Evaluation of brain iron deposition in different cerebral arteries of acute ischaemic stroke patients using quantitative susceptibility mapping

AIM

To investigate differences in iron deposition between infarct and normal cerebral arterial regions in acute ischaemic stroke (AIS) patients using quantitative susceptibility mapping (QSM).

MATERIALS AND METHODS

Forty healthy controls and 40 AIS patients were recruited, and their QSM images were obtained. There were seven regions of interest (ROIs) in AIS patients, including the infarct regions of responsible arteries (R1), the non-infarct regions of responsible arteries (R2), the contralateral symmetrical sites of lesions (R3), and the non-responsible cerebral arterial regions (R4, R5, R6, R7). For the healthy controls, the cerebral arterial regions corresponding to the AIS patient group were selected as ROIs. The differences in corresponding ROI susceptibilities between AIS patients and healthy controls and the differences in susceptibilities between infarcted and non-infarct regions in AIS patients were compared.

RESULTS

The susceptibilities of infarct regions in AIS patients were significantly higher than those in healthy controls (p<0.0001). There was no significant difference in non-infarct regions between the two groups (p>0.05). The susceptibility of the infarct regions in AIS patients was significantly higher than those of the non-infarct region of responsible artery and non-responsible cerebral arterial regions (p<0.01).

CONCLUSIONS

Abnormal iron deposition detected by QSM in the infarct regions of AIS patients may not affect iron levels in the non-infarct regions of responsible arteries and normal cerebral arteries, which may open the door for potential new diagnostic and treatment strategies.

ABHD2 deficiency aggravates ovalbumin-induced airway remodeling through the PI3K/Akt pathway in an animal model of chronic asthma

Airway remodeling is a major pathological characteristic of chronic obstructive pulmonary disease (COPD). This study aimed to investigate the effect of Abhd2 deficiency on ovalbumin (OVA)-induced airway remodeling and inflammation in vivo. Abhd2-deficient mice were used to establish an OVA-induced asthma model. Lung tissues were analyzed using hematoxylin and eosin (HE) staining, Masson staining, immunohistochemistry, quantitative reverse transcription- polymerase chain reaction (qRT-PCR), and western blotting were used to determine the role of Abhd2 in the regulation of OVA-induced airway remodeling and inflammation. Our findings revealed that the RNA expression of inflammatory factors, including IL-1β, IL-6, IL-4, and IL-13, was significantly increased in OVA-induced Abhd2 Gt/Gt asthmatic mice. The expression of IFN-γ was decreased significantly in OVA-induced Abhd2 Gt/Gt asthmatic mice. The protein expression of airway remodeling factors, including α-SMA, type I collagen, and Ki67, was also increased in OVA-induced Abhd2 Gt/Gt asthmatic mice compared to that in OVA-induced wild-type (WT) mice. Additionally, Abhd2 deficiency promoted the expression of p-Akt in tissues of the asthma model. These results suggest that Abhd2 deficiency exacerbates airway remodeling and inflammation through the PI3K/Akt pathway in chronic asthma.

Conventional transarterial chemoembolization combined with systemic therapy versus systemic therapy alone as second-line treatment for unresectable colorectal liver metastases: randomized clinical trial

BACKGROUND

The combination of conventional transarterial chemoembolization (cTACE) and systemic therapy has the potential to treat chemotherapy-refractory unresectable colorectal liver metastases (CRLMs). This study aimed to compare survival after this combined treatment versus systemic chemotherapy alone.

METHODS

This single-centre RCT included patients with unresectable CRLMs that progressed after first-line treatment. Patients were randomized on a 1 : 1 basis to either systemic chemotherapy with or without cTACE, without further stratification. The primary outcome was progression-free survival (PFS). Secondary outcomes were overall response rate, disease control rate, conversion rate to liver resection, overall survival, and adverse events.

RESULTS

Of 180 patients recruited, 168 were randomized. Eighty-five patients in arm A received systemic chemotherapy plus cTACE and 83 in arm B received systemic chemotherapy alone. Median PFS was longer in arm A than B (6.7 versus 3.8 months; hazard ratio (HR) 0.67, 95 per cent c.i. 0.49 to 0.91; P = 0.009), but did not translate into prolonged median overall survival (18.4 versus 14.8 months; HR = 0.92, 0.62 to 1.36; P = 0.669). Overall response rates (20 versus 22 per cent; P = 0.788) and conversion rate to liver resection (18 versus 16 per cent; P = 0.730) were no different between arms A and B. The disease control rate was higher in arm A than arm B (67 versus 51 per cent; P = 0.030). No adverse event higher than grade 3 according to the Common Terminology Criteria for Adverse Events was observed during treatment.

CONCLUSION

Systemic chemotherapy plus cTACE is a safe option as second-line treatment for unresectable colorectal liver metastases, with a modest effect on PFS. Registration number: NCT03783559 (http://www.clinicaltrials.gov).

MiR-200b-5p inhibits proliferation of ovarian cancer cells by targeting ATAD2 and regulating PI3K/AKT signaling pathway

OBJECTIVE

The purpose of this study was to investigate the influences of micro ribonucleic acid (miR)-200b-5p on proliferation and apoptosis of ovarian cancer (OC) cells, and to explore its correlations with the target gene ATPase family, AAA domain containing 2 (ATAD2), and the phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathway.

MATERIALS AND METHODS

Human ovarian fibroblasts (HOFs) or human OC cell lines (A2780) were cultured in vitro, and then, A2780 cells were separately transfected with miR-200b mimics or miR-NC or cultured with ATAD2-specific inhibitor BAY-850. Thereafter, the expression levels of miR-200b and ATAD2 messenger RNA (mRNA) were measured via qRT-PCR, and the proliferative capacity of cells was detected by CCK-8 assay. Next, the cell apoptosis was determined by means of flow cytometry and one-step TUNEL assay. Finally, the targeted regulatory relationship between miR-200b and ATAD2 was examined using a Luciferase reporter assay system, and the protein expressions were detected through Western blot (WB) assay.

RESULTS

It was found that the expression level of miR-200b was remarkably lower (p<0.05), while the mRNA expression level of ATAD2 was notably higher (p<0.05) in A2780 cells than those in HOFs. The transfection with miR-200b mimics markedly reduced the mRNA expression level of ATAD2 (p<0.05) and the proliferative capacity (p<0.05) and increased the apoptosis rate (p<0.05) of A2780 cells. Besides, it was detected via the Luciferase reporter assay system that miR-200b inhibited ATAD2. BAY-850 significantly decreased the expression level of ATAD2 protein (p<0.05) and the proliferative capacity (p<0.05) but improved the apoptosis rate (p<0.05) of cells. Moreover, both miR-200b mimics and BAY-850 could distinctly repress the protein expression levels of PI3K and p-Akt of the PI3K/Akt signaling pathway (p<0.05) and enhance the expression of suppressor gene p53 (p<0.05).

CONCLUSIONS

MiR-200b-5p can inhibit the proliferation and promote the apoptosis of OC cells through targeted inhibition of ATAD2 expression and regulation of the PI3K/Akt signaling pathway.

Effect of UV-B radiation on growth, flavonoid and podophyllotoxin accumulation, and related gene expression in Sinopodophyllum hexandrum

Sinopodophyllum hexandrum is an alpine medicinal plant that produces the anticancer compound podophyllotoxin (PPT). Although a positive relationship between PPT content and altitude has been proved and low temperature enhances plant growth and PPT accumulation has also been revealed, the role of UV radiation in regulating growth and PPT accumulation is still unclear In this study, morphophysiological traits, metabolites content and related genes expression were investigated by exposing S. hexandrum seedlings to treatment with UV-B radiation. The results showed that the contents of soluble sugars and flavonoids, and the expression levels of genes involved in glycometabolism (XET and β-1,3-glucanase) and flavonoid biosynthesis (PAL,C4H,4CL,CHS1 and DTX41) were enhanced in response to UV-B compared to CK. Moreover, genes involved in stress tolerance (MYB, WRKY,APX3 and EX2) were also upregulated in response to UV-B radiation. Although the whole plant biomass exhibited slightly increased values that depended largely on root development, the contents of chlorophyll and PPT and the expression levels of genes involved in photosynthesis (matK, ndhF,rbcL and ycf5) and PPT biosynthesis (C3H,CCoAMT,CCR,CAD, DPO, PLR,SDH, CPY719A23,OMT3,CYP71CU1,OMT1and 2-ODD) were significantly decreased in response to UV-B compared to CK. It can be concluded that UV-B radiation promotes soluble sugars and flavonoids accumulation, but inhibits PPT biosynthesis in S. hexandrum.

[Effects of occupational nickel exposure on glycemic parameters in workers]

Objective: To explore the effect of occupational nickel exposure on blood glucose related indicators of workers. Methods: In March 2019, five electroplating enterprises and one plastic hardware enterprise were selected by cluster sampling method. 159 nickel plating workers were selected as the contact group, and 66 administrative personnel of the same enterprise were selected as the control group. The serum nickel concentration, fasting blood glucose (FPG) , fasting insulin (FIns) and glycosylated hemoglobin (HbA1c) were measured in the contact group and the control group. The differences of blood glucose related indexes between the two groups were compared, and the risk factors of abnormal blood glucose indexes were analyzed. Results: Compared with the control group, the blood nickel concentration and detection rate of nickel in the contact group were higher, the levels of FIns were lower, and the proportion of HbA1c was higher in the contact group (P<0.05) . Stratified analysis showed that compared with the control group, the blood glucose index of men in the contact group changed significantly (P<0.05) ; logistic regression analysis showed that male was an independent influencing factor for decreased FIns (OR=8.264, P<0.05) . Conclusion: Long term exposure to nickel can affect the blood glucose related indexes such as fins and HbA1c.

Primary tumour location is an important prognostic factor in colorectal cancer liver metastases following radiofrequency ablation

AIM

To examine the outcomes and different prognoses for colorectal cancer patients with liver metastases (CRCLM) treated with radiofrequency ablation (RFA) based on the origin of the primary tumour (rectum versus colon).

MATERIALS AND METHODS

Patients diagnosed with CRCLM from July 2011 to June 2018 were assessed in the study. The study included 114 patients with 176 lesions. All of the patients underwent RFA of their CRCLM. The overall survival (OS) and progression-free survival (PFS) were assessed with Kaplan-Meier survival function estimate curves and Cox regression analysis between the group of patients with rectal cancer liver metastases (RCLM) and colon cancer liver metastases (CCLM).

RESULTS

Patients with RCLM exhibited worse OS and PFS than those with CCLM. The 1-, 2-, and 3-year OS rates were 87.5%, 75%, and 54.2% in the RCLM group and 93.9%, 87.8%, and 81.8% in the CCLM group (p=0.001), respectively. The 1-, 2-, and 3-year PFS rates were 43.7%, 22.9%, and 20.8% in the RCLM group and 57.6%, 45.4%, and 36.5% in the CCLM group (p=0.001), respectively. Multivariate analysis showed that primary tumour location, carcinoembryonic antigen (CEA), and response to pre-ablation chemotherapy were independent variables for OS and PFS. The N state of the primary tumour also had a significant impact on OS.

CONCLUSION

This study showed that patients with CCLM had better prognoses than those with RCLM following RFA treatment. If patients intend to undergo RFA for CRCLM, the location of the primary tumour should be considered in the assessment of long-term therapeutic effects.

Optimization of an improved aqueous method for the production of high quality white sesame oil and de-oiled meal

Research into the production of white sesame oil by aqueous extraction has been promoted because of concerns about the environment, health, and cost. The advanced aqueous method using a 1.95:10 liquid-to-raw material ratio, which was finally developed in this study, recovered 96.06% white sesame oil and produced de-oiled meal with high quality (3.98% residual oil content). The acid value and peroxide value of the oil produced were quite low at 0.19 mg KOH/kg and < 3.25 mmol/kg, respectively, which were better than the values required by the Chinese national standard for first class edible sesame oils and oils produced by hexane extraction. No wastewater was discharged during the extraction of white sesame oils by an aqueous salt solution. The protein rich de-oiled meal may be a good material for making protein isolate with high purity (e.g. > 90%). It can also be a nutritious ingredient or raw material for producing many food products.

Prevalence and cardiovascular risk factors of asymptomatic intracranial arterial stenosis: the Kongcun Town Study in Shandong, China

BACKGROUND AND PURPOSE

This study was to investigate the prevalence and cardiovascular risk factors (CRFs) of asymptomatic intracranial atherosclerotic stenosis (aICAS) amongst middle-aged and older adults living in rural communities in China.

METHODS

This population-based study included 2019 subjects (aged ≥40 years, 52.3% women) who were free of stroke and living in rural communities in China. From October 2017 to May 2018, data on demographics, CRFs and health conditions were collected through face-to-face interviews, physical examination and laboratory tests. Asymptomatic ICAS was detected through a two-phase procedure: a screening phase with transcranial Doppler ultrasound, followed by a diagnostic phase with magnetic resonance angiography examination. Multivariable logistic regression models were used to analyse CRFs associated with aICAS.

RESULTS

Of the 2019 participants, aICAS was detected in 153 persons. The overall prevalence of aICAS was 7.6%, and the prevalence of moderate-to-severe aICAS was 5.0%. The multi-adjusted odds ratio (95% confidence interval) of aICAS associated with CRFs was 2.40 (1.56-3.69) for hypertension, 1.91 (1.32-2.76) for high hypersensitive C-reactive protein, 1.68 (1.14-2.49) for diabetes and 1.61 (1.08-2.41) for overweight or obesity. When these four CRFs were aggregated, compared with participants without any of these factors, the multi-adjusted odds ratios (95% confidence interval) of aICAS for persons concurrently having one, two and three or more of these factors were 1.14 (0.52-2.48), 2.91 (1.42-5.99) and 5.51 (2.64-11.50), respectively (P for linear trend <0.001).

CONCLUSIONS

Asymptomatic ICAS is common amongst rural-dwelling middle-aged and older Chinese people. Hypertension, diabetes, overweight or obesity and high hypersensitive C-reactive protein, especially when coexisting, are strongly associated with aICAS.

Phonotactic steering and representation of directional information in the ascending auditory pathway of a cricket

Directional hearing is crucial for animals depending on acoustic signals to locate a mate. We focused on crickets to explore the reliability of directional information forwarded to the brain by the ascending auditory interneuron AN1, which is crucial for phonotactic behavior. We presented calling song from -45° to +45° in steps of 3° and compared the phonotactic steering of females walking on a trackball with the directional responses of AN1. Forty percent of females showed good steering behavior and changed their walking direction when the speaker passed the body's longitudinal axis. The bilateral latency difference between right and left AN1 responses was small and may not be reliable for auditory steering. In respect to spike count, all AN1 recordings presented significant bilateral differences for angles larger than ±18°, yet 35% showed a mean significant difference of 1-3 action potentials per chirp when the frontal stimulus deviated by 3° from their length axis. For small angles, some females had a very similar AN1 activity forwarded to the brain, but the accuracy of their steering behavior was substantially different. Our results indicate a correlation between directional steering and the response strength of AN1, especially for large angles. The reliable steering of animals at small angles would have to be based on small bilateral differences of AN1 activity, if AN1 is the only source providing directional information. We discuss whether such bilateral response difference at small angles can provide a reliable measure to generate auditory steering commands descending from the brain, as pattern recognition is intensity independent.NEW & NOTEWORTHY The ascending auditory interneuron AN1 has been implicated in cricket auditory steering, but at small acoustic stimulation angles, it does not provide reliable directional information. We conclude that either the small bilateral auditory activity differences of the AN1 neurons are enhanced to generate reliable descending steering commands or, more likely, directional auditory steering is mediated via a thoracic pathway, as indicated by the reactive steering hypothesis.

Optimized mid-long term management of ketogenic diet in children with refractory epilepsy

This study aims to explore the mid-long term management of ketogenic diet (KD) for the treatment of refractory epilepsy in children, and carry out an efficacy assessment. The data of epileptic children who received KD in our hospital from January 2011 to August 2012 (basic management plan group, n=57) were retrospectively analyzed. On this basis, epileptic children who received KD from September 2012 to April 2014 (optimized management plan group, n=52) were managed according to the mid-long term management plan. The effective rate of KD at the first, third, sixth and ninth month was 90.4%, 73.1%, 65.4% and 38.5%, respectively, in the optimized management plan group, and 63.2%, 45.6%, 38.6% and 21.1%, respectively, in the basic management plan group, and the differences were statistically significant. The compliance rate of KD at the third, sixth and ninth month was 94.2%, 78.8% and 63.5%, respectively, in the optimized management plan group, and 82.5%, 47.4% and 28.1%, respectively, in the basic management plan group, and the differences were statistically significant. Optimized mid-long term management of KD in children can improve the control rate of epileptic seizures, and the compliance of patients.

ED50 of intrathecal ropivacaine for cesarean delivery with and without epidural volume extension with normal saline: a randomized controlled study

Background

It was reported that epidural volume extension could decrease the ED₅₀ of intrathecal plain bupivacaine. In this study, we investigated the ED₅₀ of intrathecal hyperbaric ropivacaine followed by epidural normal saline bolus for cesarean section.

Methods

Sixty parturients were allocated into two groups in this prospective study. About 10 mL of epidural normal saline was given after the intrathecal dose of hyperbaric ropivacaine in the Group S (normal saline group), and no epidural injection of normal saline was given after the intrathecal ropivacainve injection in the Group C (control group). The dose of intrathecal ropivacaine for each parturient was decided by up-down allocation method. The initial dose was set as 10 mg. Effective anesthesia was defined as the level of T6 or above achieved within 10 minutes after intrathecal injection and no additional epidural drug to complete operation. The Massey formula was applied to calculate the ED₅₀ of intrathecal ropivacaine.

Results

The ED₅₀ of intrathecal ropivacaine for cesarean section determined by up-and-down method was 7.51 mg (95% CI, 7.09–7.93 mg) in the Group S and 8.29 mg (95% CI, 7.73–8.85 mg) in the Group C, and there was a significant difference in ED₅₀ of ropivacaine between the two groups (P<0.05). Compared with the Group C, the ED₅₀ of intrathecal ropivacaine decreased when followed by epidural normal saline bolus.

Conclusion

The ED₅₀ of intrathecal hyperbaric ropivacaine for cesarean section is 8.29 mg, and it is reduced when followed by epidural normal saline bolus (www.chictr.org.cn, registration number: ChiCTR-ROC-17013382).

[Imaging diagnostic methods for identification of sentinel lymph nodes in patients with early squamous cell carcinoma of the oral cavity mucosa: a literature review]

The paper describes properties of clinical visualization approaches which are applied for detection of sentinel lymph nodes in patients suffering from oral cavity squamous cell cancer. Diagnostic efficiency results and technological features of different imaging techniques are discussed.

[Surgical technique and early clinical outcomes of direct anterior approach to total hip arthroplasty]

OBJECTIVE

To describe the surgical technique of direct anterior approach to total hip arthroplasty and to report the early clinical outcomes.

METHODS

A series of 100 consecutive, unselected patients who had 116 primary total hip arthroplasty surgeries (16 bilateral) done through direct anterior approach from March 11 2015 to June 21 2016 was reviewed. There were 50 male patients and 50 female patients. The average patient age was 51 years, and the average body mass index was 24.69 kg/m². The preoperative diagnosis included avascular necrosis of femoral head, hip osteoarthritis, osteoarthritis secondary to acetabular dysplasia, sequelae of hip old infection, ankylosing spondylitis, rheumatoid arthritis and avascular necrosis of femoral head after cannulated screws fixation of femoral neck fracture. There were 7 hips which had surgical history prior to the index hip arthroplasty, including 3 cases with bone graft treatment for avascular necrosis of femoral head through Smith-Peterson approach, 2 cases with acetabular shelf procedures for acetabular dysplasia through Smith-Peterson approach, and 2 cases with cannulated screws fixation for femoral neck fracture (internal fixation residual). All were uncemented hips. The stems used in this study included 67 Triloc stems (DePuy company, USA), 45 Corail stems (DePuy company, USA), 2 Accolade stems (Stryker company, USA), 1 Synergy stem (Smith-Nephew company, USA) and 1 Polarstem (Smith-Nephew company, USA).

RESULTS

The average follow up period was 8.5 months, the average incision scar length was 10 cm, and the average postoperative Harris score was 93.62. There was 95% postoperative leg length discrepancy within 3 mm. The average cup inclination angle was 38.7° with 94.8% in the range of 30° to 50°. The average cup anteversion angle was 14.3° with 94.2% within the target range of 5° to 25°.The were 15 (12.9%) operative complications, including two femoral perforations (changing stem from Triloc to Corail), three calcar fractures (treated with cerclage wires), four greater trochanter fractures (2 were treated wire tension band, and 2 nondisplaced fractures untreated), one deep infection (debridement and retaining of the prothesis), one superficial infection (debridement), one hematoma and three wound healing complications (debridement). All the complications were successfully treated without any sequelae at the end of the latest follow-up. There was no postoperative dislocation. There was no major nerve and vascular injuries. There were 35 cases (30.2%) reporting symptoms of lateral femoral cutaneous nerve palsy.

CONCLUSION

Direct anterior approach to total hip arthroplasty allows accurate and reproducible cup orientation positioning and leg length restoration and decreases the risk of postoperative dislocation, which is helpful for early rapid postoperative recovery.

[Application of bilateral direct anterior approach total hip arthroplasty: a report of 22 cases]

OBJECTIVE

To analyze the operation technique and the methods to avoid early complications on the learning curve for bilateral direct anterior approach (DAA) total hip arthroplasty (THA).

METHODS

We retrospectively studied a series of continued cases with bilateral avascular necrosis of the femoral head (AVN) or degenerative dysplastic hip and rheumatoid arthritis that were treated by DAA THA in Beijing Jishuitan Hospital. A total of 22 patients with 44 hips were analyzed from June 2014 to August 2016 in this study. There were 17 males and 5 females, and the median age was 48 years (range: 34-67 years). All the surgery was done by DAA method by two senior surgeons. The clinic characters, early surgery treatment results and complications were analyzed.

RESULTS

We used the cementless stems in all the cases. The average operating time was (167±23) min; the average blood loss was (775±300) mL;the blood transfusion was in average (327±341) mL; the wound drainage in average was (111±73) mL. Most of the patients could move out of the bed by themselves on the first day after operation, 5 patients could walk without crutches on the first operating day, and 13 patients could squat on the third days after operation. The patients were discharged averagely 4 days after operation. We followed up all the patients for averagely 16 months (range: 8-24 months). There was no loosening or failure case in the latest follow up. In the study, 2 patients had great trochanter fracture, 2 patients had thigh pain, 4 patients had lateral femoral cutaneous nerve palsy, and 3 patients had muscle damage. The Harris scores were improved from 29±8 preoperatively to 90±3 postoperatively (P<0.01).

CONCLUSION

The DAA THA can achieve faster recovery and flexible hip joint after operation. However it is a kind of surgery with high technique demanding. Carefully selected patients, and skilled technique, can help the surgeon avoid the early complications. It is associated with high complication rate in the learning curve for bilateral DAA THA.

Matrix metalloproteinase 12 is an indicator of intervertebral disc degeneration co-expressed with fibrotic markers

OBJECTIVE

Recent evidence suggests a role of fibrogenesis in intervertebral disc (IVD) degeneration. We aim to explore if fibrotic genes may serve as IVD degeneration indicators, and if their expression is associated with myofibroblast activity.

DESIGN

Transcriptional expression of fibrosis markers (COL1A1, COL3A1, FN1, HSP47, MMP12, RASAL1) were analyzed in degenerated (D) and non-degenerated (ND) human nucleus pulposus (NP) and annulus fibrosus (AF) cells, along with traditional (SOX9, ACAN) and newly established degeneration markers (CDH2, KRT19, KRT18, FBLN1, MGP, and COMP). Protein expression was investigated by immunohistochemistry in human IVDs, and in rodent IVDs undergoing natural ageing or puncture-induced degeneration. Co-expression with myofibroblast markers was examined by double staining on human and rat specimens. Disc degeneration severity and extent of fibrosis were determined by histological scoring and picrosirius red staining respectively.

RESULTS

Human D-NP showed more intensive staining for picrosirius red than ND-NP. Among the genes examined, D-NP showed significantly higher MMP12 expression along with lower KRT19 expression. Protein expression analysis revealed increased MMP12(+) cells in human D-IVD. Histological scoring indicated mild degeneration in the punctured rat discs and discs of ageing mouse. Higher MMP12 positivity was found in peripheral NP and AF of the degenerative rat discs and in NP of the aged mice. In addition, human D-NP and D-AF showed increased α-SMA(+) cells, indicating enhanced myofibroblast activity. MMP12 was found co-expressed with α-SMA, FSP1 and FAP-α in human and rat degenerative IVDs.

CONCLUSIONS

Our study suggests that in addition to a reduced KRT19 expression, an increased expression of MMP12, a profibrotic mediator, is characteristic of disc degenerative changes. Co-expression study indicates an association of the increased MMP12 positivity with myofibroblast activity in degenerated IVDs. Overall, our findings implicate an impact of MMP12 in disc cell homeostasis. The precise role of MMP12 in IVD degeneration warrants further investigation.

Tumorigenic potential is restored during differentiation in fusion-reprogrammed cancer cells

Detailed understanding of the mechanistic steps underlying tumor initiation and malignant progression is critical for insights of potentially novel therapeutic modalities. Cellular reprogramming is an approach of particular interest because it can provide a means to reset the differentiation state of the cancer cells and to revert these cells to a state of non-malignancy. Here, we investigated the relationship between cellular differentiation and malignant progression by the fusion of four independent mouse cancer cell lines from different tissues, each with differing developmental potentials, to pluripotent mouse embryonic stem (ES) cells. Fusion was accompanied by loss of differentiated properties of the four parental cancer cell lines and concomitant emergence of pluripotency, demonstrating the feasibility to reprogram the malignant and differentiative properties of cancer cells. However, the original malignant and differentiative phenotypes re-emerge upon withdrawal of the fused cells from the embryonic environment in which they were maintained. cDNA array analysis of the malignant hepatoma progression implicated a role for Foxa1, and silencing Foxa1 prevented the re-emergence of malignant and differentiation-associated gene expression. Our findings support the hypothesis that tumor progression results from deregulation of stem cells, and our approach provides a strategy to analyze possible mechanisms in the cancer initiation.

[Estimation of femoral version based on broach geometry after femoral-neck osteotomy]

OBJECTIVE

To find out whether it is accurate to estimate femoral version based on femoral broach after femoral neck osteotomy using computed tomography scans.

METHODS

In 32 total hip arthroplasty (THA), we performed CT scans before and after operation. Four possible levels (lesser trochanter, 5 mm above, 10 mm above and 15 mm above the lesser trochanter) of broach version were calculated based on the preoperative CT scan. Stem versions were measured on the postoperative CT scan. We determined the difference between the preoperative broach version and the postoperative stem version using the Student's t test for paired samples assuming equal variance.

RESULTS

For the operated hips, preoperative hip version differed according to the level of measurement. Our findings showed that the average femoral version was 37.0°±11.0° at the level of the lesser trochanter (section 1), 34.3°±10.6° at 5 mm above the lesser trochanter (section 2), 28.1°±10.9° at 10 mm above the lesser trochanter (section 3), and 22.4°± 13.7° at 15 mm above the lesser trochanter (section 4), and that the average version for the femoral neck (FNV) was 12.9°±13.8°. The postoperative hip version was the stem version (FSV), which we found to be an average of 26.1°±11.0°. The mean femoral version for section 1 and 2 was larger than the mean postoperative stem version (P<0.01); the mean version for sections 3 and 4 did not differ from the mean postoperative stem version (P>0.05). The mean femoral neck version was less than the mean postoperative stem version (P<0.01); the difference was 13.2°±11.1° of the increased anteversion on average for the FSV compared with FNV.

CONCLUSION

The accuracy of estimated femoral version after arthroplasty depends on broach level. When it is 10 mm above the lesser trochanter, stem version estimation is accurate, but below that level, there is a tendency to overestimate.

Effects of epidural block combined with general anesthesia on antitumor characteristics of T helper cells in hepatocellular carcinoma patients

This study discusses the changes of T helper cells (Th cells) of patients who received different anesthesia methods in liver cancer resection. We selected 122 patients who were diagnosed with hepatocellular carcinoma and underwent liver cancer resection and divided them into a general anesthesia combined with epidural anesthesia group (group A) and general anesthesia group (group B). Peripheral blood was collected to detect Th cells on the day of surgery, and on the second and seventh days after surgery. Th1 and Th2 cell frequency and mRNA expression of interferon-γ (IFN-γ) of all patients significantly rose on the second day but recovered to the previous level on the seventh day. Th1/Th2 increased remarkably on the seventh day compared to the second day. Compared to the day of surgery, Th17, regulatory T (Treg)cells as well as mRNA expression of interleukin-17 (IL-17) and FoxP3 had no obvious changes on the second day, but dramatically declined on the seventh day. Compared to group B, Th1 cell frequency and Th1/Th2 in group A had a slight increase on the second day, and a remarkable increase on the seventh day; but Th2, Th17 and Treg cell frequency in group A slightly decreased on the second day and remarkably decreased on the seventh day. mRNA of IFN-γ, cytokine levels and IFN-γ/IL-4 of group A were all higher than group B on the seventh day, while mRNA of IL-17, concentration of IL-17 as well as concentration of transforming growth factor-β1 (TGF-β1) in group A were much lower than group B. These findings suggest that improving antitumor activity of Th cells can benefit patients who receive liver cancer resection.

Observation of a Neutral Charmoniumlike State Z_{c}(4025)^{0} in e^{+}e^{-}→(D^{*}D[over ¯]^{*})^{0}π^{0}

We report a study of the process e^{+}e^{-}→(D^{*}D[over ¯]^{*})^{0}π^{0} using e^{+}e^{-} collision data samples with integrated luminosities of 1092 pb^{-1} at sqrt[s]=4.23 GeV and 826 pb^{-1} at sqrt[s]=4.26 GeV collected with the BESIII detector at the BEPCII storage ring. We observe a new neutral structure near the (D^{*}D[over ¯]^{*})^{0} mass threshold in the π^{0} recoil mass spectrum, which we denote as Z_{c}(4025)^{0}. Assuming a Breit-Wigner line shape, its pole mass and pole width are determined to be (4025.5_{-4.7}^{+2.0}±3.1) MeV/c^{2} and (23.0±6.0±1.0) MeV, respectively. The Born cross sections of e^{+}e^{-}→Z_{c}(4025)^{0}π^{0}→(D^{*}D[over ¯]^{*})^{0}π^{0} are measured to be (61.6±8.2±9.0) pb at sqrt[s]=4.23 GeV and (43.4±8.0±5.4) pb at sqrt[s]=4.26 GeV. The first uncertainties are statistical and the second are systematic.

Neddylation controls basal MKK7 kinase activity in breast cancer cells

The c-Jun NH2-terminal protein kinase (JNK) pathway has been implicated in mammary tumor development. However, the molecular mechanisms regulating JNK activity in breast cancer cells remain unclear. Here, we report that the inhibition of ubiquitination-like post-translational modification neddylation through different strategies results in enhanced basal JNK phosphorylation in human breast cancer cells. The upregulation of basal JNK phosphorylation upon neddylation inhibition is independent of the deneddylation of Cullins, the well-characterized neddylation substrates. Since augmented basal JNK phosphorylation via ectopic MKK7 expression impedes proliferation and the epithelial-to-mesenchymal transition (EMT) phenotype, the neddylation system might contribute to mammary tumor development partially through limiting basal JNK phosphorylation. Further exploration reveals that MKK7, a JNK-specific MAP2K, undergoes neddylation in human breast cancer cells. MKK7 co-precipitates with a fragment of Ran-binding protein 2 (RanBP2), a large multimodular and pleiotropic protein that has been recognized as a SUMO E3 ligase. Knockdown of RanBP2 attenuates MKK7 neddylation and augments basal JNK phosphorylation without affecting the neddylation of Cullins, whereas ectopic expression of a RanBP2 fragment possessing SUMO E3 activity (RanBP2ΔFG) manifests the opposite effects. In vitro neddylation assays confirm that RanBP2ΔFG works as the neddylation E3 ligase for MKK7. The basal kinase activity of endogenous MKK7 increases upon RanBP2 knockdown but decreases upon the ectopic expression of RanBP2ΔFG. Furthermore, purified MKK7 shows reduced basal kinase activity after in vitro neddylation by RanBP2ΔFG. Consistently, RanBP2 knockdown leads to reduced proliferation and impaired EMT phenotype in human breast cancer cells and the effects of RanBP2 knockdown are reversed by simultaneous MKK7 knockdown. Taken together, our data suggest that MKK7 undergoes neddylation in human breast cancer cells, which limits its basal kinase activity.

Observation of Z_{c}(3900)^{0} in e^{+}e^{-}→π^{0}π^{0}J/ψ

Using a data sample collected with the BESIII detector operating at the BEPCII storage ring, we observe a new neutral state Z_{c}(3900)^{0} with a significance of 10.4σ. The mass and width are measured to be 3894.8±2.3±3.2  MeV/c^{2} and 29.6±8.2±8.2  MeV, respectively, where the first error is statistical and the second systematic. The Born cross section for e^{+}e^{-}→π^{0}π^{0}J/ψ and the fraction of it attributable to π^{0}Z_{c}(3900)^{0}→π^{0}π^{0}J/ψ in the range E_{c.m.}=4.19-4.42  GeV are also determined. We interpret this state as the neutral partner of the four-quark candidate Z_{c}(3900)^{±}.

Observation and Spin-Parity Determination of the X(1835) in J/ψ→γK_{S}^{0}K_{S}^{0}η

We report an observation of the process J/ψ→γX(1835)→γK_{S}^{0}K_{S}^{0}η at low K_{S}^{0}K_{S}^{0} mass with a statistical significance larger than 12.9σ using a data sample of 1.31×10^{9} J/ψ events collected with the BESIII detector. In this region of phase space the K_{S}^{0}K_{S}^{0} system is dominantly produced through the f_{0}(980). By performing a partial wave analysis, we determine the spin parity of the X(1835) to be J^{PC}=0^{-+}. The mass and width of the observed X(1835) are 1844±9(stat)_{-25}^{+16}(syst)  MeV/c^{2} and 192_{-17}^{+20}(stat)_{-43}^{+62}(syst)  MeV, respectively, which are consistent with the results obtained by BESIII in the channel J/ψ→γπ^{+}π^{-}η^{'}.

Observation of the ψ(1 3D2) State in e+e-→π+π-γχc1 at BESIII

We report the observation of the X(3823) state in the process e+e-→π+π-X(3823)→π+π-γχc1 with a statistical significance of 6.2σ, in data samples at center-of-mass energies sqrt[s]=4.230, 4.260, 4.360, 4.420, and 4.600 GeV collected with the BESIII detector at the BEPCII electron positron collider. The measured mass of the X(3823) state is (3821.7±1.3±0.7)  MeV/c2, where the first error is statistical and the second systematic, and the width is less than 16 MeV at the 90% confidence level. The products of the Born cross sections for e+e-→π+π-X(3823) and the branching ratio B[X(3823)→γχc1,c2] are also measured. These measurements are in good agreement with the assignment of the X(3823) state as the ψ(1 3D2) charmonium state.

Enrichment of committed human nucleus pulposus cells expressing chondroitin sulfate proteoglycans under alginate encapsulation

OBJECTIVE

Intervertebral disc (IVD) degeneration is associated with a malfunction of the nucleus pulposus (NP). Alginate culturing provides a favorable microenvironment for the phenotypic maintenance of chondrocyte-like NP cells. However, NP cells are recently evidenced to present heterogeneous populations, including progenitors, fibroblastic cells and primitive NP cells. The aim of this study is to profile the phenotypic changes of distinct human NP cells populations and describe the dynamic expression of chondroitin sulfate glycosaminoglycans (CS-GAGs) in extended alginate encapsulation.

METHOD

Non-degenerated (ND-NPC) and degenerated (D-NPC) NP cells were expanded in monolayers, and subject to 28-day culture in alginate after serial passaging. CS-GAG compositional expression in monolayer-/alginate-cultured NP cells was evaluated by carbohydrate electrophoresis. Cellular phenotypic changes were assessed by immunologic detection and gene expression analysis.

RESULTS

Relative to D-NPC, ND-NPC displayed remarkably higher expression levels of chondroitin-4-sulfate GAGs over the 28-day culture. Compared with monolayer culture, ND-NPC showed increased NP marker expression of KRT18, KRT19, and CDH2, as well as chondrocyte markers SOX9 and MIA in alginate culture. In contrast, expression of fibroblastic marker COL1A1, COL3A1, and FN1 were reduced. Interestingly, ND-NPC showed a loss of Tie2+ but gain in KRT19+/CD24+ population during alginate culture. In contrast, D-NPC showed more consistent expression levels of NP surface markers during culture.

CONCLUSION

We demonstrate for the first time that extended alginate culture selectively enriches the committed NP cells and favors chondroitin-4-sulfate proteoglycan production. These findings suggest its validity as a model to investigate IVD cell function.

[Assessment of quality of life after multiple arthroplasty]

OBJECTIVE

To evaluate the effectiveness of conducting multiple arthroplasty to treat multiple joints disease in terms of quality of life (QOL) and function improvement.

METHODS

We compared our results with the reported results of single and dual arthroplasty to see if there is any improvement in QOL, functional scores or complications. In this study, 13 patients admitted to Department of Adult Reconstructive Surgery, Beijing Jishuitan hospital from 2005 to 2009 were included. Questionnaires SF-36 were used to evaluate the QOL. Harris hip score, American Knee Society Score (KSS) were used to evaluate the joint function. The patients were evaluated before surgery to the latest follow up.

RESULTS

SF-36 has changed as follow: physical function 4.17 ± 14.43 → 65.83 ± 24.76, role physical 25.00 ± 26.11 → 60.42 ± 45.8, bodily pain 23.83 ± 21.41 → 76.88 ± 20.89, general health 53.33 ± 33.87 → 76.67 ± 14.67, vitality 50.42 ± 17.25 → 71.67 ± 16.28, social functioning 29.17 ± 33.50 → 73.96 ± 33.90, role emotional 22.08 ± 35.61 → 77.77 ± 41.03, mental health 53.33 ± 25.70 → 82.67 ± 14.41, which indicated that they all improved greatly after the surgery (P < 0.05). Harris score increased from 37.68 ± 14.71 before the surgery to 83.36 ± 13.54 after the surgery. KSS has also showed sharp improvement (P < 0.001) in both clinical score (42.52 ± 23.83 → 77.74 ± 20.67) and function score (-2.61 ± 22.56 → 65.65 ± 30.76).

CONCLUSION

Multiple arthroplasty is one of the most effective methods which can markedly improve the quality of life in patients with multiple joints disease. But complications are common and joint functions are relatively poor.

Study of e(+)e(-)→ωχ(cJ) at center of mass energies from 4.21 to 4.42 GeV

Based on data samples collected with the BESIII detector at the BEPCII collider at nine center of mass energies from 4.21 to 4.42 GeV, we search for the production of e^{+}e^{-}→ωχ_{cJ} (J=0, 1, 2). The process e^{+}e^{-}→ωχ_{c0} is observed for the first time, and the Born cross sections at sqrt[s]=4.23 and 4.26 GeV are measured to be (55.4±6.0±5.9) and (23.7±5.3±3.5)  pb, respectively, where the first uncertainties are statistical and the second are systematic. The ωχ_{c0} signals at the other seven energies and the e^{+}e^{-}→ωχ_{c1} and ωχ_{c2} signals are not significant, and the upper limits on the cross sections are determined. By examining the ωχ_{c0} cross section as a function of center of mass energy, we find that it is inconsistent with the line shape of the Y(4260) observed in e^{+}e^{-}→π^{+}π^{-}J/ψ. Assuming the ωχ_{c0} signals come from a single resonance, we extract the mass and width of the resonance to be (4230±8±6)  MeV/c^{2} and (38±12±2)  MeV, respectively, and the statistical significance is more than 9σ.

Analysis of immunity index and immunopathogenesis pattern of lupus nephritis patients

Joint detection of anti-dsDNA antibodies, anti-U1RNP, anti-SM antibodies, anti-SSA antibodies, anti-ribosomal P protein antibodies, anti-nucleosome antivodies (Anua), anti-histone antibodies (AHA) and antinuclear antibodies brings to the early diagnosis of systemic lupus erythematosus (SLE) and speculation of renal lesion degree of lupus nephritis patients in order to choose a specific therapeutic schedule. This paper analyzed the abnormal immunology features and connections of each pathological pattern of LN renal biopsy and probed into the essence in order to provide basis for diagnosis, treatment, pathological pattern speculation and forward assessment of LN. We chose 97 cases, treated them with renal biopsy and pathological pattern classification, analyzed pathological pattern distribution, different pathological patterns and the correlation of immunity index with anti-dsDNA antibodies, anti-U1RNP, anti-Sm antibodies, anti-SSA antibodies, anti-ribosomal P protein antibodies, Anua, AHA and ANA of the first renal biopsy were taken as the experiment index. The results showed that the morbidity of the male was distinctly lower than the female and the age of onset was much lower (P < 0.05); pattern I, pattern II, pattern III, pattern IV, pattern V, and pattern VI accounted for 1.0%, 3.1%, 12.4%, 47.4%,16.5%, 15.5%, 4.1%, 0%,respectively; among all the LN patients, there were respectively 59, 43, 28, 52, 51, 48, 36 and 93 cases in which anti-dsDNA antibody, anti-U1RNP antibody, anti-Sm antibody, anti-SSA antibody, anti-ribosomal P protein antibodies, Anua, AHA and ANA had increased and the positive rate was 60.8%, 44.3%, 28.9%, 53.6%, 52.6%, 49.5%, 37.1% and 95.9%, respectively. In conclusion, pattern IV is the most common of all pathological patterns of LN. Among the immunity index, anti- U1RNP antibodies and anti-SSA antibodies are positively correlated with anti-dsDNA antibodies; Anua is positively correlated with anti-dsDNA antibodies and AHA; anti-dsDNA antibodies, anti U1RNP antibodies, anti-Sm antibodies, anti SSA antibodies, AHA, anti-ribosomal P protein antibodies and ANA have no obvious correlation with LN renal lesions degree; Anua level of serum is positively correlated with LN renal lesions degree.

Cloning and functional identification of a novel BCA3 splice

The human breast cancer-associated gene (BCA3) was first discovered in breast and prostate cancer cells lines. In vivo studies have shown that BCA3 is mainly expressed in breast tumor cells and not in normal breast and prostate tissues. To date, 3 splice variants of BCA3 have been reported: a double-absent variant lacking exon 3 and exon 5 (BCA3-1), an exon 3-absent variant (BCA3-2), and full-length BCA3. In this study, we investigated whether a novel BCA3 splice variant exists that lacks only the exon 5-encoding sequence. BCA3 variant splices were subcloned and sequenced using reverse transcription-polymerase chain reaction. The preliminary biological functions of the splices were identified using confocal microscopy and a luciferase assay. The absence of exon 3 and exon 5 influenced the subcellular localization of BCA3 and nuclear factor kappa B (NF-kB)-dependent gene expression. Exon 3 and exon 5 of BCA3 may function together to provide a nuclear localization signal or transport sequence to enter the nucleus, and exon 3 may contain specific sequence(s) or domain(s) that influence the NF-κB signal cascade. The discovery of novel BCA3 splicing indicates a new cancer research area, which may increase the understanding of cancer generation and development.

Observation of e(+)e(-)→π(0)π(0)hc and a neutral charmoniumlike structure Zc(4020)(0)

Using data collected with the BESIII detector operating at the Beijing Electron Positron Collider at center-of-mass energies of sqrt[s]=4.23, 4.26, and 4.36 GeV, we observe e(+)e(-)→π(0)π(0)hc for the first time. The Born cross sections are measured and found to be about half of those of e(+)e(-)→π(+)π(-)hc within less than 2σ. In the π(0)hc mass spectrum, a structure at 4.02  GeV/c(2) is found. It is most likely to be the neutral isospin partner of the Zc(4020)(±) observed in the process of e(+)e(-)→π(+)π(-)hc being found. A fit to the π(0)hc invariant mass spectrum, with the width of the Zc(4020)(0) fixed to that of its charged isospin partner and possible interferences with non-Zc(4020)(0) amplitudes neglected, gives a mass of (4023.9±2.2±3.8)  MeV/c(2) for the Zc(4020)(0), where the first error is statistical and the second systematic.

Observation of η'→π+ π π+ π- and η'→π+π- π0 π0

Using a sample of 1.3 × 10(9)  J/ψ events collected with the BESIII detector, we report the first observation of η(')→π(+)π(-)π(+)π(-) and η(')→π(+)π(-)π(0)π(0). The measured branching fractions are B(η(')→π(+)π(-)π(+)π(-)) = [8.53 ± 0.69(stat.) ± 0.64(syst.)]×10(-5) and B(η(')→π(+)π(-)π(0) π(0)) = [1.82 ± 0.35(stat.) ± 0.18(syst.)] × 10(-4), which are consistent with theoretical predictions based on a combination of chiral perturbation theory and vector-meson dominance.

Observation of a charged charmoniumlike structure in e+ e- → (D* D*)± π∓ at √s = 4.26 GeV

We study the process e+ e- →(D* D*)± π∓ at a center-of-mass energy of 4.26 GeV using a 827  pb(-1) data sample obtained with the BESIII detector at the Beijing Electron Positron Collider. Based on a partial reconstruction technique, the Born cross section is measured to be (137±9±15)  pb. We observe a structure near the (D* D*)± threshold in the π∓ recoil mass spectrum, which we denote as the Zc±(4025). The measured mass and width of the structure are (4026.3±2.6±3.7)  MeV/c2 and (24.8±5.6±7.7)  MeV, respectively. Its production ratio σ(e+ e- → Zc±(4025)π∓ → (D* D*)± π∓)/σ(e+ e- → (D* D*)± π∓) is determined to be 0.65±0.09±0.06. The first uncertainties are statistical and the second are systematic.

Observation of e+e- → γX(3872) at BESIII

With data samples collected with the BESIII detector operating at the BEPCII storage ring at center-of-mass energies from 4.009 to 4.420 GeV, the process e+e-→ γX(3872) is observed for the first time with a statistical significance of 6.3σ. The measured mass of the X(3872) is (3871.9 ± 0.7s tat ± 0.2 syst)  MeV/c(2), in agreement with previous measurements. Measurements of the product of the cross section σ[e+e- → γX(3872)] and the branching fraction B[X(3872)→π+π-J/ψ] at center-of-mass energies 4.009, 4.229, 4.260, and 4.360 GeV are reported. Our measurements are consistent with expectations for the radiative transition process Y(4260) → γX(3872).

Observation of a charged (DD*)± mass peak in e+ e- → πDD* at sqrt[s] = 4.26 GeV

We report on a study of the process e+ e- → π± (DD*)∓ at sqrt[s] = 4.26  GeV using a 525 pb(-1) data sample collected with the BESIII detector at the BEPCII storage ring. A distinct charged structure is observed in the (DD*)∓ invariant mass distribution. When fitted to a mass-dependent-width Breit-Wigner line shape, the pole mass and width are determined to be Mpole = (3883.9±1.5(stat)±4.2(syst))  MeV/c2 and Γpole = (24.8±3.3(stat)±11.0(syst))  MeV. The mass and width of the structure, which we refer to as Zc(3885), are 2σ and 1σ, respectively, below those of the Zc(3900) → π± J/ψ peak observed by BESIII and Belle in π+ π- J/ψ final states produced at the same center-of-mass energy. The angular distribution of the πZc(3885) system favors a JP = 1+ quantum number assignment for the structure and disfavors 1- or 0-. The Born cross section times the DD* branching fraction of the Zc(3885) is measured to be σ(e+ e- → π± Zc(3885)∓)×B(Zc(3885)∓ → (DD*)∓) = (83.5±6.6(stat)±22.0(syst))   pb. Assuming the Zc(3885) → DD* signal reported here and the Zc(3900) → πJ/ψ signal are from the same source, the partial width ratio (Γ(Zc(3885) → DD*)/Γ(Zc(3900) → πJ/ψ)) = 6.2±1.1(stat)±2.7(syst) is determined.

Observation of a charged charmoniumlike structure Zc(4020) and search for the Zc(3900) in e+e-→π+π-hc

We study e+e-→π+π-hc at center-of-mass energies from 3.90 to 4.42 GeV by using data samples collected with the BESIII detector operating at the Beijing Electron Positron Collider. The Born cross sections are measured at 13 energies and are found to be of the same order of magnitude as those of e+e-→π+π-J/ψ but with a different line shape. In the π±hc mass spectrum, a distinct structure, referred to as Zc(4020), is observed at 4.02  GeV/c2. The Zc(4020) carries an electric charge and couples to charmonium. A fit to the π±hc invariant mass spectrum, neglecting possible interferences, results in a mass of (4022.9±0.8±2.7)  MeV/c2 and a width of (7.9±2.7±2.6)  MeV for the Zc(4020), where the first errors are statistical and the second systematic. The difference between the parameters of this structure and the Zc(4025) observed in the D*D[over ¯]* final state is within 1.5σ, but whether they are the same state needs further investigation. No significant Zc(3900) signal is observed, and upper limits on the Zc(3900) production cross sections in π±hc at center-of-mass energies of 4.23 and 4.26 GeV are set.

Combination of cetuximab and rapamycin enhances the therapeutic efficacy in hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is one of the most deadly cancers worldwide. It is well known that the activation of PI3K/AKT/mTOR and the Ras/MAPK signaling pathway plays a critical role in cellular metabolism, growth and proliferation, and its inhibitors have been used as therapeutic drugs for hepatocellular carcinoma. Cetuximab, a chimerical monoclonal EGFR IgG1 antibody, can block the binding of EGF or other ligands to EGFR and thus inhibit ligands-induced receptor phosphorylation. In the present study, we found that rapamycin could enhance the antiproliferation effect of cetuximab in both HepG2 cells and Huh-7 cells and arrest the cell cycle. Cetuximab in combination with rapamycin had synergistic effects on inhibiting the phosphrylation of proteins in PI3K/AKT/mTOR and Ras/MAPK signaling pathway. Combination of cetuximab with rapamycin treatment significantly suppressed the HCC development in HepG2 cells-xenografted mice and improved the survival. Cetuximab and rapamycin inhibited the growth of HCC both in vitro and in vivo. These results suggest that the combination therapy using the inhibitors for both EGFR and PI3K/AKT/mTOR signaling pathways may be a novel therapeutic approach for HCC.

Observation of a charged charmoniumlike structure in e+ e- → π+ π- J/ψ at sqrt[s] = 4.26 GeV

We study the process ee+ e- → π+ π- J/ψ at a center-of-mass energy of 4.260 GeV using a 525  pb(-1) data sample collected with the BESIII detector operating at the Beijing Electron Positron Collider. The Born cross section is measured to be (62.9±1.9±3.7)  pb, consistent with the production of the Y(4260). We observe a structure at around 3.9  GeV/c2 in the π(±)J/ψ mass spectrum, which we refer to as the Z(c)(3900). If interpreted as a new particle, it is unusual in that it carries an electric charge and couples to charmonium. A fit to the π(±)J/ψ invariant mass spectrum, neglecting interference, results in a mass of (3899.0±3.6±4.9)  MeV/c2 and a width of (46±10±20)  MeV. Its production ratio is measured to be R = (σ(e+ e- → π(±)Z(c)(3900)(∓) → π+ π- J/ψ)/σ(e+ e- → π+ π- J/ψ)) = (21.5±3.3±7.5)%. In all measurements the first errors are statistical and the second are systematic.