ABSTRACT
BACKGROUND: Mast cell-derived mediators induce vasodilatation and fluid extravasation, leading to cardiovascular failure in severe anaphylaxis. We previously revealed a synergistic interaction between the cytokine IL-4 and the mast cell-derived mediator histamine in modulating vascular endothelial (VE) dysfunction and severe anaphylaxis. The mechanism by which IL-4 exacerbates histamine-induced VE dysfunction and severe anaphylaxis is unknown. OBJECTIVE: We sought to identify the IL-4-induced molecular processes regulating the amplification of histamine-induced VE barrier dysfunction and the severity of IgE-mediated anaphylactic reactions. METHODS: RNA sequencing, Western blot, Ca2+ imaging, and barrier functional analyses were performed on the VE cell line (EA.hy926). Pharmacologic degraders (selective proteolysis-targeting chimera) and genetic (lentiviral short hairpin RNA) inhibitors were used to determine the roles of signal transducer and activator of transcription 3 (STAT3) and STAT6 in conjunction with in vivo model systems of histamine-induced hypovolemic shock. RESULTS: IL-4 enhancement of histamine-induced VE barrier dysfunction was associated with increased VE-cadherin degradation, intracellular calcium flux, and phosphorylated Src levels and required transcription and de novo protein synthesis. RNA sequencing analyses of IL-4-stimulated VE cells identified dysregulation of genes involved in cell proliferation, cell development, and cell growth, and transcription factor motif analyses revealed a significant enrichment of differential expressed genes with putative STAT3 and STAT6 motif. IL-4 stimulation in EA.hy926 cells induced both serine residue 727 and tyrosine residue 705 phosphorylation of STAT3. Genetic and pharmacologic ablation of VE STAT3 activity revealed a role for STAT3 in basal VE barrier function; however, IL-4 enhancement and histamine-induced VE barrier dysfunction was predominantly STAT3 independent. In contrast, IL-4 enhancement and histamine-induced VE barrier dysfunction was STAT6 dependent. Consistent with this finding, pharmacologic knockdown of STAT6 abrogated IL-4-mediated amplification of histamine-induced hypovolemia. CONCLUSIONS: These studies unveil a novel role of the IL-4/STAT6 signaling axis in the priming of VE cells predisposing to exacerbation of histamine-induced anaphylaxis.
ABSTRACT
BACKGROUND AND AIM: This study aims to determine whether endoscopic papillectomy (EP) is a safe and effective treatment for early duodenal papillary carcinoma with long-term follow-up. METHODS: From June 2012 to September 2022, 48 patients with early duodenal papilloma carcinoma who received endoscopic treatment were included. The histological types, percentage of complete resections, postoperative residuals, adverse events, and recurrences were evaluated. RESULTS: EP was successful in all patients; 46 were lumped, and two were fragmented, with a 95.8% intact removal rate (46/48). The preoperative biopsy pathological positive rate was 70.8% (34/48). The incidence of early postoperative adverse events (within 1 month after EP) were 16.7% (8/48), including four cases of acute pancreatitis, three cases of delayed bleeding, and one case of acute cholangitis. In addition, 4.2% (2/48) of the late adverse events were bile duct stenosis. After 6 months, the postoperative residual rate was 0%. The median time to recurrence was 17.5 months, and the postoperative recurrence rate was 16.7% (8/48) in patients treated with radiofrequency ablation. The median progression-free survival was 18.6 months (95% CI, 12.1-25.1), and the median overall survival was 121.5 months (95% CI, 105.6-120.9). CONCLUSIONS: EP is a safe and efficient alternative therapy for early duodenal papillary carcinoma. Endoscopic follow-up and treatment are essential because of the potential for recurrence.
Subject(s)
Duodenal Neoplasms , Humans , Male , Female , Duodenal Neoplasms/surgery , Duodenal Neoplasms/pathology , Duodenal Neoplasms/mortality , Middle Aged , Aged , Treatment Outcome , Time Factors , Carcinoma, Papillary/surgery , Carcinoma, Papillary/pathology , Carcinoma, Papillary/mortality , Follow-Up Studies , Adult , Neoplasm Recurrence, Local , Postoperative Complications/etiology , Postoperative Complications/epidemiology , Aged, 80 and overABSTRACT
BACKGROUND: Basal zone hyperplasia (BZH) and dilated intercellular spaces (DISs) are thought to contribute to the clinical manifestations of eosinophilic esophagitis (EoE); however, the molecular pathways that drive BZH remain largely unexplored. OBJECTIVE: We sought to define the role of IL-13-induced transcriptional programs in esophageal epithelial proliferation in EoE. METHODS: We performed RNA sequencing, bioinformatics, Western blot, reverse transcriptase quantitative PCR, and histologic analyses on esophageal biopsies from healthy control and patients with EoE, primary esophageal cells derived from patients with EoE, and IL-13-stimulated esophageal epithelial keratinocytes grown at the air-liquid interface (EPC2-ALI). Genetic (shRNA) and pharmacologic (proteolysis-targeting chimera degrader) approaches and in vivo model of IL-13-induced esophageal epithelial remodeling (Krt5-rtTA x tetO-IL-13Tg) were used to define the role of signal transducer and activator of transcription 3 (STAT3) and STAT6 and secreted frizzled-related protein 1 (SFRP1) in esophageal epithelial proliferation. RESULTS: RNA-sequencing analysis of esophageal biopsies (healthy control vs EoE) and EPC2-ALI revealed 82 common differentially expressed genes that were enriched for putative STAT3 target genes. In vitro and in vivo analyses revealed a link between IL-13-induced STAT3 and STAT6 phosphorylation, SFRP1 mRNA expression, and esophageal epithelial proliferation. In vitro studies showed that IL-13-induced esophageal epithelial proliferation was STAT3-dependent and regulated by the STAT3 target SFRP1. SFRP1 mRNA is increased in esophageal biopsies from patients with active EoE compared with healthy controls or patients in remission and identifies an esophageal suprabasal epithelial cell subpopulation that uniquely expressed the core EoE proinflammatory transcriptome genes (CCL26, ALOX15, CAPN14, ANO1, and TNFAIP6). CONCLUSIONS: These studies identify SFRP1 as a key regulator of IL-13-induced and STAT3-dependent esophageal proliferation and BZH in EoE and link SFRP1+ esophageal epithelial cells with the proinflammatory and epithelial remodeling response in EoE.
Subject(s)
Eosinophilic Esophagitis , Humans , Eosinophilic Esophagitis/pathology , Interleukin-13/metabolism , STAT3 Transcription Factor/genetics , STAT3 Transcription Factor/metabolism , Epithelial Cells/metabolism , RNA, Messenger/metabolism , Cell ProliferationABSTRACT
ABSTRACT: Golf is a popular sport; however, there is a paucity of data in relation to golf-associated fractures, and the rate and timing of returning to golf. The aim of this review is to describe golf-associated fractures, including epidemiology, management, and timing of returning to golf following treatment. A literature search was performed using MEDLINE/PubMed, Embase, and Web of Science. Data were extracted and summarized in a narrative synthesis. A total of 436 articles were identified with an initial search of which 58 met the inclusion criteria. Twelve anatomical sites of golf swing-related fractures were identified, of which 10 sites were specific for stress fractures. The most common sites of golf swing-related stress fractures were the ribs followed by the hook of hamate. There was a common theme of delay to diagnosis, being initially assigned to a soft tissue injury. Most golfers with swing-related stress fractures were able to return to golf with the exception of osteoporotic associated vertebral stress fractures. Timing of returning to golf was between 4 and 12 months for most of the golfers with stress fractures following conservative management. Operative intervention was an option of hook of hamate nonunion, following a stress fracture, and tibial shaft stress fractures. Golf equipment-related fractures were not rare and were associated with major trauma and in some cases associated with significant persistent morbidity. Golf-related stress fractures commonly involve the ribs and hook of hamate; knowledge of this may aid in early diagnosis and appropriate treatment when symptomatic golfers are encountered. Although golf is a noncontact sport, fractures associated with golf equipment can be life changing, and safety training guidelines should be established.
Subject(s)
Golf , Golf/injuries , Humans , Fractures, Bone/therapy , Fractures, Bone/epidemiology , Return to Sport , Fractures, Stress/therapy , Fractures, Stress/epidemiology , Athletic Injuries/epidemiology , Athletic Injuries/therapyABSTRACT
Tyro3, Axl, and Mertk (abbreviated TAMs) comprise a family of homologous type 1 receptor tyrosine kinases (RTKs) that have been implicated as inhibitory receptors that dampen inflammation, but their roles in the pathogenesis of rheumatoid arthritis remains understudied. Here, to investigate TAMs in an inflammatory arthritis model, antibody-induced arthritis in single TAM-deficient mice (Tyro3- KO, Axl-KO, Mertk-KO) was induced by K/BxN serum injection. Subsequently, joint inflammation and cytokine levels, as well as the expression of Fcγ Rs and complement receptors were assessed in WT and TAM-deficient mice. Compared with littermate control mice, Axl-/- and Mertk-/- mice developed more severe antibody-induced arthritis, while in contrast, Tyro3-/- mice showed diminished joint inflammation. Concomitantly, the levels of cytokines in joints of Axl-/- and Mertk-/- mice were also significantly increased, while cytokines in the Tyro3-/- joint tissues were decreased. At the molecular and cellular level, TAMs showed distinct expression patterns, whereby monocytes expressed Axl and Mertk, but no Tyro3, while neutrophils expressed Axl and Tyro3 but little Mertk. Moreover, expression of Fcγ receptors and C5aR showed different patterns with TAMs expression, whereby FcγRIV was higher in monocytes of Axl-/- and Mertk-/- mice compared to wild-type mice, while Tyro3-/- neutrophils showed lower expression levels of FcγRI, FcγRIII and FcγRIV. Finally, expression of C5aR was increased in Mertk-/- monocytes, and was decreased in Tyro3-/- neutrophils. These data indicate that Axl, Mertk and Tyro3 have distinct functions in antibody-induced arthritis, due in part to the differential regulation of cytokines production, as well as expression of FcγRs and C5aR. Video Abstract.
Subject(s)
Arthritis , Axl Receptor Tyrosine Kinase , Receptor Protein-Tyrosine Kinases , Receptors, IgG , c-Mer Tyrosine Kinase , Animals , Mice , Antibodies , Axl Receptor Tyrosine Kinase/metabolism , c-Mer Tyrosine Kinase/metabolism , Carrier Proteins , Cytokines/metabolism , Inflammation , Proto-Oncogene Proteins/metabolism , Receptor Protein-Tyrosine Kinases/metabolism , Receptors, IgG/metabolism , TyrosineABSTRACT
PURPOSE: We aimed to identify pathogenic variants in a female patient with primary infertility and recurrent failure of in vitro fertilization with zygotic cleavage failure. METHODS: The genomic DNA from the affected individual was subjected to whole-exome sequencing and the variant was confirmed by Sanger sequencing. The functional effect of the identified variant was further investigated in 293 T cells. RESULTS: We identified a novel homozygous deletion in BTG4 (c.580_616del) in the affected individual. The deletion results in frameshift and replacement of the last 29 residues (aa195-223) with 66 random amino acids. The mutated amino acid residues are highly conserved among mammalian species. Co-immunoprecipitation in 293 T cells showed that the mutation abolished the interaction between BTG4 and PABPN1L. CONCLUSION: This study conforms previous studies and expands the mutational spectrum of BTG4. Our findings prove the functional importance of the C-terminal of BTG4. BTG4 is a potential diagnostic and therapeutic target for patients suffering from zygotic cleavage failure.
Subject(s)
Infertility, Female , Animals , Female , Humans , Cell Cycle Proteins/genetics , Fertilization in Vitro/methods , Homozygote , Infertility, Female/genetics , Infertility, Female/pathology , Mammals , Mutation/genetics , Poly(A)-Binding Proteins/genetics , Sequence DeletionABSTRACT
Contextual information and the dependencies between dimensions is vital in image semantic segmentation. In this paper, we propose a multiple-attention mechanism network (MANet) for semantic segmentation in a very effective and efficient way. Concretely, the contributions are as follows: (1) a novel dual-attention mechanism for capturing feature dependencies in spatial and channel dimensions, where the adjacent position attention captures the dependencies between pixels well; (2) a new cross-dimensional interactive attention feature fusion module, which strengthens the fusion of fine location structure information in low-level features and category semantic information in high-level features. We conduct extensive experiments on semantic segmentation benchmarks including PASCAL VOC 2012 and Cityscapes datasets. Our MANet achieves the mIoU scores of 75.5% and 72.8% on PASCAL VOC 2012 and Cityscapes datasets, respectively. The effectiveness of the network is higher than the previous popular semantic segmentation networks under the same conditions.
Subject(s)
Neural Networks, Computer , Volatile Organic Compounds , Image Processing, Computer-Assisted/methods , SemanticsABSTRACT
Ammonia (NH3) is a common pollutant mostly derived from pig manure composting under humid conditions, and it is absolutely necessary to develop materials for ammonia removal with high stability and efficiency. To this end, metal-organic frameworks (MOFs) have received special attention because of their high selectivity of harmful gases in the air, resulting from their large surface area and high density of active sites, which can be tailored by appropriate modifications. Herein, two synthetic metal-organic frameworks (MOFs), 2-methylimidazole zinc salt (ZIF-8) and zinc-trimesic acid (ZnBTC), were selected for ammonia removal under humid conditions during composting. The two MOFs, with different organic linkers, exhibit fairly distinctive ammonia absorption behaviors under the same conditions. For the ZnBTC framework, the ammonia intake is 11.37 mmol/g at 298 K, nine times higher than that of the ZIF-8 framework (1.26 mmol/g). In combination with theoretical calculations, powder XRD patterns, FTIR, and BET surface area tests were conducted to reveal the absorption mechanisms of ammonia for the two materials. The adsorption of ammonia on the ZnBTC framework can be attributed to both physical and chemical adsorption. A strong coordination interaction exists between the nitrogen atom from the ammonia molecule and the zinc atom in the ZnBTC framework. In contrast, the absorption of ammonia in the ZIF-8 framework is mainly physical. The weak interaction between the ammonia molecule and the ZIF-8 framework mainly results from the inherent severely steric hindrance, which is related to the coordination mode of the imidazole ligands and the zinc atom of this framework. Therefore, this study provides a method for designing promising MOFs with appropriate organic linkers for the selective capture of ammonia during manure composting.
Subject(s)
Metal-Organic Frameworks , Adsorption , Ammonia/chemistry , Animals , Imidazoles , Manure , Swine , ZincABSTRACT
Ammonia (NH3) emissions during agricultural production can cause serious consequences on animal and human health, and it is quite vital to develop high-efficiency adsorbents for NH3 removal from emission sources or air. Porous metal-organic frameworks (MOFs), as the most promising candidates for the capture of NH3, offer a unique solid adsorbent design platform. In this work, a series of MOFs with different metal centers, ZnBTC, FeBTC and CuBTC, were proposed for NH3 adsorption. The metal centers of the three MOFs are coordinated in a different manner and can be attacked by NH3 with different strengths, resulting in different adsorption capacities of 11.33, 9.5, and 23.88 mmol/g, respectively. In addition, theoretical calculations, powder XRD patterns, FTIR, and BET for the three materials before and after absorption of ammonia were investigated to elucidate their distinctively different ammonia absorption mechanisms. Overall, the study will absolutely provide an important step in designing promising MOFs with appropriate central metals for the capture of NH3.
Subject(s)
Metal-Organic Frameworks , Animals , Humans , Adsorption , Ammonia , Metals , PorosityABSTRACT
Genomic DNA is compacted via chromatin condensation in mammalian cells, and transcription of such topologically constrained DNA to messenger RNA is under strict spatiotemporal regulation. Nevertheless, control of DNA topology has been poorly explored in in vitro transcription and gene transfection. Here we report the construction of topologically ordered (TO-) prokaryotic genes composed of linear DNA templates appended with a T7 promoter sequence with the use of DNA self-assembly. We find that TO-DNA maintains the transcription activity whereas the activity is critically dependent on the configuration of the T7 promoter in a folded DNA nanostructure. By prescribing the position and the intactness of the T7 promoter, we can dynamically activate or repress transcription in response to specific DNA key strands in a Boolean logic manner. Bioorthogonal switchable transcription is realized with the insertion of multiple genes in a TO-DNA. Further, implementing TO-DNA in living bacteria leads to switchable transcription of fluorescent RNA aptamers for light-up cell imaging. Hence, the design of TO-DNAs provides a means for shape-dependent gene delivery, enriching the toolbox of genetic engineering and synthetic biology.
Subject(s)
DNA/genetics , Transcription, Genetic/genetics , DNA/chemistry , Models, Molecular , Nanostructures/chemistryABSTRACT
BACKGROUND AND AIMS: Endoscopic radiofrequency ablation (RFA) is a new ablative treatment for unresectable extrahepatic cholangiocarcinoma (EHCC). A novel 5-fluorouracil compound, S-1 (Taiho Pharmaceutical Co, Ltd, Tokushima Plant. Japan), has been widely used as a key drug with first-line or second-line chemotherapy for the treatment of advanced cholangiocarcinoma. The aim of this study was to evaluate the clinical efficacy and safety of endoscopic RFA combined with S-1 for the treatment of unresectable locally advanced EHCC. METHODS: Patients with unresectable EHCC were prospectively randomized to 1 of 2 groups: the RFA + S-1 group and the RFA group. Median overall survival (OS), stent patency time, Karnofsky performance status (KPS) score, and adverse events rate were analyzed. RESULTS: The median OS was longer in the RFA + S-1 group (n = 37) than that in the RFA group (n = 38) (16.0 months [95% confidence interval, 13.1-19.0] vs 11.0 months [95% confidence interval, 9.7-12.3]; P < .001). Stent patency time was significantly longer in the RFA + S-1 group than that in the RFA group (6.6 ± 1.5 vs 5.6 ± .1 months, P = .014). KPS scores at postoperative month 9 (51.6 ± 17.0 vs 40.4 ± 16.4, P = .012) and month 12 (35.2 ± 18.3 vs 23.9 ± 11.4, P = .014) were all higher in the RFA + S-1 group than those in the RFA group (P < .05). The incidence of ERCP-related adverse events was not significantly different between RFA+S-1 and RFA groups (8.1% vs 10.5%, P > .05). CONCLUSIONS: For the treatment of locally advanced EHCC, endoscopic RFA combined with S-1 is associated with longer survival and stent patency and improved functional status than RFA alone. (Clinical trial registration number: NCT02592538.).
Subject(s)
Antimetabolites, Antineoplastic/administration & dosage , Bile Duct Neoplasms , Cholangiocarcinoma , Fluorouracil/administration & dosage , Oxonic Acid/administration & dosage , Radiofrequency Ablation , Tegafur/administration & dosage , Administration, Oral , Aged , Bile Duct Neoplasms/drug therapy , Bile Duct Neoplasms/surgery , Bile Ducts, Extrahepatic/surgery , Cholangiocarcinoma/drug therapy , Cholangiocarcinoma/surgery , Drug Combinations , Female , Humans , Male , Middle Aged , Prospective Studies , Treatment OutcomeABSTRACT
Protein neddylation is one type of posttranslational modifications that regulates the activity of the substrate proteins. Neddylation modification is catalyzed by NEDD8-activating enzyme (NAE, E1), NEDD8-conjugating enzyme (E2), and NEDD8 ligase (E3) to attach NEDD8, an ubiquitin-like molecule, to a lysine residue of a substrate protein. The best known neddylation substrates are cullin family members, which are scaffold components of cullin-RING ligases (CRLs), and cullin neddylation is required for activation of CRLs. In mammalian cells, there are one E1, two E2s (UBC12/UBE2M and UBE2F), and over a dozen E3s. MLN4924, the first-in-class small-molecule inhibitor of NAE, blocks the entire neddylation modification to inactivate activity of all CRLs. MLN4924 is currently in the Phase I/II clinical trials for anticancer application.In the last few years, targeting protein-protein interactions of the neddylation complexes has been pursued as a potential strategy to selectively inhibit the activity of individual CRL. Analysis of the co-crystal structures of DCN1, a co-E3 for neddylation, and its binding partners UBC12 (a neddylation E2) suggested that it may be amenable for the design of potent, small-molecule inhibitors. In this chapter, we will review the discovery of small-molecule inhibitors that block the interactions of DCN1 with UBC12 (hereafter called DCN1 inhibitors) from a number of laboratories, including ours, leading to selective inactivation of CRL-1 and/or CRL-3. We will also discuss potential therapeutic applications of these small-molecule inhibitors.
Subject(s)
Intracellular Signaling Peptides and Proteins/metabolism , NEDD8 Protein/metabolism , Protein Binding/drug effects , Protein Processing, Post-Translational/drug effects , Ubiquitin-Conjugating Enzymes/metabolism , Animals , HumansABSTRACT
Structural and chemical deterioration and its impact on cell wall mechanics were investigated for visually intact cell walls (VICWs) in waterlogged archaeological wood (WAW). Cell wall mechanical properties were examined by nanoindentation without prior embedding. WAW showed more than 25% decrease of both hardness and elastic modulus. Changes of cell wall composition, cellulose crystallite structure and porosity were investigated by ATR-FTIR imaging, Raman imaging, wet chemistry, 13C-solid state NMR, pyrolysis-GC/MS, wide angle X-ray scattering, and N2 nitrogen adsorption. VICWs in WAW possessed a cleavage of carboxyl in side chains of xylan, a serious loss of polysaccharides, and a partial breakage of ß-O-4 interlinks in lignin. This was accompanied by a higher amount of mesopores in cell walls. Even VICWs in WAW were severely deteriorated at the nanoscale with impact on mechanics, which has strong implications for the conservation of archaeological shipwrecks.
Subject(s)
Archaeology/methods , Cell Wall/chemistry , Wood/chemistry , Elastic Modulus , Gas Chromatography-Mass Spectrometry , Magnetic Resonance Spectroscopy , Spectroscopy, Fourier Transform Infrared , Spectrum Analysis, RamanABSTRACT
Breast cancer, the most prevalent cancer in women, remains the second in the list of cancer mortality, the majority of these fatalities resulted from estrogen receptor alpha (ERα) positive disease. ERα is well known for its function on breast cancer initiation and development and has become the most successful biomarker in breast cancers. Ophiobolins are sesterterpene compounds with a distinct tricyclic 5-8-5 ring and have presented anti-cancer activities. MHO7(6-epi-ophiobolin G)was isolated from products of a mangrove fungus in our previous research and demonstrated robust activity against breast cancer cells (BCCs). The investigation on the precise mechanism of MHO7 shows that MHO7 acts as a novel ERα down regulator different from the known molecules in ERâ¯+â¯breast cancer cells. A whole-genome transcriptomic analysis on MCF-7 cells treated with MHO7 revealed the estrogen signaling pathway was the most affected pathway, and further evidence showed the de novo synthesis of ESR1 mRNA was inhibited. In addition, MHO7 down-regulated ERα at the protein level through multiple approaches. It not only bound to ERα, pushing helix 11 away in the agonist conformation but also increased the ERα degradation through the ubiquitin-proteasome system. These effects consequently caused decreasing of the transcriptional activity of ER modulation which was confirmed by the decreasing of estrogen receptor element (ERE) activity as well as downstream genes expressions like GREB1, BRCA1, MUC1 and CCND1. Combination of tamoxifen and MHO7 yield a synergistic effect on the inhibition of MCF-7 cells when treated around the IC50 values. Our results suggest that MHO7 is a very promising drug candidate and provides a novel drug version on ERα down-regulation to fighting with breast cancer.
Subject(s)
Breast Neoplasms/drug therapy , Breast Neoplasms/genetics , Estrogen Receptor alpha/genetics , Sesterterpenes/pharmacology , Cell Line, Tumor , Cell Proliferation/drug effects , Cell Proliferation/genetics , Down-Regulation/drug effects , Down-Regulation/genetics , Estradiol/genetics , Female , Gene Expression Regulation, Neoplastic/drug effects , Gene Expression Regulation, Neoplastic/genetics , Humans , MCF-7 Cells , RNA, Messenger/genetics , Signal Transduction/drug effects , Signal Transduction/genetics , Tamoxifen/pharmacology , Transcriptional Activation/drug effects , Transcriptional Activation/geneticsABSTRACT
OBJECTIVE: To determine the rate of falls reported by older community dwellers in Shenzhen, China and to identify fall-related risk factors. METHOD: Participants were community dwellers residing in Shenzhen, China, who were aged 60 years and over and were recruited using multistage random sampling. All participants were surveyed about demographic and health-related information, mood, vision and hearing impairment, self-rated health and retrospective falls, and a test of balance was administered. Univariate and multivariate negative binomial regression was used to identify factors associated with a greater number of falls. RESULT: Study participants were 1290 people aged 60-98 years (mean 68.2 years, SD ±6.5). One hundred and seventy-seven falls were reported. One hundred and eleven (8.6%) participants reported one fall in the past year, 17 (1.3%) participants reported two falls and 10 (0.8%) participants reported three or more falls. Univariate analysis showed that age, living alone, presence of a medical condition, medication usage, visual impairment, poor subjective body sense perception, low mood, poor self-rated health and poor balance were associated with a greater number of falls in the past year. Multivariate analysis identified presence of a medical condition (incidence rate ratio (IRR)=1.40, 95% CI 1.19 to 1.67), living alone (IRR=2.46, 95% CI 1.12 to 5.41), visual impairment (IRR=1.46, 95% CI 1.03 to 2.08), walking aid use (IRR=2.29, 95% CI 1.12 to 4.69) and impaired balance (IRR=1.05, 95% CI 1.00 to 1.10) to be significantly associated with a greater number of falls in the past year. CONCLUSION: More falls occurred in older Chinese people with presence of a medical condition, living alone, visual impairment, used a walking aid and impaired balance.
Subject(s)
Accidental Falls/statistics & numerical data , Drug Prescriptions/statistics & numerical data , Geriatric Assessment/methods , Hearing Loss/epidemiology , Vision, Low/epidemiology , Wounds and Injuries/epidemiology , Activities of Daily Living , Aged , Aged, 80 and over , China/epidemiology , Female , Health Surveys , Humans , Incidence , Independent Living , Male , Postural Balance/physiology , Risk Factors , Wounds and Injuries/etiologyABSTRACT
BACKGROUND: Endoscopic placement of biliary stents to relieve jaundice is the main palliative treatment for unresectable extrahepatic cholangiocarcinoma. Endoscopic biliary radiofrequency ablation (RFA) has been reported to prolong stent patency, which may be beneficial in improving patient survival. However, available evidence is still insufficient, as most reported studies are retrospective case series. The aim of this study was to explore the clinical effect and safety of RFA in patients with unresectable extrahepatic cholangiocarcinoma. METHODS: 65 patients with unresectable extrahepatic cholangiocarcinoma, except Bismuth type III and IV hilar cholangiocarcinoma, were enrolled and randomly underwent either RFA combined with biliary stenting (RFAâ+âstent group; nâ=â32) or biliary stent only (stent-only group; nâ=â33). Overall survival time, stent patency period, and postoperative adverse events were recorded. RESULTS: In the 21-month follow-up period, the overall mean survival time was significantly longer in the RFAâ+âstent group than in the stent-only group (13.2â±â0.6 vs. 8.3â±â0.5 months; Pâ<â0.001). The mean stent patency period of the RFAâ+âstent group was also significantly longer than that of the stent-only group (6.8 vs. 3.4 months; Pâ=â0.02). There was no significant difference in the incidence of postoperative adverse events between the two groups (6.3â% [2/32] vs. 9.1â% [3/33]; Pâ=â0.67). CONCLUSION: Endoscopic RFA combined with stenting can significantly prolong survival and the stent patency period without increasing the incidence of adverse events in patients with extrahepatic cholangiocarcinoma patient, except Bismuth type III and IV hilar cholangiocarcinoma. This approach can be considered as a safe and effective palliative treatment for these patients.
Subject(s)
Bile Duct Neoplasms/surgery , Cholangiocarcinoma/surgery , Palliative Care/methods , Radiofrequency Ablation , Stents , Aged , Bile Duct Neoplasms/diagnostic imaging , Bile Ducts, Extrahepatic , Cholangiocarcinoma/diagnostic imaging , Cholangiography , Cholangiopancreatography, Endoscopic Retrograde/adverse effects , Endosonography , Female , Humans , Male , Middle Aged , Prospective Studies , Prosthesis Failure , Radiofrequency Ablation/adverse effects , Survival RateABSTRACT
The aim of this study was to identify the most potent quinoline-based anti-infectives for the treatment of multiple myeloma (MM) and to understand the molecular mechanisms. A small-scale screen against a panel of marketed quinoline-based drugs was performed in MM cell lines. Cell apoptosis was examined by flow cytometry. Anti-MM activity was also evaluated in nude mice. Western blotting was performed to investigate mechanisms. Nitroxoline (NXQ) was the most effective in suppressing MM cell proliferation. NXQ induced more than 40% MM cell apoptosis within 24 h and potentiated anti-MM activities of current major drugs including doxorubicin and lenalidomide. This finding was shown by activation of caspase-3, a major executive apoptotic enzyme, and by inactivation of PARP, a major enzyme in DNA damage repair. NXQ also suppressed prosurvival proteins Bcl-xL and Mcl-1. Moreover, NXQ suppressed the growth of myeloma xenografts in nude mice models. In the mechanistic study, NXQ was found to downregulate TRIM25, a highly expressed ubiquitin ligase in MM. Notably, NXQ upregulated tumor suppressor p53, but not PTEN. Furthermore, overexpression of TRIM25 decreased p53 protein. This study indicated that the long-term use of anti-infective NXQ has potential for MM treatment by targeting the TRIM25/p53 axle.