[Clinical effect of one-stage total knee arthroplasty for knee osteoarthritis with femoral extra-articular deformity].

Objective: To investigate the application and efficacy of the one-stage total knee arthroplasty (TKA) of intra-articular compensation osteotomy in knee osteoarthritis(KOA) patients with extra-articular deformity (EAD). Methods: A retrospective study of 9 patients with end-stage KOA and EAD undergoing one-stage TKA from January 2014 to December 2017 in the First Affiliated Hospital of Zhejiang Chinese Medical University was performed. There were 3 males and 6 females with an average age of 56 years(range, 19-77 years);5 cases of simple coronal deformity (varus 10°-27°, mean 18.2°), 3 cases of sagittal deformity (recurvatum15°-35°, mean 22.6°), 1 case combined with coronal and sagittal deformity (varus 16°, recurvatum 31°); hemophilia dysplasia in 1 case, fracture malformation in 8 cases. Main outcome measures included the mechanical axis, range of motion (ROM) and Hospital for Special Surgery Knee Score (HSS). Results: The mean follow-up period was 33.2 months (range, 25-47 months). The mechanical axis angle was restored from 12.4°±4.1°to 1.4°±0.9°(t=7.954, P<0.01). The HSS was improved from 28±14 preoperatively to 87±7 postoperatively (t=-11.174, P=0.013). The ROM increased from 56°±22°to 99°±8° (t=-5.480, P=0.010). There was no complications such as joint instability, infection, fracture, common peroneal nerve injury and early prosthesis loosening. Conclusions: For KOA patients with femoral EAD, one-stage TKA with intra-articular compensatory osteotomy can effectively restore the mechanical axis and obtain satisfying joint function. Through a series of measures such as preoperative measurement, soft tissue evaluation and 3D printing, the accuracy of surgery can be improved and the difficulty of surgery can be reduced.

[A comparative study of 3.0T (1)H-MRS for varying degrees of liver fibrosis in cynomolgus monkeys].

Objective: To investigate the changing rules with (1)H magnetic resonance spectroscopy ((1)H-MRS) in order to provide human research theoretical basis with varying degrees of liver fibrosis in cynomolgus monkeys. Methods: Liver fibrosis model in twenty-two cynomolgus monkey was successfully established with carbon tetrachloride (CCl(4)). Among them, fifteen cynomolgus monkey developed to early-stage liver cirrhosis (S4 stage). A comparative study was conducted in 15 cynomolgus monkeys that had fully developed liver fibrosis. The changing rules for varying degrees of liver fibrosis in cynomolgus monkeys were analyzed with (1)H-MRS. Supplementary methods: statistical analysis was performed using compatibility group design and analysis of variance for each research indicators. SNK-q test was used for pairwise comparison between the groups. The correlation between the 1H-MRS research indicators and the severity of liver fibrosis was analyzed by Spearman's rank correlation. Results: The Cho of (1)H-MRS was increased with the severity of liver fibrosis in cynomolgus monkeys. Moreover, there were statistically significant (P < 0.01) differences between liver fibrosis staging (S1 ~ S4) and normal liver tissue (S0 stage), severe liver fibrosis staging (S3 and S4) and mild to moderate liver fibrosis staging (S1 and S2). Compared with S0 stage, the peak value of lipid in S1 stage was significantly higher than that of S2 stage, and the peak value of lipid in S3 and S4 stage was significantly lower than that of S0 stage, and the differences between S1, S3, S4 and S0 stages were statistically significant (P < 0.01). The Cho/lipid ratio had gradually increased with the severity of liver fibrosis progression and the differences between groups were statistical significant (P < 0.01). Spearman's rank correlation coefficient between Cho / lipid ratio and pathological stage of liver fibrosis was 0.98 (P = 0.000). ROC curve analysis showed that Cho / lipid ratio was the most significant diagnostic indicator for liver fibrosis. The threshold values of CHO/lipid ratio were≥ 0.028, and≥ 0.131 (P < 0.01) for the diagnosis of liver fibrosis and early-stage cirrhosis. Conclusion: (1)H-MRS of the cynomolgus monkey liver fibrosis model changes rules regularly with the aggravation of severity of liver fibrosis. Among them, the Cho/lipid ratio is the most valuable indicator for the diagnosis of liver fibrosis staging, which may provide a theoretical basis for the study of human liver fibrosis.

Non-Genetic Risk Factors of Alzheimer's Disease: An Updated Umbrella Review.

BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by intricate genetic and environmental etiology. The objective of this study was to identify robust non-genetic risk factors for AD through an updated umbrella review. METHODS: We conducted a comprehensive search of meta-analyses and systematic reviews on non-genetic risk factors associated with AD in PubMed, Cochrane, Embase, and Ovid Medline up to June 30, 2023. After collecting data, we estimated the summary effect size and their 95% confidence intervals. The degree of heterogeneity between studies was assessed using I2 statistics and a 95% prediction interval was determined. Additionally, we evaluated potential excess significant bias and small study effects within the selected candidate studies. RESULTS: The umbrella review encompassed a total of 53 eligible papers, which included 84 meta-analyses covering various factors such as lifestyle, diet, environmental exposures, comorbidity or infections, drugs, and biomarkers. Based on the evidence classification criteria employed in this study, two factors as convincing evidence (Class I), including rheumatoid arthritis (RA), potentially reduced the risk of AD, but diabetes significantly increased the risk of AD. Furthermore, three factors as highly suggestive evidence (Class II), namely depression, high homocysteine, and low folic acid level, potentially increased the risk of AD. CONCLUSION: Our findings highlight several risk factors associated with AD that warrant consideration as potential targets for intervention. However, it is crucial to prioritize the identified modifiable risk factors, namely rheumatoid arthritis, diabetes, depression, elevated homocysteine levels, and low folic acid levels to effectively address this complex neurodegenerative disorder.

SPOP suppresses osteosarcoma invasion via PI3K/AKT/NF-κB signaling pathway.

OBJECTIVE: Speckle-type POZ protein (SPOP), is an E3 ubiquitin ligase adaptor that is frequently mutated in prostate and endometrial cancers. SPOP has been shown to be responsible for oncogene SRC-3 ubiquitination and proteolysis in prostate cancers.  However, whether SPOP plays a role in osteosarcoma (OS) is unknown. In this study, we investigated the inhibitory effect of SPOP on invasion and migration of OS cells. PATIENTS AND METHODS: Real-time PCR and Western blot were used to detect the expression of SPOP in human OS samples and cell lines. Short hairpin RNA (shRNA) was used to silencing the expression of SPOP. Small scale Real-time PCR screen was used to identify the matrix metalloproteases (MMP) family members responsible for the phenotype caused by SPOP depletion. Matrigel-coated invasion chambers were used to detect the invasion ability of SPOP in OS cells. RESULTS: We found that SPOP was down-regulated in clinic OS samples and cultured OS cells. Furthermore, we showed that silencing of SPOP promoted cell migratory and invasive ability of OS cells in vitro, whereas restored the expression of SPOP achieved the opposite effects. At the molecular level, we found that SPOP regulated the activity of "PI3K/Akt/NF-κB" signaling pathway in OS cells. CONCLUSIONS: Our results suggested that down-regulation of SPOP promoted OS cells migratory and invasive ability via modulating the "PI3K/Akt/NF-κB" signaling pathway. Thus, SPOP could be a promising drug target for the treatment of OS invasion.

Connexin 36 is expressed and associated with zonula occludens-1 protein in PC-12 cells.

Connexin 36 (Cx36) is the predominant connexin isoform expressed in the mammalian neurons of the central nervous system (CNS). PC-12 cells, a neuronal-like cell line, are widely used for neuron functional studies. Many connexins have been shown to interact with zonula occludens-1 protein (ZO-1), a tight junction associated with protein. The present study is intended to investigate whether Cx36 is expressed in PC-12 cells and is associated with ZO-1. Cx36 transcripts were amplified and verified by RT-PCR. 2.9 kb Cx36 mRNA was detected in PC-12 cells through Northern blot hybridization. Western blotting showed a 36-kDa protein band in the homogenates of PC-12 cells. Immunofluorescence labeling revealed that Cx36 was present in cell-cell contacts of PC-12 cells and colocalized with ZO-1. The association of Cx36 and ZO-1 in PC-12 cells was also demonstrated by coimmunoprecipitation. In conclusion, PC-12 cells express Cx36 mRNA and Cx36 proteins that are associated with ZO-1. These results enhanced our understanding of the function of Cx36 in PC-12 cells.

Reevaluation of the role of early trypsin activity in the transcriptional activation of the late trypsin gene in the mosquito Aedes aegypti.

In the female mosquito Aedes aegypti, trypsin expression is largely biphasic. Early trypsin synthesis, which is regulated at the translational level relative to feeding, peaks in the first few hours post-blood meal. Late trypsin expression is regulated at the transcriptional level, and peaks 18-24h post-blood meal. It was proposed that early trypsin activity released unknown factors during digestion of a meal that caused activation of transcription of the late trypsin gene. This connection between early trypsin activity and late trypsin expression was dependent on the fact that feeding a single trypsin inhibitor, soybean trypsin inhibitor (STI), which blocked early trypsin activity, also blocked late trypsin expression. We show in this study that feeding different trypsin inhibitors which effectively blocked early trypsin activity did not result in reduced late trypsin expression. We also found that a different lot of STI failed to cause inhibition of late trypsin transcription, although it was effective in inhibiting early trypsin activity. In addition, using RNAi methodology to reduce the level of early trypsin expression had no effect on the level of late trypsin expression. We conclude that early trypsin activity is not necessary for the transcriptional activation of late trypsin and that the previous results were due to the effect of a cytotoxic agent present in some, but not all preparations of STI.

Mammary tumor induction by N-methyl-N-nitrosourea in genetically resistant Copenhagen rats.

The Copenhagen rat is completely resistant to mammary cancer induction by N-methyl-N-nitrosourea (MNU) when the carcinogen is administered during sexual development, a period when other strains of rats are normally susceptible to mammary gland carcinogenesis. Here we administered 30 mg/kg MNU i.p. to two groups of neonatal (2-3-day-old) Copenhagen rats. One group (group B, 18 animals) received no further treatment, while the other group (group C, 17 animals) received a second dose of 30 mg/kg MNU via the tail vein at 50 days of age. About 30% of the rats in group B and about 70% of those in group C developed mammary carcinomas before they were 1 year of age. About one-half of the tumors in both groups were cribriform adenocarcinomas and one-half were adenosquamous carcinomas. The latter tumor type has not been observed previously in susceptible rat strains. The ability to induce these mammary tumors in the Copenhagen rat suggests that the putative mammary carcinoma suppressor gene is functionally inactive in neonatal animals or is inactivated when these animals are treated with MNU.

Retroviral insertional mutagenesis as a strategy for the identification of genes associated with cis-diamminedichloroplatinum(II) resistance.

Expression of resistance to cis-diamminedichloroplatinum(II) (CDDP), one of the most effective chemotherapeutic drugs used to treat a variety of malignancies, remains a serious obstacle for improving cancer treatment. To study possible genetic mechanisms underlying the development of CDDP resistance, we have adopted the approach of retroviral insertional mutagenesis. An early-stage CDDP-sensitive human melanoma cell line, WM35, was infected with a defective amphotropic murine retrovirus (murine stem cell virus), and the pooled cells were subsequently selected for CDDP-resistant variants. Nine CDDP-resistant clones independently derived from murine stem cell virus-infected WM35 cells were analyzed and it was found that five of these clones acquired an identical retroviral integration site, designated as CDDP resistance locus 1 (CRL-1), as revealed by isolation of retroviral flanking sequences. Furthermore, using the flanking sequence as probe, we have detected a 3.5-4.0-kilobase message, the expression of which is strongly increased in clones carrying a rearranged CRL-1 locus. These results strongly suggest that overexpression of CRL-1 confers resistance to CDDP in these clones. In addition, the present study indicates that retroviral insertional mutagenesis represents a potential strategy to identify genes responsible for CDDP resistance and possibly other chemotherapeutic drugs as well.

A recombinant plasmid of composite cysteine proteinase inhibitor/glyceraldehyde-3-phosphate dehydrogenase gene of periodic Brugia malayi functions on DNA immunity in the host.

OBJECTIVES: Both cysteine proteinase inhibitors (CPIs) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) play important roles in the pathogenesis of parasites and their relationship with the hosts. We constructed a new eukaryotic recombinant expression plasmid pcDNA3.1(+)-BmCPI/BmGAPDH of periodic Brugia malayi for investigation of the DNA vaccine-elicited immune responses. MATERIALS AND METHODS: We cloned a gene encoding the CPIs and GAPDH from periodic B. malayi into vector pcDNA3.1. The composited plasmid or the control was injected into the tibialis anterior muscle of the hind leg in BALB/c mice, respectively. The target genes were detected by reverse transcription-polymerase chain reaction in muscle tissues. The stimulation index (SI) of T-lymphocyte proliferation and the levels of interferon-gamma (INF-g) and interleukin-4 ( IL-4) in serum were detected by thiazolyl blue tetrazolium blue and enzyme-linked immunosorbent assays. RESULTS: The pcDNA3.1(+)-BmCPI/BmGAPDH was amplified from muscle tissues of the mice after immunisation. The SI of the immunised group was significantly higher than that of the two control groups (P < 0.05). The levels of INF-g and IL-4 of pcDNA3.1(+)-BmCPI/BmGAPDH group were both higher than those of the two control groups (P < 0.05). The level of INF-g of pcDNA3.1(+)-BmCPI/BmGAPDH group was significantly higher than that of pcDNA3.1(+)-BmCPI/CpG group (P < 0.05). CONCLUSIONS: We conclude that the recombinant plasmid pcDNA3.1(+)-BmCPI/BmGAPDH could elicit specific humoural and cellular immune responses in mice.

Tyrosinase-related protein 2 as a mediator of melanoma specific resistance to cis-diamminedichloroplatinum(II): therapeutic implications.

A major obstacle in the systemic treatment of advanced malignant melanoma is its intrinsic resistance to conventionally used chemotherapeutic agents. In order to investigate the mechanisms of this intrinsic resistance, we have previously utilized retroviral insertional mutagenesis on an early-stage, drug sensitive human melanoma cell line (WM35) to establish mutated cell lines that exhibited increased resistance to cis-diammi-nedichloroplatinum(II) (CDDP). Here, we demonstrate that this increased resistance to CDDP is mediated by the over-expression of tyrosinase-related protein-2 (TYRP2), an enzyme that normally functions in the biosynthesis of the pigment, melanin. Northern and Western blot analyses revealed that the expression of TYRP2 in the virally-derived cell lines as well as in a panel of human melanoma cell lines positively correlated with their levels of resistance to CDDP. Furthermore, enforced expression of TYRP2 in WM35 cells by transfection elevated their resistance to CDDP. The increased CDDP resistance in the virally-derived clones and TYRP2 transfectants was accompanied by a reduction in CDDP-induced apoptosis. Interestingly, the virally-derived CDDP-resistant clones also showed cross resistance to carboplatin and methotrexate, but not taxol, suggesting that TYRP2 over-expression may confer resistance specifically to DNA damaging agents. Overall, these results demonstrate a novel mechanism of drug resistance in human melanoma cells that is mediated by the over-expression of TYRP2. Since TYRP2 is expressed only in cells of melanocytic lineage, this may represent the first report of a lineage-specific mechanism of drug resistance. In summary, these findings suggest a significant role for TYRP2 in the intrinsic drug resistance phenotype of human melanoma cells and may have important implications in the development of chemosensitization strategies for the clinical management of this disease.

The imaging of neuroendocrine tumors using single photon emission computed tomography/computed tomography.

There have been several advances in technology over the past decade with the advent of hybrid imaging having a large impact on nuclear medicine, first with PET/CT and then more recently with SPECT/CT. Initial SPECT/CT systems used low dose but very low quality CT and except for attenuation correction offered no great advantage over reviewing SPECT and CT images side by side. More recently hybrid machines have become available and a series of studies have shown improved accuracy compared to SPECT alone with resulting changes in patient management. This has been true not only with somatostatin analogue imaging but also for demonstrating amine uptake using MIBG. Whilst PET/CT may be seen as the ideal, this may be less accessible due to the high cost and limited availability. In this case hybrid SPECT/CT offers hope for providing high quality and accurate imaging of neuroendocrine tumors.

Elevated basal and thapsigargin-stimulated intracellular calcium of platelets and lymphocytes from bipolar affective disorder patients measured by a fluorometric microassay.

BACKGROUND: A number of investigators have reported finding elevated basal and stimulated intracellular calcium levels in the platelets or lymphocytes of bipolar disorder patients. METHODS: Intracellular calcium was measured by a micro fura-2 fluorometric method in the platelets and lymphocytes of 30 affective disorder patients and 14 control subjects. RESULTS: We observed significantly elevated basal calcium concentrations in bipolar patient platelets and lymphocytes compared to control subjects. Bipolar patient platelet calcium responses to thrombin, serotonin, and thapsigargin were also significantly greater than control subjects. The peak calcium levels of lymphocytes of bipolar patients were greater than control subjects only when stimulated by thapsigargin. There were significant differences between bipolar and unipolar patients in basal and thapsigargin-stimulated calcium measures but not between bipolar I and bipolar II patients. Unmedicated versus medicated calcium measures were not significantly different. We also found little correlation between calcium measures and the severity of mood rating. CONCLUSIONS: Using this method, we were able to confirm and extend the work of others, indicating altered intracellular calcium homeostasis in the blood cells of bipolar disorder patients. In addition, our data suggest that storage operated calcium channels may be the source of the elevated intracellular calcium in platelets and lymphocytes of bipolar patients.

Metabolism of fusarin C by rat liver microsomes. Role of esterase and cytochrome P-450 enzymes with respect to the mutagenicity of fusarin C in Salmonella typhimurium.

Fusarin C (FC) is a potent mutagen present on Fusarium moniliforme contaminated corn. This compound requires metabolic activation for which microsomes from phenobarbital-induced rats are most effective. Inhibition of the simultaneously induced esterase activity, which produced a less mutagenic metabolite, doubled the mutagenicity of FC. Carbon monoxide inhibited the mutagenicity of FC, suggesting the involvement of a heme containing enzyme. However, monoclonal antibodies specific for the phenobarbital-induced cytochrome P-450 enzymes PB-4 and PB-5, while inhibiting O-demethylation of p-nitroanisole and aflatoxin B1 mutagenicity, had not effect on FC mutagenicity. This implies that either these enzymes are not involved in the activation of FC or FC competes well with the antibodies for binding to the cytochrome P-450 enzymes. Two additional metabolites of FC were detected. One had an ultraviolet spectrum similar to FC: the other had a lambda max at 326 nm, and its retention time on reverse phase HPLC was very sensitive to changes in pH.

Effects of microwaves on the adrenal cortex.

Six-hundred-and-one male Long-Evans rats were used to study the effect of microwaves on adrenocortical secretion. Power density ranged from 0.1 to 55 mW/cm2 (SAR 0.02 to 11 W/kg). The microwave signal was 2.45 GHz amplitude modulated at 120 Hz. Serum corticosterone (CS) concentration was used as an index of adrenocortical function. Ten different exposure protocols were used to identify confounding factors influencing the sensitivity of adrenal cortex to microwave exposure. Increases in CS concentration were proportional to power density or colonic temperature and inversely proportional to the baseline CS. Increased CS concentration was never observed without increased colonic temperature and was not persistent 24 h after exposure. Acclimation (reduction in magnitude of response) could be noted after the tenth exposure. Facilitated heat loss attenuated the magnitude of CS increases by limiting the degree of hyperthermia. Ethanol enhanced the hyperthermic response and desensitized the adrenal response to microwave hyperthermia by increased baseline CS. Ether stimulated adrenal secretion irrespective of previous microwave exposure or adrenal stimulation induced by microwaves. Minor inhibition was also noted occasionally as decreased CS concentration at lower intensity (less than 20 mW/cm2) and decreased postexposure urinary CS excretion at 40 mW/cm2. Adrenal stimulation required minimally a 20 mW/cm2 (4 W/kg) or 0.7 degrees C increase in colonic temperature. An SAR lower than 4 W/kg may stimulate adrenal secretion by potentiating the hyperthermic effect if the ambient temperature is well above 24 degrees C.

Effects of microwaves on three different strains of rats.

Confounding factors influencing the sensitivity of biological indicators of microwave exposure--lethality, colonic temperature (Tco), decreased body mass (dW), corticosterone (CS), thyrotropin (TSH), thyroxine (T4), free thyroxine (FT4), and prolactin (PRL) concentration--were studied in Long-Evans (LE), Wistar-Kyoto (WKY), and spontaneous hypertensive (SHR) rats. The microwave signal was 2.45 GHz amplitude modulated at 120 Hz. Test power density ranged from 1 to 50 mW/cm2 for 2 h. In contrast to the LE and WKY rats, the SHR rats were characterized by intolerance (death) between 40 and 50 mW/cm2 (9.2 to 11.5 W/kg). The lowest lethal Tco was 41.1 degrees C. Survivors including all the LE and WKY rats were capable of maintaining Tco lower than 41.0 degrees C. In general, strain of rat seemed to influence other bioindicators and to interact with power density on these bioindicators. Except for Tco and PRL, baseline for the various bioindicators varied among the different strains of rats. Responses of T4 and FT4 were limited in magnitude and inconsistent among strains of rats. In general, the magnitude of Tco increase was more pronounced in SHR than in WKY. Differences between SHR and LE, however, could be noted only at 1, 10, and 50 mW/cm2. Increased Tco, increased magnitude of Dw, increased CS, decreased TSH, and increased PRL (stress reactions) could be noted in rats exposed to 30 mW/cm2 (approximately 6 W/kg) or higher, irrespective of strain. At least two of three strains of rats (WKY and SHR) exposed to 20 mW/cm2 (approximately 4 W/kg) showed changes in Tco, CS, TSH, and PRL. At 10 mW/cm2 (2 W/kg), increased Tco could be found in all three strains of rats accompanied by changes in dW and TSH in LE, TSH in WKY, and dW and CS in SHR. At 1 mW/cm2 (0.2 W/kg), increased Tco could be noted in two of three strains (LE and SHR) and increased PRL in LE only. The smallest Tco increases for a consistent response (increased magnitude of response with power density) were 1.59 degrees C for dW, 0.70 degrees C for CS, 0.24 degrees C for TSH, and 0.97 degrees C for PRL. Tentatively, the threshold intensity for response to microwave exposure for rats could be considered as 2 W/kg or a 0.24 degrees C increase at 24 degrees C ambient temperature.

Comparison between short-term and long-term post-operative evaluation of sleep apnoea after uvulopalatopharyngoplasty.

For a long time uvulopalatopharyngoplasty (UPPP) has been used to treat the obstructive sleep apnoea syndrome (OSAS). The diverse surgical effects, the inadequate understanding of operation effect consistency, the possibility of disease progression, and the few reported papers for long-term evaluation after UPPP aroused our interest in designing this study. Fifteen OSAS patients who had undergone UPPP with pre-operative, initial post-operative and long-term post-operative polysomnographic studies were included in this study. Long-term post-operative polysomnography was undertaken more than five years after surgery. The polysomnographic evaluations included respiratory disturbance index (RDI), duration of saturation SaO2 < 85 per cent (DOS), and the lowest O2 saturation (LOS). Amongst them, 10 patients with initial post-operative RDI reduction > 50 per cent were considered responders. In these responders, the long-term follow-up results of all three parameters showed improvement compared to the pre-operative data. In a comparison between the initial and long-term post-operative sleep study results, LOS and DOS showed no significant difference. However, the long-term post-operative RDI result became significantly worse. More than 80 per cent of all cases had subjective symptomatic improvement in the long-term post-operative evaluation. The subjective improvement after operation is not adequately correlated to the polysomnographic result. We suggest that long-term follow-up for patients after UPPP is necessary.

[Enhancing effect of danggui injection on immunologic function].

Experiments have shown that Danggui injection enhances phagocytic function of macrophage in normal mice, and antagonizes the immunosuppressive activity of macrophage by cytoxan. The injection may increase the function of B cells and the activity of serum lysozyme, thus increasing the function of humoral immunity and nonspecific immunity.