Hepatocellular carcinoma and the underlying mechanisms

The incidence of hepatocellular carcinoma is increasing worldwide as well as the associated risk factors, some of which include exposure to aflatoxin B1, Hepatitis B (HBV) virus and hepatitis C (HCV) virus. Mutation of tumour suppressor gene p53 at codon 249^ser at exon 7 has been found to contribute significantly to replication of damaged DNA and subsequent tumour progression. The x gene of HBV (HBx) is the most common open reading frame integrated into the host genome in hepatocellular carcinoma and the integrated HBx is frequently mutated in hepatocellular carcinoma. Mutant HBx proteins still retain their ability to bind to p53 thereby attenuating DNA repair and p53-mediated apoptosis.     

Changes in weight during the first year after kidney transplantation

CONTEXT: Obesity frequently occurs following kidney transplantation and is of concern because of the associated risk for cardiovascular complications. OBJECTIVE: To examine weight gain over the first year after kidney transplantation to determine associations with gender, ethnicity, and cardiovascular risk factors. DESIGN: A retrospective analysis was completed on patients who had received transplants between January 1998 and January 2002 and who had matching baseline and 1-year follow-up data and a functional graft. PARTICIPANTS: The sample consisted of 171 recipients (33% women, 58% African Americans, and 39% whites) with a mean age of 44 +/- 12.2 years. MAIN OUTCOME MEASURES: Outcome measures included fasting blood sugar, triglycerides, creatinine levels, and body mass index categorized as normal, overweight, or obese. RESULTS: The total group showed a significant increase in mean weight (6.2 +/- 10.7 kg) and body mass index (2.1 +/- 3.8). Although equivalent at baseline, by 1 year after transplantation there were significantly more obese than normal-weight recipients, regardless of gender or ethnicity, with African Americans increasing more than whites and women more than men. At baseline, those characterized as obese versus normal weight were older (47 vs. 41 years; P < .05), with a higher fasting blood sugar. At 1 year, differences in age and fasting blood sugar disappeared; however, the obese group had higher triglycerides (235 vs. 165, P = .01). CONCLUSIONS: Weight gain after transplantation was not explained by demographic and clinical factors. We speculate additional variables such as genetic factors influence weight gain and warrant study.     

Surgical hypothermia in a patient with a cold agglutinin. Management by plasma exchange

Cold agglutinins are a potential danger to patients who must be subjected to hypothermia. A patient with a cold agglutinin of moderate titer but broad thermal amplitude was to undergo hypothermia during aortic valve replacement. He was managed preoperatively with an eight- liter plasma exchange by continuous-flow centrifugation to remove the cold agglutinin. There were no adverse effects during or after hypothermia.     

地特胰岛素与甘精胰岛素控制2型糖尿病患者血糖情况的随机、交叉、双盲比较研究

地特胰岛素和甘精胰岛素均是基础胰岛素类似物，适用于每日1次单药治疗或与其他降糖药物联合治疗2型糖尿病。葡萄糖钳夹试验显示地特胰岛素和甘精胰岛素的作用时间相似。此研究旨在采用连续血糖监测系统（CGMS）比较地特胰岛素和甘精胰岛素控制24h血糖的情况。     

Effects of medications on hypoxia-inducible factor in the retina: A review

Hypoxia-inducible factor (HIF) plays a critical role in the mechanisms that allow cells to adapt to various oxygen levels in the environment. Specifically, HIF-1⍺ has shown to be widely involved in cellular repair, survival, and energy metabolism. HIF-1⍺ has also been found in increased levels in cancer cells, highlighting the importance of balance in the hypoxic response. Promoting HIF-1⍺ activity as a potential therapy for degenerative diseases and inhibiting HIF-1⍺ as a therapy for pathologies with overactive cell proliferation are actively being explored. Digoxin and metformin, HIF-1⍺ inhibitors, and deferoxamine and ⍺-ketoglutarate analogues, HIF-1⍺ activators, are being studied for application in age-related macular degeneration, diabetic retinopathy, and retinitis pigmentosa. However, these same medications have retinal toxicities that must be assessed before implementation of therapeutic care. Herein, we highlight the duality of therapeutic and toxic potential of HIF-1⍺ that must be carefully assessed prior to its clinical application in retinal disorders.