[Analysis of clinical characteristic of children with progressive familial intrahepatic cholestasis type 3]

Objective: To analyze the clinical manifestations, pathology, and gene variant characteristics in children with progressive familial intrahepatic cholestasis type 3 (PFIC3). Methods: This retrospective study assessed the clinical manifestations, pathological features, gene variants, and prognosis data of 11 children with PFIC3 hospitalized in the Department of Hepatology, Fifth Medical Center, PLA General Hospital, from January 2015 to December 2022. Panel or whole exome sequencing was performed on the probands, followed by Sanger sequencing for verification within the family. Detected pathogenic variants were compared with known disease databases. Additionally, the new variants were predicted the deleteriousness and protein structure using relevant software to evaluate their pathogenicity. Results: Among the 11 PFIC3 children, 8 were boys and 3 were girls. The age of onset was 3.1 (0.2, 15.6) years. The main complaint of onset was different in the 11 patients;5 of them were abnormal liver function, 3 of them were liver and spleen enlargement, 2 of them were abdominal distension, and 1 of them was jaundice. Alanine aminotransferase, asparate aminotransferase and γ-glutamyltransferase increased in all the patients, which were(113±40), (150±44) and (270±156) U/L respectively. Moreover, direct bilirubin increased in 9 patients, and cholestasis was showed in 8 patients. All patients showed liver fibrosis on imaging, and 8 patients had cirrhosis. The pathological features of 8 cases by liver biopsy were as follows: 8 cases of fibrosis in the portal area, 7 cases of small bile duct hyperplasia, 4 cases of positive copper staining, and 5 cases of cirrhosis. A total of 17 ABCB4 gene variants were detected, including 9 new variants: c.589C>T(p.Q197X), c.1230+1G>A(Splicing), c.2914G>A(P.D972N), c.1058G>A(p.C353Y), c.956G>T(p.G319V), c.473T>A(p.L158Q), c.164T>C(p.L55S), c.2493G>C(p.R831S), and c.1150G>C(p.G384R). All 11 patients were treated with ursodeoxycholic acid and followed up for 5.1(0.6, 7.4) years. Among them, 4 cases of cirrhosis progressed continuously, 3 cases had liver transplantations, and the remaining 4 cases were stable after medical treatment. Conclusions: Children with PFIC3 have early onset, diverse clinical manifestations, rapid progression of fibrotic and cholestasis, as well as poor prognosis. Genetic testing helps to confirm the diagnosis.

[Orthognathic surgery and temporomandibular joint]

Orthognathic surgery changes the jaw position and occlusion, and also affects the original structure and function of the temporomandibular joint (TMJ). With the widespread development of orthognathic surgery, the impact of orthognathic surgery on the structure and function of the TMJ is increasingly valued, and the importance of the TMJ in orthognathic surgery is gradually recognized. Proper understanding the relationship between orthognathic surgery and TMJ not only helps to elucidate how the orthognathic surgery affects the condyle and causes temporomandibular disorders (TMD), but also has significant clinical significance in preventing and treating TMD in patients underwent orthognathic surgery.

Infection Characteristics and Physical Prevention Strategy of Panax notoginseng Round Spot Disease Caused by Mycocentrospora acerina

Panax notoginseng round spot disease (PRSD), caused by Mycocentrospora acerina, is the main leaf disease occurring in cultured P. notoginseng. Aiming to find a safe and efficient control method for PRSD, we studied the disease characteristics of PRSD and the optimal growth conditions of M. acerina and evaluated the efficacy of rain-shelter cultivation in PRSD control. Moreover, we described M. acerina based on morphological characterization and molecular analyses (ITS, ACT, LSU, and TEF-1α). The optimum temperature for M. acerina conidial germination was found to be 14 to 22°C. Furthermore, leaf surface wetness for at least 4 h is required for conidial germination, and conidia can successfully infect P. notoginseng when the leaf wetness lasts for more than 8 h. Additionally, rainwater splashing determines the conidial transfection distance, which is less than 2 m. Finally, our study revealed that rain-shelter cultivation is an effective and simple physical prevention strategy to control PRSD, with an average efficacy of up to 100%.

[A comparative study of the upper airway changes of idiopathic condylar resorption and anterior open bite patients after bilateral temporomandibular joint prostheses surgery and bimaxillary orthognathic surgery]

Objective: To evaluate the 2-dimension and 3-dimension changes of upper airway of patients who were diagnosed with idiopathic condylar resorption (ICR) and anterior open bite as well as received bilateral temporomandibular joint (TMJ) prostheses replacement or bimaxillary orthognathic surgery. Methods: This study is a retrospective study. Seventeen patients diagnosed as ICR and anterior open bite in Department of Orthognathic and TMJ surgery, West China Hospital of Sichuan University were selected (January 2018 to December 2021) and divided into bilateral TMJ protheses replacement group (group R, n=8) and orthognathic group (group O, n=9), according to which surgery they have performed. In order to compare variation of upper airway before and after surgery in different dimensions and sections within the same group or between groups, Spiral computed tomography data were obtained before (1 month) and after operation (10 to 12 months) to measure the total volume of airway (VT), the maximum sagittal area (MSA), the maximum cross-sectional area (MACA), the minimum cross-sectional area (MICA), the area of the most posterior plane(PPA), the area of soft-palate plane (SPA), the area of the most posterior point of tongue base plane (PTA), the area of the root of epiglottis plane (EA), the oropharyngeal airway volume (VO), the glossopharyngeal airway volume (VG) and the laryngeal airway volume (VL). Wilcoxon signed-rank test were used to complete statistical analyses for VO (T2),SPA (T2),ΔMSA,ΔMACA in group R as well as PTA (T1),EA (T2) in group O. Statistical analyses of other items were performed with student's t test. Results: VT, VO, VG, VL, MSA, MACA, MIC, PPA, PTA and EA of group R (T2) were significantly increased after TMJ prosthesis with Lefort I osteotomy (P<0.05). Meanwhile the VT, VO, VG, MSA, MACA, MICA, PPA and SPA of group O (T2) were significantly increased (P<0.05). There were significant difference in ΔVT and ΔVL between group R [(6 854.80±3 197.82) mm3, (2 252.85±1 527.96) mm3] and group O [(3 367.91±3 124.62) mm3, (413.21±1 244.44) mm3](t=2.27, P=0.038; t=2.74, P=0.015). Conclusions: Bilateral temporomandibular joint (TMJ) prostheses replacement and bimaxillary orthognathic surgery can both enlarge the areas and volumes of upper airway in patients who suffer from ICR and anterior open bite. Compared with bimaxillary orthognathic surgery, bilateral temporomandibular joint prostheses replacement plays a more pronounced role in enlargement and reconstruction of middle-inferior section of upper airway.

[Comprehensive measurement and quantification of bio-mechanical properties of the temporomandibular joint disc]

Objective: To comprehensively investigate the biomechanical properties of the temporomandibular joint (TMJ) disc and to perfect the mechanical testing system of the TMJ disc by conducting tests of compression, tension, cyclic compression, cyclic tension, creep and friction. Methods: Fifteen fresh goat heads (weighing 2.5-3.0 kg) were purchased from the market. They were all ordinary goats (9-12 months old, body weighing 18-21 kg) regardless of gender. Bilateral articular discs (a total of 30) were dissected within 30 minutes after execution. According to the national standard for mechanical testing of viscoelastic materials, fresh TMJ disc specimens of goat were prepared and tests were carried out in physiological conditions. The universal mechanical testing machine was utilized to test biomechanical properties of TMJ discs. Results: The compressive modulus of TMJ discs was (8.41±2.12) MPa and the tensile modulus was (9.54±3.26) MPa. The mechanical characteristics would be irreversibly altered once the load exceeded the physiological range. In addition, it underwent apparent creep relaxation under continuous strain (0.5 MPa or 3.0 MPa) and the surface friction coefficient of the TMJ discs (0.015+0.011) was much lower than that of general viscoelastic materials. Conclusions: The TMJ disc was a bio-viscoelastic structure with excellent tensile and compressive properties and its surface was extremely smooth in wet conditions.

[Effect of serum lipid level on prognosis of patients with small cell lung cancer at the initial treatment]

Objective: To investigate the effect of serum lipid level on prognosis of patients with small cell lung cancer (SCLC) at the initial treatment. Methods: The clinical data of patients with SCLC from 2012 to 2017 in our hospital were retrospectively analyzed. According to the standard of appropriate level and abnormal stratification of blood lipid in Chinese population, the lipids included total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDLC) and low-density lipoprotein cholesterol (LDLC) at the time of initial treatment were grouped. Then the relationship between different lipid levels and clinicopathological characteristics was analyzed. Finally, Cox proportional hazard model was used to analyze the independent prognostic factors of patients. Results: A total of 129 patients with SCLC were included in this study. At the time of initial treatment, there were 90 (69.8%) cases whose TC < 5.2 mmol/L, while 39 (30.2%) cases ≥5.2 mmol/L; 95 (73.6%) cases whose TG <1.7 mmol/L, while 34 (26.4%) cases ≥1.7 mmol/L; 27 (20.9%) cases whose HDLC <1.0 mmol/L while 102 cases (79.1%) ≥1.0 mmol/L; 90 (69.8%) cases whose LDLC <3.4 mmol/L while 39 cases (30.2%) ≥3.4 mmol/L. The patients' triglyceride initial treatment was associated with their body mass index (P<0.05). The median disease-free survival (PFS) of SCLC patients was related with their serum TC level and clinical stage (P<0.05) and the overall survival (OS) was related with clinical stage of SCLC patients (P<0.05). The median PFS of SCLC patients in the TC <1.7 mmol/L group at the initial treatment was 10.5 months, significantly longer than 8.8 months of the TC ≥1.7 mmol/L group (P=0.024). The median OS of SCLC patients in the TG <1.7 mmol/L group at the initial treatment was 20.2 months, marginally longer than 15.6 months of the TG ≥1.7 mmol/L group (P=0.097). Multivariate analysis result showed that, the TG level was an independent risk factor of SCLC progression at the time of initial treatment (P=0.024). There was no significant correlation of TC, HDLC, LDLC and SCLC prognosis (P>0.05). Conclusion: TG level is an independent risk factor for the progression of SCLC at the time of initial treatment, and the increase of TG level indicates rapid disease progression and poor prognosis.

[Paclitaxel liposome for the treatment of castration-resistant prostate cancer]

OBJECTIVE

To investigate the effect and safety of the 3-week paclitaxel liposome protocol in the treatment of castration-resistant prostate cancer (CRPC).

METHODS

This retrospective study included 40 cases of CRPC treated by the 3-week paclitaxel liposome protocol from February 2014 to February 2019, which involved intravenous injection of 10 mg dexamethasone in 100 ml normal saline on the first day and that of metoclopramide and panxi tora azole on the second day, followed by about 3 hours of intravenous drip of paclitaxel liposome at 135 mg/m2 for a course of 3 weeks. During the follow-up period, the patients received detection of the serum PSA level before treatment and chest x-ray and whole-body bone scan every six months. After two courses of treatment, the patients were observed for the changes in the serum PSA level, relief of bone pain, quality of survival, overall survival rate, overall survival time and toxic reactions. The protocol was continued unless the patient underwent progression, refused for unacceptable toxicity, or died.

RESULTS

The patients were aged 59 to 79 (mean 68.80±5.67) years old, with the serum PSA level of (28.05 ± 3.22) μg/L at the baseline and (4.12 ± 0.23) μg/L after treatment. Thirty-eight of the patients were followed up for 3 to 33 (mean 12.2) months. PSA-based evaluation showed therapeutic effectiveness in 14 cases (35%), stable condition in 21 (52.5 %) and progression in 5 (12.5 %). Of the 18 patients with bone metastasis and pain, 16 (88.9 %) experienced relief of the symptoms and reduced the use of painkillers, with the bone pain scores of 5.20 ± 1.22 vs 2.79 ± 0.57 before and after treatment. By the end of the follow-up, the overall survival rate was 55.0% (22/40) and the median survival time was 17 months (95% CI: 13.4－24.6). During the treatment, no obvious adverse reactions were observed except for anemia in 1 case and hair loss in another.

CONCLUSIONS

For the treatment of CRPC in China, the 3-week paclitaxel liposome protocol has the advantages of desirable safety, low toxicity, acceptable drug tolerance and improved quality of survival, but its curative effect needs to be verified with more randomized clinical trials with larger samples and longer follow-ups.

Routine coagulation molecules predict nasopharyngeal carcinoma and associated metastases

Introduction: Most patients with malignant solid tumours have abnormal blood coagulation and an abnormal peripheral blood count, but data on nasopharyngeal carcinoma is scare. We hypothesised abnormal coagulation indices and red cell distribution width (RDW) in this group that are linked to the tumour (T), lymph node (N) and metastatic aspects (M) of the patients.Methods: We recruited 740 newly diagnosed patients with nasopharyngeal carcinoma and 238 healthy controls, taking venous blood for prothrombin time, activated partial thromboplastin time (APTT), thrombin time, fibrinogen, fibrin degradation products (FDP), D-dimer, RD), platelets and platelet distribution width (PDW). In the patients, lab indices were analysed according to clinical stage.Results: All indices except thrombin time were significantly different between cases and controls (p < 0.001), and many predicted TNM classifications and early or late stage of the disease. In sensitivity/specificity analysis, the prothrombin time, APTT and PDW gave AUCs >0.7, and in combination gave an AUC of 0.88 (95% CI 0.86-0.91) for nasopharyngeal carcinoma. No index provided an AUC >0.7 for T or N classification, or early v late stage, but APTT, fibrinogen and FDP all gave AUCs ≥0.7 for predicting metastases. Together, these three indices gave an AUC of 0.84 (0.78-0.91).Conclusions: Routine coagulation indices can predict nasopharyngeal carcinoma, with the combination of prothrombin time, APTT and PDW being strongest. The combination of APTT, fibrinogen and FDPs provides a useful score to predict metastases. These indices should be considered in the diagnosis and staging of this disease.

[Clinical and pathological characteristics and outcome of 46 children with autoimmune hepatitis]

Objective: To review and analyze the clinical and pathological data of children with autoimmune hepatitis (AIH). Methods: Medical records of 46 patients hospitalized in Pediatric Liver Diseases Treatment and Research Center, Fifth Medical Center, General Hospital of People's Liberation Army(PLA) from April 2012 to April 2018 were extracted. Medical data included type of AIH, clinical manifestations, biochemical parameters, liver biopsy results, and outcomes of treatment were analyzed retrospectively. Among 46 children, 19 were males and 27 were females. The age of onset was 10.1(1.4-18.0) years old. Chi-Square test, Rank sum test or t test were used for inter-group comparison. Results: There were 32 (70%)AIH-I cases and 14 (30%)AIH-Ⅱ cases (χ(2)=12.565, P=0.000). Among the 46 patients, there were 5 modes of onest: 17 cases (37%) had acute viral hepatitis-like presentation, 2 cases (4%) had fulminant hepatic failure, 9 cases (20%) had insidious onset, 5 cases (11%) showed cirrhosis and portal hypertension, and 13 cases (28%) were incidentally found to be due to elevated hepatic aminotransferases. Comorbidities including primary sclerotic cholangitis (n=3), primary biliary cholangitis (n=1), systemic lupus erythematosus (n=1) and inflammatory bowel disease (n=2), were all seen in AIH-Ⅰ cases. The elevated biochemical parameters of these patients were as follows: alanine aminotransferase (n=46), aspartate transminase (n=46), total bilirubin (n=35) γ-glutamyl transpeptadase (n=39), γ-globulin (n=32) and IgG (n=33). The γ-globulin and IgG levels were significantly higher in AIH-Ⅰ patients than those with AIH-Ⅱ((32±9)% vs. (23±8)%, t=3.217, P=0.002,(27±10) vs. (18±8)g/L, t=3.193, P=0.003, respectively). Thirty-nine patients received liver biopsy, among whom 22 (56%) with inflammation grade (G)≥3, 26(67%) with fibrosis stage (S) ≥3, and 7 with hepatic cirrhosis (S4) according to pathological analysis. Typical histopathological changes of AIH included: 36 cases of interfacial hepatitis (92%), 23 cases of lymphocyte/plasma cell infiltration (59%), 3 cases of rosette (8%). Forty patients received prednisolone monotherapy or combined with azathioprine after diagnosis. Complete remission was seen in 29 (72%) patients, partial remission in 10 (25%) patients and no response in 1 (3%) patient. Among complete remission patients, 15 (52%) had relapse in the process of prednisolone reduction. Repeated liver biopsy performed in 8 patients after treatment showed that hepatic inflammation and fibrosis were both improved in 6 patients, only inflammation was alleviated without fibrosis improvement in 1 patient, and neither inflammation nor fibrosis was improved in 1 case. The length of follow-up was 3.3 (0.3-10.5) years, and none of the 39 prednisolone-responded cases discontinued treatment successfully. Adverse effect of long-term prednisolone therapy included bilateral cataract (n=6), spinal fracture accompanied with delayed bone age development (n=1). Conclusions: AIH-Ⅰ is more common than AIH-Ⅱ in children, with diverse clinical characteristics. Most cases have progressive liver inflammation and fibrosis when diagnosed. Prednisolone monotherapy or combined with azathioprine could achieve both biochemical and pathological improvement, but relapse is inevitable during drug tapering, hence long-term treatment is essential.

Change in the posterior airway after mandibular distraction osteogenesis in patients with ankylosis of the temporomandibular joint: a retrospective study

Mandibular distraction osteogenesis (DO) has been shown to lead to considerable improvement in obstruction of the posterior airway space in patients with ankylosis of the temporomandibular joint (TMJ), and our objective was to find out if we could confirm these findings. Seventeen patients had spiral computed tomographic (CT) scans before and after DO. After treatment, the overall posterior airway space was enlarged in all three sections of the airway (oropharyngeal, glossopharyngeal, and laryngeal). We then compared rates of change in the airway among the sections using 2-dimensional and 3-dimensional assessments, and found that the rate of change in 3-dimensional assessment of volume was significantly higher than that in the 2-dimensional (62% compared with 34%). We also found that the higher 3-dimensional rate of change came from changes in the oropharyngeal and glossopharyngeal sections, while there was no significant difference between the 2- and 3-dimensional rates of change in the laryngeal section. Because the laryngeal section had the most robust enlargement after DO in both the overall area of the posterior airway space (increased by 54%) and volume (increased by 73%), we concluded that 3-dimensional assessments were more sensitive to smaller changes in the airway space during the operation. This suggests that 3-dimensional assessments are preferable in the prediction and evaluation of the effects of DO on the posterior airway space.

[A retrospective study on the liver pathological characteristics and the effect of antiviral treatment for 1 to 7 years old children with heptitis B e antigen negative chronic hepatitis B]

OBJECTIVE

To investigate the liver pathological characteristics and the clearance rate of hepatitis B surface antigen (HBsAg) with antiviral treatment for 1 to 7 years old children with heptitis B e antigen(HBeAg)-negative chronic hepatitis B.

METHOD

A total of 49 cases with HBeAg-negative chronic hepatitis B were treated with interferon (IFN) or IFN treatment for 6 months added with lamivudine, and were followed up for at least 6 months.Retrospective analysis was performed on the liver pathological characteristics, the efficacy of antivirus treatment and its influencing factors of the HBsAg clearance rate in the cases from June 2006 to December 2013 in the 302 Hospital of People's Liberation Army.The χ(2) test was used to compare the rates.

RESULT

(1)The median age of cases was 3 years old(1-7 years old), 38 children were male(78%). Cases in the age group 1-2, >2 -3, >3 -4, >4-5, >5-6 and >6-7 were 7, 8, 14, 6, 6 and 8 respectively. HBsAg was 100% positive in mother of the cases. (2)There were 7 children whose pre-treatment alanine aminotransferase (ALT) were ≤80 U/L and pre-treatment ALT>200 U/L in 25 children. There were 24 children whose pre-treatment HBVDNA ≥1×10(7) U/ml. Genetype analysis was detected in 43 children, 3 children were B genotype, 38 were C genotype, 2 were B and C genotype. (3)Liver biopsy was performed in all children. The degree of liver inflammation ≥2 was seen in 48 (98%) children.Severe liver fibrosis and cirrhosis were found in 21(43%) children. (4)In the age group 1-2, >2-3, >3-4, >4-5, >5-6 and >6-7 years old , the clearance of HBsAg was 5, 6, 2, 1, 0 and 0 respectively. The HBsAg clearance rate between 1-3 years old group and 3-7 years old group has significant difference ((73%(11/15) vs. 9%(3/34), χ(2)=18.180, P=0.000). (5)The clearance of HBsAg in male group was 11, but 3 in female group.It showed no significant difference between two groups (χ(2)=0.073, P=0.787). (6) The clearance rate of HBsAg were 0, 24%(4/17) and 40%(10/25) in the groups of pre-treatment ALT ≤80 U/L, 80<ALT≤200 U/L and ALT >200 U/L, respectively. There were no significant difference between the groups of ALT≤200 U/L and ALT > 200 U/L(χ(2)=2.223, P=0.136). In the groups with pre-treatment HBV DNA <1×10(7)U/ml and HBV DNA≥1×10(7)U/ml, the clearance rate of HBsAg was 28%(7/25) and 29%(7/24). There were no significant elifference between two groups(χ(2)=0.008, P=0.928). (7)The clearance rate of HBsAg was 33%(7/21) in children with severe liver fibrosis and cirrhosis, while 25%(7/28) in children who had no severe liver fibrosis and cirrhosis.There were no significant difference between two groups(χ(2)=0.408, P=0.523).

CONCLUSION

There are obvious liver injuries and severe liver fibrosis in 1-7 years old children with HBeAg-negative chronic hepatitis B. The HBsAg clearance rate in the children with antiviral treatment correlated with age, among those who received antiviral treatment before 3 years old, the HBsAg clearance rate is relatively higher.

Mandibular symphyseal midline distraction osteogenesis for micrognathia associated with aglossia and situs inversus totalis

Aglossia is a rare congenital abnormality, often associated with micrognathia and limb defects. Situs inversus totalis is also a rare congenital abnormality, defined as a mirror-image reversal of all the asymmetric organs of the thorax and abdomen. The concurrence of these two abnormalities has only been reported in eight similar cases in the literature. Although micrognathia and malocclusion were observed in all of these cases, few treatments were performed for the patients' dentofacial deformities. This report describes the case of a 7-year-old boy suffering from micrognathia, aglossia, and situs inversus totalis simultaneously, and the treatment for his micrognathia by mandibular symphyseal midline distraction osteogenesis, guided by virtual surgical planning and a three-dimensional printed surgical template. In a review of the literature, this is the first case of micrognathia associated with aglossia and situs inversus totalis that has been treated by mandibular symphyseal midline distraction osteogenesis for the dentofacial deformity.

Population structure and historical demography of Dipteronia dyeriana (Sapindaceae), an extremely narrow palaeoendemic plant from China: implications for conservation in a biodiversity hot spot

Inferring past demography is a central question in evolutionary and conservation biology. It is, however, sometimes challenging to disentangle their roles of contemporary versus historical processes in shaping the current patterns of genetic variation in endangered species. In this study, we used both chloroplast microsatellite (cpSSR) loci and nuclear microsatellite (nSSR) loci to assess the levels of genetic differentiation, genetic effective population size, contemporary/historical levels of gene flow and demographic history for five populations sampled across the range of Dipteronia dyeriana, an endangered palaeoendemism from Southwestern China. We found that D. dyeriana had a mixed pattern of moderate genetic diversity and high inbreeding. Bayesian clustering divided D. dyeriana populations into two nSSR genetic clusters. Coalescent-based approximate Bayesian computation analyses suggest the western and eastern groups of D. dyeriana likely persisted in a long-term refuge in Southern China since the beginning of the last glacial period, whereas increasingly colder and arid climates at the onset of the last glacial maximum might have fostered the fragmentation of D. dyeriana within refugia. Following their divergence, the western group kept relatively stable effective population size, whereas the eastern group had experienced 500-fold population expansion during the Holocene. Although clear loss of genetic diversity by human activities was not suggested, recent habitat fragmentation has led to a reduction of population connectivity and increased genetic differentiation by ongoing genetic drift in isolated populations, possibly owing to decreased population size in recent dozen years. Finally, we discussed the implications of these results on conservation policies.

Propofol pretreatment attenuates lipopolysaccharide-induced acute lung injury in rats by activating the phosphoinositide-3-kinase/Akt pathway

The aim of this study was to investigate the effect of propofol pretreatment on lipopolysaccharide (LPS)-induced acute lung injury (ALI) and the role of the phosphoinositide-3-kinase/protein kinase B (PI3K/Akt) pathway in this procedure. Survival was determined 48 h after LPS injection. At 1 h after LPS challenge, the lung wet- to dry-weight ratio was examined, and concentrations of protein, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in bronchoalveolar lavage fluid (BALF) were determined using the bicinchoninic acid method or ELISA. Lung injury was assayed via lung histological examination. PI3K and p-Akt expression levels in the lung tissue were determined by Western blotting. Propofol pretreatment prolonged survival, decreased the concentrations of protein, TNF-α, and IL-6 in BALF, attenuated ALI, and increased PI3K and p-Akt expression in the lung tissue of LPS-challenged rats, whereas treatment with wortmannin, a PI3K/Akt pathway specific inhibitor, blunted this effect. Our study indicates that propofol pretreatment attenuated LPS-induced ALI, partly by activation of the PI3K/Akt pathway.

First Report of Cylindrocarpon destructans var. destructans Causing Black Root Rot of Sanqi (Panax notoginseng) in China

Sanqi (Panax notoginseng (Burk.) F. H. Chen) is planted on >10,000 ha in China and is a popular Chinese medicinal material (2). Black root rot is a recently identified but worsening problem on Sanqi since 2010 in Wenshan, China. Of the plant tubers examined from 185 ha, 8.5 to 27.4% were black with necrotic lesions. The base of leaves of infected plants had brown, sunken, necrotic lesions, and symptomatic plants had one to three chlorotic leaves. A fungus was isolated consistently from the basal leaves, bulb, and tubers of symptomatic plants. Six single-spore isolates were cultured on potato sucrose agar (PSA) at 25 ± 1°C in the dark. The mycelium of each culture was white initially on PSA, and then became rust-colored. The adaxial surfaces of the plates were black. Conidiophores were 13.6 to 167.3 × 1.4 to 21.8 μm (avg. 68.6 × 2.9 μm), single or with up to four levels of branching and two to three branches (or phialides) per level. The basal branches were often divergent, whereas the terminal branches were usually more appressed. Sporodochia were not present. Microconidia were 0-septate, 4.1 to 9.5 × 2.7 to 4.1 μm (avg. 8.2 × 2.9 μm). Conidia were 1- to 3-septate and occasionally 4-septate. One- to 3-septate conidia were clavate, with a truncate or slightly protruding conidial base, 9.2 to 40.8 × 3.5 to 6.8 μm (avg. 26.7 × 5.2 μm); whereas 4-septate conidia were 32.6 to 50.3 × 5.4 to 6.8 μm (avg. 40.9 × 6.5 μm). Chlamydospores were abundant, golden to brown, single or in chains or clumps, and up to 21.8 μm in diameter. PCR amplification was carried out for one isolate, RR926, using rDNA internal transcribed spacer (ITS) primer pairs ITS1F and ITS4 (4). Sequencing of the PCR product (GenBank Accession No. KC904953) revealed 99% similarity (99% coverage) with the ITS sequence of Cylindrocarpon destructans var. destructans (AM419065). Phylogenetic analysis (MEGA 4.1) using the neighbor-joining algorithm placed the isolate in a well-supported cluster (>90% bootstrap value based on 1,000 replicates) with AM419065. Therefore, the pathogen was identified as C. destructans (Zinssm.) Scholten var. destructans (teleomorph Ilyonectria radicicola (Gerlach & L. Nilsson) P. Chaverri & C. Salgado) based on morphological characteristics and rDNA-ITS sequence analysis (1,3). Pathogenicity tests of the six isolates were conducted on five 1-year-old and five 3-year-old plants/isolate. The roots of all plants were washed with sterilized water, and then surface-sterilized with 75% ethanol. Inoculum (1 ml of 10⁶ conidia/ml) of each isolate was brushed onto the roots of each plant with a paintbrush. Inoculated plants were planted in pots in a mixture of sterilized quartz sand:vermiculite:pearlite (2:1:1, v/v). The pots were placed under black shadecloth. The roots of five 1-year-old and five 3-year-old plants were brushed similarly with sterilized water as control treatments. After 30 days, symptoms similar to those on the original diseased plants were observed on the roots of all plants inoculated with the six isolates. The roots of non-inoculated plants remained healthy. The experiment was repeated. The same pathogen was re-isolated from the inoculated plants, but no pathogen was isolated from roots of the control plants. C. destructans var. destructans is widely distributed in soils (1), but to our knowledge, this is the first report of this fungus causing black root rot of Sanqi in China. References: (1) P. Charerri et al. Stud. Mycol. 68:57, 2011. (2) C. Y. Hu. New Rural Technol. 2:59, 2013 (in Chinese). (3) K. A. Seifert and P. E. Axelrood. Can. J. Plant Pathol. 20:115, 1998. (4) K. A. Seifert et al. Phytopathology 93:1533, 2003.

Effect of in vitro chondrogenic differentiation of autologous mesenchymal stem cells on cartilage and subchondral cancellous bone repair in osteoarthritis of temporomandibular joint

This study investigated the effects of in vitro chondrogenic differentiated mesenchymal stem cells (MSCs) on cartilage and subchondral cancellous bone in temporomandibular joint osteoarthritis (TMJOA). Four weeks after induction of osteoarthritis (OA), the joints received hylartin solution, non-chondrogenic MSCs or in vitro chondrogenic differentiated MSCs. The changes in cartilage and subchondral cancellous bone were evaluated by histology, reverse transcription polymerase chain reaction and micro-computed tomography (CT). Implanted cells were tracked using Adeno-LacZ labelling. The differentiated MSC-treated group had better histology than the MSC-treated group at 4 and 12 weeks, but no difference at 24 weeks. Increased mRNA expression of collegan II, aggeran, Sox9 and decreased matrix metalloproteinase 13 (MMP13) were observed in differentiated MSC-treated groups compared to the undifferentiated MSC-treated group at 4 weeks. The differentiated MSC-treated group had decreased bone volume fraction, trabecular thickness and bone surface density, and increased trabecular spacing in the subchondral cancellous bone than the undifferentiated MSC-treated group. Transplanted cells were observed at cartilage, subchondral bone, and the synovial membrane lining at 4 weeks. Intra-articular injection of MSCs could delay the progression of TMJOA, and in vitro chondrogenic induction of MSCs could enhance the therapeutic effects. This provides new insights into the role of MSCs in cell-based therapies for TMJOA.

The effects of combined human parathyroid hormone (1-34) and zoledronic acid treatment on fracture healing in osteoporotic rats

Ovariectomized (OVX) rats with tibial fracture received vehicle, ZA, PTH, or ZA plus PTH treatment for 4 and 8 weeks. Bone metabolism, callus formation, and the mass of undisturbed bone tissue were evaluated by serum analysis, histology, immunohistochemistry, radiography, micro-computerized tomography, and biomechanical test.

INTRODUCTION

Previous studies have demonstrated the effect of ZA or PTH on osteoporotic fracture healing. However, reports about effects of ZA plus PTH on callus formation of osteoporotic fracture were limited. This study was designed to investigate the impact of combined treatment with ZA and PTH on fracture healing in OVX rats.

METHODS

Twelve weeks after bilateral ovariectomy, all rats underwent unilateral transverse osteotomy on tibiae. Animals then randomly received vehicle, ZA (1.5 μg/kg weekly), PTH (60 μg/kg, three times a week), or ZA plus PTH until death at 4 and 8 weeks. The blood and bilateral tibiae of rats were harvested for evaluation.

RESULTS

All treatments increased callus formation and strength other than the control; ZA + PTH showed the strongest effects on percent bone volume (BV/TV), trabecular thickness, total fluorescence-marked callus area, and biomechanical strength. Additionally, inhibited RANKL and enhanced osteoprotegerin expression were observed in the ZA + PTH group. But no difference in bone mineral density and BV/TV of the contralateral tibiae was observed between treated groups.

CONCLUSION

Findings in this study suggested an additive effect of ZA and PTH on fracture healing in OVX rats, and this additive effect was specific to callus formation, not to undisturbed bone tissue.

Wld(S) protects against peripheral neuropathy and retinopathy in an experimental model of diabetes in mice

AIMS/HYPOTHESIS

We aimed to evaluate the effect of the mutant Wld(S) (slow Wallerian degeneration; also known as Wld) gene in experimental diabetes on early experimental peripheral diabetic neuropathy and diabetic retinopathy.

METHODS

The experiments were performed in four groups of mice: wild-type (WT), streptozotocin (STZ)-induced diabetic WT, C57BL/Wld(S) and STZ-induced diabetic C57BL/Wld(S). In each group, intraperitoneal glucose and insulin tolerance tests were performed; blood glucose, glycated haemoglobin and serum insulin were monitored. These mice were also subjected to the following behavioural tests: grasping test, hot-plate test and von Frey aesthesiometer test. For some animals, sciatic-tibial motor nerve conduction velocity, tail sensory nerve conduction velocity and eye pattern electroretinogram were measured. At the end of the experiments, islets were isolated to detect glucose-stimulated insulin secretion, ATP content and extent of apoptosis. The NAD/NADH ratio in islets and retinas was evaluated. Surviving retinal ganglion cells were estimated by immunohistochemistry.

RESULTS

We found that the Wld(S) gene is expressed in islets and protects beta cells against multiple low doses of STZ by increasing the NAD/NADH ratio, maintaining the ATP concentration, and reducing apoptosis. Consistently, significantly higher insulin concentrations, lower blood glucose concentrations, and better glucose tolerance were observed in Wld(S) mice compared with WT mice after STZ treatment. Furthermore, Wld(S) alleviated abnormal sensory responses, nerve conduction, retina dysfunction and reduction of surviving retinal ganglion cells in STZ-induced diabetic models.

CONCLUSIONS/INTERPRETATION

We provide the first evidence that expression of the Wld(S) gene decreases beta cell destruction and preserves islet function in STZ-induced diabetes, thus revealing a novel protective strategy for diabetic models.

Molecular analysis of an additional case of hybrid sterility in rice (Oryza sativa L.)

Hybrid sterility hinders the exploitation of the heterosis displayed by japonica × indica rice hybrids. The variation in pollen semi-sterility observed among hybrids between the japonica recipient cultivar and each of two sets of chromosome segment substitution lines involving introgression from an indica cultivar was due to a factor on chromosome 5 known to harbor the gene S24. S24 was fine mapped to a 42 kb segment by analyzing a large F(2) population bred from the cross S24-NIL × Asominori, while the semi-sterility shown by the F(1) hybrid was ascribable to mitotic failure at the early bicellular pollen stage. Interestingly, two other pollen sterility genes (f5-Du and Sb) map to the same region (Li et al. in Chin Sci Bull 51:675-680, 2006; Wang et al. in Theor Appl Genet 112:382-387, 2006), allowing a search for candidate genes in the 6.4 kb overlap between the three genes. By sequencing the overlapped fragment in wild rice, indica cultivars and japonica cultivars, a protein ankyrin-3 encoded by the ORF2 was identified as the molecular base for S24. A cultivar Dular was found to have a hybrid-sterility-neutral allele, S24-n, in which an insertion of 30 bp was confirmed. Thus, it was possible to add one more case of molecular bases for the hybrid sterility. No gamete abortion is caused on heterozygous maternal genotype with an impaired sequence from the hybrid-sterility-neutral genotype. This result will be useful in understanding of wide compatibility in rice breeding.

Systemic treatment with strontium ranelate promotes tibial fracture healing in ovariectomized rats

Systemic treatment with strontium ranelate (SR) was performed on ovariectomized (OVX) rats with fractured tibiae. Callus quality was assessed by radiographic, histological, micro-computerized tomography, and biomechanical examinations at 4 and 8 weeks after fracture. Results revealed that systemic applied SR promoted osteoporotic fracture healing.

INTRODUCTION

Several studies have demonstrated the dual effect of SR on osteoporotic and undisturbed bone. However, reports of their effect on osteoporotic fracture healing are limited. This study was designed to investigate the effects of SR on bone regeneration in OVX rats with fractured tibiae.

METHODS

Three months after being OVX, female Sprague-Dawley rats accepted bilateral osteotomy on proximal tibiae fixed with intramedullary wires and were divided into two groups: OVX and OVX + SR (625 mg/kg/day). Callus quality was evaluated at 4 and 8 weeks postfracture.

RESULTS

Compared with OVX group, SR treatment significantly increased bone formation, BMD, biomechanical strength, and improved microstructural properties of the callus. The ultimate load was increased by 211.0% and 61.4% (p<0.01), and the total bone volume of callus by 74.8% and 79.3% (p<0.01) at 4 and 8 weeks postfracture, respectively. SR treatment also promoted healing progress with increased osteogenesis at 4 weeks; more mature and tightly arranged woven or lamellar bone at 8 weeks across the fracture gap in histological analysis.

CONCLUSION

This study suggests that systemic treatment with strontium ranelate could promote tibial fracture healing in OVX rats.

Fine mapping of S31, a gene responsible for hybrid embryo-sac abortion in rice (Oryza sativa L.)

Partial abortion of female gametes and the resulting semi-sterility of indica x japonica inter-subspecific rice hybrids have been ascribed to an allelic interaction, which can be avoided by the use of wide compatibility varieties. To further understand the genetic mechanism of hybrid sterility, we have constructed two sets of hybrids, using as male parent either the typical japonica variety Asominori, or the wide compatibility variety 02428; and as female, a set of 66 chromosome segment substitution lines in which various chromosomal segments from the indica variety IR24 have been introduced into a common genetic background of Asominori. Spikelet semi-sterility was observed in hybrid between CSSL34 and Asominori, which is known to carry the sterility gene S31 (Zhao et al. in Euphytica 151:331-337, 2006). Cytological analysis revealed that the semi-sterility of the CSSL34 x Asominori hybrid was caused primarily by partial abortion of the embryo sac at the stage of the mitosis of the functional megaspore. A population of 1,630 progeny of the three-way cross (CSSL34 x 02428) x Asominori was developed to map S31. Based on the physical location of linked molecular markers, S31 was thereby delimited to a 54-kb region on rice chromsome 5. This fragment contains eight predicted open reading frames, four of which encode known proteins and four putative proteins. These results are relevant to the map-based cloning of S31, and the development of marker-assisted transfer of non-sterility allele inducing alleles to breeding germplasm, to allow for a more efficient exploitation of heterosis in hybrid rice.

Hormone-regulated inflorescence induction and TFL1 expression in Arabidopsis callus in vitro

To study hormone-regulated inflorescence development, we established the in vitro regeneration system of Arabidopsis inflorescences in the presence of cytokinin and auxin. Media containing a combination of thidiazuron (TDZ) and 2,4-dichlorophenoxyacetic acid (2,4-D) were used to induce callus formation. Higher frequencies of calli were obtained by using the inflorescence stems as explants. After transferring the calli to media containing a combination of zeatin and indole-3-acetic acid (IAA), the inflorescences were induced from the calli. The morphology of regenerated inflorescences was similar to that of inflorescences in plants; however, flowers of regenerated inflorescences often lacked a few floral organs. Furthermore, TFL1, a gene involved in floral transition in Arabidopsis, was activated during the inflorescence induction. Our results suggest that the TFL1 gene plays an important role in hormone-regulated inflorescence formation.

Cloning of hypoxia-inducible factor 1alpha cDNA from a high hypoxia tolerant mammal-plateau pika (Ochotona curzoniae)

Hypoxia-inducible factor 1 is a transcription factor composed of HIF-1alpha and HIF-1beta. It plays an important role in the signal transduction of cell response to hypoxia. Plateau pika (Ochotona curzoniae) is a high hypoxia-tolerant and cold adaptation species living only at 3000-5000 m above sea level on the Qinghai-Tibet Plateau. In this study, HIF-1alpha cDNA of plateau pika was cloned and its expression in various tissues was studied. The results indicated that plateau pika HIF-1alpha cDNA was highly identical to those of the human (82%), bovine (89%), mouse (82%), and Norway rat (77%). The deduced amino acid sequence (822bp) showed 90%, 92%, 86%, and 86% identities with those of the human, bovine, house mouse, and Norway rat, respectively. Northern blot analyses detected two isoforms named pLHIF-1alpha and pSHIF-1alpha. The HIF-1alpha mRNA was highly expressed in the brain and kidney, and much less in the heart, lung, liver, muscle, and spleen, which was quite different from the expression pattern of mouse mRNA. Meanwhile, a new variant of plateau pika HIF-1alpha mRNA was identified by RT-PCR and characterized. The deduced protein, composed of 536 amino acids, lacks a part of the oxygen-dependent degradation domain (ODD), both transactivation domains (TADs), and the nuclear localization signal motif (NLS). Our results suggest that HIF-1alpha may play an important role in the pika's adaptation to hypoxia, especially in brain and kidney, and pika HIF-1alpha function pattern may be different from that of mouse HIF-1alpha. Furthermore, for the high ratio of HIF-1alpha homology among the animals, the HIF-1alpha gene may be a good phylogenetic performer in recovering the true phylogenetic relationships among taxa.

Interventional study of high dose folic acid in gastric carcinogenesis in beagles

BACKGROUND

A decrease in folic acid and subsequent DNA hypomethylation may be involved in gastric carcinogenesis. Epidemiological and nutritional studies have indicated that folate status modulates the risk of developing cancers.

AIMS

To investigate whether folic acid plays an important role in the chemoprevention of gastric carcinogenesis induced by N-ethyl-N-nitrosoguanidine (ENNG) in beagles.

METHODS

Sixteen male beagles were randomly divided into two groups: folic acid treated group and control group. In both groups beagles were fed ENNG 75 mg per day for eight months and in the treated group 20 mg folic acid was given to beagles for 15 months. Gastroscopy and biopsies were performed before and every 2-3 months after administration of ENNG until the end of the experiment. Histopathological lesions were diagnosed with regard to the criteria for human gastric mucosal biopsies. Serum and gastric mucosal tissue folic acid concentrations were measured.

RESULTS

In the control group, all beagles developed gastric cancer (8/8) compared with only 3/8 in the folic acid treated group (p<0.05). Moreover, serum and gastric mucosal tissue folic acid concentrations were markedly elevated 15 months after folic acid administration. The difference was statistically significant between the two groups (p<0.05).

CONCLUSIONS

Our results indicate that high dose folic acid plays an important role in the chemoprevention of gastric carcinogenesis induced by a chemical carcinogen ENNG in beagles.

Relationship of plasma folic acid and status of DNA methylation in human gastric cancer

To evaluate the anti-cancer effects of folic acid at the molecular level, we determined plasma folic acid concentration by radioimmuno-assay and the degree of total genomic DNA methylation by incubating DNA with 3H-S-adenosylmethionine (3H-SAM) in the presence of a methylase, and analyzed the methylation status of the c-myc and c-Ha-ras oncogenes by Southern blotting in 21 patients with advanced gastric cancer. The degree of total genomic DNA methylation of cancerous tissues was significantly lower than that of paracancerous and non-cancerous tissues; c-myc and c-Ha-ras oncogenes from cancerous (10/21, 5/10) and paracancerous (13/21, 4/10) tissues were hypomethylated. The plasma folic acid concentration in patients who showed hypomethylation was lower than that patients showing normal methylation. These findings suggest that a decrease in folic acid, and the subsequent DNA hypomethylation, may be involved in human gastric carcinogenesis.

Studies on the hypomethylation of c-myc, c-Ha-ras oncogenes and histopathological changes in human gastric carcinoma

In order to study the status of DNA methylation of specific oncogenes and the relationship between them and the pathological changes in gastric carcinoma, we analysed the methylated status of c-myc, c-Ha-ras oncogenes by Southern blot hybridization. Genomic DNA from cancerous, paracancerous and non-cancerous areas of surgically resected specimens were examined in 22 cases of advanced human gastric carcinoma. Specimens were digested by the restriction endonucleases MspI/HpaII, which are able to cleave between methylated and non-methylated cytosine at their nucleotide recognition site the DNA 5'-CCGG sequence, and were hybridized with c-myc, c-Ha-ras oncogene probes. Moreover, the corresponding pathological changes in gastric carcinoma were observed. The results showed that c-myc, c-Ha-ras oncogenes from cancerous (10/22, 5/10) and paracancerous areas (13/22, 4/10) were hypomethylated and that there was no significant relationship between them and the histopathological changes.

Clinical studies on bladder tumor-associated antigen in serum of patients with bladder cancer by using monoclonal antibody and sandwich ELISA

Investigations on tumor-associated antigen in the serum of patients with bladder cancer by using monoclonal antibody Hb 7A and sandwich ELISA were carried out on 36 patients with bladder cancer (BCa group), 18 patients with other tissue tumor (OTT group) and 22 normal subjects (control group). The average OD value of Hb 7A antigen of BCa group, OTT group and control group was 0.315 +/- 0.033, 0.124 +/- 0.026 and 0.12 +/- 0.021 respectively. The OD value of Hb 7A antigen in BCa group was significantly higher than that of control group and of OTT group (P less than 0.01), but there was no obvious difference between the control group and OTT group (P greater than 0.05). The positive detection rate in BCa group was 86% (31/36), while detection in all 22 normal subjects and the 18 patients of OTT group yielded negative results. The results indicated that the method of using McAb Hb 7A and sandwich ELISA, characterized by high specificity and sensitivity, is of value for clinical diagnosis and follow-up of patients with bladder cancer and general survey of persons at high risk of bladder cancer.

Intravenous tryptophan tolerance test for liver function

An intravenous tryptophan tolerance test (ITrpTT) was designed for liver function since 95% Trp is metabolized by the liver. After an intravenous loading dose of 4 mg/kg body weight, serum levels of both free (F) and total (T) Trp were determined at 45 and 60 minutes. In normal controls and nonhepatic-disease patients, F45 (60) and T45 (60) did not exceed 7 mumol/L and 80 mumol/L, respectively, and F/T ratio not greater than 0.14. These were set up as cutoffs of upper normal limits. The test was abnormal in 87.5% of chronic persistent hepatitis (CPH) characterized by elevation of T45 (60), 100% of chronic active hepatitis (CAH) by elevation of F45 (60) and/or T45 (60), and 100% of hepatic cirrhosis by increase in F45 (60) and F/T ratio but not in T45 (60). The test seems to be more sensitive than the conventional tests for liver function. However, one should be cautious in interpretation of the test as there are some factors which might influence the Trp metabolism like exercise, alcoholism, corticosteroids and enzyme-inducers. It merits as an indication of liver dysfunction only when these factors are considered and excluded.