Diagnosis of a patient with Spinocerebellar ataxia type 29 due to a novel variant of ITPR1 gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical and genetic characteristics of a child with spinocerebellar ataxia type 29 (SCA29) due to novel variant of the inositol 1,4,5-trisphosphate receptor type 1 (ITPR1) gene.@*METHODS@#The child was subjected high-throughput sequencing, and candidate variant was verified by Sanger sequencing of his family members.@*RESULTS@#The child was found to harbor a c.800C>T (p.T267M) variant of the ITPR1 gene, which was not found in his parents and their fetus. The variant has occurred in a hotspot of the ITPR1 gene variants and was unreported before in China. Based on his clinical and genetic characteristics, the child was diagnosed with SCA29.@*CONCLUSION@#The novel heterozygous c.800C>T (p.T267M) of the ITPR1 gene probably underlay the SCA29 in this child.

Sappanone A Alleviated IL-1ß-Induced Inflammation in OA Chondrocytes through Modulating the NF-κB and Nrf2/HO-1 Pathways.

Objective: This study was to examine the anti-inflammatory effect of sappanone A on interleukin- (IL-) 1ß-stimulated osteoarthritis (OA) chondrocytes. Methods: Chondrocytes were pretreated with sappanone A for 2 h before subsequent IL-1ß stimulation. The mRNA expression levels of iNOs, COX-2, aggrecan, and collagen-II were measured with qRT-PCR. The levels of TNF-α, IL-6, IL-8, MMP-3, and MMP-13 were determined by ELISA. The protein levels of iNOs, COX-2, ADAMTS-4, ADAMTS-5, aggrecan, collagen-II, p-p65, p65, IκBα, Nrf2, and HO-1 were assessed by Western blot. Results: Sappanone A inhibited the IL-1ß-stimulated production of NO, PGE2, iNOS, COX-2, TNF-α, IL-6, and IL-8 in OA chondrocytes. In addition, sappanone A suppressed the expression of MMP-3, MMP-13, ADAMTS-4, and ADAMTS-5 in IL-1ß-stimulated OA chondrocytes. The degradation of ECM components was reversed by sappanone A. Sappanone A prevented NF-κB activation while enhanced Nrf2/HO-1 activation in IL-1ß-treated chondrocytes. Conclusion: Sappanone A may be a potent therapeutic agent for OA.

The Plant Salicylic Acid Signalling Pathway Regulates the Infection of a Biotrophic Pathogen in Grasses Associated with an Epichloë Endophyte.

The study of the contribution of the plant defence hormones, salicylic acid (SA) and jasmonic acid (JA), in the resistance against pathogens of plants associated with Epichloë fungal endophytes has been scanty. We hypothesised that Epichloë spp., capable of inducing host plant SA-dependent defences, would increase the levels of plant resistance against biotrophic pathogens. Plants of Achnatherum inebrians, with and without the fungal endophyte Epichloë gansuensis, were inoculated with the biotrophic fungal pathogen Blumeria graminis. We measured the status of plant defences (associated with SA and JA signalling pathways) and the levels of resistance to the pathogen. Plants associated with the endophyte showed less disease symptoms caused by the biotrophic pathogen than plants without the endophyte. In agreement with our hypothesis, the Epichloë endophyte increased the plant production of SA and enhanced the expression levels of plant genes of synthesis and response to the SA hormone. The elevated expression of SA-related genes coding for putative plant enzymes with anti-fungal activities promoted by the endophyte may explain the enhanced resistance to the pathogen. The present study highlights that interaction between the plant immune system and Epichloë fungal endophytes can contribute significantly to the resistance of endophyte-symbiotic plants against pathogens.

Efficacy of Pinggan Yuyin Qingre Recipe for Treatment of Hyperevaporative Dry Eye Disease Caused by Meibomian Gland Dysfunction / 中国实验方剂学杂志

Objective:To observe the therapeutical effect and the safety of Pinggan Yuyin Qingre recipe on the hyperevaporative dry eye disease （Yin deficiency and Yang hyperactivity type） caused by the meibomian gland dysfunction（MGD）. Method:The 120 Consecutive outpatients who met the criteria were included in the trial and divided into three layers （mild， moderate and severe） according to the meibomian gland function classification （grade 1-3）. The patients in each layer were randomly assigned to the experiment group and the control group at a ratio of 1∶1. Both groups were treated with sodium hyaluronate eye drops， 1 drop/eye/time， 3 times a day. In the experiment group， Pinggan Yuyin Qingre recipe was additionally prescribed two times a day. The treatment course was 8 weeks in both groups. All patients were evaluated at the beginning and end of the study mainly for noninvasive tear breakup time （NITBUT），corneal lesions score，meibomian gland exclusion score，meibomian gland structure，eye symptom score，the ocular surface disease index（OSDI） score，and the traditional Chinese medicine（TCM） syndrome scores at both overall and layered levels. Result:A total of 116 cases completed the study，with 1 drop-out case and 3 eliminated cases. Both before and after treatment，NITBUT，the corneal lesions score，the symptom score，and the OSDI score in the experiment group were significantly superior to the control group， but there was no significant difference in meibomian gland exclusion score between two groups，only with a superior tendency in experiment group. There were significant differences in the scores of the related TCM syndrome scores between two groups after treatment. There were no adverse reactions， no abnormal changes in electro cardiogram （ECG） or liver and kidney functions in all patients. Conclusion:Pinggan Yuyin Qingre recipe can effectively improve the hyperevaporative dry eye disease caused by meibomian gland dysfunction， the tear film stability，eye dryness， burning，itching，foreign body sensation and TCM symptoms of patients with dry eye syndrome of Yin deficiency and Yang hyperactivity. The improvement effect is more obvious in moderate and severe patients. It is an effective，safe，and well-tolerated treatment for the hyperevaporative dry eye.

Do Epichloë Endophytes and Their Grass Symbiosis Only Produce Toxic Alkaloids to Insects and Livestock?

Epichloë endophytes in forage grasses have attracted widespread attention and interest of chemistry researchers as a result of the various unique chemical structures and interesting biological activities of their secondary metabolites. This review describes the diversity of unique chemical structures of taxa from Epichloë endophytes and grass infected with Epichloë endophytes and demonstrates their reported biological activities. Until now, nearly 160 secondary metabolites (alkaloids, peptides, indole derivatives, pyrimidines, sesquiterpenoids, flavonoids, phenol and phenolic acid derivatives, aliphatic metabolites, sterols, amines and amides, and others) have been reported from Epichloë endophytes and grass infected with Epichloë endophytes. Among these, non-alkaloids account for half of the population of total metabolites, indicating that they also play an important role in Epichloë endophytes and grass infected with Epichloë endophytes. Also, a diverse array of secondary metabolites isolated from Epichloë endophytes and symbionts is a rich source for developing new pesticides and drugs. Bioassays disclose that, in addition to toxic alkaloids, the other metabolites isolated from Epichloë endophytes and symbionts have notable biological activities, such as antifungal, anti-insect, and phytotoxic activities. Accordingly, the biological functions of non-alkaloids should not be neglected in the future investigation of Epichloë endophytes and symbionts.

Spontaneous intracranial hypotension complicated with cerebral venous thrombosis and spinal epidural hematoma: a case report / 中华神经科杂志

Spontaneous intracranial hypotension patients may have complications, such as cerebral venous thrombosis and intracranial subdural hematoma, while complicating with spinal epidural hematoma is rarely reported. A spontaneous intracranial hypotension patient, who started with orthostatic headache, followed by cerebral venous thrombosis , manifested as seizure, status epilepticus, and parenchymal hemorrhage, was admitted to Sir Run Run Shaw Hospital. Spinal evaluation showed lumbar epidural hematoma, without spinal cord compression symptoms. The patient improved with bed rest, fluid infusion, antiepileptic drug, and anticoagulation therapy. Three weeks after discharge, headache recurred without complete remission after lying flat. Cranial neuroimaging showed bilateral subdural hematoma. Anticoagulation was ceased. Subdural hematoma absorbed after treated with two epidural blood patches. The patient was headache-free during follow-up.

The Effect of Seed-Borne Fungi and Epichloë Endophyte on Seed Germination and Biomass of Elymus sibiricus.

The interactive effects of asexual Epichloë (formerly known as Neotyphodium) endophytes isolated from Hordeum brevisubulatum, Elymus tangutorum and Achnatherum inebrians, and seed-borne fungi on Elymus sibiricus seeds, were determined by an in vitro study using supernatants from liquid cultures of the endophyte strains. In an 8 week greenhouse study, the effects on the seedlings growth was measured. The in vitro study was carried out with the seed-borne fungi Alternaria alternata, Bipolaris sorokiniana, Fusarium avenaceum, and a Fusarium sp. isolated from E. sibiricus. Different concentrations and combinations of the liquid cultures of endophytic fungi enhanced the interim germination, germination rate, length of coleoptile and radicle, and seedling dry weight of E. sibiricus under stress from seed-borne fungi. In the greenhouse study, different concentrations of the supernatant of the endophytes from H. brevisubulatum and E. tangutorum but not A. inebrians, signficantly (P < 0.05) enhanced E. sibiricus seed germination. There was no significant (P > 0.05) increase of the tiller numbers after 2 weeks. However, later on, there were significant (P < 0.05) increases in tiller number (4-8 weeks), seedling height (2-8 weeks) and dry weight (2-8 weeks). The application of Epichloë endophyte culture supernatants was an effective strategy to improve seed germination and growth under greenhouse conditions.

Dahurelmusin A, a Hybrid Peptide-Polyketide from Elymus dahuricus Infected by the Epichloë bromicola Endophyte.

One novel hybrid peptide-polyketide, dahurelmusin A (1), was isolated from Elymus dahuricus infected by the Epichloë bromicola endophyte. Comprehensive spectroscopic analysis revealed that 1 is the first example of hybrid peptide-polyketide possessing an unprecedented 5-hydroxy-2,2,4,6-tetramethyl-3-oxooctanoic acid moiety. The single-crystal X-ray diffraction analyses allowed the absolute configuration assignment of this compound. Compound 1 also exhibited significant insecticidal activities against Rhopalosiphum padi and Brevicoryne brassicae with LC50 values of 0.092 and 0.251 mM, respectively.

Mechanism research about the role of microbleeds for early cognitive impairment in small vascular disease / 上海交通大学学报（医学版）

Objective·To make clear the role of cerebral microbleeds (CMBs) for early cognitive impairment in small vessel disease (SVD). Methods·Fifty-seven consecutive SVD patients without dementia were strictly recruited. All participants were examined with a comprehensive battery of neuropsychological tests, SWI and DTI. According to the amount of CMBs, the patients were divided into CMBs group and non-CMBs group, or divided into multiple CMBs group (CMBs ≥ 3) and non-multiple CMBs group (CMBs<3). The mean diffusivity (MD) and fractional anisotropy (FA) in periventricular, central semiovale and subcortical white matter was analyzed with a region-of-interest method. Results·The score of multiple CMBs group in attention and memory function was significantly lower than that of the non-multiple CMBs group. Correlation analysis showed that the count of CMBs in the whole brain was significantly correlated with periventricular white matter MD, subcortical white matter MD, periventricular white matter FA and subcortical white matter FA. The count of CMBs in the whole brain adjusted by age, gender, education was significantly correlated with attention/executive function. After adjustment of subcortical/ periventricular white matter FA and MD and locations of CMBs they still had significant correlation. Conclusion·CMBs can reflect the degree of destruction of white matter integrity, and have independent effects on injury of brain parenchyma, resulting in early cognitive impairment. The research also suggests the role of CMBs in cognitive impairment may exist threshold value effect.

Application of aggameline in the treatment of depressive disorder and its effect evaluation / 中国生化药物杂志

Objective To explore the application and effect of aggameline in the treatment of depression. Methods 150 patients with depression treated in our hospital from January 2015 to December 2016 were randomly divided into three groups: A, B and C, 50 cases in each group. Group A was treated with rosiglitamine, group B was treated with venlafaxine, group C was treated with paroxetine. The improvement of symptoms before and after treatment in the three groups was observed[ (Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA)], Sleep Quality [Pittsburgh Sleep Quality Index (PSQI), Sleep Self-Rating Scale (SRSS)] and cognition Function [repeat sets of neuropsychological state test (RBANS), connection test (TMT)], and adverse drug reactions were recorded. Results After four weeks of treatment, the scores of HAMD and HAMA in the three groups were lower than those before treatment (P<0.05). The results of HAMD score showed that group B (P<0.05), but there was no significant difference between group A and group C. After treatment for four weeks, the scores of PSQI and SRSS were lower than those before treatment (P<0.05). There was no significant difference between group A and group B (P<0.05). After treatment, the scores of RBANS were higher than those before treatment (P<0.05), and delayed memory, attention to the two groups in group B> group C (P<0.05), There was no significant difference between the two groups in immediate memory; there was no statistically significant difference between the three groups after treatment and speech and visual acuity scores. After 4 weeks of treatment, the time to connect and connect sequentially was shorter than that before treatment (P<0.05), and the order of alternating time showed that group A<group B<group C (P<0.05), the order of alternating connection time showed that group A< group B and group C (P<0.05), but there was no significant difference in the order of alternating connection time between group B and group C. The incidence of adverse reactions in group A was lower than that in group B and C (P<0.05),but there was no significant difference between group B and group C. Conclusion Aggameline is effective in treating depression and has high safety and considerable clinical value.

Application of aggameline in the treatment of depressive disorder and its effect evaluation / 中国生化药物杂志

Objective To explore the application and effect of aggameline in the treatment of depression. Methods 150 patients with depression treated in our hospital from January 2015 to December 2016 were randomly divided into three groups: A, B and C, 50 cases in each group. Group A was treated with rosiglitamine, group B was treated with venlafaxine, group C was treated with paroxetine. The improvement of symptoms before and after treatment in the three groups was observed[ (Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA)], Sleep Quality [Pittsburgh Sleep Quality Index (PSQI), Sleep Self-Rating Scale (SRSS)] and cognition Function [repeat sets of neuropsychological state test (RBANS), connection test (TMT)], and adverse drug reactions were recorded. Results After four weeks of treatment, the scores of HAMD and HAMA in the three groups were lower than those before treatment (P<0.05). The results of HAMD score showed that group B (P<0.05), but there was no significant difference between group A and group C. After treatment for four weeks, the scores of PSQI and SRSS were lower than those before treatment (P<0.05). There was no significant difference between group A and group B (P<0.05). After treatment, the scores of RBANS were higher than those before treatment (P<0.05), and delayed memory, attention to the two groups in group B> group C (P<0.05), There was no significant difference between the two groups in immediate memory; there was no statistically significant difference between the three groups after treatment and speech and visual acuity scores. After 4 weeks of treatment, the time to connect and connect sequentially was shorter than that before treatment (P<0.05), and the order of alternating time showed that group A<group B<group C (P<0.05), the order of alternating connection time showed that group A< group B and group C (P<0.05), but there was no significant difference in the order of alternating connection time between group B and group C. The incidence of adverse reactions in group A was lower than that in group B and C (P<0.05),but there was no significant difference between group B and group C. Conclusion Aggameline is effective in treating depression and has high safety and considerable clinical value.

Highly oxygenated triterpenoids from the roots of Schisandra chinensis and their anti-inflammatory activities.

A new highly oxygenated triterpenoid, schinchinenlactone D (1), and three known compounds (2-4) were isolated from the roots of Schisandra chinensis. Their structures were determined by combining the spectroscopic analysis with the theoretical computations. The anti-inflammatory activities of compounds 1-4 were evaluated, and compound 3 exhibits the most significant activity in the inhibition of NO production with an IC50 value of 10.6 µM.

Antifungal, Phytotoxic, and Cytotoxic Activities of Metabolites from Epichloë bromicola, a Fungus Obtained from Elymus tangutorum Grass.

The development of high-quality herbage is an important aspect of animal husbandry. Inoculating beneficial fungi onto inferior grass is a feasible strategy for producing new varieties of high-quality herbage. Epichloë bromicola is a candidate fungus that is isolated from Elymus tangutorum. A total of 17 metabolites, 1-17, were obtained from E. bromicola, and their biological activities were assayed. Metabolite 1 exhibited antifungal activities against Alternaria alternata, Fusarium avenaceum, Bipolaris sorokiniana, and Curvularia lunata. EC50 values ranged from 0.7 to 5.3 µM, which were better than the positive control, chlorothalonil. Metabolite 8 displayed obvious phytotoxic effects toward Lolium perenne and Poa crymophila seedlings, and it was as active as glyphosate. None of these isolated metabolites displayed cytotoxicity against Madin-Darby bovine kidney cells. The IC50 values were greater than 100 µM, and the metabolites increased the growth of the cells at a concentration of 12.5 µM. The bioassay indicated that E. bromicola may be a beneficial fungus for producing new varieties of herbage with various resistances. Additionally, metabolite 7, 3-(2'-(4″-hydroxyphenyl)acetoxy)-2S-methylpropanoic acid, is a new natural product, and its stereochemistry was determined by means of optical rotation computation and chemical reactions.

The role of combination of traditional Chinese and western medicine on severe allergic rhinitis / 国际中医中药杂志

Objective To explore the effects of combination of traditional Chinese medicine (TCM)and western medicine on a variety of allergen induced severe perennial seasonal allergic rhinitis patients who were treated invalidly with antihistamines and intranasal flixonase for more than two years.Methods 16 patients with moderate to severe allergic rhinitis who were uncontrolled with antihistamines and intranasal flixonase for one week were treated by combination with TCM of Xin-Yi-Qing-fei San or Gyokubeifu-san mixed formula for two weeks.Nasal symptoms,its effects on the quality of daily life,and telephone follow-up half a year later were evaluated.Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ) and Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ) were used to evaluate the quality of life.Results After 2 weeks combination-treatment,the nasal symptoms of congestion,rhinorrhea,sneezing,nasal itching,and nasal obstruction were significantly improved compared with combination-before [(52.0± 11.1)％,(69.1±5.3)％,(68.3±12.3)％,(55.5±10.0)％to (10.9±2.4)％,(8.9±3.2)％,(12.5±4.3)％,(13.2±5.3)％,respectively].The before and after treatment of nasal function of nasal minimum cross-sectional area (MCA),nasal cavity volume (V5) and nasal airway resistance (R75 and R150) respectively were (0.58±0.12)cm2,(0.38 ± 0.23) Pa/cm3 · s-1,(0.44 ± 0.32) Pa/cm3 · s-1,(3.50 ± 2.33) cm2 to (0.48 ± 0.23) cm2,(0.31 ±0.33) Pa/cm3 · s-1,(0.31 ±0.37)Pa/cm3 · s-1,(2.24± 1.03) cm2 (P＜0.01).In addition,findings of patients with nasal symptoms by half year follow-up were significantly better than those of before.Conclusion The interventionof TCM can effectively control the perennial and seasonal severe symptoms of patients with AR,and improve the quality of life of patients.

Decreased expression of KLF6 and its significance in gastric carcinoma.

To study the expression of the Krüppel-like transcription factor 6 (KLF6) in human gastric carcinoma and normal gastric mucosa tissues, and to explore the role of KLF6 in the carcinogenesis and tumor progression and its clinical significance. Expression of KLF6, P21WAF1 and PCNA was investigated by immunohistochemistry for 69 surgically resected gastric carcinoma tissues and corresponding normal gastric mucosa tissues, respectively. The correlations of KLF6 expression with clinicopathological characteristics, P21WAF1 and PCNA were examined. Positive-expression of KLF6 was 64 out of 69 cases (92.8%) in normal gastric mucosa and only 23 cases (33.3%) in gastric carcinoma. Expression of KLF6 in the gastric carcinoma was remarkably lower than normal gastric mucosa. Decreased expression of KLF6 in gastric carcinoma was significantly associated with histological differentiation (P<0.01), TNM stage (P<0.05), lymph node metastasis (P<0.01) and distant metastasis (P<0.05). There was no significant correlation between KLF6 expression and sex, age. Meanwhile, expression of KLF6 was associated with expression of P21WAF1 in both normal gastric mucosa and gastric carcinoma (P<0.05). In addition, decreased expression of KLF6 in gastric carcinoma was positively associated with PCNA level (r=0.719, P<0.01) by association analysis. Down-regulation of KLF6 might play an important role in the carcinogenesis and development of human gastric carcinoma and have significant clinical value.

Nutritional study on Embellisia astragali, a fungal pathogen of milk vetch (Astragalus adsurgens).

Embellisia astragali is a strong, virulent pathogen that develops within milk vetch (Astragalus adsurgens). In order to determine nutrient requirements, the fungus was cultured on 9 carbon sources, 9 nitrogen sources, and 13 growth media in the dark at 25 degrees C. Growth rates and sporulation capacity were measured after 4 and 12 weeks. All carbon sources supported growth, but only soluble starch, inulin, and dextrose supported sporulation. In general, better growth was obtained on disaccharides and polysaccharides than on monosaccharides. Compared with no growth on NH(4) (+)-N and urea, the fungus grew little on all NO(3) (-)-N, amino-N, and other organic-N such as peptone. There was no sporulation or very sparse conidia on almost all nitrogen sources with supplied dextrose or soluble starch as sole carbon source. The better growth and sporulation on most of the semidefined media than on defined media indicates that some components in plant or animal material may be vital to the fungus. Sporulation was positively correlated with growth rate in N source experiment at 12 weeks and in growth media experiment at 4 and 12 weeks. The fungus favors grow within agar with growth rate less than 1.18 mm day(-1).

Interactions of Neotyphodium gansuense, Achnatherum inebrians, and plant-pathogenic fungi.

Interactions of Neotyphodium gansuense, Achnatherum inebrians, and nine fungal pathogens were studied by tests of inhibition of four fungal pathogens by Neotyphodium endophytes in vitro and by inoculation of nine fungal pathogens on detached leaves of endophyte-infected (E+) and endophyte-free (E-) plants. Compared with the controls, most isolates of N. gansuense significantly inhibited the growth in vitro of, in decreasing order of inhibition, Bipolaris sorokiniana, Curvularia lunata, Fusarium acuminatum, and Alternaria alternata. Inhibition zones appeared between pathogens and some isolates of N. gansuense. Some isolates of N. gansuense significantly inhibited sporulation of B. sorokiniana, A. alternata, and C. lunata. However, there was no significant inhibition of F. acuminatum and a few isolates significantly increased sporulation. The leaf inoculation trial indicated that almost all fungal pathogens were able to cause lesions on detached leaves regardless of endophyte status. Both the number and size of disease lesions on E+A. inebrians leaves caused by A. alternata, F. chlamydosporum, F. oxysporum, and F. solani were reduced compared with those on E- leaves. Only lesion numbers (not size) of Ascochyta leptospora leaf spots were significantly reduced on E+ leaves compared with E- leaves. Conversely, only the length of Ascochyta leptospora leaf spots were significantly smaller on E+ leaves than on E- leaves; numbers of lesions were not significantly affected. C. lunata was strongly pathogenic to both E+ and E- leaves and numerous lesions developed and merged into patches, the leaf surface was covered and the leaf rotted away.

Symptomology and etiology of a new disease, yellow stunt, and root rot of standing milkvetch caused by Embellisia sp. in Northern China.

An Embellisia sp. has been established as the cause of a new disease of the herbaceous perennial forage legume, 'standing milkvetch' (Astragalus adsurgens Pall.) in Northern China, which severely reduces plant density and degrades A. adsurgens stands. The disease was common at an experimental location in Gansu Province where it was recognized by the occurrence of stunted plants with reddish-brown stems and yellow and necrotic leaf blades. An Embellisia sp. was isolated from symptomatic stem, leaf blade, petiole, and root tissues at varying frequencies of up to 90%. Single-spore isolates grew very slowly on PCA, PDA, V-8 and, wheat hay decoction agar. Pathogenicity was confirmed by inoculation of seeds, dipping 2-day-old pre-germinated seedlings in inoculum and spraying inoculum on 6-month-old plants. Symptoms on test plants included yellow leaf lesions, brown lesions on stems and petioles, stunted side-shoots with yellow, small, distorted and necrotic leaves, shoot blight, bud death, crown rot, root rot, and plant death. The disease is named as 'yellow stunt and root rot' of A. adsurgens to distinguish it from diseases caused by other known pathogens. Embellisia sp. is also pathogenic to A. sinicus but not to 11 other tested plant species.

Endoscopic diagnosis and treatment of biliary leak in patients following liver transplantation: a prospective clinical study.

BACKGROUND: Orthotopic liver transplantation has been widely used in patients with end-stage liver disease within the last two decades. However, the prevalence of biliary complications after liver transplantation remains high. The most common short-term biliary complication may be biliary leak. So, we examined 13 patients with biliary leak after liver transplantation, attempting to evaluate the role of endoscopic diagnosis and treatment of biliary leak and the incidence of bile duct stricture after healing of the leak. METHODS: Six cases of T-tube leak and seven cases of anastomosis leak complicating liver transplantation were enrolled in this prospective study. Six patients were treated by endoscopic plastic stent placement, two by nasobiliary catheter drainage, two by papillosphincterotomy, and three by nasobiliary catheter drainage combined with plastic stent placement. Some patients received growth hormone treatment. RESULTS: The bile leak resolution time was 10-35 days in 10 patients with complete documentation. The median time of leak resolution was 15.3 days. Four cases of anastomosis stricture, three cases of common hepatic duct and one case of multiple bile duct stenosis were detected by follow-up nasobiliary catheter cholangiography or endoscopic retrograde cholangiopancreatography. CONCLUSIONS: Endoscopic nasobiliary catheter or plastic stent placement is a safe and effective treatment for bile duct stricture occurring after bile leak resolution in most liver transplantation patients. Nasobiliary catheter combined with plastic stent placement may be the best choice for treating bile leak, because, theoretically, it may prevent the serious condition resulting from accidental nasobiliary catheter dislocation, and it may have prophylactic effects on upcoming bile duct stricture, although this should be further confirmed.

[Inhibitory effect of YC-1 on induction of VEGF and GPI genes in hypoxic human pancreatic cancer cells].

OBJECTIVE: To investigate the function and mechanism of 3-(5'-hydroxymethyl-2'-furyl)-1-benzylindazole (YC-1) on activity of VEGF and GPI genes in human pancreatic cancer PC-3 cells incubated under hypoxic conditions. METHODS: Human pancreatic cancer PC-3 cells were incubated under hypoxic culture conditions. Immunocytochemical staining was used to detect HIF-1alpha protein expression in hypoxic and normoxic PC-3 cells. Semi-quantitative RT-PCR was used to detect the effect of YC-1 on the expression of VEGF and GPI mRNA and HIF-1alpha protein in PC-3 cells. Effect of YC-1 on the expression of HIF-1alpha protein was examined by Western blotting. MTF assay was used to detect proliferation of hypoxicPC-3 cells. RESULTS: HIF-1alpha expression was mainly located in nuclei in hypoxic PC-3 cells. The mRNA synthesis of VEGF and GPI and the protein expression of HIF-1alpha were significantly decreased in the group treated with the highest concentration of YC-1 (100 micromol/L). Compared to placebo, YC-1 inhibited the proliferation of hypoxic PC-3 cells greatly when it was increased to 100 micromol/L. CONCLUSION: YC-1 inhibited the transcription of VEGF and GPI in hypoxic human pancreatic cancer PC-3 cells. It was induced by down-regulation of HIF-1alpha protein. YC-1 inhibites the proliferation of PC-3 cells exposed to hypoxic conditions.