Toripalimab plus axitinib versus sunitinib as first-line treatment for advanced renal cell carcinoma: RENOTORCH, a randomized, open-label, phase III study

BACKGROUND

Immune checkpoint inhibitors in combination with tyrosine kinase inhibitors are standard treatments for advanced clear cell renal cell carcinoma (RCC). This phase III RENOTORCH study compared the efficacy and safety of toripalimab plus axitinib versus sunitinib for the first-line treatment of patients with intermediate-/poor-risk advanced RCC.

PATIENTS AND METHODS

Patients with intermediate-/poor-risk unresectable or metastatic RCC were randomized in a ratio of 1 : 1 to receive toripalimab (240 mg intravenously once every 3 weeks) plus axitinib (5 mg orally twice daily) or sunitinib [50 mg orally once daily for 4 weeks (6-week cycle) or 2 weeks (3-week cycle)]. The primary endpoint was progression-free survival (PFS) assessed by an independent review committee (IRC). The secondary endpoints were investigator-assessed PFS, overall response rate (ORR), overall survival (OS), and safety.

RESULTS

A total of 421 patients were randomized to receive toripalimab plus axitinib (n = 210) or sunitinib (n = 211). With a median follow-up of 14.6 months, toripalimab plus axitinib significantly reduced the risk of disease progression or death by 35% compared with sunitinib as assessed by an IRC [hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.49-0.86; P = 0.0028]. The median PFS was 18.0 months in the toripalimab-axitinib group, whereas it was 9.8 months in the sunitinib group. The IRC-assessed ORR was significantly higher in the toripalimab-axitinib group compared with the sunitinib group (56.7% versus 30.8%; P < 0.0001). An OS trend favoring toripalimab plus axitinib was also observed (HR 0.61, 95% CI 0.40-0.92). Treatment-related grade ≥3 adverse events occurred in 61.5% of patients in the toripalimab-axitinib group and 58.6% of patients in the sunitinib group.

CONCLUSION

In patients with previously untreated intermediate-/poor-risk advanced RCC, toripalimab plus axitinib provided significantly longer PFS and higher ORR than sunitinib and had a manageable safety profile TRIAL REGISTRATION: ClinicalTrials.gov NCT04394975.

[The related factors of postoperative recurrence in trigeminalneuralgia patients undergoing fully neuroendoscopic microvascular decompression]

Objective: To evaluate the related factors of postoperative recurrence intrigeminal neuralgia (TN) patients treated with fully neuroendoscopic microvascular decompression (MVD). Methods: The clinical baseline data and preoperative MRI imaging data of 112 patients with TN treated by neuroendoscopic MVD from December 2008 to December 2020 in the Department of Neurosurgery, Beijing Shijitan Hospital Affiliated to Capital Medical University were retrospectively analyzed, including: area ratio of cerebellopontine area (CPA)(healthy side/affected side), trigeminal nerve(TGN)length ratio(healthy side/affected side), TGN angle ratio(healthy side/affected side), and criminal vessel type. Multivariate Cox proportional hazards model was used to analyze the factors affecting postoperative recurrence. Results: Among the 112 patients in this group, there were 49 males and 63 females. The age ranged from 20 to 82 (59±9) years, and the course of disease was 0.05 to 30.00 (5.60±5.15) years. Pain was located on the left side in 43 cases (38.39%) and on the right side in 69 cases (61.61%), respectively. All patients were followed up for more than 1 year, with an average follow-up time of 21.5 months, and 11 cases recurred. Multivariate Cox regression analysis revealed that disease duration≥3 years(HR=9.34, 95%CI:1.12-39.07), CPA area ratio(healthy side/affected side)>1 (HR=27.47, 95%CI:1.69-44.20), criminal vessel type with vein(HR=35.39, 95%CI:1.26-18.60) and criminal vessel type with arteriovenous (HR=46.07, 95%CI: 2.74-27.75) were the main factors influencing recurrence of MVD surgery (all P<0.05). Conclusion: The disease duration≥3 years, CPA area ratio(healthy side/affected side)>1, and criminal vessel type with vein/arteriovenous are the relevant factors that affect the recurrence rate after the fully neuroendoscopic MVD treatment for trigeminal neuralgia.

[Developmental and epileptic encephalopathy 85 caused by SMC1A gene truncating variation: 4 cases report and literature review]

Objective: To summarize the clinical phenotype of patients with developmental and epileptic encephalopathy 85 caused by SMC1A gene truncating variation. Methods: The clinical data of 4 patients with epileptic encephalopathy caused by SMC1A gene truncating variation from August 2016 to June 2020 were analyzed retrospectively. Related literatures up to October 2021 with the key words "SMC1A" "Developmental and epileptic encephalopathy 85" "SMC1A, epilepsy" and "SMC1A, truncating" in PubMed, CNKI, and Wanfang databases were searched. Relevant literature was summarized and reviewed. Results: These 4 patients were all female. The onset age of seizure were all in the infantile period. They were admitted to the hospital at 3, 2, 11 and 18 months respectively. Focal seizures occurred in all 4 patients, while 1 of them experienced infantile spasm. The characteristic of cluster was observed in all of them with an interval of 14 days to 5.0 months. The seizures were all refractory to different kinds of anti-seizure medications. All 4 patients had severe developmental retardation with microcephaly (head circumference<-2 s). The interictal electroencephalogram (EEG) was characterized by diffuse slow wave. The 4 SMC1A gene variants were p.Gly655fs, p.Glu811fs, p.Arg412fs and p.Ile143fs, all of which were de novo frameshift variation after parental validation. There were another 17 cases with SMC1A gene truncating variation reported in 6 English articles and 1 Chinese article. Among these 21 patients, who were all female, the onset of seizures occurred between 0.5 and 18.0 months of age. Seventeen cases (81%) had the characteristics of cluster attacks, and the intervals of attack cycles were different. Seizure types included generalized tonic-clonic seizure (12 cases (57%)), focal seizure (11 cases(52%)), myoclonic(4 cases(19%)), spasm (4 cases(19%)), atypical absence (3 cases(14%)), tonic seizure (2 cases (10%)), and atonia (1 case(5%)). In addition, 4 cases (19%) had status epilepsy. All patients had moderate to severe mental retardation. Microcephaly was found in all patients. Among 18 cases,EEG in 8 cases had diffuse slow wave background. Brain magnetic resonance imaging (MRI) was normal in 13 cases (62%). Other MRI changes included cerebellar atrophy (3 cases), thin corpus callosum (3 cases), and lateral ventricular enlargement (2 cases). Twenty patients did not respond well to antiepileptic drugs. Conclusions: The clinical phenotypes of patients with epilepsy encephalopathy 85 caused by SMC1A gene truncating variation are characterized by female, early-onset, clustering of seizures, development delay and microcephaly. Diffuse slow waves are shown in interictal EEG in partial. Response to treatment and prognosis are poor.

[Interleukin-1 receptor associated kinase 4 deficiency: a case report and literature review]

Objective: To summarize the clinical characteristics of children with interleukin-1 receptor associated kinase 4 (IRAK4) deficiency. Methods: The clinical data of a child with IRAK4 deficiency who was admitted to the Department of Neurology of Shenzhen Children's Hospital for several times from June 2019 to August 2020 were retrospectively analyzed. Related literature up to January 2021 with the key words "IRAK4 gene variation", and "interleukin-1 receptor-associated kinase 4 deficiency" in PubMed, CNKI, Wanfang, and CQVIP databases were searched. The clinical characteristics of this disease were summarized and analyzed. Results: The boy was 6 years of age and had recurrent respiratory tract infections. He was improved after antibiotic treatment. His clinical manifestation included Streptococcus pneumoniae meningoencephalitis, multiple sclerosis, invasive discitis and inflammatory bone destruction. Family-based whole exome sequencing showed that the boy had a homozygous frameshift variation in the IRAK4 gene, NM_016123.3:C.540del (p.Phe180leufs*26), and both parents were heterozygous. A total of 23 cases were reported in ten English articles. Together with this case, there were 24 cases, including 13 males and 11 females. The age of onset was 8 days to 7 years. The main manifestations were recurrent invasive bacterial infection, including 11 cases with Streptococcus pneumoniae meningitis, 9 cases with Streptococcus pneumoniae and (or) Staphylococcus aureus septicemia, 1 case with Pseudomonas aeruginosa meningitis, 1 case of salmonella infection, and 1 case with Staphylococcus aureus skin abscess. Only 1 case had recurrent virus infection. There were 2 patients with autoimmune diseases, 1 with autoimmune encephalitis and the other one with juvenile idiopathic arthritis. Among the 24 cases, 10 died (9 in infancy). Most of the surviving children were diagnosed early and received antibiotics preventively and intravenous immunoglobulin (IVIG). Their susceptibility to infection decreased year by year, and could be close to normal children at the age of 14 years. Among the 24 cases, 21 cases had homozygous variation of IRAK4 gene and 3 cases had complex heterozygous variation. There were 15 kinds of variation, including 9 kinds of frameshift variation, 4 kinds of nonsense variation and 2 kinds of missense variation. One candidate variation hotspot was c.877 c>T (3 cases). Conclusions: IRAK4 deficiency mainly manifest as recurrent and invasive bacterial infection, with Streptococcus pneumoniae meningitis or septicemia being the most common. A few patients are complicated with autoimmune diseases. The mortality rate is high in infancy, early diagnosis and treatment can avoid severe illness or death.

[Research on anxiety-like neurobehavior of zebrafish caused by lead exposure and its mechanism]

Objective: This study aims to explore whether lead exposure could cause anxiety of zebrafish larvae, and to explore its mechanism. Methods: In May 2020, zebrafish embryos 4 hours after fertilization (4 hpf) were collected, E3 culture medium was used as the control group, and different lead exposure concentrations (6, 12, 24, 48 μmol/L) as the poisoned group during the time was 140 h. The mortalities, hatching rates and deformity rates were calculated, the behavioral changes of 144 hpf larvae were observed (moving speed, moving distance, activity, absolute turn angle, the light-evoked startle response, darkness-evoked escape response and thigmotaxis) . The levels of reactive oxygen species (ROS) and malondialdehyde (MDA) were detected in zebrafish larvae in the heads. ELISA kits were used to detect the expression of 5-hydroxytryptamine (5-HT) , dopamine (DA) , noradrenaline (NA) and corticotropin-releasing hormone (CRH) related to anxiety. Results: The mortalities rates of zebrafish embryos in the lead exposure concentration of 12, 24 and 48 μmol/L were higher than the control group, and the embryo hatching rates were lower than control group. The deformity rates of zebrafish larvae in the lead exposure concentration of 24 and 48 μmol/L were higher than control group (P<0.01) . The movement speed, activity and thigmotaxis of zebrafish larvae in the lead exposure concentration of 24 and 48 μmol/L were significantly lower than control group, the absolute turn angle were higher than control group (P<0.01) . The moving distance and darkness-evoked escape response of zebrafish larvae in the lead exposure concentration of 48 μmol/L group were lower than control group (P<0.05) . The light-evoked startle response of zebrafish larvae in the lead exposure concentration of 12, 24 and 48 μmol/L groups were lower than control group (P<0.05) . The ROS levels and MDA concentrations in the heads of larvae in the lead exposure concentration of 24 and 48 μmol/L were higher than control group (P<0.05) . The levels of NA and DA in the heads of the larvae in the lead exposure groups of 12, 24 and 48 μmol/L were lower than control group, and the levels of 5-HT and CRH in the heads of the larvae in the lead exposure groups of 24 and 48 μmol/L were higher than control group (P<0.05) . Conclusion: Lead exposure is toxic to zebrafish embryonic development and may cause anxiety-like neurobehavior changes and oxidative stress in zebrafish.

[Efficacy analysis of fully endoscopic microvascular decompression in primary trigeminal neuralgia via keyhole approach]

Objective: To explore the efficacy and technical features of fully endoscopic microvascular decompression(MVD) in primary trigeminal neuralgia(PTN) via keyhole approach. Methods: The clinical data of 97 patients with PTN underwent fully endoscopic MVD via keyhole approach in the Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University from December 2014 to February 2019 was collected. During fully endoscopic MVD in PTN via keyhole approach, performer use natural clearance without grinding except developed rock bone crest or excessive retraction of the brain tissue, visually and panoramically observe and evaluate the CPA area, accurately identify the responsible vessels, to avoid the omission of responsible vessels or insufficient decompression. And the use of preplaced technology, bridging technology and submersible technology, ensure the efficacy of surgery and reduce the surgical side injuries.Barrow Neurological Institute (BNI) pain score was used to evaluate the efficacy and identify the recurrence. The surgical efficacy was analyzed. Results: The offending vessels were identified under endoscope in 96 cases. Among them, arterial compression was found in 77 cases, venous compression in 6 cases, and both arterial and venous compression in 13 cases. About the pain outcomes, 87 cases had immediate and complete relief of pain, 5 cases had almost relief of pain, 4 cases had partial relief of pain, and still needed medication control, but the dose was lower than that before operation, and 1 case had no obvious relief of pain. About complications, there were 4 cases of temporary facial numbness, 1 case of temporary hearing loss, both of them recovered after symptomatic treatment. There was no cerebral infarction or hemorrhage, intracranial or incision infection. All cases were followed up for 3.0-38.0 months with a median period of(22.4±2.2) months. During the follow-up periods, postoperative recurrence occurred in 3 cases. Conclusion: Fully endoscopic MVD for PTN through keyhole approach, provides panoramic view to avoid omission of offending vessels and reduce complications, seemed to be a safe and effective surgical method.

[Analysis of 123 Cases of Forensic Psychiatry Testimony of Individuals Suspected of Road Traffic Offences]

Abstract

Objective To explore the characteristics of individuals with mental disorders suspected of road traffic offences and to find their differences from normal offenders, in order to regulate mental disorder patients' driving activities and prevent road traffic offences. Methods One hundred and twenty-three cases of forensic psychiatry testimony of individuals suspected of road traffic offences between 2014 and 2019 from the West China Forensic Center of Sichuan Province were collected. Fisher exact probability test was used to compare the differences between offenders with mental disorders and without mental disorders in terms of demographic characteristics, criminological characteristics, psychiatric characteristics and criminal responsibilities. Results There was no statistical significance in the differences of demographic characteristics, vehicles and kinds of alcohol between the two groups （P>0.05）. The main type of road traffic related crimes committed by offenders with mental disorders was risky driving and were mainly evaluated as partial criminal responsibility, whereas most offenders without mental disorders committed crime of causing traffic casualties and all were evaluated as full criminal responsibility. There was statistical significance in the differences of the types of crime and the criminal responsibility rating between the two groups （P<0.05）. Meanwhile, patients with mental disorders were characterized by long course of disease and irregular treatment, and individuals diagnosed as having mental disorders caused by psychoactive substances accounted for a large proportion. Conclusion There are differences in the characteristics of road traffic-related crimes between mental disorder patients and normal people. It is of great practical significance for reducing road traffic offences to evaluate whether the individuals with mental disorders are fit for driving.

[Progression of pathogenesis, diagnosis and treatment of diversion colitis]

Diversion colitis (DC) is a common non-specific inflammation of the malfunctioning bowel segment after diversion of feces. Although most patients develop DC during stoma, there are no obvious clinical symptoms, and a small number of patients show abdominal pain, mucus discharge and hematochezia. The erythema, diffuse particles and vascular texture blur are the most prominent endoscopic manifestations, and the lymphatic follicular hyperplasia is the most prominent pathological manifestations.Reconstruction of intestinal continuity is the best way to cure recanted colitis. In this review, we summarize and review the mechanism of occurrence, clinical features, diagnosis and treatment of DC, which will be helpful for the effective control and prevention of DC.

[Application of complete endoscopic technique in microvascular decompression related tovertebrobasilar artery compression]

Objective: To study the operative method, special technique and curative effect of complete neuroendoscopic microvascular decompression(MVD) related to vertebrobasilar artery compression. Methods: Thirteen patients with functional cranial nerve disease caused by vertebrobasilar artery as direct or indirect responsible vessel accepted complete endoscopic MVD, including 11 patients with hemifacial spasm and 2 patients with trigeminal neuralgia. The procedure and curative effect of endoscopic surgery were analyzed retrospectively. Results: All procedures of complete neuroendoscopic MVD were successfully completed.Intraoperative observation by endoscope showed that 6 cases were oppressed directly by vertebral artery, 2 cases were oppressed directly by basilar artery, 5 cases were combined oppressed by displaced basilar artery and other vessels (1 case was superior cerebellar artery and 4 cases were anterior inferior cerebellar artery). During the operation, Teflon sheets was placed directly into the compression point in 2 cases, the "Pre-placed" technique was used to place Teflon sheets in 7 cases, and the "Set up bridge" technique was used to place Teflon sheets in 4 cases. Follow-up for 8-38 months,the symptoms disappeared completely in 12 cases and improved in 1 case. No deaths and severe complications occurred, such as postoperative bleeding, cerebellar infarction and intracranial infection. Conclusion: MVD related to vertebrobasilar artery compression can be performed by complete neuroendoscopic technique, which can achieve sufficient decompression effect and curative effect.Flexible use of the special technology of placing Teflon sheets by single-hand under endoscope, such as the "Pre-placed" and "Set up bridge" technique, is an important technical guarantee for the successful completion of endoscopic MVD.

Polygraph Accuracy of Control Question Test in Criminal Cases

Objective To explore polygraph accuracy of Control Question Test （CQT）and whether it could be influenced by examinee's education level and type of violation of law. Methods Real cases of CQT （n=104） and the data from MAO （n=296） were collected. The polygraph accuracy of CQT was calculated. Variance analysis on three groups of different education levels was used to compare their age, and then the chi-square test was employed to compare polygraph accuracy among the groups. Independent sample t test was used to compare the age of subjects in the two groups of different types of violation of law, and then chi-square test was used to compare the true positive rate and true negative rate of lie detection after integration. Results In CQT lie detection of criminal cases, the true positive rate was 87.00%, the false negative rate was 13.00%, the true negative rate was 82.20%, and the false positive rate was 17.80%. There was no statistical significance in the differences between the true positive rate and the true negative rate （P>0.05）. In CQT lie detection of the groups of different education levels, there was no statistical significance in the differences between the true positive rates （P>0.05） while the differences between the true negative rates had statistical significance （P<0.05）. There was no statistical significance in the differences of both the true positive rates and the true negative rates between the violent violation of law and non-violent violation of law （P>0.05）. Conclusion There is no significant difference between the efficiency of CQT lie detection of identifying criminals and excluding innocents. However, a comparatively high false positive rate and false negative rate still exist. The efficiency of CQT lie detection identifying criminals may not influenced by the examinee's education level and type of violation of law, but its efficiency of excluding innocents may be influenced by the examinee's education level.

[Efficacy analysis of soft neuroendoscopic techniques in the treatment of chronic subdural hematoma]

Objective: To investigate the efficacy of soft neuroendoscopic techniques in the treatment of chronic subdural hematoma (CSDH). Methods: A retrospective analysis of 201 cases of CSDH diagnosed and treated at Beijing Shijitan Hospital (CMU) from January 2006 to December 2017 was conducted. From January 2006 to December 2010, 126 cases of CSDH were treated with skull drilling and drainage (non-endoscopic group). From January 2011 to December 2017, 75 cases of CSDH were treated with soft neuroendoscopy (endoscopic group). The operation time of the non-endoscopic and endoscopic groups, the hematoma clearance rate on the first day after surgery, the time of the drainage tube, the length of hospital stay, the incidence of complications, mortality and recurrence rate were compared. Results: There were no deaths in both groups. The average operation time of the non-endoscopic group was 43 min, compared with the average operation time of the endoscopy group of 50 min, there was no significant difference (P>0.05). The average hematoma clearance rate on the first day after surgery in the endoscopy group (98.2%) was significantly higher than that in non-endoscopic group (87.3%) (P<0.01). The average time of drainage tube in the endoscopy group (23 h) was significantly shorter than that in the non-endoscopic group (50 h) (P<0.01). On the first postoperative day, the proportion of patients with mRS≤3 in the endoscopic group was significantly higher than that in the non-endoscopic group (P<0.01). At the time of discharge, the proportion of patients with mRS≤3 in the endoscopy group was also significantly higher than that in the non-endoscopic group, P<0.05. There was no significant difference in the average hospital stay between endoscopy group (7 d) and non-endoscopic group (8 d) (P>0.05). The postoperative complication rate in the endoscopy group was significantly lower than that in the non-endoscopic group (P<0.01). During 0.5-8 years of follow-up, the recurrence rate of CSDH in the endoscopic group (5.33%) was significantly lower than that in the non-endoscopic group (15.07%) (P<0.01). Conclusion: The application of visualization features of soft neuroendoscopy in the treatment of CSDH can significantly improve hematoma clearance, shorten the time of drainage tube, reduce postoperative complications and recurrence rate, and improve surgical outcomes.

Simple method for liquid analysis by laser-induced breakdown spectroscopy (LIBS)

As a fast-developing technique for in situ multi-element analysis method, laser induced breakdown spectroscopy - LIBS is, however, developing slowly on liquid analysis due to some technical difficulties. We propose a new method, namely capillary mode, to quantify the concentrations of the elements in solution using LIBS. A Nd:YAG laser with repetition of 10 Hz were used to analyze the solution of Na₂CrO₄ and no any sample preparation in measurements. The experimental results show that the splashing of liquid induced by laser pulses is decreased significantly and the pollution of mirrors is avoided effectively using liquid capillary mode. The results of quantitative analysis for liquid are also improved than other method. The calibration curves of Cr and Na are well characterized by straight lines and the regression coefficient values of the linear fit are better than 0.998. The limits of detection (LODs) of Cr and Na are determined to be 28.9 mg/L and 1.0 mg/L in this work, respectively. The experimental results show that the liquid capillary mode provides a more practical and very simple approach to improve accuracy of quantitative element analysis in liquids by LIBS technique.

[High expression of hnRNPAB/Kap1 together promote poor prognosis in HCC]

Objective: To further understand the interaction protein spectrum of heterogeneous ribonucleoprotein AB (hnRNP AB), and to investigate their clinical significance in hepatocellular carcinoma (HCC). Methods: We carried out mass spectrometry to reveal the specific peptides of KRAB-associated protein 1 (Kap1) and hnRNPAB, and verified their interaction by immunocoprecipitation and western blotting. Expression of hnRNPAB/Kap1 proteins were detected by immunohistochemical staining in the tissue microarrays. Categorical data were analyzed by the chi square test or Fisher exact test; enumeration data between groups were compared using Student t-test or Wilcocon signed rank test; the cumulative recurrence and survival rates were evaluated using the Kaplan-Meier method and the differences were assessed using the log-rank test. Results: We identified Kap1 as a molecular partner for hnRNPAB in HCCLM3 cells and HepG2 cells as well. We found that the 5-year survival rate of the Kap1high patients was significantly lower than the survival rate of those of the Kap1low group (36% vs 59% , HR = 1.67, P < 0.001). Similarly, Kap1high HCC patients had the poorest prognosis at 5-years, with higher cumulative recurrence rate than Kap1low patients (72% vs 54%, HR = 1.66, P = 0.001). Univariate and Multivariate analyses revealed that hnRNPAB /Kap1 alone (HR = 1.35 /1.28, P = 0.001) or in combination with Kap1 (HR =1.24 /1.27, P < 0.05) were independent prognostic indicators for overall survival and time to recurrence. Conclusion: In HCC cells, hnRNPAB and Kap1 form protein complexes. The expression levels of hnRNPAB alone or in combination with Kap1 in HCC patients are important because they provide not only a predictor for HCC prognosis but also a therapeutic target for future studies.

Abstract 4929: UbcH10 may represent a potential marker of gastric carcinoma

Gastric cancer is a fatal disease with limited early diagnostic methods available. There is an urgent need to find more effective targets for early diagnosis and therapeutics. UbcH10 is an ubiquitin-conjugating enzyme with a high expression reported in some cancers. Several gastric tumor cell lines with high or low expression of UbcH10 were exploited to study the role of UbcH10 in gastric cancer. Knocking down of UbcH10 expression using siRNA in high expressing gastric cancer cell lines resulted in reduced proliferation, increased cisplatin-induced apoptosis and reduced serum-induced ERK, Akt and p38 phosphorylation signaling. In agreement, overexpression of UbcH10 expression in low-expression gastric cancer cell lines led to enhanced cell proliferation, resistance to cisplatin-induced apoptosis. Most importantly, IHC analyses showed that the UbcH10 protein expressed at a high level in patient gastric cancer tissues, but not in adjacent mesenchyme tissues. These data suggest that UbcH10 may promote gastric cancer growth and can serve as a biomarker for diagnosis or target for new therapeutics in gastric cancer.

Citation Format: Mengxuan Yang, Yingying Qu, Gang Hu, Shiwei Tu, RL Shi, XB Wu, ZQ Hu, QM Zhang, SQ Liu, GF Pan, Ziping Zhang, He Zhou. UbcH10 may represent a potential marker of gastric carcinoma. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4929.

Dynamical evaluation of vaginal micro-ecosystem in a Chinese woman with recurrent vulvovaginal candidiasis

We reported a rare case of recurrent vulvovaginal candidiasis (RVVC) in this study. Through dynamic evaluation of the vaginal micro-ecosystem, we found that only depuratory degree, spores, blastospores, and hyphae were specific indicators and the "barometer" of RVVC development. Therefore, an understanding of vaginal micro-ecological changes can help clinicians to improve the treatment of patients with RVVC.

Atomic interaction mechanism for designing the interface of W/Zr-based bulk metallic glass composites

The interaction between active element Zr and W damages the W fibers and the interface and decreases the mechanical properties, especially the tensile strength of the W fibers reinforced Zr-based bulk metallic glass composites (BMGCs). From the viewpoint of atomic interaction, the W-Zr interaction can be restrained by adding minor elements that have stronger interaction with W into the alloy. The calculation about atomic interaction energy indicates that Ta and Nb preferred to segregate on the W substrate surface. Sessile drop experiment proves the prediction and corresponding in-situ coating appears at the interface. Besides, the atomic interaction mechanism was proven to be effective in many other systems by the sessile drop technique. Considering the interfacial morphology, Nb was added into the alloy to fabricate W/Zr-based BMGCs. As expected, the Nb addition effectively suppressed the W-Zr reaction and damage to W fibers. Both the compressive and tensile properties are improved obviously.

Laser Synthesis of Iron Nitride Nanoparticles from Pyrolysis of Fe(CO)5-NH3 System

By vapor-phase pyrolysis of Fe(CO) 5 and NH3 induced by CW CO2 laser, γ'-Fe4N and ε- Fe3N nanoparticles(≤35nm) were prepared in Ar and N2 atmospheres. In Ar, γ'-Fe4N accompanied by a little α-Fe was formed at low temperatures below 650°C, while higher temperatures favored the formation of γ-Fe. In N2 atmospheres, a mixture of Fe4N and Fe3N nanoparticles were obtained at high temperatures. In addition, the influences of synthesis parameters on the structure, morphology and magnetic properties of the nanoparticles were discussed.

Antibacterial activities of zinc oxide nanoparticles against Escherichia coli O157:H7

AIMS

To investigate antibacterial activities of zinc oxide nanoparticles (ZnO NP) and their mode of action against an important foodborne pathogen, Escherichia coli O157:H7.

METHODS AND RESULTS

ZnO NP with sizes of 70 nm and concentrations of 0, 3, 6 and 12 mmol l(-1) and NP-free solutions were used in antimicrobial tests against E. coli O157:H7. ZnO NP showed increasing inhibitory effects on the growth of E. coli O157:H7 as the concentrations of ZnO NP increased. A complete inhibition of microbial growth was achieved at the concentration level of 12 mmol l(-1) or higher. Scanning electron microscopy (SEM), transmission electron microscopy (TEM), and Raman spectroscopy were used to characterize the changes of morphology and cellular compositions of bacterial cells treated with ZnO NP and study the mode of action of ZnO NP against E. coli O157:H7. The intensity of lipid and protein bands in the Raman spectra of bacterial cells increased after exposure to ZnO NP, while no significant changes in nucleic acid bands were observed.

CONCLUSIONS

ZnO NP were found to have antibacterial activity against E. coli O157:H7. The inhibitory effects increase as the concentration of ZnO NP increased. Results indicate that ZnO NP may distort and damage bacterial cell membrane, resulting in a leakage of intracellular contents and eventually the death of bacterial cells.

SIGNIFICANCE AND IMPACT OF THE STUDY

These results suggest that ZnO NP could potentially be used as an effective antibacterial agent to protect agricultural and food safety.

Nitrification inhibition by silver nanoparticles

Nitrification inhibition by silver nanoparticles (nanosilver) was evaluated by extant respirometry using enriched nitrifying bacteria isolated from wastewater treatment plants. Silver nanoparticles were more toxic than silver ions or silver chloride colloids, all of which did not disrupt cell membrane integrity at 1 mg/L Ag. The toxicity of silver nanoparticles was reduced in the presence of various anions, especially sulfide. The results suggest that silver nanoparticles have the same behaviour of surface complexation as silver ions, and inhibition by nanosilver in wastewater treatment may be removed by reaction of silver nanoparticles with soluble sulfide species.

Penis reconstruction using three different operative methods

To identify the relative success rates, including aesthetic success, of three penis reconstruction techniques, we reviewed 44 cases of penis reconstruction carried out over the past 12 years. The three operative methods we surveyed involved: lower abdominal pedicled fascia flaps; paraumbilical island flaps; and free forearm flaps. Reconstructions survived in only half of the patients receiving lower abdominal pedicled fascia flaps, but 100% success rates were obtained with paraumbilical island flaps and free forearm flaps. The paraumbilical island flap is safe in terms of its blood supply, and the operative procedure is relatively simple in that it does not require microsurgery. Although, the flap is thicker than the forearm skin flap, its shape is satisfactory in slim patients; furthermore, it can be defatted secondarily. The free forearm skin flap provides the best shape, but skilled microsurgery is necessary to carry out the procedure, and damage is likely to the forearm. In conclusion, the best methods to repair defects in the penis in our experience are the paraumbilical island flap and free forearm flap. Lower abdominal pedicled fascia flaps are unsuitable for penile reconstruction and should be used less often.

Laparoscopic-assisted colon and rectal surgery - lessons learnt from early experience

INTRODUCTION

Current evidence shows that laparoscopic bowel surgery is associated with a lower incidence of postoperative ileus, lower postoperative pulmonary and wound complication rates, shorter hospital stays and a quicker return to activity than open surgery. This paper aims to report our early experience with laparoscopic-assisted colorectal procedures in our Centre for Advanced Laparoscopic Surgery and the important lessons we have learnt from this.

MATERIALS AND METHODS

All laparoscopic-assisted colon and rectal surgical (LAC) procedures performed between January 2000 and December 2003 were reviewed. Clinical and operative records of these patients were reviewed. Data retrieved included patient demographics, selected intraoperative parameters, and postoperative outcomes. In order to provide a comparable reference, an equal number of matched open procedures over the same period were accrued and similarly analysed. All patients were managed on a standard carepath. All data were entered into a database and analysed using a statistical software package.

RESULTS

Forty-two laparoscopicassisted colorectal procedures were performed from June 2000 to December 2003. A similar number of diagnosis-matched patients with open colorectal procedures were used as comparison. The diagnoses included cancer (68.5% versus 73.8%), diverticulosis (5.7% versus 9.5%) and polyps (14.3% versus 9.5%). Seven were converted to open surgery because of bleeding, adhesions and locally advanced disease. Laparoscopic-assisted procedures performed included 1 right hemicolectomy, 5 left hemicolectomies, 9 anterior resections, 1 abdominal-perineal resection, 3 sigmoid colectomies, 11 colostomies and 1 Hartmann's procedure. Mean perioperative time (146 min versus 125 min, P = 0.173) was comparatively longer. Mean duration for analgesic requirement (2.25 days versus 2.64 days, P = 0.05), mean length of stay (5.31 days versus 9.07 days, P < 0.05), mean time to commencement of diet (2.91 days versus 4.05 days, P < 0.001) and mean time to first bowel movement (2.57 days versus 4.10 days, P < 0.001) were all comparatively shorter. General morbidity rates (17.1% versus 21.4%, P = 0.35) were lower. No local wound complications were found in our laparoscopic-assisted group. Patients who had undergone open surgery instead of the planned laparoscopic-assisted procedures fared more poorly.

CONCLUSIONS

Laparoscopic-assisted colorectal procedures performed in well-selected patients are associated with shorter hospital stays, quicker return of bowel function and lower morbidity when compared to the matched open procedures. Early experience should be acquired from performing technically simple procedures in patients with benign conditions before progressing to definitive resections in those with cancer.

Molecular dynamics study of atomic transport properties in rapidly cooling liquid copper

Based on Mei's embedded atom model molecular dynamics simulations have been performed to investigate the rapidly cooling processes of Cu. The atomic transport property, namely the self-diffusion coefficient, is computed in the liquid state, and the results near the melting point of Cu are in good agreement with experimental data and other computational values. The atom diffusion movements during the long period of relaxation have been also studied around the solidification temperature Tc. To describe the complex microstructural evolutions during the rapidly cooling processes and the long relaxation processes, the pair correlation function and the pair analysis technique are used. It is demonstrated that the crystallization of amorphous Cu is caused by the atomic diffusion.

Growth and nutrient uptake of arbuscular mycorrhizal maize in different depths of soil overlying coal fly ash

Application of topsoil over phytotoxic mine wastes is often practised to establish perennial plant communities on minespoil areas. In China, population pressure encourages attempts to remediate such areas by growing arable crop plants, but efforts to establish agricultural crops often fail. We report an outdoor pot experiment that compared the effects of two arbuscular mycorrhizal (AM) fungi, Glomus mosseae (Nicol. and Gerd.) Gerdemann and Trappe and G. versiforme (Karsten) Berch, on the growth and nutrient uptake of maize (Zea mays L.) grown in different depths of soil layer overlying coal fly ash. Colonization by both AM fungi increased plant growth compared with non-mycorrhizal controls, with G. mosseae giving higher yields of maize than G. versiforme at the same depths of soil. Increasing soil depth led to increased plant yields. Mycorrhizal plants absorbed more nutrients than non-mycorrhizal controls, and translocated less Na to the shoots, perhaps protecting the plants from excessive Na accumulation. These preliminary results indicate that arbuscular mycorrhizas may make a substantial contribution to successful crop establishment in soils overlying areas of coal fly ash.

Mechanism of synergy between epigallocatechin gallate and beta-lactams against methicillin-resistant Staphylococcus aureus

Compared to MICs (more than 800 microg/ml) of (-)-epigallocatechin gallate (EGCg) against Escherchia coli, MICs of EGCg against methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MSSA and MRSA) were 100 microg/ml or less. Furthermore, less than 25 microg EGCg per ml obviously reversed the high level resistance of MRSA to all types of tested beta-lactams, including benzylpenicillin, oxacillin, methicillin, ampicillin, and cephalexin. EGCg also induced a supersusceptibility to beta-lactams in MSSA which does not express mecA, encoding penicillin-binding protein 2' (PBP2'). The fractional inhibitory concentration (FIC) indices of the tested beta-lactams against 25 isolates of MRSA were from 0.126 to 0.625 in combination with 6.25, 12.5 or 25 microg of EGCg per ml. However, no synergism was observed between EGCg and ampicillin against E. coli. EGCg largely reduced the tolerance of MRSA and MSSA to high ionic strength and low osmotic pressure in their external atmosphere, indicating damage of the cell wall. Unlike dextran and lipopolysaccharide, peptidoglycan from S. aureus blocked both the antibacterial activity of EGCg and the synergism between EGCg and oxacillin, suggesting a direct binding of EGCg with peptidoglycan on the cell wall. EGCg showed a synergistic effect with DL-cycloserine (an inhibitor of cell wall synthesis unrelated to PBP2') but additive or indifferent effect with inhibitors of protein and nuclear acid synthesis. EGCg did not suppress either PBP2' mRNA expression or PBP2' production, as confirmed by reverse transcription-PCR and a semiquantitative PBP2' latex agglutination assay, indicating an irrelevance between the synergy and PBP2' production. In summary, both EGCg and beta-lactams directly or indirectly attack the same site, peptidoglycan on the cell wall. EGCg synergizes the activity of beta-lactams against MRSA owing to interference with the integrity of the cell wall through direct binding to peptidoglycan.

Inhibition by epigallocatechin gallate (EGCg) of conjugative R plasmid transfer in Escherichia coli

Epigallocatechin gallate (EGCg) in tea catechins blocked or significantly diminished the transfer of conjugative R plasmid between Escherichia coli C600 with plasmid R-222 (donor) and E. coli K-12 RC85 (recipient) in a dose-dependent manner. The inhibition rates of R plasmid transfer by EGCg were 42%-67% at 50-200 microg/ml, and up to 99% at 800 microg/ml. Nevertheless, EGCg, even at the concentration of 1600 microg/ml, was not sufficient to kill E. coli cells in 1 h, as confirmed by determining viable cells after incubation with various concentrations of EGCg. The result indicates that the bactericidal activity of EGCg against the two strains was not the main factor responsible for the inhibition of R plasmid transfer. This observation suggests the possibility that tea consumption may be effective in preventing R plasmid transfer in enteric bacteria.

Epigallocatechin gallate synergy with ampicillin/sulbactam against 28 clinical isolates of methicillin-resistant Staphylococcus aureus

Compared with ampicillin, oxacillin, cefmetazole and imipenem, the combination of ampicillin and sulbactam at a constant ratio of 2:1 showed the greatest effect against 28 clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA), but MICs of ampicillin/sulbactam were still above the resistance breakpoint. When ampicillin/sulbactam was further combined with epigallocatechin gallate (EGCg, a main constituent of tea catechins), the MIC90 of ampicillin/ sulbactam was reduced to 4 mg/L, the susceptibility breakpoint. The fractional inhibitory concentration indices were between 0.19 and 0.56 in combination with 6.25 and 25 mg/L EGCg, respectively, indicating that ampicillin/sulbactam and EGCg combination may be effective against MRSA infections.

[Study on transplantation of anterolateral femoral skin flap with high site direct cutaneous artery]

OBJECTIVE

To study the availability of transplantation of anterolateral femoral skin flap with absence of the first branch of musculocutaneous artery.

METHODS

One hundred and sixty cases of anterolateral femoral skin flap transplantation in the past 15 years were reviewed, to investigate the relationship between the outcome of the transplantation and the types, distribution, original point, diameter of blood vessels. Among the 160 cases, there were 10 cases, 6.3% in total, of skin flap transplantation with the pedicle of high site direct cutaneous femoral artery, ranging from 10 cm x 14 cm to 12 cm x 18 cm in size, applied to repair soft tissue defect.

RESULTS

There were 149 cases, among the 160 cases, survived and all the 10 cases of femoral skin flap transplantation with high site anterolateral cutaneous artery survived.

CONCLUSION

The femoral skin flap with high site anterolateral cutaneous artery has good blood supply, larger size available, and easier operation. When the first branch of descending anterolateral femoral artery is absent, the femoral skin flap with high site anterolateral cutaneous artery is an optimal alternative.

[Detection of differentially expressed genes in hepatocellular carcinoma using DNA microarray]

Large scale gene expression profiles between normal hepatocytes and hepatocellular carcinomas are detected with high throughput microarray. DNA microarrays were made by spotting PCR products of 4,096 human cDNAs onto a specially treated glass slides. The probes were prepared by labelling normal tissue mRNA and cancer tissue mRNA with Cy3-dUTP and Cy5-dUTP separately through reverse transcription. The arrays were then hybridized against the cDNA probe mixture and the fluorescent signals were scanned. The obtained data were analyzed from 4 repeated experiments. There are 903 genes of which the average ratios between Cy3 signal and Cy5 signal are greater than 3.0. These genes identified through this approach are potential candidates for hepatocellular carcinoma diagnosis and therapy.

[The pathological changes of nasopharyngeal carcinoma cases treated by stereotactic radiosurgery]

OBJECTIVE

To study the pathological changes of nasopharyngeal carcinoma cases after the treatment of stereotactic radiosurgery.

METHOD

15 cases with recurrent or residual squamous cell carcinoma of nasopharynx diagnosed as T1-4 N0M0 were selected, which had undergone previous radiotherapy. The patients were treated by Gamma Knife while the isodose curve was 50% and the margin dose was 20 Gy. The nasopharynx biopsy was performed before the treatment and 1, 3, 6, 12 months after the treatment. The biopsy specimen was taken to make a pathological examination.

RESULT

1. Before the Gamma Knife treatment, carcinoma cell could be seen in the tissue; 2. 1-3 months after the treatment, cell necrosis and acute inflammation cell infiltration could be seen in the target; 3. 6-12 months after the treatment, infiltration of chronic inflammation cell, proliferation of fibrous tissue and capillary could be found in the target.

CONCLUSION

This research implies that the short-term pathological changes after the treatment of stereotactic radiosurgery can be defined as two phases: The first phase occurs from 1 to 3 months after the treatment called necrosis period. The second phase occurs from 6 to 12 months after the Gamma Knife treatment named as absorption period.

Spontaneous canine mast cell tumors express tandem duplications in the proto-oncogene c-kit

Spontaneous mast cell tumors (MCT) are the most common malignant neoplasm in the dog, representing between 7% and 21% of all canine tumors, an incidence much higher than that found in humans. These tumors often behave in an aggressive manner, metastasizing to local lymph nodes, liver, spleen, and bone marrow. The proto-oncogene c-kit is known to play a critical role in the development and function of mast cells. Point mutations in the kinase domain of c-kit leading to tyrosine phosphorylation in the absence of ligand binding have been identified in three mastocytoma lines, (P815, RBL, and HMC-1), and some human patients with various forms of mastocytosis. We now demonstrate that although c-kit derived from canine MCT did not contain the previously described activating point mutations, 5 of the 11 tumors analyzed possessed novel mutations consisting of tandem duplications involving exons 11 and 12. We also show that one such duplication, detected in a canine mastocytoma cell line, was associated with constitutive phosphorylation of c-kit protein (KIT), suggesting that these mutations may contribute to the development or progression of canine MCT.

Erythrocyte-dependent mitogenic activity of epigallocatechin gallate on mouse splenic B cells

We previously reported that epigallocatechin gallate (EGCg), the main constituent of tea catechins, displays mitogenic effect on mouse splenic B cells. During research into the mechanism(s), it was found that the mitogenic activity of EGCg was dependent on the presence of red blood cells (RBC). When RBC in T cell-depleted spleen cells were removed, EGCg did not enhance the proliferation of B cells and even showed toxic effect at 25-50 micrograms/ml. When mouse, rabbit or sheep RBC as well as RBC-ghosts were added into the cultures, EGCg showed the mitogenic activity at a range of 1-50 micrograms/ml. Thereafter, we preincubated RBC with EGCg at 4 degrees C for various times and then washed the RBC to remove free EGCg in the suspensions. The EGCg-preincubated RBC also enhanced B cell proliferation. As short as ten minutes was sufficient for EGCg to bind to RBC membrane. These results indicate that EGCg first attached to the membrane of RBC and then stimulated B cell proliferation. The above results suggest an important immunoregulatory function of RBC.

Tumor necrosis factor-alpha- and interleukin-6-triggered mast cell development from mouse spleen cells

We previously showed that interleukin-3 (IL-3) alone is not sufficient, although it is essential for murine mucosal-type mast cell development and that prostaglandin E (PGE) and interferon-gamma (IFN-gamma) are critical for survival or differentiation of mast cell precursors. We also confirmed that IL-4 is a key inhibitor for mast cell precursors despite being a growth factor of mast cells. In the present work, mouse spleen cells were cultured with recombinant (r) IL-1 beta, rIL-5, rIL-6, rIL-9, granulocyte-macrophage colony-stimulating factor (GM-CSF), stem cell factor (SCF), tumor transforming growth factor-beta (TGF-beta), or tumor necrosis factor-alpha (TNF-alpha) in the presence of endogenous IL-3. After 12 days of culture, mast cell development was induced by rIL-6 and rTNF-alpha, rIL-1 beta, rIL-5, rGM-CSF, rTGF-beta and even the mast cell growth factors, rIL-9 and rSCF, failed to induce mast cell development. However, unlike IL-9 and SCF, IL-6 and TNF-alpha did not promote the growth of mast cells already developed. Macrophage may be one of the responsive cells of IL-6 and TNF-alpha in the cultures, because removal of macrophages greatly reduced the mast cell development induced by the cytokines. The actions of TNF-alpha and IL-6 were inhibited by indomethacin, an inhibitor for prostaglandin synthesis, and by neutralizing anti-IFN-gamma and anti-IL-3 antibodies. rIL-4, when added at the start of the culture, also inhibited mast cell development induced by rIL-6 and rTNF-alpha. Nevertheless, neutralizing anti-IL-6 and anti-TNF-alpha antibodies did not suppress mast cell development induced by PGE and IFN-gamma. TNF-alpha and IL-6 enhanced IFN-gamma production, but suppressed IL-4 production in the cultures. Mast cell numbers induced were inversely and directly proportional to IL-4 and IFN-gamma levels, respectively. These results indicate that inflammatory mediators as triggers are important for mast cell development although they are not the mast cell growth factors.

Down-regulation by IL-4 and up-regulation by IFN-gamma of mast cell induction from mouse spleen cells

While investigating an involvement of other factors aside from endogenous IL-3 and prostaglandin E (PGE) in mast cell induction from mouse splenocytes, we found that the mast cell induction was inversely proportional to IL-4 levels and tended to directly proportionate IFN-gamma levels in the supernatants recovered on days 2 and 4. Thereafter, we examined the effects of rIFN-gamma, rIL-4, and rIL-10 on mast cell induction. IFN-gamma and IL-10 dose-dependently induced mast cells. Time course study showed an importance of adding rIFN-gamma into the cultures at the early phase (on days 0 and 2 of a 12-day culture). When endogenous IFN-gamma at the early phase was neutralized by anti-IFN-gamma Ab, all stimulants, including rIFN-gamma, rIL-10, and PGE1, failed to induce mast cells. On the contrary, rIL-4 dose-dependently suppressed the mast cell induction by rIFN-gamma, rIL-10, LPS, PGE, and dibutyryl cAMP. The inhibitory effect of IL-4 was observed when IL-4 was added into the cultures at the early phase, but not after day 4. The suppressive action of IL-4 was diminished completely by the addition of neutralizing anti-IL-4 Ab. IL-12, a key regulator of IFN-gamma and IL-4 production, also induced mast cells. These results revealed, for the first time, that IFN-gamma is crucial for the survival and/or differentiation of splenic mast cell precursors and that IL-4 is a key inhibitor for the precursors, although IFN-gamma is not a mast cell growth factor and IL-4 is a growth factor for immature and mature mast cells.

Down-regulation by IL-4 and up-regulation by IFN-gamma of mast cell induction from mouse spleen cells

While investigating an involvement of other factors aside from endogenous IL-3 and prostaglandin E (PGE) in mast cell induction from mouse splenocytes, we found that the mast cell induction was inversely proportional to IL-4 levels and tended to directly proportionate IFN-gamma levels in the supernatants recovered on days 2 and 4. Thereafter, we examined the effects of rIFN-gamma, rIL-4, and rIL-10 on mast cell induction. IFN-gamma and IL-10 dose-dependently induced mast cells. Time course study showed an importance of adding rIFN-gamma into the cultures at the early phase (on days 0 and 2 of a 12-day culture). When endogenous IFN-gamma at the early phase was neutralized by anti-IFN-gamma Ab, all stimulants, including rIFN-gamma, rIL-10, and PGE1, failed to induce mast cells. On the contrary, rIL-4 dose-dependently suppressed the mast cell induction by rIFN-gamma, rIL-10, LPS, PGE, and dibutyryl cAMP. The inhibitory effect of IL-4 was observed when IL-4 was added into the cultures at the early phase, but not after day 4. The suppressive action of IL-4 was diminished completely by the addition of neutralizing anti-IL-4 Ab. IL-12, a key regulator of IFN-gamma and IL-4 production, also induced mast cells. These results revealed, for the first time, that IFN-gamma is crucial for the survival and/or differentiation of splenic mast cell precursors and that IL-4 is a key inhibitor for the precursors, although IFN-gamma is not a mast cell growth factor and IL-4 is a growth factor for immature and mature mast cells.

Preliminary application of Gamma Knife in the treatment of nasopharyngeal carcinoma

Nasopharyngeal carcinoma is a malignant tumor which occurs frequently in China. Currently, radiotherapy using 60Co is the main method of treatment. However, the 5-year survival rate is only 49.5%. There is no effective method today for treating residual or recurrent tumor following radiotherapy. In principle, the Leksell Gamma Knife could contribute to better results. Since December 1993, we have treated 36 patients suffering from nasopharyngeal carcinoma with the Gamma Knife: 32 were relapses after radiotherapy and 4 were primary cases. Treatment was very effective for a short period. The rate of improvement of such symptoms as headache, facial paralysis, reduced vision, nasal obstruction and nasal bleeding was 70-100%. After treatment, tumors became smaller or even disappeared. A new nasopharyngeal biopsy was performed in 12 patients and demonstrated that the pathological tissue had returned to normal. The short duration of the survey precludes conclusions about the long-term effects of the treatment.

An essential role of prostaglandin E on mouse mast cell induction

We previously established a system for induction of mucosal-type mast cells from mouse spleen cells by long term culture without exogenous IL-3. FCS was important and was able to be divided into mast cell-inducible and non-mast cell-inducible sera. LPS contaminated in FCS was responsible for the mast cell induction. However, we unexpectedly found that both supernatants recovered from the cultures with mast cell-inducible and non-mast cell-inducible sera contained endogenous IL-3. Furthermore, addition of rIL-3 to the cultures with non-mast cell-inducible sera had no effect or induced only a small number of mast cells. This indicates that IL-3 alone is not enough for mast cell induction and that some inflammatory factor(s) induced by LPS is also essential. Prostaglandin E1 (PGE1) and PGE2 induced mast cells in a dose-dependent manner when added into the cultures. The activity of LPS for mast cell induction was inhibited by indomethacin. However, indomethacin failed to inhibit the mast cell induction by exogenous PGE. Exogenous PGE antagonized the indomethacin-induced inhibition of mast cell induction by LPS. Cholera toxin and dibutyryl cyclic AMP (cAMP) also induced mast cells. The A and B subunits of cholera toxin, PGF2 alpha, PGD2, and dibutyryl cGMP failed to induce mast cells. Furthermore, mast cell induction by PGE was dose-dependently suppressed by inhibitors for cAMP-dependent A kinase. The above results show that for mast cell induction, IL-3 needs the cooperation of PGE or other stimulants that can elevate the production of the second messenger cAMP in mast cell precursors.

An essential role of prostaglandin E on mouse mast cell induction

We previously established a system for induction of mucosal-type mast cells from mouse spleen cells by long term culture without exogenous IL-3. FCS was important and was able to be divided into mast cell-inducible and non-mast cell-inducible sera. LPS contaminated in FCS was responsible for the mast cell induction. However, we unexpectedly found that both supernatants recovered from the cultures with mast cell-inducible and non-mast cell-inducible sera contained endogenous IL-3. Furthermore, addition of rIL-3 to the cultures with non-mast cell-inducible sera had no effect or induced only a small number of mast cells. This indicates that IL-3 alone is not enough for mast cell induction and that some inflammatory factor(s) induced by LPS is also essential. Prostaglandin E1 (PGE1) and PGE2 induced mast cells in a dose-dependent manner when added into the cultures. The activity of LPS for mast cell induction was inhibited by indomethacin. However, indomethacin failed to inhibit the mast cell induction by exogenous PGE. Exogenous PGE antagonized the indomethacin-induced inhibition of mast cell induction by LPS. Cholera toxin and dibutyryl cyclic AMP (cAMP) also induced mast cells. The A and B subunits of cholera toxin, PGF2 alpha, PGD2, and dibutyryl cGMP failed to induce mast cells. Furthermore, mast cell induction by PGE was dose-dependently suppressed by inhibitors for cAMP-dependent A kinase. The above results show that for mast cell induction, IL-3 needs the cooperation of PGE or other stimulants that can elevate the production of the second messenger cAMP in mast cell precursors.

Effect of lipopolysaccharide on mouse mast cell induction by a splenic cell culture system

We have previously reported a method of mast cell induction by long-term culture of mouse spleen cells without using exogenous mast cell growth factor (Z.-Q. Hu, T. Yoshida, and T. Shimamura, J. Immunol. Methods 149:173, 1992). Supernatants recovered from the long-term cultures contain endogenous interleukin 3 and soluble stem cell factor. These were assessed by the capacity of the recovered supernatants to foster the growth of a mast cell growth factor-dependent cell line and by neutralizing antibodies. Besides the soluble factors, cell-to-cell contacts mediated by membrane stem cell factor on splenic stromal cells and c-Kit receptors on mast cells also affect mast cell induction. Different lots of fetal calf serum (FCS) were examined to determine a possible trigger for cytokine production. FCS can be divided into mast cell-inducible and noninducible sera by this process. However, not all FCS lots contain mast cell growth factor. The mast cell-inducible lots contain lipopolysaccharide (LPS) confirmed by a Limulus assay. Polymyxin B can neutralize the mast cell induction activity. Non-mast cell-inducible FCS can be converted to inducible FCS by adding exogenous LPS. The results indicate that LPS as a trigger of cytokine production is responsible for mast cell induction.

Biotin uptake by basolateral membrane vesicles of human placenta: normal characteristics and role of ethanol

This study assessed the mechanism of uptake of biotin by the fetal-facing (basolateral) membrane of the term human placenta. Using membrane vesicles, we showed that most of the uptake was attributable to transfer of the vitamin into the vesicle and that the uptake was saturable, Na-dependent, carrier-mediated, and electroneutral. The rate of uptake was less than for biotin uptake by the maternal-facing (apical) membrane of the human placenta. Because ethanol inhibits biotin uptake by the apical membrane, the effect of ethanol on uptake by basolateral vesicles was investigated. With 10-hr exposure at a concentration of 2 and 3 mg/ml, but not 1 mg/ml, ethanol modestly inhibited biotin uptake. The mechanism of inhibition by alcohol is not known.

Mast cells display natural suppressor activity partially by releasing transforming growth factor-beta

We have previously reported a method for inducing natural suppressor (NS) cells by long-term culture of normal adult mouse spleen cells. The NS cells were further identified as mucosal or immature mast cells by morphology, cytochemistry, histochemistry and function. A cloned immature mast cell line was also confirmed to have NS activity. As NS cells, the cell line suppressed non-specifically the plaque-forming cell (PFC) response. The NS cell-free supernatant was partially enriched by chromatography and some fractions suppressed the PFC response and thymocyte proliferation. Heat treatment of the fractions failed to deplete the suppressive activity. The fractions were confirmed, by immunoblotting analysis, to contain transforming growth factor (TGF)-beta. Recombinant human TGF-beta was also able to suppress the PFC response and thymocyte proliferation. Neutralizing anti-TGF-beta reversed the suppression by both human TGF-beta and the fraction. From the above results, it is clear that mast cells displayed NS activity, at least partially, through the release of TGF-beta.

Ganciclovir transfer by human placenta and its effects on rat fetal cells

Cytomegalovirus is a common cause of intrauterine infection. Ganciclovir is an accepted therapeutic agent for this infection, but is proscribed in pregnancy, except when there is a life-threatening maternal infection, because of its known teratogenic and embryotoxic effects in experimental animals. There are no such data in humans and the human transplacental transfer of this drug has not been studied. This study defines the rate and mechanism of human-placental ganciclovir transport using maternal-facing syncytiotrophoblast vesicles and the perfused, isolated single-cotyledon system and determines further the effects of ganciclovir on fetal tissue, using cultured rat fetal hepatocytes. Ganciclovir was taken up by the maternal-facing placental membrane by a carrier-dependent, Na-independent system inhibited by adenine, guanine, and acyclovir, but not by cytosine and thymine or thymidine and uridine. By contrast, the overall transfer of the drug by the placenta was passive and without drug metabolism. Therefore, the drug is concentrated initially at the maternal placental surface and then crosses passively into the fetal compartment, with the latter process being rate-limiting. There was little or no toxic effect of high concentrations of ganciclovir on cultured fetal-rat hepatocytes.

Human placental biotin transport: normal characteristics and effect of ethanol

Biotin, a vitamin essential for many metabolic reactions, is supplied to the fetus exclusively from the mother. Deficiency of biotin in pregnancy leads to impaired fetal growth and development. Alcohol taken in pregnancy likewise may cause fetal growth abnormalities. Normal biotin transport via the placenta and the effects of ethanol on this transport apparently have not been studied. Our aims were to characterize these phenomena for the normal human-term placenta. Using maternal-facing placental membrane vesicles, biotin uptake was sodium- and temperature-dependent, saturable, and inhibited by structural analogs of biotin (desthiobiotin, biocytin, and biotin methyl ester), as well as by 4 and 10 hr exposure to 3 g/liter ethanol. Using the isolated perfused single cotyledon method to measure placental transport of biotin at a perfusion concentration of 1 nM, the overall rate of biotin transport was found to be only 30% that of antipyrine, a freely diffusible marker. Clearance of biotin was approximately 2 ml/hr.g placenta, which was equal to the clearance of passively transferred L-glucose; biotin clearance was similar in both maternal to fetal and fetal to maternal directions. Overall transfer of biotin from maternal to fetal compartments was not inhibited by 500-fold greater concentrations of the three analogs, did not proceed against a biotin concentration gradient, and was not inhibited by 90-240 min exposure to an initial concentration of 4 g/liter ethanol. Concentration of biotin in the fetal compartment at the end of the study was not higher than on the maternal side (after maternal to fetal infusion), but placental concentration was 2- to 3-fold greater. No significant metabolism of biotin was detected. Exposing human placental cultured trophoblast on day 3 to 24 hr of ethanol (2 g/liter) had no effect on the net uptake of biotin by these cells. These studies provide evidence that maternal-facing placental membranes take up biotin by a mediated, carrier-dependent process that is inhibited by ethanol; however, based on the perfusion studies, we conclude that the overall (maternal-fetal) rate-limiting transfer of biotin by the human placenta is most consistent with a passive process, which is not inhibited by short-term exposure to ethanol.