) respectively, intima area was similar between rats received hTK-1 or hTIMP-1 (P>0.05), differences were found between other groups (all P<0.01). The intima/media area ratio of rats received vector virus, hTK-1, hTIMP-1 or dual gene transfer were 2.035±0.117, 1.443±0.097, 1.522±0.078 or 0.972±0.072 respectively, no difference was found between rats received hTK-1 or hTIMP-1 in intima/media area ratio (all P>0.05), differences were found between other groups (all P<0.01). The MMP-2 and MMP-9 expression of rats received vector virus, hTK-1, hTIMP-1 or dual gene transfer were 0.817±0.036, 0.606±0.044, 0.571±0.061 or 0.455±0.030 and 0.745±0.057, 0.613±0.038, 0.582±0.050 or 0.473±0.038 respectively, no difference was found between rats received hTK-1 or hTIMP-1 in MMP-2 or MMP-9 expression (all P>0.05), differences were found between other groups (all P<0.01). The PCNA expression of rats received vector virus, hTK-1, hTIMP-1 or dual gene transfer were 0.065±0.007, 0.052±0.004, 0.055±0.007 or 0.031±0.004 respectively, no difference was found between rats received hTK-1or hTIMP-1 in PCNA expression (all P>0.05), differences were found between other groups (all P<0.01).

CONCLUSION

hTK-1 and hTIMP-1 co-overexpression may synergistically inhibit neointimal hyperplasia, attenuate vascular remodeling and reduce restenosis possibly via down regulating the expressions of PCNA, MMP-2 and MMP-9 in balloon-injured rat carotids.

[The pathogenic gene screening in a cardiomyopathy pedigree of Yunnan province]

OBJECTIVE

In this study, the sreening of candidate pathogenic gene is done among family members of an dilated cardiomyopathy(DCM)and hypertrophic cardiomyopathy (HCM) coexistence, and find the relationship between the genotype and the phenotype.

METHODS

The inheritance atlas was drawn, analysis of genetic characteristics and clinical phenotype.Peripheral venous blood samples of proband and family members were candidated gene exon high-throughput sequencing sub target capture, make the result compares with related database, ultimately screening the target area of the exon and mutations of candidate genes and then using bidirectional sequencing of Sanger to sequence other family members and the health group which were matching with gender and age to testify whether there is the above mutations.

RESULTS

In this family, the proband and his father carry three missense mutations, about TTNc.604 A>G(p.Lys202Glu)、TAZ c. 580A>G(p.Ile194Val)and MYH7c.730 T>C(p.Phe244Leu). The heart function of proband was failure, and accompanied malignant arrhythmia.But his father has no obvious clinical symptoms.In this family, the same genetic mutation of disease causing gene lead to different clinical phenotype, but different genetic mutation of disease causing gene lead to the same clinical phenotype.None of the mutations found in this family was found in the health group.

CONCLUSION

The patient of this family carries the genetic mutation of MYH7, TTN and TAZ.The patient of this family carries the composite mutation of MYH7(+) /TTN(+) heterozygous missense mutation and TAZ(+) /TTN(+) heterozygous missense mutation may be show the performance of the genetic characteristics of early onset, severe phenotype.