Suture clamping of intraocular lenses without a scleral flap: A new implantation method for patients with an aphakic capsule

We aim to describe a technique for intraocular lens (IOL) implantation with suture clamping for aphakic capsules. This prospective, noncomparative, interventional case study included three eyes of three patients with an aphakic capsule after vitrectomy, in which the IOL was clamped by suturing. The suturing procedure was transconjunctival or subconjunctival performed without scleral flaps. The IOLs were implanted without difficulty, and visual acuity improved after IOL implantation. There were no severe complications, and the position of each IOL remained correct through 18 months of follow-up. The present technique is straightforward and effective in the treatment of eyes with an aphakic capsule.

Choroidal metastatic mucinous abscess caused by Pseudomonas aeruginosa: A case report

BACKGROUND

Pseudomonas aeruginosa (P. aeruginosa) is considered a common pathogenic bacterium. Choroidal metastatic mucinous abscess caused by P. aeruginosa is rarely reported.

CASE SUMMARY

We describe the diagnostic and treatment processes of a case involving a complex choroidal space-occupying lesion. Our analyses of early clinical manifestations revealed a high possibility of choroidal melanoma, as indicated by the choroidal space-occupying lesion and uveitis. Further magnetic resonance imaging results revealed no positive evidence for the diagnosis of choroidal melanoma. The exact properties of the space-occupying lesion could not be ascertained prior to surgery. However, the lesion was subsequently confirmed as a metastatic abscess by diagnostic vitrectomy. The occupying lesion was found to occupy 75% of the vitreous cavity in the surgery. The entire white viscous tissue was completely removed, and the necrotic retina was cleaned up. After surgery, microbiological culture revealed mucoid P. aeruginosa, which was sensitive to a variety of antibiotics. The bacterial infection grew and disseminated towards the outside of the eye. After the fifth injection, the left eye was successfully retained.

CONCLUSION

This is a peculiar case because a huge, local, space-occupying lesion had formed due to the dissemination of low-toxic mucinous P. aeruginosa in the blood from the lungs to the choroid. After surgical removal, the bacteria were able to re-grow; thus, local infection re-spread following surgery. The patient lost vision, but we managed to retain the full structure of the eyeball and eliminated the focus of infection.

CIHH protects the heart against left ventricular remodelling and myocardial fibrosis by balancing the renin-angiotensin system in SHR

AIM

The aim of our study was to clarify the cardioprotection of chronic intermittent hypobaric hypoxia (CIHH) and the underlying mechanism in spontaneously hypertensive rats (SHR).

MAIN METHODS

Adult male rats were divided into normal blood pressure Wistar-Kyoto rats (WKY) control (WKY-CON), WKY rats with CIHH treatment (WKY-CIHH), SHR control (SHR-CON) and SHR with CIHH treatment (SHR-CIHH) groups. SHR-CIHH and WKY-CIHH rats were subjected to hypobaric hypoxia simulating 4000-m altitude for 35 days, 5 h per day. Arterial blood pressure and cardiac function parameters, including ejection fraction, fractional shortening and left ventricular (LV) wall thickness, were evaluated. Cardiac pathomorphology and myocardial fibrosis were determined. The expression of angiotensin-converting enzyme (ACE), ACE2, Ang II, Ang1-7, AT1 receptor, Mas receptor, IL-6, TNF-α，IL-10, SOD and MDA were assayed in myocardium.

KEY FINDINGS

CIHH significantly decreased arterial blood pressure, alleviated LV hypertrophy, and improved cardiovascular function in SHR (P < 0.05-0.01). Also, CIHH protected SHR heart against morphological changes and fibrosis. In addition, CIHH significantly down-regulated the ACE/Ang II/AT1 receptor axis and up-regulated the ACE2/Ang1-7/Mas axis of renin-angiotensin system (RAS) in SHR (P < 0.05-0.01). CIHH significantly reduced IL-6, TNF-α, and MDA levels, but increased IL-10 and SOD in SHR myocardium (P < 0.05-0.01).

SIGNIFICANCE

The CIHH treatment protected the heart of SHR against LV remodelling and myocardial fibrosis, which might be carried out through a balance in the ACE/Ang II/AT1 axis and the ACE2/Ang1-7/Mas axis of the RAS to reduce inflammation, and inhibit oxidative stress.

The Kv12 voltage-gated K+ channels are expressed in the Phox2b-expressing neurons in the nucleus tractus solitarii in mice

Accumulating evidence demonstrates that the nucleus tractus solitarii (NTS) neurons serve as central respiratory chemoreceptors, but the underlying molecular mechanisms remain undefined. The present study investigated the expression of acid-sensitive ether-à-go-go-gene-like (Elk, Kv12) channels in the NTS of mice. Immunofluorescence staining was used to observe the distribution and cellular localization of the Kv12 channels in NTS neurons. Western blot and quantitative real-time PCR (qPCR) were used to evaluate protein and mRNA expression levels of Kv12 channels. The results showed that all of the three members (Kv12.1, Kv12.2, Kv12.3) of the Kv12 channel family were expressed in NTS neurons, and their expressions were co-localized with paired-like homeobox 2b gene (Phox2b) expression. The expression of Kv12.1 mRNA was the largest, whereas the expression of Kv12.3 was the least in the NTS. The results suggest Kv12 channels are expressed in Phox2b-expressing neurons in the NTS of mice, which provides molecular evidence for pH sensitivity in Phox2b-expressing NTS neurons.

Delayed seroreversion of specifical antibody against HIV in HIV-exposed infants: A retrospective cohort study

OBJECTIVES

To investigate the seroreversion time in HIV-1-exposed but uninfected infants from two tertiary hospitals in China.

METHODS

This study retrospectively investigated the data of perinatal, HIV-1-exposed infants from hospitals in Beijing and Shenzhen. Maternal and infant medical records from both hospitals from January 2009 to December 2019 were reviewed, and the HIV antibody seroreversion times of infants were determined. From 2009 to 2019, a total of 485 HIV-1-exposed but uninfected infants were enrolled. The majority of infants were born at term with normal birth weight.

RESULTS

The seroreversion rates were 89.3%, 94.2% and 100% at 12, 18 and 24 months of age, respectively. There were no significant associations between seroreversion and several risk factors, such as gender, birth weight, gestational age, mode of delivery, postpartum prophylaxis and antiretroviral treatment duration. The mean value of HIV-specific immunoglobulin G concentration decreased from 15.4 at day 42 to 0.03 after 24 months in HIV-exposed, uninfected infants.

CONCLUSIONS

Clearance of HIV antibodies could take more than 18 months in a small number of perinatally exposed infants. Caution should be used in excluding or diagnosing perinatal HIV infection in children with long persistence of HIV antibodies.

[Clinical study on the accuracy of occlusal contacts on digital model]

Objective: To explore the accuracy of occlusal contacts on digital model made by intraoral scanner. Methods: Twenty healthy subjects [6 males, 14 females, (24.4±1.4) years old] with intact dentition were randomly recruited from postgraduate students in Capital Medical University School of Stomatology who volunteered to participate in this study. For each participant, the 2nd and 3rd quadrant of natural dentition was scanned. A diagnostic test design was performed. The occlusal contacts of the maximal intercuspal position (MIP) were extracted with the transillumination of silicone interocclusal records, and the extraction threshold was set as ≤50 μm. Intraoral scanning system was used to scan in MIP and generate occlusal contacts on digital model. Five groups were designed as test groups according to included tooth position: group 1 (buccal scanning ranged from tooth 21 to 23), group 2 (buccal scanning ranged from tooth 23 to 26), group 3 (buccal scanning ranged from tooth 24 to 26), group 4 (buccal scanning ranged from tooth 25 to 26), group 5 (buccal scanning ranged from tooth 21 to 26). Five groups occlusal contacts on digital model were generated respectively. According to the relevant literature, the upper occlusal surface was divided into 28 partitions, and the accuracy of occlusal contacts on digital model was calculated with the transillumination of silicone interocclusal records as the reference standard. Subgroup analysis was performed according to anterior teeth area, premolars area and molars area. Results: The accuracy of occlusal contacts on digital models of the half dentition in five buccal scanning positions were: group 1 (86.8%), group 2 (92.0%), group 3 (90.7%), group 4 (91.1%), group 5 (90.4%), and the accuracy of occlusal contacts in group 1 was significantly lower than those in the other four groups (P<0.05). The accuracy of anterior teeth area were 85.6%-93.9%; the accuracy of premolar area were 92.5%-94.4%; the accuracy of molar area were 77.3%-93.6%, group 1 was significantly lower than those in the group 4 in molars area (P<0.05), the accuracy of anterior area was statistically less than premolars area and molars area in group 1 (P<0.05). There was no statistical difference in pairwise comparison between the three sections (P>0.05). Conclusions: The digital models scanned intraoral methods provide accurate, quantitative measures of occlusal contacts when transillumination contacts are the reference standard.

[Prevalence and risk factors of ischemic stroke in rural areas of Liaoning province]

Objective: To explore the prevalence and risk factors of ischemic stroke in rural areas of Liaoning province. Methods: The study was a cross-sectional survey. From September 2017 to May 2018, a total of 10 926 rural residents aged ≥40 years were investigated in Chaoyang county, Lingyuan, Liaoyang county and Donggang city of Liaoning province. The investigation included questionnaire survey, physical examination and laboratory examination.Univariate and multivariate logistic regression models were used to analyze the risk factors of ischemic stroke. Results: The prevalence of ischemic stroke in the rural areas of Liaoning province was 5.51% (602/10 926), and the standardized prevalence rate was 4.04%. The standardized prevalence rate of male (5.05%) is higher than that of female (3.44%). The prevalence of ischemic stroke increased with age in both males (P<0.01) and females (P<0.01). Multivariate logistic regression analysis showed that age increase(compared with 40-49 years old group, 50-59 years old, OR=2.08, 95%CI 1.31-3.30, P=0.02; 60-69 years old, OR=3.90, 95%CI 2.51-6.05, P<0.01; 70-79 years old, OR=5.32, 95%CI 3.37-8.34, P<0.01; ≥80 years old, OR=3.64, 95%CI 2.00-6.62, P<0.01), male(OR=2.35, 95%CI 1.95-2.84, P<0.01),family history of stroke(OR=2.18, 95%CI 1.83-2.60, P<0.01),coronary heart disease (OR=2.01, 95%CI 1.52-2.66, P<0.01), hypertension (OR=2.82, 95%CI 2.21-3.60, P<0.01), diabetes mellitus (OR=1.36, 95%CI 1.11-1.67, P=0.03) and overweight/obese (OR=1.22, 95%CI 1.02-1.47, P=0.03) were the major risk factors of ischemic stroke. Conclusions: The prevalence of ischemic stroke in rural areas of Liaoning province is high. Age, male, family history of stroke, coronary heart disease, hypertension, diabetes mellitus, overweight/obesity are the risk factors of ischemic stroke in rural areas of Liaoning province.

Elevated expression of the leptin receptor ob‑R may contribute to inflammation in patients with ulcerative colitis

The effect of leptin on ulcerative colitis (UC) has been controversial. The present study aimed to investigate the role of leptin and its receptor ob‑R in UC and the underlying mechanism of this role. The level of serum leptin and the protein expression of the leptin receptor ob‑R in the colonic mucosa were determined in patients with UC. Experimental colitis was induced through intrarectal administration of 2,4,6‑trinitrobenzene sulfonic acid (TNBS) in leptin receptor‑deficient Zucker rats (LR‑D). The body weight, disease activity index, colon length, and macroscopic and histopathological appearance were evaluated. Furthermore, the myeloperoxidase (MPO) enzyme activity and cytokine levels in colon tissues were also determined. The expression of the signal transducer and activator of transcription 3 (STAT3), phosphorylated STAT3 (p‑STAT3), nuclear factor (NF)‑κB‑p65, and Ras homolog gene family member A (RhoA) proteins in colon tissues was assessed. The results revealed that the expression of the leptin receptor ob‑R was increased in the colonic mucosa but the serum leptin level was not altered in patients with UC compared with healthy volunteers. The severity of experimental colitis, represented by body weight loss, disease activity index, colon length, and macroscopic and histological changes, was ameliorated in LR‑D rats compared with the wild‑type (WT) rats. Moreover, the MPO activity; levels of cytokines including interleukin (IL)‑1β, IL‑6, and tumor necrosis factor‑α; and expression of p‑STAT3, NF‑κB, and RhoA proteins were reduced in colon tissues of LR‑D rats compared with WT rats. In conclusion, activation of the leptin receptor ob‑R is an important pathogenic mechanism of UC, and leptin receptor deficiency may provide resistance against TNBS‑induced colitis by inhibiting the NF‑κB and RhoA signaling pathways.

Amplified cardiorespiratory activity by hypoxia in conscious spontaneously hypertensive rats

Activation of peripheral respiratory chemoreceptors provokes respiratory and cardiovascular reflexes, providing a novel understanding of pathogenic mechanism of hypertension. Here we hypothesize that activation of peripheral respiratory chemoreceptors by hypoxia causes enhanced cardiorespiratory activity in conscious spontaneously hypertensive rats (SHRs). Using whole body plethysmography in combination with radio telemetry, pulmonary ventilation, arterial blood pressure and heart rate were examined in SHRs and Wistar-Kyoto (WKY) rats. We found that exposure to hypoxia induced greater increases in tidal volume and minute ventilation volume in SHRs compared to WKY rats. In addition, hypoxia caused a robust increase in arterial blood pressure and heart rate in SHRs relative to WKY counterparts. After carotid body denervation, the hypoxic ventilatory response was significantly decreased in both SHRs and WKY rats, but without significant difference between the two strains; moreover, the differences of arterial blood pressure and heart rate changes during hypoxic exposure were statistically insignificant between SHRs and WKY rats. It is concluded that hypoxia remarkably potentiates cardiorespiratory activity in the SHRs, suggesting an enhanced sensitivity of carotid bodies to hypoxia.

Chronic intermittent hypobaric hypoxia attenuates skeletal muscle ischemia-reperfusion injury in mice

AIM

The aim of this study was to investigate the protective effect of chronic intermittent hypobaric hypoxia (CIHH) against skeletal muscle ischemia-reperfusion (IR) injury and to determine the underlying mechanism.

MAIN METHODS

C57BL/6 mice were randomly divided into 3 groups: skeletal muscle IR injury group (IR), CIHH pretreatment following IR group (IR + CIHH), and sham operation group (Sham). The skeletal muscle IR injury model was induced by the unilateral application of a tourniquet on a hind limb for 3 h and then releasing it for 24 h. CIHH pretreatment simulating a 5000-m altitude was applied 6 h per day for 28 days. The functional and morphological performance of IR-injured gastrocnemius muscle was evaluated using contraction force, H&E staining, and transmission electron microscopy. IR injury-induced CD68⁺ macrophage infiltration was assessed by immunofluorescence. TNFα levels in serum and muscle were measured by ELISA and western blotting, respectively. Apoptosis was examined by TUNEL staining and Cleaved Caspase-3 protein expression.

KEY FINDINGS

Acute IR injury resulted in reduced contraction tension, morphological destruction, macrophage infiltration, increased TNFα levels, and apoptosis in gastrocnemius muscle. CIHH pretreatment significantly ameliorated contraction function and morphological performance in IR-injured skeletal muscle. In addition, CIHH pretreatment resulted in marked decreases in CD68⁺ macrophage infiltration, TNFα levels, and apoptosis.

SIGNIFICANCE

These data demonstrated that CIHH has a protective effect against acute IR injury in skeletal muscle via inhibition of inflammation and apoptosis.

Chronic Intermittent Hypobaric Hypoxia Ameliorates Renal Vascular Hypertension Through Up-regulating NOS in Nucleus Tractus Solitarii

Chronic intermittent hypobaric hypoxia (CIHH) is known to have an anti-hypertensive effect, which might be related to modulation of the baroreflex in rats with renal vascular hypertension (RVH). In this study, RVH was induced by the 2-kidney-1-clip method (2K1C) in adult male Sprague-Dawley rats. The rats were then treated with hypobaric hypoxia simulating 5000 m altitude for 6 h/day for 28 days. The arterial blood pressure (ABP), heart rate (HR), and renal sympathetic nerve activity (RSNA) were measured before and after microinjection of L-arginine into the nucleus tractus solitarii (NTS) in anesthetized rats. Evoked excitatory postsynaptic currents (eEPSCs) and spontaneous EPSCs (sEPSCs) were recorded in anterogradely-labeled NTS neurons receiving baroreceptor afferents. We measured the protein expression of neuronal nitric oxide synthase (nNOS) and endothelial NOS (eNOS) in the NTS. The results showed that the ABP in RVH rats was significantly lower after CIHH treatment. The inhibition of ABP, HR, and RSNA induced by L-arginine was less in RVH rats than in sham rats, and greater in the CIHH-treated RVH rats than the untreated RVH rats. The eEPSC amplitude in NTS neurons receiving baroreceptor afferents was lower in the RVH rats than in the sham rats and recovered after CIHH. The protein expression of nNOS and eNOS in the NTS was lower in the RVH rats than in the sham rats and this decrease was reversed by CIHH. In short, CIHH treatment decreases ABP in RVH rats via up-regulating NOS expression in the NTS.

[Application of RapidHIT™ 200 System in Forensic Medicine]

OBJECTIVES

To validate the analysis capability of RapidHIT™ 200 system for four kinds of routine forensic samples and the recyclable capability of template, template DNA and PCR products in the process of twice duplicate detection.

METHODS

The buccal swabs underwent the test twice by RapidHIT™ 200 system, and the template DNA and PCR products that arose in the system were also tested for two times. After four kinds of routine forensic samples were detected by RapidHIT™ 200 system, the follow-up tests of the template, template DNA and PCR products that arose in the system were performed.

RESULTS

The STR loci could be detected in the buccal swabs by the system for the first time. However, part of the STR loci lost during the second test. And the peak value obtained in the second test was significantly reduced than the one in the first time. The average STR loci detection rates of the template DNA and PCR products were both less than 50% in the second test, which were significantly reduced than that in the first test. In addition, the analysis capability of the system for the tissues and buccal swabs was better than that for the blood and cigarette butts. Compared with the first test, the STR loci detection rate of the tested items, template DNA and PCR products decreased with the numbers of tests.

CONCLUSIONS

RapidHIT™ 200 system is more effective in retesting buccal swabs than other samples, whereas the items, DNA template, PCR products obtained in the first and second time cannot be directly used for the further application and study of forensic medicine.

Effects of subpressure on the sealing ability of dental sealant in vitro

OBJECTIVES

Pits and fissures sealing with flowable materials is a popular method for preventing caries in preventive dentistry while there is still microleakage existed. This in vitro study aimed to explore the effects of subpressure technique on the sealing ability of pit and fissure sealant.

MATERIALS AND METHODS

One hundred and forty-one extracted human premolars were collected in this study and treated with different pressure (atmosphere pressure as group C, -0.04 MPa as group S₄ and -0.08 MPa as group S₈). Thermocycling (×5000) was also performed. Penetration percentage, microleakage, cross-sectional microhardness (Knoop, KMH) and mineral loss were evaluated. Kappa tests, Friedman nonparametric and two-way ANOVA were used for data analysis.

RESULTS

Penetration percentages of group S₄ and S₈ were significant higher compared to that of group C. Microleakage of groups was similar before thermocycling, while subpressure groups showed lower scale of microleakage after thermocycling. Data of KMH and mineral loss showed significant differences between subpressure and thermocycling groups.

SIGNIFICANCE

Subpressure technique could increase the penetration of pit and fissure sealant, decrease microleakage and increase resistance of demineralization after thermocycling. This novel technique may have great potential for preventing from secondary caries.

Chronic intermittent hypobaric hypoxia ameliorates diabetic nephropathy through enhancing HIF1 signaling in rats

AIM

Our previous study demonstrated that chronic intermittent hypobaric hypoxia (CIHH) had anti-diabetes effect. The present study was to explore the renal protective effect of CIHH in diabetic rats.

METHODS

Sprague-Dawley rats were randomly divided into three groups: diabetes mellitus group (DM, induced by high-fat diet combined with low-dose streptozotocin), diabetes plus CIHH treatment group (DM+CIHH, simulated 5000-m altitude, 6h per day for 28days, after diabetes model confirmed) and control group (CON). Systolic arterial blood pressure (SAP), blood biochemicals, urinary albumin, and histopathology of kidney were determined. The superoxide dismutase (SOD) activity, malondialdehyde (MDA) level, protein levels of hypoxia induced factors (HIFs) and transforming growth factor β1 (TGF-β1) in kidney were assayed.

RESULTS

The increased SAP, urinary albumin, hyperplasia of glomerular, fibrosis in mesangial and glomerular, and abnormal lipid metabolism in diabetic rats were ameliorated by CIHH treatment. And decreased superoxide dismutase (SOD) activity and increased malondialdehyde (MDA) level in diabetic kidney were reversed in CIHH-treated DM rats. In addition up-regulated TGF-β1 and down-regulated HIF1α in diabetic kidney returned back to normal level in CIHH-treated DM rats.

CONCLUSIONS

These data demonstrated for the first time that CIHH had protective effects against the early stage damage of diabetic nephropathy through activating HIF1 signaling, improving anti-oxidation and inhibiting TGF-β1 signaling in diabetic rats.

Chronic intermittent hypobaric hypoxia antagonizes renal vascular hypertension by enhancement of vasorelaxation via activating BKCa

AIM

The purpose of the present study was to explore anti-hypertensive effect of chronic intermittent hypobaric hypoxia (CIHH) in renovascular hypertension (RVH) rats, as well as the role of large-conductance calcium-activated potassium channel (BKCa) in anti-hypertensive effect of CIHH.

MAIN METHODS

Male adult age- and body weight-matched Sprague-Dawley rats were divided into SHAM, CIHH, RVH and RVH+CIHH groups. Hypertension was induced by two-kidney-1-clip method (2K1C) in RVH rats. CIHH rats were exposed to 28-days hypobaric hypoxia simulating 5000m altitude, 6h daily. SHAM rats got an operation without 2K1C, and RVH+CIHH rats received CIHH treatment after 2K1C. The endothelium-dependent vasorelaxation induced by acetylcholine (ACh), BKCa currents in smooth muscle cells (VSMCs) of mesenteric arteries and the protein expression of BKCa in mesenteric arteries was examined.

KEY FINDINGS

The systolic arterial blood pressure (SAP) in RVH rats was higher than that in SHAM rats and CIHH treatment significantly decreased SAP in RVH rats. The enhanced vasorelaxation of mesenteric artery in CIHH-treated RVH rats was cancelled by BKCa blocker IBTX. The vasorelaxation induced by BKCa activator was reduced in RVH rats and the decreased vasorelaxation was improved by CIHH treatment. The β1 subunit of BKCa in mesenteric artery was upregulated and BKCa current in VSMCs was increased in CIHH-treated RVH rats compared with RVH rats.

SIGNIFICANCE

In conclusion, CIHH treatment enhances the relaxation of mesenteric artery through activation of BKCavia up-regulating β1 subunit of BKCa, which might be one of mechanisms for anti-hypertensive effect of CIHH in RVH rats.

Beneficial Effects of Hypoxic Preconditioning on Human Umbilical Cord Mesenchymal Stem Cells

As human umbilical cord mesenchymal stem cells (hUC-MSCs) transplanation may be promising in heart failure treatment, it is important to know whether hypoxic preconditioning (HP) promote hUC-MSCs proliferation and differentiation and protect them against chemical hypoxic damages. This study aimed to investigate the effects of HP on proliferation and differentiation of human umbilical cord mesenchymal stem cells (hUC-MSCs). The study also aimed to confirm our hypothesis that HP could promote hUC-MSCs proliferation and differentiation to cardiomyocyte-like cells as well as effectively protecting hUC-MSCs and cardiomyocyte-like cells against chemical hypoxic damages. Isolated hUC-MSCs were cultured in hypoxia at 1%, 3% and 5% O₂ for 72 hours. 5-azacytidine (5-AZA) induced differentiation of hUC-MSCs to cardiomyocyte-like cells was determined by streptavidin-perosidase (SP) immunohistochemical staining and the content of troponin (TnI). Flow cytometry was used to measure cell cycle in hUC-MSCs and cardiomyocyte-like cells. The mitochondrial membrane potential (ΔΨ(m)) and mitochondrial Ca²⁺ concentration ([Ca²⁺](m)), were measured in hUC-MSCs and cardiomyocyte-like cells during chemical hypoxia induced by cobalt chloride (100 μmol/L). HP optimally promoted the proliferation of hUC-MSCs at 3% O₂ and enhanced the differentiation of hUC-MSCs to cardiomyocyte-like cells by 5-AZA in a concentration-dependent manner. The cell cycle distribution of cardiomyocyte-like cells, but not hUC-MSCs, was clearly changed by HP. Chemical hypoxic damage, decreased ΔΨ(m) and increased [Ca²⁺](m), were alleviated significantly in HP-treated cells compared with the normaxia-treated cells. The results demonstrate that HP promoted hUC-MSCs proliferation and differentiation to cardiomyocyte-like cells, and protected both cell types against chemical hypoxic damage.

Photon-conversion and sensitization evaluation of Eu³⁺ in a borate glass system

Photon conversion is exhibited in a borate (LKZBSB) glass system containing Eu(3+), and the enhanced characteristic emissions of Eu(3+) with the codoping of Ce(3+) have been verified. A large Judd-Ofelt intensity parameter Ω2 of Eu(3+) indicates a high asymmetrical and strong covalent environment around rare-earth (RE) ions in LKZBSB glasses and spontaneous emission probability and a maximum emission cross section of the dominant 5D0→7F2 transition were derived to be 370  s(-1) and 1.28×10(-21)  cm2, respectively, revealing the potential UV→visible photon-conversion capacity of Eu(3+). Absolutely quantitative evaluation illustrates that Eu(3+) is a favorable photon-conversion center to achieve high photon-conversion efficiency. The addition of Ce(3+) is beneficial to realizing effective red emission of Eu(3+), which possesses commercial value by decreasing the dopant of expensive europium compounds. As an expectation, this photon-conversion LKZBSB glass system can promote the development of a photon downconversion layer for solar cells, which are particularly used in outer space with intense UV radiation.

Clinical observation on removal of small foreign bodies touching the optic nerve in the deep orbital region: a case series

PURPOSE

Five patients presented to our institution with deep intraorbital foreign bodies adjacent to the optic nerve. We removed all foreign bodies by lateral orbitotomy to evaluate the treatment and the benefits of their extraction.

METHODS

The clinical outcomes of the five patients were retrospectively analyzed.

RESULTS

Radiology in all five patients revealed small foreign bodies touching the optic nerve in the deep orbital region. All patients also suffered from significant secondary psychological disturbances, these including anxiety and altered sleep patterns. They had become preoccupied with a strong desire to remove the intraorbital foreign bodies [IFB]. In this cohort, two had no light perception before surgery, another two had light perception, and one had hand motion perception as well as vitreous hemorrhage that had been plugged with silicone oil in other hospital. All foreign bodies were removed via lateral orbitotomy. Visual acuity improved after the operation in only three cases. However, the psychological well-being of all five patients improved.

CONCLUSIONS

Consideration should be given to removal of intraorbital foreign bodies adjacent to the optic nerve, even where a significant degree of vision has already been lost. Furthermore some patients can achieved vision improvement and such surgery can frequently address the significant psychological disturbance that can be associated with such orbital foreign bodies.

Adhesion of cavernous hemangioma in the orbit revealed by CT and MRI: analysis of 97 cases

AIM

To assess features of cavernous hemangioma (CH) in the orbit revealed by CT and MRI and summarize prediction of preoperative CT and MRI for the adhesion degree of CH in the orbit.

METHODS

A total of 97 patients with pathologically confirmed CH in the orbit were examined with axial and coronal CT scan, and axial, coronal, sagittal, and enhanced fat suppression MRI scan. CT and MRI findings and intraoperative adhesion degrees were retrospectively analyzed.

RESULTS

There were 47 patients with slight adhesion, for whom CT and MRI showed round masses with well defined margins in the extraocular muscles; 14 patients with mild adhesion, for whom CT and MRI revealed irregular masses with unclear boundary between CH and the optic nerve in coronal images, and emissary veins in the posterior region of masses in contrast-enhanced images; 36 patients with severe adhesion, for whom CT and MRI exhibited an irregular or ovoid mass filling the orbital apex, or showed distorted and even spiky margins in the posterior region of masses in contrast enhanced images at the presence of a transparent triangle between the mass and the orbital apex.

CONCLUSION

Preoperative CT and MRI aid in accurate diagnosis, selection of the surgical approach, and assessment of the adhesion degree and surgical risks for CH.

Use of novel monoclonal antibodies to determine the expression and distribution of the hypoxia regulatory factors PHD-1, PHD-2, PHD-3 and FIH in normal and neoplastic human tissues

AIMS

The cellular response to hypoxia includes the hypoxia inducible factor (HIF)-induced transcription of genes involved in diverse processes such as glycolysis, angiogenesis and the growth of experimental tumours. Regulation of the level of hypoxia inducible factors 1alpha and 2alpha (HIF-1alpha and HIF-2alpha) is a primary determinant of HIF activity. Recent biochemical and candidate gene approach studies have led to the discovery of three HIF-regulatory prolyl hydroxylases, PHD-1, -2 and -3 and an asparaginyl hydroxylase, also known as FIH (factor inhibiting HIF). In this study, we raised and characterized monoclonal antibodies against PHD-1, PHD-2, PHD-3 and FIH.

METHODS AND RESULTS

Immunohistochemistry of normal tissues with these monoclonal antibodies demonstrated a wide distribution in epithelial cells, stromal cells and leucocytes, with cytoplasmic staining predominating over nuclear staining. A preliminary study of tumours showed variable staining in tumour, stromal and inflammatory cells. While all tumour types showed some positive staining with each antibody, the overall pattern suggested a slight decrease in the amount of staining seen with PHD-1, -2 and -3 and an increase in FIH staining in neoplasia compared with corresponding normal tissues.

CONCLUSIONS

These monoclonal antibodies will allow further larger scale studies to determine the significance of PHD and FIH expression in neoplasia.

C. elegans EGL-9 and mammalian homologs define a family of dioxygenases that regulate HIF by prolyl hydroxylation

HIF is a transcriptional complex that plays a central role in mammalian oxygen homeostasis. Recent studies have defined posttranslational modification by prolyl hydroxylation as a key regulatory event that targets HIF-alpha subunits for proteasomal destruction via the von Hippel-Lindau ubiquitylation complex. Here, we define a conserved HIF-VHL-prolyl hydroxylase pathway in C. elegans, and use a genetic approach to identify EGL-9 as a dioxygenase that regulates HIF by prolyl hydroxylation. In mammalian cells, we show that the HIF-prolyl hydroxylases are represented by a series of isoforms bearing a conserved 2-histidine-1-carboxylate iron coordination motif at the catalytic site. Direct modulation of recombinant enzyme activity by graded hypoxia, iron chelation, and cobaltous ions mirrors the characteristics of HIF induction in vivo, fulfilling requirements for these enzymes being oxygen sensors that regulate HIF.

Rejuvenation of degenerative thymus by oral melatonin administration and the antagonistic action of melatonin against hydroxyl radical-induced apoptosis of cultured thymocytes in mice

The effect of melatonin on age-related thymic involution and apoptosis induced by hydroxyl radicals (*OH) in mouse thymocyte cultures was investigated. Exogenous melatonin was administered in the drinking water (15 microg/mL) of 7-month-old male Balb/c mice for 40 consecutive days. Our results show that melatonin distinctly reversed the age-related thymic involution as revealed by the notable increase of cellular density, particularly the number of thymocytes, percentage of thymocytes at G2+S phases and the younger morphological appearance as a whole when compared with control animals. More strikingly, the recovery of these morphometric parameters were maintained for 30 days after the termination of melatonin administration suggesting that the re-established homeostasis by melatonin may last for a longer time. At the same time, when primary culture of thymocytes was preincubated with 200 microM melatonin before their exposure to hydroxyl radicals (*OH) generated by Fe(2+)-mediated Fenton reaction, apoptotic cell death induced by *OH was almost completely prevented as determined by both flow cytometric analysis and the TUNEL assay. DNA laddering assay also documented the inhibition of thymocyte apoptosis by melatonin. Furthermore, we found that the *OH-induced increment of caspase-3 activity in thymocytes was completely abolished by melatonin preincubation. Taken together, our study indicates that in addition to other mechanisms, melatonin may also directly act as an antioxidant via attenuating apoptotic thymocyte death caused by free radicals and stimulates thymocyte proliferation in thymus and thus to rejuvenate the degenerative organ.

Targeting of HIF-alpha to the von Hippel-Lindau ubiquitylation complex by O2-regulated prolyl hydroxylation

Hypoxia-inducible factor (HIF) is a transcriptional complex that plays a central role in the regulation of gene expression by oxygen. In oxygenated and iron replete cells, HIF-alpha subunits are rapidly destroyed by a mechanism that involves ubiquitylation by the von Hippel-Lindau tumor suppressor (pVHL) E3 ligase complex. This process is suppressed by hypoxia and iron chelation, allowing transcriptional activation. Here we show that the interaction between human pVHL and a specific domain of the HIF-1alpha subunit is regulated through hydroxylation of a proline residue (HIF-1alpha P564) by an enzyme we have termed HIF-alpha prolyl-hydroxylase (HIF-PH). An absolute requirement for dioxygen as a cosubstrate and iron as cofactor suggests that HIF-PH functions directly as a cellular oxygen sensor.

Expression of telomerase inhibits hydroxyl radical-induced apoptosis in normal telomerase negative human lung fibroblasts

In tumor cells telomerase activity is associated with resistance to apoptosis and the introduction of the human telomerase reverse transcriptase (hTERT) subunit into normal human cells is associated with life span extension of the cells. To determine the role of telomerase in regulating apoptosis, telomerase negative human embryo lung fibroblasts were transfected with the hTERT gene. Unlike the control fibroblasts, the telomerase-expressing cells had elongated telomeres and were resistant to apoptosis induced by hydroxyl radicals. The results indicate that expression of telomerase and, thus, the maintenance of telomere length in normal human somatic cells caused resistance to not only cellular senescence but also apoptosis. Moreover, we found that hydroxyl radical-induced apoptosis in telomerase-expressing and control fibroblasts was caspase-3 independent. These findings have revealed a new type of interrelation between telomerase and caspase-3, which may indicate that in this case the expressed telomerase may inhibit apoptosis at a site not related to the caspase-3 cascade.

Oxygen-regulated and transactivating domains in endothelial PAS protein 1: comparison with hypoxia-inducible factor-1alpha

Endothelial PAS protein 1 (EPAS1) is a basic helix-loop-helix Per-AHR-ARNT-Sim transcription factor related to hypoxia-inducible factor-1alpha (HIF-1alpha). To analyze EPAS1 domains responsible for transactivation and oxygen-regulated function, we constructed chimeric fusions of EPAS1 with a GAL4 DNA binding domain, plus or minus the VP16 activation domain. Two transactivation domains were defined in EPAS1; a C-terminal domain (amino acids 828-870), and a larger internal domain (amino acids 517-682). These activation domains were interspersed by functionally repressive sequences, several of which independently conveyed oxygen-regulated activity. Two types of activity were defined. Sequences lying N-terminal to and overlapping the internal transactivation domain conferred regulated repression on the VP16 transactivator. Sequences lying C-terminal to this internal domain conveyed repression and oxygen-regulated activity on the native EPAS1 C-terminal activation domain, but not the Gal/VP16 fusion. Fusions containing internal but not C-terminal regulatory domains manifested regulation of fusion protein level. Comparison of EPAS1 with HIF-1alpha demonstrated a similar organization for both proteins, and for the C terminus defined a conserved RLL motif critical for inducibility. Overall, EPAS1 sequences were less inducible than those of HIF-1alpha, and inducibility was strikingly reduced as their expression level was increased. Despite these quantitative differences, EPAS1 regulation appeared similar to HIF-1alpha, conforming to a model involving the modulation of both protein level and activity, through distinct internal and C-terminal domains.

Protein kinase C in beta-cells: expression of multiple isoforms and involvement in cholinergic stimulation of insulin secretion

The mammalian protein kinase C (PKC) family consists of at least 11 distinct isotypes with marked differences in tissue distribution, localization, cofactor dependence and substrate specificity. Evidence exists for the expression of some of the PKC isoforms in pancreatic beta-cells but no comprehensive analysis of all the known PKC types has been accomplished. To assess the functional relevance of phosphorylation by PKC in the mechanism of insulin secretion we firstly investigated the expression of PKC isoforms in pancreatic beta-cells. The combination of reverse transcription-polymerase chain reaction (RT-PCR), Northern analysis and immunoblotting demonstrated the expression of PKC-alpha, beta II, epsilon, zeta, lambda and mu in MIN6 beta-cells. PKC-mu has not previously been detected in beta-cells. Expression of PKC-delta was also observed at the mRNA level; however, the protein could not be detected by Western blotting in MIN6 cells but was readily observed in RINm5F beta-cells. In short-term incubations, insulin release from MIN6 cells was augmented by 12-0-tetradecanoyl-phorbol-13-acetate (TPA), by carbachol, and by 40 mM K+. Culture of MIN6 cells overnight with TPA resulted in down-regulation of PKC-alpha (totally) and epsilon (partially), without significant change in the other isoforms. In such TPA-treated cells, the secretory response to TPA and to carbachol was abolished but not that elicited by high K+. It is suggested that PKC-alpha and/or epsilon may play a role in cholinergic potentiation of insulin secretion.