[Efficacy of surgical treatment for pontine hemorrhage via infratemporal-prepetrosal approach].

Herein, the clinical data of 20 patients with pontine hemorrhage were retrospectively analyzed. All the patients underwent surgery via infratemporal-prepetrosal approach between January 2013 and June 2021 in the Department of Neurosurgery from the First Affiliated Hospital of Soochow University. There were 15 males and 5 females. The age ranged from 32 to 69 years, with an average age of 47.9 years. The course of disease was 3.5-16.0 h, with an average of 6.7 h. All the patients underwent surgery successfully. The hematomas of 17 patients were completely removed while the hematomas of the other 3 patients were partially removed. One patient died of multiple organ dysfunction syndrome during 30 days follow-up after surgery. The other patients were evaluated by Glasgow outcome scale (GOS), and the results showed that 1 patient was in Grade 5, 7 patients were in Grade 4, 6 patients were in Grade 3, 4 patients were in Grade 2, and 2 patients were in Grade 1. The surgery via infratemporal-prepetrosal approach is a safe, reasonable and feasible treatment for pontine hemorrhage. Especially for the patients who were younger than 50 years old, with high preoperative Glasgow Coma Scale (GCS) grade and surgical indications. This surgical technique can effectively reduce the mortality and improve the prognosis of patients with pontine hemorrhage. Moreover, patients should be operated within 6 hours after pontine hemorrhage as soon as possible.

[Combined endoscopic and microsurgical resection of pineal region meningiomas by modified Poppen approach].

To retrospectively analyze the clinical data of patients with pineal region meningioma. All the patients underwent combined endoscopic and microsurgical procedure by modified Poppen approach (double-scopic technique) between January 2018 and March 2021 in the Department of Neurosurgery of the First Affiliated Hospital of Soochow University. A total tumor resection was achieved in all the patients without deaths. All the pineal region meningiomas were pathologically confirmed. During the follow-up period, none of the 10 patients experienced tumor progression, and 4 of patients were treated by radiotherapy after surgery. The external ventricular drainage was performed in 8 cases intraoperatively, and no case underwent the ventriculoperitoneal shunt during the follow-up period. The clinical symptoms of 9 cases were improved,1 case had no improvement, and no patients presented deteriorated symptoms. Combined endoscopic and microsurgical surgery resection of pineal region meningiomas by modified Poppen approach helped the surgeons directly observe the cerebral deep vein systems in pineal region with endoscope and significantly enhance the total resection rate of pineal region meningiomas, thereby decreasing the damage of cerebral deep vein systems in pineal region and reducing the incidence of surgical complications.

Collaborative care model improves self-care ability, quality of life and cardiac function of patients with chronic heart failure.

Chronic heart failure (CHF) is a common chronic disease that requires much care. This study aimed to explore the effects of collaborative care model (CCM) on patients with CHF. A total of 114 CHF patients were enrolled in this study, and were randomly and equally divided into two groups: control and experimental. Patients in the two groups received either usual care or CCM for 3 continuous months. The impacts of CCM on the self-care ability and quality of life were assessed using self-care of heart failure index and short form health survey 12, respectively. Further, cardiac function was assessed by measuring left ventricular ejection fraction (LVEF) and the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP), and by the 6-min walking test. Clinical and demographic characteristics of patients in the control and CCM groups were statistically equivalent. Compared with usual care, CCM significantly enhanced self-care abilities of patients with CHF, including self-care maintenance, self-care management and self-care confidence (all P<0.05). The physical and mental quality of life was also significantly improved by CCM (P<0.01 or P<0.05). Compared with usual care, CCM significantly increased the LVEF (P<0.01), decreased the NT-proBNP level (P<0.01), and enhanced exercise capacity (P<0.001). In conclusion, CCM improved the self-care, quality of life and cardiac function of patients with CHF compared with usual care.

Analysis of the interaction of ZAP-70 and syk protein-tyrosine kinases with the T-cell antigen receptor by plasmon resonance.

Tyrosine phosphorylation of a 17-amino acid immunoreceptor tyrosine-based activation motif (ITAM), conserved in each of the signaling subunits of the T-cell antigen receptor (TCR), mediates the recruitment of ZAP-70 and syk protein-tyrosine kinases (PTKs) to the activated receptor. The interaction between the two tandemly arranged Src-homology 2 (SH2) domains of this family of PTKs and each of the phosphotyrosine-containing ITAMs was examined by real-time measurements of kinetic parameters. The association rate and equilibrium binding constants for the ZAP-70 and syk SH2 domains were determined for the CD3 epsilon ITAM. Both PTKs bound with ka and Kd values of 5 x 10(6) M-1.sec-1 and approximately 25 nM, respectively. Bindings to the other TCR ITAMs (zeta 1, zeta 2, gamma, and delta ITAMs) were comparable, although the zeta 3 ITAM bound approximately 2.5-fold less well. Studies of the affinity of a single functional SH2 domain of ZAP-70 provided evidence for the cooperative nature of binding of the dual SH2 domains. Mutation of either single SH2 domain decreased the Kd by > 100-fold. Finally, the critical features of the ITAM for syk binding were found to be similar to those required for ZAP-70 binding. These data provide insight into the mechanism by which the multisubunit TCR interacts with downstream effector molecules.

Reconstitution of Syk function by the ZAP-70 protein tyrosine kinase.

ZAP-70 and Syk are PTKs required for TCR and BCR function, respectively. Loss of the Syk PTK results in a nonfunctional BCR. We provide evidence here that ZAP-70 and Syk are functionally homologous in antigen receptor signaling by demonstrating that expression of ZAP-70 in Syk- B cells reconstitutes BCR function. Reconstitution required the presence of functional Src homology 2 (SH2) and catalytic domains of ZAP-70. Thus, drug targeting of a single SH2 domain within ZAP-70 should be sufficient to inhibit hematopoietic antigen receptor function. In addition, we demonstrate that both ZAP-70 and Syk can bind directly to the phosphorylated Ig alpha and Ig beta subunits with affinities comparable to their binding to the TCR CD3 epsilon subunit. These data suggest that ZAP-70 and Syk are comparable in their abilities to mediate hematopoietic antigen receptor signaling.

Regulation of PAK activation and the T cell cytoskeleton by the linker protein SLP-76.

Tyrosine phosphorylation of linker proteins enables the T cell antigen receptor (TCR)-associated protein tyrosine kinases to phosphorylate and regulate effector molecules that generate second messengers. We demonstrate here that the SLP-76 linker protein interacts with both nck, an adaptor protein, and Vav, a guanine nucleotide exchange factor for Rho-family GTPases. The assembly of this tri-molecular complex permits the activated Rho-family GTPases to regulate target effectors that interact through nck. In turn, assembly of this complex mediates the enzymatic activation of the p21-activated protein kinase 1 and facilitates actin polymerization. Hence, phosphorylation of linker proteins not only bridges the TCR-associated PTK, ZAP-70, with downstream effector proteins, but also provides a scaffold to integrate distinct signaling complexes to regulate T cell function.

Functional expression of a novel human neurokinin-3 receptor homolog that binds [3H]senktide and [125I-MePhe7]neurokinin B, and is responsive to tachykinin peptide agonists.

In 1992, Xie et al. identified a cDNA sequence in the expression cloning search for the kappa opioid receptor. When the cDNA was expressed in Cos-7 cells, binding of opioid compounds was observed to be of low affinity and without kappa, mu, or delta selectivity [Xie, G.-X., Miyajima, A. and Goldstein, A. (1992) Proc. Natl. Acad. Sci. USA 89, 4124-4128]. This cDNA was highly homologous to the human neurokinin-3 (NK-3) receptor sequence, and displayed lower homology to NK-1 and NK-2 sequences. This sequence was stably expressed in Chinese hamster ovary cells, which do not express neurokinin receptors naturally, and ligand binding and second messenger characteristics were compared with a human NK-3 receptor. The NK-3 receptor homolog bound [3H] senktide with a Kd of 39 nM, similar to that of the NK-3 receptor. The rank order of tachykinin peptides competing for [3H]senktide binding at the NK-3 receptor homolog was [MePhe7]neurokinin B > senktide > substance P = neurokinin A > neurokinin B. This cell line also bound [125I-MePhe7]neurokinin B; however, neurokinin B was an effective competitor. Tachykinin peptides stimulated both inositol phospholipid hydrolysis and arachidonic acid release at NK-3 and NK-3 receptor homolog cell lines, with similar rank orders of potency of [MePhe7] neurokinin B = neurokinin B = senktide > NKA = substance P. These results indicate that expression of the NK-3 receptor homolog cDNA in the Chinese hamster ovary cell system induces the expression of a receptor site with many similarities but certain key differences from that of the human NK-3 receptor. The results are discussed with reference to the existence of a novel human tachykinin receptor.