[Cistanches tubulosa water extract protects the testis against cyclophosphamide-induced injury: Effect and mechanism].

OBJECTIVE: To investigate the protective effect of Cistanche tubulosa water extract (CTWE) against cyclophosphamide (CTX)-induced testis injury (TI) in mice and its action mechanism. METHODS: Thirty male mice were equally randomized into a normal control, a CTX-induced TI model control and a CTWE treatment group. After 7 days of adaptive feeding, the mice in the CTWE treatment group were treated intragastrically with CTWE at 10 g/kg/d, those in the normal control and TI model control groups with the same volume of normal saline qd all for 35 successive days, and those in the TI model control and CTWE treatment groups by intraperitoneal injection of cyclophosphamide at 80 mg/kg/d at 7, 14, 21, 28 and 35 days. Then all the animals were weighed, blood samples collected, and their testes and epididymides harvested for detection of the serum T content, examination of semen quality, measurement of testis weight, observation of histopathological changes in the testis, and determination of the levels of super oxide dismutase (SOD) and malondialdehyde (MDA) in the testis tissue and the mRNA expressions of the genes related to the nuclear factor erythroid-2-related factor (Nrf2) signaling pathway. RESULTS: The mice in the TI model control group, compared with the normal controls, showed significant decreases in the body weight (ï¼»34.13 ± 1.56ï¼½ vs ï¼»47.08 ± 1.98ï¼½ g, P < 0.05), testis weight (ï¼»81.82 ± 10.61ï¼½ vs ï¼»148.50 ± 14.82ï¼½ mg, P < 0.05), sperm concentration (ï¼»32.60 ± 5.29ï¼½ vs ï¼»78.90 ± 7.95ï¼½ ×106/ml, P < 0.05), sperm motility (ï¼»45.20 ± 7.09ï¼½% vs ï¼»86.70 ± 5.64ï¼½%, P < 0.05), serum T content (ï¼»7.49 ± 1.03ï¼½ vs ï¼»15.93 ± 1.36ï¼½ ng/L, P < 0.05), and SOD level (ï¼»152.22 ± 10.66ï¼½ vs ï¼»356.10 ± 30.95ï¼½ U/mg prot, P < 0.05), but remarkable increases in the percentage of morphologically abnormal sperm (MAS) (ï¼»39.30 ± 7.36ï¼½% vs ï¼»14.40 ± 3.53ï¼½ %, P < 0.05) and MDA level (ï¼»54.91 ± 5.12ï¼½ vs ï¼»31.71 ± 3.57ï¼½ nmol/mg prot, P < 0.05). The animals treated with CTWE, in comparison with the TI model controls, exhibited markedly increased body weight (ï¼»40.67 ± 2.13ï¼½ vs ï¼»34.13 ± 1.56ï¼½ g, P<0.05), testis weight (ï¼»121.21 ± 17.38ï¼½ vs ï¼»81.82 ± 10.61ï¼½ mg, P<0.05), sperm concentration (ï¼»58.40 ± 9.94ï¼½ vs ï¼»32.60 ± 5.29ï¼½ ×106/ml, P < 0.05), sperm motility (ï¼»72.30 ± 7.51ï¼½ % vs ï¼»45.20 ± 7.09ï¼½ %, P < 0.05), serum T content (ï¼»10.89 ± 1.07ï¼½ vs ï¼»7.49 ± 1.03ï¼½ ng/L, P < 0.05) and SOD level (ï¼»217.69 ± 24.59ï¼½ vs ï¼»152.22 ± 10.66ï¼½ U/mg prot, P < 0.05), but decreased percentage of MAS (ï¼»22.20 ± 6.07ï¼½% vs ï¼»39.30 ± 7.36ï¼½%, P < 0.05) and MDA level (ï¼»36.41 ± 4.27ï¼½ vs ï¼»54.91 ± 5.12ï¼½ nmol/mg prot, P < 0.05). The mRNA expressions of Nrf2, HO-1 and NQO-1 in the testis tissue were significantly down-regulated in the TI model controls compared with those in the normal controls (P < 0.05), and remarkably up-regulated in the CTWE treatment group in comparison with those in the TI model group (P < 0.05), while that of Caspase3 markedly increased in the TI model controls (P< 0.05) and decreased in the CTWE treatment group (P < 0.05). Histopathologically, the testis tissue of the TI model controls showed indistinct outlines from the base of the seminiferous tubule to the lumen surface, with disarranged and reduced layers of spermatogenic cells and decreased number of sperm in the seminiferous tubules, while the structure of the spermatogenic tubules recovered almost to normal in the CTWE treatment group. CONCLUSION: Cistanches tubulosa water extract can effectively inhibit cyclophosphamide-induced testis injury by enhancing the activity of antioxidant enzyme and regulating the expressions of the Nrf2 signaling pathway-related genes.

Identification of Prognostic Related Hub Genes in Clear-Cell Renal Cell Carcinoma via Bioinformatical Analysis.

Objective To identify new genes that correlate with prognosis of clear-cell renal cell carcinoma (ccRCC) via bioinformatics analysis. Methods The gene expression profiles of 62 ccRCC and 54 normal kidney tissues were available from the Gene Expression Omnibus database: GSE12606, GSE36895 and GSE66272. The differentially expressed genes were screened with GEO2R and J Venn online tools. Functional annotation including Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) was applied to identify the possible function of the hub genes involved in prognosis of ccRCC. In protein protein interaction network (PPI network), the STRING online tool was used to visualize the network of the differentially expressed genes, and the core gene was selected by MCODE App in Cytoscape software. Finally, GEPIA Survival Plot was performed to assess genes associated with worse survival. Results We totally found 648 differentially expressed genes, including 222 up-regulated genes and 426 down-regulated genes. PPI network showed that in 28 up-regulated genes 7 (CCNE2, CDK1, CDC6, CCNB2, BUB1, TTK and PTTG1) enriched in cell cycle and 4 genes (CCNE2, CDK1, CCNB2 and RRM2) enriched in p53 signaling pathway. GEPIA Survival Plot assay revealed that ccRCC patients carrying CDK1, CCNB2, RRM2, BUB1, and PTTG1 had a worse survival. GEPIA Box Plot showed that BUB1, CCNB2, PTTG1, and RRM2 were over expressed in the ccRCC tissues in contrast to the normal tissues (P<0.05). Conclusion ccRCC patients with the four up-regulated differentially expressed genes including BUB1,CCNB2,PTTG1, and RRM2might manifest a poor prognosis.

Combined PET/CT with thoracic contrast-enhanced CT in assessment of primary cardiac tumors in adult patients.

BACKGROUND: 18F-FDG PET/CT is a key molecular imaging modality to noninvasively assess and differentiate benign and malignant cardiac tumors. However, few benign cardiac tumors can be characterized by increased 18F-FDG uptake, which makes differential diagnosis difficult. This study sought to retrospectively evaluate whether combined 18F-FDG PET/CT with thoracic contrast-enhanced CT (CECT) helps in assessing primary cardiac tumors in adult patients, compared with CECT or PET/CT alone. METHODS: Forty-six consecutive patients who were diagnosed as primary cardiac tumors were enrolled. All patients underwent 18F-FDG PET/CT followed by thoracic CECT before biopsy or surgery. Visual qualitative interpretation and quantitative analysis were performed, and diagnostic performance was evaluated. RESULTS: More than half (16/29) of benign tumors exhibited with mild 18F-FDG uptake. There were significant differences in 18F-FDG uptake and the degree of absolute enhancement between benign and malignant tumors (P < 0.001). The combination of two modalities improved the specificity from 79 to 93%, the positive predictive value from 73 to 89%, and the accuracy of diagnosis from 85 to 93%. There were significant differences between PET/CT alone or thoracic CECT alone and combined modalities (P = 0.034 and P = 0.026, respectively). The combination with the optimal SUVmax cutoff value generated 94% sensitivity, 100% specificity, 97% negative predictive values, 100% positive predictive values, and 98% accuracy rates. CONCLUSIONS: Combining 18F-FDG PET/C with thoracic CECT significantly improved specificity and accuracy compared to CECT or PET/CT alone in detecting tumors. This combination of diagnostic imaging is effective in differentiating malignant from benign masses.

Adult Pancreatoblastoma With Liver Metastasis Diagnosed by 18F-FDG PET/CT and 2 Years' Postoperative Follow-up.

Pancreatoblastoma is an extremely rare malignant tumor of the pancreas. Most patients are infants and children; however, a few cases have been reported in adults. Herein, we present the case of a 49-year-old man with pancreatoblastoma and liver metastasis who underwent preoperative multimodal imaging, in which F-FDG PET/CT showed a markedly increased F-FDG uptake in the metastatic lesion and a slightly increased uptake in the primary lesion. Subsequently, the patient underwent complete resection of the primary and metastatic lesions. No recurrences or metastases were found in 2 years of follow-up.

Berberine ameliorates CCl4­induced liver injury in rats through regulation of the Nrf2­Keap1­ARE and p53 signaling pathways.

Berberine (BBR) is an isoquinoline alkaloid, reported to have multiple pharmacological functions. However, its effects against CCl4­induced oxidative damage remain poorly studied. Therefore, the present study investigated the protective action of BBR, and its antioxidant mechanisms, against CCl4­induced liver injury in rats. A total of 48 rats were randomly arranged into six groups: Control; model; positive control (PC); BBR low­dose (BL); BBR middle­dose (BM); and BBR high­dose (BH). The BL, BM and BH animals received BBR (5, 10 and 15 mg/kg by weight, respectively) orally for 7 consecutive days. Rats in the PC group were given silymarin (150 mg/kg), and the control and model groups were administered distilled water orally. At the end of the experiment, blood samples and livers were collected. To measure the liver biochemical indices, the reactive oxygen species (ROS) generation and the expression levels of related genes and protein, the following methods were used: An automatic biochemical analyzer; flow cytometry; spectrophotometry; reverse transcription­quantitative PCR; western blotting; and hematoxylin and eosin staining. The results revealed that BBR significantly decreased the serum levels of alanine transaminase, aspartate transaminase and alkaline phosphatase, and increased those of glutathione and superoxide dismutase, but decreased malondialdehyde activity in hepatic tissue, and significantly decreased the reactive oxygen species level in hepatocytes. In hepatic tissue, the expressions of nuclear factor erythroid 2­related factor 2 (Nrf2), kelch­like ECH­associated protein 1 (Keap-1), NAD(P)H quinone dehydrogenase 1 (NQO-1), heme oxygenase 1 (HO­1), Bcl­2 and Bcl­xL mRNA, and HO­1 protein were elevated, and the expression of p53 mRNA was decreased, particularly in the BH group (15 mg/kg). In conclusion, BBR exerts a protective action against CCl4­induced acute liver injury in rats via effectively regulating the expression of Nrf2­Keap1­antioxidant responsive element­related genes and proteins, and inhibiting p53 pathway­mediated hepatocyte apoptosis.

Comparison of the value of superficial mark guided localization and hook-wire guided localization techniques for non-palpable breast microcalcifications: A retrospective clinical research.

AIM: The present study compares the effect and accuracy of the superficial mark guided localization (SGL) and hook-wire guided localization (WGL) techniques for non-palpable breast microcalcifications. METHODS: This retrospective study was conducted to compare SGL and WGL techniques. These techniques were performed on 51 patients with non-palpable breast microcalcifications from January 2015 to May 2016. RESULTS: Among these 51 patients, 25 (49.01%) patients were subjected to WGL and 26 patients (50.99%) were subjected to SGL. The SGL technique had a higher rate of malignant cancer detection (WGL = 12.0% and SGL = 23.0%). Furthermore, no significant differences were found with regard to average age, the rate of a second excision and the diameter of the excised tissue. Moreover, no complications were observed in the SGL group, while four (16.0%) patients in the WGL group experienced problems. CONCLUSION: The SGL technique is as accurate as the WGL technique. Furthermore, the procedure has advantages of being less expensive and causing less complications.

[Predictive factors for clinical pregnancy in patients with nonmosaic Klinefelter's syndrome undergoing microdissection testicular sperm extraction].

OBJECTIVE: To investigate the efficiency of microdissection testicular sperm extraction (micro-TESE) in male patients with nonmosaic Klinefelter's syndrome (NMKS), the outcomes of intracytoplasmic sperm injection (ICSI) in their wives, and the possible predictors of clinical pregnancy. METHODS: Forty-nine males with NMKS underwent micro-TESE in our hospital from July 2016 to November 2018. We compared the age, reproductive hormone levels, and testis volume of the patients between the sperm-positive and -negative groups. We performed ICSI for the wives of the sperm-positive patients, recorded the numbers of pregnancies and births, compared the age, reproductive hormone levels and number of mature oocytes between the successful and failed ICSI groups, and analyzed the possible predictors of the results of micro-TESE and outcomes of ICSI. RESULTS: The 49 patients were aged (28.20 ± 3.52) years, all diagnosed as with 47,XXY nonmosaicism by karyotype analysis, with a testis volume of (2.95 ± 0.84) ml, a serum FSH content of (42.42 ± 14.37) IU/L, a serum LH level of (22.50 ± 8.64) IU/L, and a serum T level of (6.64 ± 4.13) nmol/L. Sperm were obtained from 32 of the patients, with a sperm retrieval rate (SRR) of 65.31%, and the wives (aged ï¼»26.79 ± 2.97ï¼½ years) of 29 of the sperm-positive males underwent ICSI, achieving a fertilization rate of (48.14 ± 27.33)%, an available embryo rate of (63.71 ± 28.90)%, a pregnancy rate of 48.28% (14/29), and a birth rate of 24.14% (7/29) up to the present time, with 7 cases awaiting delivery. The 2 cases failing to achieve pregnancy were waiting for transplantation of the frozen embryos. Logistic regression analysis showed that the preoperative serum T level of the NMKS patients had a significant predictive value for the pregnancy rate (AUC = 0.832, cut-off value = 5.17 nmol/L, P = 0.015), but not the other factors for either the SRR or the pregnancy rate. CONCLUSIONS: Sperm can be retrieved from over 60% of the NMKS patients undergoing micro-TESE, and some of them can achieve pregnancy and have their own children by ICSI. Moreover, those with a preoperative serum T level of >5.17 nmol/L are very likely to achieve clinical pregnancy after successful sperm retrieval.

[Dynamic renal scintigraphy versus dual-plasma sample clearance for determining glomerular filtration rates in patients with nonfunctioning kidneys shown by intravenous pyelography].

OBJECTIVE: To study the actual glomerular filtration rates (GFR) in patients with nonfunctioning kidneys as shown by intravenous pyelography (IVP) using single photon emission computed tomography (SPECT) dynamic renal scintigraphy and dual-plasma sample clearance method. METHODS: We retrospectively analyzed 107 patients with nonfunctioning kidneys shown by IVP who underwent renal dynamic 99Tcm-DTPA SPECT imaging. GFR was measured by Gates' methods (GFRGates') and dual-plasma sample clearance method (GFRdual-plasma). Based on the dynamic functional images and GFRdual-plasma measurements, the patients were categorized into mild renal impairment (GFRdual-plasma≥30 mL/min), moderate renal impairment group (GFRdual-plasma of 20-30 mL/min), severe renal impairment group (GFRdual-plasma of 10 to 20 mL/min), and nonfunctioning kidney group (GFRdual-plasma≤10 mL/min), and GFRGates' were compared among the groups. RESULTS: According to GFRdual-plasma, the numbers of patients having mild, moderate, and severe renal impairment and nonfunctioning kidneys were 12(11.2%), 33(30.8%), 41(38.3%), and 21(19.6%), respectively. GFRdual-plasma and GFRGates' were not significantly different in mild and moderate renal impairment groups, but in patients with severe renal impairment, GFRdual-plasma was significantly lower than GFRGates' (13.9∓6.2 vs 18.8∓4.2 mL/min; t=-2.73, P=0.03), which was also the case with patients with nonfunctinging kidneys (4.5∓2.1 vs 7.2∓3.2 mL/min; t=-3.81, P=0.005). CONCLUSION: Of the patients with nonfunctinging kidneys shown by IVP, only 58% of them actually have severe renal impairment or worse, and further SPECT dynamic renal scintigraphy is necessary to assess the actual risk of renal function impairment before operation.

Spontaneous osteosarcoma in craniomaxillofacial fibrous dysplasia: clinical and computed tomographic features in 8 cases.

OBJECTIVE: The aim of this study was to evaluate the patient demographic and computed tomography (CT) imaging findings of spontaneous osteosarcoma in craniomaxillofacial fibrous dysplasia. STUDY DESIGN: Ten cases of spontaneous osteosarcoma in craniomaxillofacial fibrous dysplasia diagnosed during 1993-2013 were reviewed. Eight cases with CT images were reviewed. RESULTS: The mean age of diagnosis of osteosarcoma was 37.8 years (range, 8-55 years). The presence of a soft tissue extension component beyond the area of cortical bone destruction was demonstrated radiographically in 7 out of 8 cases. Mineralization of tumor matrix was seen in 6 cases. Periosteal reaction was demonstrated in only 1 case; 1 out of 6 cases showed significant enhancement on postcontrast CT images. Nine patients had surgical resections of tumor. Seven of them died of tumor, with a mean survival time of 5.3 years. CONCLUSIONS: This study provides CT imaging features with clinical information of spontaneous osteosarcoma in craniomaxillofacial fibrous dysplasia.

[Visualized study on acupuncture treatment of children autism using single photon emission computed tomography].

OBJECTIVE: To provide the molecular iconographic evidence for acupuncture treatment of children autism (CA). METHODS: Electric acupuncture (EA) was applied on acupoints of bilateral Hegu (LI4), Quchi (LI11), Zusanli (ST36) and Sanyinjiao (SP6) in 34 CA patients' with ABC scale > 57 scores. Using SIEMENS ECAM / ICON double head system, single photon emission computed tomography (SPECT) brain perfusion imaging were performed before and during EA with 99mTc-ECD. Then SPECT images were analyzed visually and quantitatively. RESULTS: Visual analysis showed that 114 foci of low cerebral perfusion and function were found in 34 CA patients before EA, 28 cases (82.35%) of them with abnormalities in left (or both) front lobes, left Broca area and left Wernicke area. During EA, the affected areas improved to different extent. Quantitative analysis showed that significant difference existed between pre-EA focal Ff and mirror-side Ff, pre-EA Ff and mid-EA Fe, focal BFCR% and mirror-side BFCR % (all P < 0.01). The improving analysis of cerebral perfusion and function showed that the efficacy of EA was 78.95%. CONCLUSION: Acupuncture was proved preliminarily effective in treating children autism.