小脑变性相关蛋白2 mRNA在癫痫患者脑组织中的表达及其临床意义

目的了解小脑变性相关蛋白2(CDR2)mRNA在癫痫(EP)患者脑组织中的表达及其临床意义。方法将48例EP患者分成耐药(40例)和非耐药(8例)两组,用基因芯片扫描和FQ-PCR分别检测脑组织中CDR2基因表达,并与对照组比较。结果基因芯片扫描提示CDR2 mRNA在EP患者与对照组中的表达差异有统计学意义(P<0.05)。FQ-PCR结果与基因芯片扫描一致。结论EP患者脑组织中有CDR2 mRNA表达,由于其表达产物可通过血-脑脊液屏障进入脑脊液(CSF)和血液中,因而检测CDR2 mRNA在血或CSF中的表达产物有可能成为诊断EP的一个重要指标。     

快速康复外科理念在关节镜下治疗肩袖损伤中的应用

目的探讨快速康复外科理念在关节镜下治疗肩袖损伤中的应用效果。 方法回顾性分析自2015年2月至2016年8月咸宁市中心医院关节外科收治的肩袖损伤患者37例,所有患者术前诊断为单纯肩袖损伤并在关节镜下行肩袖缝合修补术。随机将37例无合并严重内科疾患的单纯肩袖损伤患者分为快速康复组(FTS)和传统康复组(TRG),其中FTS组19例,男10例,女9例,平均年龄(43±9)岁(22～60岁);TRG组18例,男11例,女7例,平均年龄(42±8)岁(19～63岁)。术后1周、1、3个月随访时比较两组Constant-Murley评分、美国肩与肘协会评分系统(ASES)、加州大学肩关节评分系统(UCLA)、患者满意度及术后住院时间。FTS组与TRG组均数比较采用t检验,切口愈合不良发生率比较采用Fisher检验,性别及肩袖损伤分类应用χ²检验。 结果术后1周Constant-Murley评分、ASES评分、UCLA评分、患者满意度FTS组均明显高于TRG组(t＝2.217,t＝2.255,t＝2.457,t＝2.537,P<0. 05),术后1个月Constant-Murley评分、ASES评分、UCLA评分、患者满意度FTS组均明显高于TRG组(t＝2.395,t＝2.693,t＝2.204,t＝2.183,P<0. 05)。术后住院时间、住院总费用FTS组均低于TRG组(t＝2.695,t＝2.179,P<0. 05);切口愈合不良发生率FTS组与TRG组差异无统计学意义(F＝0.717,P>0. 05)。FTS术后3个月的Constant-Murley评分、ASES评分UCLA评分及患者满意度与TRG比较无明显差异(t＝1.873,t＝1.737,t＝1.984,t＝1.483,P>0. 05)。 结论快速康复外科理念在关节镜下治疗肩袖损伤中的应用可有效促进术后患者的早期康复,改善肩关节评分,缩短住院时间,提高患者满意度等优点。     

Aucubin prevents interleukin-1 beta induced inflammation and cartilage matrix degradation via inhibition of NF-κB signaling pathway in rat articular chondrocytes

Proinflammatory cytokine interleukin-1β (IL-1β) plays a crucial role in the pathogenesis of Osteoarthritis (OA) by stimulating several mediators contributed to cartilage degradation. Aucubin, a natural compound derived from plants which has been shown to possess diverse biological activities including anti-inflammatory property, may benefit the IL-1β stimulated chondrocytes. The present study was aimed to investigate the effects of Aucubin on IL-1β stimulated rat chondrocytes. Rat chondrocytes were cultured and pretreated with Aucubin (1, 10, 20, 50 μM), and then stimulated with or without IL-1β (10 ng/ml). Gene and protein expression of MMP-3, MMP-9, MMP-13, cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS) was determined by real-time PCR and Western blotting respectively. Nitric oxide (NO) production was quantified by Griess reagent. Phosphorylation and nuclear translocation of p65 were detected by western blotting and immunofluorescence, respectively. We found that Aucubin significantly reversed the elevated gene and protein expression of MMP-3, MMP-9, MMP-13, iNOS, COX-2 and the production of NO induced by IL-1β challenge in rat chondrocytes. Furthermore, Aucubin was able to suppress the IL-1β-mediated phosphorylation and nuclear translocation of p65, indicating Aucubin may possibly act via the NF-κB signaling pathway. The present study proposes that Aucubin may be a potential therapeutic choice in the treatment of OA due to its anti-inflammatory and chondroprotective features.     

Observations and Single-Center Outcomes in Orthotopic Heart Transplant for Patients With Adult Congenital Heart Disease: A Call for Equity and Parity

BackgroundFor persons with adult congenital heart disease (ACHD), optimum patient selection and eligibility for orthotopic heart transplant (OHT) is not well defined. There is difficulty quantifying risk in patients with ACHD, leading to variability in OHT listing time and status. They are often disadvantaged due to a lack of mechanical support options, a shortage of congenital surgeons, and encounters with risk adverse health care programs. We examined patient characteristics and outcomes of a contemporary cohort of patients with ACHD undergoing OHT at a single high-volume Adult Congenital Heart Association accredited transplant center.MethodsRetrospective analysis of 49 consecutive patients with ACHD who underwent OHT from November 2010 through March 2020 was performed. Survival analysis was performed using Kaplan-Meier analysis.ResultsSurvival at 1 month, 1 year, 3 years, and 10 years was 94%, 92%, 92%, and 83%, respectively.ConclusionsThis study highlights the diversity and complexity of the population with ACHD proceeding to OHT as well as the multispecialty care needed to overcome disadvantages and optimize survival. Continued national discussions and policy adjustments will be necessary to bring parity and equity to this unique population.     

Zafirlukast attenuates advanced glycation end-products (AGEs)-induced degradation of articular extracellular matrix (ECM)

Zafirlukast, a leukotriene receptor antagonist, has been shown to exert a wide range of effects including anti-asthmatic, anti-inflammatory and oral anti-bacterial. Osteoarthritis is one of the most prevalent age-related public health burdens in the modern world. In the present study, we applied zafirlukast in the treatment of human primary chondrocytes and found that it exerts potent anti-osteoarthritic effects. Zafirlukast inhibited AGEs-induced degradation of the articular extracellular matrix by suppressing expression of MMPs, ADAMTS, NOX-4, generation of ROS, and activation of NF-κB via the IκBα/JNK/AP-1 pathway through targeted inhibition of CysLTR1. These findings suggest that zafirlukast possesses a protective effect against AGEs- induced damage and dysfunction in human chondrocytes.     

Downregulation of mTOR by lentivirus inhibits prostate cancer cell growth

Prostate cancer, one of the most lethal forms of urinary system cancer, remains resistant to currently available treatments. Therefore, novel mechanism and target-based approaches are needed for the management of this neoplasm. PI3K/AKT signaling pathway activation correlates with human prostate cancer progression and metastasis. However, the role of mTOR in prostate cancer is not well-established. Here, we demonstrate that mTOR is over-expressed in both clinical tissue specimens and cultured human prostate cancer cells when compared to normal prostate tissues, respectively. Further, mTOR gene knockdown via lentivirus mediated mTOR specific shRNA resulted in a significant decrease in the viability and growth of prostate cancer cells without affecting normal human prostate cells. In addition, mTOR inhibition resulted in a significant i) decrease in 4EBP1, S6K, PI3K and AKT protein, ii) increase in PARP protein of prostate cancer cells. Most importantly, mTOR inhibition triggered apoptosis and suppressed pancreatic carcinoma growth in vivo in a mouse xenograft model. We suggest that targeting of mTOR may be a viable approach for the treatment of prostate cancer.     

Comparison of embolic agents for varices during transjugular intrahepatic portosystemic shunt for variceal bleeding: Tissue gel or coil?

PurposeWe aimed to compare treatment efficacy, safety and material cost between tissue gel and coil regarding variceal embolization during transjugular intrahepatic portosystemic shunt (TIPS).Materials & Methods: This retrospective study including cirrhotic patients with variceal bleeding treated with TIPS combined with variceal embolization between January 2016 and August 2017. Patients were divided into three groups according to embolic agents used in variceal embolization: tissue gel group (Group A), combination group (Group B), and coil group (Group C). The primary endpoint was 1-year rebleeding rate after TIPS creation. The secondary endpoints included shunt dysfunction, overt hepatic encephalopathy, liver function, and embolic agents-related expense.ResultsA total of 60 patients (30, 10, and 20 in Group A, B, and C) were included. Variceal rebleeding occurred in 3 (10%), 0 (0%), and 4 (20%) patients within one year after TIPS creation in Group A, B, and C, respectively. Stent dysfunction occurred in 2 (3.3%) patients and 9 (15.0%) patients experienced overt hepatic encephalopathy. No significant differences were observed between three groups regarding primary and secondary endpoints except embolic agents-related expense, with a significantly lower cost in Group A when compared to the other two groups. Stent dysfunction occurred in two patients, with one patient in Group A developed acute occlusion caused by thrombus and another patient in Group C underwent stent stenosis during follow-up.ConclusionsCompares to coil alone or combines with coil, tissue gel has similar treatment efficacy and safety, but with significantly lower cost for variceal bleeding during TIPS.