Bilateral simultaneous tubal sextuplets: pregnancy after in-vitro fertilization--embryo transfer following salpingectomy

The presence of a damaged tube has been suggested in recent studies to have a negative effect on in-vitro fertilization (IVF) outcome. Performing bilateral salpingectomy prior to IVF to maximize pregnancy rates may also result in unnecessary surgery. This case is also an example of the occurrence of interstitial pregnancy after salpingectomy. This unusual type of ectopic pregnancy must be kept in mind when evaluating a patient suspected of a possible early abnormal gestation after assisted reproductive technolologies.      

A HIT-trapping strategy for rapid generation of reversible and conditional alleles using a universal donor

Targeted mutagenesis in model organisms is key for gene functional annotation and biomedical research. Despite technological advances in gene editing by the CRISPR-Cas9 systems, rapid and efficient introduction of site-directed mutations remains a challenge in large animal models. Here, we developed a robust and flexible insertional mutagenesis strategy, homology-independent targeted trapping (HIT-trapping), which is generic and can efficiently target-trap an endogenous gene of interest independent of homology arm and embryonic stem cells. Further optimization and equipping the HIT-trap donor with a site-specific DNA inversion mechanism enabled one-step generation of reversible and conditional alleles in a single experiment. As a proof of concept, we successfully created mutant alleles for 21 disease-related genes in primary porcine fibroblasts with an average knock-in frequency of 53.2%, a great improvement over previous approaches. The versatile HIT-trapping strategy presented here is expected to simplify the targeted generation of mutant alleles and facilitate large-scale mutagenesis in large mammals such as pigs.

Following the completion of animal genome sequencing projects, rapid and efficient mutagenesis strategies are needed for analyzing gene function and for creating human disease models. Gene trapping is a high-throughput mutagenesis strategy whereby random vector insertion can be achieved across the mouse genome. A typical gene-trap vector contains a promoter-less reporter/selection gene flanked by an upstream splice acceptor (SA) and a downstream poly(A) signal. Upon insertion into an intron of a gene, the vector both inactivates the trapped gene and enables the gene-specific expression of a reporter gene (Gossler et al. 1989; Stanford et al. 2001). To date, gene-trapping approaches have been successfully applied toward large-scale mutagenesis in mouse embryonic stem cells (mESCs) and generation of gene knockout mice (Skarnes et al. 2004). The main drawback of random gene trapping is that gene-trap alleles are not specifically engineered to target genes of interest in advance. Therefore, methods to streamline the introduction of predesigned, site-specific modifications into the genome by homologous recombination would represent a significant technological advance. Previously, a hybrid approach combining gene targeting and gene trapping (targeted trapping) enabled mutation of expressed genes in mESCs with high efficiency, using a gene-trap construct flanked by homologous sequences of the target locus (Friedel et al. 2005). Also, homologous recombination is commonly used for creating conditional alleles, which is essential to avoid embryonic lethality and to study the stage- and tissue-specific functions of genes (Branda and Dymecki 2004). However, both standard gene trapping and targeted trapping are only suitable for genes expressed in embryonic stem (ES) cells. Furthermore, construction of targeting donor vectors with homology arms is labor intensive and costly, and the low efficiency of homologous recombination is also a rate-limiting step for gene targeting in mammalian genomes.Recently, by taking advantage of precise genomic double-strand breaks (DSBs) created by the clustered regularly interspaced short palindromic repeats (CRISPR)-associated protein 9 (Cas9) system (Ran et al. 2013; Doudna and Charpentier 2014; Hsu et al. 2014), homology-directed repair (HDR) efficiency was substantially enhanced (Porteus and Carroll 2005), and even donors with short homology arms (Orlando et al. 2010) or single-stranded DNA oligonucleotides (Chen et al. 2011; Quadros et al. 2017) were found to be compatible with site-specific integration. However, each targeting donor for HDR still needs to be customized with gene-specific homology sequences. Because of the lack of ES cells for certain animals such as pigs, sheep, and cattle, the genome must be edited either in a zygote embryo or in a somatic cell for somatic cell nuclear transfer (SCNT) (Reddy et al. 2020). It is still not feasible to achieve large-scale insertional mutagenesis including conditional knockouts in these important species with random gene trapping or HDR-based methods. Also, the problem of genetic mosaicism in embryo editing remains unresolved (Mehravar et al. 2019), prompting a need for technological advances to accelerate genetic modification in somatic cells.Alternatively, the generally more efficient nonhomologous end joining (NHEJ) pathway has been exploited for site-specific insertion of exogenous DNA by simultaneous cleavage of both donor plasmid and genome using programmable nucleases (Cristea et al. 2013; Maresca et al. 2013; Brown et al. 2016; Suzuki et al. 2016; Sawatsubashi et al. 2018). In contrast to HDR-based strategies, NHEJ-mediated insertions do not require gene-specific homology arms, enabling diverse sites to be targeted with a universal donor vector. Therefore, we speculated that a gene-trap cassette could be inserted into a specific locus easily through this mechanism in any cell type.Here, by combining NHEJ-mediated knock-in and gene trapping, we developed a strategy for targeted mutagenesis, especially in somatic cells with low HDR activity, referred to as HIT-trapping. By using a universal donor, this strategy allows us to (1) create null alleles, (2) produce a fluorescent reporter signal that could potentially allow cells with null alleles to be identified very quickly, and (3) produce reversible and conditional alleles that would be very helpful to have in most animal models but are often cumbersome to create.     

Bacterial superantigen-treated intestinal epithelial cells upregulate heat shock proteins 25 and 72 and are resistant to oxidant cytotoxicity

While the pathological events evoked by infection are commonly described, effective host responses to bacteria and their products should primarily be protective. Heat shock protein (Hsp) expression is upregulated by many stimuli and serves to maintain intracellular protein integrity. The ability of the prototypic superantigen, Staphylococcus aureus enterotoxin B (SEB) to induce Hsps was investigated with BALB/c mice and by in vitro addition to the murine small intestinal epithelial cell line MSIE. SEB-treated (5 or 100 microg intraperitoneally) mice revealed increased Hsp25 and Hsp72, but not Hsc73, in jejunal lymphocytes and epithelial cells. A similar Hsp response to SEB occurred in MSIE cells and was preceded by activation of the ERK1/2 and p38 mitogen-activated protein kinases but not the SAPK/JNK pathway; pharmacological inhibition of ERK1/2, but not p38, significantly reduced SEB-induced Hsps. Moreover, SEB-treated MSIE cells were protected against oxidant-induced cytotoxicity (measured by 51Cr release) and F-actin depolymerization. Thus, SEB exposure results in a rapid induction of the Hsp25 and Hsp72 in intestinal epithelial cells, both directly and through lymphocyte activation, and we suggest that this event is important in protecting the gut from damage by Staphylococcus infection or in the reparatory process and may be a generalized response to lumen-derived bacterial toxins.     

骨髓间充质干细胞治疗急性心肌梗塞的实验研究

目的研究自体骨髓间充质干细胞(MSC)经冠脉内注射治疗急性心肌梗死(AMI)的有效性和可行性。方法球囊阻塞法制成AMI模型。经冠脉注入标记的MSC,4周后核素心肌断层显像检测相对心肌梗死面积、心肌灌注评分和射血分数,经导管检测左室收缩压(LVSP)、左室舒张末压(LVEDP)、压力升高最大速率( dP/dt)和压力下降最大速率(-dP/dt)。免疫荧光法分析MSC的植入和分化。结果与对照组相比,细胞治疗组射血分数显著增加(P<0.05),心肌灌注评分和相对心肌梗死面积显著降低(P<0.01,P<0.05),LVSP、 dP/dt和-dP/dt显著增加(P<0.05,P<0.01,P<0.01),LVEDP显著降低(P<0.05)。标记的MSC在心肌中阳性表达肌凝蛋白重链、连接蛋白43、平滑肌肌动蛋白和Ⅷ因子相关抗原。结论MSC在体内分化为心肌和血管组织,可改善AMI猪的心功能。     

Synergistic antimicrobial effect of cefotaxime and minocycline on proinflammatory cytokine levels in a murine model of Vibrio vulnificus infection.

BACKGROUND AND PURPOSE: Vibrio vulnificus causes primary bacteremia and necrotizing wound infection, leading to high morbidity and mortality in humans. This study aimed to evaluate the antimicrobial effect of cefotaxime and minocycline on proinflammatory cytokine levels in a murine model of V. vulnificus infection. METHODS: We investigated the dynamics of proinflammatory cytokines and their modulation by antimicrobial agents using a murine model of V. vulnificus infection. The change in cytokine levels was followed over a time course to identify the antimicrobial activity of the drugs against V. vulnificus. BALB/c female mice were challenged with an intraperitoneal infection using a clinical invasive isolate of Vv05191, and their cytokine levels were assayed over various time points. RESULTS: Serum levels of tumor necrosis factor-alpha, interleukin (IL)-1 beta, and IL-6 post-infection were found to be inoculum dose-dependent and positively correlated to the subsequent fatality rate in the infected mice. With an inoculum of 6.6 x 10(6) colony-forming units and intraperitoneal administration of cefotaxime, minocycline, or both, the serum and peritoneal fluid cytokine levels increased and then declined gradually. Comparison of the 3 antimicrobial regimens revealed that the magnitude of reduction in cytokine levels was greatest in mice treated with cefotaxime-minocycline combination. Moreover, the peritoneal fluid cytokine level in the combination group was significantly lower than that in the groups treated with minocycline or cefotaxime alone. CONCLUSIONS: The current results support the superiority of the combination therapy in treating invasive V. vulnificus infections.     

具有三层管壁结构组织工程血管支架的生物力学性能

目的针对组织工程血管的体内培养技术路线，对所制备的具有三层管壁结构的组织工程血管支架的生物力学性能进行测试，并研究了壁厚对支架力学性能的影响，以保证后续的动物体内移植实验能顺利进行。方法采用涂敷，喷涂．滤沥的方法制备了具有三层管壁结构（多孔PLGA层．致密PU层．多孔PLGA层）的可降解组织工程血管支架，用自制的设备测试了其爆破强度和径向顺应性，并对血管支架进行了缝合强度的测试。结果所制备的厚度为0．295mm-0．432mm的三层结构血管支架的径向顺应性为3．80％／100mmHg-0．57％／100mmHg，爆破强度为160kPa～183kPa，缝合强度为0．63N／针～1．52N／针。结论支架的管壁厚度，尤其是中间层厚度，对支架的力学性能有重要影响。增大壁厚可导致径向顺应性急剧下降，爆破强度和缝合强度线性提高。在所制备的样品中，管壁厚度为0．295mm的支架其综合力学性能最优，可满足血管组织工程体内植入的力学性能要求。     

CS无支架心包二尖瓣应用研究

目的比较传统有支架心包瓣与CS无支架心包二尖瓣的性能。方法测试瓣膜分为两组:A组,有支架心包瓣(与Ionescu-Shiley瓣相似);B组,无支架心包二尖瓣(与Quattro相似,由中南大学研制,简称CS瓣)。检测内容包括:①钙化倾向(SD鼠皮下埋藏模型);②组织学;③热皱缩温度;④断裂强度;⑤生物相容性;⑥血流动力学;⑦疲劳试验;⑧有限元分析。结果①B组钙化明显低于A组(P<0.01)。②组织学示A组心包片有大块钙化及胶元纤维裂解;B组仅见稍许钙化灶,胶原纤维保存完好。③热皱缩温度A组与B组无统计学意义。④断裂强度B组明显强于A组(P<0.005)。⑤内皮细胞种植后第1天,A组细胞明显少于B组(P<0.001);第3天A组已无细胞生长,B组内皮细胞增殖活跃;多数细胞Ⅷ因子检测呈阳性。⑥在模拟心输出量为2、4、6L,A组跨瓣压差明显高于B组(P<0.05),返流量和回流百分比A组显著高于B组(P<0.01),有效瓣口面积两组无统计学意义,仅在流量为4L时A组优于B组。⑦B组寿命比A组(n=2)长2.5倍。⑧B组瓣叶应力分布较为合理。结论CS无支架心包二尖瓣避免了应力集中区,其抗钙化、胶原纤维保存、断裂强度、生物相容性、血流动力学、疲劳寿命等均明显优于传统有支架心包瓣。