Effects of maternal pulmonary arterial hypertension on fetal hemodynamics and maternal-fetal outcome in late pregnancy.

PURPOSE: The aim of this study was to investigate the effects of maternal pulmonary arterial hypertension (PAH) on fetal hemodynamics in the third trimester and to identify hemodynamic indicators associated with adverse maternal and fetal outcomes. METHODS: We recruited 48 pregnant women with PAH in the third trimester and 32 women with normal pregnancies as controls matched for age and gestational week. Fetal growth and hemodynamic parameters were assessed by two-dimensional and color Doppler. All cases were followed up until delivery and maternal and fetal outcomes were collected. High throughput sequencing method was used to determine differential miRNA patterns in plasma exposed to pulmonary arterial hypertension (PAH) in pregnant women. We then performed the validated of key differentially expressed miRNAs by real-time PCR. RESULTS: Compared with the normal and mild PAH groups, resistance index (RI), pulsatility index (PI) of the fetal umbilical artery (UA) and quantitative ductus venosus (QDV) blood flow were increased in subjects with moderate to severe PAH, while PI and the ratio of peak systolic velocity (PSV) to end-diastolic velocity (EDV) (S/D) of the middle cerebral artery (MCA) were decreased. Compared with the normal group, subjects in the mild and moderate PAH groups had lower neonatal weight, shorter neonatal height, and higher preterm birth rates. In addition, miRNA sequencing data showed that PAH affected the levels of 23 miRNAs in plasma. At the same time, we showed that PAH significantly decreased the level of miR-1255a and increased the level of miR-548ar-3p by real-time PCR. CONCLUSION: In the group of pregnant women with moderate to severe pulmonary hypertension, there was a higher proportion of preterm births and low birth weight babies. Hemodynamic changes in the fetal UA, MCA, and ductus venosus (DV) during late pregnancy were associated with adverse fetal outcomes. At the same time, miRNA sequencing results showed that miR-1255a and miR-548ar-3p may play an important role in the development of PAH.

Unraveling the effect of CDI electrode characteristics on Cs removal from the perspective of ion transfer and energy composition.

Capacitive deionization (CDI) is surprisingly efficient to remove the aqueous Cs ion due to its small hydrated size and low hydration energy. But current experimental techniques fail in investigating deeply into the influence of some key electrode characteristics due to the difficulty in experimentally fabricating the electrodes as desired. This work presents a dynamic transport model of salt ions in a flow-by CDI cell. By using this model, the electrode thickness, macro- and micro-porosity are investigated to evaluate Cs ion removal efficiency and energy efficiency particularly from the aspect of ion transfer by the approach of decomposing energy contribution. The results indicate that the thick electrode coupled with the high current could greatly improve the effluent quality, but reduce the salt adsorption capacity (SAC). The increasement of the current density from 3 A/m2 to 6 A/m2 greatly decreases the SAC from 4.0 mg/g to 0.8 mg/g. Lower current could prolong the charging period, leading to more ions stored in the micropore. Not all the electrical energy is consumed for separating ions from the feed as desired, but some are used for driving ions diffusing in the electrodes. Consequently charging efficiency will be reduced especially when the electrodes are characterized with high porosity. It is highlighted that future work is required to further consider the complex details of porous structure and pore connectivity.

Prediction Efficiency of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection Patients with Renal Resistive Index and Semiquantitative Color Doppler.

OBJECTIVES: This study is aimed to evaluate the efficiency in early prediction of postoperative persistent acute kidney injury (PAKI) after surgery in acute Stanford type A aortic dissection (AAAD) patients by using Doppler renal resistive index (RRI) and semiquantitative color (SQC) Doppler grade, respectively. METHODS: 84 AAAD patients received Sun's surgical management, and 67 patients were enrolled. RRI and SQC Doppler grade were evaluated by ultrasonography, respectively, at 6 hours after surgery. Serum creatinine (sCr) was recorded before operation and at 24 hours, 48 hours, and 72 hours after operation. AKI grade was evaluated according to the classifications of the Acute Kidney Injury Network (AKIN). PAKI is defined as persistent oliguria and/or sCr elevation after 3 days. RRI and SQC Doppler grade were compared, respectively, between the PAKI and non-PAKI groups. Potential predictors were first tested by univariate logistic regression analysis, and a multivariate model was identified to determine the independent predictive ability of RRI and SQC Doppler grade for the PAKI. Receiver operating characteristic (ROC) analysis was performed to compare the diagnostic accuracy between RRI and SQC Doppler grade in early prediction of PAKI by using AKIN classifications as the reference standard. RESULTS: Of a total of 67 patients enrolled during the study period, 21 (31.3%) patients suffered from PAKI and 8 (11.9%) patients required dialysis. There are significant differences in RRI (0.80 ± 0.09 vs. 0.70 ± 0.05, P=0.002) and SQC Doppler grade (x 2=12.193, P=0.007) between the 2 groups with and without PAKI. Univariate analysis showed that RRI, SQC Doppler grade, length of stay in ICU, time of CPB, and length of stay in hospital were significant predictors of PAKI. RRI and the SQC Doppler grade remained independent predictors of PAKI. Area under the curve (AUC) of RRI was 0.855 (95% CI, 0.74-0.96) with cutoff value 0.725 (sensitivity 90.9% and specificity 71.1%), AUC of SQC Doppler grade was 0.642 (95% CI, 0.49-0.79) with cutoff value grade 2 (sensitivity 50% and specificity 73.3%). CONCLUSION: Both postoperative RRI and SQC Doppler grade are independent predictors for PAKI after surgery in AAAD patients. Both postoperative RRI and SQC Doppler grade can be obtained rapidly by bedside ultrasound, which is a good tool for early prediction for postoperative PAKI.

Prognosis of patients with newly diagnosed glioblastoma treated with molecularly targeted drugs combined with radiotherapy vs temozolomide monotherapy: A meta-analysis.

BACKGROUND: Glioblastoma (GB) is one of the most common malignancies with limited standard therapies such as surgery, radiotherapy (RT) plus temozolomide (TMZ). Molecularly targeted drugs have been investigated among various clinical trials and are expected to develop in the field of tumor therapy, while the efficacy remains uncertain due to limited previous results. Thus, we focus on the evaluation of molecularly targeted drugs to clarify its overall effectiveness in terms of treating newly diagnosed GB. METHODS: Electronic databases were searched for eligible literatures updated to April 2018. Randomized-controlled trials were included to assess the efficacy and safety of molecularly targeted drugs in patients with newly diagnosed GB. The main outcomes were further calculated including the following parameters: PFS (progression-free survival), OS (overall survival) as well as AEs (adverse events). All data were pooled along with their 95% confidence interval using RevMan software. Sensitivity analyses and heterogeneity were evaluated quantitatively. RESULTS: The combination of molecularly targeted drugs with TMZ + RT had no significant effects on OS (OR = 0.96, 95%CI = 0.89-1.04, P = .36). Meanwhile, the combination regimen significantly improved the PFS of patients with newly diagnosed GB (OR = 0.86 ,95% CI 0.75-0.98, P = .02). The rate of AEs (OR = 1.68,95%CI = 1.44-1.97, P < .00001) was higher in patients receiving molecularly targeted drugs, which was comparable to the contemporary group. CONCLUSION: Longer PFS and a higher rate of AEs were observed with the addition of molecularly targeted drugs to standard chemoradiation in patients harboring newly diagnosed GB. Nevertheless, compared with the control arm, the regimen did not significantly prolong OS.

Can Renal Resistive Index Predict Acute Kidney Injury After Acute Type A Aortic Dissection Repair?

BACKGROUND: This study sought to determine whether assessment of the renal resistive index (RRI) can predict the short-term reversibility of acute kidney injury (AKI) after repair of acute type A aortic dissection (TAAD). METHODS: This prospective study included 62 patients undergoing repair of acute TAAD. Doppler-based RRIs were obtained preoperatively, immediately after the surgical procedure, and 6, 24, and 48 hours postoperatively. The occurrence of AKI was evaluated daily according to Acute Kidney Injury Network criteria. Persistent AKI was defined as AKI lasting longer than 3 days. The association between the maximum RRI level at different time points and persistent AKI was analyzed by the receiver-operating characteristic curve. RESULTS: Of the 62 patients, 22 (35.5%) had no AKI, 21 (33.9%) had transient AKI, and 19 (30.6%) had persistent AKI. The maximum RRI was 0.67 ± 0.03 (0.62 to 0.71), 0.71 ± 0.05 (0.59 to 0.79), and 0.78 ± 0.05 (0.70 to 0.92) in the no AKI, transient AKI, and persistent AKI groups, respectively. The maximum level of RRI was significantly correlated with that of SCr during the first 48 hours postoperatively (rho = 0.606; p < 0.001). RRI could predict persistent AKI with an area under the receiver-operating characteristic curve of 0.918 (95% confidence interval, 0.850 to 0.986; p < 0.001). A postoperative RRI of 0.725 or higher was a marker for early detection of persistent AKI with high sensitivity and specificity (94.7% and 72.1%, respectively). CONCLUSIONS: An elevated maximum RRI may be a predictor of persistent AKI after repair of acute TAAD. This is helpful for management decision making and improving the prognosis of patients with AKI.

Early Detection of Postoperative Acute Kidney Injury in Acute Stanford Type A Aortic Dissection With Doppler Renal Resistive Index.

OBJECTIVES: This study aimed to evaluate the early efficiency of Doppler renal resistive index (DRRI) in prediction of acute kidney injury (AKI) after surgery in acute Stanford Type A aortic dissection (AAAD) patients. METHODS: Sixty-one AAAD patients who planned to receive Sun's surgical management were prospectively enrolled. The DRRI was measured by ultrasonography Doppler on the day before surgery (DRRIpre ), on admission to the intensive care unit (DRRIT0 ), 6 hours after surgery (DRRIT6 ), 24 hours after surgery (DRRIT24 ), and 48 hours after surgery (DRRIT48 ). The maximum DRRI value (DRRImax ) was recorded. The AKI was evaluated according to the classifications of the Acute Kidney Injury Network. The DRRI and serum creatinine (sCr) were compared between the pre- and postoperative time stations, as well as between the AKI and no-AKI groups. RESULTS: Thirty-nine (63.9%) patients suffered from AKI, and 12 (19.6%) patients received dialysis. No significant difference was found in DRRIpre (0.63 ± 0.04 versus 0.65 ± 0.06, P = .059) and sCrpre (84.13 ± 23.77 versus 94.29 ± 51.11, P = .383) between the two groups with and without AKI. Both the DRRI and sCr increased significantly after surgery in the AKI groups (P < .001). However, the DRRI reached its maximum 6 hours after surgery, whereas the sCr reached its maximum after 24 hours. Both the DRRI and sCr improved 48 hours after surgery. The area under the receiver operating characteristic curve for DRRImax (0.864, 95% confidence interval: 0.770-0.957) and DRRIT6 (0.861, 95% confidence interval: 0.766-0.957) was larger than the other three DRRIs measured at different time points. The cutoff value of DRRImax was 0.71, a sensitivity of 76.9% and specificity of 95.5%. CONCLUSIONS: Postoperative DRRI predicts the AKI earlier than sCr after AAAD surgery. The best time to detect DRRI was 6 hours after surgery.

Long-term outcome of ketoconazole and tacrolimus co-administration in kidney transplant patients.

AIM: To study the long-term outcome of ketoconazole and tacrolimus combination in kidney transplant recipients. METHODS: From 2006 to 2010, ketoconazole was given in 199 patients and was continued for at least 1 year or until graft failure (Group 1), while 149 patients did not receive any ketoconazole (Group 2). A combination of tacrolimus, mycophenolate and steroid was used as maintenance therapy. High risk patients received basiliximab induction. RESULTS: Basic demographic data was similar between the 2 groups. The 5-year cumulative incidence of biopsy-confirmed and clinically-treated acute rejection was significantly higher in Group 1 than in Group 2 (34% vs 18%, P = 0.01). The 5-year Kaplan-Meier estimated graft survival (74.3% vs 76.4%, P = 0.58) and patient survival (87.8% vs 87.5%, P = 0.93) were not different between the 2 groups. Multivariable analyses identified ketoconazole usage as an independent risk of acute rejection (HR = 2.33, 95%CI: 1.33-4.07; P = 0.003) while tacrolimus dose in the 2(nd) month was protective (HR = 0.89, 95%CI: 0.75-0.96; P = 0.041). CONCLUSION: Co-administration of ketoconazole and tacrolimus is associated with significantly higher incidence of acute rejection in kidney transplant recipients.

Genetic association of CHEK2, GSTP1, and ERCC1 with glioblastoma in the Han Chinese population.

Glioblastoma (GBM), a deadly brain tumor, is the most malignant glioma. It mainly occurs in adults and occurs significantly more in males than in females. We genotyped 19 tag single nucleotide polymorphisms (tSNPs) from 13 genes in a case-control study of the Han Chinese population to identify genetic factors contributing to the risk of GBM. These tSNPs were genotyped by Sequenom MassARRAY RS1000. Statistical analysis was performed using χ(2) test and SNPStats, a website software. Using χ(2) test, we found that the distribution of two tSNPs (rs2267130 in checkpoint kinase 2 (CHEK2), p = 0.040; rs1695 in GSTP1, p = 0.023) allelic frequencies had significant difference between cases and controls. When we analyzed all of the tSNPs using the SNPStats software, we found that rs1695 in GSTP1 decreased the risk of GBM in log-additive model (OR = 0.56, 95% CI, 0.34-0.94, p = 0.022). Besides, we found that there is an interaction between rs3212986 in excision repair cross-complementing group 1 (ERCC1) and gender under codominant and recessive models. The gene polymorphisms in CHEK2, GSTP1, and ERCC1 may be involved in GBM in the Han Chinese population. Since our sample size is small, further investigation needs to be performed.

Protective effect of quercetin against oxidative stress and brain edema in an experimental rat model of subarachnoid hemorrhage.

Quercetin has been demonstrated to play an important role in altering the progression of ischemic brain injuries and neurodegenerative diseases by protecting against oxidative stress. The effects of quercetin on brain damage after subarachnoid hemorrhage (SAH), however, have not been investigated. This study was designed to explore the effects of quercetin on oxidative stress and brain edema after experimental SAH using four equal groups (n = 16) of adult male Sprague-Dawley (SD) rats, including a sham group, an SAH + vehicle group, an SAH + quercetin10 group, and an SAH + quercetin50 group. The rat SAH model was induced by injection of 0.3 ml of non-heparinised arterial blood into the prechiasmatic cistern. In the SAH + quercetin10 and SAH + quercetin50 groups, doses of 10 mg/kg and 50 mg/kg quercetin, respectively, were directly administered by intraperitoneal injection at 30 min, 12 h, and 24 h after SAH induction. Cerebral tissue samples were extracted for enzymatic antioxidant determination, lipid peroxidation assay, caspase-3 activity and water content testing 48 h after SAH. Treatment with a high dose (50 mg/kg) of quercetin markedly enhanced the activities of copper/zinc superoxide dismutase (CuZn-SOD) and glutathione peroxidase (GSH-Px), and treatment with this dose significantly reduced the level of malondialdehyde (MDA). Caspase-3 and brain edema was ameliorated and neurobehavioral deficits improved in rats that received the high dose of quercetin. The findings suggest that the early administration of optimal dose of quercetin may ameliorate brain damage and provide neuroprotection in the SAH model, potentially by enhancing the activity of endogenous antioxidant enzymes and inhibiting free radical generation.

Overexpression of NDRG2 can inhibit neuroblastoma cell proliferation through negative regulation by CYR61.

Several recent studies have showed that the n-myc downstream regulated gene 2 (NDRG2) is a new tumor suppressor gene, and that it plays an important role in tumor suppression in several cancers or cancer cell lines. However, few studies focused on its function in neuroblastoma cells. In the present investigation, we demonstrated that NDRG2 overexpression inhibited their proliferation. Using a cDNA microarray, we found that overexpression of NDRG2 inhibited the expression of cysteine-rich protein 61 (CYR61), a proliferation related gene. From our research, CYR61 may partially hinder NDRG2-mediated inhibition of cell proliferation. Overexpression of NDRG2 resulted in accumulation of cells in the G1 phase, which was accompanied by upregulation of p21 and p27 and downregulation of CDK4 and cyclin D1. Taken together, these data indicate that NDRG2 inhibits the proliferation of neuroblastoma cells partially through suppression of CYR61. Our findings offer novel insights into the physiological roles of NDRG2 in neuroblastoma cell proliferation, and NDRG2 may prove to be effective candidate for the treatment of children with neuroblastoma.

Downregulation of MSP58 suppresses cell proliferation in neuroblastoma cell lines.

MSP58, a novel oncogene, shows transforming activity in mouse embryonic fibroblasts. However, the oncogenic role of MSP58 in tumor cells has not been fully characterized. To extend understanding of how this protein operates in tumorigenesis, we aimed to identify the effect of MSP58 on neuroblastoma cell proliferation. Here, we found that MSP58 was highly expressed in neuroblastoma tumor samples and cell lines. We found that the majority of MSP58 protein can be detected in the nucleus as reported in other cells. Moreover, MSP58-targeted shRNA lentivirus attenuated neuroblastoma cell proliferation. Knockdown of MSP58 resulted in S-phase cell accumulation, which was accompanied by changes in cell cycle-related molecules. These results indicate that MSP58 plays an oncogenic role in the proliferation of neuroblastoma cells and could be a novel target for the treatment of neuroblastoma.

Astragaloside IV prevents MPP⁺-induced SH-SY5Y cell death via the inhibition of Bax-mediated pathways and ROS production.

Parkinson's disease (PD) is characterized by a progressive degeneration of dopaminergic neurons in the substantia nigra. Oxidative stress and neural degeneration are suggested to be involved in the pathogenesis of PD. Previous studies have revealed that Astragaloside IV (AS-IV) can reduce inflammation and oxidation, making it a potential therapeutic agent for neurodegenerative disease. In this study, we investigated whether AS-IV protect against 1-methyl-4-phenylpyridnium ion (MPP(+))-induced dopaminergic neurotoxicity in SH-SY5Y cells and determined the mechanism of AS-IV neuroprotection. We found that pretreatment with AS-IV significantly reversed the loss of cell viability, nuclear condensation, the generation of intracellular reactive oxygen species (ROS), and the increase in Bax/Bcl-2 ratio and the activity of caspase-3 induced by MPP(+). Our study suggests that the neuroprotective effect of AS-IV is related to mechanisms including ROS production and the inhibition of Bax-mediated pathway. The present study supports the notion that AS-IV may be a promising neuroprotective agent for the treatment of neurodegenerative disorders such as PD.

[A cross-sectional investigation on cognition and health education needs on child neglect among parents/carers to the preschool children in Guangdong Province].

OBJECTIVE: To investigate the cognition and health education needs on child neglect among parents/carers to the preschool children in Guangdong Province. METHODS: A total of 621 parents/carers of preschool children aged 3-6 years from four cities (Dongguan, Huizhou, Zhongshan, and Foshan) in Guangdong Province completed self-designed questionnaires concerning the cognition and health education needs on child neglects. RESULTS: Only 5.4% of the parents/carers had a good knowledge of child neglect, and 55.9% had never heard about this term. About 90.5%-90.7%of the surveyed parents/carers were willing to learn more about child neglect and 94.6%-97.4% of them agreed that education on child neglect was necessary. It was found that normal brochures, books, newspapers, and magazines were the preferred way of education for parents/carers (77.0%); also nearly half of the parents/carers welcomed courses (55.6%) or lectures (49.1%). Most of them believed that awareness raising activities should be carried out in kindergarten (70.5%), public places (61.4%) or by providing collective training for teachers in kindergarten (59.6%). CONCLUSIONS: Most parents/carers of preschool children in Guangdong Province have a poor knowledge of child neglect. Efforts should be made to strengthen awareness raising activities on this topic via appropriate pathways.

Application of intraoperative ultrasonography for guiding microneurosurgical resection of small subcortical lesions.

OBJECTIVE: We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. MATERIALS AND METHODS: Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. RESULTS: All the lesions were located in the cortex and their mean size was 1.3 ± 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. CONCLUSION: Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.

A cross-sectional investigation on cognition and health education needs on child neglect among parents/carers to the preschool children in Guangdong Province / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the cognition and health education needs on child neglect among parents/carers to the preschool children in Guangdong Province.</p><p><b>METHODS</b>A total of 621 parents/carers of preschool children aged 3-6 years from four cities (Dongguan, Huizhou, Zhongshan, and Foshan) in Guangdong Province completed self-designed questionnaires concerning the cognition and health education needs on child neglects.</p><p><b>RESULTS</b>Only 5.4% of the parents/carers had a good knowledge of child neglect, and 55.9% had never heard about this term. About 90.5%-90.7%of the surveyed parents/carers were willing to learn more about child neglect and 94.6%-97.4% of them agreed that education on child neglect was necessary. It was found that normal brochures, books, newspapers, and magazines were the preferred way of education for parents/carers (77.0%); also nearly half of the parents/carers welcomed courses (55.6%) or lectures (49.1%). Most of them believed that awareness raising activities should be carried out in kindergarten (70.5%), public places (61.4%) or by providing collective training for teachers in kindergarten (59.6%).</p><p><b>CONCLUSIONS</b>Most parents/carers of preschool children in Guangdong Province have a poor knowledge of child neglect. Efforts should be made to strengthen awareness raising activities on this topic via appropriate pathways.</p>

Evaluation of transcranial color-coded duplex sonography for cerebral artery stenosis or occlusion.

BACKGROUND AND PURPOSE: Cerebral artery stenosis or occlusion is the most common etiological factor in patients with acute cerebral ischemia, but the rate of early diagnosis is low. The purpose of the study is to evaluate the diagnostic accuracy of transcranial color-coded sonography (TCCS) for cerebral artery stenosis with digital subtraction angiography used as the gold standard of reference. METHODS: Seventy-eight patients who were suspected of cerebrovascular disease were involved in the study. Major cerebral arteries were observed through the transcranial echo window by TCCS. The course, shape of the color blood beam and velocity were given special attention. The hemodynamic parameter was measured and analyzed. The findings of TCCS were compared with the results of digital subtraction angiography, according to a double-blind design. A 4-fold table was used as the statistical analysis method to evaluate TCCS. The indexes included sensitivity, specificity, accuracy and false-positive rate. RESULTS: Imaging of TCCS revealed that the blood flow beam narrowed where the artery had stenosis and looked like girdling. The velocity of the foci increased abnormally, while the velocity before and after the foci decreased. Severe stenosis and the long stenotic segment may show discontinuity of the blood flow beam. The velocity of the foci did not noticeably increase or decrease. The blood flow beam of the occlusive artery cannot be seen and the frequency spectrum cannot be obtained, but the other artery was well visualized at the same time. Analysis of the diagnostic value of TCCS according to the 4-fold table included the validity index, with a sensitivity, specificity, false-positive rate, false-negative rate, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and Youden index of 72.9%, 82.9%, 17.1%, 27.0%, 78.2%, 79.4%, 77.3%, 4.3, 0.3 and 0.56, respectively. The reliability index included the agreement rate and kappa value, which were 78.2% and 0.56, respectively. CONCLUSIONS: TCCS could be considered a valuable method for the screening diagnosis of cerebral artery stenosis or occlusion.

Inhibition of transcription factor STAT5b suppresses proliferation, induces G1 cell cycle arrest and reduces tumor cell invasion in human glioblastoma multiforme cells.

Abnormalities in the signal transducer and activator of transcription 5 (STAT5) signaling are involved in the oncogenesis of several cancers. However, previous studies have not elucidated clear and distinct roles for each STAT5 gene in cancers. To investigate the role of STAT5a, -5b isoforms in human glioblastoma multiforme (GBM) progression, we depleted each STAT5 isoforms with siRNA. Our results demonstrate that STAT5b is involved in GBM cell growth, cell cycle progression, invasion and migration through regulation of gene expression, such as Bcl-2, p21(waf1/cip1), p27(kip1), FAK and VEGF. Moreover, immunohistochemical staining reveals that cytoplasm staining of STAT5b is markedly increased in GBM (57.1%) compared with that in normal cortex (22.2%) and diffuse astrocytoma (27.3%), suggesting that STAT5b could have important implications in astrocytoma biology. Therefore, our findings illustrate the biological significance of STAT5b in GBM progression, and provide novel evidence that STAT5b may serve as a therapeutic target in the prevention of human glioblastoma multiforme.

Intracranial angioplasty with Gateway-Wingspan system for symptomatic atherosclerotic stenosis: preliminary results of 27 Chinese patients.

BACKGROUND: We investigated the safety of treatment of symptomatic intracranial atherosclerotic stenoses with the Gateway-Wingspan system and its initial effect on prevention of ischemic events. METHODS: Twenty-seven cases of symptomatic intracranial atherosclerotic stenoses were treated with angioplasty with a Wingspan stent. Location of stenoses, extent of stenoses before and after angioplasty, success rate of treatment, occurrence of procedural complications, and changes in recurrence of symptoms of ischemic events 30 days after treatment were recorded. RESULTS: Twenty-nine angioplasties with the Wingspan system were successfully carried out in 29 stenoses in 27 patients. Of 29 stenoses, 17 were in the posterior circulation, and 12, in the anterior circulation. The degree of stenoses was reduced from baseline 71.8% (56%-87.8%) to 24.9% (0%-45%) after stenting. Complications were seen in four patients (14.8%), 3 of which were lesion-related infarction of a perforated artery, and 1 was a non-lesion-related infarction. Two complications led to transient neurologic dysfunction, one led to defect of the visual field, and one led to hemiplegia. The prevalence of morbidity and serious morbidity were 7.4% and 3.7%, respectively, and no death occurred. No new ischemic events happened during 30 days after stenting. CONCLUSION: Angioplasty with the Wingspan system to treat symptomatic intracranial atherosclerotic stenoses appears to be safe. Its initial effect on prevention of ischemic events is acceptable.

Repeat gamma knife radiosurgery for recurrent or refractory trigeminal neuralgia.

BACKGROUND: Repeat gamma knife radiosurgery (GKRS) is considered to be an effective treatment for refractory or recurrent trigeminal neuralgia (TN). AIMS: The purpose of this report was to demonstrate the relationship between the outcome of repeat GKRS and prior operative procedures on patients with recurrent or refractory TN. MATERIALS AND METHODS: A retrospective analysis was performed on 34 patients with refractory or recurrent TN who had undergone repeat GKRS; 21 patients had undergone other types of procedures, 11 of whom had undergone more than three such procedures prior to radiosurgery. The maximum dose of the repeat procedure was between 60 and 75 Gy. The mean follow-up time was 21.6 months. STATISTICAL ANALYSIS USED: The log-rank test and Fisher's exact test were used to analyze the data. RESULTS: Excellent pain relief was achieved in 14 patients (41.2%) after repeat GKRS, while a successful outcome occurred in 29 of 34 patients (85.3%). Better pain relief occurred in the patients who did not have a prior procedure or who had undergone fewer than three prior procedures (P=0.042). Twenty-four of 25 patients (96.0%) who had recurrent pain had a successful operation and five of nine patients (55.6%) who did not have significant relief of pain after the first procedure had a successful operation. The difference was statistically significant (P<0.01). Only four patients had mild complications. CONCLUSION: It is more likely to relieve pain in patients with recurrent or refractory TN who did not have a prior procedure or who had fewer than three procedures before undergoing their first GKRS. Moreover, it seems that patients who had a good response following the initial GKRS had better results after a repeat procedure.

[Study on the cost-effectiveness, benefit and utility analysis on the infant inoculation hepatitis B vaccine in Shanghai].

OBJECTIVE: To study the cost-effectiveness, benefit and utility of infant hepatitis B vaccination in Shanghai from 1992 to 2001. METHODS: To calculate the cost of hepatitis B vaccination by cost analysis method. Both the numbers of persons with HBsAg positive and patient with hepatitis B, cirrhosis and liver cancer decreased as the index of direct effect. To study the sick-time and the cost of treating hepatitis B, cirrhosis and liver cancer patients, a face to face questionnaire was used and quasi method was adopted to understand the effect of cure and the course of hepatitis B. The cost benefit analysis method was also used to calculate the cost benefit of HBV vaccine. The disability adjusted life years (DALY) was regarded as an index of utility to measure the disease burden. RESULTS: Input of 501,129.49 Yuan might have the result of reducing one liver cancer patient, ten cirrhosis patients, one hundred chronic hepatitis B patients and one thousand HBsAg positive people. The cost of hepatitis B vaccination was 0.24 hundred million Yuan during the past ten years in Shanghai, which had obtained the total benefit value of 41.22 hundred million Yuan, with a cost benefit ratio of 1:172 Yuan. It was estimated that the total disease burden of hepatitis B, cirrhosis and liver cancer patients was 59,762.55 DALY in order to reduce one DALY loss cost of 402.50 Yuan. CONCLUSION: HBV vaccine inoculation in infants seemed to be a low-cost input and high-effect output strategy.