Everolimus in de novo liver transplant recipients: a systematic review.

BACKGROUND: Everolimus has no nephrotoxicity and is used to treat patients with post-liver transplant chronic renal insufficiency. The present systematic review was to evaluate the efficacy and safety of everolimus in de novo liver transplant patients. DATA SOURCES: Randomized controlled trials comparing everolimus for de novo liver transplant in PubMed, the Cochrane Library, and ScienceDirect published up to March 31, 2014 were searched by two independent reviewers. Mean differences and 95% confidence interval (95% CI) for renal function, relative risk (RR) and 95% CI for treated biopsy-proven acute rejection (tBPAR), graft loss, death, neoplasms/tumor recurrence, and adverse events were collected. Meta-analyses were performed with RevMan version 5.10. RESULTS: A total of four randomized controlled trials covering 1119 cases were included. The meta-analyses revealed that compared with standard exposure of calcineurin inhibitors (CNIs), everolimus combined with reduced CNIs improved creatinine clearance (calculated with the Cockcroft-Gault formula) by 5.13 mL/min at one year (95% CI: 0.42-9.84; P=0.03), and decreased tBPAR (RR: 0.56; 95% CI: 0.35-0.90; P=0.02). Everolimus initiation with CNIs elimination improved glomerular filtration rate (GFR, measured with the modification of diet in renal disease formula) of 10.42 mL/min/1.73 m2 (95% CI: 3.44-17.41; P<0.01) one year after treatment, but increased tBPAR (RR: 1.71; 95% CI: 1.15-2.53; P<0.01). Everolimus decreased the risk of neoplasms/tumor recurrence after liver transplant (RR: 0.60; 95% CI: 0.34-1.03; P=0.06), but was associated with greater risk of adverse events which resulted in drug discontinuation (RR: 1.98; 95% CI: 1.49-2.64; P<0.01). CONCLUSIONS: Early introduction of everolimus combined with low-dose or no CNI in de novo liver transplant significantly improves renal function one year post treatment. Everolimus combined with low-dose CNI decreases the risk of tBPAR one year after liver transplant, but everolimus administered without CNIs increases tBPAR.

Multi-slice spiral CT evaluation of chronic radiation colitis and rectitis.

The aim of the present study was to retrospectively analyse the multi-slice spiral CT (MSCT) findings of radiation colitis and rectitis (RC&R). A total of 23 cases of RC&R detected by helical CT were included. The CT findings and clinical and endoscopy data of the patients were reviewed. The primary tumours included cancers of the cervix (n=17), rectum (n=4), ovaries (n=1) and bladder (n=1). The total dose of radiation per patient was 46-60 Gy (mean, 49.7 Gy) delivered over 5 weeks. The CT manifestations included different degrees of increased thickness of the intestinal wall (n=20, 87.0%), with a maximum thickness of 16.6 mm. On enhanced CT, the target sign was observed (n=16, 69.9%), with an obviously enhanced mucosa and/or serosa and the following changes observed: Oedema and increased density of the mesentery (n=15, 65.2%); increased density of the subcutaneous fat, and blurred and oedematous pelvic wall muscles (n=4, 17.4%), with the obturator internus and levator ani muscles being most commonly affected; narrowed intestinal lumen (n=3, 13.0%); and a small amount of ascitic fluid (n=2, 8.7%) located in the paracolic sulci and bladder or Douglas pouch. The 23 patients underwent colonoscopy and were diagnosed with RC&R. The major manifestations included telangiectasia and mucosal hyperaemia (n=21, 91.3%). MSCT of chronic RC&R (CRC&R) was associated with certain characteristic findings, which, combined with a medical history of radiotherapy and the clinical manifestations, may prove to be of value in the diagnosis of CRC&R.

[Inhibitory control deficit in patients with panic disorder: an event-related potentials study].

OBJECTIVE: To investigate the electrophysiological evidence of inhibitory control deficit in panic disorder patients using a visual simple Go/Nogo task. METHOD: Sixteen patients with panic disorder and 13 healthy volunteers received a visual simple Go/Nogo task. The stimuli were single or double English letters and appeared with equal probability. The subjects were instructed to press a button as quickly as possible when the double letter was presented (i.e., Go), but make no response to the single letter (i.e., Nogo). 32 channel EEG data were recorded. RESULT: All subjects displayed a distinct Go/Nogo effect in the N2 component (PD group:F(1,30) = 8.00, P = 0.008; NC group: F(1,24) = 4.60, P = 0.042) and P3 component (PD group: F(1,30) = 7.85, P = 0.009; NC group: F(1,24) = 13.57, P = 0.000) at frontocentral sites, but the amplitudes of Nogo-N2 and Nogo-P3 were significantly reduced in panic disorder patients as compared to the healthy subjects (Fz: F = 9.135, P = 0.005; F = 8.511, P = 0.006, respectively). There was no significant differences between the latencies of Nogo-N2 and Nogo-P3. CONCLUSION: Panic disorder may consist inhibitory control deficit which may assist in offering new objective evidence to understand the etiology of panic disorder.

[Automatic auditory information management in panic disorder patients: an event-related potentials study].

OBJECTIVE: To investigate the characteristics of automatic auditory information management in sufferers of panic disorder (PD). METHOD: Mismatch negativity (MMN), as a component of event-related potentials, was recorded from 15 PD patients, 8 males and 7 females, aged 40 +/- 12, and 15 sex, and aged-matched controls. Repeated measures ANOVA was used on 4 representative electrodes: T3, T4, F3, and F4. RESULTS: Compared with the normal controls, the PD patients showed significant enlargement of MMN amplitude in 60 - 210 ms latency windows (60 - 110 ms: F(1, 28) = 11.413, P = 0.02; 110 - 160 ms: F(1, 28) = 6.639, P = 0.016; 160 - 210 ms: F(1, 28) = 5.758, P = 0.023), and exhibited early (60 - 160 ms) left encephalic region predominant effect. CONCLUSION: PD patients may deal excessive automatic processing of the auditory information changes which may assist in offering new objective evidence to understand the etiology of PD.

A novel periplasmic protein (Slr0280) tunes photomixotrophic growth of the cyanobacterium, Synechocystis sp. PCC 6803.

Cyanobacteria are among the main contributors to global photosynthesis and show a high degree of metabolic plasticity. Synechocystis sp. PCC 6803 can grow under photoautotrophic, photomixotrophic or photoheterotrophic conditions. We have characterized a novel periplasmic protein (Slr0280) that tunes the photomixotrophic growth of Synechocystis sp. PCC 6803. Slr0280 is a multi-domain protein consisting mainly of ß-sheets. Several proteins that interact with Slr0280 were identified via bacterial two-hybrid screening. Slr0280 may interact through its DUF2233 domain with partners that participate in sugar metabolism, thereby coordinating the respective regulations. When slr0280 was deleted, the mutant grew more slowly than wild-type in the presence of glucose, which is ascribed to the down-regulation of glycolysis, glycogen catabolism, oxidative pentose phosphate pathway, Calvin cycle and glucose utilization. A positive regulation of Slr0280 on these sugar catabolic enzymes was confirmed by transcript (qPCR) analyses. Based on these findings, we proposed a speculative model that Slr0280 plays a coordinating regulatory role in sugar metabolism.

Prognostic significance of EBV latent membrane protein 1 expression in lymphomas: evidence from 15 studies.

BACKGROUND: Epstein-Barr virus (EBV) infection has been associated with lymphoma development. EBV latent membrane protein 1 (LMP1) is essential for EBV-mediated transformation and progression of different human cells, including lymphocytes. This meta-analysis investigated LMP1 expression with prognosis of patients with lymphoma. METHODS: The electronic databases of PubMed, Embase, and Chinese Biomedicine Databases were searched. There were 15 published studies available for a random effects model analysis. Quality assessment was performed using the Newcastle-Ottawa Quality Assessment Scale for cohort studies. A funnel plot was used to investigate publication bias, and sources of heterogeneity were identified by meta-regression analysis. The combined hazard ratios (HR) and their corresponding 95% confidence intervals of LMP1 expression were calculated by comparison to the overall survival. RESULTS: Overall, there was no statistical significance found between LMP1 expression and survival of lymphoma patients (HR 1.25 [95% CI, 0.92-1.68]). In subgroup analyses, LMP1 expression was associated with survival in patients with non-Hodgkin lymphoma (NHL) (HR = 1.84, 95% CI: 1.02-3.34), but not with survival of patients with Hodgkin disease (HD) (HR = 1.03, 95% CI: 0.74-1.44). In addition, significant heterogeneity was present and the meta-regression revealed that the outcome of analysis was mainly influenced by the cutoff value. CONCLUSIONS: This meta-analysis demonstrated that LMP1 expression appears to be an unfavorable prognostic factor for overall survival of NHL patients. The data suggested that EBV infection and LMP1 expression may be an important factor for NHL development or progression.

LMP1 and LMP2A are potential prognostic markers of extranodal NK/T-cell lymphoma, nasal type (ENKTL).

BACKGROUND: Latent membrane protein (LMP) 1 and LMP2A encoded by Epstein-Barr virus (EBV) are associated with the development of malignancies, but their expression in extranodal NK/T-cell lymphoma, nasal type (ENKTL) and the relationship with clinical characteristics of this disease remain poorly understood. In the present study, we examined the expression of LMP1 and LMP2A in ENKTL, and investigated the correlations between LMP1 and LMP2A expression with clinicopathological characteristics of ENKTL patients. METHODS: Paraffin sections of surgically removed samples from 16 ENKTL patients were analyzed by immunohistochemistry and the related clinicopathological data were collected and analyzed. RESULTS: Elevated expression (immunohistochemistry score ≥ 4) of LMP1 and LMP2A was detected in the tumor cells of ENKTL. High LMP1 expression was associated with positive B symptoms (p = 0.012), while high LMP2A expression was related to gender (p = 0.029). The expression of both LMP1 and LMP2A showed significant correlations with patients' overall survival (p = 0.049, p = 0.036). CONCLUSION: LMP1 and LMP2A may be prognostic indicators of survival in patients with ENKTL. VIRTUAL SLIDES: http://www.diagnosticpathology.diagnomx.eu/vs/2443352538545899.

Alpha B-crystallin is a new prognostic marker for laryngeal squamous cell carcinoma.

BACKGROUND: Alpha B-crystallin (αB-crystallin) has been suggested to play an important role in the development of solid tumors. However, the association between αB-crystallin expression and clinicopathological characteristics of human laryngeal carcinoma is not well defined. This study aimed to examine the expression of αB-crystallin in human laryngeal squamous cell carcinoma (LSCC) and investigate the relationship between its expression and the prognosis of LSCC. METHODS: Real-time polymerase chain reaction (six LSCC samples, six tumor-adjacent normal samples) and immunohistochemistry by tissue microarrays (109 LSCC samples and 28 tumor-adjacent normal samples) were performed to characterize expression of the αB-crystallin gene in LSCC. Kaplan-Meier survival and Cox regression analyses were carried out to evaluate the prognosis of LSCC. RESULTS: Real-time polymerase chain reaction and immunohistochemistry analysis showed that the expression of αB-crystallin in LSCC was significantly higher than that in tumor-adjacent normal tissues. Moreover, the expression level of αB-crystallin protein in LSCC was significantly related to alcohol consumption (P = 0.022), tumor differentiation (P = 0.007), pTNM stage (P = 0.041) and 5 years' survival (P =0.030). COX multi-factor analysis showed that αB-crystallin (P = .013), as well as pTNM stage (P =0.027) and lymphatic metastasis (P = 0.015) were independent prognosis factors for LSCC. CONCLUSIONS: The data suggest that αB-crystallin expression is correlated with malignant phenotypes of LSCC and it may serve as a novel prognostic factor for LSCC.