Complete miRNA-15/16 loss in mice promotes hematopoietic progenitor expansion and a myeloid-biased hyperproliferative state

Dysregulated apoptosis and proliferation are fundamental properties of cancer, and microRNAs (miRNA) are critical regulators of these processes. Loss of miR-15a/16-1 at chromosome 13q14 is the most common genomic aberration in chronic lymphocytic leukemia (CLL). Correspondingly, the deletion of either murine miR-15a/16-1 or miR-15b/16-2 locus in mice is linked to B cell lymphoproliferative malignancies. However, unexpectedly, when both miR-15/16 clusters are eliminated, most double knockout (DKO) mice develop acute myeloid leukemia (AML). Moreover, in patients with CLL, significantly reduced expression of miR-15a, miR-15b, and miR-16 associates with progression of myelodysplastic syndrome to AML, as well as blast crisis in chronic myeloid leukemia. Thus, the miR-15/16 clusters have a biological relevance for myeloid neoplasms. Here, we demonstrate that the myeloproliferative phenotype in DKO mice correlates with an increase of hematopoietic stem and progenitor cells (HSPC) early in life. Using single-cell transcriptomic analyses, we presented the molecular underpinning of increased myeloid output in the HSPC of DKO mice with gene signatures suggestive of dysregulated hematopoiesis, metabolic activities, and cell cycle stages. Functionally, we found that multipotent progenitors (MPP) of DKO mice have increased self-renewing capacities and give rise to significantly more progeny in the granulocytic compartment. Moreover, a unique transcriptomic signature of DKO MPP correlates with poor outcome in patients with AML. Together, these data point to a unique regulatory role for miR-15/16 during the early stages of hematopoiesis and to a potentially useful biomarker for the pathogenesis of myeloid neoplasms.

[Application of high-density polyethylene implants in adult cleft lip and palate nasal deformity and dysfunction]

Objective: Through the use of high-density polyethylene implants in adults with cleft lip and palate nasal deformities and abnormal functions, to evaluate the clinical effect of postoperative patients on improving nasal shape and symptoms. Methods: A retrospective study of 12 patients with nasal deformities after cleft lip and palate surgery in the Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University School of Medicine from January 2018 to January 2022 was completed, including 7 males and 5 females, with the age ranging from 18 to 29 years. All the patients underwent nasal deformity correction, and nasal septum correction was performed if necessary. High-density polyethylene implants (MEDPOR/Su-Por) were used intraoperatively. Follow-up for at least 6 months was performed to measure the relevant appearance indicators and subjective Visual Analog Scale (VAS) scores, and to compare the clinical effects before and after surgery. SPSS 22.0 software was used for statistical analysis. Results: Before and after surgery, the average VAS score of nasal obstruction decreased by (4.83±0.94) points; the average VAS score of appearance satisfaction increased by (3.92±1.08) points; the height of nasal columella was increased by (1.79±0.78)mm; the height of nasal tip was increased by (2.79±1.50)mm; the height of ipsilateral nostril was increased by (1.83±0.62)mm; the width of the ipsilateral nasal floor was reduced by (0.42±0.47)mm. All of above were statistically significant (all P<0.05). Conclusion: High-density polyethylene implants can effectively improve the shape and function of the nose in operations related to cleft lip and palate nasal deformity and abnormal functions, and are an ideal synthetic material.

[Trends of the disease burden of intellectual disability among children and adolescents from 1990 to 2019 in China]

Objective: This study aims to analyze the disease burden of intellectual disability among Chinese children and adolescents aged 0-19 years in 2019 and its trends from 1990 to 2019. Methods: Data were gathered from the Global Burden of Disease study. The prevalence and years lived with disability (YLDs) of intellectual disability among Chinese children and adolescents were compared with the global average by gender, age group, and severity of disability in 2019. Joinpoint regression model was used to analyze the trends in the prevalence and YLDs of intellectual disability among Chinese children and adolescents from 1990 to 2019. Results: The prevalence and YLDs of intellectual disability among Chinese children and adolescents in 2019 were 1 522.65 per 100 000 (95%UI: 1 228.62 per 100 000-1 817.55 per 100 000) and 109.81 per 100 000 (95%UI: 72.15 per 100 000-158.09 per 100 000), respectively, which were lower than the global average. The prevalence and YLDs of severe intellectual disability in China were slightly higher than the global average. The average annual percent changes in the prevalence and YLDs of intellectual disability among Chinese children and adolescents were -0.23% (95%CI: -0.26%--0.21%, P<0.001) and 0.74% (95%CI: 0.66%-0.81%, P<0.001) from 1990 to 2019, respectively. The prevalence and YLDs of severe intellectual disability showed continuously increasing trends over the past 30 years. Conclusions: The disease burden of intellectual disability among Chinese children and adolescents was lower than the global average in 2019, but severe intellectual disability was higher than the global average. The prevalence of intellectual disability among Chinese children and adolescents showed an overall decrease, while YLDs showed an increasing trend from 1990 to 2019.

[Analysis of changes in mortality of children and adolescents aged 5 to 19 years in China from 2004 to 2018 and policy effects]

Objective: To analyze the trend of child and adolescent mortality rate in China from 2004 to 2018 and explore the possible policy effects. Methods: This study used the mortality data of child and adolescent aged 5 to 19 years from 2004 to 2018 based on the National Disease Surveillance System. Age-standardized mortality rate was calculated by using the population from the sixth national census. Joinpoint regression was used to analyze the trend of child and adolescent mortality with different features from 2004 to 2018. Results: From 2004 to 2018, the overall mortality rate of children and adolescents in China dropped from 40.02 per 100 000 to 22.00 per 100 000, and the average annual percentage change (AAPC) was -4.28 (95%CI:-5.35,-3.20,P<0.001). The mortality rate dropped rapidly from 2004 to 2006, and the annual percentage change (APC) was -9.20 (95%CI:-15.63,-2.28,P=0.017). The decline rate slowed down between 2006 and 2013, and the APC was -1.56 (95%CI:-2.78,-0.33,P=0.020). The downward trend accelerated from 2013 to 2018, and the APC was -5.99 (95%CI:-7.52,-4.43,P<0.001). The trend of child mortality rate in rural area, females, eastern provinces of China, children aged 10 to 14 years, children aged 15 to 19 years, and injury mortality rate were basically consistent with the overall trend. The child mortality rate in urban area, central provinces of China and the mortality rate of infectious diseases, maternal and infant, and nutritional deficiencies diseases showed a uniform downward trend from 2004 to 2018, with AAPC values about -3.59 (95%CI:-4.38,-2.78,P<0.001), -2.89 (95%CI:-3.24,-2.54,P<0.001) and -6.66 (95%CI:-7.64,-5.68,P<0.001), respectively. Conclusion: The mortality rate of children and adolescents aged 5 to 19 years in China continues to decline from 2004 to 2018, and the decline rate becomes faster after 2011.

[Methods for evaluating overweight and obesity among children and adolescents and application in SPSS and SAS]

Overweight/obesity has become one of the major public health problems among children and adolescents all over the world. The current screening standards for overweight and obesity in children and adolescents are not unified. It is easy to make mistakes and inefficient to evaluate item by item or develop self-written packages. Taking the"Screening standards for overweight and obesity in Chinese school-age children and adolescents"as an example, this study introduced four methods and procedures for evaluating overweight and obesity among children and adolescents from the world and China and described their application methods in combination with specific cases. At the same time, the SPSS and SAS packages were compiled and the specific application steps were explained, so that users could correctly and quickly screen overweight and obesity among children and adolescents, and conduct horizontal comparisons of similar studies across different regions.

[Gender difference in secular trends of body height in Chinese Han adolescents aged 18 years, 1985-2014]

Objective: To analyze the gender difference in secular trends of body height in Chinese Han adolescents aged 18 years from 1985 to 2014. Methods: Data were extracted from 1985, 1995, 2000, 2005, 2010 and 2014 Chinese National Surveys in Students' Constitution and Health. A total of 124 099 Chinese Han adolescents aged 18 years were included in the analysis. ANOVA test was used to compare the body height between different subgroups stratified by gender and the mean difference and ratio in body height were calculated. Quantile regression model was used to assess the association between body height and gender over time in the adolescents stratified by region or area. Results: The mean body height of adolescents aged 18 years increased significantly from 1985 to 2014 with the rate of 1.3 cm/decade in male adolescents and 0.8 cm/decade in female adolescents, and the highest increment occurred from 1995 to 2005 in both groups. Male adolescents were taller than female adolescents at each subgroup (P<0.05). Gender difference in body height increased from 11.1 cm in 1985 to 12.6 cm in 2014 and ratio remained to be 1.07-1.08. The body height was taller in adolescents in urban area than in rural area (P<0.05) and in northeastern China than in other regions (P<0.05) in both male and female adolescents. The body height of obese male adolescents had been taller since 2000 and the body height of obese female adolescents had been taller since 2010 than other groups. When adjusted for urban-rural areas, region, socioeconomic status and nutritional status, the body height increased over time at P₅, P₂₅, P₅₀, P₇₅ and P₉₅ in both male and female adolescents, and the increments of gender difference in body height at different percentile ranged from 0.45 cm/decade to 0.57 cm/decade. When stratified by region, the gender difference in body height showed similar trend with total sample except P₅ and P₉₅ in northeastern China, the difference of increments were not significant. Conclusions: From 1985 to 2014, the gender difference in body height of Chinese Han adolescents aged 18 years increased, and male adolescents showed greater increase than female adolescents. Moreover, the adolescents in northeastern and eastern China had larger increment in body height. It is necessary to paid more attention to the adolescents in central and western China to promote their physical development.

[Evaluation of the effects auricular reconstruction with Medpor combined with hearing rehabilitation]

Objective: To investigate the clinical effects of single-stage auricular reconstruction and hearing rehabilitation in children with microtia and external auditory canal atresia. Methods: Sixty eight cases of microtia with external auditory canal atresia (53 males and 15 females, age from 7 to 12 years, with a median age of 8.8 years), who received operations in Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine from July 2017 to December 2019 were collected.A total of 28 cases received auricle reconstruction with high-density polyethylene (Medpor) framework and hearing reconstructions, among which 20 patients received the traditional external auditory canal and middle ear repair (EACR), and eight patients were implanted bone conduction device bone bridge(BB) simultaneously.In the control group, 40 patients only received Medpor frame implantation for auricle plasty. Postoperative changes in auricle morphology and auditory function and postoperative complications were evaluated. Results: After three to thirty months follow-ups, the auricles shape recovered well in all three groups. The average scores of 14 fine structures in the auricles were 9.43(EACR) and 10.67(BB) points. The average score of auricle symmetry were 6.83(EACR) and 6.00(BB) points. There was no significant difference compared to the auricle reconstruction group (8.23/6.20 points). P>0.05. After surgery, the average hearing improvement in the BB group was 43.33 dB HL and the average speech recognition threshold declined 42.28 dB HL. In the EACR group, the average hearing improvement was 4.13 dB HL and the average speech recognition threshold declined 11.36 dB HL. No vertigo, tinnitus, cerebrospinal fluid leakage and other complications occurred in all the patients. In the EACR group, sensorial hearing loss, auricle stent fracture, ear canal restenosis and ear canal atresia occurred in one patient respectively. In the auricle group, one auricle stent exposure and one facial branch nerve injury occurred. Nearly ten patients had difficulty in hair growth at scalp incisions. Conclusions: The operation of single-stage auricular reconstruction and hearing rehabilitation for microtia is feasible. The methods of hearing reconstruction should be determined by evaluating the development of the inner and middle ear of the patients. For those with poor mastoid development, bone bridge implantation is recommended to achieve a stable and significant hearing effect.

[Association between endurance quality and blood pressure levels in Han students aged 13-18 years in China, 2014]

Objective: To analyze the association between the endurance quality and blood pressure levels in Han students aged 13-18 years in China. Methods: We used the data of Han students aged 13-18 years from 2014 Chinese National Survey on Students' Constitution and Health. Elevated blood pressure and its components, including isolated elevated SBP, isolated elevated DBP, and mix elevated blood pressure, were evaluated according to the reference of screening for elevated blood pressure among children and adolescents aged 7-18 years. The students' endurance quality was scored according to the National Standards for Students' Physical Health (2014 revision) and categorized based on their percentiles into four groups as follows: P(0)-, P(25)-, P(50)-, and P(75)-P(100). Trend χ(2) test was used to analyze the trend of the detection rates of elevated blood pressure and its components in different groups of endurance quality. Logistic regression model was used to estimate the odds ratio (OR) for elevated blood pressure and its components in different endurance quality groups and P(0)-group was set as reference group. Quantile regression model was used to analyze the association between different blood pressure levels and endurance quality. Results: The detection rate of elevated blood pressure in the students aged 13-18 years in China in 2014 was 9.2%. The detection rate of elevated blood pressure and its components decreased with the improvement of endurance quality (P<0.001). With the P(0)-endurance quality group as reference, the OR(95%CI) were 0.89(0.84-0.95), 0.81(0.76-0.86) and 0.79(0.74-0.84) respectively in P(25)-, P(50)- and P(75)-P(100) endurance quality groups respectively. The negative association existed between endurance quality and elevated blood pressure in overweight, obese and normal students, but not in malnourished students. The quantile regression analysis results showed that in overweight and obese students, the SBP levels at the P(10), P(25), P(50), P(75), P(9)0 and P(95) groups were negatively associated with the endurance quality, and the DBP levels at the P(25) and above group were negatively associated with the endurance quality. In malnourished and normal students, only some levels of DBP were negatively associated with the endurance quality. Conclusions: The negative association existed between endurance quality and elevated blood pressure in Han students aged 13-18 years in China. In overweight and obese students, the association between endurance quality and blood pressure level was stronger. Improving students' endurance quality may facilitate the prevention of elevated blood pressure.

[Analysis on the trend of prevalence of excellent and good physical fitness and health status among Chinese Han students aged 13 to 18 years and related influencing factors from 1985 to 2014]

Objective: Using the Chinese National Survey on Students' Constitution and Health data from 1985 to 2014 to analyze the trend of excellent and good physical fitness and health status among Chinese Han students aged 13 to 18 years and the related influencing factors. Methods: 738 523 students aged 13 to 18 years with completed data of gender, age, urban and rural, physical form, vital capacity and physical fitness were selected from the six Chinese National Surveys on Students' Constitution and Health. According to National Standards for Students' Physical Health (2014 revision), the comprehensive scores and the prevalence of excellent and good physical fitness and health status were calculated (90.0-120.0 was classified as excellent, and 80.0-89.9 was classified as good). The trend of prevalence of excellent and good physical fitness and health status in different years and the corresponding differences among students with different characteristics were analyzed and compared. The log-binomial regression model was used to analyze related factors of physical fitness and health status. Results: From 1985 to 2014, the overall prevalence of excellent and good physical fitness and health status increased from 27.6% in 1985 to 35.6% in 1995, and then declined to 13.9% in 2005. In the 2010 and 2014 cycles, the prevalence increased steadily, at 16.5% and 19.1% respectively. Except for 1995 and 2014, the prevalence of boys was higher than that of girls (P<0.001). The prevalence of students aged 13 to 15 was higher than that of students aged 16 to 18 (P<0.001). Log-binomial regression model analysis showed that girls ［PR（95%CI）=1.03（1.00-1.05）, P=0.021］, rural area ［PR（95%CI）=1.09（1.07-1.12）, P<0.001］, 13-15 years old［PR（95%CI）=1.89（1.84-1.94）, P<0.001］, eastern region［PR（95%CI）=1.94（1.88-2.00）, P<0.001］, middle region［PR（95%CI）=1.15（1.11-1.20）, P<0.001］, Exercise time ≥1 h/d［PR（95%CI）=1.41（1.37-1.45）, P<0.001］, parents support participation in sports activities after school［PR（95%CI）=1.10（1.06-1.15）, P<0.001］, TV time ≤1 h/d［PR（95%CI）=1.26（1.21-1.30）, P<0.001］, playing video games, watching videos or e-books ≤1 h/d［PR（95%CI）=1.05（1.02-1.09）, P<0.001］ were all related to the high prevalence of excellent and good physical fitness and health status. Conclusion: The prevalence of excellent and good physical fitness and health status among students aged 13 to 18 was changing between 1985 and 2014. Gender, age, area, physical exercise time, screen time for non-learning purposes, and parents' attitudes toward students' participation in physical activities were all related to the excellent and good physical fitness and health status of students.

[The application of the National Standards for Students' Physical Health (2014 revision) in SPSS]

The National Standards for Students' Physical Health (2014 revision)is a standard for providing primary guidance for the national school education work and applicable to the evaluation of the physical health of primary school, secondary school and university students in China. This standard sets indicators and assessment scores by gender and grade from three aspects, i.e. body shape, function and quality. Given the complexity of the application process and the large number of indicators, it could be inefficient and misused due to a large sample size. Therefore, this study aims to comprehensively introduce the application of the standard with examples, and compile the corresponding SPSS package for potential audience to quickly and accurately evaluate students' physical health.

[Comparison of status of physical activity time at school and influencing factors in students in China, 2010 and 2014]

Objective: To compare the probability of physical activity (PA) time ≥1 hour at school and influencing factors in students in China between 2010 and 2014. Methods: We used the data of 2010 and 2014 Chinese National Survey on Students' Constitution and Health (CNSSCH). The surveys covered the Han students aged 9-22 years and Tibetan students aged 9-18 years (Tibet). The participants were primary school students (9-12 years old), junior high school students (13-15 years old), senior high school students (16-18 years old) and college students (19-22 years old). The probability of PA time ≥1 hour at school was compared using χ(2) tests between 2010 and 2014 survey years. Log-binomial Regression was used to estimate the relative risk (RR) for the probability of PA time ≥1 hour at school in different age groups. Results: The overall probability of PA time ≥1 hour at school in students aged 9-22 years was 20.5% in 2010, and 23.8% in 2014. The difference between 2010 and 2014 was significant (P<0.001). On the whole, the probability of PA time ≥1 hour at school increased in the eastern, central and western areas in 2014 compared with 2010 (P<0.05), and the increase range was highest in eastern area, followed by western area and central area (P<0.05). The probability of PA time of 1 hour at school in all age groups increased in 2014 compared with 2010 (P<0.05). The increase in the probability of PA time ≥1 hour at school was larger in primary school students than that in high school students and college students (P<0.05). The probability of PA time ≥1 hour at school increased in all age groups in three areas, except in junior and senior high school students in the central area where the probability of PA time ≥1 hour at school decreased. The probability of PA time ≥1 hour at school in primary and junior/senior high school students in the eastern area had the greatest increase, but in college students it had the smallest increase in the three areas. From 2010 to 2014, the changes in the probability of PA time ≥1 hour at school in students in different provinces were quite different, especially in primary school students. The probability of PA time ≥1 hour at school in four age groups increased in only three provinces. With the probability of PA time ≥1 hour at school in primary school students as the reference, the RR in junior high students had no significant change between 2010 and 2014. The RR in senior high school increased from 0.34 (0.33-0.35) in 2010 to 0.36 (0.36-0.37) in 2014, and the RR in college students increased from 0.33 (0.32-0.34) in 2010 to 0.43 (0.42-0.44) in 2014. Conclusions: The probability of PA time ≥1 hour at school in all age groups increased in 2014 compared with 2010, but there were great differences among provinces. The findings of our study suggests that although the national policy played a certain role, the provinces should take specific measures to improve the probability of PA time ≥1 hour at school in students according to their own conditions. In addition, more attention should be paid to PA of older students.

[Secular trends and geographic disparities of all-cause mortality among Chinese adolescents aged 10-24 years, between 1953 and 2010]

Objective: To analyze the secular trends and geographic disparities of all-cause mortality among Chinese adolescents aged 10-24 years over the period of 1953-2010. Methods: Data were extracted from the Chinese National Census in 1953-2010. We calculated the all-cause mortality and annualized rates of the changes. Using the provincial gross domestic product (GDP) per capita as an indicator of regional socio-economic development level, we calculated the Wagstaff normal concentration indices for adolescent mortality. Results: Over the period of 1953-2010, the general patterns of Chinese adolescent mortality appeared higher in males than those in females, higher in the 20-24-year-old than those in the 15-19 year-old and in the 10-14 year-old groups, higher in adolescents from the western than those in the eastern regions. The mortality of adolescents decreased from 554.6/100 000 in 1953-1964 to 55.7/100 000 in 2010 in males and decreased from 488.4/100 000 to 26.7/100 000 in females, respectively. The percentage of decrease for females (94.5%) was higher than that for males (90.0%). In 1981-2010, the highest annualized rate of decline for males was seen in Beijing (4.4%), with the lowest seen in Qinghai (0.1%). For girls, Hubei showed the highest annualized rate of decline (6.4%) while Qinghai the lowest (0.8%). Provinces that with higher mortality tended to have lower annualized rate of decline. The concentration indices for boys were -0.07 (95%CI: -0.11- -0.03), -0.13 (95%CI: -0.18- -0.08), and -0.16 (95%CI: -0.22- -0.10) in 1990, 2000, and 2010, respectively, and were -0.07 (95%CI: -0.13- -0.02), -0.18 (95%CI: -0.24- -0.12), and -0.18 (95%CI: -0.26- -0.09) respectively in girls. The indices among 1990, 2000, and 2010 did not show statistically significantly differences, both for boys and girls (P>0.05). Conclusions: Over the half century, the mortality of Chinese adolescents showed dramatic decreasing trend. However, in terms of death rates, gender and geographic disparities were consistently seen in the adolescents.

[Effects of heme oxygenase-1 knockdown on proliferation, invasion and metastasis of lung adenocarcinoma A549 cells and its mechanism]

Objective: To investigate the effects of heme oxygenase-1 (HO-1) knockdown on proliferation, invasion and migration of lung adenocarcinoma A549 cells and explore the mechanism. Methods: The expression levels of HO-1 mRNA in human bronchial epithelial cells (HBECs) and human lung cancer cell lines (A549, H1299, H358 and H1993) were detected by real-time quantitative polymerase chain reaction (RT-qPCR), and immunohistochemistry (IHC) was used to detect the expression level of HO-1 in human lung adenocarcinoma specimens. The HO-1 short hairpin RNA (shRNA) was transfected into A549 cells by RNA interference technique. HO-1 stably deleted A549 cells were selected (HO-1 shRNA group) and verified by RT-qPCR and western blot. HO-1 shRNA A549 cells and control shRNA A549 cells were treated with the inducer of autophagy Torin1 or its inhibitor Bafilomycin A1 (Baf A1), respectively. The expressions of autophagic markers LC3B and p62 were determined by western blot. The proliferation, invasion and migration abilities of each group of A549 cells were assessed by cell counting, Transwell and wound healing assays, respectively. Results: The expressions of HO-1 mRNA in lung cancer cell lines (A549, H1299, H358 and H1993) were significantly higher than that of HBECs, and HO-1 upregulated in human lung adenocarcinoma. The expression of p62 protein and the ratio of LC3B-Ⅱ/ LC3B-Ⅰ in no treatment group, Torin1 treatment group and Baf A1 treatment group were significantly higher than those of the corresponding control group (P<0.05). After 11 days of culture, the number of cells in HO-1 shRNA group were 41.8%, 30.4% and 14.0% of the corresponding control group, respectively. The number of lower chamber cells in HO-1 shRNA group were (35.7±2.1), (27.0±1.0) and (38.0±1.0)/field, respectively, which were lower than (66.0±9.2), (39.3±1.2) and (43.0±2.6)/field of the corresponding control group, respectively (P<0.05). The migration distances of HO-1 shRNA group were (7.47±0.91) mm, (4.23±0.82) mm and (5.42±0.24) mm, which were lower than (10.07±1.26) mm, (7.14±0.07) mm and (12.04±0.80) mm of the corresponding control groups, respectively (P<0.05). Conclusion: Knockdown of HO-1 inhibits the proliferation, invasion and migration of A549 cells by impeding autophagy.

[Analysis on the urban-rural disparity of childhood stunting and its association with economic growth among Chinese Han students aged 7-18 years old]

Objective: To analyze the urban-rural disparity of childhood stunting and its association with subnational economic growth among Chinese Han students aged 7-18 years. Methods: We used the data from 2014 Chinese National Survey on Students' Constitution and Health. 213 940 Chinese Han students aged 7-18 years with complete height records were included in this study. Stunting was defined according to the Screening Criteria of Malnutrition for School-age Children and Adolescents(2014 version, in Chinese). We divided students into two groups (economically developed and underdeveloped areas) according to the provincial GDP per capita. Spearman correlation coefficient was used to explore the association between the difference of urban-rural stunting prevalence and the provincial GDP per capita. Logistic regression models were established to assess the risk of stunting in rural children compared with urban children. Results: Among 213 940 students, 107 033 (50.0%) were from urban areas. The average height of 7-18 years old and 18 years old [(152.9±15.7) and (166.1±8.7) cm] of urban students were both higher than those of rural students [(150.7±16.0) and (165.1±8.6) cm] (P<0.001). The stunting prevalence of Chinese urban students (0.4%) was statistically significant lower than that of rural students (1.1%) (P<0.001), which was consistent in all age groups (P<0.05). The urban-rural disparity was found in 60% (18/30) of Chinese provinces. The difference of urban-rural stunting prevalence was negatively associated with provincial GDP per capita (r=-0.62, P<0.001). In economically underdeveloped areas, the risk of stunting for rural students aged 7-9 years was 4.69 (95%CI: 2.93-7.52) times that for urban children, while for students aged 10-18 years, the odds ratio was 2.44 (95%CI: 2.02-2.96). In economically developed areas, the risk of stunting for rural students aged 7-9 years was 5.43 (95%CI: 3.67-8.03) times that for urban children, while for students aged 10-18 years, the odds ratio was 2.15 (95%CI: 1.85-2.49). Conclusions: The urban-rural disparity of childhood stunting existed in most places in China. The difference of growth retardation between urban and rural areas was related to regional economic development.

[Clinical study of nasopharyngeal masses with suspicion of nasopharyngeal carcinoma in adult patients]

Objective: To improve the accuracy of diagnosis and to reduce the misdiagnosis rate of nasopharyngeal carcinoma by analyzing the characteristics of such masses. Methods: Clinical data from 55 patients with suspicion of nasopharyngeal carcinoma diagnosed and treated between March 2016 and September 2017 were analyzed. All patients were followed up regularly. Results: With following-up of 12 to 25 months, 6 (10.9%) of 55 cases were identified as nasopharyngeal malignant tumors, including 4 cases of nasopharyngeal carcinoma and 2 cases of lymphoma, and 49 cases (89.1%) were diagnosed with nasopharyngeal benign masses, including 29 (59.2%) cases for nasopharyngeal lymphoid proliferation, 15 (30.6%) for adenoid hypertrophy, 2 (4.1%) for nasopharyngeal cyst, 1 (2.0%) for polyp, 1 for papilloma and 1 for nasopharyngeal pharyngeal cyst. Small nasopharyngeal malignant tumor and masses with benign hyperplasia showed the overlap of images on the enhanced MRI/CT and Fibro-nasopharyngoscopy, but all 6 patients with nasopharyngeal malignant tumors presented with moderately enhanced multiple enlarged lymph nodes. Conclusions: Fibro-nasopharyngoscopy and enhanced MRI/CT have some value on evaluation of nasopharyngeal masses, but biopsy is a golden standard for diagnosis. Follow-up is necessary for the patients with negative biopsy and benign nasopharyngeal hyperplasia indicated by fibro-nasopharyngoscopy and enhanced MRI/CT.

[Immunotherapies for head and neck squamous cell carcinomas]

The Head and neck squamous cell carcinoma (HNSCC) is a group of heterogeneous diseases. Patients with HNSCC demonstrate poor prognosis and survival time with standard therapy, especially in patients with advanced HNSCC. Recurrence and metastasis have not yet been effectively controlled. The immune profile in HNSCC, whether caused by carcinogen exposure or human papillomavirus (HPV), showed significantly immunosuppression. With the understanding of the complex interaction between tumor and immune system and immune escape mechanism of HNSCC, new immunotherapies have been generating. This article will summarize the immunological mechanism and immune therapy of HNSCC currently..

Vagal afferent-dependent cholecystokinin modulation of visceral pain requires central amygdala NMDA-NR2B receptors in rats

BACKGROUND

Cholecystokinin (CCK), a gut hormone that is released during feeding, exerts gastrointestinal effects in part through vagal pathway. It is reported to be a potential trigger for increased postprandial visceral sensitivity in healthy subjects and, especially in patients with irritable bowel syndrome. NR2B-containing N-methyl-d-aspartate (NMDA) receptors in the central amygdala (CeA) participate in pain modulation. Systemically administered CCK activates the CeA-innervating neurons. Here, we investigated whether CCK modulation of visceral sensitivity is mediated through CeA NMDA-NR2B receptors and whether this modulation involves vagal pathway.

METHODS

We first examined the visceromotor response (VMR) to colorectal distention (CRD) following i.p. injection of CCK octapeptide (CCK-8) in a rat model. Next, the NR2B antagonist ifenprodil and the NR2A antagonist NVP-AAM077 were microinjected into the CeA before systemic CCK injection. NR2B phosphorylation was detected by Western blot. To down-regulate NR2B gene expression, NR2B-specific small interfering RNA (siRNA) was delivered into CeA neurons by electroporation. In addition, the effects of functional deafferentation by perivagal application of capsaicin and pretreatment with the CCK1 receptor antagonist devazepide were investigated.

KEY RESULTS

CCK-8 increased VMR to CRD in a dose-dependent manner. This effect was blunted by intra-CeA administration of ifenprodil (but not NVP-AAM077) and was accompanied by phosphorylation of NR2B subunits in the CeA. CCK failed to increase VMR to CRD in NR2B siRNA-treated rats. Perivagal capsaicin application and pretreatment with devazepide prevented CCK-induced pronociception and CeA NR2B phosphorylation.

CONCLUSIONS & INFERENCES

The pronociception induced by systemic CCK, which is vagal afferent-dependent, requires activation of CeA NMDA-NR2B receptors.

A Selective Novel Peroxisome Proliferator-Activated Receptor (PPAR)-α Antagonist Induces Apoptosis and Inhibits Proliferation of CLL Cells In Vitro and In Vivo

Tumor-specific metabolic changes can reveal new therapeutic targets. Our findings implicate a supporting role for fatty acid metabolism in chronic lymphocytic leukemia (CLL) cell survival. Peroxisome proliferator-activated receptor (PPAR)-α, a major transcriptional regulator of fatty acid oxidation, was recently shown to be upregulated in CLL. To evaluate PPARα as a potential therapeutic target, we developed a highly selective, potent small molecule antagonist of PPARα, NXT629. NXT629 inhibited agonist-induced transcription of PPARα-regulated genes, demonstrating target engagement in CLL cells. Furthermore, NXT629 induced apoptosis of CLL cells even in the presence of a protective microenvironment. To mimic the proliferative lymphoid compartment of CLL, we examined the activity of NXT629 on CLL cells that were stimulated to proliferate in vitro. NXT629 reduced the number of leukemia cells undergoing cell division. In addition, in two xenograft mouse models of CLL (one a model for nondividing and one for dividing CLL), NXT629 reduced the number of viable CLL cells in vivo. Overall, these results suggest that fatty acid metabolism promotes survival and proliferation of primary CLL cells and that inhibiting PPARα gene regulation could be a new therapeutic approach to treating CLL.

Outcomes of laryngectomy in elderly patients with laryngeal carcinoma

Laryngeal carcinoma is a common tumor of the head and neck region. This study aimed to examine the outcomes of laryngectomy in elderly patients with laryngeal carcinoma. One-hundred twenty-two patients (male, 117; female, 5) aged 60 years or older (range, 60-94 years) who underwent laryngectomy between 1996 and 2010 were included. All patients were diagnosed with squamous cell carcinoma of the larynx, and 95 patients (77.9%) had additional concurrent diseases. Tumors were staged according to the TNM categories of the American Joint Committee on Cancer 2002 criteria; there were 16 stage-I, 24 stage-II, 52 stage-III, and 30 stage-IV cases. With regard to treatment modalities, 10 patients underwent transoral laser laryngectomy, 25 underwent partial laryngectomy, and 87 underwent total laryngectomy. When necessary, neck dissection was performed according to the Dalian criteria set in 2004 (a Chinese standard). Of the 122 cases, there were 114 cases of grade I (93.4%), 5 cases of grade II, and 3 cases of grade III (pharyngeal fistula in 2 cases recovered after 2 weeks of care) wound healing. No significant differences were observed in the occurrence or severity of comorbidities. The 1-, 3-, and 5-year actuarial survival rates were 97.5% (119/122), 84.4% (92/109), and 68.4% (67/98), respectively. Age alone should not be used to determine treatment options for elderly patients with squamous cell carcinoma. Presuming that careful pre-treatment evaluations are performed, laryngectomy is a key method for elderly patients with laryngeal carcinoma.

Genomic imbalance defines three prognostic groups for risk stratification of patients with chronic lymphocytic leukemia

Array comparative genomic hybridization (aCGH) has yet to be fully leveraged in a prognostic setting in chronic lymphocytic leukemia (CLL). Genomic imbalance was assessed in 288 CLL specimens using a targeted array. Based on 20 aberrations in a hierarchical manner, all 228 treatment-naive specimens were classified into a group with poor outcome (20.6%) exhibiting at least one aberration that was univariately associated with adverse outcome (gain: 2p, 3q, 8q, 17q, loss: 7q, 8p, 11q, 17p, 18p), good outcome (32.5%) showing 13q14 loss without any of the other 10 aberrations (gain: 1p, 7p, 12, 18p, 18q, 19, loss: 4p, 5p, 6q, 7p) or intermediate outcome (remainder). The three groups were significantly separated with respect to time to first treatment and overall survival (p < 0.001), and validation of the stratification scheme was performed in two independent datasets. Gain of 3q and 8q, and 17p loss were determined to be independent unfavorable prognostic biomarkers. TP53, NOTCH1 and SF3B1 mutations correlated with the presence of one poor outcome aCGH marker, at a considerably higher frequency than when only considering poor risk aberrations routinely detected by fluorescence in situ hybridization (FISH). These data support genomic imbalance evaluation in CLL by aCGH to assist in risk stratification.

Effects of prostaglandin E2 on p53 mRNA transcription and p53 mutagenesis during T-cell-independent human B-cell clonal expansion

Within T-cell-dependent germinal centers, p53 gene transcription is repressed by Bcl-6 and is thus less vulnerable to mutation. Malignant lymphomas within inflamed extranodal sites exhibit a relatively high incidence of p53 mutations. The latter might originate from normal B-cell clones manifesting activation-induced cytosine deaminase (AID) and up-regulated p53 following T-cell-independent (TI) stimulation. We here examine p53 gene transcription in such TI clones, with a focus on modulatory effects of prostaglandin E2 (PGE2), and evaluate progeny for p53 mutations. Resting IgM(+)IgD(+)CD27(-) B cells from human tonsils were labeled with CFSE and stimulated in vitro with complement-coated antigen surrogate, IL-4, and BAFF ± exogenous PGE2 (50 nM) or an analog specific for the EP2 PGE2 receptor. We use flow cytometry to measure p53 and AID protein within variably divided blasts, qRT-PCR of p53 mRNA from cultures with or without actinomycin D to monitor mRNA transcription/stability, and single-cell p53 RT-PCR/sequencing to assess progeny for p53 mutations. We report that EP2 signaling triggers increased p53 gene transcriptional activity in AID(+) cycling blasts (P<0.01). Progeny exhibit p53 mutations at a frequency (8.5 × 10(-4)) greater than the baseline error rate (<0.8 × 10(-4)). We conclude that, devoid of the repressive influences of Bcl-6, dividing B lymphoblasts in inflamed tissues should display heightened p53 transcription and increased risk of p53 mutagenesis.

Studies on pathogenicity and prevalence of white spot syndrome virus in mud crab, Scylla serrata (Forskal), in Zhejiang Province, China

Mud crab, Scylla serrata (Forskal), is the most commercially important marine crab species in China. In recent years, serious diseases have occurred in major mud crab culture regions in SE China. PCR detection of white spot syndrome virus (WSSV) in diseased mud crabs collected from Zhejiang Province during 2006-2008 showed a prevalence of 34.82%. To study the pathogenicity of WSSV to mud crab, healthy mud crabs were injected intramuscularly with serial 10-fold dilutions of a WSSV inoculum. The cumulative mortalities in groups challenged with 10⁻¹, 10⁻², 10⁻³ and 10⁻⁴ dilutions were 100%, 100%, 66.7% and 38.9% at 10 days post-injection, respectively. All moribund and dead mud crabs except the control group were positive for WSSV by PCR. Based on the viral load of the WSSV inoculum by quantitative real-time PCR, the median lethal dose (LD50) of WSSV in S. serrata was calculated as 1.10 × 10⁶ virus copies/crab, or 7.34 × 10³ virus copies g⁻¹ crab weight. The phenoloxidase, peroxidase and superoxide dismutase activities in haemolymph of WSSV-infected moribund crabs, were significantly lower than the control group, whereas alkaline phosphatase, glutamate-pyruvate transaminase and glutamic-oxaloacetic transaminase were higher than in the control group. WSSV was mainly distributed in gills, subcuticular epithelia, heart, intestine and stomach as shown by immunohistochemical analysis with Mabs against WSSV. The epithelial cells of infected gill showed hypertrophied nuclei with basophilic inclusions. Numerous bacilliform virus particles were observed in nuclei of infected gill cells by transmission electron microscopy. It is concluded that WSSV is a major pathogen of mud crab with high pathogenicity.

Direct effects of fascaplysin on human umbilical vein endothelial cells attributing the anti-angiogenesis activity

Novel anti-angiogenesis activity of fascaplysin via VEGF blockage was recently revealed by our previous study in addition to the reported cyclin-dependent kinase 4 (CDK4) selective inhibition. To uncover more details of this pharmacologically prospective property, this study further investigated whether fascaplysin had direct anti-proliferation effects on human umbilical vein endothelial cells (HUVEC), which might be contributing to anti-angiogenesis. The results showed that G1 cell cycle arrest was induced by 2.6 μM fascaplysin in a time-dependent manner, and exhibited more sensitive than hepatocarcinoma cells BeL-7402 and Hela cells. Approximately 56.09 ± 2.63% of the cells were arrested at the G1 phase after 24h, and 64.94 ± 2.07% after 36 h, comparing to the 22.82 ± 1.2% in methanol treated cells. Apoptosis of HUVEC cells was induced by 1.3 μM fascaplysin and indicated by the sub-G1, Hoechst staining, terminal deoxynucleotidyl transferase dUTP-mediated nicked end labeling (TUNEL) assay, and annexin-V and propidium (PI) label. This apoptosis response was further confirmed by the detection of active caspase-3 and by western blotting using antibodies against Bax, Bcl-2, procaspase-8, and Bid, indicating that apoptosis in HUVEC cells may involve a mitochondria pathway, by the demonstration of an increase in the Bax/Bcl-2 ratio. Together, our results suggest that the anti-angiogenesis activity of fascaplysin is through the direct effects of cell cycle arrest and apoptosis on HUVEC.

Extraction and protein component analysis of venom from the dissected venom glands of Latrodectus tredecimguttatus

Black widow spiders (genus Latrodectus) have attracted increasing attention due to frequently reported human injuries caused by them and the potential applications of biologically active components in their venoms. Although a number of studies have described the biological properties and structures of several venomous proteins such as latrotoxins, a comprehensive analysis of protein component of the venom from the spider is not available. We used combinative proteomic strategies to assess the protein components of the crude venom collected from Latrodectus tredecimguttatus by extracting the dissected venom glands. The experiments demonstrated that the crude venom of L. tredecimguttatus has a high abundance of acidic proteins with molecular masses greater than 15 kDa, and the content of proteins and peptides of below 15 kDa is low. 86 unique proteins were identified, part of which were contaminations of cellular components during the extraction, determined in comparison with venom obtained by electrostimulation. Except for members of latrotoxin family that were commonly considered as the primary toxic components of the venom, several other special enzymes and proteins were detected such as protease, phosphatase, lysozyme, inhibitory protein, and so on. These protein components, particularly the proteases, were speculated to play important roles in the action of L. tredecimguttatus venom.

[Using L-form bacterium ATP bioluminescence assay for rapid testing L-form bacterial susceptibility]

Adenosine triphosphate is a kind of necessary metabolites in living cells. The authors detected ATP contents by using bioluminescence method in 111 strains of L-form bacteria after exposing to 5 kinds of antibiotics. The results showed that the mean value of CPM was less than (35 +/- 10.2)%.s-1. Thus, the value could be acted as a critical concentration between susceptibility and resistance. The conincidence rate of this method and K-B method was 95.3%. It indicates that the bioluminescence method has a high sensitivity. It can be used to detect L-form bacterium-drug susceptibility quickly and may play an important role for choosing the antibiotics.

Virtual hepatic resection using three-dimensional reconstruction of helical computed tomography angioportograms

OBJECTIVE

To establish the accuracy of virtual hepatic resection using three-dimensional (3D) models constructed from computed tomography angioportography (CTAP) images in determining the liver volume (LV) resected during resectional liver surgery.

SUMMARY BACKGROUND DATA

The ability to measure LV before surgery could be useful in determining the extent and nature of hepatic resection. Accurate assessment of LV and an estimate of liver function may also allow prediction of postoperative liver failure in patients undergoing resection, assist in volume-enhancing embolization procedures, help with the planning of staged hepatic resection for bilobar disease, and aid in selection of living-related liver donors.

METHODS

A retrospective study was conducted involving 27 patients scheduled for liver resection. Using mapping technology, 3D models were constructed from helical CTAP images. From these 3D models, tumor volume, total LV, and functional LV were calculated and were compared with body weight. The 3D liver models were subjected to a virtual hepatectomy along established anatomical planes, and the resected LV was calculated. The resected volume predicted by radiologists (unaware of the actual weight) was compared with the specimen weight measured after actual surgical resection.

RESULTS

A significant correlation was found between body weight and functional LV but not total LV. The computer prediction of resected LV after virtual hepatectomy of 3D models compared well with resected liver weight.

CONCLUSION

Virtual hepatectomy of 3D CTAP reconstructed images provides an accurate prediction of liver mass removed during subsequent hepatic resection. The authors intend to combine this technology with an assessment of liver function to attempt to predict patients at risk for liver failure after hepatic resection.

[Detection of Epstein-Barr virus and human papillomavirus in sinonasal malignant neoplasms]

OBJECTIVE

To investigate the existance of Epstein-Barr virus (EBV) and papilloma virus(HPV) in sinonasal malignant neoplasms.

METHOD

EBV and HPV (including HPV6,11,16,18,33) gene were detected in paraffin-embedded tissues with polymerase chain reaction(PCR) from 32 cases of sinonasal malignant neoplasms.

RESULT

EBV was detected in 12(37.5%), HPV in 21(65.6%); The coinfection of EBV and HPV was found in 6 cases with stage III-IV by TNM; 10 cases of nasal polyps contained neither EBV nor HPV.

CONCLUSION

Like HPV, there may be relationship between EBV and sinonasal malignant neoplasms. The coinfection of EBV and HPV is related to stage III-IV by TNM of sinonasal malignant neoplasms.

An innate natural antibody is reactive with a cryptic sequence of lactoferrin exposed on sperm head surface

Lactoferrin (LF), an 80-kDa glycoprotein of ubiquitous occurrence in body fluids, is multifunctional and capable of assuming different configurations to serve those functions. The capacity of LF to undergo endocytosis and the recent demonstration of LF binding to sequence specific DNA indicate that a function or capability of LF, in addition to iron chelation, bacteriostasis, and receptor-specific lymphocyte binding, may be that of gene activation or silencing. The data of this report present a human physiological system, that of sperm entry into the oocyte in performance of fertilization in which, since LF is a component of the sperm protein coat, that capability could be expressed. However, the configuration of LF in that locus is one in which a revealed cryptic sequence provides the specific binding site for a natural antibody present in the fertilization milieu. The presence of that antibody suggests that a system of control of the potential interaction of LF with the intra-ooplasmic DNA, that of gametes or pronuclei, is operative. The configuration of LF on the sperm surface and designation of the reactive site for the natural antibody were enabled by a monoclonal antibody secreted by a hybridoma derived from a human cord blood B cell. Thus, in addition to information concerning the molecular flexibility of LF, these observations support the proposition that the repertoire of natural antibodies provides an innate homeostatic system, with each antibody serving a specific role.

UCN-01 in ovary cancer cells: effective as a single agent and in combination with cis-diamminedichloroplatinum(II)independent of p53 status

Our goal was to determine the cytotoxicity of 7-OH-hydroxystaurosporine (UCN-01) as a single agent and in combination with cis-diamminedichloroplatinum(II) (CDDP) in a panel of ovarian carcinoma cells. We sought to examine the role of p53 gene function and alterations in cell cycle progression or other mechanisms of action of UCN-01 including perturbation of the apoptosis pathway mediated by NF-kappaB and Bcl-2/Bax. Cytotoxicity was determined from dose-response curves established by the Alamar blue vital dye indicator assay. Restoration of wild-type p53 in a p53 null cell line, SKOV 3, was achieved by transfection of a p53 expression vector. Cell cycle distribution was measured by fluorescence-activated cell sorting analysis of ethidium bromide-stained nuclei. Apoptosis was measured by quantitative fluorescence microscopy. NF-kappaB DNA binding activity was measured by electrophoretic mobility shift assay. Bcl-2 and Bax levels were determined by Western immunoblotting. UCN-01 was effective as a cytotoxic agent alone and in combination with CDDP in all cell lines studied, regardless of p53 status. The degree of sensitization to CDDP conferred by UCN-01, however, was found to correlate with p53 gene status. p53 wild-type cells seem to be more sensitive to the cytotoxic effects of the combination of UCN-01 + CDDP than the p53 mutant cells. This was confirmed in cells in which p53 wild-type function was restored by transfection of p53 cDNA, but these cells are also significantly more sensitive to CDDP alone. The effects of UCN-01 on cell cycle progression also appear to be p53 dependent but may not be the primary mechanism of action. The rate of apoptosis is increased 4-fold in UCN-01 + CDDP-treated cells compared to either agent alone. UCN-01 does not effect NF-kappaB DNA binding activity or Bcl-2 and Bax levels. UCN-01 enhances CDDP cytotoxicity and apoptosis in ovary cancer cells. This occurs regardless of p53 status, but wild-type p53 seems to increase the degree of sensitization.

Identification of murine T cells reactive with the bacterial superantigen Yersinia pseudotuberculosis-derived mitogen (YPM) and factors involved in YPM-induced toxicity in mice

We previously reported that Yersinia pseudotuberculosis-derived mitogen (YPM) acts as a superantigen to human T cells. In this study, we assessed the superantigenicity and toxicity of YPM using murine experimental models. YPM activated T cells to produce interleukin-2 in a major histocompatibility complex class II molecule-dependent manner. The T-cell blasts induced by YPM expressed T-cell receptor (TCR) beta-chain variable region (Vbeta)7, Vbeta8.1, Vbeta8.2 and Vbeta8.3. The injection of YPM into mice pre-sensitized with D-galactosamine induced lethal shock. This shock was blocked by the injection of monoclonal antibodies (mAbs) to CD4, TCR Vbeta7 plus Vbeta8, tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma), but not by injection to CD8 or unrelated Vbeta. These results indicate that YPM-induced shock requires the presence of CD4+ T cells bearing TCR Vbeta7 and Vbeta8, and that endogenous TNF-alpha and IFN-gamma mediate the lethal effects.

Examples of in vivo isotype class switching in IgM+ chronic lymphocytic leukemia B cells

Chronic lymphocytic leukemia (CLL) usually involves the expansion of a clone of CD5+ B cells synthesizing IgM antibodies. These B cells appear to be blocked at the antigen receptor-expressing stage of B cell differentiation and are thought not to undergo an isotype class switch to IgG or IgA production. In vivo and in vitro studies suggest, however, that in some instances terminal differentiation and isotype switching can occur. To test the hypothesis that in vivo isotype class switching occurs in IgM+ B-type CLL cells, we analyzed the PBMC of 19 CLL patients for the presence of transcripts encoding the rearranged CLL V(H)DJ(H) associated with either gamma or alpha H chains. The molecular data indicate that approximately 50% of B-CLL patients have amplifications of IgM+ B cells that undergo an isotype class switch. Switching to IgA appears to occur more often than to IgG; also, switching can involve different IgG subclasses in individual patients. In many instances, these CLL-related gamma and alpha transcripts are much more plentiful than those of normal B cells that produce the same isotype. These switched transcripts do not reveal evidence for the accumulation of significant numbers of new V(H) gene mutations. The cellular data indicate that B cells with lesser amounts of surface membrane IgD and higher IgM/IgD ratios are more likely to undergo this switching process. Furthermore, B cells expressing IgG and IgA of the same idiotype or V(H) family and the same CDR3 length as those of the CLL IgM+ clone can be identified in the blood of patients studied using multiparameter immunofluorescence analyses. Collectively, these data suggest that not all members of a B-CLL clone are frozen at the surface membrane Ig-expressing stage of B cell maturation, and that some members can switch to the production of non-IgM isotypes. The occurrence of switching without the accumulation of V gene mutations indicates that the processes of differentiation and diversification are not linked.

Implantation of IL-2-containing osmotic pump prolongs the survival of superantigen-reactive T cells expanded in mice injected with bacterial superantigen

In the present study we investigated the mechanism of deletion of superantigen (sAg)-reactive T cells expanded in sAg-injected mice. In staphylococcal enterotoxin A (SEA)-injected mice, IL-2 activity in serum peaked at 1 to 3 h and the expression of IL-2R alpha-chain (IL-2R alpha) on SEA-reactive (V beta 3+, or V beta 11+) T cells peaked at 6 to 12 h after the injection. Expansion of V beta 3+ or V beta 11+ T cells peaked at 2 days after the injection when most of these T cells were IL-2R alpha negative, and IL-2 activity was not detected at all in serum, suggesting the involvement of IL-2 deprivation in the deletion of expanded T cells. Implantation of an osmotic pump containing human rIL-2 (IL-2 pump) prolonged the expanded states of V beta 3+ or V beta 11+ T cells in SEA-injected C57BL/6 mice and of V beta 8+ T cells in SEB-injected MRL +/+ and Fas Ag-defective MRL-Ipr/Ipr mice. Adult thymectomy did not change at all the effect induced by implantation of IL-2 pump. DNA fragmentation was blocked substantially in mice co-treated with SEA and IL-2 pump. In addition, CD4+ T cell blasts, obtained by in vitro stimulation with rIL-2 of splenic CD4+ T cells from mice co-treated with SEA and IL-2 pump, produced substantial amounts of IL-2 upon restimulation with SEA. These results indicate that deprivation of IL-2 is deeply involved in the deletion of expanded sAg-reactive T cells and their anergy induction in sAg-injected mice.

Implantation of IL-2-containing osmotic pump prolongs the survival of superantigen-reactive T cells expanded in mice injected with bacterial superantigen

In the present study we investigated the mechanism of deletion of superantigen (sAg)-reactive T cells expanded in sAg-injected mice. In staphylococcal enterotoxin A (SEA)-injected mice, IL-2 activity in serum peaked at 1 to 3 h and the expression of IL-2R alpha-chain (IL-2R alpha) on SEA-reactive (V beta 3+, or V beta 11+) T cells peaked at 6 to 12 h after the injection. Expansion of V beta 3+ or V beta 11+ T cells peaked at 2 days after the injection when most of these T cells were IL-2R alpha negative, and IL-2 activity was not detected at all in serum, suggesting the involvement of IL-2 deprivation in the deletion of expanded T cells. Implantation of an osmotic pump containing human rIL-2 (IL-2 pump) prolonged the expanded states of V beta 3+ or V beta 11+ T cells in SEA-injected C57BL/6 mice and of V beta 8+ T cells in SEB-injected MRL +/+ and Fas Ag-defective MRL-Ipr/Ipr mice. Adult thymectomy did not change at all the effect induced by implantation of IL-2 pump. DNA fragmentation was blocked substantially in mice co-treated with SEA and IL-2 pump. In addition, CD4+ T cell blasts, obtained by in vitro stimulation with rIL-2 of splenic CD4+ T cells from mice co-treated with SEA and IL-2 pump, produced substantial amounts of IL-2 upon restimulation with SEA. These results indicate that deprivation of IL-2 is deeply involved in the deletion of expanded sAg-reactive T cells and their anergy induction in sAg-injected mice.

CD45 (leucocyte common antigen) expression in T and B lymphocyte subsets

CD45 is the dominant tyrosine phosphatase in haematopoietic cells and can modulate the effects of many other signaling molecules by dephosphorylation. The extracellular portion of CD45 has considerable variability due to differential splicing and glycosylation. This may allow for interactions with a variety of ligands expressed on interacting cells or on the same cell surface. Monoclonal anti CD45 antibodies that are reactive with epitopes that result from differential splicing and glycosylation can distinguish between cell populations that differ in maturation and function. These reagents can be used in the immunophenotyping of hematopoietic malignancies as well as in immunodeficiencies and autoimmune diseases. Several studies have shown that different anti CD45 reagents have different activating or inhibiting effects in vitro on a variety of T and B cell activation events. There are some indications that anti CD45 reagents can also selectively modify lymphocyte function in vivo. Such applications could potentially allow for the selective upregulation and down regulation of lymphocyte functions in a variety of immunologically mediated diseases.

[Topical fibronectin for enhancement of burn healing]

The effects of fibronectin (Fn) on burn healing were observed in mice. A split thickness burn covered 7% approximately 8% TBSA was created on the back of mouse. Experimentally 0.05ml of Fn (0.5mg/ml) was topically applied daily. Wound healing time and healing rate were determined. On 5 and 10 postburn days, biopsy sample of wound tissue was obtained. Total protein, DNA, and hydroxyproline contents were measured according to Bradford method, Hoechest 33258 dye fluorometry, and routine measure respectively. The mean wound healing time in mice treated with Fn was 18.67 +/- 4.50 days compared to 22.89 +/- 2.85 days in the controls. The wound healing rate was significantly higher in the Fn-treated mice. The contents of wound tissue DNA and hydroxyproline in Fn group were significantly increased on day 5, and total protein was significantly increased on day 10. This study indicated that topical application of Fn is beneficial to wound healing.

Superantigenic properties of a novel mitogenic substance produced by Yersinia pseudotuberculosis isolated from patients manifesting acute and systemic symptoms

A novel product from Yersinia pseudotuberculosis exhibiting mitogenic activity for human PBMC (designated Y. pseudotuberculosis-derived mitogen, YPM) was examined for its biologic activities for human lymphocytes. YPM induced a substantial proliferative response and IL-2 production at 0.1 ng/ml or more in whole PBMC but not in T-depleted PBMC. IL-2 production occurred within 12 h after YPM stimulation. T cells from PBMC produced IL-2 in the presence of L cells transfected with HLA DR genes or DP genes but not in the presence of control L cells used as accessory cells. Paraformaldehyde fixation did not abolish the AC activity of the DR+ L cells. The results suggest that YPM bind directly to HLA class II molecules. Analysis of the TCR V beta element using the polymerase chain reaction revealed that YPM selectively activated human T cells bearing V beta 3, V beta 9, V beta 13.1, and V beta 13.2 in TCR. These results indicate that YPM is a potent T cell activator and has superantigenic properties (abilities to bind directly to MHC class II molecules and selectively stimulate T cell populations bearing particular V beta elements in TCR). The role of YPM in the mechanism of pathogenesis of Y. pseudotuberculosis infections manifesting acute and systemic clinical symptoms is discussed.

Superantigenic properties of a novel mitogenic substance produced by Yersinia pseudotuberculosis isolated from patients manifesting acute and systemic symptoms

A novel product from Yersinia pseudotuberculosis exhibiting mitogenic activity for human PBMC (designated Y. pseudotuberculosis-derived mitogen, YPM) was examined for its biologic activities for human lymphocytes. YPM induced a substantial proliferative response and IL-2 production at 0.1 ng/ml or more in whole PBMC but not in T-depleted PBMC. IL-2 production occurred within 12 h after YPM stimulation. T cells from PBMC produced IL-2 in the presence of L cells transfected with HLA DR genes or DP genes but not in the presence of control L cells used as accessory cells. Paraformaldehyde fixation did not abolish the AC activity of the DR+ L cells. The results suggest that YPM bind directly to HLA class II molecules. Analysis of the TCR V beta element using the polymerase chain reaction revealed that YPM selectively activated human T cells bearing V beta 3, V beta 9, V beta 13.1, and V beta 13.2 in TCR. These results indicate that YPM is a potent T cell activator and has superantigenic properties (abilities to bind directly to MHC class II molecules and selectively stimulate T cell populations bearing particular V beta elements in TCR). The role of YPM in the mechanism of pathogenesis of Y. pseudotuberculosis infections manifesting acute and systemic clinical symptoms is discussed.

Study of activation of murine T cells with bacterial superantigens. In vitro induction of enhanced responses in CD4+ T cells and of anergy in CD8+ T cells

Primary and secondary responses of murine CD4+ T cells and CD8+ T cells upon stimulation with staphylococcal enterotoxin E (SEE) bearing superantigenic properties were examined. Both isolated C57BL/6 splenic CD4+ T cells and CD8+ T cells proliferated and produced IL-2 and IFN-gamma upon stimulation with SEE in substantial levels. The amounts of IL-2 were greater in CD4+ T cells and those of IFN-gamma were somewhat greater in CD8+ T cells. SEE-induced CD4+ T lymphoblasts, larger parts of which bore the V beta 11 element in their TCR, proliferated, produced IL-2 and IFN-gamma, and showed toxin-dependent cytotoxicity in substantial levels upon restimulation with SEE. By contrast, SEE-induced CD8+ T lymphoblasts, the larger part of which bore the V beta 11 element, did not show the first two of the three responses at all upon restimulation with SEE, whereas these cells showed greater cytotoxicity. The CD8+ T lymphoblasts did not suppress the reactivity of the CD4+ T lymphoblasts. Both SEE-induced CD4+ T lymphoblasts and CD8+ T lymphoblasts proliferated and produced IL-2 and IFN-gamma in comparable levels upon stimulation with rIL-2 or mAb to CD3 or V beta 11.

Study of activation of murine T cells with bacterial superantigens. In vitro induction of enhanced responses in CD4+ T cells and of anergy in CD8+ T cells

Primary and secondary responses of murine CD4+ T cells and CD8+ T cells upon stimulation with staphylococcal enterotoxin E (SEE) bearing superantigenic properties were examined. Both isolated C57BL/6 splenic CD4+ T cells and CD8+ T cells proliferated and produced IL-2 and IFN-gamma upon stimulation with SEE in substantial levels. The amounts of IL-2 were greater in CD4+ T cells and those of IFN-gamma were somewhat greater in CD8+ T cells. SEE-induced CD4+ T lymphoblasts, larger parts of which bore the V beta 11 element in their TCR, proliferated, produced IL-2 and IFN-gamma, and showed toxin-dependent cytotoxicity in substantial levels upon restimulation with SEE. By contrast, SEE-induced CD8+ T lymphoblasts, the larger part of which bore the V beta 11 element, did not show the first two of the three responses at all upon restimulation with SEE, whereas these cells showed greater cytotoxicity. The CD8+ T lymphoblasts did not suppress the reactivity of the CD4+ T lymphoblasts. Both SEE-induced CD4+ T lymphoblasts and CD8+ T lymphoblasts proliferated and produced IL-2 and IFN-gamma in comparable levels upon stimulation with rIL-2 or mAb to CD3 or V beta 11.

Involvement of HLA class II molecules in acquisition of staphylococcal enterotoxin A-binding activity and accessory cell activity in activation of human T cells by related toxins in vascular endothelial cells

Human umbilical vascular endothelial cells (HUVEC) express HLA class II molecules upon stimulation with recombinant human interferon-gamma (IFN-gamma). Staphylococcal enterotoxin (SE) A (SEA)-binding assay using [125I]-SEA showed the presence of specific SEA binding in HUVEC stimulated with IFN-gamma but not in unstimulated HUVEC. Levels of HLA class II expression and SEA-binding increased as the IFN-gamma concentration and the period of stimulation were increased. Binding of [125I]-SEA to the IFN-gamma-stimulated HUVEC was reduced markedly by an anti-DR/DP MoAb. T cells produced IL-2 upon stimulation with a group of SEs (SEA, SEB, SEC, SED and SEE) in the presence HUVEC stimulated with IFN-gamma but not in the presence of control HUVEC. The level of accessory cell activity in the IFN-gamma-stimulated HUVEC was related to the level of HLA class II expression and SEA-binding activity. Antibodies to HLA class II molecules almost completely inhibited the response. These results indicate that HLA class II molecules are directly involved in the acquisition of these activities in HUVEC.

Relative ability of distinct isotypes of human major histocompatibility complex class II molecules in binding staphylococcal enterotoxin A

Relative ability of distinct isotypes of human major histocompatibility complex class II molecules to bind staphylococcal enterotoxin A (SEA) was investigated. SEA-binding was observed in L cells transfected with DR2 and DQw1 genes. By contrast, it was not detected in L cells transfected with DPw4 and DP (Cp63) genes. All the transfectants supported SEA-induced IL-2 production by human T cells. Levels of the accessory activity were low in the DPw4 and DP (Cp63) transfectants compared with the DR2 and DQw1 transfectants. In view of the observation that all the transfectants express well the transfected gene products on their surface, the results indicate that DR and DQ molecules bind SEA with high affinity, while DP molecules bind it with fairly low affinity.

Activation of murine T cells by staphylococcal enterotoxin E: requirement of MHC class II molecules expressed on accessory cells and identification of V beta sequence of T cell receptors in T cells reactive to the toxin

We investigated a mechanism leading to activation of murine T cells by staphylococcal enterotoxin E (SEE). L cells transfected with I-Ab genes but not control L cells supported IL-2 production by SEE-induced C57BL/6 T lymphoblasts upon restimulation with SEE. mAb to I-Ab markedly inhibited the above response. Flow cytometric analyses showed that SEE-induced C57BL/6 T lymphoblasts are composed of both CD4+ T cells and CD8+ T cells, and that larger parts of them bore V beta 11 (40-75%). mAb to V beta 11 markedly inhibited the SEE-induced proliferative response and IL-2 production by T cells. Analysis of SEE-induced IL-2 production in spleen cells from various mouse strains showed that C57BL/6 and B10.A(4R) mice (I-E, not expressed; V beta 11+ T cells, normally generated) are highly responsive to SEE. In contrast, BALB/c, C3H/HeN, (C57BL/6 x BALB/c or C3H/HeN) F1 mice (I-E, normally expressed and V beta 11+ T cells, deleted), and SJL and C57L mice (V beta 11 genes, deleted) are weakly responsive to SEE. The results indicate that SEE activates mainly T cells bearing V beta 11 in physical association with MHC class II molecules expressed on AC. In addition, the results indicate that SEE activates both CD4+ T cells and CD8+ T cells.

Activation of human vascular endothelial cells by IFN-gamma: acquisition of HLA class II expression, TSST-1-binding activity and accessory activity in T cell activation by the toxin

Human umbilical vascular endothelial cells (HUVEC) stimulated with recombinant human IFN-gamma were investigated for expression of HLA class II molecules, toxic shock syndrome toxin-1 (TSST-1)-binding activity and accessory cell (AC) activity in TSST-1-induced T cell activation. HUVEC stimulated with recombinant human IFN-gamma ranging from 10 to 1,000 units/ml for 72 h express HLA class II molecules. Intensity of the expression was dependent on the concentration of IFN-gamma. HUVEC stimulated with 1,000 units/ml of IFN-gamma for 72 h exhibited 125I-TSST-1-binding that was blocked by the unlabeled toxin and monoclonal antibodies (mAb) to DR/DP. The activity was not removed by paraformaldehyde fixation. The IFN-gamma-stimulated HUVEC exhibited AC activity in TSST-1-induced IL-2 production by T cells from human peripheral blood mononuclear cells. The activity was blocked by mAb to DR. The above two activities were also observed in L cells transfected with DR2 genes but not in the unstimulated HUVEC and control L cells. In view of the fact that TSST-1 binds directly to HLA class II molecules and activates human T cells in association with HLA class II molecules on AC, it is likely that the acquisition of TSST-1-binding activity and AC activity in the toxin-induced T cell activation is mediated by the expression of HLA class II molecules. Vascular endothelial cells may play an important role in the development of pathological changes in TSS patients.

Relative activities of distinct isotypes of murine and human major histocompatibility complex class II molecules in binding toxic shock syndrome toxin 1 and determination of CD antigens expressed on T cells generated upon stimulation by the toxin

Relative abilities of murine and human major histocompatibility complex class II molecules to bind toxic shock syndrome toxin 1 (TSST-1) and T-cell subsets activated by the toxin were investigated. TSST-1 binding was observed in L cells transfected with I-Ab, I-Ak, DR2, and DQw1 genes. Scatchard plot analysis showed similar Kd values (1 x 10(-8) to 3 x 10(-8) M) for these cells. By comparison, binding was not detected in L cells transfected with I-Ek, DPw4, and DP(Cp63) genes. All of the transfectants supported TSST-1-induced proliferative response and interleukin-2 production by murine and human T cells. Levels of accessory activity were lower in the I-Ek transfectants and the DPw4 and DP(Cp63) transfectants than in the I-Ab and I-Ak transfectants and the DR2 and DQw1 transfectants, respectively. The results indicate that I-A, DR, and DQ molecules bind TSST-1 with similar affinities, whereas I-E and DP molecules bind it with fairly low affinity. TSST-1-activated T cells consisted of both CD4+ and CD8+ T cells, indicating that TSST-1 activates these two T-cell subsets.

Activation of murine T cells by toxic shock syndrome toxin-1. The toxin-binding structures expressed on murine accessory cells are MHC class II molecules

Toxic shock syndrome toxin-1 (TSST-1)-binding structures present on murine lymphoid tissues were investigated by using 125I-TSST-1. T-depleted C57BL/6 spleen cells incubated with TSST-1 for 3 h at 0 degree C were mitogenic to splenic T cells, indicating that the former cells bind and present TSST-1 to T cells. TSST-1-binding activity was observed in C57BL/6 splenic B cells and L cells transfected with I-Ab genes, but not in splenic T cells and control L cells. Scatchard plot analysis showed that these B cells and transfectants bound TSST-1 with similar binding affinity. SDS-PAGE analysis showed that lysates of C57BL/6 spleen cells and the I-Ab-positive transfectants contain a single band which bound TSST-1 and comigrated with I-Ab heterodimers. TSST-1-binding activity observed clearly in C57BL/6. BALB/c, and C3H/HeN spleen cells and L cells transfected with I-Ab or I-Ak genes was not reduced by paraformaldehyde fixation. Binding of 125I-TSST-1 to the three spleen cells was markedly reduced by anti-I-A antibodies, but not by anti-I-E antibodies. C57BL/6, C3H/HeN, and (C3H/HeN x C57BL/6) F1 T cells were activated by TSST-1 to proliferate and produce IL-2 in the presence of FT6.2 cells, LT1-30-3 cells and either of them, respectively, but not in the presence of control L cells. These results indicate that I-A molecules function as the structures via that accessory cells directly bind TSST-1 on the cell surface and present a triggering signal of TSST-1 to T cells.

Activation of murine T cells by toxic shock syndrome toxin-1. The toxin-binding structures expressed on murine accessory cells are MHC class II molecules

Toxic shock syndrome toxin-1 (TSST-1)-binding structures present on murine lymphoid tissues were investigated by using 125I-TSST-1. T-depleted C57BL/6 spleen cells incubated with TSST-1 for 3 h at 0 degree C were mitogenic to splenic T cells, indicating that the former cells bind and present TSST-1 to T cells. TSST-1-binding activity was observed in C57BL/6 splenic B cells and L cells transfected with I-Ab genes, but not in splenic T cells and control L cells. Scatchard plot analysis showed that these B cells and transfectants bound TSST-1 with similar binding affinity. SDS-PAGE analysis showed that lysates of C57BL/6 spleen cells and the I-Ab-positive transfectants contain a single band which bound TSST-1 and comigrated with I-Ab heterodimers. TSST-1-binding activity observed clearly in C57BL/6. BALB/c, and C3H/HeN spleen cells and L cells transfected with I-Ab or I-Ak genes was not reduced by paraformaldehyde fixation. Binding of 125I-TSST-1 to the three spleen cells was markedly reduced by anti-I-A antibodies, but not by anti-I-E antibodies. C57BL/6, C3H/HeN, and (C3H/HeN x C57BL/6) F1 T cells were activated by TSST-1 to proliferate and produce IL-2 in the presence of FT6.2 cells, LT1-30-3 cells and either of them, respectively, but not in the presence of control L cells. These results indicate that I-A molecules function as the structures via that accessory cells directly bind TSST-1 on the cell surface and present a triggering signal of TSST-1 to T cells.

Activation of human T cells by toxic shock syndrome toxin-1: the toxin-binding structures expressed on human lymphoid cells acting as accessory cells are HLA class II molecules

Toxic shock syndrome toxin-1 (TSST-1)-binding assay using 125I-labeled TSST-1 showed the presence of specific TSST-1 binding in a B cell fraction of human peripheral blood mononuclear cells and L cells transfected with DR2 genes or DR4 genes but not in a T cell fraction and control L cells. Fixation with paraformaldehyde, an inhibitor of antigen processing, did not remove TSST-1-binding activity of the transfectants. Binding of 125I-labeled TSST-1 to the transfectants was reduced by an anti-DR monoclonal antibody. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed the presence of a single band with TSST-1-binding activity and the same migration pattern as DR heterodimers. TSST-1-induced T cell responses, proliferation and interleukin 2 (IL2) production were observed in the presence of the transfectants but not in the presence of control L cells, while concanavalin A-induced IL2 production was observed in the presence of either the transfectants or control L cells. Presence of an anti-DR monoclonal antibody inhibited the TSST-1-induced responses. Paraformaldehyde-fixed Daudi cells were effective in supporting TSST-1-induced IL2 production by T cells. These results indicate that HLA class II molecules directly bind intact TSST-1 and perform an essential role as the TSST-1-binding structures on accessory cells in T cell activation by the toxin.