Identification of Clec7a as the therapeutic target of rTMS in alleviating Parkinson's disease: targeting neuroinflammation.

Parkinson's disease (PD) is a neurodegenerative disease. Repetitive transcranial magnetic stimulation (rTMS) is a therapeutic tool in PD. High-throughput sequencing was performed to screen potential therapeutic targets in unilaterally 6-hydroxydopamine (6-OHDA)-lesioned rats. The candidate gene, Clec7a, was screened out and validated. Clec7a is a pattern recognition receptor involved in neuroinflammation. The higher expression of Clec7a was observed in the substantia nigra (SN) and striatum of PD rats with dopaminergic neurons damage and was mainly localized in the microglial. Adeno-associated virus (AAV)-mediated specific knockdown of Clec7a in microglial alleviated 6-OHDA induced motor deficits and nigrostriatal dopaminergic neuron damage of rats, as evidenced by the increase of tyrosine hydroxylase (TH) -positive neurons in SN, as well as dopaminergic nerve fibers in the striatum. Clec7a knockdown restrained the neuroinflammation by suppressing inflammatory factors (IFN-γ, TNF-α, IL-1ß, IL-18, and IL-6) release in SN, which might result from enhanced Arg-1 expression (M2 polarization) and defective inducible nitric oxide synthase (iNOS) expression (M1 polarization). The same phenomena were also observed in the LPS inflammatory rat model of PD. In vitro, α-synuclein fibrils induced upregulation of Clec7a expression and microglia polarization to a pro-inflammatory state of BV2 cells, leading to increased release of cytokines. However, Clec7a knockdown reversed those changes and induced a shift to an anti-inflammatory phenotype in BV2 cells. In conclusion, our study suggested that Clec7a was involved in PD pathogenesis, and its inhibition might protect rats from PD by depressing neuroinflammation through microglial polarization.

[The derivation and validation of a prediction rule for differential diagnosis of thyroid nodules].

OBJECTIVE: To set up a prediction rule for the pro-operative differential diagnosis of thyroid nodules and evaluate its clinical value. METHODS: All patients of thyroid nodules underwent thyroid operations in Changzheng hospital from June, 1997 to July, 2012 were included in this study. They were randomly divided into the derivation cohort (2/3) and the validation cohort (1/3). A prediction rule was developed based on the logistic regression model and the scoring system was established in accordance with assigning of the value of each variable ß in the model. The prediction consistency, discriminatory power and diagnostic accuracy were conducted to evaluate the clinical value of the scoring system. RESULTS: A total of 13 980 patients were enrolled in the study with 9195 in the derivation cohort and 4785 in the validation cohort. The prediction rule consisted of 18 variables, which were gender, clinical manifestations including fever, neck sore, neck mass, palpitation and sweating, serum level of thyroid stimulating hormone (TSH) , free triiodothyronine (FT3) , thyroid peroxidase antibody (TPOAb) , thyroglobulin antibody (TgAb) , thyroglobulin (Tg) , calcitonin and carcinoembryonic antigen (CEA) , ultrasonography features including nodules number, location, size, boundaries and ethological patterns and the presence and patterns of lymph nodes. The model showed good calibration consistency (P = 0.437) and discrimination power (area under the receiver operating characteristic curve was 0.928) in the derivation cohort. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of the model were 89.3%, 81.5%, 83.2%, 56.8%, 96.6%, 4.83 and 0.13, respectively. CONCLUSION: The prediction rule and its scoring system established in the study are efficacious for the calibration and discrimination of thyroid nodules in Chinese population, which could be a useful tool for the pro-operative risk stratification.

Netrin-1 protects against L-Arginine-induced acute pancreatitis in mice.

Acute pancreatitis (AP) is a common inflammatory disease mediated by damage to acinar cells and subsequent pancreatic inflammation with infiltration of leukocytes. The neuronal guidance protein, netrin-1, has been shown to control leukocyte trafficking and modulate inflammatory responses in several inflammation-based diseases. The present study was aimed toward investigating the effects of netrin-1 in an in vivo model of AP in mice. AP was induced in C57BL/6 mice by administration of two intraperitoneal injections of L-Arginine (4 g/kg). Mice were treated with recombinant mouse netrin-1 at a dose of 1 µg/mouse or vehicle (0.1% BSA) intravenously through the tail vein immediately after the second injection of L-Arginine, and every 24 h thereafter. Mice were sacrificed at several time intervals from 0 to 96 h after the induction of pancreatitis. Blood and tissue samples of pancreas and lung were collected and processed to determine the severity of pancreatitis biochemically and histologically. Immunohistochemical staining demonstrated that netrin-1 was mainly expressed in the islet cells of the normal pancreas and the AP model pancreas, and the pancreatic expression of netrin-1 was down-regulated at both the mRNA and protein levels during the course of AP. Exogenous netrin-1 administration significantly reduced plasma amylase levels, myeloperoxidase activity, pro-inflammatory cytokine production, and pancreas and lung tissue damages. Furthermore, netrin-1 administration did not cause significant inhibition of nuclear factor-kappa B activation in the pancreas of L-Arginine-induced AP. In conclusion, our novel data suggest that netrin-1 is capable of improving damage of pancreas and lung, and exerting anti-inflammatory effects in mice with severe acute pancreatitis. Thus, our results indicate that netrin-1 may constitute a novel target in the management of AP.

Randomized clinical trial of vessel sealing system (LigaSure) in esophagogastric devascularization and splenectomy in patients with portal hypertension.

BACKGROUND: The LigaSure vessel sealing system (Valleylab, Boulder, CO) has been tested, with excellent results, in different fields of surgery. However, no study has evaluated the efficiency of the LigaSure in open esophagogastric decongestion and splenectomy in a randomized trial to date. METHODS: Patients scheduled to undergo esophagogastric decongestion and splenectomy were assigned to the use of either the LigaSure or a conventional clamp-and-tie technique. Primary outcome measures were operating time and intraoperative blood loss. Secondary outcome measures were postoperative drainage volume, complications such as spleen fever, bleeding, portal vein thrombosis, length of incision, pain, and time to discharge. RESULTS: Sixty patients were randomized to the LigaSure (n = 30) and clamp-and-tie (n = 30) groups. The groups were well matched with respect to liver function, associated illnesses, and grading of esophageal varices. Postoperative outcomes in drainage and major complications did not differ between the groups, while operative time and the volume of blood loss were significantly decreased in the LigaSure group compared with the clamp-and-tie group (P < .001). CONCLUSIONS: The use of the LigaSure is safe and effective in vessel division and homeostasis in the esophagogastric decongestion and splenectomy, with statistically significant decreases in operative time and intraoperative blood loss and without significantly modifying postoperative results.

[Interventions on the exposure of non-smoking pregnant women to passive smoking].

OBJECTIVE: To investigate the extent of exposure of non-smoking pregnant women to passive smoking; to undertake interventions on the knowledge, attitudes and behaviors of those women toward passive smoking; and to evaluate the effectiveness of the interventions. METHODS: A total of 128 non-smoking pregnant women participated in the survey. Their knowledge, attitudes and behaviors towards passive smoking were measured by a self-administered questionnaire. A sixteen-week intervention was undertaken. RESULTS: The knowledge and attitudes of the non-smoking pregnant women towards passive smoking improved significantly, as well as their attempts to avoid exposure to the passive smoking brought by their smoking husbands or other family members. Telephone counseling, booklets and doctors' advices were the most acceptable approaches of health education. CONCLUSION: The comprehensive interventions are effective for improving the knowledge, attitudes and behaviors of non-smoking women toward passive smoking.

Lithium manganese(II) diaqua-boro-phosphate monohydrate.

The title compound, LiMn(H(2)O)(2)[BP(2)O(8)]·H(2)O, is built up of an open framework of helical borophosphate ribbons inter-connected by MnO(4)(H(2)O)(2) octa-hedra, forming one-dimensional channels along [001] occupied by Li(+) cations and disordered H(2)O mol-ecules (site occupancy 0.5). The Li cations reside in two partially occupied sites [occupancies = 0.42 (3) and 0.289 (13)] near the helices.