Copy Number Analyses Identified a Novel Gene: APOBEC3A Related to Lipid Metabolism in the Pathogenesis of Preeclampsia.

Background: Preeclampsia is a heterogeneous and complex disease with its pathogenesis mechanism not fully elucidated. A certain subset of patients with preeclampsia exhibit disturbances in lipid metabolism before clinical symptoms. Moreover, there is a tendency for preeclampsia to run in families. Whether genetic factors play a role in abnormal lipid metabolism during the incidence of preeclampsia has not been well investigated. Methods: Preeclampsia patients (n = 110) and healthy age- and gravidity-matched pregnant women (n = 110) were enrolled in this study. Peripheral blood specimens were used for genomic analysis (n = 10/group) or laboratory validation (n = 100/group). We retrospectively obtained the baseline clinical characteristics of 68 preeclampsia patients and 107 controls in early pregnancy (12-14 gestational weeks). Correlation analyses between differential genes and baseline lipid profiles were performed to identify candidate genes. In vitro and in vivo gain-of-function models were constructed with lentivirus and adeno-associated virus systems, respectively, to investigate the role of candidate genes in regulating lipid metabolism and the development of preeclampsia. Results: We observed that preeclampsia patients exhibited significantly elevated plasma TC (P = 0.037) and TG (P < 0.001) levels and increased body mass index (P = 0.006) before the disease onset. Within the region of 27 differential copy number variations, six genes potentially connected with lipid metabolism were identified. The aberrant copies of APOBEC3A, APOBEC3A_B, BTNL3, and LMF1 between preeclampsia patients and controls were verified by quantitative polymerase chain reaction. Especially, APOBEC3A showed a significant positive correlation with TC (P < 0.001) and LDL (P = 0.048) in early pregnancy. Then, our in vitro data revealed that overexpression of APOBEC3A disrupted lipid metabolism in HepG2 cells and affected both cholesterol and fatty acid metabolisms. Finally, in vivo study in a hepatic-specific overexpressed APOBEC3A mouse model revealed abnormal parameters related to lipid metabolism. Pregnant mice of the same model at the end of pregnancy showed changes related to preeclampsia-like symptoms, such as increases in sFlt-1 levels and sFlt-1/PLGF ratios in the placenta and decreases in fetal weight. Conclusion: Our findings established a new link between genetics and lipid metabolism in the pathogenesis of preeclampsia and could contribute to a better understanding of the molecular mechanisms of preeclampsia.

Analysis of the relationship between postoperative ophthalmic complications and dialysis time of pre-kidney transplantation.

AIM: To determine the influence of the dialysis time before kidney transplantation on postoperative ophthalmic complications. METHODS: One hundred and eighty three patients who were given the follow-up after kidney transplantation were selected, including 124 males and 59 females. The dialysis time before kidney transplantation was (2.9±2.1) years. Among them, there were 93 cases having cadaveric renal transplantation and 90 cases having living relative renal transplantation. The conditions of ophthalmic complications in all the patients after kidney transplantation were investigated and the incidence rate on ophthalmic complications having different dialysis time before kidney transplantation was given Chi-square test and Chi-square linear trend test. RESULTS: Among 183 patients with kidney transplantation, 95 patients (51.9%) had at least one ophthalmic complication and the rest 88 patients (48.1%) had no significant abnormality at the eye region. The most common ophthalmic complications were pinguecula/conjunctival degeneration (31 cases), the following was caligo lentis (24 cases). The main manifestations were grayish white granule and plaque turbidity occurred in posterior capsule at the posterior pole of crystaline lens. The angulus iridocornealis of 5 patients (5.3%) with cataract and glaucoma were all open-angle through the detection by gonioscope. Through visual field examination, there were 2 patients with paracentral scotoma, 2 patients with arcuate scotoma and one case with nasal step. CONCLUSION: The experiments verify that the incidence of glaucomawas relates to the dialysis time before kidney transplantation, and the incidence rate might be higher if the dialysis time is longer.

[Clinical observation of hand-assisted laparoscopic live donor nephrectomy].

OBJECTIVE: To investigate the feasibility and advantage of hand-assisted laparoscopic live donor nephrectomy in renal transplantation. METHODS: Six living relative donors received retroperitoneal left-side laparoscopic nephrectomy. The operating time of nephrectomy, the warm ischemic time, the recovery time of allograft and donors were recorded and analyzed. RESULTS: The mean operating time of nephrectomy was 150 minutes, the mean warm ischemic time was 3.5 minutes, and the mean time of micturition after graft reperfusion was 82 seconds. The donors recovered rapidly and returned to normal within 30 days . The urine volume and renal function of the 6 recipients were normal without complications in the following 3 months. CONCLUSION: Hand-assisted laparoscopic live donor nephrectomy is feasible with short operating time and warm ischemic time; the donors experience less pain, and recover rapidly. This technique may be widely used in living donor nephrectomy.

[Operative treatment of pheochromocytoma: report of 11 cases].

BACKGROUND & OBJECTIVE: Pheochromocytoma is clinically uncommon. Pheochromocytoma patients without hypertension or symptoms are often misdiagnosed. The patients could be cured by surgical removal of the tumor. However, surgery is dangerous if the preoperative preparation was not well done. The authors reported their experiences in surgical treatment of pheochromocytoma. METHODS: Clinical data of 11 patients with pheochromocytoma were reviewed retrospectively to summarize the management of blood pressure during pre-operation and operation. RESULTS: After excision of the tumors, 11 patients have been followed up for 3 months to 10 years. Blood pressure became normal and symptoms vanished in all patients. Only one patient recurred at paraveterbral sympathetic chain 6 months after operation and underwent another operation for removal of the tumor. CONCLUSION: Surgery is the mainstay of therapy for pheochromocytoma. The adequate preoperative preparation is very important for successful surgery.