Conservative management of double teeth in molar teeth with pulp or periapical disease: a report of five cases and literature review.

BACKGROUND: Double teeth are usually the result of an abnormality in the developing tooth germ. Double teeth can occur in either the primary or permanent dentition, with the majority of cases concerning permanent teeth reported in the anterior teeth and less frequently in the molar teeth. CASE PRESENTATION: This report illustrates five cases of double teeth in molars with pulp and periapical disease, including one case of geminated teeth and four cases of fused teeth. Radiographic findings revealed the presence of extra teeth on the buccal aspect of the molar in five cases, with or without communication between the two root canal systems. Root canal treatment was performed by using CBCT and a dental operating microscope. The treatment outcome was good in all five cases. CONCLUSION: The diagnosis and treatment of double teeth requires special attention. The root canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Proper anatomical structure analysis prior to treatment facilitates the development of an appropriate treatment plan, thereby increasing the likelihood of successful treatment both aesthetically and functionally.

Discovery of novel spiro compound as RAF kinase inhibitor with in vitro potency against KRAS mutant cancer.

The development of RAF inhibitors targeting cancers with wild type RAF kinase and/or RAS mutation has been challenging due to the paradoxical activation of the RAS-RAF-MEK-ERK cascade following RAF inhibitor treatment. Herein is the discovery and optimization of a series of RAF inhibitors with a novel spiro structure. The most potent spiro molecule 9 showed excellent in vitro potency against b/c RAF enzymes and RAS mutant H358 cancer cells with minimal paradoxical RAF signaling activation. Compound 9 also exhibited good drug-like properties as demonstrated by in vitro cytochrome P450 (CYP), liver microsome stability (LMS) data and moderate oral pharmacokinetics (PK) profiles in rat and mouse.

iTRAQ-based quantitative analysis reveals the mechanism underlying the changes in physiological activity in a glutamate racemase mutant strain of Streptococcus mutans UA159.

Streptococcus mutans UA159 is responsible for human dental caries with robust cariogenic potential. Our previous study noted that a glutamate racemase (MurI) mutant strain (designated S. mutans FW1718), with the hereditary background of UA159, displayed alterations of morphogenesis, attenuated stress tolerance, and weakened biofilm-forming capabilities, accompanying with unclear mechanisms. In this study, we applied isobaric tags for relative and absolute quantitation (iTRAQ)-based proteomics to characterize the proteome profiles of the murI mutant strain vs. the wild-type strain in chemically defined media to elucidate the mechanisms by which S. mutans copes with MurI deficiency. Whole-cell proteins of S. mutans FW1718 and UA159 were assessed by iTRAQ-coupled LC-ESI-MS/MS. Furthermore, differentially expressed proteins (DEPs) were identified by Mascot, Gene Ontology (GO) annotation, Cluster of Orthologous Groups of proteins (COG), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Finally, a protein-protein interaction (PPI) network was established using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING). Among 1173 total bacterial proteins identified, 112 DEPs exhibited altered expression patterns in S. mutans UA159 with or without the murI mutation. The ΔmurI cells displayed an increase in the relative expression of 93 proteins (fold change ≥ 1.2, p < 0.05) and a decrease in 29 proteins (fold change ≤ 0.833, p < 0.05) compared with the wild-type cells. PPI analysis revealed a complex network of DEPs containing 191 edges and 122 nodes. The DEPs significantly upregulated after murI knockout had roles in diverse functional processes spanning cell-wall biosynthesis, energy production, and DNA replication and repair. We identified distinct variations and diverse modulators caused by murI mutation in the proteome of S. mutans, indicating that the modification of cell membrane structure, redistribution of energy metabolism and enhanced nucleic acid machinery contributed to the S. mutans response to specific environmental contexts.

Increased substantia nigra echogenicity correlated with visual hallucinations in Parkinson's disease: a Chinese population-based study.

As a noninvasive technique, transcranial sonography (TCS) of substantia nigra (SN) has gradually showed its effectiveness not only in diagnosis but also in understanding clinical features of Parkinson's Disease (PD). This study aimed to further evaluate TCS for clinical diagnosis of PD, and to explore the association between sonographic manifestations and visual hallucinations (VH). A total of 226 subjects including 141 PD patients and 85 controls were recruited. All participants received TCS. A series of rating scales to evaluate motor and non-motor symptoms were performed in PD patients. Results showed that 172 subjects were successfully assessed by TCS. The area of SN was greater in PD patients than that in controls (P < 0.001). As receiver-operating characteristic (ROC) curve analysis showed, the best cutoff value for the larger SN echogenicity size was 23.5 mm2 (sensitivity 70.3%, specificity 77.0%). Patients with VH had larger SN area (P = 0.019), as well as higher Non-Motor Symptoms Scale (NMSS) scores (P = 0.018). Moreover, binary logistic regression analysis indicated that SN hyperechogenicity (odds ratio = 4.227, P = 0.012) and NMSS scores (odds ratio = 0.027, P = 0.042) could be the independent predictors for VH. In conclusion, TCS can be used as an auxiliary diagnostic tool for Parkinson's disease. Increased SN echogenicity is correlated with VH in Parkinson's disease, possibly because the brain stem is involved in the mechanism in the onset of VH. Further studies are needed to confirm these findings.

Release and Degradation Mechanism of Modified Polyvinyl Alcohol-Based Double-Layer Coated Controlled-Release Phosphate Fertilizer.

This study aims to improve the slow-release performance of a film material for a controlled-release fertilizer (CRF) while enhancing its biodegradability. A water-based biodegradable polymer material doped with biochar (BC) was prepared from modified polyvinyl alcohol (PVA) with polyvinylpyrrolidone (PVP) and chitosan (CTS), hereinafter referred to as PVA/PVP-CTSaBCb. An environmentally friendly novel controlled-release phosphate fertilizer (CRPF) was developed using PVA/PVP-CTS8%BC7% as the film. The effect of the PVA/PVP-CTS8%BC7% coating on the service life of the CRPF was investigated. The film was characterized via stress-strain testing, SEM, FTIR, XRD, and TGA analyses. The addition of the CTS modifier increased the stress of PVA/PVP-CTS8% by 7.6% compared with that of PVA/PVP owing to the decrease in the crystallinity of PVP/PVP-CTS8%. The hydrophilic -OH groups were reduced due to the mixing of CTS and PVA/PVP. Meanwhile, the water resistance of the PVA/PVP-CTS8%BC7% was improved. And the controlled-release service life of the CRPF was prolonged. Moreover, the addition of BC increased the crystallinity of the PVA/PVP-CTS8% by 10%, reduced the fracture elongation of the material, and further improved the biodegradability of the PVA/PVP-CTS8%BC7%. When the amount of BC added was 7%, the phosphorus release rate of the CRPF was 30% on the 28th day. Moreover, the degradation rate of the PVA/PVP-CTS8%BC7% polymer film was 35% after 120 days. This study provides basic data for applying water-based degradable polymer materials in CRFs.

Reference values of carotid intima-media thickness and arterial stiffness in Chinese adults based on ultrasound radio frequency signal: A nationwide, multicenter study.

BACKGROUND: Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants. METHODS: A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, ß stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson's correlation, multiple linear regression, and analyses of covariance. RESULTS: All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The ß stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 µm/year in women and 5.8 µm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. CONCLUSIONS: The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.

ACH-806, an NS4A antagonist, inhibits hepatitis C virus replication by altering the composition of viral replication complexes.

Treatment of hepatitis C patients with direct-acting antiviral drugs involves the combination of multiple small-molecule inhibitors of distinctive mechanisms of action. ACH-806 (or GS-9132) is a novel, small-molecule inhibitor specific for hepatitis C virus (HCV). It inhibits viral RNA replication in HCV replicon cells and was active in genotype 1 HCV-infected patients in a proof-of-concept clinical trial (1). Here, we describe a potential mechanism of action (MoA) wherein ACH-806 alters viral replication complex (RC) composition and function. We found that ACH-806 did not affect HCV polyprotein translation and processing, the early events of the formation of HCV RC. Instead, ACH-806 triggered the formation of a homodimeric form of NS4A with a size of 14 kDa (p14) both in replicon cells and in Huh-7 cells where NS4A was expressed alone. p14 production was negatively regulated by NS3, and its appearance in turn was associated with reductions in NS3 and, especially, NS4A content in RCs due to their accelerated degradation. A previously described resistance substitution near the N terminus of NS3, where NS3 interacts with NS4A, attenuated the reduction of NS3 and NS4A conferred by ACH-806 treatment. Taken together, we show that the compositional changes in viral RCs are associated with the antiviral activity of ACH-806. Small molecules, including ACH-806, with this novel MoA hold promise for further development and provide unique tools for clarifying the functions of NS4A in HCV replication.

Clinical characteristics and acute complication of COVID-19 patients with diabetes: a multicenter, retrospective study in Southern China.

Aims: This study aims to describe the clinical characteristics, laboratory data and complications of hospitalized COVID-19 patients with type 2 diabetes mellitus (T2DM) since epidemic prevention and control optimization was adjusted in December 2022 in China. Methods: This retrospective multicenter study included 298 patients with confirmed type 2 diabetes mellitus with or without COVID-19. We collected data from the first wave of the pandemic in The Fifth Affiliated Hospital of Guangzhou Medical University, Loudi Central Hospital and The First People's Hospital of Xiangtan from December 1, 2022 to February 1, 2023. We extracted baseline data, clinical symptoms, acute complications, laboratory findings, treatment and outcome data of each patient from electronic medical records. Results: For among 298 hospitalized patients with type 2 diabetes, 136 (45.6%) were COVID-19 uninfected, and 162 (54.4%) were COVID-19 infected. We found that the incidence of cough, fatigue, fever, muscle soreness, sore throat, shortness of breath, hyposmia, hypogeusia and polyphagia (all p<0.01) were significantly higher in the exposure group. They showed higher levels of ketone (p=0.04), creatinine (p<0.01), blood potassium (p=0.01) and more diabetic ketoacidosis (p<0.01). Patients with COVID-19 less use of metformin (p<0.01), thiazolidinediones (p<0.01) and SGLT2 (p<0.01) compared with patients without COVID-19. Conclusion: COVID-19 patients with diabetes showed more severe respiratory and constitutional symptoms and an increased proportion of hyposmia and hypogeusia. Moreover, COVID-19 patients with diabetes have a higher incidence of acute complications, are more prone to worsening renal function, and are more cautious about the use of antidiabetic drugs.

Successful individualized endodontic treatment of severely curved root canals in a mandibular second molar: A case report.

BACKGROUND: The incidence rate of severely curved root canals in mandibular molars is low, and the root canal treatment of mandibular molars with this aberrant canal anatomy may be technically challenging. CASE SUMMARY: A 26-year-old Chinese female patient presented with intermittent and occlusal pain in the left mandibular second molar. The patient had undergone filling restoration for caries before endodontic consultation. With the aid of cone beam computed tomography (CBCT), a large periapical radiolucency was observed, and curved root canals in a mandibular second molar were confirmed, depicting a severe and curved distolingual root. Nonsurgical treatments, including novel individualized preparation skills and techniques and the use of bioceramic materials as an apical barrier, were performed, and complete healing of the periapical lesion and a satisfactory effect were achieved. CONCLUSION: A case of severely curved root canals in a mandibular second molar was successfully treated and are reported herein. The complex anatomy of the tooth and the postoperative effect were also evaluated via the three-dimensional reconstruction of CBCT images, which accurately identified the aberrant canal morphology. New devices and biomaterial applications combined with novel synthesis techniques can increase the success rate of intractable endodontic treatment.

Discovery of spiro amide SHR902275: A potent, selective, and efficacious RAF inhibitor targeting RAS mutant cancers.

The RAS-RAF-MEK-ERK signaling pathway plays a key role to regulate multiple cellular functions. Acquired resistance to the first-generation RAF inhibitors that only targeted the bRAFV600E mutation prompted the need for a new generation of RAF inhibitors to target cancers bearing mutant RAS and wild type RAF activity by inhibition of paradoxical activation. Starting from the company's previously reported RAF inhibitor 1, extensive drug potency and drug-like properties optimizations led to the discovery of molecule 33 (SHR902275) with greatly improved in vitro potency and solubility. Molecule 33 exhibited good DMPK (Drug Metabolism and Pharmacokinetics) properties, excellent permeability, and outstanding mouse/rat oral PK. It was further evaluated in an in vivo RAS mutant Calu6 xenograft mouse model and demonstrated dose dependent efficacy. To achieve high exposure in a toxicity study, pro-drug 48 was also explored.

Novel Small Molecule Tyrosine Kinase 2 Pseudokinase Ligands Block Cytokine-Induced TYK2-Mediated Signaling Pathways.

A member of the Janus kinase (JAK) family, Tyrosine Kinase 2 (TYK2), is crucial in mediating various cytokine-signaling pathways such as interleukin-23 (IL23), interleukin-12 (IL12) and type I Interferons (IFN) which contribute to autoimmune disorders (e.g., psoriasis, lupus, and inflammatory bowel disease). Thus, TYK2 represents an attractive target to develop small-molecule therapeutics for the treatment of cytokine-driven inflammatory diseases. Selective inhibition of TYK2 over other JAK isoforms is critical to achieve a favorable therapeutic index in the development of TYK2 inhibitors. However, designing small molecule inhibitors to target the adenosine triphosphate (ATP) binding site of TYK2 kinase has been challenging due to the substantial structural homology of the JAK family catalytic domains. Here, we employed an approach to target the JAK homology 2 (JH2) pseudokinase regulatory domain of the TYK2 protein. We developed a series of small-molecule TYK2 pseudokinase ligands, which suppress the TYK2 catalytic activity through allosteric regulation. The TYK2 pseudokinase-binding small molecules in this study simultaneously achieve high affinity-binding for the TYK2 JH2 domain while also affording significantly reduced affinity for the TYK2 JAK homology 1 (JH1) kinase domain. These TYK2 JH2 selective molecules, although possessing little effect on suppressing the catalytic activity of the isolated TYK2 JH1 catalytic domain in the kinase assays, can still significantly block the TYK2-mediated receptor-stimulated pathways by binding to the TYK2 JH2 domain and allosterically regulating the TYK2 JH1 kinase. These compounds are potent towards human T-cell lines and primary immune cells as well as in human whole-blood specimens. Moreover, TYK2 JH2-binding ligands exhibit remarkable selectivity of TYK2 over JAK isoforms not only biochemically but also in a panel of receptor-stimulated JAK1/JAK2/JAK3-driven cellular functional assays. In addition, the TYK2 JH2-targeting ligands also demonstrate high selectivity in a multi-kinase screening panel. The data in the current study underscores that the TYK2 JH2 pseudokinase is a promising therapeutic target for achieving a high degree of biological selectivity. Meanwhile, targeting the JH2 domain represents an appealing strategy for the development of clinically well-tolerated TYK2 inhibitors that would have superior efficacy and a favorable safety profile compared to the existing Janus kinase inhibitors against autoimmune diseases.

Heterologous expression, purification and biochemical characterization of a glutamate racemase (MurI) from Streptococcus mutans UA159.

BACKGROUND: Glutamate racemase (MurI) is a cofactor-independent enzyme that is essential to the bacterial peptidoglycan biosynthesis pathway and has therefore been considered an attractive target for the development of antimicrobial drugs. While in our previous study the essentiality of the murI gene was shown in Streptococcus mutans, the primary aetiologic agent of human dental caries, studies on S. mutans MurI have not yet provided definitive results. This study aimed to produce and characterize the biochemical properties of the MurI from the S. mutans UA159 genome. METHODS: Structure characterization prediction and multiple sequence alignment were performed by bioinformatic analysis. Recombinant His6-tagged S. mutans MurI was overexpressed in the expression vector pColdII and further purified using a Ni2+ affinity chromatography method. Protein solubility, purity and aggregation state were analyzed by SDS-PAGE, Western blotting, native PAGE and SEC-HPLC. Kinetic parameters were assessed by a circular dichroism (CD) assay. Kinetic constants were calculated based on the curve fit for the Michaelis-Menten equation. The effects of temperature and pH on enzymatic activity were determined by a series of coupled enzyme reaction mixtures. RESULTS: The glutamate racemase gene from S. mutans UA159 was amplified by PCR, cloned and expressed in Escherichia coli BL21 (DE3). The 264-amino-acid protein, as a mixture of dimeric and monomeric enzymes, was purified to electrophoretic homogeneity. In the CD assay, S. mutans MurI displayed unique kinetic parameters (K m, d-Glu→l-Glu = 0.3631 ± 0.3205 mM, V max, d-Glu→l-Glu = 0.1963 ± 0.0361 mM min-1, k cat, d-Glu→l-Glu = 0.0306 ± 0.0065 s-1, k cat/K m, d-Glu→l-Glu = 0.0844 ± 0.0128 s-1 mM-1, with d-glutamate as substrate; K m, l-Glu→d-Glu = 0.8077 ± 0.5081 mM, V max, l-Glu→d-Glu = 0.2421 ± 0.0418 mM min-1, k cat , l - Glu→d-Glu = 0.0378 ± 0.0056 s-1, k cat/K m, l-Glu→d-Glu = 0.0468 ± 0.0176 s-1 mM-1, with l-glutamate as substrate). S. mutans MurI possessed an assay temperature optimum of 37.5 °C and its optimum pH was 8.0. CONCLUSION: The findings of this study provide insight into the structure and biochemical traits of the glutamate racemase in S. mutans and supply a conceivable guideline for employing glutamate racemase in anti-caries drug design.

[Effect of root canal wall moisture and filling techniques on the sealability of iRoot sp].

PURPOSE: To study the effect of root canal wall moisture and filling techniques on the sealability of iRoot sp. METHODS: Sixty-two undamaged extracted human single-rooted teeth with fully developed apex were selected and prepared by crown-down technique. Two teeth were selected randomly to observe dentin tubules, opening, the residual teeth were randomly assigned to 3 groups: group A (wet), group B (slightly moist),group C(dry).The roots were further divided into 4 subgroups, group a: iRoot sp sealer without a core material (bulk-fill); group b: iRoot sp sealer with single cone obturation techniques; group c: iRoot sp sealer with heated gutta-purcha vertical pressure; group d: iRoot sp sealer with cold gutta-percha lateral compression technique. Glucose microleakage were measured in each group by glucose oxidase method. The differences in distribution of each group were analyzed with SPSS 19.0 software package. RESULTS: Group A and group B always showed the maximum and minimum amount of glucose penetration in the whole experimental process, and the difference was statistically significant at 28d (P<0.05). Under the same degree of moisture of root canal wall, glucose leakage of subgroup Aa was significantly higher than that of subgroup Ab and Ac at 15 d; and significantly higher than Ab, Ac, Ad at 21 d and 28 d(P<0.05). In group B and C, the subgroups a, b, c, d had no significant difference from each other during the experimental process(P>0.05). CONCLUSIONS: iRoot sp sealer has the best sealing effect when root canals were slightly moist. When the root canal wall is completely dry or slightly moist, the sealability of iRoot sp bulk-fill is similar to that of iRoot sp sealer with gutta-percha filling technique.

[Experimental study of a new animal model with trigeminal neuralgia produced by administration of talc to peripheral infraobital nerve in rats].

PURPOSE: To establish a new animal model of trigeminal neuralgia（TN） produced by administration of talc to peripheral infraobital nerve in rats. METHODS: Thirty male Wistar rats were randomly divided into 2 groups. Talcum powder (30％,0.3 mL) was injected into the peripheral infraorbital foramen in one group, the same dose of normal saline was injected by the same method in another group. On 3 day before surgery and 3 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 6 weeks, 8 and 12 weeks postoperatively, mechanical pain behavior was determined. Statistical analysis of the threshold of pain response was performed and the behavior of pain was observed in the area of infraorbital nerve innervation in rats. Histopathological changes of the peripheral infraorbital nerve tissue in the rats were observed 3 days, 4 weeks, 8 weeks and 12 weeks postoperatively. The expression of inflammatory factors such as tumor necrosis factor-α (TNF-α) and interleukin -1ß (IL-1ß) in the territory of the infraorbital nerve was detected by immunohistochemistry. SPSS16.0 software package was used to analyze the data. RESULTS: The mechanical pain threshold of rats in the infraorbital innervation area 3 days postoperatively in the experimental group was significantly decreased compared with that in the preoperative group and the control group (P<0.01). The rats in the experimental group 3 days postoperatively experienced symptoms of irritability, scratching the face or aggressive behavior. Twelve weeks after operation, the mechanical pain threshold was still significantly decreased. Histopathological examination in the experimental group 3 days postoperatively mainly showed inflammation with a few inflammatory factors（IL-1ß and TNF-α）expression. Inflammation in the experimental group 1week postoperatively was more intense and more inflammatory factors were expressed. Four weeks postoperatively, there was more proliferation of granulation tissue in the area of peripheral infraorbital nerve tissue and expression of inflammatory factors was highest. Four to twelve weeks, the inflammatory response in the experimental group was gradually reduced, increased scar and infraorbital nerve compressing by scar were observed, and the expression of inflammatory factors decreased gradually. CONCLUSIONS: Injection of talc to the peripheral infraorbital foramen can establish a reliable and stable animal model for research of etiology and treatment of TN.

Design and synthesis of conformationally constrained Grb2 SH2 domain binding peptides employing alpha-methylphenylalanyl based phosphotyrosyl mimetics.

Previous work has shown that incorporation of either 1-aminocyclohexanecarboxylic acid (Ac6c) or alpha-methyl-p-phosphonophenylalanine ((alpha-Me)Ppp) in the phosphotyrosyl (pTyr) C-proximal position (pY + 1 residue) of Grb2 SH2 domain binding peptides confers high affinity. The tetralin-based (S)-2-amino-6-phosphonotetralin-2-carboxylic acid (Atc(6-PO3H2)) simultaneously presents structural features of both (alpha-Me)Ppp and Ac6c residues. The current study compares the affinity of this tetralin hybrid Atc(6-PO3H2) versus Ac6c and (alpha-Me)Ppp residues when incorporated into the pY + 1 position of a high-affinity Grb2 SH2 domain binding tripeptide platform. The highest binding affinity (KD = 14.8 nM) was exhibited by the (alpha-Me)Ppp-containing parent, with the corresponding Ac6c-containing peptide being nearly 2-fold less potent (KD = 23.8 nM). The lower KD value was attributable primarily to a 50% increase in off-rate. Replacement of the Ac6c residue with the tetralin-based hybrid resulted in a further 4-fold decrease in binding affinity (KD = 97.8 nM), which was the result of a further 6-fold increase in off-rate, offset by an approximate 45% increase in on-rate. Therefore, by incorporation of the key structural components found in (alpha-Me)Ppp into the Ac6c residue, the tetralin hybrid does enhance binding on-rate. However, net binding affinity is decreased due to an associated increase in binding off-rate. Alternatively, global conformational constraint of an (alpha-Me)Ppp-containing peptide by beta-macrocyclization did result in pronounced elevation of binding affinity, which was achieved primarily through a decrease in the binding off-rate. Mathematical fitting using a simple model that assumed a single binding site yielded an effective KD of 2.28 nM. However this did not closely approximate the data obtained. Rather, use of a complex model that assumed two binding sites resulted in a very close fit of data and provided KD values of 97 pM and 72 nM for the separate sites, respectively. Therefore, although local conformational constraint in the pY + 1 residue proved to be deleterious, global conformational constraint through beta-macrocyclization achieved higher affinity. Similar beta-macrocyclization may potentially be extended to SH2 domain systems other than Grb2, where bend geometries are required.

Assessment of postoperative perfusion with contrast-enhanced ultrasonography in kidney transplantation.

The aim of this study was to use contrast-enhanced ultrasound (CEUS) to evaluate renal perfusion after kidney transplantation and investigate the clinical significance of CEUS in monitoring postoperative renal perfusion. Thirty-five patients who underwent kidney transplantations were included in this study and divided into two groups-normal and abnormal-based on their serum creatinine (SCr) levels. Conventional ultrasound and CEUS were used to monitor renal perfusion after kidney transplantation. The differences in the results between the two groups were then compared. Color doppler ultrasonography showed that there were significant differences in the resistance index (RI) and the pulsatility index (PI) of the interlobar artery between the groups. Furthermore, CEUS indicated a significant difference between the two groups regarding the slope rate of the cortical ascending curve (A1), the medullary ascending curve (A2), and the derived peak intensity (DPI1). CEUS precisely showed the characteristics of microcirculation in renal parenchyma after kidney transplantation. It also detected changes in the microcirculation, which was a new method of evaluating tissue perfusion in transplanted kidneys.

Application of laparospic ultrasonography in surgery of small renal cell carcinoma.

PURPOSE: : To assess the clinic value of application of laparospic ultrasonography (LU) in partial nephrectomy of small renal cell carcinoma. MATERIALS AND METHODS: From 2007 to 2011, 28 small renal cell carcinoma patients in ou clinic underwent laparoscopic partial nephrectomy with LU. For comparison with preoperative conventional ultrasound and CT, we collected ultrasonic performance of the affected side kidney, renal tumor location, size, echo change, blood supply situation and the relationship with the surrounding tissue. RESULTS: LU could more clearly show the tumor interior structure and blood supply, as well as the relationship with the surrounding tissue. It also can provided doctor assistance with real-time tumor resection, reducing operative complications. CONCLUSIONS: LU can clearly show tumor internal structure and blood supply, which is helpful for explicit diagnosis. Moreover, it supplies accurate information for surgeons and assists surgery. Therefore LU has an important guiding value in partial nephrectomy for small renal cell carcinoma.

Comparison of ultrasound echo-tracking technology and pulse wave velocity for measuring carotid elasticity among hemodialysis patients.

This study aims to investigate the correlation between carotid elasticity in hemodialysis patients as evaluated by ultrasound echo-tracking technology and aortic pulse wave velocity. A total of 103 patients with end-stage renal disease who underwent stable hemodialysis were enrolled. An ultrasonic echo-tracking method was used to evaluate the elastic modulus and the stiffness index (ß), which were compared with pulse wave velocity (PWV). Blood glucose, blood lipids, and serum creatinine were also tested. These indices were analyzed to determine the independent factor for arterial elasticity. The carotid elastic modulus and ß were in good correlation with PWV among hemodialysis patients (P = 0.000). Diabetes and age are independent risk factors for arterial elasticity among hemodialysis patients. Ultrasound echo-tracking technology is a sensitive and accurate method for evaluating arterial elasticity and is a good alternative to traditional PWV.

Enantioselective synthesis of N(alpha)-Fmoc protected (2S,3R)-3-phenylpipecolic acid. A constrained phenylalanine analogue suitably protected for solid-phase peptide synthesis.

Reported herein is the first enantioselective preparation of (2S,3R)-3-phenylpipecolic acid as a conformationally constrained phenylalanine analogue bearing N(alpha)-protection suitable for solid-phase peptide synthesis. Stereochemistries at both the 2- and 3-positions are derived inductively from a single chiral center provided by the commercially available Evans chiral auxiliary, (4S)-4-benzyl-1,3-oxazolidin-2-one. By constraining phi and chi(1) torsion angles, this novel amino acid analogue can serve as a useful tool for the induction of defined geometry in phenylalanine-containing peptides.