The Right Hand Must Know What the Left Hand is Doing: A False-Positive Hotspot on the Sestamibi Scan.

Objective: Imaging studies in the setting of primary hyperparathyroidism are performed to rule out an ectopic parathyroid adenoma. Although rare, false-positive scans can cause confusion and possibly more extensive procedures. Method: A 68-year-old woman with parathyroid hormone-dependent hypercalcemia was found to have uptake in the left midclavicular area on the parathyroid scan with sestamibi. Retention of the isotope was considered a possibility, and the sestamibi scan was repeated after injecting the isotope in the right hand and this did not show uptake in the left midclavicular area. Results: Sestamibi is taken up by the mitochondrial-rich adenoma cells and can help identify an ectopic location of the adenoma. Sestamibi scans are commonly performed before neck exploration to rule out an ectopic adenoma and to localize the parathyroid adenoma. Thyroid adenoma and thyroid cancer can also cause retention of isotopes. Retention of the isotope in the vein can also give an illusion of an ectopic parathyroid adenoma. Injecting the isotope in the contralateral hand can overcome this retention issue. Conclusion: Uptake on parathyroid scan outside of normal embryologic decent of the parathyroid gland should raise the possibility of a false-positive uptake.

Neuroendocrine and neuroimmune mechanisms underlying comorbidity of pain and obesity.

Pain and obesity, as well as their associated impairments, are major health concerns. Understanding the relationship between the two is the focus of a growing body of research. However, early researches attribute increased mechanical stress from excessive weight as the main factor of obesity-related pain, which not only over-simplify the association, but also fail to explain some controversial outcomes arising from clinical investigations. This review focuses on neuroendocrine and neuroimmune modulators importantly involved in both pain and obesity, analyzing nociceptive and anti-nociceptive mechanisms based on neuroendocrine pathways including galanin, ghrelin, leptin and their interactions with other neuropeptides and hormone systems which have been reported to play roles in pain and obesity. Mechanisms of immune activities and metabolic alterations are also discussed, due to their intense interactions with neuroendocrine system and crucial roles in the development and maintenance of inflammatory and neuropathic pain. These findings have implications for health given rising rates of obesity and pain-related diagnoses, by providing novel weight-control and analgesic therapies targeted on specific pathways.

RNA-Sequencing-Based Transcriptomic Analysis Reveals a Role for Annexin-A1 in Classical and Influenza A Virus-Induced Autophagy.

Influenza viruses have been shown to use autophagy for their survival. However, the proteins and mechanisms involved in the autophagic process triggered by the influenza virus are unclear. Annexin-A1 (ANXA1) is an immunomodulatory protein involved in the regulation of the immune response and Influenza A virus (IAV) replication. In this study, using clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 (CRISPR associated protein 9) deletion of ANXA1, combined with the next-generation sequencing, we systematically analyzed the critical role of ANXA1 in IAV infection as well as the detailed processes governing IAV infection, such as macroautophagy. A number of differentially expressed genes were uniquely expressed in influenza A virus-infected A549 parental cells and A549 ∆ANXA1 cells, which were enriched in the immune system and infection-related pathways. Gene ontology and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway revealed the role of ANXA1 in autophagy. To validate this, the effect of mechanistic target of rapamycin (mTOR) inhibitors, starvation and influenza infection on autophagy was determined, and our results demonstrate that ANXA1 enhances autophagy induced by conventional autophagy inducers and influenza virus. These results will help us to understand the underlying mechanisms of IAV infection and provide a potential therapeutic target for restricting influenza viral replication and infection.

Proximal gastrectomy versus total gastrectomy for adenocarcinoma of the esophagogastric junction: a meta-analysis.

Aim: To compare efficacy between total gastrectomy (TG) and proximal gastrectomy (PG) for upper-third gastric cancer. Materials & methods: PubMed, Embase and Cochrane library were searched to select suitable researches. Stata was used for meta-analysis including 5-year overall survival rate, recurrence rate, complication morbidities and serum nutritional levels. Results: Ten retrospective English researches were contained. Our study showed no significant difference of 5-year overall survival rate, recurrence rate, reflux symptoms and anastomotic leakage. TG experienced longer operation time, more lymph nodes-retrieved number, more estimated blood loss and higher ileus, but less anastomotic stricture. PG showed advantages over TG in terms of serum nutritional levels. Conclusion: PG is more preferable to TG for treatment of upper-third gastric cancer.

[Changes of HPAA in Different Rat Models of Gan Stagnation, Pi Deficiency, Gan Stagnation Pi Defi- ciency and Interventional Effect of Chaishu Sijun Decoction].

OBJECTIVE: To compare changes of hypothalamus-pituitary-adrenal axis (HPAA) in different rat models of Gan stagnation (GS), Pi deficiency (PD), Gan stagnation Pi deficiency (GSPD) syndromes, and to observe interventional effect of Chaishu Sijun Decoction (CSD, capable of soothing Gan-qi invigorating Pi) on them. METHODS: Seventy Wistar rats were divided into the normal control group (group 1), the GS group (group 2), the PD group (group 3), the GSPD group (group 4), the GS intervention group (group 5), the PD intervention group (group 6), and the GSPD intervention group (group 7) according to random digit table, 10 in each group. Rats in group 1 received no treatment. Rats in group 2 and 5 were modeled by chronic restraint method. Rats in group 3 and 6 were modeled by excess fatigue plus alimentary abstinence method. Rats in group 4 and 7 were modeled by chronic restraint, excess fatigue, and alimentary abstinence method. At the 2nd weekend of modeling, CSD at 2.86 g/kg was fed to rats in group 5, 6, and 7 by gastrogavage for 2 successive weeks. Equal volume of distilled water was given to rats in the rest 4 groups. On the 29th day, rats were killed, adrenal weight weighed, and adrenal index calculated. Levels of plasma and hypothalamus corticotropin-releasing hormone (CRH), plasma and pituitary adrenocorticotrophic hormone (ACTH), and plasma corticosterone (CORT) were determined using radioimmunity. RESULTS: Compared with group 1, adrenal index significantly decreased in group 2, 3, and 4 (P < 0.05). Of them, plasma and hypothalamus CRH, plasma CORT increased significantly in group 2 and 4 (P < 0.05). Besides, plasma and pituitary ACTH increased in group 4 (P < 0.05). Plasma and pituitary ACTH, as well as plasma CORT decreased significantly in group 3 (P < 0.05). Compared with group 2, 3, and 4, adrenal index increased significantly in group 5, 6, and 7 (P < 0.05). Compared with group 2, plasma CORT, hypothalamus CRH, and pituitary ACTH decreased significantly in group 5 (P < 0.05). Compared with group 3, plasma ACTH and CORT increased significantly in group 6 (P < 0.05). Compared with group 4, plasma CRH, ACTH, CORT, hypothalamus CRH, and pituitary ACTH decreased in group 7 (P < 0.05). CONCLUSIONS: The function of HPA .axis was damaged to varying degrees in rats of the three models in this experiment. Hyperactivity of HPA axis existed in GS syndrome and GSPD syndrome. Impairment of feedback regulation in hypothalamus and pituitary was accompanied in GSPD syndrome. Hypofunction of HPA axis existed in PDS. CSD, capable of soothing Gan-qi invigorating'Pi, showed improvement on disarranged HPAA, but with optimal effect on GSPD syndrome. CSD had higher correlation with GSPD syndrome.

Changes of HPAA in Different Rat Models of Gan Stagnation, Pi Deficiency, Gan Stagnation Pi Defi- ciency and Interventional Effect of Chaishu Sijun Decoction / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To compare changes of hypothalamus-pituitary-adrenal axis (HPAA) in different rat models of Gan stagnation (GS), Pi deficiency (PD), Gan stagnation Pi deficiency (GSPD) syndromes, and to observe interventional effect of Chaishu Sijun Decoction (CSD, capable of soothing Gan-qi invigorating Pi) on them.</p><p><b>METHODS</b>Seventy Wistar rats were divided into the normal control group (group 1), the GS group (group 2), the PD group (group 3), the GSPD group (group 4), the GS intervention group (group 5), the PD intervention group (group 6), and the GSPD intervention group (group 7) according to random digit table, 10 in each group. Rats in group 1 received no treatment. Rats in group 2 and 5 were modeled by chronic restraint method. Rats in group 3 and 6 were modeled by excess fatigue plus alimentary abstinence method. Rats in group 4 and 7 were modeled by chronic restraint, excess fatigue, and alimentary abstinence method. At the 2nd weekend of modeling, CSD at 2.86 g/kg was fed to rats in group 5, 6, and 7 by gastrogavage for 2 successive weeks. Equal volume of distilled water was given to rats in the rest 4 groups. On the 29th day, rats were killed, adrenal weight weighed, and adrenal index calculated. Levels of plasma and hypothalamus corticotropin-releasing hormone (CRH), plasma and pituitary adrenocorticotrophic hormone (ACTH), and plasma corticosterone (CORT) were determined using radioimmunity.</p><p><b>RESULTS</b>Compared with group 1, adrenal index significantly decreased in group 2, 3, and 4 (P < 0.05). Of them, plasma and hypothalamus CRH, plasma CORT increased significantly in group 2 and 4 (P < 0.05). Besides, plasma and pituitary ACTH increased in group 4 (P < 0.05). Plasma and pituitary ACTH, as well as plasma CORT decreased significantly in group 3 (P < 0.05). Compared with group 2, 3, and 4, adrenal index increased significantly in group 5, 6, and 7 (P < 0.05). Compared with group 2, plasma CORT, hypothalamus CRH, and pituitary ACTH decreased significantly in group 5 (P < 0.05). Compared with group 3, plasma ACTH and CORT increased significantly in group 6 (P < 0.05). Compared with group 4, plasma CRH, ACTH, CORT, hypothalamus CRH, and pituitary ACTH decreased in group 7 (P < 0.05).</p><p><b>CONCLUSIONS</b>The function of HPA .axis was damaged to varying degrees in rats of the three models in this experiment. Hyperactivity of HPA axis existed in GS syndrome and GSPD syndrome. Impairment of feedback regulation in hypothalamus and pituitary was accompanied in GSPD syndrome. Hypofunction of HPA axis existed in PDS. CSD, capable of soothing Gan-qi invigorating'Pi, showed improvement on disarranged HPAA, but with optimal effect on GSPD syndrome. CSD had higher correlation with GSPD syndrome.</p>

[Risk assessment and countermeasures of BTEX contamination in soils of typical pesticide factory].

Soil samples around three representative pesticide factories were collected in Zhangjiakou City, Hebei Province, and analyzed to identify their pollution characteristics and health risk of BTEX by purge-and trap and gas chromatography/mass spectroscopy method. Total concentrations of BTEX in soils in Plant A, B and C ranged from 673.50 to 32 363.50 ng x g(-1), nd to 6 461.80 ng x g(-1) and 461.70 to 8 740.80 ng x g(-1), respectively. Concentrations of detected toluene (4 619.50-7 234.30 ng x g(-1)) and ethylbenzene (364.60-7 944.60 ng x g(-1)) had exceeded the Canadian guidelines for industrial land (370 ng x g(-1) and 82 ng x g(-1)), and concentration of xylene (19 799.40 ng x g(-1)) in dust in production area of Plant A was larger than the Dutch soil intervention value (17 000 ng x g(-1)). While concentrationsn of BTEX around Plant A (Region I ) and Plant B and C (Region II) ranged from nd to 645.81 ng x g(-1), and nd to 309.13 ng x g(-1), respectively, which were below the Canadian guidelines for agricultural land. The non-carcinogenic risk of BTEX in Plant A (2.90E-06 -1.32E-04), B (nd -4.30E-05) and C (1.29E-06 -5.64E-05) were all below 1, which suggested that no obvious health risk existed in each plant. The non-carcinogenic risks in Region I (nd -2.02E-06) and Region II (nd -1.10E-06) were below than 1, and also lower than those in factories. High risk areas were mainly concentrated in the downwind, moreover, soils around villages and towns were also with higher risk. In conclusion, soils and dusts in each factory had been polluted and the quality of agricultural land had been partly deteriorated. Finally, environmental management and occupational protection countermeasures were proposed based on the research results.

Chinese Medicine Formula "Jian-Pi-Zhi-Dong Decoction" Attenuates Tourette Syndrome via Downregulating the Expression of Dopamine Transporter in Mice.

Jian-Pi-Zhi-Dong Decoction (JPZDD) is dedicated to the treatment for Tourette syndrome (TS) with the guidance of the theories of Traditional Chinese Medicine (TCM). This study aims to investigate the expression of dopamine transporter (DAT) in the striatum and stereotyped behavior of TS mice model by intervention of JPZDD. Mice were induced by 3,3'-iminodipropionitrile (IDPN, 350 mg kg(-1) day(-1), i.p.) for 7 days and divided into 4 groups (n = 20, each): control and IDPN groups were gavaged with saline and the remaining 2 groups with Tiapride (Tia, 50 mg kg(-1) day(-1)) and JPZDD (20 g kg(-1) day(-1)), respectively. The results showed that the scores of stereotyped behavior in IDPN+JPZDD group were significantly reduced. A noticeably increased (11)C-ß-CFT binding at bilateral striatum was observed after administration of JPZDD versus that of IDPN or Tia. Immunohistochemistry and in situ hybridization studies manifested higher levels of DAT protein and mRNA in IDPN+JPZDD group. These findings not only demonstrated that JPZDD could effectively inhibit the abnormal behaviors of TS mice model, but also increase the level of DAT in striatum. Therefore, JPZDD could be one of potential treatments of patients with TS.

[Pollution characteristics and health risk assessment of atmospheric volatile organic compounds (VOCs) in pesticide factory].

A method for determining volatile organic compounds (VOCs) in air by summa canister collecting and gas chromatography/ mass spectroscopy detecting was adopted. Pollution condition and characteristics of VOCs were discussed in three representative pesticide factories in Zhangjiakou City, Hebei Province. Meanwhile, an internationally recognized four-step evaluation model of health risk assessment was applied to preliminarily assess the health risk caused by atmospheric VOCs in different exposure ways, inhalation and dermal exposure. Results showed that serious total VOCs pollution existed in all factories. Concentrations of n-hexane (6161.90-6910.00 microg x m(-3)), benzene (126.00-179.30 microg x m(-3)) and 1,3-butadiene (115.00-177.30 microg x m(-3)) exceeded the Chronic Inhalation Reference Concentrations recommended by USEPA, corresponding to 700, 30 and 2 microg x m(-3), respectively. Concentration of dichloromethane (724.00 microg x m(-3)) in factory B was also higher than the reference concentration (600 microg x m(-3)). Results of health risk assessment indicated that non-carcinogenic risk indexes of VOCs ranged from 1.00E-04 to 1.00E + 00 by inhalation exposure, and 1.00E-09 to 1.00E-05 by dermal exposure. Risk indexes of n-hexane and dichloromethane by inhalation exposure in all factories exceeded 1, and risk index of benzene by inhalation in factory B was also higher than 1. Carcinogenic risk indexes exposed to VOCs ranged from 1.00E-08 to 1.00E-03 by inhalation exposure and 1. oo00E -13 to 1.00E-08 by dermal exposure. Cancer risk of 1,3-butadiene by inhalation exceeded 1.0E-04, which lead to definite risk, and those of benzene by inhalation also exceeded the maximum allowable level recommended by International Commission on Radiological Protection (5.0E-05). The risks of dermal exposure presented the same trend as inhalation exposure, but the level was much lower than that of inhalation exposure. Thus, inhalation exposure of atmospheric VOCs was the dominant way of health risk in these factories.