Two novel mutations in TCIRG1 induced infantile malignant osteopetrosis: a case report.

BACKGROUND: Infantile malignant osteopetrosis (IMO) is a rare autosomal recessive disease characterized by a higher bone density in bone marrow caused by the dysfunction of bone resorption. Clinically, IMO can be diagnosed with medical examination, bone mineral density test and whole genome sequencing. CASE PRESENTATION: We present the case of a 4-month-old male infant with abnormal skull development, hypocalcemia and premature closure of the cranial sutures. Due to the hyper bone density showed by his radiographic examination, which are characteristic patterns of IMO, we speculated that he might be an IMO patient. In order to confirm this diagnosis, a high-precision whole exome sequencing of the infant and his parents was performed. The analysis of high-precision whole exome sequencing results lead to the identification of two novel heterozygous mutations c.504-1G > C (a splicing site mutation) and c.1371delC (p.G458Afs*70, a frameshift mutation) in gene TCIRG1 derived from his parents. Therefore, we propose that there is a close association between these two mutations and the onset of IMO. CONCLUSIONS: To date, these two novel mutations in gene TCIRG1 have not been reported in the reference gene database of Chinese population. These variants have likewise not been reported outside of China in the Genome Aggregation Database (gnomAD). Our case suggests that the use of whole exome sequencing to detect these two mutations will improve the identification and early diagnosis of IMO, and more specifically, the identification of homozygous individuals with TCIRG1 gene mutation. We propose that these mutations in gene TCIRG1 could be a novel therapeutic target for the IMO in the future.

[Lignan glycosides and sucrose esters from roots of Securidaca inappendiculata].

Nine compounds, including five lignan glycosides (1-5), three sucrose esters (6-8), and one organic acid ester (9), were isolated from the ethanol extract of the roots of Securidaca inappendiculata by various chromatographic methods including silica gel, MPLC and preparative HPLC. Their structures were elucidated as acernikol-4″-O-ß-D-glucopyranoside (1), (7R, 8S)-dihydrodehydrodiconiferyl alcohol 9-O-ß-D-glucopyranoside (2), (7R, 8S)-dihydrodehydrodiconiferyl alcohol 4-O-ß-D-glucopyranoside (3), (7R, 8S)-dihydrodehydrodiconiferyl alcohol 9'-O-ß-D-glucopyranoside (4), (7R, 8S)-5-methoxydihydrodehy-drodiconiferyl alcohol 4-O-ß-D-glucopyranoside (5), 3, 6'-O-diferuloylsucrose (6), 3-O-feruloyl-6'-O-sinapoylsucrose (7), sibricose A5 (8), and mehyl ferulate (9) on the basis of 1H-, 13C-NMR and MS experiments. Compounds 1-5, 8, and 9 were isolated from the Securidaca genus for the first time. Compounds 2, 3, and 7 exhibited weak cytotoxic activities against Hela and MCF-7 cell lines.

[Saponins from roots of Securidaca inappendiculata with cytotoxic activities].

Seven acylated triterpene saponins were isolated from the roots of Securidaca inappendiculata by means of various chromatographic techniques such as silica gel, MPLC, preparative HPLC, and semi-preparative HPLC. Their chemical structures were identified as securioside A(1), securioside B(2), 3-O-ß-D-glucopyranosyl presenegenin 28-O-ß-D-xylopyranosyl-(1-->4)-α-L-rhamnopyranosyl-(1-->2)-[ß-D-glucopyranosyl-(1-->3)]-4-O-[(E)-3,4-dimethoxycinnamoyl]-ß-D-fucopyranosyl ester(3), 3-O-ß-D-glucopyranosyl presenegenin 28-O-ß-D-xylopyranosyl-(1-->4)-α-L-rhamnopyranosyl-(1-->2)-[ß-D-glucopyranosyl-(1-->3) ] -4-O-[(E/Z)-3, 4-dimethoxycinnamoyl]-ß-D-fucopyranosyl ester(3/4), 3-O-ß-D-glucopyranosyl presenegenin 28-O-α-L-arabinopyranosyl-(1-->3)-ß-D-xylopyranosyl-(1-->4)-α-L-rhamnopyranosyl-(1-->2)-4-O-[(E)-3,4-dimethoxycinnamoyl]-ß-D-fucopyranosyl ester(5), polygalasa- ponin XLV(6), and polygalasaponin XLVI (7) on the basis of spectroscopic data analysis and physicochemical properties. Among them, compounds 5-7 were isolated from the plants in genus Securidaca for the first time and compounds 3, 3/4 were isolated from the species for the first time. The cytotoxicity assay showed that compounds 2, 3/4, 5 have moderate cytotoxic activities against Lewis lung carcinoma LLC cells with IC50 values of 41.10, 38.17, and 48.92 µmol · L(-1), respectively; compound 2 exhibited moderate cytotoxic activities against human breast cancer MCF-7 cells with an IC50 value of 47.93 µmol · L(-1).

[Effects of performing pelvic lymph node dissection before versus after radical cystectomy].

OBJECTIVE: To explore the efficacies of extended pelvic lymph node dissection (e-PLND) before or after radical cystectomy (RC). METHODS: From January 2003 to January 2013, a total of 107 patients underwent e-PLND plus RC. And their relevant clinical data were reviewed. Their median age was (62 ± 10) years. The e-PLND were divided into 10 regions and 6 groups according to the anatomic sites. Forty-seven (43.9%) underwent RC after e-PLND (group A) and 60 (56.1%) had RC before e-PLND (group B). Two groups were compared for operative duration, numbers of lymph nodes removed, metastatic rates of lymph node, dissected lymph node positive rates and operative complications. The results were analyzed with Chi-square or Student's test. RESULTS: Clinicopathological characteristics were comparable for two groups (P > 0.05). The mean operative durations of e-PLND were similar in both groups ( (83 ± 27) vs (78 ± 24) min , P > 0.05). The mean operative durations of RC were significantly shorter in group A than those in group B ( (79 ± 41) vs (113 ± 44) min, P < 0.01) . The mean number of lymph nodes removed (25.5 ± 9.7 vs 29.0 ± 8.4) and the mean number of lymph nodes removed at internal iliac (5.7 ± 2.9 vs 7.2 ± 3.5) and presacral (1.3 ± 1.1 vs 2.5 ± 1.6) regions were significantly fewer in group A than those in group B (all P < 0.05). The metastatic rates of lymph node (34.0% (16/47) vs 31.7% (19/60)), dissected lymph node positive rates (9.0% (108/1197) vs 7.5% (130/1743)) and operative complications (23.4% (11/47) vs 20.0% (12/60)) were similar in both groups (all P > 0.05). CONCLUSION: RC is performed preferably after e-PLND, and internal iliac and presacral area should be dissected for additional lymph nodes after RC.

The changes of brainstem auditory evoked potentials (BAEP) after vertebrobasilar artery ischemia in rabbits.

Brainstem auditory evoked potentials (BAEPs) have been used as a valuable neurophysiologic index of neuronal dysfunction in the level of the brainstem. BAEPs are also useful in subdividing evoked potentials into normal, slight, or pronounced in patients with vertebrobasilar insufficiency. We investigated the changes of BAEP after vertebrobasilar artery ischemia in rabbits and its significance in clinical work. A brainstem ischemic model was made by unilateral extracranial occlusion of vertebral artery to monitor BAEPs at 0, 10, 20, 30, 40, 50, and 60 min after occlusion. We found that peak latencies (PL) of I, III, and most notably V were gradually extended. In addition, we observed a significant (P < 0.05) delay of interpeak latencies (IPL) of waves I­III, III­V, and I­V after occlusion. This delay became more significant in IPL I­V 60 min after occlusion. Our results also demonstrate that the amplitude of I and V had no obvious change (P < 0.05). In the rabbit with bilateral extracranial occlusion of vertebral artery, BAEP waveforms disappeared 10 min after occlusion. Our results showed that vertebrobasilar insufficiency caused brainstem ischemia, which induced BAEP abnormity. Taken together, our findings suggest that BAEP has important significance for the clinical diagnosis of vertebrobasilar insufficiency. Therefore, early detection of neuronal change after transient cerebral ischemia is important in initiating treatment within the therapeutic window.

Tracheobronchial intubation using flexible bronchoscopy in children with Pierre Robin sequence: Nursing considerations for complications.

BACKGROUND: It has been shown that children with Pierre Robin sequence (PRS) have a higher risk of difficult intubation before surgery. When mask ventilation or tracheobronchial intubation is expected to be challenging, flexible bronchoscopy (FB) is advantageous in airway safety when it is used to guide tracheobronchial intubation (TI). AIM: To evaluate the complications of TI using FB in children with PRS and explore the effect of nursing services on postoperative complications. METHODS: One hundred and five children with PRS underwent TI using FB before early mandibular distraction osteogenesis. One hundred and eight children with common pneumonia who did not have a difficult airway were set as the control group. Demographic data, success rates of TI, time required for TI, number of TI attempts, and the incidence of postoperative complications were assessed. Besides, the strategies used to attenuate complications were investigated. RESULTS: The success rate of TI was 100% in children with PRS, while the success rate at the first attempt in the PRS group was significantly lower than that in the control group (88.6% vs 98.2%, P = 0.005). The time required for TI in the PRS group was markedly longer than that in the control group (P < 0.001). Children in the PRS group required repetitive operations to enter the glottis successfully (P = 0.017). The incidence of complications was noticeably higher in the PRS group (50/105, 47.6%) than in the control group (36/108, 33.3%) (P = 0.034). Seven of 105 PRS children experienced laryngeal edema (LE) (6.7%), compared with one (0.9%) in the control group (P = 0.034). Out of the seven patients who had LE, all were reintubated and managed with steroids: six recovered with inhaled steroids alone before extubated, and one was given systemic corticosteroids before recovery. CONCLUSION: FB contributes to a high success rate of TI in children with PRS. To prevent LE, operators should pay more attention to catheter material, catheter lubrication and intubation time.

Comprehensive analysis of immune ferroptosis gene in renal clear cell carcinoma: prognosis and influence of tumor microenvironment.

OBJECTIVE: We conducted an in-depth study of the immune system and ferroptosis to identify prognostic biomarkers and therapeutic targets for renal clear cell carcinoma. METHODS: Immune ferroptosis-related differentially expressed genes (IFR-DEGs) were selected from The Cancer Genome Atlas (TCGA). A lasso-Cox risk scoring model was established; its prognostic value was determined using prognostic analysis and single multivariate Cox analysis. Model genes were subjected to subcellular fluorescence localization, mRNA and protein expression analyses, and single-cell RNA sequencing localization analysis. Risk score was analyzed using the immune score, immune infiltrating cell correlation, immune checkpoint, TIDE, and drug sensitivity. RESULTS: A total of 103 IFR-DEGs were identified; a risk model comprising ACADSB, CHAC1, LURAP1L, and PLA2G6 was established. The survival curve, single multivariate Cox regression, and receiver operating characteristic (ROC) curve analysis showed that the model had good predictive ability (p < 0.05). It was also validated using the validation set and total cohort. Subcellular fluorescence localization revealed that ACADSB, CHAC1, and PLA2G6 were distributed in the cytoplasm and LURAP1L in the nucleus. The mRNA and protein expression trends were consistent. Single-cell RNA sequencing mapping revealed that ACADSB was enriched in distal tubule cell clusters. In the Kidney renal clear cell carcinoma (KIRC) mutation correlation analysis, 1.56% of the patients were found to have genetic alterations; The Spearman correlation analysis of model gene mutations showed that ACADSB was positively correlated with LURAP1L, which may have a synergistic effect; it was negatively correlated with CHAC1 and PLA2G6, and CHAC1 was negatively correlated with LURAP1L, which may have an antagonistic effect. Model and immune correlation analyses found that high-risk patients had significantly higher levels of CD8+ T cells, regulatory T cells (Tregs), immune checkpoints, immune scores, and immune escape than those in low-risk patients. High-risk patients had a higher susceptibility to small-molecule drugs. CONCLUSION: A novel prognostic model of immune ferroptosis-related genes (ACADSB, CHAC1, LURAP1L, and PLA2G6), which plays an important role in immune infiltration, microenvironment, and immune escape, was constructed. It effectively predicts the survival of patients with KIRC.

Two new phenolic glycosides from the stems of Clematis parviloba.

To study the chemical constituents of the stems of Clematis parviloba, six compounds were isolated from a 95% ethanol extract by using a combination of various chromatographic techniques including column chromatography over silica gel, ODS, Sephadex LH-20, and semi-preparative HPLC. Two new phenolic glycosides, 2-((E)-3-carboxybut-2-en-yl)-4-hydroxy-3-methyl-phenyl-O-beta-D-glucopyranoside (1) and 4'-hydroxy-phenol-beta-D-[6-O-(4"-hydroxy-3", 5"-dimethoxy-benzoate)] glucopyranoside (2) were isolated, together with a known phenolic glycoside, 4'-hydroxy-3'-methoxy-phenol-beta-D-[6-O-(4"-hydroxy-3", 5"-dimethoxy-benzoate)] glucopyranoside (3) as well as three known megastigmane glycosides, linarionoside A (4), linarionoside C (5), and staphylionoside K (6). Their structures were determined on the basis of spectroscopic analysis and chemical evidence. Among them, compounds 1 and 2 were named as clemaparvilosides A (1) and B (2), respectively, and compounds 3-6 were obtained from Clematis genus for the first time.

Chantriolide C, a new withanolide glucoside and a new spirostanol saponin from the rhizomes of Tacca chantrieri.

A new withanolide, chantriolide C (1) and a new spirostanol saponin, chantrieroside A (2) were isolated from the rhizomes of Tacca chantrieri, together with another five known steroidal compounds. Their structures were established as (22R)-1alpha,12alpha-diacetoxy-2alpha,3alpha;6alpha,7alpha-diepoxy-27-[(beta-D-glucopyranosyl)oxy]-5alpha-hydroxywith-24-enolide (1) and (25R)-spirost-5-en-3-yl-O-alpha-L-rhamnopyranosyl-(1-->2)-O-[O-beta-D-glucopyranosyl-(1-->4)-alpha-L-rhamnopyranosyl-(1-->3)]-beta-D-glucopyranoside (2). The structures of the new saponins were determined by detailed analysis of their 1 dimensional (1D) and 2D NMR spectra, and chemical evidences.

Triterpenoid saponins from the stems of Clematis parviloba.

Sixteen triterpenoid saponins (1-16) were isolated from the stems of Clematis parviloba, including a new compound, parvilobaside A (1), which was established as 23-O-acetyl-hederagenin-3-O-beta-D-ribopyranosyl-(1 --> 3)-alpha-L-rhamnopyranosyl-(1 --> 2)-alpha-l-arabinopyranoside on the basis of various spectroscopic techniques and chemical evidences. Among the isolated compounds, clematoside S (2) and alpha-hederin (4) showed moderate cytotoxic activities against four human tumor cell lines (HCT-8, Bel-7402, BGC-823, and A-2780) with IC(50) values in the range of 1.44-6.86 microg/ml.

Two new polyoxygenated cyclohexenes from Uvaria kweichowensis.

Two new polyoxygenated cyclohexenes, kweichowenols C and D, were isolated from the leaves of Uvaria kweichowensis, and their structures were established on the basis of their spectral data. The two new compounds showed some antitumor activity by the MTT assay.

Inositol angelates from the whole herb of Inula cappa.

A new inositol derivative, cis-1,2,3,5-trans-4,6-inositol-2,3,6-triangelate(1) along with the known l-inositol-1,2,3,5-tetra angelate(2), was isolated from the ethanolic extract of the whole plant Inula cappa and identified on the spectroscopic analysis.

[Studies on lignan constituents of Clematis parviloba].

OBJECTIVE: To study the chemical constituents of the stems of Clematis parviloba. METHOD: The compounds were isolated and purified by repeated column chromatography with silica gel, Sephadex LH-20 and HPLC. Their structures were identified by spectroscopic data together with physical and chemical property. RESULT: Ten compounds have been isolated from the stems of C. parviloba, and identified as: (+) pinoresionol (1), (+) pinoresionol-4'-O-p-D-glucopyranoside (2), ( +) pinoresionol4, 4'-O-bis-beta-D-glucopyranoside (3), (-) syringaresinol (4), (+) syringaresinol-4'-O-beta-D-glucopyranoside (5), (-)episyringaresinol (6), (+) medioresinol-4'-O-beta-D-glucopyranoside (7), (+) lariciresinol-4-O-beta-D-glucopyranoside (8), (+) lariciresinol-4'-O-beta-D-glucopyranoside (9), (+) lariciresinol-4, 4'-O-bis-beta-D-glucopyranoside (10), respectively. CONCLUSION: Compounds 6, 7 were isolated from this genus for the first time, and the other ones were isolated from this plant for the first time.

[Amides from the stems of Uvaria kweichowensis].

Uvaria kweichowensis is a folk nongovernmental herb used to treat cure inflammation and tumour in the Southwest area of China. During the course of our investigation for antitumour agents from the stems of Uvaria kweichowensis, six amides were obtained by means of solvent extraction, chromatography on silica gel and Sephadex LH-20 repeatedly. And their structures were identified as uvariadiamide (1), cepharanone (2), aristololactam A II (3), enterocarpam II (4), aristololactam A Ia (5), and 4,5-dioxodehydroasimilobine (6) on the basis of chemical methods and spectral analyses (EI-MS, 1H NMR, 13C NMR). Among them, compound 1 is a new compound; the other compounds were obtained from this plant for the first time.

A new glycoside from Alpinia officinarum.

AIM: To investigate the glycosidic constituents in the rhizomes of Alpinia officinarum Hance. METHODS: The isolation and purification of glycosides were done with column chromatography on macro porous resin, polyamides and Sephadex LH-20, whilst the structure elucidation was done by HRCI-MS and NMR (1D and 2D) methods. RESULTS: A glycosidic ester identified as 4'-hydroxy-2'-methoxyphenol-beta-D-{6-0-[4"-hydroxy-3", 5"-dimethoxy (benzoate)]}-glucopyranoside (I), along with a known compound n-butyl-beta-D-fructopyranoside (II), were isolated and characterized. CONCLUSION: I was found to be a new compound, named as alpinoside A, whilst II was isolated from the genus Alpinia for the first time.

[A new benzophenone from the root of Securidaca inappendiculata].

AIM: To study the benzophenones in the roots of Securidaca inappendiculata Hassk. METHODS: Column chromatography (including silica gel and Sephadex LH-20) was used to isolate benzophenones whose structures were elucidated by HREI-MS, NMR (1D and 2D) methods. RESULTS: A new benzophenone was isolated and identified as 2-methoxy-3,4-methylenedioxy-benzophenone (I), along with a known compound 4-hydroxy-2,6-dimethoxy-benzophenone (II). CONCLUSION: Compound I is a new one named as securiphenone B, compound II was isolated from the genus for the first time.

Identification and characterization of two new xanthones from Cudrania fruticosa.

The present study was designed to investigate the chemical constituents of the roots of Cudrania fruticosa Wight. Compounds were isolated by various column chromatographic methods including silica gel, polyamide, sephadex LH-20, and semi-preparative HPLC. Their structures were elucidated by a combination of 1D and 2D NMR techniques, mass spectrometry, and chemical methods. Two new xanthones, Cudraxanthone T and U (1-2), along with four known compounds (3-6) were isolated from the roots of Cudrania fruticosa Wight.

Effect of high ovarian response on the expression of endocrine gland-derived vascular endothelial growth factor (EG-VEGF) in peri-implantation endometrium in IVF women.

OBJECTIVE: To investigate the effect of ovarian stimulation on the expression of EG-VEGF mRNA and protein in peri-implantation endometrium in women undergoing IVF and its relation with endometrial receptivity (ER). DESIGN: Prospective laboratory study. SETTING: University hospital. PATIENTS: Eighteen women in stimulated cycles (SC) as study subjects and 18 women in natural cycles (NC) as controls. Women in SC group were classified with two subgroups, high ovarian response (SC1, n=9) with peak serum E2>5,000 pg/mL and moderate ovarian response (SC2, n=9) with peak serum E2 1,000-5,000 pg/mL. INTERVENTION(S): Endometrial biopsies were collected 6 days after ovulation in NC or after oocyte retrieval in SC. MAIN OUTCOME MEASURE(S): Endometrium histological dating was observed with HE staining. EG-VEGF mRNA expression levels determined by real-time polymerase chain reaction analysis, and protein levels by immunohistochemistry. RESULTS: All endometrial samples were in the secretory phase. The endometrial development in SC1 was 1 to 2 days advanced to NC, and with dyssynchrony between glandular and stromal tissue. Immunohistochemistry analysis showed that EG-VEGF protein was predominantly expressed in the glandular epithelial cells and endothelial cells of vessels, and also presented in the stroma. The image analysis confirmed that both the gland and stroma of endometrium in SC1 had a significantly lower EG-VEGF protein expression than that in SC2 and NC endometrium. Moreover, EG-VEGF mRNA levels were significantly lower in SC1 than in NC. Both EG-VEGF protein and mRNA levels had no significant difference between SC2 and NC. CONCLUSION: Decreased expression of EG-VEGF in the peri-implantation is associated with high ovarian response, which may account for the impaired ER and lower implantation rate in IVF cycles.

[Studies on the chemical constituents of Securidaca inappendiculata].

AIM: To investigate the chemical constituents of Securidaca inappendiculata. METHODS: Compounds were isolated by silica gel column chromatography and Medium Pressure Liquid Chromatography, respectively. Structures of the compounds were elucidated by chemical evidence and spectral (UV, IR, MS, 1HNMR and 13CNMR) analysis. RESULTS: Eight compounds (1-8) were isolated and identified. Seven of them (2-7) are known compounds: oleanolic acid, p-hydroxytruxinic acid, p-coumaric acid, ethyl p-methoxycinnamate, uridine, beta-sitosterol and daucosterol. One (1) is a new hemiterpenoic acid glycoside, named securiterpenoside. CONCLUSION: A new hemiterpenoic acid glycoside, named securiterpenoside, was isolated from Securidaca inappendiculata Hassk. Seven known compounds were isolated from genus Securidaca for the first time.

[Pharmacokinetics of patchouli alcohol and patchouli alcohol in patchouli oil after iv administrated to rats].

AIM: To develop a capillary gas chromatographic method for the determination and pharmacokinetic study of patchouli alcohol in rat plasma after iv administration. METHODS: The drug was extracted with ethyl acetate. Eugenol was used as internal standard. The separation was carried out on a HP-5MS quartz capillary column, with high-purity nitrogen as carrier gas and flame ionization detector (FID) as detector. The column temperature was maintained at 80 degrees C for 1 min and then programmed to 200 degrees C at a rate of 15 degrees C x min(-1); it was held at 200 degrees C for 1 min, and then programmed to 290 degrees C at a rate of 60 degrees C x min(-1); the final temperature was held for 1 min. The temperature of both injector and detector was set at 290 degrees C. RESULTS: The standard curve was linear from 25 to 5 000 microg x L(-1) in rat plasma. The recovery of this method was from 90.0% to 110.0% with satisfactory relative standard deviation (RSD) less than 10.0%. The pharmacokinetic parameters demonstrated patchouli alcohol were consistent with the two-compartment open model and showed linear pharmacokinetics. The T1/2beta, AUC and MRT of patchouli alcohol in patchouli oil were all higher than that of patchouli alcohol. CONCLUSION: This method is quick, precise and reliable. The pharmacokinetics of patchouli alcohol is different from that of patchouli alcohol in patchouli oil.