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Small extracellular vesicle (sEV, or exosome) communication among cells in the tumor microenvironment has been modeled mainly in cell culture, whereas their relevance in cancer pathogenesis and progression in vivo is less characterized. Here we investigated cancer–microenvironment interactions in vivo using mouse models of chronic lymphocytic leukemia (CLL). sEVs isolated directly from CLL tissue were enriched in specific miRNA and immune-checkpoint ligands. Distinct molecular components of tumor-derived sEVs altered CD8+ T-cell transcriptome, proteome, and metabolome, leading to decreased functions and cell exhaustion ex vivo and in vivo. Using antagomiRs and blocking antibodies, we defined specific cargo-mediated alterations on CD8+ T cells. Abrogating sEV biogenesis by Rab27a/b knockout dramatically delayed CLL pathogenesis. This phenotype was rescued by exogenous leukemic sEV or CD8+ T-cell depletion. Finally, high expression of sEV-related genes correlated with poor outcomes in CLL patients, suggesting sEV profiling as a prognostic tool. In conclusion, sEVs shape the immune microenvironment during CLL progression. Significance: sEVs produced in the leukemia microenvironment impair CD8+ T-cell mediated antitumor immune response and are indispensable for leukemia progression in vivo in murine preclinical models. In addition, high expression of sEV-related genes correlated with poor survival and unfavorable clinical parameters in CLL patients. See related commentary by Zhong and Guo, p. 5. This article is highlighted in the In This Issue feature, p. 1

Congenital Dacryocystocele is a rare disease of the eye and nose, which originates from congenital obstruction of lacrimal duct system, but accounts for a low proportion in congenital obstruction of lacrimal duct system. We present a case of congenital dacryocystocele to analyze the clinical features and to explore the clinical treatment effect of special congenital dacryocyst protrusion. doi: https://doi.org/10.12669/pjms.39.2.6819 How to cite this: Han L, Wang F, Zhang C. Special congenital dacryocystocele. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.6819 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background There has been increased development of robotic technologies for the accuracy of percutaneous pedicle screw placement. However, it remains unclear whether the robot really optimize the selection of screw sizes and enhance screw stability. The purpose of this study is to compare the sizes (diameter and length), placement accuracy and the loosening rate of pedicle screws using robotic-assisted versus conventional fluoroscopy approaches for thoracolumbar fractures. Methods A retrospective cohort study was conducted to evaluate 70 consecutive patients [34 cases of robot-assisted percutaneous pedicle screw fixation (RAF) and 36 of conventional fluoroscopy-guided percutaneous pedicle screw fixation (FGF)]. Demographics, clinical characteristics, and radiological features were recorded. Pedicle screw length, diameter, and pedicle screw placement accuracy were assessed. The patients’ sagittal kyphosis Cobb angles (KCA), anterior vertebral height ratios (VHA), and screw loosening rate were evaluated by radiographic data 1 year after surgery. Results There was no significant difference in the mean computed tomography (CT) Hounsfield unit (HU) values, operation duration, or length of hospital stay between the groups. Compared with the FGF group, the RAF group had a lower fluoroscopy frequency [14 (12–18) vs. 21 (16–25), P P P P P > 0.05). Conclusion Compared with the fluoroscopy-guided technique, robotic-assisted spine surgery decreased radiation exposure and optimizes screw trajectories and dimensions intraoperatively. Although not statistically significant, the loosening rate of the RAF group was lower that of than the FGT group.

BACKGROUND: COPD and bronchiectasis frequently coexist, which creates an emerging phenotype with a worse prognosis. However, the impact of bronchiectasis on the natural history of COPD has not been fully evaluated and is still controversial. This meta-analysis was performed to clarify the associations of the presence of bronchiectasis with the prognosis and quality of life of patients with COPD. METHODS: A systematic review and meta-analysis was performed following a search of medical databases, and included articles published up to April 2019. The following outcome measures were analyzed: age, sex, smoking history, body mass index, exacerbation rate, lung function, inflammatory biomarkers, albumin, colonization by potentially pathogenic microorganisms, Pseudomonas aeruginosa isolates, Haemophilus influenzae isolates, hospital admissions, and mortality. RESULTS: A total of 415,257 subjects with COPD from 18 observational studies were eligible; bronchiectasis was present in 25,929 subjects (6.24%). The coexistence of COPD and bronchiectasis occurred more often in older subjects with lower body mass index. The presence of bronchiectasis in the subjects with COPD increased the risk of daily sputum production (odds ratio [OR] 1.80, 95% CI 1.24–2.61), exacerbation (weighted mean difference [WMD] 0.72 times, 95% CI 0.59–0.85), frequent hospital admissions (WMD 0.35 times, 95% CI 0.21–0.49), and follow-up (>3 years) mortality (OR 2.26, 95% CI 0.95–5.36). The subjects with COPD and bronchiectasis showed poorer pulmonary function (FEV1/FVC: WMD –3.37%, 95% CI –5.63 to –1.11), lower albumin (Standardized mean difference [SMD] –0.17, 95% CI –0.26 to –0.08), elevated C-reactive protein (SMD 0.40, 95% CI 0.06–0.74), a greater proportion of chronic colonization by potentially pathogenic microorganisms (OR 6.65, 95% CI 4.44–9.95), and a higher isolation rate of P. aeruginosa (OR 5.13, 95% CI 4.89–5.38) or H. influenzae (OR 1.90, 95% CI 1.29–2.79) than the subjects with COPD without bronchiectasis. CONCLUSIONS: This meta-analysis confirmed the significant associations of the presence of bronchiectasis with the natural history, disease course, and outcomes in COPD. The COPD-bronchiectasis phenotype had adverse effects on subjects’ health condition and prognosis.

Although the Mobi-C artificial disc and the ROI-C cervical cage have been widely used in the treatment of cervical degenerative disc diseases (CDDD), few reports addressed the features of combined application of both devices. This study is aimed at comparing the clinical and radiological outcomes of treating contiguous two-level CDDD using Mobi-C and ROI-C combined in a hybrid surgery (HS) with anterior cervical discectomy and fusion (ACDF) using ROI-C. We reviewed ninety-one patients who underwent HS (n = 48) or ACDF (n = 43) surgery for symptomatic contiguous two-level CDDD.2 years' clinical and radiological outcomes were reviewed and evaluated retrospectively. At the last follow-up, significant improvement in the mean VAS, JOA, and NDI scores was found both in the HS and ACDF groups (p 0.05), while the differences between groups were not significant (p 0.05). The global range of motion (ROM) in the HS group was significantly larger than that in the ACDF group (p 0.05). The local lordosis improved significantly after surgery in all patients (p 0.05). Bone resorption and heterotopic ossification (HO) were found after surgery. The result showed that, for the selected patients, HS may provide an alternative approach for the treatment of contiguous two-level CDDD. HS also offers the benefit of both greater global ROM and greater ROM at the Mobi-C index level. Some degree of bone resorption may be an integral component in the early stage of bony fusion in the cage index level. Further studies and long-term follow-up are still needed.

Ischaemic stroke is a severe disease worldwide. Restoration of blood flow after ischaemic stroke leads to cerebral ischaemia–reperfusion injury (CIRI). Various operations, such as cardiac surgery with deep hypothermic circulatory arrest, predictably cause cerebral ischaemia. Diabetes is related to the occurrence of perioperative stroke and exacerbates neurological impairment after stroke. Therefore, the choice of anaesthetic drugs has certain clinical significance for patients with diabetes. Isoflurane (ISO) exerts neuroprotective and anti-neuroinflammatory effects in patients without diabetes. However, the role of ISO in cerebral ischaemia in the context of diabetes is still unknown. Toll-like receptor 4 (TLR4) and NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome activation play important roles in microglia-mediated neuroinflammatory injury. In this study, we treated a diabetic middle cerebral artery occlusion mouse model with ISO. We found that diabetes exacerbated cerebral ischaemia damage and that ISO exerted neuroprotective effects in diabetic mice. Then, we found that ISO decreased TLR4-NLRP3 inflammasome activation in microglia and the excessive autophagy induced by CIRI in diabetic mice. The TLR4-specific agonist CRX-527 reversed the neuroprotective effects of ISO. In summary, our study indicated that ISO exerts neuroprotective effects against the neuroinflammation and autophagy observed during diabetic stroke via the TLR4-NLRP3 signalling pathway.

This study aimed to compare the efficacy and safety of immune checkpoint inhibitors (ICIs) combined with antiangiogenic agents in patients with unresectable hepatocellular carcinoma (HCC).We conducted a systematic literature search of articles published between the establishment of the database and February 2022. Data were extracted and analyzed using STATA 14.0.Six randomized controlled trials (RCTs) (980 patients for combination therapy and 565 patients for monotherapy) and 5 single-arm studies (246 patients for ICIs combination therapy) were enrolled. The objective response rate (ORR) and disease control rate (DCR) were 26% and 70%, respectively, after ICIs combination therapy. Compared with monotherapy in RCTs, ICIs combination therapy resulted in higher progression-free survival (PFS) and overall survival (OS), but also increased the incidence of adverse events (AEs). Increased incidences of fatigue, hypertension, hyperbilirubinemia, proteinuria, and nausea were more common after ICIs combination therapy.The analysis results reveal that ICI-combined anti-angiogenesis therapy has higher efficacy than either ICIs or anti-angiogenesis options for unresectable HCC, but it is necessary to manage the AEs.

Background: Studies have shown inconsistent results regarding the association between circulating osteoprotegerin (OPG) levels and all-cause mortality in patients with chronic kidney disease (CKD). The aim of this meta-analysis is to investigate the association between circulating OPG levels and all-cause mortality in patients with CKD. Methods: The PubMed, EMBASE and Cochrane Library databases were searched for eligible studies investigating the association between circulating OPG levels and all-cause mortality in patients with CKD. Pooled hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were calculated using a random effects model. Results: In all, 13 studies that included 2,895 patients with CKD were included in this analysis. According to the meta-analysis, patients with the highest circulating OPG level had a significantly higher risk of all-cause mortality (7 studies; the adjusted HR, 1.88; 95% CI, 1.45 - 2.44) compared with patients with the lower circulating OPG level. An increase of 1 pmol/L in the circulating OPG level was associated with a 6% increased risk of all-cause mortality (7 studies; the adjusted HR, 1.06; 95% CI, 1.03-1.10). A subgroup analysis by dialysis methods suggested that an elevated circulating OPG level was independently associated with all-cause mortality in the HD only population. Conclusion: Elevated circulating OPG levels independently predict an increased risk of all-cause mortality in patients with CKD, especially in the HD only population.

Objective Carvedilol is nonselective beta-blocker with a mild anti-alpha-1-adrenergic effect. Several studies proposed improved hemodynamic effects of carvedilol compared with propanolol. Our study was to perform a systematic review and meta-analysis of randomized control trials comparing carvedilol with variceal banding ligation (VBL). Methods Studies were searched on online databases MEDLINE, EMBASE(Ovid), the Cochrane Library, Chinese Wanfang Database, and China National Knowledge Infrastructure between January 2000 and May 2018. Incidence of bleeding and mortality were main outcome measures. Subgroup analysis and sensitivity analysis were conducted to ensure the robustness of pooled estimates. Results Ten randomized control trials including 1,269 cirrhotic patients were chosen. Compared with VBL, carvedilol showed similar preventive efficacy of risk ratios (RRs) in variceal bleeding, and bleeding-related mortality over different follow-up periods from 6 months to 24 months. Also, significant differences between carvedilol and VBL in overall mortality and other causes of mortality were failed to be found. Carvedilol achieved a lower incidence of portal hypertension gastropathy in both 6 months (RR=0.49, 95% CI: 0.38-0.64, P

Objectives. Depression is highly prevalent in non-Hodgkin’s lymphoma (NHL) patients undergoing chemotherapy. The social stress associated with malignancy induces neurovascular pathology promoting clinical levels of depressive symptomatology. The purpose of this study was to establish an effective depressive symptomatology risk prediction model to those patients. Methods. This study included 238 NHL patients receiving chemotherapy, 80 of whom developed depressive symptomatology. Different types of variables (sociodemographic, medical, and psychosocial) were entered in the models. Three prediction models (support vector machine-recursive feature elimination model, random forest model, and nomogram prediction model based on logistic regression analysis) were compared in order to select the one with the best predictive power. The selected model was then evaluated using calibration plots, ROC curves, and C -index. The clinical utility of the nomogram was assessed by the decision curve analysis (DCA). Results. The nomogram prediction has the most efficient predictive ability when 10 predictors are included ( AUC = 0.938 ). A nomogram prediction model was constructed based on the logistic regression analysis with the best predictive accuracy. Sex, age, medical insurance, marital status, education level, per capita monthly household income, pathological stage, SSRS, PSQI, and QLQ-C30 were included in the nomogram. The C -index was 0.944, the AUC value was 0.972, and the calibration curve also showed the good predictive ability of the nomogram. The DCA curve suggested that the nomogram had a strong clinical utility. Conclusions. We constructed a depressive symptomatology risk prediction model for NHL chemotherapy patients with good predictive power and clinical utility.

Objective To compare the clinical application effects of peripherally inserted central catheter (PICC) and deep venous catheters placed through the lower limbs in adults with malignancy obviating the use of upper limb PICC. Study design Descriptive study. Place and duration of study Department of Oncology, Beijing Shijingshan Hospital, Capital Medical University, Beijing, China between February 2017 and February 2019. Methodology The patients enrolled in this study were assigned to PICC under ultrasound guidance group and deep venous catheterisation group. The inclusion criteria were patients with advanced malignant tumor after bilateral breast cancer lymphadenectomy or superior vena cava obstruction syndrome; bedridden patients; and patients without mental disorders; who could understand the content of this study and agreed to participate in this study. Patients with high-risk thrombosis and venous thrombosis of lower limbs were excluded. The success rate of one-time catheterisation, the length of catheterisation puncture time, the number of catheterisations, and the occurrence of catheter-related complications of the two groups were compared. Results Ultrasound-guided PICC through the lower limbs had a higher success rate than deep venous catheterization (84.6% vs. 42.9%, p=0.046). The average length of puncture time in adults with PICC through the lower limbs under ultrasound guidance was shorter than that in the femoral vein group (24.69 ± 4.35 vs. 29.14 ± 6.02, p=0.038). No catheter-related infection was found in the two groups of patients. Conclusion The indications for PICC through the lower limbs in adults include patients with advanced malignant tumor after bilateral breast cancer lymphadenectomy or superior vena cava obstruction syndrome, and mainly bedridden patients. This technique has certain advantages over deep venous catheterisation and is an effective choice for venous access. Key Words: Lower limb PICC, Deep venous catheterisation, Advanced malignant tumor, Bedridden.

Background: Medium-long catheters are being used more and more widely in clinical practice, but we still do not know the impact of different placements, but this is an important clinical issue that cannot be ignored. Objective: At present, the tip positioning of the mid-length catheter mainly includes the anterior part of the axilla and the midclavicular line. Different positioning may have different effects. Therefore, we did this research to confirm which positioning is more safety. Methods: We systematically searched the Chinese and English databases: PubMed, Embase, CENTRAL, CINAHL, Web of Science, China Knowledge Network, China Biomedical Literature Database, VIP, Wan Fang. Literature screening, data extraction, and quality evaluation were carried out by 2 researchers, and finally, use Stata to carry out meta-analysis. Results: This study is ongoing and the results will be submitted to a peer-reviewed journal for publication. Ethics and dissemination: Ethical approval is not applicable, since this is an overview based on published articles. Protocol registration number: INPLASY2020110042

Aim. Portal hypertension is a series of syndrome commonly seen with advanced cirrhosis, which seriously affects patient’s quality of life and survival. This study was designed to access the efficacy and safety of selective esophagogastric devascularization in the modified Sugiura procedure for patients with cirrhotic hemorrhagic portal hypertension. Methods. Sixty patients with hepatitis B cirrhotic hemorrhagic portal hypertension and meeting the inclusion criteria were selected and randomly divided by using computer into the selective modified Sugiura group (sMSP group, n = 30) and the modified Sugiura group (MSP group, n = 30). The primary endpoint measurement is the postoperative rebleeding rate. Secondary endpoint measurements included free portal venous pressure, liver Child–Pugh score, liver volume, portal vein width and blood flow velocity, survival rate, quality of life, and dysphagia as well as other complications one year postoperatively. This trial is registered with ChiCTR, number ChiCTR2000033468. Results. There was no statistically significant difference in rebleeding rates within one year after surgery between patients in the sMSP and MSP groups (χ = 0.11, p = 0.73 ). In comparison with the MSP group, the Child–Pugh score of liver function in the sMSP group significantly increased (χ = 6.4, p = 0.04 ) and the incidence of dysphagia was significantly reduced (χ = 6.23, p = 0.01 ) one year after surgery. There was a statistically significant difference in the quality of life between the two groups. However, there were no statistically significant differences in free portal venous pressure (MD = −3.44, 95% CI: −7.87 to 0.98, p = 0.12 ), postoperative liver volume (3 months: MD = -258.81, 95% CI: −723.21 to 205.57, p = 0.24 ; 1 year: MD = −320.12, 95% CI: −438.43 to 102.78, p = 0.16 ), postoperative portal vein width (3 months: MD = −0.06, p = 0.50 ; 1 year: MD = 0.17, p = 0.21 ), portal vein flow velocity (3 months: MD = 1.64, p = 0.21 ; 1 year: MD = −1.19, p = 0.57 ), 1-year survival rate (χ = 1.01, p = 0.31 ), and other complications between the two groups. Conclusions. Selective esophagogastric devascularization in the modified Sugiura procedure may not lower the incidence of rebleeding in the short term based on our findings. However, it may significantly improve quality of life of patients with cirrhotic hemorrhagic portal hypertension, improve liver function, and reduce postoperative dysphagia.

On 6 February 2020, our team had published a rapid advice guideline for diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infection, and this guideline provided our experience and make well reference for fighting against this pandemic worldwide. However, the coronavirus disease 2019 (COVID-19) is a new disease, our awareness and knowledge are gradually increasing based on the ongoing research findings and clinical practice experience; hence, the strategies of diagnosis and treatment are also continually updated. In this letter, we answered one comment on our guideline and provided the newest diagnostic criteria of "suspected case" and "confirmed case" according to the latest Diagnosis and Treatment Guidelines for COVID-19 (seventh version) that issued by the National Health Committee of the People's Republic of China.

Background The merits of spontaneous ventilation video-assisted thoracic surgery (SV-VATS) are still controversial. Our team retrospectively evaluated the intraoperative and postoperative advantages of this surgical approach, comparing with mechanical ventilation video-assisted thoracic surgery (MV-VATS). Methods We did a single center retrospective study at the First Affiliated Hospital of Yunnan Province. 244 patients were eventually assigned to the SV-group and MV-group, and their intraoperative indicators and thoracic surgery postoperative data were included in the comparison. Results The SV-group exhibited markedly less intraoperative bleeding and postoperative thoracic drainage, and the bleeding volume was correlated with the volume and duration of drainage. Further analysis showed that, patients undergoing SV-VATS had less activation of white blood cells and neutrophils after surgery, but they also had lower serum albumin concentrations. Risks of short-term postoperative complications, including inflammatory reactions, malignant arrhythmias, constipation, and moderate or more pleural effusions, were also significantly reduced in the SV-group. Additionally, hospitalization cost was lower in the SV-group than that in the MV-group. Conclusions SV-VATS is suitable for various types of thoracic surgery, and effectively reduce intraoperative bleeding and postoperative thoracic drainage. With less postoperative inflammatory response, it reduces the risk of short-term postoperative complications. It is also able to help to reduce the financial burden of patients.

MicroRNAs (miRNAs or miRs) have been shown to play a critical role in osteoblast differentiation. miR-10b has been found to be downregulated during osteoblast differentiation; however, its precise effect on osteoblast differentiation remains unknown. In this study, we aimed to investigate the potential role of miR-10b and the potential underlying mechanism in regulating osteoblast differentiation. We found that miR-10b was downregulated during osteoblast differentiation. Overexpression of miR-10b inhibited osteoblast differentiation, whereas the suppression of miR-10b promoted osteoblast differentiation. Bioinformatics analysis and the dual-luciferase reporter assay demonstrated that miR-10b could target the 3'-untranslated regions of B cell lymphoma 6 (Bcl6) which is an important regulator of osteoblast differentiation. Real‑time quantitative polymerase chain reaction and western blot analysis showed that miR-10b directly regulated Bcl6 expression. Further experiments showed that the overexpression of miR-10b increased the expression of signal transducer and activator of transcription 1 (STAT1) and blocked Runt-related transcription factor 2 (Runx2) nuclear translocation, whereas miR-10b suppression showed an opposite effect. Moreover, the miR-10b suppression-induced effects were partially reversed by Bcl6 knockdown. Taken together, our study suggests that miR-10b contributes to osteoblast differentiation through targeting Bcl6, providing a novel insight into understanding the molecular mechanism underlying osteoblast differentiation and suggesting a potential target for inhibiting bone loss.

Bupivacaine has been shown to induce neurotoxicity through inducing excessive reactive oxygen species (ROS), but the underlying mechanism remains unclear. NOX2 is one of the most important sources of ROS in the nervous system, and its activation requires the membrane translocation of subunit p47phox. However, the role of p47phox in bupivacaine-induced neurotoxicity has not been explored. In our in vitro study, cultured human SH-SY5Y neuroblastoma cells were treated with 1.5 mM bupivacaine to induce neurotoxicity. Membrane translocation of p47phox was assessed by measuring the cytosol/membrane ratio of p47phox. The effects of the NOX inhibitor VAS2870 and p47phox-siRNA on bupivacaine-induced neurotoxicity were investigated. Furthermore, the effect of VAS2870 on bupivacaine-induced neurotoxicity was assessed in vivo in rats. All these changes were reversed by pretreatment with VAS2870 or transfection with p47phox-siRNA in SH-SY5Y cells. Similarly, pretreatment with VAS2870 attenuated bupivacaine-induced neuronal toxicity in rats. It is concluded that enhancing p47phox membrane translocation is a major mechanism whereby bupivacaine induced neurotoxicity and that pretreatment with VAS2870 or local p47phox gene knockdown attenuated bupivacaine-induced neuronal cell injury.

The interaction between bone marrow stromal cells and leukemia cells is critical for the persistence and progression of leukemia, and this interaction may account for residual disease. However, the link between leukemia cells and their environment is still poorly understood. In our study, runt‑related transcription factor 3 (RUNX3) was identified as a novel target gene affected by As2O3 and involved in mesenchymal stem cell (MSC)‑mediated protection of leukemia cells from As2O3‑induced apoptosis. We observed induction of RUNX3 expression and the translocation of RUNX3 into the nucleus after As2O3 treatment in leukemia cells. In K562 chronic myeloid leukemia cells, downregulation of endogenous RUNX3 compromised As2O3‑induced growth inhibition, cell cycle arrest, and apoptosis. In the presence of MSC, As2O3‑induced expression of RUNX3 was reduced significantly and this reduction was modulated by CXCL12/CXCR4 signaling. Furthermore, overexpression of RUNX3 restored, at least in part, the sensitivity of leukemic cells to As2O3. We conclude that RUNX3 plays an important role in As2O3‑induced cellular responses and allows cells to overcome MSC‑mediated drug resistance. Therefore, RUNX3 is a promising target for therapeutic approaches to overcome MSC‑mediated drug resistance.

Objective. Portal hypertension is a major complication of decompensated cirrhosis. In China, modified Hassab’s and Sugiura procedure are the two major methods of nonshunting surgery. This study aims to compare the efficacy and safety of the two procedures for portal hypertension.Method. Between January 1994 and December 2009, 172 elective patients diagnosed with decompensated cirrhosis with significant hypersplenism adopted elective splenectomy for hypersplenism, and also modified Hassab’s (n= 91) or Sugiura (n= 81) procedure was additionally performed to reduce the risk of variceal bleeding. Postoperative mortality and morbidity data were collected, and a retrospectively comparative analysis was conducted.Results. All of the patients were treated successfully without death during operation, and no variceal bleeding occurred during hospitalization. There were 4 (4.4%) deaths in Hassab’s group and 3 (3.7%) deaths in Sugiura group postoperatively (P > 0.05). During follow-up, the survival rate was 90.2%, 82.42%, and 71.43% in Hassab’s group and 96.29%, 81.48%, and 75.31% in Sugiura group in 1, 3, and 5 years (P > 0.05). There were 22/71 and 12/63 patients in each groups who suffered no deadly variceal bleeding (P = 0.11). Bleeding related death and no bleeding related death occurred in 7/23 and 3/13 patients in each group (P = 0.26 and 0.14, respectively).Conclusion.Elective splenectomy combined with modified Sugiura procedure seemed to be associated with a reduced trend of no deadly variceal bleeding compared with Hassab’s procedure. As statistical significance was not found, further large scale and prospective study was warranted.

The peach tree,Prunus persica(L.) Batsch, is widely cultivated in China, and its flowers have been used for centuries in traditional Chinese medicine to treat gut motility disorders. But few studies have explored the pharmacological effect ofPrunus persica(L.) Batsch flowers on gastrointestinal motility. In this study, the activities of different extracts fromPrunus persica(L.) Batsch flowers on the smooth muscle contractions were evaluated using isolated colon model, and the ethyl acetate extract (EAE) showed the strongest effects in vitro. EAE (10−8–10−5 g/mL) caused a concentration-dependent stimulatory effect in rat colonic tissue. Additionally, ketotifen (100 µM), cimetidine (10 µM), and pyrilamine (1 µM) produced a significant inhibition of contractions caused by EAE. Furthermore, immunofluorescence and toluidine blue staining revealed increased numbers of mast cells in the EAE group, and EAE increased histamine release from the colonic tissues. These data indicate that EAE has significant prokinetic activity and acts by a mechanism that mainly involves mast cell degranulation. Our study provides a pharmacological basis for the use of an extract ofPrunus persica(L.) Batsch flowers in the treatment of gut motility disorders.

This paper introduces a methodology for creating geometrically of real terrain based on DEM data, which provided by the international scientific data sharing center.The method is to convert the DEM data in Global Mapper, AutoCAD and other softwares, process batch of data using office software, based on APDL language programming in ANSYS software , so as to realize the real remote sensing data to establish 3-D geological model in finite element software. An example illustrates the capabilities of the proposed methodology in this paper.

For current less-invasive hernia repair study, operation method and repair material were the most important issues [1]. Our study reviewed the current evidence and concluded an advantage of TAPP in clinical feasibility with comparable efficacy compared with TEP. In their correspondence they raised 2 questions in trial quality assessment and combined model, to which we would reply as follows.

OBJECTIVE We aimed to systematically evaluate the efficacy and safety of lixisenatide in patients with type 2 diabetes mellitus. METHODS PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov, Google, Web of Science and the Chinese Science Citation Database were searched up to March 2018. Randomized controlled trials determining the efficacy and safety of lixisenatide in patients with type 2 diabetes mellitus were eligible for inclusion. Two authors independently extracted the data in a prespecified Microsoft Excel spreadsheet. A meta-analysis was performed using Review Manager 5.3 software. Weighted mean difference (WMD) and relative risk (RR) together with their corresponding 95% confidence intervals (CIs) were estimated, and only the random effects model was used in order to achieve a more conservative estimate of the efficacy and safety. RESULTS Fourteen multicenter randomized controlled trials involving 11,947 patients were eligible for inclusion. Compared to placebo, lixisenatide could more significantly reduce the level of HbA1c (WMD=-0.44; 95% confidence interval [CI] [-0.55,-0.33]), and a higher proportion of lixisenatide-treated patients achieved the HbA1c level of

Regional materials and mixing ratio in Datong region are used to make the concrete testing blocks. The rebounding and ultrasonic non-destruction detecting testing for concrete compression strength were done by using the six types of strength grades concrete standard specimens according to the technical regulation. By using the common software Matlab7.0, the mathematical models between rebounding values, ultrasonic velocity values, rebounding- ultrasonic method values and concrete compression strength were set up by three kinds of functions’ regression analysis. The error analysis showed that the rebounding-ultrasonic non-destruction detecting testing method had higher precision results and was used firstly when the conditions were permitted, compared with the rebounding testing method or the ultrasonic testing method.

Background. Antitumor necrosis factor (anti-TNF) drugs have been applied for rheumatoid arthritis (RA) treatment; however, patients having anti-drug antibodies (ADAbs) do not benefit from these drugs. The meta-analysis aims to comprehensively assess the relationship between ADAb positive (ADAb+) and anti-TNF response in RA patients.Methods. Observational studies comparing different clinical response between ADAb+ and ADAb negative groups were included. Odds ratio (OR) with its corresponding 95% confidence interval (CI) was used as effect size. Subgroup analyses stratified by TNF inhibitor types and assay methods for ADAb detection were performed.Results. Totally, 10 eligible studies containing 1806 subjects were included. ADAb+ was significantly associated with reduced anti-TNF response to RA at all the time points after follow-up (P<0.001). Subgroup analysis also supported this significant association (P<0.05), except for enzyme-linked immunosorbent assay (ELISA) group at 3 months, infliximab (INF) and enzyme-linked immunosorbent assay (ELISA) groups at 6 months, and Immunological Multi-Parameter Chip Technology (IMPACT) group at 12 months.Conclusion. ADAb+ was significantly associated with reduced clinical response in RA patients, and other alternatives should be considered in RA patients presenting ADAb+.

MicroRNA-21 (miR-21) is overexpressed in patients with rheumatoid arthritis (RA). This study was designed to investigate the effect and mechanism of miR-21 on cell proliferation in fibroblast-like synoviocytes (FLS) of RA. FLS were primary-cultured from a rat RA model. RA-FLS and normal FLS were infected with lentivirus (anti-miR-21 or pro-miR-21) for overexpression or downregulation of miR-21, respectively. The effects of miR-21 overexpression or inhibition on nucleoprotein NF-κB levels and FLS cell proliferation were evaluated by western blotting and MTT assays. The effects of an inhibitor of NF-κB nuclear translocation (BAY 11-7082) were also evaluated. The results showed that the levels of miR-21 and nucleoprotein NF-κB were increased in FLS of RA model rats compared to the control group. Downregulation of miR-21 in RA FLS led to a significant decrease in nucleoprotein NF-κB levels and cell proliferation rates compared to the antinegative control (NC) group. However, miR-21 overexpression in normal FLS resulted in a significant increase of nucleoprotein NF-κB levels and cell proliferation rates compared to the pro-NC group. The effects of miR-21 overexpression were reversed by BAY 11-7082. We concluded that upregulated miR-21 in FLS in RA model rats may promote cell proliferation by facilitating NF-κB nuclear translocation, thus affecting the NF-κB pathway.

PVA hydroscopic films were prepared by solution and tape casting method. PVA 1799 was selected as the best material of hygroscopic film. This work evaluated the effect of PVA concentration, glycerol and methylcellulose (MC) on mechanical property, transmittance and absorbability of the film. The result showed that the transmittance of PVA film was high, and that plasticizer and MC had little effect on it; while the addition of MC affected the haze of PVA film greatly, the haze increased along with the increasing of adding amount of MC. The suitable concentration of PVA, glycerol and MC was 7%, 0.8%, 0.18%, respectively..

Biopolymers have the potential to serve as coating materials for paper to improve its performance properties. The objectives of this study were to determine the effect of kelp coating on the physical properties of coated papers. It was found that kelp coated paper showed significant difference on physical properties, compared with uncoated. Kelp coated papers greatly increased in tensile strength. Paper coated with kelp solution can be used to produce packages with the potential to be used to maintain agricultural produce quality for the food industry, and may have other applications.

To make the dot gain compensation curve more precise, this paper analyzes the methods already used and then propose a new method. We implement this new method and the old ones respectively through MATLAB, and get their dot gain compensation curves. At the same time, the average error and variance were counted to test their precision. The results show that the new method can apparently improve the precision and reduce the error. The average error of the normal method is 2.96% while it is reduce to 1.56% by the new method.

The 1st, 2nd and 3rd generations of hydroxyl-terminated hyperbranched polyesters (HBPE-1, HBPE-2, and HBPE-3) were synthesized. A3rd generation hyperbranched polyester (HBPE-3) was used as original crosslinking agent to prepared hyperbranched waterborne polyurethane dispersions (HPU). FTIR spectra confirmed that this reaction really took place. The experimental data indicated that, compared with the linear one, the hyperbranched HPU aqueous dispersions exhibited lower viscosity, and larger particle size. For the hyperbranched HPU films, mechanical properties were obviously enhanced.

Epigenetic therapy has had a significant impact on the management of haematologic malignancies. The aim of this study was to assess whether 5-aza-CdR and TSA inhibit the growth of leukaemia cells and induce caspase-3-dependent apoptosis by upregulating RUNX3 expression.K562 and Reh cells were treated with 5-aza-CdR, TSA or both compounds. RT-PCR and Western blot analyses were used to examine the expression of RUNX3 at the mRNA and protein levels, respectively. Immunofluorescence microscopy was used to detect the cellular location of RUNX3. Additionally, after K562 cells were transfected with RUNX3, apoptosis and proliferation were studied using Annexin V staining and MTT assays.The expression of RUNX3 in leukaemia cell lines was markedly less than that in the controls. Demethylating drug 5-aza-CdR could induce RUNX3 expression, but the combination of TSA and 5-aza-CdR had a greater effect than did treatment with a single compound. The combination of 5-aza-CdR and TSA induced the translocation of RUNX3 from the cytoplasm into the nucleus. TSA enhanced apoptosis induced by 5-aza-CdR, and Annexin V and Hoechst 33258 staining showed that the combination induced apoptosis but not necrosis. Furthermore, apoptosis was dependent on the caspase-3 pathway. RUNX3 overexpression in K562 cells led to growth inhibition and apoptosis and potentiated the effects of 5-aza-CdR induction.RUNX3 plays an important role in leukaemia cellular functions, and the induction of RUNX3-mediated effects may contribute to the therapeutic value of combination TSA and 5-aza-CdR treatment.

Nucleophosmin (NPM1) gene mutations resulting in cytoplasmic delocalization of Nucleophosmin (NPMc+) are the most common genetic alteration in acute myeloid leukemia (AML). Here, we attempted to prepare monoclonal antibodies (mAbs) against NPM1 mutation A (NPM-mA) and investigated the mAbs' clinical utility in immunohistochemical detection of NPMc+AML. The pET-32a-NPM-mA vector with the whole open reading frame of the NPM-mA gene was constructed. E.coli BL21 transformed with the vector were induced to express the NPM-mA recombinant protein. BALB/c mice were immunized with the recombinant NPM-mA. Positive clones were selected by indirect ELISA and the mAbs were obtained. Immunohistochemistry was performed to detect the NPMc+ in bone marrow smears from 10 AML patients with NPM-mA. The results showed that the pET-32a-NPM-mA vector was successfully constructed and the NPM-mA recombinant protein was used to immunize the mice. Two positive clones (2G3 and 3F9) were selected. The mAbs against NPM-mA were raised, but did cross-react with wild type NPM1. The mAbs can be used to detect the cytoplasmic dislocation of NPM1 in all AMLs carrying NPM-mA. Our results show that anti-NPM-mA mAbs were produced. Though they would cross-react with wild type NPM1, the mAbs may still have potential in the detection of NPMc+AMLs.

Nucleophosmin (NPM1) is an abundant and ubiquitously expressed phosphoprotein that is known to influence solid tumors progression. However, little is known about the role of NPM1 in leukemia. Here, we knocked down the NPM1 expression by RNA interference to investigate the role of NPM1 in leukemic cells proliferation and apoptosis. The interference vector pNPM1-shRNA was constructed and transfected into the human leukemic K562 cell line. The expression levels of NPM1 mRNA and protein were detected by quantitative real-time PCR and Western blot, respectively. Cells proliferation potential in vitro was assessed by methyl thiazolyl tetrazolium (MTT) and colony formation assays. Flow cytometry was used to detect the distribution of cell cycle. Cellular apoptosis was reflected by the relative activities of caspase-3 and caspase-8. The results showed that the expression levels of NPM1 mRNA and protein in K562 cells were significantly reduced after pNPM1-shRNA transfection. The cells growth was significantly inhibited in a time-dependent manner and the number of colonies was significantly reduced in the pNPM1-shRNA transfected cells. Meanwhile, the percentage of cells in G1 phase in the K562/pNPM1-shRNA cells was significantly increased. In addition, there were higher relative activities of caspase-3/8 in the pNPM1-shRNA transfected cells. These results indicate that down-regulation of NPM1 expression inhibits leukemic cells proliferation, blocks cell cycle progression and induces cellular apoptosis. It may implicate a potential target for leukemia gene therapy.

Aim To elucidate the cause of cerebral hypoperfusion on the stent placement side after carotid artery stent placement (CAS) measured by pseudocontinuous arterial spin labelling (PCASL) perfusion imaging. Materials and methods Consecutive patients with symptomatic internal carotid artery stenosis receiving CAS were included in the study. Cerebral blood flow (CBF) was measured by PCASL perfusion imaging at 3 T magnetic resonance imaging (MRI) the day before and 3 days after the procedure. Changes in cerebral haemodynamics after CAS were assessed. Results Twenty-two patients were included; 17 patients had increased or stationary CBF after CAS and five patients had significantly reduced CBF on the stenting side after CAS whereas CBF increased on the contralateral side. High stent position was noticed in the five patients. After labelling plane adjustment to avoid labelling on the stent, no more cerebral hypoperfusion was noticed. Conclusion When using PCASL perfusion imaging to monitor post-stenting CBF, the stent may cause an artefact that leads to a low CBF in the territory of the stented vessel. Routinely adding a fast T2 star gradient-echo echo-planar-imaging covering the upper neck region before PCASL perfusion imaging to identify the stent position and avoid the stent-related artefact is recommended.

Supplemental Digital Content is available in the text, Vedolizumab is an anti-inflammatory monoclonal antibody that exclusively targets the α4β7 integrin. We aimed to systematically review the efficacy and safety of vedolizumab for patients with inflammatory bowel diseases (IBDs). PubMed, EMBASE, and the Cochrane Library were searched up to May 2014. Randomized controlled trials examining the efficacy or safety of vedolizumab in patients with IBDs were eligible for inclusion. Data were extracted independently by 2 investigators and pooled using Review Manager 5.0 software (The Cochrane Collaboration, Copenhagen). Results were expressed as the relative risk (RR) with 95% confidence intervals (CIs). Six randomized controlled trials involving 2815 patients were eligible for inclusion. Vedolizumab was more effective than placebo for patients with ulcerative colitis and Crohn disease (CD) in clinical response (RR = 1.82, 95% CI, [1.43, 2.31]; RR = 1.46, 95% CI [1.18,1.81]) and clinical remission (RR = 2.23, 95% CI [1.35, 3.68]; RR = 1.71, 95% CI [1.25, 2.34]) during induction therapy. A superior effect was found during maintenance therapy in durable clinical/CD Activity Index-100 response (RR = 2.22, 95% CI [1.62, 3.05]; RR = 1.48, 95% CI [1.13, 1.94]) and clinical remission (RR = 2.55, 95% CI [1.38, 4.70]; RR = 1.15, 95% CI [0.75, 1.77]). However, vedolizumab may be associated with serious adverse events (RR = 1.25, 95% CI [1.03, 1.52]) and nasopharyngitis (RR = 1.56, 95% CI [1.08, 2.25]) for patients with CD. Vedolizumab was more effective than placebo as induction and maintenance therapy for IBDs, with an acceptable short-term safety profile, and achieving cure, although it may be associated with serious adverse events and nasopharyngitis for patients with CD.

Purpose: pCASL was recommended as a potent approach for absolute cerebral blood flow (CBF) quantification in clinical practice. However, uncertainties of tagging efficiency in pCASL remain an issue. This study aimed to estimate tagging efficiency by using short quantitative pulsed ASL scan (FAIR-QUIPSSII) and compare resultant CBF values with those calibrated by using 2D Phase Contrast (PC) MRI. Methods: Fourteen normal volunteers participated in this study. All images, including whole brain (WB) pCASL, WB FAIR-QUIPSSII and single-slice 2D PC, were collected on a 3T clinical MRI scanner with a 8-channel head coil. DeltaM map was calculated by averaging the subtraction of tag/control pairs in pCASL and FAIR-QUIPSSII images and used for CBF calculation. Tagging efficiency was then calculated by the ratio of mean gray matter CBF obtained from pCASL and FAIR-QUIPSSII. For comparison, tagging efficiency was also estimated with 2D PC, a previously established method, by contrast WB CBF in pCASL and 2D PC. Feasibility of estimation from a short FAIR-QUIPSSII scan was evaluated by number of averages required for obtaining a stable deltaM value. Setting deltaM calculated by maximum number of averaging (50 pairs) as reference, stable results were defined within ±10% variation. Results: Tagging efficiencies obtained by 2Dmore » PC MRI (0.732±0.092) were significantly lower than which obtained by FAIRQUIPPSSII (0.846±0.097) (P

AIM: To conduct a network meta-analysis to evaluate the effectiveness of different chemotherapy regimens for patients with gastric cancer. METHODS: PubMed (1966-2011.12), the Cochrane Library (2011 Issue 2) and EMBASE (1974-2011.12) were searched with the terms “gastric cancer” and “chemotherapy”, as well as the medical subject headings. References from relevant articles and conferences were also included. Patients who had previous gastric surgery, radiation before or after surgery or chemotherapy before surgery were excluded. In this study, only randomized controlled trials (RCTs) were considered, and the end-point was the overall mortality. Direct comparisons were performed using traditional meta-analysis whereas indirect comparisons were performed using network meta-analysis. RESULTS: In total, 31 RCTs with 7120 patients were included. Five chemotherapy regimens, fluorouracil (FU) + BCNU, FU + methyl-CCNU (mCCNU), FU + cisplatin, FU + anthracyclines and FU + mitomycin c (MMC) + cytarabine (Ara-c), were found to be less beneficial in terms of overall mortality. In contrast, four chemotherapy regimens were effective for the patients after surgery, including FU + MMC + adriamycin (FMA), FU + MMC (FM), Tegafur and MMC, There was no significant difference in terms of overall mortality among these regimens. The evidence for the FM regimen and MMC regimen was poor. Additionally, the FMA regimen, which includes a variety of chemotherapy drugs and causes many side effects, was not better than the Tegafur regimen. CONCLUSION: Although the four chemotherapy regimens were effective in patients with gastric cancer after surgery and the overall mortality revealed no significant difference among them in the network meta-analysis, thorough analysis of the results recommends Tegafur as the first-line adjuvant chemotherapy regimen for patients after complete resection.

Objective. To assess the effects of bariatric surgery versus medical therapy for type 2 diabetes mellitus.Methods. The Cochrane library, PubMed, Embase, Chinese biomedical literature database, and Wanfang database up to February 2012 were searched. The literature searches strategies contained terms (“diabetes*”, “surg*”, and “medic*” were used), combined with the medical subject headings. Randomized controlled trails (RCTs) of frequently used bariatric surgery for obese patients with type 2 diabetes were included. Study selection, data extraction, quality assessment, and data analyses were performed according to the Cochrane standards.Results. Three randomized controlled trials (RCTs) involving 170 patients in the bariatric surgery groups and 100 patients in the medical therapy group were selected. Compared with medical therapy, bariatric surgery for type 2 diabetes can significantly decrease the levels of HbA1c, FBG, weight, triglycerides, and the dose of hypoglycemic, antihypertensive, and lipid-lowering medicine, while increasing the rate of diabetes remission (RR = 9.74, 95%CI, (1.36, 69.66)) and the levels of high-density lipoprotein. However, there are no statistical differences in serious adverse events between the surgical and medical groups (RR = 1.23, 95%CI, (0.80, 1.87)).Conclusions. Surgical procedures were more likely to help patients achieve benefits than medical therapy alone. Further intensive RCTs of high-quality, multiple centers and long-term followup should be carried out to provide more reliable evidence.

Dissolved organic matter (DOM) was extracted from six sediment samples in arid and semi-arid region, which was characterized by fluorescence excitation-emission matrices (EEMs). The results showed that four fluorescent peak, fulvic-like (peak A), humic-like (peak C) and two tryptophan-like (peaks B and D), were identified in lake sediment DOM. Fluorescence quenching titration showed that peaks B and D were quenched gradually by adding additional Cu (II) and Hg (II), whereas humic-like substances had no systematic trend of the change of fluorescence intensity. Increasing fluorescence intensity value of humic-like substances can also be found. The modified Stern-Volmer model was used to calculate conditional stability constants (logK) and the percent of fluorophores (f %) which participate in the complexation between DOM and Cu (II), and Hg (II). The results showed that DOM-Cu (II) and DOM-Hg (II) complexes had higher logK values of 4.21-5.23 and the logK values of DOM-Cu (II) are much larger than the corresponding values for Hg (II). Peak B showed relatively low logK and high f % values than those of peak D. Different pollution sources which are mainly obtained from the upstream industrial wastewater, domestic sewage and return water of farmland irrigation tend to affect the stability constants and complexing capacities of Cu (II) and Hg (II).

The aim of this study was to investigate lipid profiles in patients with end-stage renal disease receiving hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD), or no dialysis (nondialytic treatment group, NT), and to analyze the association between dyslipidemia in CAPD patients with glucose-containing dialysate dosages. Lipid profiles were determined in 64 NT patients, 62 HD patients, and 180 CAPD patients at a single time point. NT patients' samples were collected following hospitalization due to renal failure. HD and CAPD patients' samples were collected after 3 months of dialysis. The association between lipid profiles of 180 CAPD patients and glucose-containing dialysate was analyzed using Pearson methods; 76.56% of NT patients, 66.13% of HD patients, and 72.22% of CAPD patients had dyslipidemia. Compared with NT patients, CAPD patients had significantly altered levels of cholesterol, triglycerides, high-density lipoprotein, apolipoproein (Apo)-A1, and Apo-E (p < 0.05), but unchanged levels of low-density lipoprotein or Apo-B. There was no correlation between the three different concentrations of glucose in the dialysate with the lipid profile of CAPD patients. We concluded that patients on CAPD exhibit dyslipidemia, and that different concentrations of glucose in the dialysate do not affect lipid profiles in these patients.

Background: Increased cell-free DNA (cf-DNA) and the integrity of cf-DNA in plasma of patients with cancer has been described. We investigated the clinical utility of cf-DNA in the detection and monitoring of progression of leukemia. Methods: Plasma samples from 60 patients with acute leukemia were analyzed in comparison to plasma from 30 healthy controls. Plasma DNA was determined by quantitative PCR (qPCR) by amplifying the β-actin gene (ACTB). The DNA integrity index was calculated as the ratio of qPCR results (ACTB384/106). Paired diagnostic/complete remission (CR)/relapse samples from eight of 60 patients were analyzed, and the minimum residual disease (MRD) situations were monitored. Results: DNA concentrations (median: 8.80 ng/mL, p=0.004) and DNA integrity (median: 0.51, p Conclusions: Our preliminary data suggest that plasma DNA integrity is increased in acute leukemia and may be a potential biomarker for monitoring MRD. However, more work is needed. Clin Chem Lab Med 2010;48:1651–6.

Within a relative abundance dynamic range of ~10,000: 1, the world's most compositionally complex organic mixture is petroleum crude oil. As such, it provides the most challenging target for mass spectral resolution and identification of molecules below m/z 2000. The mass “splits” in petroleum include most of those that also appear in proteomics, metabolomics and other complex organic mixture analysis. Therefore, petroleum provides an excellent test bed for optimizing mass spectrometer performance in general. The presence of multiple elemental compositions spanning less than 1 Da in mass facilitates mapping and correction of rf phase variation across a Fourier transform ion cyclotron resonance mass spectrum, as well as exposing otherwise inaccessible systematic mass deviations, for additional improvement in mass resolving power and mass accuracy by a factor of up to 5. Internal mass calibration, combined with systematic peak assignment for successive homologous series, enables automated elemental composition assignment of tens of thousands of peaks in a single mass spectrum.

Two 2D Anderson polyoxomolybdate-based compounds, [{Ni(H2O)4}2{Ni(OH)6Mo6O18}]·4H2O (1) and [Ni(H2O)6][Ag2{Ni(OH)6Mo6O18}]·8H2O (2), were synthesized and characterized by elemental analysis, IR spectroscopy, SEM, and single-crystal XRD. Their thermal behavior was studied by TGA, DSC, XRTD, and IR spectroscopy. Both 1 and 2 are arranged in 2D networks. In 1, [Ni(OH)6Mo6O18]4– Anderson units are covalently linked to each other by two different types of Ni2+, whereas in 2, the corresponding interactions are ensured exclusively by Ag+ ions. In addition, all the Ni2+ cations in 2 are located in interplanar positions and act selectively as counterions. Upon the addition of silver, the thermal stability of the Anderson anion is increased from 170 °C for pure nickel compound 1 up to 220 °C for mixed silver–nickel 2. Below 220 °C, 2 exhibits reversible hydration–dehydration processes with preservation of the Anderson anion structure. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2008)

AIM: To explore hemodynamics and vasoactive substance levels during renal vein congestion that occurs in the anhepatic phase of liver transplantation. METHODS: New Zealand rabbits received ligation of the hepatic pedicle, supra-hepatic vena cava and infra-hepatic vena cava [anhepatic phase group (APH); n = 8], the renal veins (RVL; n = 8), renal veins and hepatic pedicle [with the inferior vena cava left open) (RVHP; n = 8)], or a sham operation (SOP; n = 8). Hemodynamic parameters (systolic, diastolic, and mean arterial blood pressures) and the levels of serum bradykinin (BK) and angiotensin II (ANGII) were measured at baseline (0 min), and 10 min, 20 min, 30 min, and 45 min after the surgery. Correlation analyses were performed to evaluate the associations between hemodynamic parameters and levels of vasoactive substances. RESULTS: All experimental groups (APH, RVL, and RVHP) showed significant decreases in hemodynamic parameters (systolic, diastolic, and mean arterial blood pressures) compared to baseline levels, as well as compared to the SOP controls (P < 0.05 for all). In contrast, BK levels were significantly increased compared to baseline in the APH, RVL, and RVHP groups at all time points measured (P < 0.05 for all), whereas no change was observed in the SOP controls. There were no significant differences among the experimental groups for any measure at any time point. Further analyses revealed that systolic, diastolic, and mean arterial blood pressures were all negatively correlated with BK levels, and positively correlated with ANGII levels in the APH, RVL, and RVHP groups (P < 0.05 for all). CONCLUSION: In the anhepatic phase of orthotopic liver transplantation, renal vein congestion significantly impacts hemodynamic parameters, which correlate with serum BK and ANGII levels.

Purpose: The transfer constant (Ktrans) obtained from DCE‐MRI data is commonly used as an indicator for vessel permeability in tumors. However, it is known that Ktrans is also weighted by blood flow. This study proposed to combine the cerebral blood flow (CBF) measurement, by using the pseudo‐continuous arterial spin labeling (PCASL) technique, and the DCE‐MRI to estimate PS in brain tumors. Methods: Eleven pediatric patients with brain tumors participated in this study. The CBF maps were acquired at a 3T clinical scanner using a 3D FSE PCASL sequence with spiral acquisition (TR/TE = 4500ms/10 ms, post‐labeling delay = 1525 ms, matrix = 128 × 128, slice thickness = 5mm, 23 slices). Before the DCE‐MRI, T1 maps were acquired by using a 3D SPGR sequence with multiple flip angles. DCE‐MRI were performed by using a T1‐weighted 3D SPGR sequence (TR/TE/FA=4.9ms/1.3ms/30°, matrix = 256 × 128, slice thickness = 5mm, 8 slices, 60 dynamics), following the injection of contrast agents. The Ktrans, Ve, and Vp maps were obtained by using the mTK model. The PS map was calculated using the equation PS = ‐ CBFxln(1‐Ktrans /CBF). Results: The mean tumor Ktrans, CBF and PS values were 0.045+/−0.031 1/min, 52.3+/−20.9 ml/100g/min and 0.048+/−0.036 1/min, respectively. Similar patterns were found between Ktrans and PS maps, with slightly higher PS values in some patients. Significant positive correlations were found between Ktrans and PS (p

Silver atoms and strongly interlinking Keggin units ensure the tridimensionnal macrocationic structure of [Ag(6)(PMo(10)V(2)O(40))](CH(3)COO).8H(2)O, which catalyzes O(2)-based oxidation of p-methoxytoluene in acetic acid by air.

AIM: To investigate the roles of Golgi protein (GP) 73 in the regulation of cell proliferation and apoptosis. METHODS: Stealth RNAi targeting GP73 gene sequence was used to silence its expression in Hep G2 cells and Bel7402 cells. Stealth RNAi effects were assessed by reverse transcriptase polymerase chain reaction and ELISA. Cell proliferation assay and cell cycle analysis were assessed by MTT assay and flow cytometry. Apoptosis was assessed by flow cytometry and transmission electron microscopy. Apoptosis-related proteins were assessed by western immunoblot analysis. RESULTS: Stealth RNAi targeting GP73 gene sequence markedly reduced the expression of GP73 gene. The reduction of GP73 in Hep G2 cells and Bel7402 cells inhibited cell proliferation and induced apoptosis, however, terminal apoptosis occurred in Hep G2 cells, but early apoptosis occurred in Bel7402 cells. Reduced expression of GP73 gene might lead to a reduction in Bcl-2/Bax ratio, an increase in cytochrome c, but a reduction in capase-3. CONCLUSION: GP73 might play an important role in proliferation and apoptosis in hepatocellular carcinoma cells. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

In order to determine whether Fas antigen plays a role in the gastric carcinogenic sequence, an im-munohistochemical study of Fas antigen expression in gastric carcinoma and its relation to clinical status, pathomorphological parameters and prognosis was carried out and reported below.

Objective We conducted a perspective study to investigate the association between mRNA expression quantities of ERCC1, BRCA1, RRM1 and RRM2 and response to chemotherapy and clinical outcome of advance Non-Small Cell Lung Cancer.(NSCLC). Methods Two hundred eight patients who were diagnosed as advanced stage NSCLC were included in our study. A fluorescence-based and real-time detection method was used to determine the relative cDNA quantification for ERCC1, BRCA1, RRM1 and RRM2, and β-actin was used as the reference gene. Results The median expression levels of ERCC1, BRCA1, RRM1 and RRM2 mRNA were 0.67±0.17, 0.095±0.012, 0.24±0.17 and 2.45±0.32, respectively. Our study found that the low ERCC1 (OR=1.82, 95% CI=1.01-3.20) and Low BRCA1 (OR=2.53, 95%CI=1.38-4.64) mRNA expression was more likely to response to chemotherapy when compared with high expression, respectively. Multivariate Cox regression analysis indicated that patients with low mRNA expression of ERCC1 and BRCA1 attained 0.43 (OR=0.43, 95%CI=0.27-0.89) and 0.37 (OR=0.37, 95%CI=0.22-0.66) fold risk of death from NSCLC. However, we found RMM1 and RRM2 mRNA expression could not influence the response to chemotherapy and clinical outcome of NSCLC. Conclusion ERCC1 and BRCA1 mRNA expression could be important predictive markers for individualized platinum-based chemotherapy for NSCLC patients.