RESUMO
SM03, an anti-CD22 recombinant IgG1 mAb, is currently in a phase III clinical trial for the treatment of rheumatoid arthritis (NCT04312815). SM03 showed good safety and efficacy in phase I systemic lupus erythematosus and phase II moderate to severe rheumatoid arthritis clinical trials. We propose the success of SM03 as a therapeutic to systemic autoimmune diseases is through the utilization of a novel mechanism of action unique to SM03. CD22, an inhibitory coreceptor of the BCR, is a potential immunotherapeutic target against autoimmune diseases. SM03 could disturb the CD22 homomultimeric configuration through disrupting cis binding to α2,6-linked sialic acids, induce rapid internalization of CD22 from the cell surface of human B cells, and facilitate trans binding between CD22 to human autologous cells. This in turn increased the activity of the downstream immunomodulatory molecule Src homology region 2 domain-containing phosphatase 1 (SHP-1) and decreased BCR-induced NF-κB activation in human B cells and B cell proliferation. This mechanism of action gives rationale to support the significant amelioration of disease and good safety profile in clinical trials, as by enabling the "self" recognition mechanism of CD22 via trans binding to α2,6 sialic acid ligands on autologous cells, SM03 specifically restores immune tolerance of B cells to host tissues without affecting the normal B cell immune response to pathogens.
Assuntos
Artrite Reumatoide , Lúpus Eritematoso Sistêmico , Artrite Reumatoide/terapia , Humanos , Ligantes , Ácido N-Acetilneuramínico , Polissacarídeos , Receptores de Antígenos de Linfócitos B , Lectina 2 Semelhante a Ig de Ligação ao Ácido Siálico , Ácidos SiálicosRESUMO
BACKGROUND: Recently, circular RNA (circRNA) has become a vital targeted therapy gene for non-small-cell lung cancer (NSCLC) cells. CircRNA_0000877 (Circ_0000877) has been researched in diffuse large B-cell lymphoma (DLBCL). However, whether circ_0000877 regulated NSCLC cell progression is still poorly investigated. The research attempted to investigate the influence of circ_0000877 in NSCLC. METHODS: Circ_0000877 levels in NSCLC tissues and cell lines were determined applying RT-qPCR. Cell functions were evaluated by CCK-8, EdU, flow cytometry, ELISA, and western blot. Gene interactions were predicted by Cirular RNA interactome database and Target Scan website and certified by dual-luciferase reporter, RIP, and RNA pull-down assays. Finally, mice experimental model was established to explore the effects of circ_0000877 on tumor growth in vivo. RESULTS: The elevated trend of circ_0000877 expression was discovered in NSCLC tissues compared to para-carcinoma tissues. The clinicopathological data uncovered that up-regulated circ_0000877 was linked to tumor size, differentiation, and TNM stages of NSCLC patients. Knockdown of circ_0000877 inhibited the proliferation, triggered apoptosis, and prohibited immune escape in NSCLC cells. It was certified that miR-637 was directly interacted with circ_0000877 and targeted by E2F2. Overexpressed E2F2 strongly overturned the functions of circ_0000877 knockdown in NSCLC cells. Mice experimental data demonstrated that circ_0000877 knockdown suppressed tumor growth in vivo. CONCLUSION: The research demonstrated that circ_0000877 exhibited the promotive effect on NSCLC cells proliferation and immune escape by regulating miR-637/E2F2 axis.
Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , MicroRNAs , Humanos , Animais , Camundongos , Carcinoma Pulmonar de Células não Pequenas/genética , RNA Circular/genética , Neoplasias Pulmonares/genética , Proliferação de Células/genética , MicroRNAs/genética , Linhagem Celular Tumoral , Fator de Transcrição E2F2RESUMO
PURPOSE: The toughest challenge in pedestrian traffic accident identification lies in ascertaining injury manners. This study aimed to systematically simulate and parameterize 3 types of craniocerebral injury including impact injury, fall injury, and run-over injury, to compare the injury response outcomes of different injury manners. METHODS: Based on the total human model for safety (THUMS) and its enhanced human model THUMS-hollow structures, a total of 84 simulations with 3 injury manners, different loading directions, and loading velocities were conducted. Von Mises stress, intracranial pressure, maximum principal strain, cumulative strain damage measure, shear stress, and cranial strain were employed to analyze the injury response of all areas of the brain. To examine the association between injury conditions and injury consequences, correlation analysis, principal component analysis, linear regression, and stepwise linear regression were utilized. RESULTS: There is a significant correlation observed between each criterion of skull and brain injury (p < 0.01 in all Pearson correlation analysis results). A 2-phase increase of cranio-cerebral stress and strain as impact speed increases. In high-speed impact (> 40 km/h), the Von Mises stress on the skull was with a high possibility exceed the threshold for skull fracture (100 MPa). When falling and making temporal and occipital contact with the ground, the opposite side of the impacted area experiences higher frequency stress concentration than contact at other conditions. Run-over injuries tend to have a more comprehensive craniocerebral injury, with greater overall deformation due to more adequate kinetic energy conduction. The mean value of maximum principal strain of brain and Von Mises stress of cranium at run-over condition are 1.39 and 403.8 MPa, while they were 1.31, 94.11 MPa and 0.64, 120.5 MPa for the impact and fall conditions, respectively. The impact velocity also plays a significant role in craniocerebral injury in impact and fall loading conditions (the p of all F-test < 0.05). A regression equation of the craniocerebral injury manners in pedestrian accidents was established. CONCLUSION: The study distinguished the craniocerebral injuries caused in different manners, elucidated the biomechanical mechanisms of craniocerebral injury, and provided a biomechanical foundation for the identification of craniocerebral injury in legal contexts.
Assuntos
Acidentes de Trânsito , Traumatismos Craniocerebrais , Análise de Elementos Finitos , Pedestres , Humanos , Fenômenos Biomecânicos , Estresse MecânicoRESUMO
From the perspective of forensic wound age estimation, experiments related to skeletal muscle regeneration after injury have rarely been reported. Here, we examined the time-dependent expression patterns of multiple biomarkers associated with satellite cell fate, including the transcription factor paired box 7 (Pax7), myoblast determination protein (MyoD), myogenin, and insulin-like growth factor (IGF-1), using immunohistochemistry, western blotting, and quantitative real-time PCR in contused skeletal muscle. An animal model of skeletal muscle contusion was established in 30 Sprague-Dawley male rats, and another five rats were employed as non-contused controls. Morphometrically, the data obtained from the numbers of Pax7 + , MyoD + , and myogenin + cells were highly correlated with the wound age. Pax7, MyoD, myogenin, and IGF-1 expression patterns were upregulated after injury at both the mRNA and protein levels. Pax7, MyoD, and myogenin protein expression levels confirmed the results of the morphometrical analysis. Additionally, the relative quantity of IGF-1 protein > 0.92 suggested a wound age of 3 to 7 days. The relative quantity of Pax7 mRNA > 2.44 also suggested a wound age of 3 to 7 days. Relative quantities of Myod1, Myog, and Igf1 mRNA expression > 2.78, > 7.80, or > 3.13, respectively, indicated a wound age of approximately 3 days. In conclusion, the expression levels of Pax7, MyoD, myogenin, and IGF-1 were upregulated in a time-dependent manner during skeletal muscle wound healing, suggesting the potential for using them as candidate biomarkers for wound age estimation in skeletal muscle.
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Contusões , Células Satélites de Músculo Esquelético , Ratos , Animais , Masculino , Miogenina/genética , Miogenina/metabolismo , Fator de Crescimento Insulin-Like I/genética , Fator de Crescimento Insulin-Like I/metabolismo , Ratos Sprague-Dawley , Músculo Esquelético/metabolismo , Contusões/metabolismo , Biomarcadores/metabolismo , RNA Mensageiro/metabolismo , Células Satélites de Músculo Esquelético/metabolismo , Proteína MyoD/genética , Proteína MyoD/metabolismoRESUMO
The finite element method (FEM) is a mathematical method for obtaining approximate solutions to a wide variety of engineering problems. With the development of computer technology, it is gradually applied to the study of biomechanics of human body. The application of the combination of FEM and biomechanics in exploring the relationship between vascular injury and disease, and pathological mechanisms will be a technological innovation for traditional forensic medicine. This paper reviews the construction and development of human vascular FEM modeling, and its research progress on the vascular biomechanics. This paper also looks to the application prospects of FEM modeling in forensic pathology.
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Medicina Legal , Modelos Biológicos , Humanos , Simulação por Computador , Fenômenos Biomecânicos , Análise de Elementos FinitosRESUMO
OBJECTIVES: To explore the difference in CT values between pulmonary thromboembolism and postmortem clot in postmortem CT pulmonary angiography (CTPA) to further improve the application value of virtual autopsy. METHODS: Postmortem CTPA data with the definite cause of death from 2016 to 2019 were collected and divided into pulmonary thromboembolism group (n=4), postmortem clot group (n=5), and control group (n=5). CT values of pulmonary trunk and left and right pulmonary artery contents in each group were measured and analyzed statistically. RESULTS: The average CT value in the pulmonary thromboembolism group and postmortem clot group were (168.4±53.8) Hu and (282.7±78.0) Hu, respectively, which were lower than those of the control group (1 193.0±82.9) Hu (P<0.05). The average CT value of the postmortem clot group was higher than that of the pulmonary thromboembolism group (P<0.05). CONCLUSIONS: CT value is reliable and feasible as a relatively objective quantitative index to distinguish pulmonary thromboembolism and postmortem clot in postmortem CTPA. At the same time, it can provide a scientific basis to a certain extent for ruling out pulmonary thromboembolism deaths.
Assuntos
Embolia Pulmonar , Trombose , Humanos , Autopsia , Embolia Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Angiografia , CadáverRESUMO
The present study combined three-dimensional (3D) motion capture with finite element simulation to reconstruct a real shaking adult syndrome (SAS) case and further explore the injury biomechanics of SAS. The frequency at which an adult male can shake the head of another person, head-shaking amplitude, and displacement curves was captured by the VICON 3D motion capture system. The captured shaking frequency and shaking curve were loaded on the total human model for safety (THUMS) head to simulate the biomechanical response of brain injury when a head was shaken in anterior-posterior, left-right, and left anterior-right posterior directions at frequencies of 4 Hz (Hz), 5 Hz, 6 Hz, and 7 Hz. The biomechanical response of the head on impact in the anterior, posterior, left, left anterior, and right posterior directions at the equivalent velocity of 6 Hz shaking was simulated. The violent shaking frequency of the adult male was 3.2-6.8 Hz; head shaking at these frequencies could result in serious cerebral injuries. SAS-related injuries have obvious directionality, and sagittal shaking can easily cause brain injuries. There was no significant difference between the brain injuries caused by shaking in the simulated frequency range (4-7 Hz). Impact and shaking at an equivalent velocity could cause brain injuries, though SAS more commonly occurred due to the cumulative deformation of brain tissue. Biomechanical studies of SAS should play a positive role in improving the accuracy of forensic identification and reducing this form of abuse and torture in detention or places of imprisonment.
Assuntos
Lesões Encefálicas Traumáticas , Síndrome do Bebê Sacudido , Adulto , Anodontia , Fenômenos Biomecânicos , Mama/anormalidades , Hemorragia Cerebral , Displasia Ectodérmica , Análise de Elementos Finitos , Humanos , Obstrução dos Ductos Lacrimais , Deformidades Congênitas dos Membros , Masculino , Modelos Biológicos , Unhas Malformadas , Transtornos da Pigmentação , Síndrome do Bebê Sacudido/etiologiaRESUMO
OBJECTIVES: To explore the application value of virtual autopsy to obtain key evidence information on drowned corpses and its application value of virtual autopsy in the diagnosis of drowning. METHODS: In this study, 7 corpses were selected as the research objects. The image data of corpses were collected by computed tomography (CT) before conventional autopsy. The characteristics of corpses were observed through image reading, combined with virtual measurement indexes, and compared with 15 non-drowned corpses. RESULTS: The postmortem CT of drowning showed the more fluid in respiratory tract than the non-drowning, and ground-glass opacities in the lung. The statistical volume of fluid in the sinus (maxillary sinus and sphenoid sinus) was (10.24±4.70) mL in drowning cases and (2.02±2.45) mL in non-drowning cases. The average CT value of fluid in the sinus, left atrial blood and gastric contents in drowning cases were (15.91±17.20), (52.57±9.24) and (10.33±12.81) HU, respectively, which were lower than those in non-drowning cases (P<0.05). CONCLUSIONS: The comprehensive consideration of multiple characteristic image manifestations and the virtual measurement indexes are helpful to the forensic pathological diagnosis of drowning. Virtual autopsy can be used as an auxiliary method in the forensic diagnosis of drowning.
Assuntos
Afogamento , Autopsia/métodos , Cadáver , Afogamento/diagnóstico por imagem , Patologia Legal/métodos , Humanos , Tomografia Computadorizada por Raios X/métodosRESUMO
Forensic scholars are paying more attention to postmortem computed tomography (PMCT) and PMCT angiography (PMCTA), which are gradually becoming effective and practical methods in forensic practice. However, few studies have focused on the application of PMCTA to cardiac ventricular puncture-especially of the right ventricle. In this article, we introduce a pulmonary PMCTA approach by right ventricle cardiac puncture and its potential value in fatalities from pulmonary thromboembolism (PTE). The procedure was performed on 11 males and 6 females. PMCT was performed first; then a biopsy core needle was used for percutaneous puncture of the right ventricle under CT guidance. About 400 mL of contrast media was injected at a rate of 50 mL/8 s, followed by CT scanning. Visualization of the pulmonary artery contrast filling was complete in 9 cadavers, and the pulmonary arteries showed significant filling defects in 8 subjects. Unlike in clinical practice, the phenomenon of postmortem coagulation sometimes occurs in the vascular lumina after death. Therefore, the results of these 8 cases can only suggest or be highly suspicious of death from PTE. Then autopsy and histopathological examination confirmed that 4 of the above 8 patients were diagnosed with PTE; the remaining 4 had postmortem clot including chicken fat clot in the pulmonary artery. Pulmonary PMCTA approach is a simple, convenient, and effective method for the visualization of the pulmonary artery, which can be used as an effective auxiliary tool to identify PTE in forensic practice. It will also provide technical support to further investigate PTE imaging characteristics.
Assuntos
Autopsia , Angiografia por Tomografia Computadorizada/métodos , Ventrículos do Coração , Artéria Pulmonar/diagnóstico por imagem , Embolia Pulmonar/diagnóstico , Punções/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Medicina Legal , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The pharmacokinetics, safety, and clinical activity of antibodies targeting CD22 have been evaluated in systemic lupus erythematosus (SLE) and non-Hodgkin lymphoma (NHL) patients, however, there have been no reports for the rheumatoid arthritis (RA) population. SM03 is a novel chimeric IgG1 monoclonal antibody which targets the B-cell-restricted antigen CD22. This is the first study of the anti-CD22 antibody in RA patients. OBJECTIVES: This study was designed to preliminarily evaluate the pharmacokinetics, pharmacodynamics, safety, and clinical activity profiles of the anti-CD22 monoclonal antibody SM03 in Chinese patients with active RA. MATERIALS AND METHODS: This study was an open phase I study in 8 RA patients. Eligible patients received two 600 mg doses of SM03 administered through intravenous infusions given 2 weeks apart and were monitored over an 84-day observation period for pharmacokinetics, pharmacodynamics, immunogenicity, safety, and clinical responses. RESULTS: After multiple doses of SM03, the maximum serum concentration of SM03 was reached within 2 - 4 hours. Mean elimination half-life was 16 days (range: 13 - 22 days). Half of the patients responded according to ACR and DAS28 assessments, and CD19+ B lymphocyte counts decreased. Upper respiratory tract infections and headaches were the most common adverse events (AEs). No drug-related serious AEs were reported. CONCLUSION: This study is the first to report on the preliminary pharmacokinetics, pharmacodynamics, clinical activity, and safety of SM03 in RA patients. All AEs were mild or moderate in severity. SM03 showed potential efficacy in RA patients.
Assuntos
Artrite Reumatoide , Lúpus Eritematoso Sistêmico , Animais , Anticorpos Monoclonais/efeitos adversos , Artrite Reumatoide/tratamento farmacológico , Humanos , Infusões Intravenosas , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Camundongos , Resultado do TratamentoRESUMO
Diabetic nephropathy (DN), a frequent diabetes complication, has complex pathogenesis. Circular RNAs (circRNAs) circ_0000712 has been reported to be upregulated in kidney tissues and high glucose (HG)-inducted Mesangial cells (MCs). This study is designed to explore the role and mechanism of circ_0000712 in the HG-inducted MCs injury in DN. Circ_0000712, microRNA-879-5p (miR-879-5p), and SRY-Box Transcription Factor 6 (SOX6) levels were detected by real-time quantitative polymerase chain reaction (RT-qPCR). Cell apoptosis was examined by flow cytometry assay. Protein levels of B-cell lymphoma-2 (Bcl-2), Bcl-2 related X protein (Bax), fibronectin (FN), collagen type I (Col. I), collagen type IV (Col. IV), and SOX6 were assessed by western blot assay. Levels of interleukin-1ß (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA). Reactive oxygen species (ROS) generation, Lactate Dehydrogenase (LDH) activity, and Superoxide Dismutase (SOD) activity were detected by the corresponding kits. The binding relationship between miR-879-5p and circ_0000712 or SOX6 was predicted by starBase and Targetscan, and then verified by a dual-luciferase reporter and RNA Immunoprecipitation (RIP) assays. Circ_0000712 and SOX6 were highly expressed, and miR-879-5p was decreased in db/db DN mice and HG-inducted SV40-MES13 cells. Furthermore, circ_0000712 deficiency repressed HG-caused apoptosis, inflammation, oxidative stress, and fibrosis in SV40-MES13 cells. Mechanically, circ_0000712 could regulate SOX6 expression by sponging miR-879-5p. Circ_0000712 knockdown could hinder HG-inducted SV40-MES13 cell injury through targeting the miR-879-5p/SOX6 axis, implying a possible circRNA-targeted therapy for DN.
Assuntos
Apoptose , Nefropatias Diabéticas/metabolismo , Hiperglicemia/metabolismo , Inflamação/metabolismo , Células Mesangiais/metabolismo , RNA Circular/metabolismo , Fatores de Transcrição SOXD/metabolismo , Animais , Colágeno Tipo I/metabolismo , Colágeno Tipo IV/metabolismo , Fibronectinas/metabolismo , Interleucina-1beta/metabolismo , Interleucina-6/metabolismo , L-Lactato Desidrogenase/metabolismo , Camundongos , MicroRNAs/genética , MicroRNAs/metabolismo , Estresse Oxidativo , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , RNA Circular/genética , Espécies Reativas de Oxigênio/metabolismo , Fatores de Transcrição SOXD/genética , Superóxido Dismutase/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Proteína X Associada a bcl-2/metabolismoRESUMO
ABSTRACT: Postmortem computed tomography (PMCT), PMCT angiography, and 3-dimensonal (3D) printing technology are increasingly applied to forensic practice. Although their effectiveness is undeniably confirmed, their potential role in practice still needs to be further explored. Here, we report a typical case in which such 4 technologies were applied to a woman found dead with stomach content beneath the head on the pillow in her residence. At first, the cause of death was simply considered as hypertensive cerebral hemorrhage after preliminary examination. However, the initial judgment was questioned by her family for her devoid of hypertension history. As indicated by the targeted PMCT with cerebral angiography, the woman died of pathological cerebral hemorrhage due to arteriovenous malformation, which was still unconvincing enough for the family because in violent death, some cerebral hemorrhage could also be located in the same position. Finally, the family came to be convinced when the close connection between the deformed blood vessels and hematoma was perfectly demonstrated by the application of 3D printing technology. This study proved that it can be an efficient tool for identifying the cause of death when the integration is made of 3D printing technology and PMCT angiography, as a more intuitive evidence of forensic science.
Assuntos
Malformações Arteriovenosas/diagnóstico por imagem , Hemorragia Cerebral/etiologia , Angiografia por Tomografia Computadorizada , Morte Súbita/etiologia , Impressão Tridimensional , Adulto , Angiografia Cerebral , Feminino , Humanos , Ruptura Espontânea/diagnósticoRESUMO
Evaluation of postmortem interval (PMI) is of paramount importance to guide criminal investigations, especially when witnesses are not found. However, accurate PMI estimation is a challenging task in the forensic community due to the limitations of existing methods. The study aims to investigate the potential of attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy for predicting PMI based on vitreous humor (VH). VH samples were collected from 72 rabbits in the range of 0-48 h postmortem at a 6-h interval. Their FTIR spectra were normalized by the extended multiplicative signal correction (RMSC) and divided into calibration and validation sets. After analysis of the absorption bands, the Bayesian ridge regression (BRR), support vector regression (SVR), and artificial neural network (ANN) methods were established by the calibration set using a 10-fold cross-validation that was further used to predict the PMI in the validation set. The validity of the models was assessed by a permutation test. The current study demonstrated that multiple macromolecules in the VH samples were reflected in a FTIR spectrum, and the spectral absorption bands at 1313 and 925 cm-1 were highly correlated with PMI. The three models allowed generalization to the validation set due to similar R2 and errors between the calibration and validation tests. The highest accuracy with R2 = 0.983 and error = 2.018 h was achieved by the ANN model in the validation test. The results suggest that ATR-FTIR spectroscopy may be useful for VH analysis in order to predict PMI in the future. Graphical abstract á .
Assuntos
Mudanças Depois da Morte , Espectroscopia de Infravermelho com Transformada de Fourier/métodos , Corpo Vítreo/química , Algoritmos , Animais , Humanos , Masculino , Redes Neurais de Computação , CoelhosRESUMO
BACKGROUND Increased lipid accumulation in renal tubular epithelial cells (TECs) contributes to their injury and dysfunction and progression of tubulointerstitial fibrosis. Berberine (BBR), a natural plant alkaloid isolated from traditional medicine herbs, is effective in lowing serum lipid, and has a protective effect on chronic kidney disease (CKD) with dyslipidemia, including diabetic nephropathy. The aim of this study was to investigate the effect of BBR on palmitate (PA)-induced lipid accumulation and apoptosis in TECs. MATERIAL AND METHODS Human kidney proximal tubular epithelial cell line (HK-2) cells were treated with PA, BBR, and/or palmitoyltransferase 1A (CPT1A) inhibitor Etomoxir. Intracellular lipid content was assessed by Oil Red O and Nile Red staining. Cell apoptosis rate was evaluated by flow cytometry assay. The expression of apoptosis-related protein cleaved-caspase3 and fatty acid oxidation (FAO)-regulating proteins, including CPT1A, peroxisome proliferator-activated receptor α (PPARα), and PPARγ co-activator-1α (PGC1α), was measured by Western blot analysis and immunofluorescence. RESULTS In the present study, PA treatment increased intracellular lipid deposition accompanied by elevated apoptosis in TECs compared with control group, whereas the protein expression of CPT1A, PPARα, and PGC1α, did not correspondingly increase in TECs. BBR significantly up-regulated the protein expression of CPT1A, PPARα, and PGC1α in TECs treated with or without PA, and reversed PA-induced intracellular lipid accumulation and apoptosis. Moreover, the CPT1A inhibitor Etomoxir counteracted the protective effect of BBR in TECs. CONCLUSIONS These in vitro findings suggest that PA can induce intracellular lipid accumulation and apoptosis in TECs, and the mechanism may be associated with inducing defective FAO, whereas BBR can protect TECs against PA-induced intracellular lipid accumulation and apoptosis by promoting FAO.
Assuntos
Apoptose/efeitos dos fármacos , Berberina/farmacologia , Células Epiteliais/patologia , Túbulos Renais/patologia , Palmitatos/toxicidade , Substâncias Protetoras/farmacologia , Carnitina O-Palmitoiltransferase/antagonistas & inibidores , Carnitina O-Palmitoiltransferase/metabolismo , Linhagem Celular , Células Epiteliais/efeitos dos fármacos , Células Epiteliais/metabolismo , Humanos , Metabolismo dos Lipídeos/efeitos dos fármacos , Oxirredução/efeitos dos fármacosRESUMO
This report presents a case of a 52-year-old man who had a traffic accident and died later. External examination could not determine the cause of death. Approximately 3 weeks later, an autopsy was performed. Postmortem computed tomography was performed before the autopsy. Postmortem imaging was interpreted to show hemorrhage beneath the tentorium, and the C5 to C6 (the fifth and sixth cervical vertebra) disc space was widened. During the autopsy, a cervical spinal cord injury was confirmed. However, a meningioma was found under the tentorium instead of a hemorrhage. There are a number of reasons that include postmortem changes that affected the virtopsy diagnosis, which still needs development.
Assuntos
Erros de Diagnóstico , Meningioma/patologia , Neoplasias da Medula Espinal/patologia , Medula Espinal/patologia , Acidentes de Trânsito , Hemorragia Cerebral/diagnóstico , Vértebras Cervicais/lesões , Vértebras Cervicais/patologia , Humanos , Masculino , Meningioma/diagnóstico , Pessoa de Meia-Idade , Medula Espinal/diagnóstico por imagem , Traumatismos da Medula Espinal/patologia , Neoplasias da Medula Espinal/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: The aim of this study was to identify the diffuse axonal injury (DAI) of rat through screening out differentially expressed proteins which may represent potential biomarkers by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) imaging mass spectrometry (IMS), which could make a contribution for the research of forensic pathology. METHODS: A total of 15 brainstem sections of rats (10 with and 5 without DAI) were conducted by MALDI-TOF IMS. Specific protein expression patterns were obtained for normal and DAI regions within the tissue sections. "Supervised Neural Network" algorithm was used to classify the DAI group from the normal group. RESULTS: Applying a "Supervised Neural Network" algorithm, we were able to distinguish between normal and DAI regions with an overall cross-validation, a sensitivity and specificity of 95.67%, 99.34%, and 92.01%, respectively. Additionally, 4 distinctively overexpressed peaks were identified: 7059 and 1518 Da for DAI sections, and 5077 and 4327 Da for normal sections. CONCLUSIONS: This study reveals the value of MALDI-TOF IMS to classify between normal and injured tissues and identify candidates for DAI biomarkers which will provide data to eventually understand the pathological mechanisms relevant to DAI, which is a great help in forensic pathology.
Assuntos
Tronco Encefálico/patologia , Lesão Axonal Difusa/patologia , Espectrometria de Massas , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Algoritmos , Animais , Patologia Legal/métodos , Masculino , Redes Neurais de Computação , Proteômica , Ratos Sprague-Dawley , Sensibilidade e EspecificidadeRESUMO
This report presents a case of a 40-year-old woman who was found dead in her house. The examination of the body revealed no external injuries. The whole body was scanned by multi-detector-row computed tomography (CT) before autopsy, revealing massive hemorrhage in the right frontal extending into the ventricular system. At autopsy, the brain parenchyma was removed. Then CT angiography was carried on the isolated brain. Computed tomography angiography suggested a mass of irregular, tortuous vessels in areas of hemorrhage in the right frontal lobe of the brain. Finally, histological examination confirmed the result of CT angiography due to an arteriovenous malformation. Hence, postmortem CT angiography played an important role in diagnosis of the cerebral arteriovenous malformation that was responsible for a massive hemorrhage in the skull.
Assuntos
Hemorragia Cerebral/etiologia , Angiografia por Tomografia Computadorizada , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Adulto , Evolução Fatal , Feminino , HumanosRESUMO
OBJECTIVE: To investigate the knowledge and willingness of breast cancers patients from Shanghai for genetic counseling and gene testing. METHODS: A total of 428 patients filled out the questionnaire and the data was statistically analyzed. RESULTS: Most of the patients were unaware of genetic counseling and gene testing. But after a brief introduction, a majority of them were willing to accept genetic counseling and recommend their family members to participate. The willingness was education- and age-related. When told that gene testing may benefit themselves, 92.1% of the patients were willing to be tested. However, when told that gene testing may only benefit their family, only 33.9% of the patients were willing to join the testing. The acceptance was also age-, education- and family income-related. The difference was statistically significant. Moreover, the willingness ratio to participate the gene testing was lower than expected. Overall, 74.1% of the patients were willing to accept cheaper preliminary gene screening, whilst only 19.2% were willing to accept genetic testing of higher price. Despite of being told that testing results will be maintained as confidential, still 43.2% worried about adverse effects. Such patients tended to younger, from low-income families, with a family history of associated cancers, or personal history of other cancers. The difference was statistically significant. CONCLUSION: The majorities of patients do not know but are willing to accept genetic counseling and gene testing and recommend their family to participate. Lack of genetic knowledge, cost for the testing and concerns about discrimination are the obstacles for patients to participate in genetic counseling and gene testing. To spread the knowledge about breast cancer and establish a follow-up screening system for high-risk population may improve the tertiary prevention for breast cancer.
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Neoplasias da Mama/genética , Aconselhamento Genético , Testes Genéticos , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Idoso , Povo Asiático/genética , Povo Asiático/estatística & dados numéricos , Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etnologia , Distribuição de Qui-Quadrado , China , Escolaridade , Feminino , Predisposição Genética para Doença/genética , Humanos , Pessoa de Meia-Idade , Classe SocialRESUMO
OBJECTIVE: To establish a diagnostic model for diffuse axonal injury (DAI) by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). To screen the proteins or peptides associated with DAI for providing the biomarkers with theoretic foundation. METHODS: Fifteen male Sprague-Dawley rats were randomly divided into DAI group (n = 10) and control group (n = 5). The protein or peptide expression profiles of rat brain stem were detected by MALDI-TOF-MS. ClinProTools 2.2 software was used to find specific peaks, and a diagnostic model was established by the genetic algorithm. RESULTS: There were significant differences in 61 peaks of DAI group (P < 0.05), 9 peaks were down-regulated and 52 up-regulated. The diagnostic model was established based on 5 different peaks. The specificity and sensitivity of cross validation was 96.14% and 95.98%; while the specificity and sensitivity of blind validation showed was 73.33% and 70.00%, respectively. CONCLUSION: A specific and sensitive diagnostic model of DAI can be established by MALDI-TOF-MS to provide a potential value for determining DAI in forensic practice.
Assuntos
Tronco Encefálico/metabolismo , Lesão Axonal Difusa/diagnóstico , Peptídeos/sangue , Proteômica , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Animais , Biomarcadores , Lesão Axonal Difusa/sangue , Regulação para Baixo , Masculino , Ratos , Ratos Sprague-Dawley , Sensibilidade e Especificidade , Software , Regulação para CimaRESUMO
Matrix-assisted laser desorption/ionization time-of-flight imaging mass spectrometry (MALDI-TOF-IMS) has been a classical technique for studying proteomics in present and a tool for analyzing the distribution of proteins and small molecules within biological tissue sections. MALDI-TOF-IMS can analyze multiple unknown compounds in biological tissue sections simultaneously through a single measurement which can obtain molecule imaging of the tissue while maintaining the integrity of cellular and molecules in tissue. In recent years, imaging mass spectrometry technique develops relatively quickly in all biomedical domain. This paper based on the relevant data and reviews the present developing level of MALDI-TOF-IMS, the principle of imaging mass spectrometry, methology and the prospect in forensic pathology.