Clinical observation of the reduced glutathione in the treatment of diabetic chronic kidney disease.

BACKGROUND: Diabetic chronic kidney disease (CKD) has become the main cause of death in diabetic patients, but its pathogenesis has not yet been clear. OBJECTIVE: To investigate the effects of reduced glutathione (GSH) on oxidative stress (OS), angiogenesis factors and lymphocyte subsets in diabetic CKD patients. METHODS: A total of 130 subjects were retrospectively studied. The subjects were divided into the control group (45 cases), treatment group (45 cases, treated with reduced GSH), and a healthy control group (40 cases). The levels of superoxide dismutase (SOD), advanced oxidation protein products (AOPP), malondialdehyde (MDA), endostatin (ES), and vascular endothelial growth factor (VEGF), and the percentages of lymphocyte subsets were detected. RESULTS: After treatment, the indexes of OS and angiogenesis and the percentage of CD3- CD19+ B cells were obviously decreased, and the percentages of T cell subsets and natural killer (NK) cell subsets were markedly increased in the treatment group compared with the control group. AOPP was positively correlated with angiogenesis indexes, MDA and CD3- CD19+ B cells, and negatively correlated with SOD and other lymphocyte subsets. SOD was inversely associated with angiogenesis indexes and MDA, and positively associated with lymphocyte subsets. Moreover, MDA had a positive correlation with angiogenesis indexes, B and T cell subsets, and a negative correlation with NK cell subsets. AOPP, MDA, SOD, VEGF, CD3+ T cells, CD3+ CD8+ T cells, CD3- CDl6+ CD56+ NK cells, and CD3- CDl6+ CD56+ NK T cells were the risk factors of diabetic CKD. CONCLUSION: GSH could inhibit OS and abnormal angiogenesis, and improve cellular immune response in CKD patients.

Differential responses of stressful elements to predatory exposure in behavior-lateralized mice.

BACKGROUND: Predatory stress as a psychological stressor can elicit the activation of the hypothalamic-pituitary-adrenal (HPA) axis, which is involved in the dialogue of the neuroimmunoendocrine network. The brain has been proven to regulate the activity of the HPA axis by way of lateralization. In the present study, we probed the pivotal elements of the HPA circuitry including CRH, GR and a multifunctional cytokine in behavior-lateralized mice to determine their changes when the animals were subjected to predator exposure. METHODS: Behavior-lateralized mice were classified into left-pawed and right-pawed mice through a paw-preference test. Thereafter, mice in the acute stress group received a single 60-min cat exposure, and mice in the chronic group received daily 60-min cat exposure for 14 consecutive days. The plasma CS and TNF-α were determined by ELISA, the hypothalamic CRH mRNA and hippocampal GR mRNA were detected by real-time PCR, and the hippocampal GR protein was detected by western blot analysis. RESULTS: The results revealed that the levels of plasma CS were significantly elevated after chronic predatory exposure in both right-pawed and left-pawed mice; the right-pawed mice exhibited a higher plasma CS level than the left-pawed mice. Similarly, the acute or chronic cat exposure could induce the release of plasma TNF-α, and the left-pawed mice tended to show a higher level after the acute stress. Chronic stress significantly upregulated the expression of hypothalamic CRH mRNA in both left-pawed and right-pawed mice. Normally, the left-pawed mice exhibited a higher GR expression in the hippocampus than the right-pawed mice. After the cat exposure, the expression of GR in both left-pawed and right-pawed mice was revealed to be greatly downregulated. CONCLUSION: Our findings indicate that predatory stress can invoke a differential response of stressful elements in behavior-lateralized mice. Some of these responses shaped by behavioral lateralization might be helpful for facilitating adaption to various stimuli.

Oxymatrine Inhibits Influenza A Virus Replication and Inflammation via TLR4, p38 MAPK and NF-κB Pathways.

Oxymatrine (OMT) is a strong immunosuppressive agent that has been used in the clinic for many years. In the present study, by using plaque inhibition, luciferase reporter plasmids, qRT-PCR, western blotting, and ELISA assays, we have investigated the effect and mechanism of OMT on influenza A virus (IAV) replication and IAV-induced inflammation in vitro and in vivo. The results showed that OMT had excellent anti-IAV activity on eight IAV strains in vitro. OMT could significantly decrease the promoter activity of TLR3, TLR4, TLR7, MyD88, and TRAF6 genes, inhibit IAV-induced activations of Akt, ERK1/2, p38 MAPK, and NF-κB pathways, and suppress the expressions of inflammatory cytokines and MMP-2/-9. Activators of TLR4, p38 MAPK and NF-κB pathways could significantly antagonize the anti-IAV activity of OMT in vitro, including IAV replication and IAV-induced cytopathogenic effect (CPE). Furthermore, OMT could reduce the loss of body weight, significantly increase the survival rate of IAV-infected mice, decrease the lung index, pulmonary inflammation and lung viral titter, and improve pulmonary histopathological changes. In conclusion, OMT possesses anti-IAV and anti-inflammatory activities, the mechanism of action may be linked to its ability to inhibit IAV-induced activations of TLR4, p38 MAPK, and NF-κB pathways.

Emodin Inhibition of Influenza A Virus Replication and Influenza Viral Pneumonia via the Nrf2, TLR4, p38/JNK and NF-kappaB Pathways.

Lasting activations of toll-like receptors (TLRs), MAPK and NF-κB pathways can support influenza A virus (IAV) infection and promote pneumonia. In this study, we have investigated the effect and mechanism of action of emodin on IAV infection using qRT-PCR, western blotting, ELISA, Nrf2 luciferase reporter, siRNA and plaque inhibition assays. The results showed that emodin could significantly inhibit IAV (ST169, H1N1) replication, reduce IAV-induced expressions of TLR2/3/4/7, MyD88 and TRAF6, decrease IAV-induced phosphorylations of p38/JNK MAPK and nuclear translocation of NF-κB p65. Emodin also activated the Nrf2 pathway, decreased ROS levels, increased GSH levelss and GSH/GSSG ratio, and upregulated the activities of SOD, GR, CAT and GSH-Px after IAV infection. Suppression of Nrf2 via siRNA markedly blocked the inhibitory effects of emodin on IAV-induced activations of TLR4, p38/JNK, and NF-κB pathways and on IAV-induced production of IL-1ß, IL-6 and expression of IAV M2 protein. Emodin also dramatically increased the survival rate of mice, reduced lung edema, pulmonary viral titer and inflammatory cytokines, and improved lung histopathological changes. In conclusion, emodin can inhibit IAV replication and influenza viral pneumonia, at least in part, by activating Nrf2 signaling and inhibiting IAV-induced activations of the TLR4, p38/JNK MAPK and NF-κB pathways.

Inhibition of Tanshinone IIA, salvianolic acid A and salvianolic acid B on Areca nut extract-induced oral submucous fibrosis in vitro.

Salvia miltiorrhiza Bunge has been reported to possess excellent antifibrotic activity. In this study, we have investigated the effect and mechanism of tanshinone IIA (Tan-IIA), salvianolic acid A (Sal-A) and salvianolic acid B (Sal-B), the important active compounds of Salvia miltiorrhiza Bunge, on areca nut extract (ANE)-induced oral submucous fibrosis (OSF) in vitro. Through human procollagen gene promoter luciferase reporter plasmid assay, hydroxyproline assay, gelatin zymography assay, qRT-PCR, ELISA and Western blot assay, the influence of these three compounds on ANE-stimulated cell viability, collagen accumulation, procollagen gene transcription, MMP-2/-9 activity, MMP-1/-13 and TIMP-1/-2 expression, cytokine secretion and the activation of PI3K/AKT, ERK/JNK/p38 MAPK and TGF-ß/Smads pathways were detected. The results showed that Tan-IIA, Sal-A and Sal-B could significantly inhibit the ANE-stimulated abnormal viability and collagen accumulation of mice oral mucosal fibroblasts (MOMFs), inhibit the transcription of procollagen gene COL1A1 and COL3A1, increase MMP-2/-9 activity, decrease TIMP-1/-2 expression and inhibit the transcription and release of CTGF, TGF-ß1, IL-6 and TNF-α; Tan-IIA, Sal-A and Sal-B also inhibited the ANE-induced activation of AKT and ERK MAPK pathways in MOMFs and the activation of TGF-ß/Smads pathway in HaCaT cells. In conclusion, Tan-IIA, Sal-A and Sal-B possess excellent antifibrotic activity in vitro and can possibly be used to promote the rehabilitation of OSF patients.

Panax notoginseng saponins inhibit areca nut extract-induced oral submucous fibrosis in vitro.

BACKGROUND: Oral submucous fibrosis (OSF) is a premalignant and fibrosing disease, which is closely associated with the habit of chewing areca nut. Panax notoginseng Buck F. H. Chen is an often used antifibrotic and antitumor agent. To treat areca nut-induced OSF, we have developed a chewable tablet, in which one of the major medicines is total Panax notoginseng saponins (PNS). In this study, we have investigated the antifibrotic effect and mechanism of PNS on areca nut-induced OSF in vitro. METHODS: Through human procollagen gene promoter luciferase reporter plasmid, hydroxyproline assay, gelatin zymography, qRT-PCR, ELISA, and Western blot, the influences of PNS on areca nut extract (ANE)-induced cell growth, collagen accumulation, procollagen gene transcription, MMP-2/-9 activity, MMP-1/-13 and TIMP-1/-2 expression, cytokine secretion, and the activation of PI3K/AKT, ERK/JNK/p38 MAPK, and TGFß/Smads pathways were detected. RESULTS: Panax notoginseng saponins could inhibit the ANE-induced abnormal growth and collagen accumulation of oral mucosal fibroblasts in a concentration-dependent manner. PNS (25 µg/ml) could significantly inhibit the ANE-induced expression of Col1A1 and Col3A1, augment the ANE-induced decrease of MMP-2/-9 activity, inhibit the ANE-induced increase of TIMP-1/-2 expression, and decrease the ANE-induced transcription and release of CTGF, TGFß1, IL-6, and TNFα. PNS (25 µg/ml) also significantly inhibited the ANE-induced activation of AKT and ERK/JNK/p38 MAPK pathways in oral mucosal fibroblasts and the ANE-induced activation of TGFß/smad pathway in HaCaT cells. CONCLUSION: Panax notoginseng saponins possess excellent anti-OSF activity, and its mechanism may be related to its ability to inhibit the ANE-induced activation of PI3K/AKT, ERK/JNK/p38 MAPK, and TGFß/smad pathways.

Identification of 23-(s)-2-amino-3-phenylpropanoyl-silybin as an antiviral agent for influenza A virus infection in vitro and in vivo.

It has been reported that autophagy is involved in the replication of many viruses. In this study, we screened 89 medicinal plants, using an assay based on the inhibition of the formation of the Atg12-Atg5/Atg16 heterotrimer, an important regulator of autophagy, and selected Silybum marianum L. for further study. An antiviral assay indicated that silybin (S0), the major active compound of S. marianum L., can inhibit influenza A virus (IAV) infection. We later synthesized 5 silybin derivatives (S1 through S5) and found that 23-(S)-2-amino-3-phenylpropanoyl-silybin (S3) had the best activity. When we compared the polarities of the substituent groups, we found that the hydrophobicity of the substituent groups was positively correlated with their activities. We further studied the mechanisms of action of these compounds and determined that S0 and S3 also inhibited both the formation of the Atg12-Atg5/Atg16 heterotrimer and the elevated autophagy induced by IAV infection. In addition, we found that S0 and S3 could inhibit several components induced by IAV infection, including oxidative stress, the activation of extracellular signal-regulated kinase (ERK)/p38 mitogen-activated protein kinase (MAPK) and IκB kinase (IKK) pathways, and the expression of autophagic genes, especially Atg7 and Atg3. All of these components have been reported to be related to the formation of the Atg12-Atg5/Atg16 heterotrimer, which might validate our screening strategy. Finally, we demonstrated that S3 can significantly reduce influenza virus replication and the associated mortality in infected mice. In conclusion, we identified 23-(S)-2-amino-3-phenylpropanoyl-silybin as a promising inhibitor of IAV infection.

Metagenomic analysis of the dynamical conversion of photosynthetic bacterial communities in different crop fields over different growth periods.

Photosynthetic bacteria are beneficial to plants, but knowledge of photosynthetic bacterial community dynamics in field crops during different growth stages is scarce. The factors controlling the changes in the photosynthetic bacterial community during plant growth require further investigation. In this study, 35 microbial community samples were collected from the seedling, flowering, and mature stages of tomato, cucumber, and soybean plants. 35 microbial community samples were assessed using Illumina sequencing of the photosynthetic reaction center subunit M (pufM) gene. The results revealed significant alpha diversity and community structure differences among the three crops at the different growth stages. Proteobacteria was the dominant bacterial phylum, and Methylobacterium, Roseateles, and Thiorhodococcus were the dominant genera at all growth stages. PCoA revealed clear differences in the structure of the microbial populations isolated from leaf samples collected from different crops at different growth stages. In addition, a dissimilarity test revealed significant differences in the photosynthetic bacterial community among crops and growth stages (P<0.05). The photosynthetic bacterial communities changed during crop growth. OTUs assigned to Methylobacterium were present in varying abundances among different sample types, which we speculated was related to the function of different Methylobacterium species in promoting plant growth development and enhancing plant photosynthetic efficiency. In conclusion, the dynamics observed in this study provide new research ideas for the detailed assessments of the relationship between photosynthetic bacteria and different growth stages of plants.

Dental service in 2008 Summer Olympic Games.

OBJECTIVE: How to organise an appropriate team to provide quality dental care during the Olympic Games has become an important consideration for each successive host country. The aims of this study were to document dental services provided at the Olympic Games and to provide data for planning future events. SET-UP OF THE DENTAL CARE DEPARTMENT: There were six dental chairs in six independent treatment rooms, one technical laboratory, a sterilising room and an x-ray room equipped with one digital panoramic screening machine and one intraoral x-ray machine in the polyclinic in the Olympic Village in Beijing. Shifts comprised 80 dentists and 28 nurses who were organised into three shifts working from 08:00 until 23:00. RESULTS: In the 2008 Olympic Games, there were 1607 cases involving 1126 patients requiring dental care: 795 cases from 516 athletes; 483 cases from 370 coaches and other staff; and 99 cases from volunteers. Endodontic treatments, permanent fillings, oral hygiene, mouthguards and treatment of pericoronitis were the most frequent procedures in dental care. The Mouthguard Service was extremely popular and well utilised. 122 athletes received new custom-made mouthguards in Beijing. CONCLUSIONS: As the utilisation of the dental service grows, and the burden of providing care for such a large cohort increases, a well-organised dental team becomes increasingly important. More general-practice dentists were needed in the team. Different kinds of specialist were suggested for working in the team-for example, oral and maxillofacial surgeons, sport dentists for mouthguards and endodontists.

Regulatory action of charred Gossamer urocteae on the functions of mouse oral fibroblasts.

OBJECTIVE: To explore the influence of charred Gossamer urocteae (CGU) on the functions of primary cultured mouse oral fibroblasts and reveal its mechanism in wound healing. METHODS: CGU was extracted with different solvents and ethanol extract (EE), ethyl acetate fraction (EF), n-butanol fraction (BF) and aqueous fraction (AF) were obtained. The effects of different fractions on the proliferation, matrix metalloproteinase-2,9 (MMP-2,9) activities, synthesis of collagen and tissue inhibitor of metalloproteinase 1 (TIMP-1) in the mouse oral fibroblasts were determined by MTT, gelatin zymography, chloramine-T method, and enzyme-linked immunosorbent assay (ELISA) respectively. RESULTS: EE, EF and BF at high concentrations could significantly inhibit proliferation of fibroblasts (P<0.05 or P<0.01), and at low concentrations EF and BF could promote proliferation of fibroblasts, and BF and AF could significantly inhibit collagen synthesis (P<0.05 or P<0.01). EE, EF and AF at high concentrations could significantly increase the MMP-9 activity, and BF and AF could significantly inhibit synthesis of TIMP-1. CONCLUSION: CGU at high concentrations can inhibit the proliferations of fibroblasts and synthesis of collagen, and in healing of wound, CGU at high concentrations possibly has the functions of anti-fibrosis and anti-scar, and the mechanism to promote degradation of collagen is possibly related to the increase in MMP-9 activity and the inhibition of TIMP-1 synthesis.

[Analysis on characteristics of 802 emergency cases transported from venues of the Beijing 2008 Olympic Games].

OBJECTIVE: To analyze 802 emergency cases transported from venues of the Beijing 2008 Olympic Games, in order to study the characteristics of critically ill patients and injured in mass gatherings for the purpose of improving medical care and transportation. METHODS: Using the standard medical encounter form system (MEFS) formulated by International Olympic Committee (IOC), the data of patients treated in various venues of Beijing 2008 Olympic Games (2008-07-27 T 09:00/2008-08-27 T 23:00) were analyzed. RESULTS: Eight hundred and two patients had been transported from 227 medical stations of different venues, including 471 male, 331 female, with a mean age of 42.67 years. According to MEFS, 802 patients were divided into 12 types of diseases, i.e. injury (39.03%), digestive disorder (21.82%), cardiovascular disorder (7.36%), respiratory disorder (6.48%), nervous-sensory disorder (6.23%), skin diseases (4.49%), eye disorder (4.24%), ear-nose-throat disorders (3.74%), heat related illness (3.37%), genito-urinary disorder (1.87%), dental disorder (1.37%), psychiatric disorder (0). Patients as grouped according to occupation: workforce (34.04%), non-registered (33.29%), others (13.59%), athletes (12.72%), VIP (3.74%), media (2.62%). CONCLUSION: During a mass gathering the plan for medical support should be formulated with the medical treatment of commonly occurred diseases and high-risk individuals in order to establish an efficient medical emergency transport system.

Influence of borneol on primary mice oral fibroblasts: a penetration enhancer may be used in oral submucous fibrosis.

BACKGROUND: Borneol, a widely used food and cosmetics additive, has analgesic, anti-inflammatory, antibacterial and penetration enhancing effects. We try to use it as a penetration enhancer for a formula which we have used to treat oral submucous fibrosis (OSF). To assess its safety, we investigate its effects on primary mice oral fibroblasts. METHODS: Primary mice oral fibroblasts were cultured, the effects of borneol on fibroblasts proliferation, cytotoxicity, collagen production, matrix metalloproteinases-2,9 (MMP-2,9) activities and tissue inhibitors of metalloproteinase 1 (TIMP-1) production were tested by methyl thiazolyl tetrazolium assay, lactic dehydrogenase activity assay, chloramine T method, gelatin zymography and enzyme-linked immunosorbent assay, respectively. RESULTS: Borneol, from 18.75 to 300 microg/ml, could significantly (P < 0.05) decrease the growth of fibroblasts and very significantly (P < 0.01) inhibit collagen production in a concentration dependant manner. From 18.75 to 150 microg/ml, borneol had no cytotoxicity on mice oral fibroblasts. Moreover borneol could significantly (P < 0.05) decrease MMP-2 activity, and very significantly (P < 0.01) inhibit TIMP-1 production. CONCLUSIONS: This study indicates that borneol has anti-fibrosis activity and the mechanism may partly be relevant to its inhibiting effects on fibroblasts mitosis, collagen and TIMP-1 production. It can be safely used as a penetration enhancer for our formula to treat OSF.

[Analysis on disease distribution at Beijing 2008 Olympic venues].

OBJECTIVE: To analyze the incidence and the variety of diseases at Olympic competition venues, non-competition venues and special control zones through the statistical analysis of medical data of Beijing 2008 Olympic Games. METHODS: The proportions of people contracting diseases among different groups, i.e. non-registered people, athletes, staff, media, VIPs and others were analyzed. At different venues the incidence proportions of diseases in cardiovascular system, stomatology, gastroenterology, ENT, respiratory system, surgery, neuropsychiatry, physical injury, genitourinary system and burns were calculated. And the disease spectrum and incidence proportions at specified venues were analyzed. RESULTS: 1. Among all groups of people involved in Beijing 2008 Olympic Games, the proportion of disease-contracting staff was the highest (44.83%) while that of VIPs the lowest (4.76%) so that the incidence proportions were different among different groups of people. 2. Chi2 = 2427.803, (P < 0.01) The statistical analysis of disease distribution indicates that people at different venues might contract different diseases. 3. The proportions of disease-contracting people at competition venues, non-competition venues, training venues and special control zones were 36.08%, 50.66%, 2.31% and 10.96% respectively, which was related to the number of people at a particular venue. 4. The incidence proportion of surgical diseases was quite high, especially maxillofacial and orthopedic diseases (orthopedic trauma) ranking as top 2 at all venues. Thus there should be surgeons at every venue, especially maxillofacial (for hockey) and orthopedic surgeons. At training venues, the number of people contracting E.N.T. diseases ranked No. 1, chi2 = 74.859 (P < 0.01), compared with that of non-competition venues at No. 2. So the incidence proportion of ENT diseases was higher at training venues than at non-competition venues. The number of people contracting respiratory diseases was the largest in special control zones and the figure of competition venues ranked at No. 2, chi2 = 123.708 (P < 0.01). Therefore the incidence proportion of respiratory diseases at special control zones was higher than that of competition venues. CONCLUSION: The proportions of people contracting diseases were different among different groups of people and the staff ranked the first in this regard. People contracted different diseases at different venues so that the distribution of medical resources should cater to this situation. In case of such a large-scale international competition as the Olympic Games, the patients are mainly from competition venues and non-competition venues so these two places have the largest demand for medical staff. The incidence proportion of surgical diseases is quite high and it is important to have maxillofacial and orthopedic surgeons stationed at all the venues. The ophthalmological and ENT specialists are recommended at training venues and respiratory specialists at special control zones. Meanwhile, the gastroenterologic and stomatological specialists should be present at all venues.

[Molluscicidal activity of endophyte JJ18 from Pseudolarix kaempferi inoculated to beach soil].

Endophyte JJ18 from Pseudolarix kaempferi was inoculated on solid medium (A), sterile soil (B), and non-sterile soil (C), respectively. The molluscicidal efficacy of fermented products of soil extract was detected according to the immersion test method recommended by WHO, the survival time of JJ18 was observed. Control groups included non-sterile soil (D), ionic water without chloride ion (E) and niclosamide (F). The acute toxicity of A-D group against Artemia salina was determined with artificial seawater as control. After immersing for 24 h, 48 h and 72 h, the snail mortality of group B [(36.67+/-7.56)%, (63.33+/-4.65)%, and (90+/-0)%] was significantly higher than those of group D [(30+/-6.87)%, (33.33+/-5.68)%, and (56.67+/-8.55)%] (P<0.05, P<0.01). Endophyte JJ18 survived in soil for at least 30 days. The mortality of Artemia salina in group B [(25.24+/-3.74)%] was significantly lower than that of group A[(57.15+/-8.90)%] (P<0.01).

Dynamic radiological change of gliomas located in the paralimbic system and its clinical significance.

BACKGROUND: The paralimbic system, which is composed of three parts, is an important functional unit. Gliomas located in the region remain a challenge for clinical treatment. However, the dynamic change of gliomas in the area has not been well documented. The purpose of this study was to identify the growth tendency of gliomas located in the paralimbic system and to obtain some suggestions for clinical treatment. METHODS: Eleven cases of gliomas located in the paralimbic system were recruited in the study. All of them were proven by pathology. Analysis of the serial radiological examinations in each patient was performed from the initial to the final examination, taking into consideration the following items: initial tumor location, final location and the growth tendency. RESULTS: In the initial and final examinations the ratios of insula involvement were 64% and 100%, respectively. On the other hand, the ratios of gliomas located in two or more parts of paralimbic system increased from 64% to 100% during the dynamic examination. CONCLUSIONS: Even though the paralimbic system is composed of three independent anatomical parts, gliomas tend to involve all three parts, especially the insula. Therapeutic plans should aim at the whole region of the system, even during the early stages of gliomas.

Preoperative blood oxygen level-dependent functional magnetic resonance imaging in patients with gliomas involving the motor cortical areas.

BACKGROUND: Blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) plays an important role in identifying functional cortical areas of the brain, especially in patients with gliomas. This study aimed to assess the value of fMRI in presurgical planning and functional outcome of patients with gliomas in the motor cortical areas. METHODS: Twenty-six patients with gliomas in the motor cortex were recruited in the study. Before operation, fMRI was performed in each patient to obtain the mapping of bilateral hands area on the primary sensorimotor cortex. This examination was performed on a 3.0T scanner with a bilateral hands movement paradigm. During microsurgery under awake anesthesia, the motor area was identified using direct electrical stimulation and compared with preoperative mapping. Finally the tumor was resected as much as possible with the motor cortex preserved in each patient. Karnofsky performance status (KPS) was evaluated in all patients before and after operation. RESULTS: Twenty-three patients showed a successful fMRI mapping. Among them, 19 were classified to be grade III; 4, grade II; 3, grade I. The operation time was about 7 hours in the 23 patients, 8.5 hours in the other 3. The pre- and postoperative KPS score was 82.3 +/- 8.6 and 94.2 +/- 8.1, respectively. CONCLUSIONS: Preoperative fMRI of the hand motor area shows a high consistency with intraoperative cortical electronic stimulation. Combined use of the two methods shows a maximum benefit in surgical treatment.

Anti-influenza A virus activity of rhein through regulating oxidative stress, TLR4, Akt, MAPK, and NF-κB signal pathways.

Rhein, an anthraquinone compound existing in many traditional herbal medicines, has anti-inflammatory, antioxidant, antitumor, antiviral, hepatoprotective, and nephroprotective activities, but its anti-influenza A virus (IAV) activity is ambiguous. In the present study, through plaque inhibition assay, time-of-addition assay, antioxidant assay, qRT-PCR, ELISA, and western blotting assays, we investigated the anti-IAV effect and mechanism of action of rhein in vitro and in vivo. The results showed that rhein could significantly inhibit IAV adsorption and replication, decrease IAV-induced oxidative stress, activations of TLR4, Akt, p38, JNK MAPK, and NF-κB pathways, and production of inflammatory cytokines and matrix metalloproteinases in vitro. Oxidant H2O2 and agonists of TLR4, Akt, p38/JNK and IKK/NF-κB could significantly antagonize the inhibitory effects of rhein on IAV-induced cytopathic effect (CPE) and IAV replication. Through an in vivo test in mice, we also found that rhein could significantly improve the survival rate, lung index, pulmonary cytokines, and pulmonary histopathological changes. Rhein also significantly decreased pulmonary viral load at a high dose. In conclusion, rhein can inhibit IAV adsorption and replication, and the mechanism of action to inhibit IAV replication may be due to its ability to suppress IAV-induced oxidative stress and activations of TLR4, Akt, p38, JNK MAPK, and NF-κB signal pathways.

Diffusion characteristics of the fornix in patients with Alzheimer's disease.

White matter degradation is a major part of the pathogenesis of Alzheimer's disease (AD). The fornix is the predominant outflow tract from the hippocampus, and alterations to its microstructure in patients with AD are still being explored. Diffusion tensor imaging (DTI) is an in vivo neuroimaging technique that can provide unique information about alterations in tissue microstructure, which can indicate underlying neurobiological process at the microstructural level. In this prospective study, DTI was used to assess and analyze the microstructural features of the fornix in subjects with AD (n = 17), mild cognitive impairment (MCI; n = 12) and healthy controls (n = 17). DTI was performed using Explore DTI software and the FSL package. Within the fornix, patients with AD showed decreased fractional anisotropy values and length of fiber tracts of the fornix relative to healthy controls, but higher mean diffusivity values. MCI subjects showed a trend towards elevated mean diffusivity values in the fornix. The data suggest that DTI provides supporting information on the microstructural alteration of the fornix in patients with AD, and that these diffusion characteristics of the fornix may be helpful for the clinical diagnosis of AD.

[Function magnetic resonance imaging and diffusion tensor tractography in patients with brain gliomas involving motor areas: clinical application and outcome].

OBJECTIVE: To explore the role of preoperative blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) and diffusion tensor tractography (DTT) to identify the relationship between motor cortical area, pyramidal tracts with brain gliomas in neurosurgical treatment of intraoperative electrical stimulation for gliomas involving motor areas at 3T. METHODS: Twenty-eight patients with brain gliomas involving motor areas were included. They underwent MRI examination, which included conventional T1WI, T2WI, BOLD-fMRI of bilateral hands movement paradigm and diffusion tensor imaging (DTI). The data of BOLD-fMRI and DTI were transferred to the workstation (Leonardo syngo 2003A, Siemens) and analyzed. Activation mapping of hands movement, fractional Anisotropy (FA) Color and three dimensional pyramidal tracts were produced. The relationship between motor cortical area, pyramidal tracts and brain gliomas was demonstrated, which was used to optimize the pre-surgical planning. With guidance of the result of BOLD-fMRI and DTT, all patients received microsurgery under anaesthesia retaining consciousness using intraoperative motor functional brain mapping with the method of direct electrical stimulations. The brain lesions were removed as far as possible in the case of eloquent areas and sub-cortical important white matters preservation. The preoperative and postoperative KPS of all patients were operated to evaluate the state of patients. RESULTS: BOLD-fMRI, DTI were performed successfully in 28 patients. The relationship between the primary motor cortex, premotor area, supplementary motor area, pyramidal tracts and brain gliomas localized by preoperative fMRI and DTI. Under anaesthesia retaining consciousness, the primary motor area was monitored by the method of direct electrical stimulations with the guidance of preoperative BOLD-fMRI. There was good correlation between preoperative fMRI and intraoperative cortical stimulation. Furthermore, the preoperative mappings and DTT could make up for the un-monitored motor areas and pyramidal tracts during operative cortical stimulation. Comparing the preoperative KPS, the postoperative KPS was advanced. CONCLUSIONS: BOLD-fMRI and DTT could non-invasively localize the relationship between brain motor cortex, pyramidal tracts and brain gliomas in vivo to optimize the surgical planning, guide the microsurgery under anaesthesia retaining consciousness using intraoperative motor functional brain mapping with the method of direct electrical stimulations and remove brain tumors as far as possible in the case of eloquent areas and sub-cortical important white matters preservation.

Radiologic features of primary intracranial ectopic germinomas: Case reports and literature review.

RATIONALE: Germinomas are sensitive to radiation therapy and chemotherapy; therefore, correct imaging diagnosis is crucial for them. However, the imaging findings of germinomas originating from off-midline regions displayed different patterns from those originating from midline areas. PATIENT CONCERNS: The objective of this study is to describe the radiologic features of primary ectopic germinoma. We reviewed the MR and CT findings of 12 patients with histologically proven off-midline ectopic germinomas with off-midline locations. INTERVENTIONS: All of these patients underwent conventional MR images and 3 of them underwent diffusion images. Additional CT images were available in 3 patients. Analysis was focused on the shape and entity of tumors in images, signs of hemiatrophy, and the involvement of fibers in diffusion images. OUTCOMES: Well-defined (8/12) and ill-defined margin masses (4/12) were identified according to the shape of the mass. Multicystic masses were seen in 11 of the 12 patients. The solid component of the tumors had a high density (3/3) with calcifications (2/3) on CT images, iso- to hypointensity in T2WI (11/12) and restricted diffusion on apparent diffusion coefficient (ADC) maps (3/3). Hemiatrophy was observed in 5 cases and progressive hemiatrophy was observed in 1 case. Other signs included mild peritumoral edema (10/12), and hydrocephalus (7/12). Additionally, infiltration of the corticospinal tract (CST) was identified on diffusion tensor imaging (DTI) (2/2). LESSONS: The results indicate that multicysitic entities and hypointensities in solid components on T2WI and hemiatrophy are the imaging features of ectopic germinomas. DTI has potential for assessing CST involvement.