Coronal Diffusion-weighted Magnetic Resonance Imaging of the Kidney: Agreement with Axial Diffusion-weighted Magnetic Imaging in Terms of Apparent Diffusion Coefficient Values

Background:

Coronal diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) values have gradually become applied (following conventional axial DW-MRI) in the renal analysis. To explore whether data obtained using coronal DW-MRI are comparable with those derived using axial DW-MRI, this preliminary study sought to assess the agreement in renal ADC values between coronal DW-MRI and axial DW-MRI.

Methods:

Thirty-four healthy volunteers were enrolled in the study; written consents were obtained. All subjects underwent respiratory-triggered axial and coronal DW-MRI using a 1.5-MR system with b values of 0 and 800 s/mm². The signal-to-noise ratios (SNRs) of the two DW-MRI sequences were measured and statistically compared using the paired t-test. The extent of agreement of ADC values of the upper pole, mid-pole, and lower pole of the kidney; the mean ADC values of the left kidney and right kidney; and the mean ADC values of the bilateral kidneys were evaluated via calculation of intraclass correlation coefficients (ICCs) or Bland–Altman method between the two DW-MRI sequences.

Results:

The SNR of coronal DW-MR images was statistically inferior to that of axial DW-MR images (P < 0.001). The ICCs of the ADC values of each region of interest, and the mean ADC values of bilateral kidneys, between the two sequences, were greater than 0.5, and the mean ADCs of the bilateral kidneys demonstrated the highest ICC (0.869; 95% confidence interval: 0.739–0.935). In addition, 94.1% (32/34), 94.1% (32/34), and 97.1% (31/34) of the ADC bias was inside the limits of agreement in terms of the mean ADC values of the left kidneys, right kidneys, and bilateral kidneys when coronal and axial DWI-MRI were compared.

Conclusions:

ADC values derived using coronal DW-MRI exhibited moderate-to-good agreement to those of axial DW-MRI, rendering the former an additional useful DW-MRI method, and causing the ADC values derived using the two types of DW-MRI to be comparable.     

Long-term Efficacy of Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease: A 5-year Follow-up Study in China

Background:

Subthalamic nucleus deep brain stimulation (STN DBS) is effective against advanced Parkinson''s disease (PD), allowing dramatic improvement of Parkinsonism, in addition to a significant reduction in medication. Here we aimed to investigate the long-term effect of STN DBS in Chinese PD patients, which has not been thoroughly studied in China.

Methods:

Ten PD patients were assessed before DBS and followed up 1, 3, and 5 years later using Unified Parkinson''s Disease Rating Scale Part III (UPDRS III), Parkinson''s Disease Questionnatire-39, Parkinson''s Disease Sleep Scale-Chinese Version, Mini-mental State Examination, Montreal Cognitive Assessment, Hamilton Anxiety Scale and Hamilton Depression Scale. Stimulation parameters and drug dosages were recorded at each follow-up. Data were analyzed using the ANOVA for repeated measures.

Results:

In the “off” state (off medication), DBS improved UPDRS III scores by 35.87% in 5 years, compared with preoperative baseline (P < 0.001). In the “on” state (on medication), motor scores at 5 years were similar to the results of preoperative levodopa challenge test. The quality of life is improved by 58.18% (P < 0.001) from baseline to 3 years and gradually declined afterward. Sleep, cognition, and emotion were mostly unchanged. Levodopa equivalent daily dose was reduced from 660.4 ± 210.1 mg at baseline to 310.6 ± 158.4 mg at 5 years (by 52.96%, P < 0.001). The average pulse width, frequency and amplitude at 5 years were 75.0 ± 18.21 μs, 138.5 ± 19.34 Hz, and 2.68 ± 0.43 V, respectively.

Conclusions:

STN DBS is an effective intervention for PD, although associated with a slightly diminished efficacy after 5 years. Compared with other studies, patients in our study required lower voltage and medication for satisfactory symptom control.     

Evaluation of the relationship between T663A polymorphism in the alpha-epithelial sodium channel gene and essential hypertension

Objectives:

To evaluate the relationship between alpha epithelial sodium channel (alpha-ENaC) T663A polymorphism and the risk of essential hypertension.

Methods:

This meta-analysis was conducted between November 2014 and February 2015 in Shanghai Medical Instrumentation College, Shanghai, China. We collected all published available case-control data (N=12) identified through PubMed, Web of Science, Scopus, and Chinese National Knowledge Infrastructure (CNKI) up to December 2014. The pooled odds ratio (OR) with 95% confidence interval (CI) was calculated using the fixed- or random-effect model.

Results:

Although subgroup analysis showed that alpha-ENaC T663A polymorphism was associated with essential hypertension in North American individuals (OR=1.55, 95% CI=1.22-1.98, p=0.0003), our meta-analysis results did not confirm such association overall (OR=1.03, 95% CI=0.92-1.15, p=0.62). The lack of association was further confirmed by the non-superiority test (p<0.0001).

Conclusion:

Alpha-ENaC T663A polymorphism might not be a risk factor for essential hypertension.Hypertension is one of the most important risk factor for cardiovascular disease.1-3 However, its etiology in the vast majority of cases (~90%) is unknown, and thus the essential hypertension term is employed to describe such situations.4 Nowadays, essential hypertension is considered as a multifactorial disease resulting from the interplay of many genetic, environmental, and behavioral factors.5 Among them, sodium has long been deemed as one of the pivotal environmental factors due to its direct regulatory effect on blood pressure.5,6 The amiloride-sensitive epithelial sodium channel (ENaC) lies in the collecting duct of the kidney, and regulates sodium reabsorption. This channel is composed of 3 homologous subunits: alpha, beta, and gamma. Several studies have reported that mutations in beta-ENaC or gamma-ENaC can result in constitutive sodium reabsorption, thus leading to the development of an autosomal-dominant Mendelian hypertensive disorder, Liddle syndrome.7-11 Therefore, some “milder” mutations or functional polymorphisms were assumed to play some etiological roles in essential hypertension. Following this hypothesis, recent studies have reported some potential associated variants.12 Among them, T663A polymorphism in the alpha-ENaC gene has attracted some attention due to its reported ability to influence the channel activity.13,14 The A allele of T663A polymorphism could reduce the surface expression of ENaC, and the T allele of T663A polymorphism could increase ENaC activity.13,14 Accordingly, Ambrosius et al15 observed that the A allele of T663A polymorphism was associated with being normotensive in Blacks and Caucasians. However, a similar study performed in a Japanese population indicated that the A allele of T663A polymorphism was enriched in essential hypertensive patients,16 and Wang et al17 found that there was a lack of association between the T663A polymorphism and essential hypertension in 2 ethnic groups in China. Therefore, there is still a controversy over the association between T663A polymorphism in the alpha-ENaC gene and essential hypertension. Therefore, we performed a meta-analysis to investigate the relationship between alpha-ENaC T663A polymorphism and essential hypertension.     

Proteomic analysis of exosomes derived from human lymphoma cells

Background

Exosomes secreted by tumor cells contain specific antigens that may have immunotherapeutic purposes. The aim of this study was to characterize the proteomic content of lymphoma cell-derived exosomes (LCEXs).

Methods

In this study, exosomes derived from Raji cells (EXO_Raji) were purified and proteins of EXO_Raji were separated by one-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis. Protein bands were identified by mass spectrometry. The protein components of EXO_Raji were analyzed using shotgun technology, and the function proteins of EXO_Raji were defined and described using the Gene Ontology (GO) database and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis.

Results

A total of 197 proteins were identified in EXO_Raji; 139 proteins were also identified in Raji cells, showing an overlap of 70.56% of the total proteins in EXO_Raji. Interestingly, the remaining 58 proteins were unique to EXO_Raji. The GO database and KEGG were used to define and describe the function of proteins. The data showed that some important proteins involved in antigen procession and presentation as well as cell migration and adhesion were also identified in EXO_Raji, such as MHC-I and II, HSC70, HSP90, and ICMA-1.

Conclusions

LCEXs express a discrete set of proteins involved in antigen presentation and cell migration and adhesion, suggesting that LCEXs play an important role in the regulation of immunity and interaction between lymphoma cells and their microenvironment. LCEXs harbor most of the proteins of lymphoma cells and could be one of the sources of lymphoma-associated antigens for immunotherapeutic purposes.     

微小RNA-320a通过靶向FoxM1调控肝癌细胞迁移

目的：探讨微小RNA-320a (miR-320a)在肝癌细胞中对癌基因FoxM1的靶向调控作用以及对肝癌细胞迁移能力的影响,为肝癌治疗提供新的靶点。方法通过信息学工具网站http：//www.microRNA.org找到可能靶向调控FoxM1表达的微小RNA;利用蛋白印记和双荧光素酶报告基因试验验证miR-320a对FoxM1的调控作用;采用Transwell小室分析miR-320a和FoxM1对肝癌细胞迁移的影响。结果信息学分析表明,miR-320a在FoxM1的3'端非翻译区存在2个潜在结合位点。蛋白印迹实验显示miR-320a降低FoxM1在肝癌细胞中的蛋白水平,双荧光素酶报告基因试验显示miR-320a可以调控FoxM1表达。miR-320a类似物对FoxM1表达有下调作用（P<0.01）,miR-320a抑制物对FoxM1表达有上调作用（P<0.05）。Transwell试验表明miR-320a类似物可抑制肝癌细胞株Huh7、HCC-LM3的迁移能力,miR-320a抑制物可增加Huh7、HCC-LM3的迁移能力。当使用小干扰RNA下调FoxM1在这些细胞株中的表达后,miR-320a类似物和miR-320a抑制物对肝癌细胞迁移能力的调控作用明显减弱。结论 miR-320a有抑制肝癌细胞迁移的作用,这种抑制作用是通过靶向调控癌基因FoxM1来实现的。     

经气管切开导管高流量氧疗的生理效应及临床应用

经气管切开导管高流量氧疗(THFO)与经鼻高流量氧疗有相近的生理效应,提供准确的吸入氧浓度、最佳的气道湿化。但THFO由于连接界面不同,研究显示其对死腔的冲刷作用有限,呼气末正压效应不明显。THFO目前主要应用于长期机械通气患者的撤机、慢性呼吸衰竭患者的家庭氧疗以及气管切开术后的氧疗等,其临床应用也在不断地被探索,但目前还没有大样本随机临床试验研究。在临床上,应根据患者实际情况进行综合评估后,选择适当的治疗手段。     

南京市区老年人便秘患病率及其与亚健康症状关系的调查

目的 为了解南京市老年人便秘现状，以及探讨便秘与亚健康的关系。方法 采用整群抽样方法，对南京市2个街道(20个居委会)和1个老年公寓60岁以上3731名老年人进行便秘与亚健康调查。结果 南京市老年人便秘患病率为24.0％，并随年龄增长其患病率增高(P＜0．01)。根据32项亚健康症状调查，便秘组(男性：28项；女性：23项)亚健康症状的发生率均高于非便秘组；前10位亚健康症状中，皮肤瘙痒和皮肤干燥为便秘者易发生的亚健康症状；便秘者平均个体有3种以上亚健康症状者(64．6％)明显高于非便秘组(42.7％，P＜0.01)。结论 老年人便秘的患病率较高，便秘者较易发生亚健康症状。防治老年人便秘，对预防亚健康症状的发生及增进老年人健康非常重要。     

蒲公英提取物体外抗毛囊蠕形螨活性及皮肤安全性的实验研究

目的 探讨蒲公英治疗蠕形螨病的应用价值。 方法 将粉碎的蒲公英浸泡于80％乙醇中12 h，然后85 ℃回流提取蒲公英提取液，同法制备百部提取液。取蠕形螨感染者面部皮脂，分离并鉴定蠕形螨备用。设蒲公英实验组，百部对照组和生理盐水对照组，每组蠕形螨15只，进行体外抗螨实验。pH仪测定蒲公英提取物pH值。设蒲公英试验组和75%乙醇对照组，应用健康家兔进行皮肤刺激实验和急性皮肤毒性试验。 结果 蒲公英提取物的体外杀螨时间为（1.50±0.65） min，显著短于百部提取物的体外杀螨时间（3.53±1.04） min（P＜0.01），生理盐水组螨死亡时间大于120 min。蒲公英提取物的pH值为5.00±0.28，对家兔完整皮肤的刺激评分为0，破损皮肤的刺激评分为0.3，无明显毒性。 结论 蒲公英提取物具有较强的体外抗毛囊蠕形螨活性且具有皮肤安全性。     

Comparison of percutaneous microwave ablation and laparoscopic resection in the prognosis of liver cancer

The effect of percutaneous microwave ablation and laparoscopic resection on the prognosis of liver cancer was investigated. Ninety patients with liver cancer treated at our hospital from March 2010 to March 2012 were divided into group A and group B (n=45) by using a random number table, and the surgical conditions and the prognosis were compared. The surgical conditions of patients in group A were significantly better than those in group B (P<0.05). The incidence of complications in group A was 6.67%, which was obviously lower than that of group B (P<0.05). The local recurrence rate of group A was 20.00%, and that of group B was 8.89%, which showed a significant difference (P<0.05). The two groups did not differ significantly in terms of either total recurrence rate (P>0.05) or 1-year, 2-year and 3-year survival (P>0.05). Both percutaneous microwave ablation and laparoscopic resection had a good long-term efficacy in liver cancer. However, percutaneous microwave ablation was superior as it caused less invasiveness, reduced the incidence of complications and improved prognosis of liver cancer.