Individual differences in relative fertility costs and fertility benefits and their effects on fertility desire for a second child in China: a latent profile analysis.

BACKGROUND: Fertility desire for a second child has been a lively topic since the implementation of the two-child policy in China. Chinese researchers have explored various factors influencing the fertility desire for a second child. However, there have not been studies on the individual differences in the relative fertility costs and fertility benefits and their effects on fertility desire for a second child. METHODS: A total of 396 participants rated four kinds of relative fertility costs, four kinds of fertility benefits and their fertility desire for a second child. Latent profile analysis (LPA) was used to explore the individual differences in the relative fertility costs and fertility benefits and their effects on fertility desire for a second child. RESULTS: Stepwise regression analysis showed that parenting joy, health risks, mutual care among siblings, the flourishing of family, and time pressure and opportunity cost significantly predicted the fertility desire for the second child. According to the latent profile analysis, the participants were classified into four classes. Participants in the lowest-cost/lowest-benefit and high-cost/medium-benefit classes had low fertility desire for a second child, while those in the low-cost/high-benefit and highest-cost/highest-benefit classes had high fertility desire. CONCLUSION: Fertility benefits have a stronger effect on the fertility desire for a second child than relative fertility costs. Fertility benefits should be paid more attention to than relative fertility costs.

Bradykinin regulates the expression of claudin-5 in brain microvascular endothelial cells via calcium-induced calcium release.

To investigate the mechanism underlying the regulation of claudin-5, a tight junction protein that participates primarily in the constitution of the blood-brain barrier by bradykinin (BK), we established a primary culture of rat brain microvascular endothelial cells (BMECs). BMECs were treated with 10(-5) M BK, and changes in the intracellular Ca(2+) levels were measured by using the sensitive fluorescent dye fluo-3; the expression and distribution of claudin-5 were investigated by immunocytochemistry and Western blot analyses. We did not detect any expression of bradykinin B2 receptors in the BMECs or freshly isolated rat brain microvessels. We found that 10(-5) M BK triggered Ca(2+) transients in BMECs, and further investigations revealed that inositol 1,4,5-trisphosphate receptors (IP3 Rs) and ryanodine receptors (RyRs) on the endoplasmic reticulum (ER) were responsible for the Ca(2+) fluctuation. Consequently, these intracellular Ca(2+) changes that occur in response to BK application were identified as Ca(2+) -induced Ca(2+) release (CICR). Immunocytochemistry and Western blot results demonstrated that 10(-5) M BK could cause the internalization and a decrease in the expression of claudin-5; agonists of IP3 Rs and RyRs, such as IP3 and caffeine, enhanced the BK-induced downregulation of claudin-5, whereas antagonists of IP3 Rs and RyRs, such as 2-APB and ryanodine, abrogated BK's effect on claudin-5. In conclusion, the BK-induced CICR in primary culture BMECs might be the mechanism by which BK modulates claudin-5.

Performance Comparison of Public Hospitals Between 2014 and 2018 in Different Regions of Guangdong Province, China, Following 2017 Medical Service Price Reforms.

This study analyzed performance of public hospitals and regional differences in performance following reform of medical service prices in Guangdong province, China. From three cities in four regions, we randomly selected a total of 12 traditional Chinese medicine hospitals and 12 general tertiary hospitals. Six questionnaires were completed by the hospitals, using 2014-2018 internal data. Principal components analysis was used to compare performances of the hospitals and regions following price reform. The extent to which medical service prices were adjusted varied considerable for different procedures in the same region and for the same category of procedures among regions. After reform, compensation for medical services in public hospitals reached the target of 80%, except in the Western region. However, annual growth of costs to patients was generally above 4%; the burden on patients was not alleviated by fee control. Reforms were more effective for comprehensive than Chinese traditional medicine hospitals. Performance scores of general hospitals in the Pearl River Delta, Eastern, Western, and Northern regions were 1.24, 1.16, -0.22, and -1.01, respectively. This is consistent with ranking by level of economic development of each region. The government should implement a regional medical service pricing mechanism. Additionally, comprehensive and traditional Chinese medicine hospitals should each have appropriate pricing policies. Future policies should focus on controlling costs incurred by patients.

[Analysis of surgical treatment strategies of petroclival region tumors].

OBJECTIVE: To explore the surgical strategy of the tumors of petroclival region. METHODS: The surgical data of 55 cases presented with meningioma and trigeminal nerve sheath tumors from January 2002 to February 2009 was retrospectively analyzed. All the cases were divided into full-cut group, sub-total resection group, part of resection group or divided into full-cut group and no-total resection group, in terms of various surgical strategy. The incidence of postoperative neurological disorder and quality of life status were focused and statistical analysis was carried out. RESULTS: There were 21 patients with complete cut, 22 patients with sub-total resection and 12 patients with part of resection. There were 12 patients with neurological deterioration in full-cut group and 10 patients in no-total resection group. There was significant difference between total resection group and no-total resection group (χ(2) = 4.16, P < 0.05). All the patients were assessed based on the criterion of KPS, 12 patients of full-cut whose KPS ≥ 80, 29 patients were the same in no-total resection group. There was significant difference between the two groups (χ(2) = 5.42, P < 0.05). The mean follow-up time was 3 years. No recurrence was found in full-cut group and 5 recurrence of no-total resection group. CONCLUSIONS: The pursuit of full-cut for the tumors of petroclival region may result in serious neurological dysfunction and poor life quality after the operation. Non-full-cut combination of postoperative radiotherapy may receive a relative better results.

Bradykinin selectively modulates the blood-tumor barrier via calcium-induced calcium release.

To investigate the underlying mechanism for the selective modulation of permeability of the blood-tumor barrier by small dose of BK, we established cell lines of rat brain microvascular endothelial cells (BMECs) and astrocytes by primary culture from neonatal rats. BMECs, astrocytes, or C6 glioma cells were treated with BK, and changes of intracellular NO and intracellular calcium level were measured with a fluorescent spectrophotometer. Similarly to the observations in astrocytes, although the initial application of BK easily triggered a ryanodine-mediated calcium-induced calcium release (CICR), we also detected a long-lasting intracellular nitric oxide (NO) elevation in C6 glioma cells upon BK treatment. However, BMECs are not the direct target of BK. Further study showed that ryanodine-mediated CICR contributes greatly to the secondary NO elevation induced by BK treatment. With an in vitro blood-tumor barrier (BTB) model, we demonstrated that NO generated in C6 glioma cells might act as an intercellular messenger and play an important role in the selective modulation of permeability of BMECs by BK. In conclusion, BK triggered CICR in C6 glioma cells, and the associated NO generation might be the underlying mechanism for the selective modulation of BTB permeability by BK.

SRPK1 gene silencing promotes vascular smooth muscle cell proliferation and vascular remodeling via inhibition of the PI3K/Akt signaling pathway in a rat model of intracranial aneurysms.

OBJECTIVE: Intracranial aneurysm (IA) is a life threatening cerebrovascular disease characterized by phenotypic modulation of vascular smooth muscle cells (VSMCs) and loss of vessel cells. In addition to environmental factors, genetic factors have been proposed to be a critical factor in the onset and progression of IA. The present study investigates the effects of serine-arginine protein kinase 1 (SRPK1) on VSMC proliferation and apoptosis both in vivo and in vitro, as well as its role in vascular remodeling in vivo through PI3 K/Akt signaling in IA. METHODS: Differentially expressed genes related to IA were initially identified using microarray analysis. Immunohistochemistry was conducted to determine SRPK1 expression in the vascular walls in IA and normal cerebral vascular walls. TUNEL staining were applied to observe cell apoptosis patterns of VSMCs. VSMC proliferation and apoptosis in vitro were detected by cell counting kit-8 (CCK8) assay and flow cytometry. The expressions of SRPK1, PI3 K/Akt signaling pathway- and apoptosis-related genes were evaluated by RT-qPCR and Western blot analysis. RESULTS: Microarray data of GSE36791 and GSE54083 were analyzed to determine the selection of SRPK1 gene. The vascular walls in IA rat models produced high levels of SRPK1 expression and an activated PI3 K/Akt signaling pathway. VSMCs treated with siRNA-SRPK1 exhibited enhanced cell proliferation, repressed cell apoptosis, and increased vascular remodeling, all of which suggest the inhibition of the PI3 K/AKT pathway. Notably, PI3 K/AKT pathway reversed the effect of SRPK1 silencing. CONCLUSION: Our results show that siRNA-mediated silencing of SRPK1 gene inhibits VSMC apoptosis, and increases VSMCs proliferation and vascular remodeling in IA via the PI3 K/Akt signaling pathway. Our findings provide a novel intervention target for the molecular treatment of IA.

Bromocriptine-responsive supersellar germinoma with the expression of dopamine receptors: A case report.

BACKGROUND: Germinomas are sensitive to radiotherapy and chemotherapy. However, there has been no report involving in the potential therapeutic effect of dopamine agonists (DAs) such as bromocriptine on germinomas. CASE DESCRIPTION: A 20-year-old female was presented with bitemporal visual disturbance and amenorrhea. Magnetic resonance imaging demonstrated a huge sellar tumor with upward extension and invasion of the parasellar region. The blood tests showed an exceedingly high level of prolactin. A sellar tumor with hyperprolactinemia was diagnosed, and bromocriptine was initially given. After three months, the tumor volume had been obviously decreased by 82%. However, the tumor re-grew after ten months and the endoscopic endonasal surgery was performed. Histopathological and immunohistochemical examination indicated the patient had a pure sellar germinoma. The tumor cells strongly expressed dopamine 2 receptor and dopamine 5 receptor, which located in the membrane and cytoplasm. CONCLUSIONS: The transient but significant partial responsiveness of germinoma to bromocriptine treatment in this patient is a novel discovery, suggesting that DAs may be a potential therapeutic choice for tumors with the expression of dopamine 2/5 receptors.

Bradykinin increases blood-tumor barrier permeability by down-regulating the expression levels of ZO-1, occludin, and claudin-5 and rearranging actin cytoskeleton.

Bradykinin (BK) has been shown to open blood-tumor barrier (BTB) selectively and to increase permeability of the BTB transiently, but the mechanism is unclear. This study was performed to determine whether BK opens the BTB by affecting the tight junction (TJ)-associated proteins zonula occluden-1 (ZO-1), occludin, and caludin-5 and cytoskeleton protein filamentous actin (F-actin). In rat brain glioma model and BTB model in vitro, we find that the protein expression levels of ZO-1, occludin, and claudin-5 are attenuated by BK induction. Immunohistochemistry and immunofluorescence assays show that the attenuated expression of ZO-1, occludin, and claudin-5 and F-actin is most obvious in the smaller tumor capillaries (<20 microm) after BK infusion, and there is no change in the larger tumor capillaries (>20 microm). The redistribution of ZO-1, occludin, and claudin-5 and rearrangement of F-actin in brain microvascular endothelial cells are observed at the same time. Meanwhile, Evans blue assay shows that the permeability of BTB increases after BK infusion. Transmission electron microscopy indicates that TJ is opened and that pinocytotic vesicular density is increased. Transendothelial electrical resistance (TEER) and horseradish peroxidase flux assays also reveal that TJ is opened by BK induction. In addition, radioimmunity and Western blot assay reveal a significant decrease in expression levels of cAMP and catalytic subunit of protien kinase A (PKAcs) of tumor tissue. This study demonstrates that the increase of BK-mediated BTB permeability is associated with the down-regulation of ZO-1, occludin, and claudin-5 and the rearrangement of F-actin and that cAMP/PKA signal transduction system might be involved in the modulating process.

Clival metastasis of renal clear cell carcinoma: Case report and literature review.

The clivus is an atypical metastatic site for renal clear cell carcinoma (RCCC). Here we report a 54 year old man with acute cavernous sinus syndrome. Brain magnetic resonance imaging identified a clival-based lesion with associated bony erosion. The patient underwent endoscopic endonasal biopsy and partial resection of the clival mass. Because histologic examination of the resected specimen resulted in a diagnosis of RCCC, contrast-enhanced computed tomography scan of the abdomen was performed and showed an enhanced left renal mass. The patient subsequently underwent laparoscopic left radical nephrectomy and gamma knife was planned for the residual clival lesion. We also retrospectively reviewed available published reports on clival metastases, specifically those from RCCC, since 1990.

Low dose of bradykinin selectively increases intracellular calcium in glioma cells.

To investigate the underlying basis for the selective modulation of the permeability of the blood-brain barrier by small doses of bradykinin, we first established cell lines of rat brain microvascular endothelial cells (BMECs) and astrocytes by primary cultures from neonatal rats. BMECs, astrocytes and C6 glioma cells were treated with different concentrations of BK (range from 10(-8) M to 10(-4) M), and changes of intracellular calcium levels were measured by fluorescence spectrophotometry. Expression levels of B2 receptors were analyzed by Western blot analysis. We found that a low dose (10(-6) M) of BK could trigger an elevation of intracellular calcium level in C6 glioma cells, whereas astrocytes responded to a higher concentration of BK (10(-5) M), and the BMECs remained unresponsive to BK. Western blot results showed that C6 glioma cells expressed the highest level of B2 receptors compared with primary astrocytes or BMECs. B2 receptors are highly expressed in glioma cells and a low dose of BK selectively increases the intracellular calcium level in tumor cells which, in turn, could contribute to the selective increase in the permeability of the blood-tumor barrier by small doses of BK.

Microsurgical management of dumbbell C1 and C2 schwannomas via the far lateral approach.

Dumbbell C1 and C2 schwannomas are rare and have a distinctive presentation and anatomical features. To study the clinical characteristics of these tumors, we reviewed the microsurgical management of 18 patients with dumbbell C1 and C2 schwannomas by the far lateral approach. Data regarding clinical manifestations, radiological findings and surgical results were analyzed retrospectively. Total and subtotal resection of the tumor was achieved in 15 and three patients, respectively. At the time of discharge, 12 patients showed improvement while five patients remained the same. The average follow-up duration was 43 months (range = 3-110 months); six of seven patients had recovery from local pain or numbness. With the exception of one patient with hemiplegia or hemiparesthesia preoperatively, all patients recovered within 6 months postoperatively. The far lateral approach offers adequate exposure and access with minimal neural manipulation for treating dumbbell C1 and C2 schwannomas, and is considered the preferred surgical approach for resection of these tumors located ventrally or ventrolaterally to the first two cervical vertebrae.

Initial bradykinin triggers calcium-induced calcium release in C6 glioma cells and its significance.

OBJECTIVE: To investigate the underlying mechanism for the selective modulation of the permeability of blood-tumor barrier (BTB) by small dose of bradykinin (BK). METHODS: C6 glioma cells were treated with BK, and changes of intracellular nitric oxide (NO) and intracellular calcium level were measured with fluorescent spectrophotometer. RESULTS: The initial application of BK easily triggered extracellular calcium influx, which resulted in intracellular calcium store release in C6 glioma cells. The above mechanism was also named ryanodine mediated calcium induced calcium release (CICR). We also detected a long-lasting intracellular NO elevation in C6 glioma cells upon BK treatment. Further study showed that ryanodine mediated CICR contributed greatly to the secondary NO elevation induced by BK treatment. CONCLUSION: These results suggested that BK triggered CICR in C6 glioma cells and the associated NO generation might be the underlying mechanism for the selective modulation of BTB permeability by BK.