Effect of propofol-based total intravenous anaesthesia on postoperative cognitive function and sleep quality in elderly patients.

PURPOSE: This study aimed to observe the effect of propofol-based total intravenous anaesthesia (TIVA) on postoperative cognitive function and sleep quality in elderly patients. METHODS: From August 2019 to August 2020, 130 cases of elderly patients who underwent abdominal surgery in The Third Hospital of Hebei Medical University were enrolled in this study. All participants were randomly divided into TIVA group (n = 65, receiving propofol-based TIVA) and control group (n = 65, receiving inhaled of sevoflurane anaesthesia). Intra-operative indicators were recorded in both groups. The cognitive function, sleep quality, urine melatonin sulphate, free cortisol, S-100 ß protein and interleukin-6 (IL-6) levels were compared at different times. RESULTS: On 1, 3, 7 and 15 days after operation, the cognitive function of the TIVA group was better than that of the control group, with statistically significance (P < .05, respectively). On the day of surgery, the two groups had similar sleep quality. The sleep quality of the TIVA group was better than that of the control group on 1, 3 and 7 days after surgery (P < .05, respectively). On the day of surgery, the levels of melatonin, cortisol, S-100ß protein and IL-6 in the two groups were equivalent (P > .05). On 1, 3, 7 and 15 days after surgery, cortisol and IL-6 in the TIVA group were lower than those of the control group, and melatonin was higher than that of the control group (P < .05, respectively). On 1, 3 and 7 days after operation, the S-100 ß protein in the TIVA group was lower than that in the control group (P < .05, respectively). CONCLUSION: Propofol-based TIVA has little effect on the cognitive function and sleep quality of elderly patients after surgery, and it is worthy of clinical application.

Should oral anticoagulant therapy be continued during dental extraction? A meta-analysis.

BACKGROUND: Oral anticoagulation therapy is widely used to reduce the risks of thromboembolism. However, the therapy increases the risk of hemorrhage during the surgical procedures. The aim of this meta-analysis was to evaluate the bleeding risk of patients continuing or discontinuing oral anticoagulant therapy while undergoing dental extractions. METHODS: Six electronic databases, including PubMed, Embase, Cochrane library, Web of Science, China Biology Medicine disc (CBM), and China National Knowledge Infrastructure (CNKI), were searched in March, 2016. Relevant articles were screened by two independent reviewers under our inclusion criteria. Quality was evaluated using the Cochrane Collaboration risk of bias tool. Meta-analyses were conducted with fixed and random effects models as appropriate. RESULTS: Six studies (with a total of 591 patients) were included in our meta-analysis. Our results showed that there was no significant difference in the bleeding risk between patients continuing or discontinuing oral anticoagulant therapy while undergoing dental extractions (risk ratio, 1.31; 95 % CI, 0.79, 2.14; P > 0.05). There was also no significant difference in bleeding risk 1 day (risk ratio, 0.91; 95 % CI, 0.35, 2.37; P > 0.05) and 7 days (risk ratio, 1.47; 95 % CI, 0.83, 2.59; P > 0.05) after the dental extraction. CONCLUSION: Under current studies and evidence, it appears that patients continuing oral anticoagulant therapy do not have an increased risk of bleeding after dental extractions compared to patients who discontinue oral anticoagulant therapy.

Kimura's disease of the lacrimal gland mimicking IgG4-related orbital disease.

BACKGROUND: Kimura's disease (KD) is a rare and benign chronic inflammatory soft tissue disorder of unknown origin, which predominantly inflicts young male adults in Asia. IgG4-related disease is a new disease concept, established this century and characterized by fibrosis and sclerosis of the involved organs, with infiltration of IgG4-positive plasma cells. These two kinds of diseases share similar characteristics, which may complicate their diagnosis. CASE PRESENTATION: A 47-year-old Chinese man presented to our Department of Ophthalmology with a 26-month history of painless swelling and redness left upper eyelid. Surgical excisions of the left lacrimal gland were performed. A histopathology examination showed follicular hyperplasia with reactive germinal centres and eosinophilic infiltration involving the interfollicular areas as well as proliferation of post capillary venules, all signs of Kimura disease. Immunohistochemical analysis of the cells demonstrated positive staining for CK, Vimentin, CD3, CD4, CD20, CD21, CD117, CD5, CD8, CD23, IgG and IgG4 (30 per high-power field) and negative staining for CD10 and CD34. Some ophthalmologists in our department questioned whether the histological and immunohistochemical findings were also compatible with features of IgG4-related diseases. There was no sign of recurrence during the twelve months of regular follow-up. CONCLUSION: Kimura's disease may present with high serum IgG4 levels, which may be an epiphenomenon related to chronic antigen exposure. As clinical doctors, especially ophthalmologists, we should recognize the possibility of the occurrence of increased serum levels of IgG4 in Kimura's disease to ensure correct diagnosis.

Long-term trends in the burden of colorectal cancer in Europe over three decades: a joinpoint regression and age-period-cohort analysis.

Background: The burden of colorectal cancer (CRC) in Europe is at a high level, but the epidemiological features have not yet been systematically studied. This study aimed to provide a timely and reliable assessment of the burden and trends of CRC in Europe to provide a scientific basis for its prevention and treatment. Methods: We analyzed data on CRC in 44 European countries between 1990 and 2019 from the Global Burden of Disease study (GBD) 2019. In addition, the joinpoint regression model was applied to reflect temporal trends. The age-period-cohort model was constructed to explore age, period, and birth cohort effects that influence the risk of morbidity and mortality. Results: In Europe, new cases, disability-adjusted life years (DALYs) and deaths of CRC rose by 70.01%, 22.88% and 38.04% from 1990 to 2019, respectively. The age-standardized incidence rate (ASIR) has increased, while age-standardized DALY rate and age-standardized mortality rate (ASMR) have declined. We found that men experienced a significantly higher CRC burden than women. Age-period-cohort analysis showed that the risk of incidence and mortality increased with age and time; and it was lower in the later-born cohort than the earlier-born cohort. Conclusion: ASIR for CRC in Europe generally trended upwards from 1990 to 2019, stabilizing in recent years but still at a high level. CRC burden varied considerably in different countries. There was a pronounced gender difference in CRC burden, and middle-aged and older men should be a priority population for CRC prevention and treatment.

Different Sedation Strategies in Older Patients Receiving Spinal Anesthesia for Hip Surgery on Postoperative Delirium: A Randomized Clinical Trial.

Background: Postoperative delirium (POD) is of great concern as a complication of surgery in older adult patients. Sedation strategies influence the development of POD. This study compared how sedation strategies administered during spinal anesthesia influenced POD in patients aged ≥65 years undergoing elective surgery for hip fracture repair. Patients and Methods: A randomized clinical trial was conducted from 1 August 2021 to 30 June 2022 at a single academic medical center. Two hundred and twenty-six patients were randomly divided into four groups: lighter sedation with propofol (LP), heavier sedation with propofol (HP), lighter sedation with dexmedetomidine (LD), and heavier sedation with dexmedetomidine (HD). The incidence of delirium was the primary outcome and was assessed daily by the blinded Confusion Assessment Method. Results: There was a significant association between dexmedetomidine (LD+HD group) and a lower incidence of delirium (11.9% [13/109] vs the propofol group (23.6% [26/110]; Risk ratio, 0.51; 95% CI, 0.274 to 0.929; p=0.024). In the propofol group, heavier sedation had a higher rate of POD (32.7% [18/55] vs the lighter sedation group (14.5% [8/55]; Risk ratio, 2.25; 95% CI, 1.069 to 4.736; p=0.025). Conclusion: Dexmedetomidine was associated with a lower incidence of delirium than that with propofol among older patients with hip fractures. In patients that received propofol, heavier sedation was associated with high incidence of POD.

Effects of aggregation and the surface properties of gold nanoparticles on cytotoxicity and cell growth.

The effect of gold nanoparticles (Au NPs) on cells remains open for investigation. Here we show that small Au NPs can be endocytosed by cells and form aggregates inside the cell, resulting in cytotoxicity. When the aggregates become too large to enter the cell and instead adhere onto the cell surface, however, the growth rate of HeLa cells increases. Printed patterns of Au NPs fabricated through inkjet printing technology were used to study the effects of Au NP aggregation on human cervical carcinoma (HeLa) cell activity. The growth of the HeLa cells was inhibited on the polymer-coated Au NPs but increased on the silicon substrate. On the uncoated Au NP surface, however, the HeLa cell growth rate was higher than that on the silicon substrate. Experiments with Escherichia coli cells showed a similar effect of the Au NPs. This phenomenon provides a new perspective for research on toxicity in nanoparticle biology. FROM THE CLINICAL EDITOR: Printed patterns of Au NPs fabricated through inkjet printing technology were used to study the effects of Au NP aggregation on human cervical carcinoma (HeLa) cell activity. Small Au NPs can be endocytosed by cells resulting in cytotoxicity; in contrast, large aggregates adhere onto the cell surface and increase the growth rate of HeLa cells.

Epigenetic involvement of Alien/ESET complex in thyroid hormone-mediated repression of E2F1 gene expression and cell proliferation.

The ligand-bound thyroid hormone receptor (TR) is known to repress via a negative TRE (nTRE) the expression of E2F1, a key transcription factor that controls the G1/S phase transition. Alien has been identified as a novel interacting factor of E2F1 and acts as a corepressor of E2F1. The detailed molecular mechanism by which Alien inhibits E2F1 gene expression remains unclear. Here, we report that the histone H3 lysine 9 (H3K9) methyltransferase (HMT) ESET is an integral component of the corepressor Alien complex and the Alien/ESET complex is recruited to both sites, the E2F1 and the nTRE site of the E2F1 gene while the recruitment to the negative thyroid hormone response element (nTRE) is induced by the ligand-bound TRß1 within the E2F1 gene promoter. We show that, overexpression of ESET promotes, whereas knockdown of ESET releases, the inhibition of TRß1-regulated gene transcription upon T3 stimulation; and H3K9 methylation is required for TRß1-repressed transcription. Furthermore, depletion of ESET impairs thyroid hormone-repressed proliferation as well as the G1/S transition of the cell cycle. Taken together, our data indicate that ESET is involved in TRß1-mediated transcription repression and provide a molecular basis of thyroid hormone-induced repression of proliferation.

[Significant improvement of motor symptoms by deep brain stimulation of bilateral subthalamic nucleus in patients with moderate or advanced Parkinson's disease].

OBJECTIVE: To study the effects of deep brain stimulation (DBS) of bilateral subthalamic nucleus (STN) on the motor and non-motor symptoms in moderate or advanced Parkinson's disease (PD) patients. METHODS: From August 2006 to January 2010, 21 consecutive PD patients with refractory motor fluctuations or dyskinesia underwent operations at our hospital. All patients were evaluated by unified Parkinson's disease rating scale (UPDRS), Hoehn & Yahr (H&Y) stage, Parkinson's disease questionnaire (PDQ-39), mini mental state examination (MMSE), Parkinson's disease sleep scale-Chinese vision (PDSS-CV), Pittsburgh sleep quality index (PSQI), Hamilton depression rating scale (HAMD) and Hamilton anxiety rating scale (HAMA). And the daily dosage of dopaminergic agents was recorded at 1 week pre-operation and 3, 6 and 12 months post-operation. RESULTS: Ten patients finished a 12-month follow-up. Their motor functions showed significant improvement. And the scores of UPDRS-motor, tremor, rigidity, bradykinesia and axial symptoms reduced significantly in the on-stimulation-off-medication condition and the on-stimulation-on-medication condition vs the on-medication condition pre-operation. And the improvement of tremor was the most pronounced (52.1% and 77.7% respectively). The H&Y stage decreased significantly from 3.2 ± 0.7 to 2.5 ± 0.4 post-operation. The activities of daily living improved while PDQ-39 declined significantly from 56 ± 9 pre-operation to 32 ± 13 at 12 months follow-up. The score changes of MMSE, PDSS-CV, PSQI, HAMA and HAMD were statistically insignificant. The levo-dopa equivalent dose of 1-year post-operation decreased significantly by 49.2% versus that of pre-operation (P < 0.05). CONCLUSION: Bilateral STN-DBS can significant ameliorate the motor symptoms of moderate or advanced PD patients, reduce the dosage of anti-PD medications and improve the quality of life. This procedure has the advantages of a greater safety, minor side effects and an easy controllability.

Contraction-related stimuli regulate GLUT4 traffic in C2C12-GLUT4myc skeletal muscle cells.

Muscle contraction stimulates glucose uptake acutely to increase energy supply, but suitable cellular models that faithfully reproduce this complex phenomenon are lacking. To this end, we have developed a cellular model of contracting C(2)C(12) myotubes overexpressing GLUT4 with an exofacial myc-epitope tag (GLUT4myc) and explored stimulation of GLUT4 traffic by physiologically relevant agents. Carbachol (an acetylcholine receptor agonist) induced a gain in cell surface GLUT4myc that was mediated by nicotinic acetylcholine receptors. Carbachol also activated AMPK, and this response was sensitive to the contractile myosin ATPase inhibitor N-benzyl-p-toluenesulfonamide. The gain in surface GLUT4myc elicited by carbachol or by the AMPK activator 5-amino-4-carboxamide-1 beta-ribose was sensitive to chemical inhibition of AMPK activity by compound C and partially reduced by siRNA-mediated knockdown of AMPK catalytic subunits or LKB1. In addition, the carbachol-induced gain in cell surface GLUT4myc was partially sensitive to chelation of intracellular calcium with BAPTA-AM. However, the carbachol-induced gain in cell surface GLUT4myc was not sensitive to the CaMKK inhibitor STO-609 despite expression of both isoforms of this enzyme and a rise in cytosolic calcium by carbachol. Therefore, separate AMPK- and calcium-dependent signals contribute to mobilizing GLUT4 in response to carbachol, providing an in vitro cell model that recapitulates the two major signals whereby acute contraction regulates glucose uptake in skeletal muscle. This system will be ideal to further analyze the underlying molecular events of contraction-regulated GLUT4 traffic.

PromPDD, a web-based tool for the prediction, deciphering and design of promiscuous peptides that bind to HLA class I molecules.

Promiscuous peptides that can be presented by multiple human leukocyte antigens (HLAs) have great potential for the development of vaccines with wide population coverage. However, the current available methods for the prediction of peptides that bind to major histocompatibility complex (MHC) are mainly aimed at the rapid or mass screening of potential T cell epitopes from pathogen antigens or proteomics. The current approaches do not allow deciphering the contribution of the residue at each peptide position to the promiscuous binding ability of the peptide or obtaining guidelines for the design of promiscuous peptides. In this study, we re-evaluated and characterized four matrix-based prediction models that have been extensively used for the prediction of HLA-binding peptides and found that the prediction models generated based on the average relative binding (ARB) matrix shared a consistent and conservative threshold for all well-studied HLA class I alleles. Evaluations performed using datasets of HLA supertype-specific peptides with various cross-binding abilities and peptide mutant analogues indicated that the ARB-based binding matrices could be used to decipher and design promiscuous peptides that bind to multiple HLA molecules. A web-based tool called PromPDD was developed using ARB matrix-based models, and this tool enables the prediction, deciphering and design of promiscuous peptides that bind to multiple HLA molecules within or across HLA supertypes in a simpler and more direct manner. Furthermore, we expanded the application of PromPDD to HLA class I alleles with limited experimentally verified data by generating pan-specific matrices using a derived modular method, and 2641 HLA molecules encoded by HLA-A and HLA-B genes are available in PromPDD. PromPDD, which is freely available at http://www.immunoinformatics.net/PromPDD/, is the first tool for the deciphering and design of promiscuous peptides that bind to HLA class I molecules.

The red-shift of surface plasmon absorption of 2D nanogold arrangement from disordered to ordered.

In this article, the changing of surface plasmon resonance (SPR) absorption of 2D arrangement of Au (3 nm) nanoparticles coated with 1-dodecanethiol (C12H25SH), obtained at different desolvation extents, had been investigated. It has been found that an obvious red-shifted happened when these arrays changed from loose, disordered to close-packed and ordered. Both transmission electron microscopy pictures and variation of SPR absorption of these arrays showed that the formation of long range two-dimension (2D) arrangement of nanoparticles coated with C12H25SH might be involved in two stages: At the first stage the particles can move freely and random patterns from loose to close package was driven by the Brownian Movement of solvated particles and as a result the voids were eliminated. The red shift of SPR absorption with the coverage (d lamda/d theta) is relative low. At the second stage, where the particles cannot move freely because of lack of solvent and a long-range two-dimension crystal was formed, the SPR shift to a longer wavelength with a larger d lamda/d theta. It is mainly attributed to the strong increase of the orientation and dipolar moment of the absorbed C12H25SH molecule on nanoparticles.

[Clinical manifestations and molecular genetics of spinal bulbar muscular atrophy: report of 5 cases].

OBJECTIVE: To study the clinical and molecular genetic characteristics of spinal bulbar muscular atrophy (SBMA). METHODS: The clinical data, including case history, physical examination, biochemical analyses of blood, EMG, and muscle biopsy, of 5 Chinese patients with SBMA, all males, aged 29 - 58, with the onset age of 36 (17 - 49), were collected the information of in 5 cases. Four patients underwent PCR to examine the number of copies of CAG repeat region in androgen receptor (AR) gene. RESULTS: The clinical characteristics of the 5 patients included atrophy of lingualis, dysarthria, weakness and waste of the limbs, especially in the hands, and elevated creatine kinase (CK), fasting glucose, testosterone, and progesterone in the blood. EMG showed denervation motor potentials in all cases. The muscle biopsy in one case showed neurogenic atrophy. The number of (CAG) n repeat in AR gene was 50 - 62 in the, remarkably from that of 13 normal controls (19 - 20) without overlapping. CONCLUSION: SBMA affects the middle age males, shows a slowly progressing muscular atrophy in spinal and bulbar muscles. The different number of (CAG) n repeat of AR gene between the SBMA patients and the normal controls may be an important identification to differentiate SBMA from other motor neuron diseases.

Manipulating the solubility of gold nanoparticles reversibly and preparation of water-soluble sphere nanostructure through micellar-like solubilization.

On the basis of micellar solubilization, a strategy tuning the solubility of gold nanoparticles reversibly was developed. Hydrophobic gold nanoparticles stabilized by octadecylamine (ODA-gold) solubilized in the micellar-like core of poly(vinylpyrrolidone) (PVP) in water to form gold nanoparticles with protective multilayer induced by reduction of interfacial energy. Interestingly, upon redispersing in chloroform, the PVP micellar-like structure can break down and the ODA-gold can be released again. By changing the ratio of PVP/ODA, size-controllable hydrophilic spherical assembly can be prepared. On the basis of the observation of transmission electron microscopy (TEM) and Fourier transform infrared spectroscopy (FTIR), a reasonable mechanism is interpreted thermodynamically.

Enhancement of DNA immobilization and hybridization on gold electrode modified by nanogold aggregates.

Gold electrodes modified by nanogold aggregates (nanogold electrode) were obtained by the electrodeposition of gold nanoparticles onto planar gold electrode. The Electrochemical response of single-stranded DNA (ssDNA) probe immobilization and hybridization with target DNA was measured by cyclic voltammograms (CV) using methylene blue (MB) as an electroactive indicator. An improving method using long sequence target DNA, which greatly enhanced the response signal during hybridization, was studied. Nanogold electrodes could largely increase the immobilization amount of ssDNA probe. The hybridization amount of target DNA could be increased several times for the manifold nanogold electrodes. The detection limit of nanogold electrode for the complementary 16-mer oligonucleotide (target DNA1) and long sequence 55-mer oligonucleotide (target DNA2) could reach the concentration of 10(-9) mol/L and 10(-11) mol/L, respectively, which are far more sensitive than that of the planar electrode.

Biosensor signal amplification of vesicles functionalized with glycolipid for colorimetric detection of Escherichia coli.

A supramolecular assembly of phospholipid-polymerized diacetylene vesicles functionalized with glycolipid can provide a molecular recognition function. The Escherichia coli-glycolipid binding event leads to a visible color change from blue to red, readily seen with the naked eye and quantified by absorption spectroscopy. The biosensor signal is amplified through a suitable increase of phospholipid content in the mixed lipid vesicles and pH of aqueous solutions.

A novel nanogold multilayer constructed by Langmuir-Blodgett and self-assembly techniques.

A multilayer comprising nanogold particles and organic molecules was constructed by self-assembly of the small organic molecule 1-phenyl-5-mercaptotetrazole onto the octadecylamine-protected nanogold monolayer in the course of transferring the monolayer, layer by layer, from a Langmuir-Blodgett trough to solid substrates. The structure and properties of the constructed multilayer were characterized by TEM images and ATR-IR, XPS, and UV-vis spectra. It is evidenced for the first time that the combination of Langmuir-Blodgett and self-assembly techniques provides a new way to organize functional nanoparticles such as organic-nanogold complexes.

[Effect of the oil from ganoderma lucidum spores on pathological changes in the substantia nigra and behaviors of MPTP-treated mice].

OBJECTIVE: To investigate the oil from the spores of ganoderma lucidum, a rare Chinese herb, on the behaviors and pathological changes in the substantia nigra pars compacta (SNpc) in mouse models of Parkinson's disease (PD) induced by MPTP. METHODS: C57BL mice were divided into 3 groups, and the ganoderma spores oil + MPTP group were treated with ganoderma spores oil for 8 days, together with subcutaneous injection of MPTP (30 mg/kg) starting on the third day for 6 days; MPTP group were pretreated with normal saline before subcutaneous MPTP injection, and the normal control group received pretreatment with normal saline before subcutaneous normal saline injection. The behavioral changes of the mice in different groups were observed by pole test, dopamine and its metabolic products in the striatum determined by HPLC, tyrosine hydroxylase (TH) positive cells detected by immunofluorescence method, and expression of TH protein by Western blotting. RESULTS: The mice in the ganoderma spores oil + MPTP group presented significantly less involuntary movement of the limbs in the pole test than the mice in MPTP group. The levels of dopamine and DOPAC in the striatum of ganoderma spores oil-treated mice were increased as compared with those in MPTP group. The number of surviving TH-positive neurons in SNpc of mice in ganoderma spores oil + MPTP group was significantly greater than that in MPTP group, with also significantly increased TH protein expression. CONCLUSION: Ganoderma spores oil has neuroprotective effect for preventing doparminergic neuron from impairment by MPTP.

Facile preparation of gold nanocages and hollow gold nanospheres via solvent thermal treatment and their surface plasmon resonance and photothermal properties.

Although template etching method is one of the most common ways of preparation of hollow gold nanostructures, this approach still requires further improvements to avoid the collapse of gold shells after the cores were removed. In this work, an improved template etching method, with which hollow gold nanostructure is fabricated by etching Polystyrene (PS) cores from PS@Au core-shell nanospheres with solvent thermal treatment in N,N-Dimethylformamide (DMF), is demonstrated. When PS cores were removed by a thermal treatment process, gold nanoshells reconstruct and the collapse of the nanoshells is avoided. Gold nanocages and hollow gold nanospheres are easily obtained from the various structures of PS@Au core-shell nanospheres. These hollow nanostructures represent special near infrared (NIR) optical property and photothermal property. Compared with hollow gold nanospheres, the gold nanocages show higher temperature increase at the same particle concentration.

Shape separation of gold nanoparticles using a pH-responsive amphiphilic dendrimer according to their shape anisotropy distinction.

We present a novel method for shape-selective separation of nanoparticles in aqueous media utilizing an amphiphilic cationic dendrimer (C18N5) through regulation of the pH of the dispersion medium. This amphiphilic dendrimer (C18N5) bears a poly(amidoamine) dendron with four terminal amine groups and one hydrophobic long alkyl chain, and it can strongly adsorb to the surface of gold nanoparticles at low pH and promote their aggregation at high pH. During aggregation, isotropic NPs with smaller inter-particle contact area have much better solution stability than anisotropic NPs. Therefore, isotropic NPs remain stable in the supernatant, while anisotropic NPs are subject to aggregation and subsequent precipitation. As a result of this simple separation strategy, gold nanoplates with a purity level of 97% (in number density) can be rapidly and conveniently achieved.

Association of TCR-signaling pathway with the development of lacrimal gland benign lymphoepithelial lesions.

AIM: To identify the association of the T cell receptor (TCR) signaling with the development of benign lymphoepithelial lesions (BLEL) of the lacrimal gland. METHODS: We collected affected lacrimal gland tissues from 9 patients who underwent dacryoadenectomy in the Capital Medical University Beijing Tongren Hospital Eye Center between August 2010 and March 2013 and were confirmed to have lacrimal gland BLEL by histopathological analysis. Tumor tissues from 9 patients with orbital cavernous hemangioma were also collected and used as control. Whole genome gene expression microarray was used to compare gene expression profiles of affected lacrimal gland tissues from patients with lacrimal gland BLEL to those from of orbital cavernous hemangiomas. Differential expression of TCR pathway genes between these tissues was confirmed by polymerase chain reaction (PCR) and immunohistochemistry. RESULTS: Microarray analysis showed that in lacrimal glands with BLEL, 32 signaling pathways were enriched in the upregulated genes, while 25 signaling pathways were enriched in the downregulated genes. In-depth analysis of the microarray data showed that the expression of 27 genes of the TCR signaling pathway increased significantly. To verify the differential expression of three of these genes, CD3, CD4, and interleukin (IL)-10, reverse transcription-PCR (RT-PCR) and immunohistochemistry assays were performed. RT-PCR analysis showed that CD3 and CD4 were expressed in the lacrimal glands with BLEL, but IL-10 was not expressed. Immunohistochemistry confirmed that CD3 and CD4 proteins were also present, but IL-10 protein was not. CD3, CD4, or IL-10 expression was not found in the orbital cavernous hemangiomas with either RT-PCR or immunohistochemistry. CONCLUSION: TCR signaling pathway might be involved in the pathogenesis of lacrimal gland BLEL.