[Clinical features and spinal lesions in patients with chronic prostatitis/chronic pelvic pain syndrome]

Objective: To analyze the clinical features and spinal lesions related to micturitionin of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) patients. Methods: Patients with CP/CPPS were enrolled to this study at the outpatient department of Tongji Hospital between January and June 2019. The data of clinical features was collected and analyzed, including lower urinary tract symptoms(LUTS), bowel syndrome and pain over different parts of body, as well as lower urinary tract dysfunction, spinal lesions and pelvic organ morphological changes demonstrated by MRI. The potential role of spinal lesions in the development of CP/CPPS syndrome was investigated. Results: A total of 126 CP/CPPS patients were included, with an age［M（Q₁，Q₃）］of 41(31,53) years and a course of disease of 2(1,20) years. Among them, 126 (100.0%) were complicated with LUTS, 72(57.1%) with bowel dysfunction and 88(69.8%) with pain. MRI showed the cervical central disc herniation(126 cases, 100.0%), the ischemic changing in the cervical area of visceral efferant pathway(82 cases, 65.1%), the lumbar central disc herniation(65 cases, 51.6%), and the sacral nerve cysts(97 cases, 77.0%) are commonly seen. In addition, the morphological changes in the visceral organs containing smooth muscle were demonstrated, including thickened bladder wall(91 cases, 72.2%), distended seminal vesicles(70 cases, 55.6%) and distended sigmoid colon/rectum(59 cases, 46.8%). Conclusions: CP/CPPS patients were characterized by the co-existence of LUTS, bowel dysfunction and somatic pain in one individual. The presence of multi-organ symptoms, combined with the high prevalence of spinal lesions associated with micturition reflex, suggesting the potential role of the spinal lesions in the development of CP/CPPS.

Challenge of evolving Klebsiella pneumoniae infection in patients on hemodialysis: from the classic strain to the carbapenem-resistant hypervirulent one

Loss of renal function may render hemodialysis patients more susceptible to infectious diseases, which is the second of all-causes mortality in this population. In addition to infection caused by the classic Klebsiella pneumoniae (cKp), however, hemodialysis staffs are now facing new challenge with growing prevalence of the carbapenem-resistant Kp (CR-Kp) and hypervirulent Kp (hvKp) as they are respectively associated with increased drug-resistance and virulence. We therefore chose to share our recent experience in treating severe infections either caused (cKp, CR-Kp, hvKp) or complicated (CR-hvKp) by these strains in hemodialysis patients. Based upon yet beyond published works, we further came up with the detection of intracranial lesion, novel diagnostic approach using unique biomarkers followed by selection of appropriate antibiotics, management of metastasic abscesses and bracing for the most lethal scenario in the order of cKp, CR-Kp, hvKp and CR-hvKp, respectively. Since reports of complicated hvKp infection in hemodialysis patients were rare, we also discussed in details this clinical entity focusing on its epidemiology, mechanism of increased virulence and involvement of the arteriovenous fistula as insidious source of persistent septicemia. By covering the full spectrum of clinically relevant Kp stains specifically from the viewpoint of nephrology, our work had highlighted the importance of infection control in uremic state and vice versa. As such, it may greatly raise the awareness of dialysis staffs against the challenge of evolving Klebsiella pneumoniae infection in hemodialysis patients and expeditiously reach a higher degree of readiness which was proved to be the key determinant of ultimate survival.

Acute necrotising pancreatitis: measurements of necrosis volume and mean CT attenuation help early prediction of organ failure and need for intervention

OBJECTIVES

This study explored the early predictive value of volume and mean CT density of necrosis for adverse outcomes in patients with acute necrotising pancreatitis (ANP).

METHODS

A total of 155 patients with ANP who underwent CECT within 7 days of symptom onset were included. The necrosis volume, mean CT density, and modified CT severity index (mCTSI) were calculated. C-reactive protein (CRP) and blood urea nitrogen (BUN) levels both 48 h after symptom onset were reviewed. Adverse outcomes were recorded. The predictive value of each indicator was assessed using ROC curve analysis.

RESULTS

There were significant associations between necrosis volume and mean CT density and organ failure (OF), persistent OF (POF), and need for intervention (p < 0.001 for all). For predicting OF, the area under the curve (AUC) was significantly higher for necrosis volume than for mCTSI and BUN (AUC: 0.84 vs 0.67, p = 0.0011; 0.84 vs 0.71, p = 0.0193, respectively). For predicting POF and need for intervention, the AUCs for necrosis volume were significantly higher than those for mCTSI (AUC: 0.79 vs 0.66, p = 0.0045; 0.77 vs 0.61, p = 0.0019, respectively), but did not significantly differ from those for CRP and BUN. For predicting OF, a significantly better predictive value was achieved with mean CT density than with mCTSI (AUC: 0.79 vs 0.67, p = 0.0163). There were no significant differences in predictive value between mean CT density, CRP, and BUN.

CONCLUSIONS

The volume and mean CT density of necrosis based on CECT can provide early prediction of OF, POF, and need for intervention.

KEY POINTS

• Compared to mCTSI, necrosis volume might be used to more accurately diagnose organ failure and persistent organ failure and might be better associated with the need for intervention. • Necrosis volume and mean CT density based on CECT are reliable quantitative predictors for organ failure, persistent organ failure, and intervention in acute pancreatitis.

Perfluorocarbon Protects against Lipopolysaccharide-Induced Apoptosis of Endothelial Cells in Pulmonary Microvessels

This study was aimed to explore the effect and mechanisms of action of perfluorocarbon on LPS-induced apoptosis of pulmonary microvascular endothelial cells (PMVEC) isolated from Sprague-Dawley rats. Apoptosis rates were assessed by flow cytometry. Ultrastructural characteristics of PMVEC were evaluated by transmission electron microscopy. The protein expression of cleaved caspase-3 was measured using Western blotting. LPS significantly increased the level of apoptosis, induced the appearance of ultrastructural changes typical of apoptosis, up-regulated the expression of active caspase-3 protein. These effects of LPS were attenuated by co-administration of perfluorocarbon. These results suggest that perfluorocarbon can attenuate LPS-induced apoptosis of PMVEC by inhibiting TLR-4 signaling and caspase-3 activation.

[A model analysis on the knowledge-attitude-practice of children guardians in Jiangxi, Shanghai and Qinghai]

Objective: To understand the knowledge attitude and practice (KAP) on vaccination among children's parents in Jiangxi, Shanghai, and Qinghai and explore the factors influencing KAP. Methods: The study selected two counties/districts in Jiangxi, Shanghai, and Qinghai, respectively, by stratified sampling and used a unified questionnaire to investigate the parental KAP of vaccination. A structural equation model (SEM) was used to explore factors influencing parental KAP, as well as the relationship between knowledge and behavior. Results: Of the 760 valid questionnaires, the knowledge of vaccination among children's parents was better, and the vaccination knowledge of parents in Qinghai and Shanghai were slightly better than those in Jiangxi. Parents mainly obtained vaccination knowledge through medical staff and vaccination manuals. The fitting degree of SEM was relatively good; the root mean square error of approximation of the model is 0.033. The higher the parents' education level, the better their knowledge of vaccination (β̂=0.082). Parental vaccination knowledge could influence whether the vaccinated children stay for half an hour in the clinics (β̂=0.541). It could also impact whether parents giving up vaccinating their children in the face of media reports about the adverse effects of vaccinations (β̂=0.515). Conclusions: The knowledge of vaccination among the parents in Jiangxi, Shanghai, and Qinghai was quite good. Moreover, we should pay more attention to the mass media programs and vaccination knowledge among parents with low or middle education backgrounds. Vaccination knowledge can be disseminated through medical staff, vaccination manuals, or mobile applications.

[Analysis of gene mutation profile of adult soft tissue sarcomas using high-throughput sequencing technology]

Objective: To understand the genetic variation of soft tissue sarcomas, and to provide a scientific evidence for the individualized treatment. Methods: The somatic mutation and germline mutation of 45 adult soft tissue sarcomas had been detected by high-throughput sequencing technology, the clinical data were also analyzed. Results: A total of 88 gene mutations were detected in 45 samples, including 78 single nucleotide variation (SNV), 13 insertion/deletion (Indel) and 19 copy number variation (CNV). The most common mutant genes are TP53, CDKN2A, MDM2, CDK4, NF1 and PTEN. Among them, the mutation rates of TP53-MDM2/MDM4-CDKN2A pathway, CDKN2A/CDK4/RB1 pathway, and RAS/NF1/PTEN/PI3K pathway were more frequent (32/88, 36%). In terms of immunotherapy biomarkers among 10 samples, the median value of tumor mutation burden was 2.02 muts/Mb (0-4.24 muts/Mb), and all were microsatellite stable. Conclusions: This study analyzes the genetic variation of soft tissue sarcoma, and determines the high-frequency gene mutations and pathways, which may be the potential drug targets. This finding can provide scientific evidences for the personalized treatment of soft tissue sarcoma.

Long Non-coding RNA LINC00628 Interacts Epigenetically with the LAMA3 Promoter and Contributes to Lung Adenocarcinoma

Long non-coding RNAs (lncRNAs) have emerged as key regulators of cellular progress in lung adenocarcinoma. In this study, to identify cancer-related lncRNAs and genes, we screened for those lncRNAs that were differentially expressed in lung adenocarcinoma, which revealed LINC00628 overexpression and low expression of laminin subunit alpha 3 (LAMA3). This was further validated in the cancerous tissues from patients diagnosed with lung adenocarcinoma. Thereafter, we explored the functional relevance of LINC00628 and LAMA3 in lung adenocarcinoma by analyzing the recruitment of DNA methyltransferase (DNMT) and the cellular processes of lung adenocarcinoma cells following treatments that induced LINC00628 overexpression or LINC00628 silencing or with 5-azacytidine (5-Aza, a DNMT inhibitor). The results showed that LINC00628 silencing decreased cell proliferation, migration, and invasion as well as the drug resistance of lung adenocarcinoma cells to vincristine (VCR). The results were opposite in the cells with LAMA3 demethylation induced by 5-Aza treatment. Further research indicated that LINC00628 recruited DNMT1, DNMT3A, and DNMT3B to promote the methylation of LAMA3 promoter, thereby decreasing its expression. Moreover, an in vivo experiment was performed in nude mice to assess the tumor growth ability and drug resistance of human lung adenocarcinoma cells. It was observed that LINC00628 silencing or 5-Aza treatment inhibited the in vivo tumor growth ability of the human lung adenocarcinoma cells and reduced their resistance to VCR. Altogether, our results provide evidence of a mechanism by which LINC00628 silencing exerts an inhibitory role in lung adenocarcinoma by modulating the DNA methylation of LAMA3, indicative of a novel molecular target for treatment of lung adenocarcinoma patients showing resistance to VCR.

Long non-coding RNA H19 is responsible for the progression of lung adenocarcinoma by mediating methylation-dependent repression of CDH1 promoter

Lung adenocarcinoma is a common histologic type of lung cancer with a high death rate globally. Increasing evidence shows that long non-coding RNA H19 (lncRNA H19) and CDH1 methylation are involved in multiple tumours. Here, we tried to investigate whether lncRNA H19 or CDH1 methylation could affect the development of lung adenocarcinoma. First, lung adenocarcinoma tissues were collected to detect CDH1 methylation. Then, the regulatory mechanisms of lncRNA H19 were detected mainly in concert with the treatment of overexpression of lncRNA H19, siRNA against lncRNA H19, overexpression of CDH1 and demethylating agent A-5az in lung adenocarcinoma A549 cell. The expression of lncRNA H19 and epithelial-mesenchymal transition (EMT)-related factors as well as cell proliferation, sphere-forming ability, apoptosis, migration and invasion were detected. Finally, we observed xenograft tumour in nude mice so as to ascertain tumorigenicity of lung adenocarcinoma cells. LncRNA H19 and methylation of CDH1 were highly expressed in lung adenocarcinoma tissues. A549 cells with silencing of lncRNA H19, overexpression of CDH1 or reduced CDH1 methylation by demethylating agent 5-Az had suppressed cell proliferation, sphere-forming ability, apoptosis, migration and invasion, in addition to inhibited EMT process. Silencing lncRNA H19 could reduce methylation level of CDH1. In vivo, A549 cells with silencing lncRNA H19, overexpression of CDH1 or reduced CDH1 methylation exhibited low tumorigenicity, reflected by the smaller tumour size and lighter tumour weight. Taken together, this study demonstrates that silencing of lncRNA H19 inhibits EMT and proliferation while promoting apoptosis of lung adenocarcinoma cells by inhibiting methylation of CDH1 promoter.

Tumor-suppressive effects of microRNA-181d-5p on non-small-cell lung cancer through the CDKN3-mediated Akt signaling pathway in vivo and in vitro

The involvement of several microRNAs (miRs) in the initiation and development of tumors through the suppression of the target gene expression has been highlighted. The aberrant expression of miR-181d-5p and cyclin-dependent kinase inhibitor 3 (CDKN3) in non-small-cell lung cancer (NSCLC) was then screened by microarray analysis. In the present study, we performed a series of in vivo and in vitro experiments for the purpose of investigating their roles in NSCLC and the underlying mechanism. There was a high expression of CDKN3, whereas miR-181d-5p was downregulated in NSCLC. Quantitative RT-PCR, Western blot analysis, and dual-luciferase reporter gene assay further identified that CDKN3 could be negatively regulated by miR-181d-5p. Moreover, the upregulation of miR-181d-5p or silencing of CDKN3 could inactivate the Akt signaling pathway. A549 with the lowest miR-181d-5p and H1975 with the highest CDKN3 among the five NSCLC cell lines (H1299, A549, H1975, NCI-H157, and GLC-82) were adopted for in vitro experiments, in which expression of miR-181d-5p and CDKN3 was altered by transfection of miR-181d-5p mimic/inhibitor or siRNA-targeting CDKN3. Afterwards, cell proliferation, apoptosis, invasion, migration, and angiogenesis, as well as epithelial-mesenchymal transition (EMT), were evaluated, and tumorigenicity was assessed. In addition, an elevation in miR-181d-5p or depletion in CDKN3 led to significant reductions in proliferation, invasion, migration, angiogenesis, EMT, and tumorigenicity of NSCLC cells, coupling with increased cell apoptosis. In conclusion, this study highlights the tumor-suppressive effects of miR-181d-5p on NSCLC via Akt signaling pathway inactivation by suppressing CDKN3, thus providing a promising therapeutic strategy for the treatment of NSCLC.

[Analysis on reproductive health service, demographics and characteristics of internal migrant population in three municipalities of China]

Objective: To investigate the utilization of reproductive health services and relating factors among internal migrant population in Beijing, Shanghai and Chongqing. Methods: A multi-stage cluster sampling method was adopted in this cross-sectional study, conducted in Beijing, Shanghai and Chongqing from August 2014 to August 2015. Standard methods on statistics and nonlinear canonical correlation were applied. Results: Out of the 6 545 internal migrant persons, 41.76% ever used the reproductive health services in the past year. Results from the nonlinear canonical correlation analysis revealed that the utilization of reproductive health services was correlated with the demographic features (=0.28, P<0.000 1) and characteristics of the population mobility (=0.21, P<0.000 1), respectively. For the above said demographic features, canonical variable L(1) which represented the demographic features was mainly determined by area, occupation and education attainment. Canonical variable M(1) that reflected the utilization of reproductive health services, was mainly determined by factors as free contraceptives, education on contraception/reproductive health, and pregnancy diagnosis/antenatal care. As for the characteristics of the population mobility, canonical variable U(1), which represented population mobility characteristics, was mainly determined by factors as purpose of migration, current pattern of residence and the length of annual stay in the area. Again, the canonical variable V(1), reflecting the use of reproductive health services was mainly determined by factors as free contraceptives, check-up on reproductive tract infection, education on contraception/reproductive health, and pregnancy diagnosis/antenatal care. Conclusions: The utilization of reproductive health services was low among the internal migrant population under study. Responsible departments for health and family planning in those cities should make internal migrants attach importance to reproductive health.

[Analysis of clinicopathological characteristics and prognostic factors of foot and ankle soft tissue and bone tumors]

Objective: To evaluate the clinicopathological characteristics of foot and ankle soft tissue and bone tumor, and to analyze the prognosis and the related factors of malignant tumors in this site. Methods: 74 patients with soft tissue and bone tumors of foot and ankle from January 2006 to February 2017 were retrospectively analyzed. The clinicopathological characteristics, the treatment and survival status of malignant tumors were followed up, and the clinical and therapeutic factors related to prognosis were analyzed. Results: Of the 74 patients, 34 were males and 40 were females. The male to female ratio was 1∶1.18; the age ranged from 12 to 64 years and the median age was 42 years. Tumors located in forefoot of 22 cases, 22 in midfoot, 10 in hind foot, 14 in ankle joint and 6 in multiple sites. 14 cases were bone tumors, including 7 benign and 7 malignant, and 60 cases were soft tissue tumors, including 14 benign and 46 malignant. The most common malignant soft tissue tumors were synovial sarcomas (13 cases), and the most common benign soft tissue tumors were hemangiomas (4 cases). 44 cases of malignant tumors underwent surgery were followed up, of which were 7 bone and 37 soft tissue malignant tumors. Limb salvage surgeries were performed in 33 cases and amputation in 11 cases. The median follow-up time was 69.8 months, and the median survival time was 40.7 months. The 1-year, 3-year and 5-year survival rate of soft tissue malignant tumors was 88.0%, 73.0%, and 63.0%, respectively. The 1-year, 3-year and 5-year survival rate of bone malignant tumors was 86.0%, 57.0% and 57.0%, respectively. Univariate analysis showed that the prognostic factors affecting 5-year survival rate were tumor size and adjuvant therapy (P<0.05). Patient's gender, age, tumor location, histological type and surgical procedure had no effect on overall survival(P>0.05). Multivariate analysis showed that tumor size was an independent prognostic factor (RR=7.262, P=0.005). Conclusions: Forefoot and midfoot are more common in foot and ankle soft tissue and bone tumors. Synovial sarcoma is the most common diagnosis in malignant soft tissue tumors, and hemangioma is the most common diagnosis in benign soft tissue tumors. The prognostic factor of malignant soft tissue and bone tumors in foot and ankle is tumor size. Patients with the tumor size of 5 cm or more have a worse prognosis.

[The role of preoperative (18)F-FDG PET-CT in lymphatic metastasis diagnosis of cutaneous malignant melanoma on extremities and trunk]

Objective: To evaluate the clinical value of preoperative (18)F-Fludeoxyglucose ((18)F-FDG PET-CT) in lymphatic metastasis diagnosis of cutaneous melanoma on extremities and trunk. Methods: 112 patients with cutaneous melanoma pathologically of extremities and trunk from January 2006 to December 2016, who received (18)F-FDG PET-CT examination preoperatively, were retrospectively reviewed. The correlations between the maximal diameters of lymph nodes, the maximal standard uptake value (SUV) and the diagnostic impression grades of PET-CT examination, and the final pathological diagnosis were analyzed. The correlations between Breslow thickness of primary lesions and the diagnostic impression of PET-CT examination were also analyzed. All the above were analyzed with Receiver Operating Characteristic (ROC) curve to get the cut-off value. Based on the final results of pathological diagnosis of lymph nodes as the golden standard, the statistically significant indicators of ROC curve analysis were used to evaluate the diagnostic effect, as well as to calculate the sensitivity, specificity and accuracy. With gender, age, maximal diameter of lymph nodes, maximal SUV, diagnosis impressions, and Breslow thickness as the independent variables and pathological diagnosis results of lymph nodes as the dependent variable, two-class stepwise Logistic regression analysis was used to determine the independence of diagnostic indicators. ROC curve analysis and log rank test were used to analyze the relationship between Breslow thickness and patient survival. Results: To evaluate melanoma patients' lymph node status, the results of ROC curve analysis showed that the area under the curve of lymph node maximal diameter, maximal SUV, diagnosis impression of PET-CT examinations were 0.789, 0.786 and 0.816, respectively (all P<0.05). The cut-off values were 0.85 cm, 1.45 and 2.5, respectively. The sensitivity of the cut-off values to determine the status of lymph nodes in melanoma patients were 71.4%, 64.9% and 72.1% respectively, and the specificities were 85.2%, 88.7% and 87.0% respectively. Multivariate Logistic regression analysis showed that PET-CT diagnosis impressions had independent diagnostic significance for the lymph node status of melanoma patients (OR=11.296, 95%CI: 2.550~50.033). The area under the curve of Breslow thickness evaluating PET-CT diagnostic impression is 0.664 (P=0.042) and the cut-off value was 4.25 mm. The survival rate of the patients with Breslow thickness ≥ 4.25 mm was lower than that in the group <4.25 mm (P=0.006). Conclusions: (18)F-FDG PET-CT can help to evaluate metastases and make treatment decisions for cutaneous melanoma of extremities and trunk, especially for patients whose primary lesion's Breslow thickness has reached more than 4.25 mm. For the patients whose maximal SUV of regional lymph node is higher than 1.45 and short diameter of the largest lymph node is larger than 0.85cm, the possibility of metastases should be considered.

Screening of specific nucleic acid aptamers binding tumor markers in the serum of the lung cancer patients and identification of their activities

Lung cancer is by far the leading cause of cancer death in the world. Despite the improvements in diagnostic methods, the status of early detection was not achieved. So, a new diagnostic method is needed. The aim of this study is to obtain the highly specific nucleic acid aptamers with strong affinity to tumor markers in the serum of the lung cancer patients for targeting the serum. Aptamers specifically binding to tumor markers in the serum of the lung cancer patients were screened from the random single-stranded DNA library with agarose beads as supports and the serum as a target by target-substituting subtractive SELEX technique and real-time quantitative polymerase chain reaction technique. Subsequently, the secondary single-stranded DNA library obtained by 10 rounds of screening was amplified to double-stranded DNA, followed by high-throughput genome sequence analysis to screen aptamers with specific affinity to tumor markers in the serum of the lung cancer patients. Finally, six aptamers obtained by 10 rounds of screening were identified with high specific affinity to tumor markers in the serum of the lung cancer patients. Compared with other five aptamers, the aptamer 43 was identified both with the highest specificity to bind target molecule and without any obvious affinity to non-specific proteins. The screened aptamers have relatively high specificity to combine tumor markers in the serum of the lung cancer patients, which provides breakthrough points for early diagnosis and treatment of lung cancer.

[Clinicopathological features and prognosis of malignant peripheral nerve sheath tumor: a retrospective study of 140 cases]

Objective: To investigate the clinicopathological features and prognosis of malignant peripheral nerve sheath tumors (MPNST). Methods: We retrospectively reviewed the clinical data of MPNST patients who were treated at Cancer Institute & Hospital, Chinese Academy of Medical Science from January 1999 to January 2016. A total of 140 patients with 66 male and 74 female with MPNST were enrolled in the study. The median age was 40 at the time of diagnosis. Survival analysis were estimated by Kaplan-Meier method and Log rank test. Multivariate analysis were estimated by Cox proportional hazards regression model. Results: The median follow-up time was 43.0 months. The 3- and 5-year overall survival (OS) rates were 56.4% and 48.6%, respectively. The 3-year local recurrence (LR) rate and distant metastasis (DM) rates were 42.9% and 49.3%, respectively. Univariate analysis showed that the tumor location, AJCC stage, S-100, radiotherapy and margin status affected 5-year OS rate (all P<0.05). The tumor location, AJCC stage, S-100, Ki-67 staining, margin status, radiotherapy and chemotherapy affected 3-year LR rate (all P<0.05). The tumor location, AJCC stage, S-100, Ki-67 staining and margin status affected 3-year DM rate (all P<0.05). Multivariate analysis showed that the tumor location, AJCC stage, S-100 were independent factors for 5-year OS rate (all P<0.05). The tumor location, Ki-67 staining and chemotherapy were independent factors for LR (all P<0.05) while the AJCC stage, margin status and Ki-67 staining were independent factors for DM (all P<0.05). Conclusions: MPSNT is an aggressive tumor with poor prognosis. Multiple factors were identified in this study. Patients with the tumor located at head and neck, advanced AJCC stage and negative S-100 usually have a low 5-year overall survival rate. Patients with the tumor located at head and neck, Ki-67 staining ≥ 20% and without chemotherapy had a higher tendency of local recurrence. Poor prognosis factors for DM were advanced AJCC stage, positive margin and Ki-67 staining ≥ 20%.

The role of microRNA-21 in predicting brain metastases from non-small cell lung cancer

Objective

This study aimed at exploring the role of microRNA-21 (miR-21) in predicting brain metastases (BM) from non-small cell lung cancer (NSCLC).

Methods

A total of 132 NSCLC patients, including 68 patients with BM and 64 patients without BM, were included in the study. NSCLC cells were collected and assigned to the inhibitor (IN) group, the mock group, and the negative control (NC) group. The quantitative real-time polymerase chain reaction assay was used to detect the miR-21 expression. Cell proliferation, migration, invasion, and apoptosis were detected by colony-forming assay, MTT assay, transwell assay, and flow cytometry, respectively. Angiogenesis was measured by endothelial cell tube formation assay.

Results

The miR-21 expression was higher in NSCLC patients with BM than in those without BM. The miR-21 expression in the IN group was lower than that in the NC and mock groups. Compared with the NC and mock groups, the values of optical density (OD) and the colony-forming number decreased in the IN group. Compared with the NC and mock groups, cell invasion and migration abilities significantly reduced in the IN group. The IN group had higher apoptosis rate than the NC and mock groups. The tube length was shorter and the number of junction points was less in the IN group in comparison to the NC and mock groups.

Conclusion

miR-21 might be a potential biomarker for the development of BM in NSCLC patients and could promote the proliferation, migration, invasion, and angiogenesis of NSCLC cells.

Comparison of mercury sulfides with mercury chloride and methylmercury on hepatic P450, phase-2 and transporter gene expression in mice

Zuotai (mainly β-HgS) and Zhusha (also called as cinnabar, mainly α-HgS) are used in traditional medicines in combination with herbs or even drugs in the treatment of various disorders, while mercury chloride (HgCl2) and methylmercury (MeHg) do not have known medical values but are highly toxic. This study aimed to compare the effects of mercury sulfides with HgCl2 and MeHg on hepatic drug processing gene expression. Mice were orally administrated with Zuotai (β-HgS, 30mg/kg), α-HgS (HgS, 30mg/kg), HgCl2 (33.6mg/kg), or MeHg (3.1mg/kg) for 7days, and the expression of genes related to phase-1 drug metabolism (P450), phase-2 conjugation, and phase-3 (transporters) genes were examined. The mercurials at the dose and duration used in the study did not have significant effects on the expression of cytochrome P450 1-4 family genes and the corresponding nuclear receptors, except for a slight increase in PPARα and Cyp4a10 by HgCl2. The expressions of UDP-glucuronosyltransferase and sulfotransferase were increased by HgCl2 and MeHg, but not by Zuotai and HgS. HgCl2 decreased the expression of organic anion transporter (Oatp1a1), but increased Oatp1a4. Both HgCl2 and MeHg increased the expression of multidrug resistance-associated protein genes (Mrp1, Mrp2, Mrp3, and Mrp4). Zuotai and HgS had little effects on these transporter genes. In conclusion, Zuotai and HgS are different from HgCl2 and MeHg in hepatic drug processing gene expression; suggesting that chemical forms of mercury not only affect their disposition and toxicity, but also affect their effects on the expression of hepatic drug processing genes.

[Effects of the interleukin-21 expression in patients with immune thrombocytopenia and its regulation by high-dose dexamethasone]

OBJECTIVE

To investigate the correlation of immunologic thrombocytopenia(ITP) pathogenesis with the abnormal expression of IL-21, and to explore the association of high-dose dexamethasone (HD-DEX) treatment with the IL-21 expression.

METHODS

26 newly diagnosed ITP patients and 24 healthy controls were enrolled in this study. The mononuclear cells and serum were obtain from density gradient centrifugation in the newly diagnosed ITP patients before HD-DXM treatment, and the samples of healthy controls were also used for assays. The protein and mRNA expression of IL-21 on peripheral blood mononuclear cells(MNC) were determined by flow cytometry and real-time reverse-transcription polymerase chain reaction. Plasma levels of IL-21, IFN-γ and IL-4 were determined by enzyme-linked immunoabsorbent assay (ELISA).

RESULTS

IL-21 expression on mononuclear cells was significantly higher in ITP patients (13.07%) than that in normal controls (8.2%), the ratio of IL-21/GAPDH mRNA expression on MNC was significantly higher in ITP patients (9.524±0.97) than that in normal controls (3.701±0.60, P<0.01). After HD-DXM therapy, the ratio of IL-21/GAPDH mRNA decreased significantly (5.87±1.21) as compared with the level before treatment. Significantly high levels of serum IL-21, IFN-γ and lower IL-4 were found in ITP patients, as compared with healthy controls. Serum IL-21 and IFN-γ levels in ITP patients decreased significantly after HD-DXM administration (P<0.01), while post-treatment levels of IL-4 were increased significantly, compared with the levels before treatment (P<0.01).

CONCLUSION

Therapeutic effect of DXM on ITP associates with down-regalation of IL-21 expression. The increased expression of IL-21 involves in the pathogenesis of ITP.

Successful management of a childhood osteosarcoma with epiphysiolysis and distraction osteogenesis

In an 11-year-old boy with osteosarcoma in the proximal tibia (type iii), 2 cycles of dia chemotherapy (cisplatin, ifosfamide, doxorubicin) were administered preoperatively while epiphysiolysis was performed. Clinical response was determined to be complete by radiography and histopathology. Marginal excision was then performed with preservation of the proximal tibial epiphysis. Metaphyseal reconstruction was performed using distraction osteogenesis. Six cycles of dia chemotherapy were administered postoperatively. Twenty months later, the patient had developed no complications and experienced full bone healing, with no limb discrepancy. In selected adolescent patients with osteosarcoma, in whom the tumour is in full contact with the epiphysis, epiphyseal preservation by epiphysiolysis and reconstruction by distraction osteogenesis can provide an excellent outcome, resulting in a stable reconstruction that functionally restores the native limb.

Effects of photoperiod on broodiness, egg-laying and endocrine responses in native laying hens

1. The effects of photoperiod on broodiness, egg-laying and endocrine responses in native laying hens were investigated. A total of 648, 18-week-old native laying hens (Beijing You Chicken, BYC) were randomly allocated to 6 groups with 3 replicates. The birds were exposed to 1 of 6 different photoperiods, including 16L:8D (06:00 to 22:00 h) for group 1; 12L:2D:4L:6D for group 2; 8L:4D:4L:8D for group 3; 16L:8D (03:00 to 19:00 h) for group 4; 14L:10D for group 5; and 18L:6D for group 6. 2. The broodiness rate and egg-laying rate for weeks 20-26, 27-33, 34-40, 41-47, 48-54 and 55-61 were calculated, and serum prolactin (PRL), luteinising hormone (LH), 17-beta-oestradiol (E2), melatonin (Mel) and progesterone (P4) concentrations were measured at the end of each stage. 3. Significant effects were observed on the rate of broodiness by the photoperiod and stage, but the interaction of photoperiod and stage was not significant. The rate of broodiness for group 3 (5.9%) was significantly higher than other groups, with group 2 being the lowest (2.8%). Broodiness rate was the highest for weeks 41-47 (9.9%). Significant effects were observed on average egg-laying rate by photoperiod and stage: the rate of egg-laying of groups 2 and 5 were significantly higher than groups 1, 4 and 6. 4. There were no significant effects of photoperiod on PRL, LH and Mel concentrations at 26, 33, 40 and 54 weeks of age (P > 0.05), but at 47 weeks of age, PRL and LH concentrations of group 1 were significantly lower than those in other groups. 5. The study suggests that the photoperiod of group 2 (12L:2D:4L:6D) is optimal for the birds' performance to give the lowest broodiness rate and the highest egg-laying rate during the whole laying period, and 41-47 weeks may be a key stage for the photomodulation of broodiness.

Effects of polymorphisms in the XRCC1, XRCC3, and XPG genes on clinical outcomes of platinum-based chemotherapy for treatment of non-small cell lung cancer

This study aimed to investigate the effects of single-nucleotide polymorphisms (SNPs) XRCC1 Arg194Trp, XRCC1 Arg280His, XRCC1 Arg399Gln, XRCC3 Thr241Met, XPG His104Asp, and XPG His46His in genes involved in the DNA-repair pathway on the outcomes of platinum-based chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). The study period was from January 2005 to January 2006, and 378 NSCLC patients were enrolled within 1 month after being diagnosed with NSCLC. Genomic DNA was extracted using the Qiagen Blood Kit. Polymerase chain reaction combined with a restriction fragment length polymorphism assay was used for genotyping. Individuals with the XRCC1 399A/A genotype had a higher probability of responding well to platinum-based chemotherapy, indicated by an odds ratio (OR) of 2.27 [95% confidence interval (CI)=1.64-6.97]. Similarly, the XPG T/T genotype was significantly associated with improved responses to chemotherapy, indicated by an OR of 1.90 (95%CI=1.10-3.28). The XRCC1 399A/A genotype was significantly associated with longer disease-free survival and overall survival, indicated by hazard ratios (HRs) of 0.48 (95%CI=0.25-0.88) and 0.51 (95%CI=0.26- 0.98), respectively. Moreover, the XPG 46T/T genotype increased the likelihood of longer disease-free survival and overall survival of NSCLC patients treated with platinum-based chemotherapy (HR=0.47; 95%CI=0.22-0.82 and HR=0.52; 95%CI=0.31- 0.96, respectively). These results indicate that XRCC1 Arg399Gln and XPG His46His might significantly affect the clinical outcomes of platinum-based chemotherapy, highlighting the need for larger studies to confirm the role of these two SNPs in outcomes of NSCLC treatments.

Denosumab and giant cell tumour of bone-a review and future management considerations

Giant cell tumour of bone (gctb) is one type of giant-cell-rich bone lesion characterized by the presence of numerous multinucleated osteoclast-type giant cells. Giant cells are known to express rankl (receptor activator of nuclear factor κB ligand) and are responsible for the aggressive osteolytic nature of the tumour. No available treatment option is definitively effective in curing this disease, especially in surgically unsalvageable cases. In recent years, several studies of denosumab in patients with advanced or unresectable gctb have shown objective changes in tumour composition, reduced bony destruction, and clinical benefit. Denosumab is a fully human monoclonal antibody that targets and binds with high affinity and specificity to rankl. Several large phase iii studies have shown that denosumab is more effective than bisphosphonates in reducing skeletal morbidity arising from a wide range of tumours and that it can delay bone metastasis. The relevant articles are reviewed here. The controversies related to the future use of denosumab in the treatment of gctb are discussed.

An effectiveness study comparing acupuncture, physiotherapy, and their combination in poststroke rehabilitation: a multicentered, randomized, controlled clinical trial

CONTEXT

Stroke is a leading cause of death and disability worldwide, being the third leading cause of death in the United States and the second and third most common causes of death in Chinese cities and rural areas, respectively. Evaluation of different rehabilitative modalities appears necessary to optimize treatment.

OBJECTIVES

To compare acupuncture and physiotherapy for effectiveness and reliability in treating hemiplegic patients after stroke.

DESIGN

The research team designed a multicentered, three-arm, randomized controlled trial. Power calculations revealed a targeted sample size of 310 participants.

SETTING

The study took place at seven in-patient hospitals in China.

PARTICIPANTS

The research team screened a total of 310 patients. Of that number, 274 completed the study, 15 did not meet the inclusion/exclusion criteria, and 21 dropped out. Adverse events were rare (less than 1%), mild, and temporary.

INTERVENTION

The research team randomly divided participants into three groups that all received conventional care as needed-including psychological counseling, standard nursing care, and daily medical evaluation plus (1) acupuncture, (2) physiotherapy, or (3) acupuncture plus physiotherapy. The participants received treatments once a day, 6 days a week for 4 weeks.

OUTCOME MEASURES

The research team evaluated all patients at baseline, after 2 weeks, and after 4 weeks using the Fugl-Meyer Assessment of Physical Performance (FMA), a modified Barthel Index (BI), and the Neurologic Defect Scale (NDS).

RESULTS

No significant differences existed between the three groups at baseline. Compared to baseline, participants in all groups improved their FMA, BI, and NDS scores by the end of week 2 (P≤.05) and further improved by the end of week 4 (P≤.05) The study found no statistically significant differences in outcomes between the three groups after treatment (P>.05).

CONCLUSION

Acupuncture plus conventional care was similar in effectiveness to physiotherapy treatment plus conventional care for poststroke rehabilitation. The study found no synergistic effects for the combination of acupuncture and physiotherapy in addition to conventional care; that combination of treatments was no more effective than either treatment by itself. The effectiveness and lack of adverse events associated with acupuncture in this study suggest that it may represent an additional treatment option for stroke patients.

Perfluorocarbon attenuates lipopolysaccharide-mediated inflammatory responses of alveolar epithelial cells in vitro

BACKGROUND

Toll-like receptor-4 (TLR-4) is integrally involved in lipopolysaccharide (LPS) signaling and has a requisite role in the activation of nuclear factor-κB (NF-κB). The exact mechanisms that lend perfluorocarbon (PFC) liquids a cytoprotective effect have yet to be elucidated. Therefore we examined in an in vitro model the cytoprotective effect of PFC on LPS-stimulated alveolar epithelial cellls (AECs).

METHODS

AECs (A549 cells, human lung adenocarcinoma cell line) were divided into four groups: control, PFC, LPS and LPS + PFC (coculture group) groups. Intercellular adhesion molecule-1 (ICAM-1) was detected by ELISA, tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) were detected by radioimmunological methods. The expression of TLR-4 mRNA and protein was detected by real time PCR and Western blotting, respectively. The activation of NF-κB was detected by Western blotting (proteins of I-κBa and NF-κB p65).

RESULTS

ICAM-1, TNF-α and IL-8 were significantly increased in LPS-stimulated AECs groups. The expression of TLR-4 mRNA and protein in LPS-stimulated groups was markedly increased. Meanwhile, NF-κB was activated as indicated by the significant degradation of IκB-α and the significant release of NF-κB P65 and its subsequent translocation into the nucleus. There were no significant effects of PFC alone on any of the factors studied while the coculture group showed significant downregulation of the secretion of ICAM-1, TNF-α and IL-8, the expression of TLR-4 mRNA and the activity of NF-κB.

CONCLUSIONS

Taken together, our results demonstrate that LPS can induce AEC-related inflammatory injury via the activation of TLR-4 and subsequent activation of NF-κB. PFC is able to protect AECs from LPS-induced inflammatory injury by blocking the initiation of the LPS signaling pathway, which is indicated by the significant decrease of TLR-4 expression and NF-κB activation.

Active components of common traditional Chinese medicine decoctions have antioxidant functions

Many traditional Chinese medicine (TCM) decoctions are proven to have multiple functions in animal production. These decoctions are seldom recognized by the international scientific community because the mechanisms of action are not clearly elucidated. According to TCM theory, Cortex Phellodendri (COP), Rhizoma Atractylodes (RA), Agastache Rugosa (AR), and Gypsum Fibrosum (GF) can be used to formulate a medicinal compound that prevents or cures animal disease caused by heat stress. The aim of this research was to study the regulatory functions of the active components of TCM and to elucidate the effects of different TCM decoctions on antioxidant activity and lipid peroxide content, using in vitro and in vivo models of heat stress. For in vitro experiments, intestinal crypt-like epithelial cell line-6 (IEC-6) cells were employed to evaluate the effects of the active components of COP, RA, AR, and GF. For in vivo experiments, forty-eight 2-mo-old Chinese experimental mini-pigs (7.20 ± 0.02 kg) were randomly assigned to 4 groups: a normal-temperature group (NTG); a high-temperature group (HTG); HTG treated with COP, RA, AR, and GF (1:1:1:1, TCM1); and HTG treated with COP, RA, AR, and GF (1:1:1:0.5, TCM2). Results showed that the active components of the COP, RA, AR, and GF increased (P < 0.05) the proliferation and viability of heat-stressed IEC-6 cells and that the most effective treatment doses of COP alkaloid, RA Aetherolea, Herba Agastachis Aetherolea, and GF water extract were 200, 100, 100, and 200 µg/mL, respectively. All 4 active components increased (P < 0.05) superoxide dismutase, glutathione peroxidase activities, and glutathione content, and decreased (P < 0.05) malondialdehyde content with respect to the heat-stressed group to concentrations similar to those seen in NTG. In vivo experiments demonstrated that TCM1 and TCM2 improved (P < 0.05) the poor growth performance seen in HTG pigs. The superoxide dismutase, glutathione peroxidase activities, and malondialdehyde content in porcine jejunum treated with TCM1 and TCM2 were not different (P > 0.05) from those seen in the NTG and were better (P < 0.05) than results seen in the HTG. Overall, it appeared that TCM2 was more effective than TCM1 in ameliorating the effects of heat stress in pigs. In conclusion, this study revealed that the active components of common TCM decoctions have antioxidant functions.

Relationship between genetic polymorphism of MCP-1 and non-small-cell lung cancer in the Han nationality of North China

Monocyte chemoattractant protein 1 (MCP-1) is an important chemokine that has a dose-dependent anti-tumoral effect. Polymorphism in the MCP-1 distal regulatory region (-2518A/G) can affect the level of MCP-1 expression. We examined the polymorphisms of 112 unrelated patients with non-small-cell lung cancer (NSCLC) and 82 unrelated healthy controls of Han nationality in North China using PCR-RFLP. We found that the distributions of AA, AG and GG genotypes of MCP-1-2518 were significantly different in NSCLC patients compared to controls (chi(2) = 10.106, P = 0.006). There was a significant increase in the frequency of the AA genotype (odds ratio (OR) = 3.138, chi(2) = 8.905, P = 0.003) and a significant decrease in the frequency of the GG genotype (OR = 0.516, chi(2) = 4.613, P = 0.032) in the NSCLC patients, compared to controls. The frequencies of AA, AG and GG genotypes did not differ in the NSCLC patients according to the number of pack-years smoked. Based on these results, we suggest that the MCP-1 -2518A/G polymorphism is associated with genetic susceptibility to NSCLC.

Analysis of HLA-A, HLA-B and HLA-DRB1 alleles in Chinese patients with lung cancer

The primary function of the human leukocyte antigen (HLA) system is to regulate the immune response. Because of its important role in the immune response and its high degree of polymorphism, the HLA system is associated with many diseases. We examined the polymorphisms of HLA-A, B and DRB1 alleles in 100 unrelated patients with lung carcinoma and in 438 unrelated normal controls of Han nationality from North China, using sequence-based typing and PCR with sequence-specific primers. We found that the frequencies of HLA-A*0201, A*2601, B*1518, B*3802, DRB1*0401, DRB1*0402, and DRB1*1201 were higher in the lung carcinoma group than in the normal control group. The P values were 0.035, 0.040, 0.001, 0.017, 0.014, 0.004, and 0.019, respectively, and the odds ratio values were 1.052, 3.513, 4.047, 3.054, 4.237, 19.397, and 2.128, respectively. The frequency of HLA-DRB1*1302 was lower in the lung carcinoma group than in the normal control group (P = 0.046, odds ratio = 0.168). We concluded that patients with lung cancer and healthy controls of Han nationality from North China differ in the frequencies of various HLA alleles.

Intrinsic anisotropy of degree of transport spin polarization in typical ferromagnets

A general approach is presented for investigation of the anisotropy of the degree of transport spin polarization (P) in ferromagnets both in the ballistic regime, P(1,i), and in the diffusive regime, P(2,i), as a function of crystal direction. The validity of this approach is confirmed by the benchmark calculation for the isotropic P. By this approach, we have investigated the anisotropy of P in bcc Fe, fcc Co, fcc Ni and hcp Co. For cubic structures, P(1,i) shows a small but appreciable anisotropy, due to the difference in the electronic orbital extension for spin-up and spin-down conduction bands. However, P(2,i) shows an isotropic feature for the cubic structure, as a result of the combination of its dependence on the square of electron velocity and the lattice symmetry. On the other hand, for hcp Co, both P(1,i) and P(2,i) show a very strong anisotropy. The large anisotropy of P(1,i) and P(2,i) in hcp Co is mainly attributed to the anisotropy of spin-down ballistic (diffusive) conductance.

[Effect of melatonin on release of beta-endorphin, norepinephrine and 5-hydroxytryptamine in rat brain]

AIM

In order to explore the mechanism of action of melatonin to induce analgesia, the present study was undertaken to observe the effects of melatonin on the release of beta-endorphin (beta-Ep), norepinephrine (NE) and 5-hydroxytryptamine in rat brain.

METHODS

With the measurement of pain threshold, push-pull perfusion technique and radioimmunoassay were used to determine the immunoreactive beta-Ep content in the perfusate from the third ventricle of rat brain. The contents of 3-methoxy-4-hydroxyphenyl glycol (MHPG) and 5-hydroxyindole acetic acid in the microdialysate from rat brain were measured by techniques of in vivo microdialysis and high performance liquid chromatography with electrochemical detection.

RESULTS

The immunoreactive beta-Ep content in the perfusate from the third ventricle of rat brain was increased significantly (P < 0.05) following an intraperitoneal administration of 110 mg.kg-1 of melatonin, with the increase of pain threshold. The MHPG and 5-HIAA contents in the microdialysate from the periaqueductal gray (PAG) or the hypothalamus were not changed after the administration of melatonin.

CONCLUSION

Melatonin may promote the release of beta-Ep in brain, which may be one of the mechanisms of the analgesic action of melatonin. The analgesic action of melatonin may not be related to the release of NE and 5-HT in the PAG or the hypothalamus.

The analgesic effects of peripheral and central administration of melatonin in rats

To explore the site and mechanism of the analgesic action of melatonin, the present study was designed to evaluate the analgesic effects of intraperitoneal (i.p.) and intracerebroventricular (i.c.v. ) administration of melatonin, and to investigate the effect of i.c. v. naloxone on the analgesic effect induced by i.p. melatonin in rats. Antinociception was determined by tail-flick latency to hot water at 50 degrees C. On i.p. administration, melatonin (30, 60 and 120 mg/kg) produced the antinociceptive effect in a dose-dependent manner, with an A(50) of 72.8 mg/kg. Administered i.c.v., melatonin (0.25, 0.5 and 1 mg/kg) also resulted in dose-dependent antinociception, with an A(50) of only 0.693 mg/kg. Injected i.c.v. to rats, 10 microg of naloxone antagonized significantly the antinociceptive effect induced by i.p. melatonin. It is concluded that melatonin has an analgesic effect in rats and the central nervous system (CNS) may be the primary site for melatonin to elicit the response, and the effect of melatonin is related to the central opioid system.

Polychlorinated organic compounds (PCOCs) in waters, suspended solids and sediments of the Yangtse River

The contamination levels of polychlorinated organic compounds (PCOCs) in waters, suspended solids and sediments of the Yangtse River (Nanjing part) were analyzed in this paper. Their concentrations determined by GC/MS were very low in comparison with those in European River. The average concentration of total HCH (alpha-HCH, beta-HCH, gamma-HCH) was much higher than that of other PCOCs in all waters, which made up 65% of total amount of PCOCs. Due to the complete dilution and mixture of pollutants in the mighty Yangtse River, the content of PCOCs at each sampling station demonstrated very similar spatial pattern for waters and suspended solids. Since the small suspended solid (<0.7 microm) passed through the filter was also considered as dissolved part, the dominant parts of HCHs, PCA and PCBs were found in dissolved phase with percentage proportion of 85-94%, 72-85% and 61-78%, respectively. For DDTs, HCB and PeCB, their contents in dissolved phase were slightly higher than in particulate phase. The contents of PCOCs in sediments were also very low and varied with high fluctuation at different sampling points, indicating the heterogeneous deposition. HCB and its metabolite (PeCB) presented the highest contamination levels among PCOCs in sediments.

[Melatonin influences the release of endogenous opioid peptides in rat periaqueductal gray]

The present study was undertaken to explore central mechanisms underlying the analgesic effect of melatonin. Push-pull perfusion technique and radioimmunoassay were used to observe the changes in the contents of beta-endorphin (beta-Ep) and leucine-enkephalin (L-EK) in the perfusate from the rat periaqueductal gray (PAG) after administration of melatonin. 30 50 min after an intraperitoneal injection of melatonin (110 mg/kg), the beta-Ep content in the perfusate was increased significantly, while the L-EK content was not changed. Pain threshold was measured using the warm water tail-flick test during the push-pull perfusion of the PAG. It was found that the rat pain threshold was increased significantly 40 min after the intraperitoneal injection of melatonin (110 mg/kg). The results suggest that melatonin may promote the release of beta-Ep in the PAG, which may be one of the mechanisms of the analgesic effect of melatonin.

Melatonin attenuates the intensity of beta-endorphin immunoreactivity in the arcuate nucleus of rat hypothalamus

The present study was undertaken to observe the effect of exogenously administered melatonin on the intensity of beta-endorphin (beta-Ep) immunoreactivity of the neuron in the arcuate nucleus of rat hypothalamus with an aim to explore the possible mechanisms of the analgesic effect of melatonin. The experimental rats were divided into two groups, one injected intraperitoneally with melatonin (110 mg/kg) and the other with only a vehicle. One hour after injection, the brain was processed for coronal sections, which were stained with immunohistochemical ABC technique. The integral optical density (IOD) and mean optical density (OD) of the stained sections were measured with a computer-assisted image-processing and analytical system. beta-Ep immunoreactivity was much decreased in the sections treated with melatonin and the IOD and OD were also decreased significantly (P<0.01; P<0.05). The above results suggest that melatonin may result in a decrease of beta-Ep content in the arcuate nucleus, as a result of increased beta-Ep release induced by administration of melatonin. It is likely that the analgesic effect of melatonin may be in part mediated by the release of beta-endorphin from the arcuate nucleus.

Effect of melatonin on pro-opiomelanocortin mRNA expression in arcuate nucleus of rat hypothalamus

AIM

To observe altered expression of pro-opiomelanocortin (POMC) mRNA localized in neurons in the arcuate nucleus of rat hypothalamus following exogenous administration of melatonin.

METHODS

The experimental animals were divided into two groups injected i.p. with melatonin 90 mg.kg-1 and vehicle at 12 h interval (9:00 am and 9:00 pm). Twelve hours after the last injection, the rat brains were processed for coronal sections and nonradioactive in situ hybridization histochemistry technic was used. The integral optical density (IOD) and mean optical density (OD) of the stained brain sections were measured using the computer-assisted image processing technique.

RESULTS

The POMC mRNA expression in the arcuate nucleus showed obvious enhancement in the brain sections of rats treated with melatonin. The IOD and OD values in the hypothalamic arcuate nucleus area were increased significantly (P < 0.01, P < 0.05 respectively) with melatonin treatment.

CONCLUSION

Melatonin may enhance the POMC mRNA expression in the arcuate nucleus of rat hypothalamus.

Selective MT(2) melatonin receptor antagonist blocks melatonin-induced antinociception in rats

The present study was undertaken to assess the effects of intracerebroventricular (i.c.v.) luzindole (a selective MT(2) melatonin receptor antagonist) and prazosin (a selective MT(3) melatonin receptor antagonist) on melatonin-induced antinociception, so as to clarify which of melatonin receptor subtypes within the central nervous system (CNS) was mediating antinociception. The pain threshold of rats was measured by the hot water (50 degrees C) tail-flick test. It was found that intraperitoneal (i.p.) melatonin (30, 60, 120 mg/kg) resulted in a dose-dependent antinociception. Luzindole (50, 100 microgram) administered intracerebroventricularly antagonized significantly the antinociceptive effect induced by i.p. melatonin (120 mg/kg), whereas prazosin (50 microgram) did not. Neither luzindole (100 microgram, i.c.v.) nor prazosin (50 microgram, i.c.v.) affected the nociceptive threshold when given alone. The results suggest that melatonin-induced antinociception is mediated through the MT(2) melatonin receptor subtype within the CNS.

Effects of fenfluramine combined with electroacupuncture on monoamine release in periaqueductal gray of rat brain

AIM

To study the changes of monoamines in ventrolatoral periaqueductal gray of rat brain before and after electroacupuncture (EA) analgesia (EAA) was enhanced by fenfluramine (Fen), a 5-hydroxytryptamine (5-HT) releaser.

METHODS

Monoamines were collected by in vivo microdialysis and measured by HPLC connected with electrochemical detector.

RESULTS

The level of norepinephrine (Nor) after EA was decreased (P < 0.05 vs NS group). The contents of 5-HT, 5-hydroxyindol acetic acid (5-HIAA), dopamine (DA), and homovanillic acid (HVA) in periaqueductal gray dialysate were increased (P < 0.05 vs NS group). When Fen was combined with EA, the level of 5-HT and 5-HIAA were further increased (P < 0.05 vs NS + EA group). There was no obvious change of Nor, DA, and HVA.

CONCLUSION

Fen potentiating EAA may be related to further activation of serotoninergic system.

Distinct leukemia phenotypes in transgenic mice and different corepressor interactions generated by promyelocytic leukemia variant fusion genes PLZF-RARalpha and NPM-RARalpha

Acute promyelocytic leukemia (APL) is characterized by a specific chromosome translocation involving RARalpha and one of four fusion partners: PML, PLZF, NPM, and NuMA genes. To study the leukemogenic potential of the fusion genes in vivo, we generated transgenic mice with PLZF-RARalpha and NPM-RARalpha. PLZF-RARalpha transgenic animals developed chronic myeloid leukemia-like phenotypes at an early stage of life (within 3 months in five of six mice), whereas three NPM-RARalpha transgenic mice showed a spectrum of phenotypes from typical APL to chronic myeloid leukemia relatively late in life (from 12 to 15 months). In contrast to bone marrow cells from PLZF-RARalpha transgenic mice, those from NPM-RARalpha transgenic mice could be induced to differentiate by all-trans-retinoic acid (ATRA). We also studied RARE binding properties and interactions between nuclear corepressor SMRT and various fusion proteins in response to ATRA. Dissociation of SMRT from different receptors was observed at ATRA concentrations of 0.01 microM, 0.1 microM, and 1.0 microM for RARalpha-RXRalpha, NPM-RARalpha, and PML-RARalpha, respectively, but not observed for PLZF-RARalpha even in the presence of 10 microM ATRA. We also determined the expression of the tissue factor gene in transgenic mice, which was detected only in bone marrow cells of mice expressing the fusion genes. These data clearly establish the leukemogenic role of PLZF-RARalpha and NPM-RARalpha and the importance of fusion receptor/corepressor interactions in the pathogenesis as well as in determining different clinical phenotypes of APL.

[Effect of intrathecal injection of dopamine receptor agonists/antagonists on pain and acupuncture analgesia in rats]

Some selective dopamine receptor agonists and antagonists were tested on rat tail flick model to investigate the role of D1 and D2 dopamine receptor in pain and acupuncture analgesia (AA). It was found that intrathecal administration (i.t.) of D2 receptor agonist LY171555 or D1/D2 receptor agonist apomorphine increased pain threshold and had a potentiating effect on AA. In contrast, D1 receptor agonist SKF38393 had no effect. It D1 receptor antagonist SCH23390 or D2 receptor antagonist sulpiride attenuated the effect of AA. The results suggest that D2 receptor is involved in pain modulation and activation of D2 receptor and enhances AA in the spinal cord, while such effect is absent in D1 receptor and inactivation of D1 receptor attenuates AA.

Antagonistic effect of orphanin FQ on opioid analgesia in rat

AIM

To study the effect of orphanin FQ (OFQ), a newly discovered heptadecapeptide, on nociception and opioid analgesia.

METHODS

The intracerebroventricular (i.c.v.) and intrathecal (i.t.h.) injections were used to give the drugs. The tail-flick model of rats were used to test the pain threshold.

RESULTS

OFQ (i.c.v. or i.t.h.) 0.1 microgram had no effect on nociception but 0.5-10 micrograms induces hyper-reaction of rat to noxious electric stimulus; the decapeptide (OFQ1-10 i.c.v.), a fragment of the OFQ, did not affect the pain reaction of rats. Fentanyl (1 microgram, i.c.v. or i.t.h.), a selective mu-receptor agonist, DSLET (5 micrograms, i.c.v. or i.t.h.), a selective delta-receptor agonist, or U50488H (1 microgram, i.t.h.), a kappa-receptor agonist, induced an increase in pain threshold, when OFQ (0.1 or 1 microgram) was added together with one of them (except for the ith injection of DSLET), the increase of pain threshold was reduced obviously.

CONCLUSION

OFQ induces hyperalgesia and antagonizes opioid analgesia mediated by mu- and delta-receptors in the brain and by mu- and kappa- but not delta-receptors in the spinal cord of rats.

Orphanin FQ potentiates formalin-induced pain behavior and antagonizes morphine analgesia in rats

The present study was designed to observe the effect of orphanin FQ (OFQ, also known as 'nociceptin'), a newly-discovered neuropeptide, on pain behavior and morphine analgesia evaluated by formalin test in rats. It was found that intracerebroventricular (i.c.v.) injection of 0.1 microg OFQ had no effect on formalin-induced pain behavior; but 1, 5, 10 or 20 microg OFQ produced prolonged lifting, licking, biting or shaking of the affected paw with higher pain scoring in dose dependent manner. Repeated i.c.v. injection of antisense olignucleotide (ASO) complementary to OFQ receptor but not mismatch olignucleotide (MSO) resulted in the decrease of pain behavior; in such circumstances, OFQ showed no enhancing effect on formalin nociception. OFQ (0.1 or 1 microg, i.c.v.) significantly attenuated morphine analgesia and ASO could validly antagonize the effect of it. Pretreatment with MSO had no such effect. The present results suggest that OFQ enhances the pain behavior of rat and antagonizes morphine analgesia in formalin test.

[Effect of intrathecal or intracerebroventricular administrition of OFQ on pain threshold and acpuncture analgesia in rats]

Orphanin FQ (OFQ) is a newly discovered 17-amino-acid peptide capable of inducing hyperalgesia. In the present study, the effects of OFQ on basal pain threshold and acupuncture anlgesia (AA) in rats were observed using the tail-flick test. It was found that intrathecal (i.t.) or intracerebroventricular (i.c.v.) administrition of 0.1 microgram OFQ had no effect on basal pain threshold of rats, while 1 microgram OFQ could lower the threshold. However, OFQ at both the doses (0.1 or 1.0 microgram) administered by either i.t. or i.c.v. injection could antagonize AA with that occuring in the brain being more prominent then in the spinal cord. When the rats were repeatedly treated with antisense oligonucleotide to block synthesis of OFQ receptor, pain threshold increased significantly. At such instance, when the OFQ was combined with acupuncture, the effect of AA showed no obvious change. The above results show that the OFQ at small dose has no effect on pain threshold but can lower it at larger dose; while in both cases OFQ can antagonize AA.

Expression of preproopiomelanocortin mRNA and preprodynorphin mRNA in brain of spontaneously hypertensive rats

AIM

To compare the expressions of prepropiomelanocortin (POMC) mRNA and preprodynorphin (PPD) mRNA between 16-wk-old spontaneously hypertensive rats (SHR) and age-matched normotensive Wistar-Kyoto rats (WKY).

METHODS

The expression of POMC mRNA and PPD mRNA were detected with nonradioactive in situ hybridization by digoxigenin-labeled RNA probe.

RESULTS

POMC mRNA mainly was expressed in arcuate nucleus, compared with WKY, SHR had higher level of POMC mRNA (542). PPD mRNA was found in hippocampus, hypothalamus, central gray, nucleus of the solitary tract (NTS), and thoracic spinal cord (T4-T6). Compared with WKY, PPD mRNA level of SHR decreased in dentate gyrus (2342), NTS (381), and medial preoptic area (467); no difference was observed in arcuate nucleus (263), thoracic spinal cord (750-1800) and CA1, CA2, CA3 of hippocampus (1674, 2014, 2626).

CONCLUSION

Increase of POMC mRNA in arcuate nucleus and decrease of PPD mRNA in dentate gyrus of SHR may be associated with the genesis of spontaneous hypertension.

[Alteration of monoamine contents in microdialysate following droperidol enhanced electroacupuncture]

The monoamine contents in microdialysate from rat brain before and after droperidol (DRO), a dopamine (DA) antagonist, enhanced electroacupuncture-induced analgesia (EA) were measured using techniques of in vivo microdialysis and high performance liquid chromatography with electrochemical detection (HPLC-EC), so as to investigate the monoamine mechanism of the potentiating effect of DRO on acupuncture analgesia (AA). The results showed that the levels of DA and its metabolites homovanillic acid (HVA) in perfusate increased after EA (P < 0.05 or 0.01), and further increased after DRO + EA (P < 0.05 and 0.01, vs EA treatment). A significant decrease in norepinephrine (NE) content after EA (P < 0.01) was observed, but no further change after DRO + EA (P > 0.05, vs EA treatment). The contents of 5-hydroxytryptamine (5-HT) and its metabolite 5-hydroxyindole acetic acid (5-HIAA) we elevated after EA treatment, and a further elevation in 5-HT and 5-HIAA contents induced by DRO + EA was noted. The results in the present study suggest that DRO potentiated AA not only via antagonizing the activity of dopaminergic system, but also by coordinating the activities of other monoamines in the brain.

Autologous bone marrow mixed with HLA-haploidentical allogeneic marrow transplantation for treatment of patients with malignant blood diseases

We have previously demonstrated that syngeneic marrow mixed with H-2 haploidentical marrow transplantation could provide not only protection against graft-versus-host disease (GVHD) but also anti-leukemic (GVL) effects in mice. In the present studies, we report clinical observations using autologous marrow mixed with HLA-haploidentical allogeneic marrow transplantation for treatment of patients with malignant blood diseases. Sixteen cases, including 12 with acute leukemia and four with advanced malignant lymphoma, were treated by autologous marrow, which was purged in vitro by hyperthemia (42.5 degrees C for 70 min) following incubation for 5 days with interleukin 2 (IL-2) in liquid culture and mixed with HLA haploidentical marrow cells from their sibling or parent. Acute GVHD was not observed in any patient after transplantation. Hematological rescue in the clinical setting was demonstrated in all cases but one who died early from hepatic veno-occlusive disease (VOD). Five cases who were transplanted at the time of CR2 or CR3 and in advanced phase of lymphoma, relapsed 4 to 7 months after transplantation. The relapse rate was 31.3%. None of eight patients who received allogeneic BMT within 2 h after ABMT relapsed with median follow-up of 12 months and two of them died from procedure-related complications. Seven cases are still alive and disease-free with a median follow-up of 12 months. Mixed chimerism was found in 3/6 cases, who had different sex donors, by analysis of sex chromosomes. These results show that mixed transplantation is a safe, effective and new approach to treating patients with malignant tumors. In order to detect the effects of GVL, studies are now in progress in our clinic.

Preproopiomelanocortin and preprodynorphin mRNA expressions in rat brain after electroacupuncture + droperidol

AIM

To study the expression of preproopiomelanocortin (POMC) and preprodynorphin (PPD) mRNA following the combination of electroacupuncture (EA) with droperidol (Dro), a dopamine receptor antagonist.

METHODS

The brains and spinal cords of Sprague-Dawley rats were sectioned after combination of EA with Dro, and the gene expression was investigated using nonradioactive in situ hybridization histochemistry (ISHH).

RESULTS

Ten hours after EA, the POMC mRNA expression was enhanced; the expression was further enhanced when EA was combined with Dro. The expression of PPD mRNA showed regional difference in central nervous system (CNS): in spinal cord, EA enhanced the PPD mRNA expression and the combination of EA with Dro further promoted the expression; in the brain, the PPD mRNA expression after EA or combination of EA with Dro showed no obvious change in most regions (caudate-putamen, accumbens, arcuate nucleus of hypothalamus) or was decreased in supraoptic nucleus.

CONCLUSION

Dro combined with EA promoted the expression of POMC mRNA in CNS and PPD mRNA in spinal cord, but reduced or had no effect on PPD mRNA expression in the brain.

Antagonistic action of orphanin FQ on acupuncture analgesia in rat brain

The influence of orphanin FQ (OFQ) (a newly discovered 17-amino acid peptide) on acupuncture analgesia (AA) was assessed in rat tail-flick model. Intracerebroventricular (i.c.v.) injection of OFQ (1 microgram) elicited a significant decrement of pain threshold which was abolished by the repeated pretreatment with antisense oligonucleotide (ASO) to OFQ receptor. Electroacupuncture (EA) induced an obvious analgesic effect; when OFQ was used combined with EA, it showed a dose-dependent effect on antagonizing the EA analgesia. When rat was repeatedly i.c.v. injected with ASO to block the synthesis of OFQ receptor, the EA analgesia was enhanced markedly. In this instance, the OFQ did not show antagonistic effect on EA analgesia any more. The results suggest that the OFQ play its antagonistic role on EA analgesia via activating OFQ receptor.

Effect of phencyclidine on dog coronary artery

AIM

To study the effect of phencyclidine (Phe) on dog coronary artery.

METHODS

Contraction of spiral strips of dog coronary artery in bioassay and coronary artery blood flow (CBF) using electromagnetic flowmeter on anesthetized dogs were observed.

RESULTS

Phe 0.1-100 mumol.L-1 induced contraction of strips in a concentration-dependent manner. Dextromethorphan (Dex) 10 mumol.L-1, an antagonist of Phe receptor, antagonized the action of Phe. In vivo, Phe 10 mg.kg-1 increased flow of left circumflex coronary artery of anesthetized dogs from 334 +/- 35 mL.kg-1.min-1 to 510 +/- 58 mL.kg-1.min-1, and both left ventrical pressure (LVP) and blood pressure (BP) rose slowly after medication. Dextromethorphan (Dex) 5 mg.kg-1 also antagonized the effect of Phe.

CONCLUSION

The regulation of Phe on coronary artery in vivo differs from that in vitro, which may result in the contradictory effects.

Mapping of preproenkephalin mRNA in brain of spontaneously hypertensive rats

AIM

To detect different expression of preproenkephalin mRNA (PPE mRNA) in 16-wk-old spontaneously hypertensive rat (SHR) and age-matched normotensive Wistar-Kyoto rat (WKY).

METHODS

Nonradioactive in situ hybridization was performed using digoxigenin-labeled RNA probe.

RESULTS

Compared with WKY rats, PPE mRNA levels of 16-wk-old SHR increased in hypothalamic nuclei (> 20), amygdaloid nuclei (> 23), ventrolateral central gray (21.2), reticular substantia nigra (21.5), interpeduncular nuclei (> 21), nucleus of the solitary tract (30.7), rostroventrolateral reticular nucleus (29.1), gigantocellular reticular nucleus (23.9) and thoracic spinal cord (> 30); decreased in dorsal central gray (22.7). No difference was found in compact substantia nigra (22.8), dentate gyrus (26.2) and CA1, CA2, CA3 of hippocampus (> 25).

CONCLUSION

PPE mRNA in brain regions involved in modulation of blood pressure may be associated with the genesis of spontaneous hypertension in SHR. Enkephalin, an endogenous ligand of opioid receptors, is important in the regulation of blood pressure (BP). Intracerebroventricular injection (icv) of mu agonist [D-Ala2-MePhe4-Gly5-ol]-enkephalin (DAGO) and delta agonist [D-Ala2, D-Leu5]-enkephalin (DADLE) increased the BP[1]. In situ hybridization study showed preproenkephalin mRNA was localized in hypothalamic nuclei, hippocampus, NTS, and spinal cord[2], where the cardiovascular regulation took place. The icv of mu agonist morphiceptin induced a pressor response in SHR but hypotension in WKY rat, and delta agonist Tyr-D-Thr-Gly-Phe-Leu-Thr (DTLET) icv decreased BP in SHR but increased BP in WKY[3]. Compared with WKY rats, SHR had greater concentration of methionine-enkephalin (Met-Enk) in cortex, pons, and medulla[4], but lower Leu-Enk in suprachiasmatic nucleus[5]. These studies imply that opiate system is disturbed in essential hypertension. The aim of this study is to determine whether the biosynthetic activity of CNS opiates in brain is altered in case of essential hypertension.

Distributions of mu and delta opioid receptors in central nervous system of SHR rats and normotensive WKY rats

AIM

To compare the distributions of opioid receptor subtypes in central nervous system of spontaneously hypertensive rat (SHR) and normotensive Wistar-Kyoto (WKY) rat.

METHODS

[3H] Ohmefentanyl (OMF), [3H]N-methyl-N-[7-(I-pyrrolidinyl)-1-oxaspiro (4,5)dec-8-yl] benzeneacetamide (U-69593) and [3H]etorphine after suppression of mu and kappa-sites by 15 mumol.L-1 each of unlabeled OMF and trans-(1R,2R)-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl) cyclohexyl]-benzeneacetamide hydrochloride (U-50 488H) were used as ligands for mu, kappa, and delta opioid receptor subtypes in autoradiography, respectively.

RESULTS

Delta receptors had an increase in hypothalamic nuclei, periaqueductal gray, caudate and interpeduncular nuclei, and a decrease in substantia nigra in SHR than in those of WKY rat. Mu receptors were less concentrated in basolateral amygdaloid nucleus, habenular nuclei and nucleus of solitary tract of SHR than in those of WKY rats. Kappa receptor density was not checked out in the present study.

CONCLUSION

Distribution of opioid receptor subtypes is related to hypertension of SHR, and delta opioid receptor is more important than mu opioid receptor in the maintenance of hypertension in SHR.