bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum-free media for articular chondrocytes in vitro expansion
Authors: SHAO Xin-xin , Neil Duncan A. , LIN Lin , FU Xin , ZHANG Ji-ying , YU Chang-long
Published: January 2024

Background

In vitro chondrocyte expansion is a major challenge in cell-based therapy for human articular cartilage repair. Classical culture conditions usually use animal serum as a medium supplement, which raises a number of undesirable questions. In the present study, two kinds of defined, serum-free media were developed to expand chondrocytes in monolayer culture for the purpose of cartilage tissue engineering.

Methods

Bovine chondrocytes were expanded in serum-free media supplemented with fibroblast growth factor-2 and platelet-derived growth factor or fibroblast growth factor-2 and insulin-like growth factor. Expansion culture in a conventional 10% fetal bovine serum (FBS) medium served as control. Fibronectin coating was used to help cell adhesion in serum-free medium. Next, in vitro three-dimensional pellet culture was used to evaluate the chondrocyte capacity. Cell pellets were expanded in different media to re-express the differentiated phenotype (re-differentiation) and to form cartilaginous tissue. The pellets were assessed by glycosaminoglycans contents, collagen II, collagen I and collagen X immunohistological staining.

Results

Chondrocytes cultured in serum-free media showed no proliferation difference than cells grown with 10% FBS medium. In addition, chondrocytes expanded in both serum-free media expressed more differentiated phenotypes at the end of monolayer culture, as indicated by higher gene expression ratios of collagen type II to collagen type I. Pellets derived from chondrocytes cultured in both serum-free media displayed comparable chondrogenic capacities to pellets from cells expanded in 10% FBS medium.

Conclusion

These findings provide alternative culture approaches for chondrocytes in vitro expansion, which may benefit the clinical use of autologous chondrocytes implantation.
Investigation of mental health and its influence on Chinese cancer patients using a multidisciplinary screening flow: an epidemiological survey in the west of China
Authors: SONG Huan , LI Jin , LU You , DENG Lei , SUN Xue-li
Published: January 2024

Background

Despite psycho-oncological concerns and studies having thrived these past decades, sparse reports illustrate to what extent Chinese cancer patients are involved and influenced by comorbid mental health problems. To investigate the mental health condition of cancer patient, as well as its possible impacts on prognosis, the first large-scale survey was performed in the west of China.

Methods

For standardizing and facilitating the assessment of mental illness in inpatients with cancer, a multidisciplinary rating flow was designed and established. On the basis of this system, between May 1st and 31st 2009, 2279 cancer inpatients from nine medical centers received preliminarily screening executed by oncologists using screening scales Mental Health Screening Questionnaire (MHSQ), Zung self-rating depression scales (SDS), Zung self-rating anxiety scale (SAS), and posttraumatic stress disorder checklist-civilian version (PCL-C). Further analyses of the ones screened positively were conducted by psychiatrists applying corresponding symptom-rating scales (HAMA/HAMD/BPRS). We summarized the overall proportion of patients with impaired mental health based on the data acquired from preliminary screening, and then calculated occurrence rates of each clinical syndrome of mental disorder according to symptom conclusions. The impact of comorbid mental illness was evaluated through the follow-up scheduled 1 year later, by comparing the survival rate, progression of disease, and quality of life (QoL) between subgroup patients with or without clinical syndrome of mental disorder.

Results

In preliminary screenings, 26.1% (595/2279) yielded positive results. Further symptom conclusions confirmed 15.8% (359/2279) with clinical syndrome of mental disorder. Regarding specific type of syndrome, the occurrence rates of depression, anxiety, psychotic symptoms, and stress-related disorders were 13.3%, 10.2%, 2.8%, and 1.4%, respectively. Follow-up assessments were successfully performed in 1918 subjects (84.2%). Further analyses indicated that although insignificant influence was observed in terms of 1-year survival rate and disease progression, cancer patients with a clinical syndrome of mental disorder obtained significantly lower levels (P <0.05) in five domains of QoL (scored by QLQ-C30).

Conclusion

In China, at least 26% of cancer patients experienced impaired mental health, of which 60% already had a detectable clinical syndrome of mental disorder, which could significantly undermine their QoL.
Genetic characterization and protein stability analysis of a Chinese family with Von Hippel-Lindau disease
Authors: Gao Yong , Huang Yan-ping , Tu Xiang-an , Luo Dao-sheng , Wang Dao-hu , Qiu Shao-peng , Xiang Peng , Li Wei-qiang , Jan Rohozinski , Zhang Yuan-yuan , Sun Xiang-zhou , Deng Chun-hua
Published: January 2024

Background

Von Hippel-Lindau disease (VHL), a heritable autosomal dominant disease characterized by neoplasia in multiple organ systems, has rarely been reported in Asia. We genetically investigated a unique Chinese family with VHL disease and performed an analysis of the VHL protein stability.

Methods

Genomic deoxyribonucleic acid (DNA) extracted from peripheral blood was amplified by polymerase chain reaction (PCR) to three exons of the VHL gene in 9 members of the Chinese family with VHL disease. PCR products were directly sequenced. We estimated the effects of VHL gene mutation on the stability of pVHL, which is indicated by the free energy difference between the wild-type and the mutant protein (ΔΔG).

Results

The Chinese family was classified as VHL type 1. Three family members, including two patients and a carrier, had a T to G heterozygotic missense mutation at nucleotide 515 of the VHL gene exon 1. This missense mutation resulted in the transition from leucine to arginine in amino acid 101 of the VHL protein. There was low stability of the VHL protein (the ΔΔG was 12.71 kcal/mol) caused by this missense mutation.

Conclusions

We first reported a family with this VHL gene mutation in Asia. This missense mutation is predicted to significantly reduce the stability of the VHL protein and contribute to the development of the renal cell carcinoma (RCC) phenotype displayed by this family. The genetic characterization and protein stability analysis of families with VHL disease are important for early diagnosis and prevention of the disease being passed on to their offspring.
A single center experience: post-transplantation adjuvant chemotherapy impacts the prognosis of hepatocellular carcinoma patients
Authors: Junyi Wu , Hongcheng Sun , Zhongbo Han , Zhihai Peng
Published: January 2024

Background

The aim of this research was to investigate the impact of post-transplantation adjuvant chemotherapy in the prevention of tumor recurrence and metastasis for hepatocellular carcinoma (HCC) exceeding Milan criteria after liver transplantation.

Methods

A total of 117 patients with HCC exceeding the Milan criteria who had undergone orthotopic liver transplantation (OLT) from August 2002 to February 2009 were enrolled and retrospectively analyzed. The patients were divided into four groups according to chemotherapy regimens and the impact of different chemotherapy regimens on survival, disease-free survival, and adverse effects were compared.

Results

One year survival rates for the gemicitabine, conventional chemotherapy, oxaliplatin plus capecitabine and the best supportive care (BSC) group were 87.5%, 84.2%, 81.6%, and 67.5%. The 3-year survival rates were 48.1%, 25.9%, 31.6%, and 33.7%, respectively for the four groups. One year disease free survival rates for the four groups were 69.8%, 47.4%, 53.8%, and 45.7% respectively. And 3-year disease free survival rates were 43.2%, 23.7%, 23.6%, and 25.1% for the four groups. Stratification analysis showed that the gemcitabine regimen and conventional chemotherapy could significantly improve the survival rate and disease free survival rate for HCC patients who had major vascular invasion and/or microvascular invasion after liver transplantation compared with BSC group.

Conclusions

For HCC patients beyond Milan criteria, especially who had vascular invasion and/or micorvascular invasion, post-transplantation adjuvant chemotherapy can significantly improve survival. Gemcitabine is a proper regimen for postoperative adjuvant chemotherapy. Conventional chemotherapy can also benefit patients, but the adverse effects are not satisfactory.
Frequency of T-cell FoxP3+ Treg and CD4+/CD8+ PD-1 expression is related to HBeAg seroconversion in hepatitis B patients on pegylated interferon
Authors: MA Hui , ZHANG Heng-hui , WEI Lai
Published: January 2024

Background

Host immune responses against hepatitis B virus (HBV) induced by antiviral therapy play a crucial role in viral clearance. To further investigate the immune mechanisms underlying the differences between respondents and non-respondents, we analyzed myeloid dendritic cells (mDCs), plasmacytoid dendritic cells (pDCs), FoxP3+ regulatory T cells (FoxP3+ Treg) and programmed death 1 (PD-1) expression in CD4+/CD8+ T cells in chronic hepatitis B patients undergoing pegylated interferon (PegIFN)α-2b treatment.

Methods

Patients received PegIFNα-2b for 24 or 48 weeks, with follow-up at 24 weeks. The frequencies of mDCs, pDCs, FoxP3+ Treg, and PD-1 expression by CD4+/CD8+ T cells were evaluated by flow cytometry at baseline, weeks 4 and 12, end of treatment, and follow-up (12/24 weeks).

Results

In HBeAg seroconverters (respondents), the mDC relative frequency decreased at week 4 and then rebounded at week 12. The pDC relative frequency decreased consistently. In non-HBeAg seroconverters (non-respondents), both mDC and pDC frequencies decreased slightly. The FoxP3+ Treg relative frequency decreased during treatment and remained low during follow-up in respondents, while in non-respondents it decreased slightly during therapy but rebounded after discontinuation. In patients with HBeAg <17.55 PEI-U/ml at week 12 and <8.52 PEI-U/ml at week 24, the FoxP3+ Treg frequency decreased during treatment and at follow-up. In respondents, CD4+PD-1 and CD8+PD-1 levels decreased at week 4 and remained low at week 12. In non-respondents, PD-1 expression decreased at week 4 but rebounded at week 12.

Conclusions

The results indicate that the dynamic changes in DCs, FoxP3+ Treg frequency, and PD-1 expression by CD4+ and CD8+ T cells exhibit different trends in HBeAg and non-HBeAg seroconversion patients. During PegIFNα-2b treatment of chronic hepatitis B patients, these changes may be of predictive value for HBeAg seroconversion. HBsAg and HBeAg levels are related to FoxP3+ Treg frequency.
Abnormal function of the posterior cingulate cortex in heroin addicted users during resting-state and drug-cue stimulation task
Authors: LI Qiang , YANG Wei-chuan , WANG Ya-rong , HUANG Yu-fang , LI Wei , ZHU Jia , ZHANG Yi , ZHAO Li-yan , QIN Wei , YUAN Kai , von Deneen Karen M. , WANG Wei , TIAN Jie
Published: January 2024

Background

Previous animal and neuroimaging studies have demonstrated that brain function in heroin addicted users is impaired. However, the posterior cingulate cortex (PCC) has not received much attention. The purpose of this study was to investigate whether chronic heroin use is associated with craving-related changes in the functional connectivity of the PCC of heroin addicted users.

Methods

Fourteen male adult chronic heroin users and fifteen age and gender-matched healthy subjects participated in the present study. The participants underwent a resting-state functional magnetic resonance imaging (fMRI) scan and a cue-induced craving task fMRI scan. The activated PCC was identified in the cue-induced craving task by means of a group contrast test. Functional connectivity was analyzed based on resting-state fMRI data in order to determine the correlation between brain regions. The relationship between the connectivity of specific regions and heroin dependence was investigated.

Results

The activation of PCC, bilateral anterior cingulate cortex, caudate, putamen, precuneus, and thalamus was significant in the heroin group compared to the healthy group in the cue-induced craving task. The detectable functional connectivity of the heroin users was stronger between the PCC and bilateral insula, bilateral dorsal striatum, right inferior parietal lobule (IPL) and right supramarginal gyrus (P <0.001) compared to that of the healthy subjects in the resting-state data analysis. The strength of the functional connectivity, both for the PCC-insula (r=0.60, P <0.05) and for PCC-striatum (r=0.58, P <0.05), was positively correlated with the duration of heroin use.

Conclusion

The altered functional connectivity patterns in the PCC-insula and PCC-striatum areas may be regarded as biomarkers of brain damage severity in chronic heroin users.
Effect of chronic intermittent hypoxia on theophylline metabolism in mouse liver
Authors: CHEN Xiao-yang , ZENG Yi-ming , ZHANG Yi-xiang , WANG Wan-yu , WU Run-hua
Published: January 2024

Background

Chronic intermittent hypoxia (CIH) has been associated with abnormalities in the liver, which is the most important organ for drug metabolism. This study aimed to investigate the effect of CIH on theophylline metabolism in mouse liver.

Methods

Eight C57BL/6J mice were exposed to CIH for 12 weeks. Eight C57BL/6J mice were exposed to room air as a control group. Serum levels of alanine aminotransferase and aspartate aminotransferase were measured. Liver histology was observed by light and electron microscopy. Total hepatic cytochrome P450 concentration was measured. Hepatocytes were isolated and incubated with 15 mg/ml theophylline for four hours. After incubation, the theophylline concentration in the supernatant was measured and the theophylline metabolism rate was calculated.

Results

CIH did not affect the serum transaminase levels. Livers from mice exposed to CIH showed hepatocellular edema, and liver cells had fuzzy rough endoplasmic reticulum under the electron microscope. The theophylline metabolism rate was significantly inhibited by CIH compared with controls; (16.60±2.43)% vs. (21.58±4.52)% (P=0.02). The total liver cytochrome P450 concentration in the CIH group was significantly lower than in the control group; (0.83±0.08) vs. (1.13±0.21) mol/mg microsomal protein (P=0.004).

Conclusion

CIH decreases theophylline metabolism by mouse hepatocytes, which may correlate with the downregulation of cytochrome P450 expression by CIH.
Magnetic resonance imaging features of vulnerable plaque in an atherosclerotic rabbit model
Authors: ZHAO Xue-cheng , ZHAO Quan-ming , MA Xiao-hai , ZENG Cong-he , FENG Ting-ting , ZHAO Xin , ZHANG Zhao-qi , ZHANG Ming-duo , ZHUANG Xu-cui
Published: January 2024

Background

Noninvasive detection of vulnerable plaque has a significant implication for prevention and treatment of atherosclerotic diseases. The aim of this study is to investigate the difference between vulnerable plaques and stable plaques in magnetic resonance (MR) images.

Methods

Atherosclerosis was induced in twenty male New Zealand white rabbits by high cholesterol diet and balloon injury of the abdominal aorta. After baseline (pre-triggering) MR imaging (MRI) scan, the rabbits underwent pharmaceutical triggering with Russell’s viper venom and histamine to induce atherothrombosis, followed by another MRI scan 48 hours later (post-triggering). Rabbits were euthanized to obtain pathological and histological data. The results of MRI were compared with those of pathology and histology.

Results

MRI showed that abdominal aorta of the rabbits had pathological change of atherosclerosis in different degrees. Seventy-five plaques were analysed, among which 14 had vulnerable thrombi and 61 stable. Thrombosis was identified in 7 of 11 rabbits by post-triggering MRI, the sensitivity and K value of MR in detection of vulnerable plaque was 71% and 0.803 (P <0.05). MRI data significantly correlated with the histopathological data in fibrous cap thickness (r=0.749) plaque area (r=0.853), lipid core area (r=0.900). Compared with stable plaques, vulnerable plaques had a significantly thinner fibrous cap ((0.58±0.27) mm vs. (0.95±0.22) mm), larger lipid core area ((7.56±2.78) mm2 vs. (3.29±1.75) mm2), and a higher ratio of lipid core area/plaque area ((55±16)% vs. (27±17)%), but plaque area was comparable in two groups on MRI. The ratio of lipid core area/plaque area was a strong predictor of vulnerable plaques.

Conclusion

MRI could distinguish vulnerable plaques from stable plaques in a rabbit model of atherothrombosis and may thus be useful as a noninvasive modality for detection of vulnerable plaques in humans.
Genetic analyses of Chinese patients with digenic oculocutaneous albinism
Authors: WEI Ai-hua , YANG Xiu-min , LIAN Shi , LI Wei
Published: January 2024

Background

Oculocutaneous albinism (OCA) is a heterogeneous and autosomal recessive disorder in all populations worldwide. The mutational spectra of OCA are population-specific. Some OCA patients carry mutations from different OCA genes. In this study, we investigated the frequency of digenic mutations in Chinese OCA patients.

Methods

Genomic DNAs were extracted from the blood samples of 184 clinically diagnosed OCA patients and 120 unaffected subjects. The amplified DNA segments of the exons and exon-intron boundaries were screened for mutations of TYR, OCA2, TYRP1, SLC45A2, and HPS1 by direct sequencing. To exclude the previously unidentified alleles from polymorphisms, samples from 120 unaffected controls were sequenced for the same regions of variations.

Results

In all 184 patients, 134 had two pathologic mutations on one locus. Eleven cases had no apparent pathologic mutations in any of the genes studied. Among the remaining 39 patients who had only one pathologic mutation, five patients (2.7% in total) were found to carry the mutational alleles on a second locus in TYR, OCA2 or SLC45A2. Of the five digenic OCA patients, four patients were clinically diagnosed as OCA2 and one patient as OCA1. A previous unidentified allele p.G188D in SLC45A2 was identified, which was not present in the 120 unaffected controls.

Conclusions

The identification of the digenic OCA patients suggests the synergistic roles among TYR, OCA2 and SLC45A2 during melanin biosynthesis, which may cause OCA under digenic mutations. This information will be useful for gene diagnosis and genetic counseling of OCA in China.

Chin Med J 2013;126 (2): 226-230
Subchondral bone grafting reduces degenerative change of knee joint in patients of giant cell tumor of bone
Authors: XU Hai-rong , NIU Xiao-hui , ZHANG Qing , HAO Lin , DING Yi , LI Yuan
Published: January 2024

Background

Giant cell tumors (GCTs) most commonly occur around the knee. The most beneficial procedure for this disease has been extensive curettage with reconstruction. However, since many GCTs may compromise the subchondral bone, surgery can further jeopardize the articular cartilage and result in secondary osteoarthritis. In this study, we aimed to determine the factors associated with the development of degenerative arthritis and the effect of bone grafting on the prevention of secondary osteoarthritis.

Methods

We retrospectively analyzed 76 patients with GCT around the knee. The mean age at first diagnosis was 31.1 years. Surgical treatments included extensive curettage and cementation with or without bone grafting in the subchondral bone. Patient follow-up was a median duration of 35 months, ranging from 18 to 113 months.

Results

The local recurrence rate was 5.3% (4/76). Secondary degenerative changes occurred in 30.3% (23/76) of the patients. Less than 10 mm of the residual thickness of the remaining subchondral bone was correlated with secondary degenerative changes in 57 patients (P <0.001). Of these 57 patients, 56.5% (13/23) treated with bone cement reconstruction alone developed secondary degenerative changes; following bone grafting, the rate decreased to 29.4% (10/34), with a statistically significant difference (P=0.041).

Conclusions

GCT patients with less residual thickness of the subchondral bone are more likely to develop degenerative arthritis after curettage. Bone grafting in the subchondral bone area is recommended when the residual thickness of the subchondral bone is less than 10 mm.
Detection and functional annotation of misregulated microRNAs in the brain of the Ts65Dn mouse model of Down syndrome
Authors: HE Xiang-jun , XIAO Yun , ZHANG Qi , MA Li-ping , LI Na , YANG Jing
Published: January 2024

Background

Brain hypoplasia and mental retardation in Down syndrome (DS) can be attributed to a severe and selective disruption of neurogenesis. Secondary disruption of the transcriptome, as well as primary gene dosage imbalance, is responsible for the phenotype. MicroRNA (miRNA) expression is relatively abundant in brain tissue. Perturbed miRNA expression might contribute to the cellular events underlying the pathology in DS.

Methods

MiRNA expression profiles in the cerebrum of Ts65Dn mice, a DS model, were examined with a real-time RT-PCR array. MiRNA target gene expression was detected by real-time quantitative PCR and Western blotting. Based on the prediction of their cerebrum-specific targets, the functions of the misregulated miRNAs were annotated by Gene Ontology (GO) enrichment analysis.

Results

A total of 342 miRNAs were examined. Among them, 20 miRNAs showed decreased expression in the brains of Ts65Dn mice, and some of these belonged to the same family. Two known targets of the miR-200 family, Lfng and Zeb2, were specifically selected to compare their expression in the cerebrum of Ts65Dn mice with those of euploids. However, no significant difference was found in terms of mRNA and protein expression levels of these genes. By enrichment analysis of the cerebrum-specific targets of each miRNA, we found that 15 of the differential miRNAs could significantly affect target genes that were enriched in the GO biological processes related to nervous system development.

Conclusion

Perturbed expression of multiple functionally cooperative miRNAs contributes to the cellular events underlying the pathogenesis of DS.
Effects of insulin, insulin-like growth factor-I and -II on proliferation and intracellular signaling in endometrial carcinoma cells with different expression levels of insulin receptor isoform A
Authors: WANG Chun-fang , ZHANG Guo , ZHAO Li-jun , LI Xiao-ping , QI Wen-juan , WANG Jian-liu , WEI Li-hui
Published: January 2024

Background

Hyperinsulinemia, insulin-like growth factor (IGF)-I and -II (IGF-II) are associated with increased risk of endometrial carcinoma. Insulin receptor isoform A (IR-A) is more frequently expressed in endometrial carcinoma than in normal endometrial tissues. To better understand their roles in endometrial carcinoma, we investigated the effects of insulin, IGF-I, and IGF-II in endometrial carcinomas cells with different IR-A expression levels.

Methods

To explore the role of IR-A in mediating the activity of IGF-I, IGF-II, and insulin, we investigate the cellular proliferation of endometrial carcinoma cell lines RL95-2 and RL95-2-IR-A by MTS assays. Then we examined the protein kinase Akt phosphorylation and extracellular signal-regulated kinase (ERK) 1/2 phosphorylation in both cell lines by Western blotting. The effect of IGF-II and AG1024 on cell cycle progression and apoptosis was assessed by flowcytometry. To examine whether the effects of IGFs were mediated by IR-A, we blocked IGF-I receptor (IGF-IR) in both cell lines using AG1024, an IGF-IR-specific inhibitor.

Results

IGF-I and IGF-II significantly enhanced proliferation of both cell lines (P <0.05). By contrast, insulin significantly increased proliferation of RL95-2-IR-A cells only (P <0.05). IGF-I and IGF-II significantly increased pAkt levels in RL95-2 cells and pERK1/2 levels in RL95-2-IR-A cells (all, P <0.05). Insulin increased pERK1/2 levels in RL95-2-IR-A cells only (P <0.05). LY294002 and PD98059 inhibited the specific signaling activities and cellular proliferation. After AG1024 pretreatment, neither IGF-I nor IGF-II affected pAkt levels in RL95-2 cells. IGF-II, but not IGF-I, increased pERK1/2 levels in RL95-2-IR-A cells. After AG1024 pretreatment, the proliferation rate and DNA content corresponding to the S phase increased and apoptosis decreased significantly in IGF-II-treated RL95-2-IR-A cells only (P <0.05).

Conclusions

The proliferation effect of insulin is mediated by IR-A. When IR-A dominates in a cell line, IGF-II activated cell proliferation mainly through the ERK1/2 pathway. On the other hand, IGF-II activated cell proliferation mainly through the Akt pathway. IR-A can at least partly mediate the proliferative and anti-apoptotic effects of IGF-II through the ERK1/2 pathway.
High frequency of regulatory T cells among HIV type 1-infected men who have sex with men correlates with disease progression
Authors: WANG Wan-hai , MING Liang , KAN Quan-cheng , ZHANG Xiao-yan , WANG Ying
Published: January 2024

Background

Regulatory T cells (Tregs) may play an important role in immunopathology during HIV-1 infection. Transcription factor forkhead box P3 (FoxP3) orchestrates the development of Tregs and is a useful marker to identify this population. Using a FoxP3 phenotype to define Tregs, we investigated the level and phenotype of peripheral blood natural CD4+Tregs and assessed the relationship between the frequencies and absolute numbers of CD4+Tregs and disease progression among untreated HIV-infected men who have sex with men (HIV+MSM) in China.

Methods

Fifty-two untreated HIV+MSM with CD4+T-cell counts of <350 cells/μl or >350 cells/μl were compared in a cross-sectional study. Twelve age-matched HIV-uninfected MSM and nine patients receiving antiretroviral therapy for at least 1 year were also included. Expression of CD25, CD127, CD45RA, CCR7 and CTLA-4 was assessed on CD4+Tregs using polychromatic flow cytometry.

Results

The percentage of CD4+Tregs was increased significantly, whereas CD4+Tregs expressed less CTLA-4 in HIV+MSM compared with controls. CD4+Tregs displayed predominantly an effector memory phenotype (CD45RA˜CCR7˜), phenotypically distinct from conventional CD4+T cells. Moreover, the expansive frequencies of CD4+Tregs coincided with lower CD4+T-cell counts and higher viral loads whereas the absolute numbers of CD4+Tregs were associated with higher CD4+T-cell counts and lower viral loads. The expansion of Tregs was also associated with CD8+T-cell activation.

Conclusion

Increased proportions and decreased numbers of CD4+Tregs are associated with HIV progression, and their functions may impair with the progression of HIV infection.
A new classification of duplex kidney based on kidney morphology and management
Authors: MA Rui , WU Rong-de , LIU Wei , WANG Gang , WANG Tao , XU Zhuo-dong , YU Qi-hai , GUO Zong-yuan
Published: January 2024

Background

The initial classic classification of duplex kidney into complete (two ureters) and incomplete (“Y” shaped ureter) types are based on the ureter status. At the meantime, the features of the upper and lower moieties of duplex kidney were very crucial for appropriate procedure of hemi-nephrectomy, which was most commonly used for addressing the issues caused by a duplex kidney; and recently more applications of laparoscopy were used. In this study, we aimed prudently to propose a new classification based on the features of the upper and lower moieties of duplex kidney.

Methods

Sixty-five children with 83 duplex kidneys were reviewed retrospectively. Based on kidney morphology found in CT urography and surgical findings, duplex kidney was classified into five types.

Results

The first was the appendant type (36/83) and its feature was that the mini upper moiety was located on top of the lower one, with a visualized shallow groove between them. The ureter was dilated with an ectopic orifice or ureterocele. The second was the embedded type (13/83), the feature of which was that mini upper moiety located in the interior top of the lower one within the same capsule. The upper ureter was dilated with an ectopic orifice or ureterocele. The third was the hydronephrosis type (12/83). The severe hydronephrotic upper moiety was almost as big as the lower moiety. The upper ureter was severely dilated and circuitous with an ectopic orifice. The forth was the dual-poor type (2/83). The two moieties were all very small with “Y” shaped ureters and ectopic orifices. The last was the dual-well type (20/83). The upper moiety was almost the same size as the lower one, without apparent dilation of “Y” shaped or double ureters.

Conclusion

Based on kidney morphology, duplex kidney can be mainly classified into five types which can be depicted by CT urography prior to management and can provide an aid in selecting a successful course of surgical correction.
Relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions
Authors: Hongling LI , Changcheng WANG , Shuqing LIU , Dongsheng XU , Ju ZHANG , hongmei CHEN
Published: January 2024

Background

The causes and mechanisms of chronic diarrhea are complex. This study aimed to explore the relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions.

Methods

All cases were collected from January 2009 to June 2010. The 40 patients in the patient group had chronic diarrhea with normal colonoscopy findings. Those who had hyperthyroidism, diabetes, chronic pancreatitis, cirrhosis, atrophic gastritis, short bowel syndrome and connective tissue diseases had been excluded. The control group contained 40 healthy individuals without diarrhea. Endoscopy of the terminal ileum was applied in both groups, with the endoscope inserted into terminal ileum for more than 20 cm. The patients diagnosed of chronic diarrhea with terminal ileum lesions were treated with metronidazole and probiotics for 10-14 days.

Results

Before treatment there were significant differences in endoscopy findings of the terminal ileum between the two groups (P <0.05). In the patient group, endoscopy showed congestion, edema, erosion and ulcers in 29 cases, hyperplasia and enlargement of lymphoid follicles in 10 cases with a maximal diameter of 7-8 mm, and 1 case showed normal endoscopy results. After treatment, 35 patients recovered from diarrhea, and terminal ileum lesions disappeared in 30 cases as determined by endoscopy. In the control group, endoscopy showed scattered hyperplasia of lymphoid follicles in 5 cases, and the follicles were small with the maximal diameter being 3 mm. There was no hyperemia, edema, erosion or ulcers.

Conclusions

Chronic diarrhea patients with normal colonoscopy findings may have lesions in the terminal ileum that can be detected by endoscopy; including hyperemia, erosion, ulcers and lymphoid follicle hyperplasia. Therapeutic effect is good with metronidazole and probiotics.
Functional annotation of the microRNA-mediated network in gigantomastia by integrating microRNA and mRNA expression profiling
Authors: LI Jing-yi , MU Da-li , MU Lan-hua , XIN Min-qiang , LUAN Jie
Published: January 2024

Background

Gigantomastia is the overdevelopment of the female mammary gland, and it causes great physiological and psychological burdens to patients. A better understanding of the molecular mechanisms involved in gigantomastia is needed to develop less invasive and more effective medical treatments. MicroRNA (miRNA) is a class of small noncoding RNAs that play an important regulatory role at the post-transcriptional level. These miRNAs are known to be involved in many diseases, including breast cancer; however, the relationship between miRNA and gigantomastia is largely unknown.

Methods

Whole genome-wide expression of miRNA and mRNA in gigantomastia was detected using microarray and functional annotation was performed based on the altered expression of miRNAs and mRNAs.

Results

We found many miRNAs and mRNAs to be significantly differentially expressed in gigantomastia compared with normal breast tissues. Functional annotation analysis indicated that APK, Wnt, and Neurotrophin signaling pathways may participate in gigantomastia.

Conclusion

This study addresses the need for better diagnosis and treatment of gigantomastia by providing new insight into the molecular mechanisms underlying this disease.
Application of computer-assisted three-dimensional quantitative assessment and a surgical planning tool for living donor liver transplantation
Authors: WEI Lin , ZHU Zhi-jun , LÜ Yi , JIANG Wen-tao , GAO Wei , ZENG Zhi-gui , SHEN Zhong-yang
Published: January 2024

Background

Precise evaluation of the live donor's liver is the most important factor for the donor's safety and the recipient's prognosis in living donor liver transplantation (LDLT). Our study assessed the clinical value of computer-assisted three-dimensional quantitative assessment and a surgical planning tool for donor evaluation in LDLT.

Methods

Computer-assisted three-dimensional (3D) quantitative assessment was used to prospectively provide quantitative assessment of the graft volume for 123 consecutive donors of LDLT and its accuracy and efficiency were compared with that of the standard manual-traced method. A case of reduced monosegmental LDLT was also assessed and a surgical planning tool displayed the precise surgical plan to avoid large-for-size syndrome.

Results

There was no statistically significant difference between the detected graft volumes with computer-assisted 3D quantitative assessment and manual-traced approaches ((856.76+162.18) cm3 vs. (870.64+172.54) cm3, P=0.796). Estimated volumes by either method had good correlation with the actual graft weight (r-manual-traced method: 0.921, r-3D quantitative assessment method: 0.896, both P <0.001). However, the computer-assisted 3D quantitative assessment approach was significantly more efficient taking half the time of the manual-traced method ((16.91+1.375) minutes vs. (39.27+2.102) minutes, P<0.01) to estimate graft volume. We performed the reduced monosegmental LDLT, a pediatric case, with the surgical planning tool (188 g graft in the operation, which was estimated at 208 cm3 pre-operation). The recipient recovered without large-for-size syndrome.

Conclusions

Computer-assisted 3D quantitative assessment provided precise evaluation of the graft volume. It also assisted surgeons with a better understanding of the hepatic 3D anatomy and was useful for the individual surgical planning tool.
Effectiveness of the UroMentor virtual reality simulator in the skill acquisition of flexible cystoscopy
Authors: ZHANG Yi , LIU Jin-shun , WANG Gang , YU Cheng-fan , ZHU He , NA Yan-qun
Published: January 2024

Background

Virtual reality (VR) has been recognized as a useful modality in the training of surgical skills. With respect to basic endoscopic skill training of urology, we sought to investigate the effectiveness of the UroMentor™ virtual reality simulator (VRS) in the skill acquisition of flexible cystoscopy.

Methods

Urologists familiar with rigid cystoscopy procedures were selected to take part in a virtual training course of flexible cystoscopy. Changes in total operating time, frequency of injury, number of digital markers inside the bladder, and the global rating scale (GRS) scores were assessed following eight repeated training sessions on the UroMentor™.

Results

Eighteen urologists voluntarily took part in the study. Total operating time was significantly lower after eight sessions of training by comparison ((111±10) seconds and (511±67) seconds, respectively; P<0.001). Additionally the frequency of injury decreased with training from (12±2) times to (5±1) times (P<0.001), while the number of digital markers observed increased from 9±0 to 10±1 (P=0.005). Finally, training with the UroMentor™ resulted in a GRS increase from (1.3±0.2) points to (3.9±0.2) points (P<0.001 ).

Conclusion

the VRS UroMentor™ can improve urologists’ ability to perform flexible cystoscopy and could be used as an effective training tool for trainees.
Training for percutaneous renal access on a virtual reality simulator
Authors: ZHANG Yi , YU Cheng-fan , LIU Jin-shun , WANG Gang , ZHU He , NA Yan-qun
Published: January 2024

Background

The need to develop new methods of surgical training combined with advances in computing has led to the development of virtual reality surgical simulators. The PERC Mentor™ is designed to train the user in percutaneous renal collecting system access puncture. This study aimed to validate the use of this kind of simulator, in percutaneous renal access training.

Methods

Twenty-one urologists were enrolled as trainees to learn a fluoroscopy-guided percutaneous renal accessing technique. An assigned percutaneous renal access procedure was immediately performed on the PERC Mentor™ after watching instruction video and an analog operation. Objective parameters were recorded by the simulator and subjective global rating scale (GRS) score were determined. Simulation training followed and consisted of 2 hours daily training sessions for 2 consecutive days. Twenty-four hours after the training session, trainees were evaluated performing the same procedure. The post-training evaluation was compared to the evaluation of the initial attempt.

Results

During the initial attempt, none of the trainees could complete the appointed procedure due to the lack of experience in fluoroscopy-guided percutaneous renal access. After the short-term training, all trainees were able to independently complete the procedure. Of the 21 trainees, 10 had primitive experience in ultrasound-guided percutaneous nephrolithotomy. Trainees were thus categorized into the group of primitive experience and inexperience. The total operating time and amount of contrast material used were significantly lower in the group of primitive experience versus the inexperience group (P=0.03 and 0.02, respectively).

Conclusions

The training on the virtual reality simulator, PERC Mentor™, can help trainees with no previous experience of fluoroscopy-guided percutaneous renal access to complete the virtual manipulation of the procedure independently. This virtual reality simulator may become an important training and evaluation tool in teaching fluoroscopy-guided percutaneous renal access.
Virtual reality simulator for training urologists on transurethral prostatectomy
Authors: ZHU He , ZHANG Yi , LIU Jin-shun , WANG Gang , YU Cheng-fan , NA Yan-qun
Published: January 2024

Background

A virtual reality simulator provides a novel training model for improving surgical skills in a variety of fields. They can simulate a variety of surgical scenarios to improve the overall skills required for endoscopic operations, and also record the operative process of trainees in real-time and allow for objective evaluation. At present, some simulators for transurethral resection of the prostate (TURP) are available. The utility of virtual reality simulators in training of transurethral prostatectomy was investigated.

Methods

Thirty-eight urologists were randomly selected to take part in a simulation based training of TURP using the TURPSim™ system. Pre and post-training global rate scale (GRS) scores and objective parameters recorded by the simulator were assessed. Then, questionnaires were filled out.

Results

Compared with baseline levels, the GRS scores of trainees increased (18.0±4.0 vs. 12.4±4.2, P <0.001), while the rate of capsule resection (26.3%±0.6% vs. 21.2%±0.4%, P <0.001), amount of blood loss ((125.8±86.3) ml vs. (83.7±41.6) ml, P<0.001), external sphincter injury (3.6±2.9 vs. 2.0±2.0, P <0.001) decreased significantly after training. Most trainees were satisfied with the simulator based training and believed that the simulator accurately mimicked actual surgical procedures and could help improve their surgical skills.

Conclusions

As a new method of training on transurethral prostatectomy skills, training of TURP using a virtual simulator can help urologists improve their surgical skills and safety. Therefore, the application of the TURPSim™ system in education and training of urologic surgery is warranted.
Effect of low-molecular-weight heparin and urokinase on pulmonary arteries involved in pulmonary embolism
Authors: WU Jun-ping , SUN Xin , WU Qi , DU Zhong-zhen , LI Li , WU Qian , SUN Hong-fen
Published: January 2024

Background

Pulmonary embolism (PE) is a common and often fatal disease. Early after pulmonary thromboembolism, inflammation and associated intimal hyperplasia occur within the pulmonary arteries, similar to what is observed with chronic thromboembolic pulmonary hypertension. This study tested the hypothesis that thrombolytic and anticoagulant agents would have anti-inflammatory effects or inhibit intimal hyperplasia of involved pulmonary arteries.

Methods

Seventy-two male New Zealand white rabbits were randomly divided into two groups (54 rabbits in the PE group and 18 in the sham group). Experimental PE was induced in 54 rabbits by femoral vein injection of autologous blood clots and confirmed with pulmonary angiography, and other 18 rabbits underwent sham operations. Fifty-four rabbits in the PE group were randomly divided into three groups: a control group (treated with normal saline), a low-molecular-weight heparin (LMWH) group (treated with LMWH), and a urokinase (UK) group (treated with UK). Arterial blood gas was analyzed at 2, 7, and 28 days (n=6 per time point by random group division), then lung tissues were removed and were analyzed for pro-inflammatory cytokines and chemokines, and were stained for intimal hyperplasia.

Results

The overall survival of rabbits undergoing PE was 100%. PE distribution detected on digital signal angiography (DSA) and histopathology was shown in 67% of rabbits (36/54) in the bilateral low lobar pulmonary arteries (PAs). The results showed that alveolar-arterial partial pressure of oxygen (PO2) difference (PA-aO2) significantly increased and PO2 decreased in the control group compared with the sham group. Compared with controls, the UK group had a decreased level of PA-aO2 on day 2 (P <0.05), however, there was no significant difference in the LMWH group. Compared with controls, the LMWH group had a decreased level of monocyte chemoattractant protein-1 (MCP-1) in affected tissue and serum samples on days 7 and 28 (P <0.05), and the UK group had decreased levels on days 2 and 7 (P <0.05). Compared with sham group, all PE groups had an increased level of interleukin-13 (IL-13) and transforming growth factor-β (TGF-β) in unaffected lung tissue samples at days 2 and 7. IL-13 in affected lung tissue in the LMWH group was decreased at all time points compared with controls (P <0.05). However, TGF-β in affected lung tissue of the LMWH and UK groups increased at day 28. There was less intimal hyperplasia in involved pulmonary arteries at days 7 and 28 in the LMWH group compared with controls; there was no statistical difference in the UK group compared with controls.

Conclusions

UK treatment can rapidly improve the V/Q mismatch in PE and appears a short-term anti-inflammatory benefit. However, LMWH maybe inhibit the later local inflammatory reaction and reduce intimal hyperplasia.
Severe pathological manifestation of cerebral amyloid angiopathy correlates with poor outcome from cerebral amyloid angiopathy related intracranial hemorrhage
Authors: TANG Ya-juan , WANG Shuo , ZHU Ming-wei , SUN Yi-lin , ZHAO Ji-zong
Published: January 2024

Background

Cerebral amyloid angiopathy (CAA) is one of the main causes of spontaneous intracranial hemorrhage (ICH). No established link is available between pathological scores of CAA and its outcome. This study aimed to identify the correlations between pathological severity and poor postoperative outcome in the Chinese population.

Methods

Between May 2006 and April 2011, 367 consecutive patients who underwent surgery for CAA-related ICH in 71 hospitals throughout the mainland of China were enrolled in this study. Twelve months after surgery, we evaluated these patients' outcomes according to the modified Rankin Scale (mRS) and statistically correlated risk factors (demographics, medical history, pathological results, and surgical details) that are associated with a favorable (mRS <3) and poor (mRS ≥3) outcome groups.

Results

Risk factors for poor postoperative outcome in 367 patients with CAA-related ICH included advanced age (OR 1.034, 95% CI 1.001-1.067, P=0.042), CAA pathology severity (OR 2.074, 95% CI 7.140-16.25, P <0.001), lobar hematoma (OR 0.225, 95% CI 0.104-0.486, P <0.001), presence of intraventricular hemorrhage (OR 0.478, 95% CI 0.229-1.001, P=0.050), and/or subarachnoid hemorrhage (OR 2.629, 95% CI, 1.051-6.577, P=0.039).

Conclusions

Poor postoperative outcome of patients with CAA-related ICH was more related to the severe pathological manifestation instead of other factors. Prior ischemia may present an early stage of CAA.
Grading system modification and management of blunt aortic injury
Authors: Reddy Kaavya N , Matatov Tim , Doucet Linda D , Heldmann Maureen , Zhao Cynthia X , Zhang Wayne W
Published: January 2024

Background

The traditional approach to blunt aortic injury (BAI) has been emergent intervention. This study aimed to utilize a modified imaging grading system that may allow us to categorize these injuries as needing emergent, urgent, or non-operative management.

Methods

From January 2003 to December 2011, 28 patients with BAI were managed at our institution. Imaging and medical records were reviewed retrospectively. BAI was classified into 4 grades based on imaging studies. Grade Ia: intimal tear, Grade Ib: intramural hematoma; Grade II: intimal injury with periaotic hematoma; Grade IIIa: aortic transection with pseudoaneurysm, Grade IIIb: multiple aortic injuries; and Grade IV: free rupture. Progression and clinical outcomes of ABI were analyzed.

Results

Of the 28 patients, 22 were males and 6 were females with mean age of 38 (range, 7-69) years. Twenty-five (89.3%) had descending thoracic aortic injury, two (7.1%) had abdominal aortic injury and one (3.6%) presented with multiple aortic injuries. Three patients (10.7%) with Grade I, 1 (3.6%) Grade II, 22 (78.6%) Grade III, and 2 (7.1%) Grade IV injuries. Twenty-five patients underwent thoracic endovascular aortic repair and 3 were managed medically. Median time between injury and surgical intervention was (2+1) days. One (3.6%) patient developed paraplegia after thoracic endovascular aortic repair (TEVAR). One Type 2 endoleak spontaneously sealed within 1 month, and another patient died from ruptured Type 1 endoleak 3 years later. Median follow-up time was 16 (range, 1-96) months. Perioperative 30-day mortality rate was 3.6%.

Conclusions

This study based on our modified BAI grading system indicated that Grade I BAI can be managed conservatively. Grade II injury requires close observation and repeated computerized tomography angiogram (CTA) within 48-72 hours. If injury appears worse on follow up imaging, surgery should be performed. Delayed repair of Grade III BAI is acceptable if associated life threatening traumatic injuries need to be addressed first.