[Disease burden of acute viral hepatitis in Guangdong Province, 1990-2019]

Objective: To examine the burden and trends of acute viral hepatitis in Guangdong Province from 1990 to 2019, and provide reference evidences for hepatitis prevention and control in the province. Methods: Data on acute viral hepatitis (hepatitis A, B, C, and E) in Guangdong from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The incidence, prevalence, mortality, and disability-adjusted life years (DALY) data were analyzed by age and gender, and the estimated annual percentage change (EAPC) was calculated to describe the changing trends in disease burden. Results: From 1999 to 2019, the standardized incidence, prevalence, mortality, and DALY of acute viral hepatitis in Guangdong were higher than the national averages. In 2019, 51.43% (2 245 087/4 365 221) of acute viral hepatitis cases in Guangdong Province were mainly attributed to hepatitis B, and 77.18% (106/138) of deaths were due to acute hepatitis B. In different age groups, except for acute hepatitis B, which was more common in adults, the incidence rates of other types of viral hepatitis such as hepatitis A, B, and E showed an overall decreasing trend with age. The mortality rates of different types of acute viral hepatitis, except for the <5 age group, increased with age. The overall incidence and mortality rates of acute viral hepatitis were higher in men than in women. Conclusions: The overall burden of acute viral hepatitis in Guangdong declined in 2019, but remained higher than the national level. Further efforts are needed to strengthen hepatitis prevention and screening in different population in Guangdong Province, especially in children and the elderly.

[Evaluation of differences in quality of life in patients with chronic graft-versus-host disease]

Objective: To evaluate the status of, differences in, and factors influencing quality of life (QoL) in patients with chronic graft-versus-host disease (GVHD). Methods: From September 2021 to February 2023, a cross-sectional study of 140 patients with chronic GVHD was conducted at our center. Symptom burden was assessed by the Lee Symptomatology Scale (LSS), and QoL was assessed by the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) (version 1) and five-level EuroQoL five-dimensional questionnaire (EQ-5D-5L). Results: Data from 140 respondents, including 32 (22.9%) with mild chronic GVHD, 87 (62.1%) with moderate chronic GVHD, and 21 (15.0%) with severe chronic GVHD, were analyzed. Of the respondents, 61.4% were male, and the median transplantation age was 34 (15-68) years. The primary diagnoses were acute myeloid leukemia (50.0%), acute lymphoblastic leukemia (20.0%), and myelodysplastic syndrome (15.0%). The common chronic GVHD-affected organs included the skin in 74 patients (52.9%), the eyes in 57 patients (40.7%), and the liver in 50 patients (35.7%). Among the whole cohort, the eye (20.48±23.75), psychological (16.13±17.00), and oral (13.66±20.55) scores were highest in the LSS group. The physiological function (36.07±11.13), social function (36.10±10.68), and role-emotional functioning (38.36±11.88) scores were lowest in the SF-36 group. The EQ-5D index was 0.764. The total LSS scores for mild, moderate, and severe chronic GVHD were 6.51±6.15, 10.07±5.61, and 20.90±10.09, respectively. The SF-36 physical component scores (PCSs) were 43.12±6.38, 40.73±7.14, and 36.97±6.97, respectively, and the mental component scores (MCSs) were 43.00±8.47, 38.90±9.52, and 28.96±9.63, respectively. The EQ-5D values were 0.810±0.124, 0.762±0.179, and 0.702±0.198, respectively. The multivariate analysis showed that the overall symptom burden (β=-0.517), oral symptom burden (β=-0.456), National Institute of Health (NIH) criteria for the eyes (β=-0.376), and nutrition-related symptom burden (β=-0.211) were significantly negatively correlated with the PCS. The NIH score (β=-0.260) was negatively correlated with the MCS score. Oral symptom burden (β=-0.400), joint/fascia NIH criteria (β=-0.332), number of involved systems (β=-0.253), overall NIH criteria (β=-0.205), and number of immunosuppressants taken (β=-0.171) were significantly negatively correlated with the EQ-5D score (all P<0.05). Medium to strong correlations were found between the EQ-5D score and the SF-36 score (|r|=0.384-0.571, P<0.001). Conclusions: The QoL of patients with chronic GVHD is impaired, and the more severe the disease, the poorer the QoL. Overall symptom burden, severity of eyes, and oral symptom burden were the most important factors affecting QoL.

Metformin reduces decline in the estimated glomerular filtration rate during progression of autosomal dominant polycystic kidney disease: a systematic review and meta-analysis

OBJECTIVE

A meta-analysis (MA) was carried out to examine the influence of metformin on autosomal dominant polycystic kidney disease (ADPKD) patient prognosis.

MATERIALS AND METHODS

We reviewed and examined scientific articles from PubMed, Clinicalkey, Google Scholar, Medline, Embase, and Cochrane from the initiation date till June 2023 to identify investigations that examined metformin performance in managing ADPKD. Among the employed search terminology, we searched for terms such as "metformin" and "ADPKD". MA was conducted using the Cochrane Collaboration's RevMan version 5.3.0 (The Cochrane Collaboration, Oxford, UK).

RESULTS

We identified 4 investigations, with 164 total subjects who fulfilled our inclusion criteria. The experimental cohort displayed a marked reduction in the decline of estimated glomerular filtration rate (eGFR) relative to controls [mean difference (MD) = 2.31, 95% confidence interval (CI) = 0.82-3.79, p = 0.002]. We observed no obvious difference in the height-adjusted total kidney volume alteration, gastrointestinal side effects, and hypoglycemia between the two cohorts.

CONCLUSIONS

Metformin was easily tolerable and safe and substantially reduced the eGFR decline among ADPKD patients. Moreover, although metformin-treated patients were more likely to suffer gastrointestinal adverse events, we observed no discernible difference between the two cohorts.

Ultrasonic bone curette in thoracic spinal decompression: a comprehensive systematic review and meta-analysis

OBJECTIVE

The aim of this study was to compare the efficacy and safety of ultrasonic bone curette (UBC) and conventional surgical instruments in thoracic laminectomy decompression (TLD) for the treatment of thoracic spinal stenosis (TSS) by meta-analysis.

MATERIALS AND METHODS

Two authors independently searched Medline via PubMed, Embase, Cochrane Library, Web of Science, Wanfang Database, and China National Knowledge Infrastructure for the period from the establishment of the database until January 2023 to identify the studies on the safety and efficacy of UBC vs. conventional instruments for TSS. Data extraction and quality assessment were performed by two researchers independently. We used RevMan 5.4 software (Review Manager Web, The Cochrane Collaboration, Copenhagen, Denmark) to analyze the data.

RESULTS

Eight retrospective studies were included in the present work. This meta-analysis revealed that no significant differences in the preoperative JOA scores, the JOA scores at the last follow-up, the improvement rate of JOA scores, and the incidence of cerebrospinal fluid leakage/dura injury were detected between the two groups (p>0.05). However, there were significant differences in the operative time and intraoperative blood loss during single-level TLD [operative time: MD=-1.47, 95% CI (-1.86, -1.09), p<0.001; intraoperative blood loss: MD=-46.62, 95% CI (-53.83, -39.40), p<0.001], total operative time [MD=-56.88, 95% CI (-69.66, -44.10), p<0.001], total intraoperative blood loss [MD=-143.52, 95% CI (-212.49, -74.54), p<0.001], the incidence of neurological deterioration/nerve root injury [RR= 0.29, 95% CI (0.09, 0.91), p=0.03] between the groups.

CONCLUSIONS

The application of UBC in TLD to treat TSS is safe and effective. UBC can significantly shorten operation time and reduce intraoperative blood loss compared to traditional surgical instruments. Moreover, it has the advantage of reducing perioperative nerve injury.

Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3)

BACKGROUND

Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology.

METHODS

We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator.

RESULTS

The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults.

CONCLUSIONS

To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.

Damage control strategies in gallbladder-preserving cholecystolithotomy: from incision to channel establishment to non-invasive procedure

Damage control strategies for cholecystolithotomy are summarized as incision–suture technique, puncture and channel establishment method, and physiological duct-directed approach. Cultural influence, medical assessment, complications, recurrences, and further direction for cholecystolithotomy are involved.

Analyses of microRNA166 gene structure, expression, and function during the early stage of somatic embryogenesis in Dimocarpus longan Lour

MicroRNA166 (miR166) contributes to post-transcriptional regulation by binding the mRNAs of HD-ZIP III genes, which affects plant growth and development. The structural characteristics, expression, and functions of miR166 genes during the early somatic embryogenesis stage in Dimocarpus longan remain unknown. We isolated the transcripts of pri-miR166 S78 with two transcription initiation sites (TSSs) and pri-miR166 S338 with one TSS. These sequences contain potential smORFs and encode different miRNA peptides (miPEPs). Additionally, their promoters contain cis-acting elements responsive to diverse stimuli. The pre-miR166 S78 and pre-miR166 S338 expression levels were up-regulated in response to 2,4-D, abscisic acid, and ethylene. Although the expression patterns induced by hormones were similar, there were differences in the extent of the response, with pre-miR166 S338 more responsive than pre-miR166 S78. Thus, miRNA transcription and maturation are not simply linearly correlated. Moreover, pre-miR166 S78 and pre-miR166 S338 expression levels were down-regulated, whereas ATHB15 (target gene) expression was up-regulated, from the longan embryonic callus to the globular embryo stages. These results are indicative of a negative regulatory relationship between miR166 and ATHB15 during the early somatic embryogenesis stage in longan. At the same stages, miR166a.2-agomir, miR166a.2-antagomir, and miPEP166 S338 increased or decreased the expression of miR166a.2 and ATHB15, but with no consistent patterns or linear synchronization, from which we've found some reasons for it.

Long non-coding RNA expression profile in permanent atrial fibrillation patients with rheumatic heart disease

OBJECTIVE

Atrial fibrillation (AF) is the most common type of arrhythmia, especially in rheumatic heart disease (RHD) patients. The differences in structural remodeling and electrical remodeling between the left and right atrium associated with AF in RHD patients are well known, and alterations in the expression profiles of long noncoding RNAs (lncRNAs) in the left atrium have also been investigated. However, the role of lncRNAs in the right atrium (RA) remains largely unknown.

PATIENTS AND METHODS

We identified differentially expressed lncRNAs in RA tissues of RHD patients with AF or a normal sinus rhythm (NSR) using microarray analysis. Then, we performed gene ontology (GO) and KEGG pathway analyses for functional annotation of the deregulated lncRNAs. Finally, we constructed a lncRNA-mRNA co-expression network.

RESULTS

Of the 22,829 human non-coding RNAs analyzed, a total of 1,909 long non-coding RNAs were detected. A total of 182 lncRNAs (117 downregulated and 65 upregulated) were shown to be differentially expressed (fold-change > 1.5) in AF patients compared with NSR patients. Many lncRNAs might be partially involved in an AF-related pathway.

CONCLUSIONS

AF dysregulates the expression of lncRNAs in the RA of RHD patients. These findings may be useful for exploring potential therapeutic treatments for AF in RHD patients.

Nectar yeasts enhance the interaction between Clematis akebioides and its bumblebee pollinator

It has been hypothesised that intense metabolism of nectar-inhabiting yeasts (NIY) may change nectar chemistry, including volatile profile, which may affect pollinator foraging behaviours and consequently plant fitness. However, empirical evidence for the plant-microbe-pollinator interactions remains little known. To test this hypothesis, we use a bumblebee-pollinated vine Clematis akebioides endemic to southwest China as an experimental model plant. To quantify the incidence and density of Metschnikowia reukaufii, a cosmopolitan NIY in floral nectar, a combination of yeast cultivation and microscopic cell-counting method was used. To examine the effects of NIY on plant-pollinator interactions, we used real flowers filled with artificial nectar with or without yeast cells. Then the volatile metabolites produced in the yeast-inoculated nectar were analysed with coupled gas chromatography and mass spectrometry (GC-MS). On average 79.3% of the C. akebioides flowers harboured M. reukaufii, and cell density of NIY was high to 7.4 × 10⁴ cells mm^-3 . In the field population, the presence of NIY in flowers of C. akebioides increased bumblebee (Bombus friseanus) pollinator visitation rate and consequently seed set per flower. A variety of fatty acid derivatives produced by M. reukaufii may be responsible for the above beneficial interactions. The volatiles produced by the metabolism of M. reukaufii may serve as an honest signal to attract bumblebee pollinators and indirectly promote the female reproductive fitness of C. akebioides, forming a potentially tripartite plant-microbe-pollinator mutualism.

Pituitary tumor transforming gene binding factor (PBF) is required for androgen-induced prostate cancer proliferation and invasion

Pituitary tumor transforming gene binding factor (PBF) is a proto-oncogene that plays a role in many cancers; however, its involvement in prostate cancer (PCa) remains unclear. Here, we examined PBF expression in clinical specimens and investigated its regulation and function in human PCa cell lines. Immunohistochemical staining of patient tissues revealed higher PBF expression in PCa than in benign prostatic hyperplasia or adjacent normal prostate specimens. In LNCaP and 22Rv1 cells, PBF expression was upregulated by androgen treatment in a manner partially blocked by the androgen receptor (AR) antagonist bicalutamide. We identified a novel androgen response element in the PBF gene promoter and demonstrated its functional relevance using luciferase reporter assays. Androgen treatment of LNCaP cells induced binding between the endogenous AR and the androgen response element in PBF, as measured by chromatin immunoprecipitation assays. Finally, RNA interference of PBF expression significantly reduced androgen-induced LNCaP cell growth and invasion. Thus, PBF is a novel AR target gene and plays a role in androgen-induced proliferation and metastatic functions in PCa cells.

Diabetes-induced colonic slow transit mediated by the up-regulation of PDGFRα+ cells/SK3 in streptozotocin-induced diabetic mice

BACKGROUND

A major complication related to gastrointestinal (GI) symptoms in diabetic patients is chronic constipation. Constipation has serious negative impacts on quality of life; however, without a comprehensive understanding of the disease, currently available treatments cannot provide a cure. Platelet-derived growth factor receptor alpha-positive cells (PDGFRα+ cells), which form the SIP syncytium with interstitial cells of Cajal and smooth muscle cells, play important roles in GI motility. In the present study, the contributions of PDGFRα+ cells to diabetes-induced colonic slow transit were investigated in streptozotocin (STZ)-induced diabetic mice.

METHODS

Western blotting, quantitative PCR, contractile experiments, and intracellular recording were used in the present study.

KEY RESULTS

The results demonstrated that the colon length was increased in STZ-treated mice. The colonic transit of artificial fecal pellets in vitro was significantly delayed in STZ-treated mice. The mRNA and protein expression of PDGFRα, small-conductance Ca2+ -activated K channels (SK3), and P2Y1 receptors were increased in the colons of STZ-treated mice. In contractile experiments, the colonic smooth muscles were more sensitive to the SK3 agonist and antagonist (CyPPA and apamin) and the P2Y1 agonist and antagonist (MRS2365 and MRS2500) in STZ-treated mice. Intracellular recordings showed the responses of membrane potentials in colonic smooth muscle cells to CyPPA, apamin, MRS2365, and MRS2500 were more sensitive in STZ-treated mice. The electric field stimulation-induced P2Y1/SK3-dependent fast inhibitory junctional potentials (fIJPs) of colonic smooth muscles were more significantly hyperpolarized in STZ-treated mice.

CONCLUSIONS AND INFERENCES

These results suggest that the purinergic neurotransmitters/P2Y1/SK3 signaling pathway is up-regulated in the diabetic colons, thereby mediating diabetes-induced colonic slow transit.

Geometric Parameter Analysis of Ruptured and Unruptured Aneurysms in Patients with Symmetric Bilateral Intracranial Aneurysms: A Multicenter CT Angiography Study

BACKGROUND AND PURPOSE

Previous studies of geometric and morphologic parameters of intracranial aneurysms have been conducted to determine rupture risk, which remains incompletely defined due to patient-specific risk factors, such as sex, hypertension, and age. To this end, we compared characteristics of ruptured and unruptured aneurysms in the same patients with symmetric bilateral intracranial aneurysms.

MATERIALS AND METHODS

Between January 2008 and March 2014, 2361 patients with 2674 aneurysms were diagnosed by CT angiography or surgical findings at 4 medical centers. Geometric and morphologic parameters examined for symmetric bilateral intracranial aneurysms comprised aneurysm wall regularity, size, neck width, aspect ratio, size ratio, neck-to-parent artery ratio, and area ratio. Univariate and multivariate statistical analyses were performed to determine independent risk factors for rupture.

RESULTS

Sixty-three patients (48 women, 15 men; mean age, 62.5 ± 9.8 years) with symmetric bilateral aneurysms were eligible for the study and were included. The most frequent aneurysm location was the posterior communicating artery. Univariate analysis disclosed that aneurysm size, aspect ratio, size ratio, area ratio, and irregular wall differed between patients with ruptured and unruptured aneurysms. Multivariate analysis indicated that aspect ratio of ≥1.6 (adjusted OR, 9.521; 95% CI, 2.182-41.535), area ratio of ≥1.5 (adjusted OR, 4.089; 95% CI, 1.247-13.406), and irregular shape (adjusted OR, 10.443; 95% CI 3.394-32.135) were significant predictive factors for aneurysm rupture after adjustment for aneurysm size.

CONCLUSIONS

An aspect ratio of ≥1.6, area ratio of ≥1.5, and irregular wall are associated with aneurysm rupture independent of aneurysm size and patient characteristics. These characteristics alone can help in distinguishing ruptured bilateral intracranial aneurysms from unruptured ones.

Epsilon-aminocaproic acid improves postrecirculation hemodynamics by reducing intraliver activated protein C consumption in orthotopic liver transplantation

BACKGROUND

Activated protein C (APC) is related to regulating the inflammatory response and hemodynamic stability upon reperfusion in cardiac operations and orthotopic liver transplantation (OLT). Epsilon-aminocaproic acid (EACA) is frequently used to treat fibrinolysis during OLT. It also has inhibitory effects related to the inflammatory response. However, it remains to be determined whether EACA can attenuate intraliver APC consumption and improve hemodynamic stability after reperfusion during OLT.

METHODS

Fifty-nine recipients were randomized to receive either EACA (150 mg kg(-1) given intravenously prior to incision, followed by 15 mg kg(-1) h(-1) infusion until 2 h after the graft reperfusion) or the same volume of saline. Blood samples to assess plasma APC and protein C were obtained immediately before and after reperfusion from the inferior caval effluent or the portal veins for calculation of transliver differences (Δ). Hemodynamics and vasoactive medication use during the reperfusion period were observed in both groups.

RESULTS

No transhepatic changes in protein C were found in either group. Immediately after reperfusion, a marked intraliver consumption of APC was noted in all recipients (P < 0.001), and intraliver consumption of APC in the control group was greater than that in the EACA-treated group (P < 0.05). Fewer requirements for vasoactive medication use after reperfusion and better initial graft function were noted in the EACA-treated group (P < 0.05).

CONCLUSIONS

EACA can attenuate intraliver APC consumption and improve hemodynamic stability after reperfusion and initial graft function during OLT.

Interspecific variation in pollen-ovule ratio is negatively correlated with pollen transfer efficiency in a natural community

The pollination efficiency hypothesis has long been proposed as an explanation for interspecific variation in pollen-ovule (P:O) ratios. However, no empirical study on P:O ratios has directly and quantitatively measured pollen transfer efficiency (PE). Here, we use a PE index, defined as the proportion of pollen grains removed from anthers that are subsequently deposited on conspecific stigmas, as a direct and quantitative measure of PE. We investigated P:O ratios, pollen removal and pollen deposition in 26 plant species in an alpine meadow, over three consecutive years. Our community survey showed that nearly 5% of removed pollen was successfully deposited on conspecific stigmas. The PE index ranged from 0.01% up to 78.56% among species, and correlated negatively with the P:O ratio across years. This correlation was not changed by controlling for phylogenetic relationships among species, suggesting that the interspecific variation in P:O ratios can be attributed to the probability of pollen grains reaching a stigma. The results indicate that the pollination efficiency hypothesis can help to explain interspecific variation in P:O ratios.

Novel cerebellum-enriched miR-592 may play a role in neural progenitor cell differentiation and neuronal maturation through regulating Lrrc4c and Nfasc in rat

MicroRNAs (miRNAs) are a class of small non-encoding RNAs that regulate gene expression at the posttranscriptional level. MiRNAs may characterize not only specific stages of the development of the neural cell population in CNS, but also distinct types of neural cells. However, the common pathways of the neural enriched miRNAs involved in neurogenesis of specific cell lineages remain poorly understood. In this report, in order to get insights into the common role of the miRNAs shared by cerebellum and forebrain, we studied the regulatory mechanism of neural enriched-miRNA in neural progenitor cell (NPCs) differentiation. Here, we identified a new cerebellum-enriched rno-miR-592 in rat cerebellum. It showed that rno-miR-592 was a neural enriched miRNA and may play an important role in rat embryonic neurogenesis or/and astrogliogenesis. We used both gain-of -function and loss-of -function approaches to demonstrate that rno-miR-592 could change the balance between neuron- and astrocyte- like differentiation and neuronal morphology. We observed that miR-592 could induce astrogliogenesis differentiation arrest or/and enhance neurogenesis in vitro. Meanwhile, silencing of miR-592 was not beneficial for neuronal maturation. We also identified Lrrc4c and Nfasc as miR-592 target genes, and miR-592 could affect the changes of Lrrc4c and Nfasc expression levels, suggesting that these two target genes may be involved in miR-592 regulative function in NPCs differentiation and neuronal maturation. Thus, we conclude that rno-miR-592 may affect the neural lineage differentiation via reducing astrogliogenesis or/and enhancing neurogenesis at least in part through regulating its target genes Lrrc4c and Nfasc in vitro. Together, we report here for the first time the important role of miR-592 in rat NPCs differentiation and neuronal maturation.

Role of anhepatic time in endothelial-related coagulation in liver transplantation

BACKGROUND

Disturbances in coagulation homeostasis are common in patients undergoing orthotopic liver transplantation (OLT) and anhepatic period is one of the important factors related to the coagulation abnormalities. The endothelium can regulate hemostasisby producing substances such as thrombomodulin (TM). The primary aim was to evaluate the effect of an hepatic time on the thrombomodulin-protein C system in patients undergoing OLT.

METHODS

Fifty patients undergoing OLT were stratified in two groups: anhepatic time ≥ 60 min (N.=18) or anhepatic stage <60 min (N.=32). TM, protein C, activated protein C (APC) and (free) protein S plasma concentrations were measured by enzymelinked immunosorbent assays (ELISA) at the start of the surgery (To); immediately before the anhepatic period (A1); immediately before reperfusion (A2); 5 minutes; 15 minutes; 30 minutes after reperfusion of the graft (R1; R2; R3); at the end of operation (R4); the first day after operation (R5).

RESULTS

Blood loss and transfusion were significantly greater in patients whose anhepatic time ≥ 60 min during the operation. TM levels increased most in patients whose anhepatic time ≥ 60 min. Protein C levels remained low throughout the surgery and decreased significantly at other points compared with To (P<0.05). There were no differences in protein C levels between groups except R5. The ratio of circulating APC activity to protein C antigen (APC/PC) increased significantly during the surgery. APC/PC ratio in the neohepatic stage increased significantly in patients whose anhepatic time ≥ 60 min (P<0.05).

CONCLUSION

Patients with prolonged anhepatic time had greater changes in the thrombomodulin-protein C system.

RNAi-mediated knockdown of pituitary tumor- transforming gene-1 (PTTG1) suppresses the proliferation and invasive potential of PC3 human prostate cancer cells

Pituitary tumor-transforming gene-1 (PTTG1) is a proto-oncogene that promotes tumorigenesis and metastasis in numerous cell types and is overexpressed in a variety of human tumors. We have demonstrated that PTTG1 expression was up-regulated in both human prostate cancer specimens and prostate cancer cell lines. For a more direct assessment of the function of PTTG1 in prostate tumorigenesis, RNAi-mediated knockdown was used to selectively decrease PTTG1 expression in PC3 human prostate tumor cells. After three weeks of selection, colonies stably transfected with PTTG1-targeted RNAi (the knockdown PC3 cell line) or empty vector (the control PC3 cell line) were selected and expanded to investigate the role of PTTG1 expression in PC3 cell growth and invasion. Cell proliferation rate was significantly slower (28%) in the PTTG1 knockdown line after 6 days of growth as indicated by an MTT cell viability assay (P < 0.05). Similarly, a soft agar colony formation assay revealed significantly fewer (66.7%) PTTG1 knockdown PC3 cell colonies than control colonies after three weeks of growth. In addition, PTTG1 knockdown resulted in cell cycle arrest at G1 as indicated by fluorescence-activated cell sorting. The PTTG1 knockdown PC3 cell line also exhibited significantly reduced migration through Matrigel in a transwell assay of invasive potential, and down-regulation of PTTG1 could lead to increased sensitivity of these prostate cancer cells to a commonly used anticancer drug, taxol. Thus, PTTG1 expression is crucial for PC3 cell proliferation and invasion, and could be a promising new target for prostate cancer therapy.

Genetic polymorphism of the human cytochrome P450 2C9 gene and its clinical significance

Human cytochrome P450 2C9 (CYP2C9) accounts for approximately 20% of total hepatic CYP content and metabolizes approximately 15% clinically used drugs including S-warfarin, tolbutamide, phenytoin, losartan, diclofenac, and celecoxib. To date, there are at least 33 variants of CYP2C9 (*1B through to *34) being identified. CYP2C9*2 and CYP2C9*3 differ from the wild-type CYP2C9*1 by a single point mutation: CYP2C9*2 is characterised by a 430C>T exchange in exon 3 resulting in an Arg144Cys amino acid substitution, whereas CYP2C9*3 shows an exchange of 1075A>C in exon 7 causing an Ile359Leu substitution in the catalytic site of the enzyme. CYP2C9*2 is frequent among Caucasians with approximately 1% of the population being homozygous carriers and 22% heterozygous. The corresponding figures for the CYP2C9*3 allele are 0.4% and 15%, respectively. Worldwide, a number of other variants have also to be considered. The CYP2C9 polymorphisms are relevant for the efficacy and adverse effects of numerous nonsteroidal anti-inflammatory agents, sulfonylurea antidiabetic drugs and, most critically, oral anticoagulants belonging to the class of vitamin K epoxide reductase inhibitors. Numerous clinical studies have shown that the CYP2C9 polymorphism should be considered in warfarin therapy and practical algorithms how to consider it in therapy are available. These studies have highlighted the importance of the CYP2C9*2 and *3 alleles. Warfarin has served as a practical example of how pharmacogenetics can be utilized to achieve maximum efficacy and minimum toxicity. Polymorphisms in CYP2C9 have the potential to affect the toxicity of CYP2C9 drugs with somewhat lower therapeutic indices such as warfarin, phenytoin, and certain antidiabetic drugs. CYP2C9 is one of the clinically significant drug metabolising enzymes that demonstrates genetic variants with significant phenotype and clinical outcomes. Genetic testing of CYP2C9 is expected to have a role in predicting drug clearance and implementing individualized pharmacotherapy. Prospective clinical studies with large samples are required to establish gene-dose and gene-effect relatiohsips for CYP2C9.

Reduced recombination in gynodioecious populations of a facultative apomictic orchid

Many plants combine sexual reproduction with some form of asexual reproduction to different degrees, and lower genetic diversity is expected with asexuality. Moreover, the ratios of sexual morphs in species with gender dimorphism are expected to vary in proportion to the reproductive success of the sexual process. Hence, sex ratios can directly influence the genetic structure and diversity of a population. We investigated genotypic diversity in 23 populations of a facultative, apomictic gynodioecious orchid, Satyrium ciliatum, to examine the effect on genotypic diversity of variation in the frequency of females and in the amount of sexual reproduction. The study involved one pure female, seven gynodioecious (both females and hermaphrodites present) and 15 hermaphroditic populations. Pollinia receipt was higher in hermaphroditic than in gynodioecious populations. Analyses of variation in ISSRs demonstrated that genotypic diversity was high in all populations and was not significantly different between hermaphroditic and gynodioecious populations. We used character compatibility analysis to determine the extent to which recombination by sexual reproduction contributed to genotypic diversity. The results indicate that the contribution of recombination to genotypic diversity is higher in hermaphroditic than in gynodioecious populations, consistent with the finding that hermaphroditic populations received higher amounts of pollinia. Our finding of reduced recombination in gynodioecious populations suggests that maintenance of sex in hermaphrodites plays an important role in generating genotypic diversity in this apomictic orchid.

Plasma propofol concentrations during orthotopic liver transplantation

OBJECTIVE

The aim of this study was to investigate the changes in plasma concentrations of propofol in three phases (the paleohepatic, anhepatic, and neohepatic phases) during orthotopic liver transplantation (OLT) using target-controlled infusion (TCI).

METHODS

Ten patients undergoing OLT without venovenous bypass were studied (age 29-53 years, weight 56-79 kg). After intubation, a non-hypnotic target concentration of propofol 0.5 microg ml(-1) using a Diprifusor pump (Zeneca Pharmaceuticals, Macclesfield, UK) was administered as a supplement anesthesia throughout the procedure. Plasma samples were obtained in each phase for propofol assay, respectively. Performance parameters for the Diprifusor system in each phase, the percentage median performance error (MDPE), the percentage median absolute performance error (MDAPE), and the percentage median absolute constancy error (MDACE) were evaluated.

RESULTS

In all patients, measured plasma propofol concentrations were several times higher than Diprifusor values in each phase during the procedure. In nine patients, propofol concentrations in the anhepatic phase were higher than those in the paleohepatic or neohepatic phase (P < 0.05). There were no significant differences between the paleohepatic and neohepatic phases. Interindividual variation of the plasma propofol concentrations was significant (P < 0.05). Percentage median performance error of Diprifusor in each phase, as well as MDAPE, was large (>300%) and was significantly higher in the anhepatic phase (P < 0.01), whereas MDACE was relatively small and there was no significant difference between phases.

CONCLUSIONS

Models used by Diprifusor are not suitable for liver transplantation patients. A further study should be performed in order to determine all pharmacokinetic parameters of propofol in these patients.

[Prevention and treatment of the complications for whole-scale cataract surgery in rural hospitals]

OBJECTIVE

To investigate the method of prevention and treatment of the complications of cataract surgery carried out on a large scale concentrated effort in rural hospitals.

METHOD

The cataract extraction combined with intraocular lens (IOL) implantation in 394 eyes of 385 cases were analyzed in review.

RESULTS

In 394 eyes, IOL implanting rate was 86%, cornea edema was observed in 8 eyes, hemorrhage anterior chamber in 2 eyes, secondary glaucoma in 1 eye, and IOL ccentricity in 3 eyes. The corrected visual acuity of these patients after being discharged from hospitals was distinctly improved comparing with pre-operation (P < 0.01), the rate of visual acuity relieved from blindness was 98%, and the rate of visual acuity relieved from visual handicap was 86%.

CONCLUSION

The attentive examination before operation, careful manipulation at the time of operating and conscientious observation of treatment after operation are the keys of preventing and decreasing post-operation complications.

[Resection of odontoid process by transoccipitocervical posterolateral approach to treat old atlantoaxial dislocation]

OBJECTIVE

To explore a new surgical treatment of old atlantoaxial dislocation.

METHODS

5 patients aged 12 to 45 years, who suffered from old atlantoaxial dislocation for 1 to 4.5 years, received the new surgical treatment by the transoccipitocervical posterolateral approach, and expansion of the foramen magnum, odontectomy and bony fusion of the occipitoatlantoid region were performed. Neurological examinations and CT scan were undertaken after operation.

RESULTS

All 5 patients survived. Sensory function recovered almost completely and motor function was better more than 1 degree. CT scan showed the diameter of the spinal canal restored well.

CONCLUSION

The transoccipitocervical posterolateral approach is an ideal and safe pathway to reach the site of old atlantoaxial dislocation and the operating field is exposed completely. Anterior-posterior decompression and occipitocervical spinal fusion can be performed simultaneously.

Risk factors and early detection of lung cancer in a cohort of Chinese tin miners

PURPOSE

To examine risk factors and establish a biologic specimen and data bank for the study of early markers of lung cancer.

METHODS

We designed a dynamic cohort using an ongoing lung cancer screening program among radon- and arsenic-exposed tin miners in Yunnan China. Through the first four years of the study, 8,346 miners aged 40 years and older with over 10 years of occupational exposure have been enrolled, risk factors have been assessed, annual sputum and chest radiographs have been obtained, and numerous biologic specimens have been collected.

RESULTS

A total of 243 new lung cancer cases have been identified through 1995. Radon and arsenic exposures are the predominant risk factors, but lung cancer risk is also associated with chronic bronchitis and silicosis, as well as a number of exposure to tobacco smoke, including early age of first use, duration, and cumulative exposure. Tumor and sputum samples are being examined for early markers of lung cancer.

CONCLUSION

A cohort of occupationally-exposed tin miners with an extensive biologic specimen repository has been successfully established to simultaneously study the etiology and early detection of lung cancer.

MR appearance of the pseudocapsule of renal cell carcinoma and its pathologic basis

The pseudocapsule of renal cell carcinoma (RCC) appears as a low-intensity band or rim on magnetic resonance (MR) images. The frequency of its appearance differed on T1- and T2-weighted images. In our group of 19 RCC (in 18 patients), it appeared on 26.3% of T1-weighted images and on 57% of T2-weighted images. The pathology of the pseudocapsule on MR is its thickness and composition. On T1-weighted images, the appearance of the pseudocapsule is mainly related to the fibrous element, and on T2-weighted images to the fibrous element and compressed renal parenchyma.

Passive exercise system: effect on muscle activity, strength, and lean body mass

There is little information concerning the effects of passive exercise training in healthy humans. This prompted an investigation to evaluate muscle activity and the associated changes in strength and lean body mass resulting from a passive exercise program. Twenty-eight healthy volunteers, aged 26 to 44 years, participated in this six-week study. Lean body mass changes were evaluated by tetrapolar bioelectric impedance measurements, strength changes by isokinetic strength evaluation, and muscle activity by surface EMG techniques. Reproducible muscle activity was recorded in all three muscles studied during two of three preselected exercises. This involuntary muscle activity was attributed to fusimotor and postural reflexes. No significant change (p greater than .05), however, occurred in muscle strength or lean body mass at the end of the six weeks. Lack of these physiologic changes in light of the documented muscle activity is attributed to insufficient training effect.

[Autoimmune reaction factors of infertility in patients with endometriosis]

The presence of immunoprotein depositions in endometrium and antiendometrial autoantibodies in serum was detected in 59 infertile patients with endometriosis, 45 infertile patients without endometriosis and 11 fertile women by the methods of immunohistochemistry determination and immunodiffusion assay. The immunoprotein depositions in endometrium of endometriosis were significantly increased. The antiendometrial auto-antibodies in serum were positive in 32.2% for infertile patients with endometriosis, 6.7% for infertile patients without endometriosis and 0% for fertile women. This suggested that an autoimmune response might be an etiologic factor of infertility in patients with endometriosis.

[Significance of the serum level of Cu, Zn, Mn, Cr and Ni in acute leukemia]

Serum Cu and Ni increase, while serum Zn and Mn decrease in acute leukemia patients. The results of this study showed that there is correlation between the change of the level of serum Ni and the condition of the patient. Higher level of serum Ni in patients with acute leukemia indicates inefficient chemotherapy and poor prognosis. The results suggest that the level of serum Ni may be used as an in acute leukemia. Increase of serum Ni with simultaneous decrease of serum Mn may be an instinctive reflection in acute leukemia.

[A new athraquinone compound from the stem and leaves of Tripterygium wilf or dii Hook. f]

A new anthraquinone compound was isolated from the stem and leaves of Thipterygium wilfordii. The structure was elucidated to be 1,8-dihydroxy-4-hydroxymethylanthraquinone on the basis of UV-VIS,IR,HNMR and MS analysis.

[Surgical treatment of intracranial venous sinus injury. A report of 111 cases]

The article analysed 111 cases of intracranial venous sinus injury which were treated in recent 26 years. The cure rate is 77.5% and the mortality rate is 22.5%. The diagnosis and treatment of intracranial venous sinus injury were discussed. Some principles for repairing the lacerations and surgical techniques were introduced. Temporary extracranial shunt of superior sagittal sinus to control bleeding during operation was recommended also.

[Occult lung cancer with positive cytology and normal chest film--an analysis of 54 cases]

From 1973 to 1980 and 1982 to 1984, mass annual screening was carried out in Yunnan Tin Corporation. Chest X-ray and sputum cytology were used to detect lung cancer among subjects with an underground work history over 10 years and over 40 years of age. 54 cases of occult lung cancer with positive cytology and negative X-ray plain film were found, 48 out of 100,725 subjects and 6 out ot 8,808 out-patients. 42 lesions were located by bronchoscopy and 12 by various roentgenologic examinations. Among these 54 cases, 52 (96.3%) were central type lung cancers. Squamous cell carcinoma was found in 53 and small cell anaplastic carcinoma in only 1. Diagnosis was established by pathology in 35 and by cytology in 19. In 18 cases treated by surgery, there were 15 Ia stage and 3 Ib (UICC staging system). 3 Ib died of recurrence 33, 62 and 101 months after operation. 1 Ia died of residual cancer recurrence 21 months after sleeve-resection. The overall 5 year survival rate was 91.6% (11/12). The authors believe that X-ray plain films sometimes fail to detect the early stage central type lung cancers. Bronchoscopy, in particular fiberoptic bronchoscopy is one of the most effective means in diagnosis and location. By bronchoscopy, in general, the tumor could be detected and the extent of involvement in the bronchus assessed. Finally, the authors emphasize that mass screening is a useful method to detect early lung cancer among the high risk population.

[Fibrobronchoscopy in lung cancer--an analysis of 560 cases]

560 cases of lung cancer were detected from 1100 cases examined by fibrobronchoscopy. 91.2% of these cases were diagnosed by histology or/and cytology. 71.9% were squamous cell carcinoma. The fibrobronchoscopy gave a positive detection rate of 89.8%, and in 51.1% of cases, it was able to see the tumor or the tumor with necrosis. The positive rate of the cellular brushings was 48%, and that of biopsy, 73.7%. The fibrobronchoscopy is most efficient in localizing the occult lung cancer (positive cytology but negative chest films). The false negative causes of the biopsy or cellular brushings are discussed.