Misdiagnosed gastric diverticulum as a left adrenal lesion on imaging.

Key Clinical Message: Gastric diverticulum in the posterior wall of the stomach is very rare, and it is easy to be misdiagnosed as a left adrenal mass on imaging. Therefore, we must consider the possibility of gastric diverticulum when diagnosing a left adrenal mass. Abstract: This paper reports a case of gastric diverticulum that was misdiagnosed as a left adrenal mass on abdominal enhanced CT. The patient underwent laparoscopic adrenalectomy, but there was no mass in the left adrenal found during surgery. After the incision of the retroperitoneum, a cystic mass was found adjacent to the posterior gastric wall which turned out to be gastric diverticulum. This case suggests that gastric diverticulum, a rare disease, may be interpreted as an adrenal mass on imaging. Therefore, as a urologist, the gastric diverticulum must be excluded when CT suggests a mass in the left adrenal region.

Long-Term Immunogenicity and In Vitro Prophylactic Protective Efficacy of M. tuberculosis Fusion Protein DR2 Combined with Liposomal Adjuvant DIMQ as a Boosting Vaccine for BCG.

The resuscitation of dormant Mycobacterium tuberculosis is an important cause of adult tuberculosis (TB) transmission. According to the interaction mechanism between M. tuberculosis and the host, the latency antigen Rv0572c and region of difference 9 (RD9) antigen Rv3621c were selected in this study to prepare the fusion protein DR2. Stimulating clinically diagnosed active tuberculosis infections (i.e., TB patients), latent tuberculosis infections, and healthy controls confirmed that T lymphocytes could recognize DR2 protein in the peripheral blood of TB-infected individuals more than subcomponent protein. The DR2 protein was then emulsified in the liposome adjuvant dimethyl dioctadecyl ammonium bromide, and imiquimod (DIMQ) was administered to C57BL/6 mice immunized with Bacillus Calmette-Guérin (BCG) vaccine to evaluate their immunogenicity. Studies have shown that DR2/DIMQ, a booster vaccine for BCG primary immunization, can elicit robust CD4+ Th1 cell immune response and predominant IFN-γ+ CD4+ effector memory T cells (TEM) subsets. Furthermore, the serum antibody level and the expression of related cytokines increased significantly with the extension of immunization time, with IL2+, CD4+, or CD8+ central memory T cells (TCM) subsets predominant in the long term. This immunization strategy showed matched prophylactic protective efficacy by performing in vitro challenge experiment. This result provides robust evidence that the novel subunit vaccine prepared by fusion protein DR2 combined with liposomal adjuvant DIMQ is a promising TB vaccine candidate for further preclinical trials as a booster vaccine for BCG.

Schisandrin Protects against Norepinephrine-Induced Myocardial Hypertrophic Injury by Inhibiting the JAK2/STAT3 Signaling Pathway.

Aims. Heart failure is closely associated with norepinephrine-(NE-) induced cardiomyocyte hypertrophy. Schisandrin is derived from the traditional Chinese medicine Schisandra; it has a variety of pharmacological activities, and the mechanism of schisandrin-mediated protection of the cardiovascular system is not clear. Main Methods. NE was used to establish a cardiomyocyte hypertrophy model to explore the mechanism of action of schisandrin. An MTT assay was used for cell viability; Hoechst fluorescence staining was used to observe the cell morphology and calculate the apoptosis rate. The cell surface area was measured and the protein to DNA ratio was calculated, changes in mitochondrial membrane potential were detected, and the degree of hypertrophic cell damage was evaluated. WB, QRT-PCR, and immunofluorescence were used to qualitatively, quantitatively, and quantitatively detect apoptotic proteins in the JAK2/STAT3 signaling pathway. Key Findings. In the NE-induced model, schisandrin treatment reduced the apoptosis rate of cardiomyocytes, increased the ratio of the cell surface area to cardiomyocyte protein/DNA, and also, increased the membrane potential of the mitochondria. The expression of both JAK2 and STAT3 was downregulated, and the BAX/Bcl-2 ratio was significantly reduced. In conclusion, schisandrin may protect against NE-induced cardiomyocyte hypertrophy by inhibiting the JAK2/STAT3 signaling pathway and reducing cardiomyocyte apoptosis.

Overexpression of Sirt6 is a novel biomarker of malignant human colon carcinoma.

Sirt family has been reported playing a significant role in the cancer development, especial its deacetylase activity plays a key function, but whether SIRT6 plays a role in mediating tumor epithelial-mesenchymal transition (EMT) and metastasis in colon cancer has not been explored. Here, the mass spectrometry and co-immunoprecipitation assays were utilized to detect that SIRT6 was physically associated with transcription factor snail. Most important, HCT116 cells transfected with SIRT6 shRNA reversed EMT, while increased the expression of TET1, and the HCT116 cells transfected with SIRT6 displayed the contrary tendency. Transwell invasion assay, soft agar assay, as well as colony formation together showed that SIRT6 promoted cell EMT and tumorigenesis in vitro. We also found SIRT6 is a reader of snail. ChIP as well as qChIP suggested H3K9 binding on the promoter of TET1 dependent on SIRT6. SIRT6 promoted EMT process through two different ways, one is as a reader of snail, and other way was the suppression of TET1 transcription. These two ways are all dependent on its H3K9 deacetylase activity. Further, patient samples collected showed that SIRT6 was significantly increased in colon cancer samples, and its higher expression was correlated with poor prognosis, worse overall survivals. Together, our experiments revealed the mechanism for SIRT6 in facilitating tumorigenesis and metastasis of colon cancer cells, suggesting that SIRT6 might be a potential therapeutic target for treating colon cancer.

Constitutive activation of NF-κB signaling by NOTCH1 mutations in chronic lymphocytic leukemia.

NOTCH1 mutations occur in approximately 10% of patients with chronic lymphocytic leukemia (CLL). However, the relationship between the genetic aberrations and tumor cell drug resistance or disease progression remains unclear. Frameshift deletions were detected by gene sequencing in the NOTCH1 PEST domain in three naive CLL patients. These mutations were associated with chromosomal abnormalities including trisomy 12 or 13q deletion. Of note, one of the patients developed Richter's transformation during FCR treatment. Immunofluorescent and western blot analyses revealed a markedly higher intracellular domain of NOTCH (ICN) expression in the mutated cells compared with their unmutated counterparts and normal CD19+ B lymphocytes (P<0.01 and P<0.001, respectively). In addition, strong DNA-κB binding activities were observed in the mutant cells by gel shift assays. RT-PCR analysis revealed elevated RelA mRNA expression in the mutant cells, while RelB levels were variable. Reduced levels of RelA and RelB mRNA were observed in unmutated CLL and normal B cells. Compared to unmutated CLL and normal B cells, increased apoptosis occurred in the mutant cells in the presence of GSI (ICN inhibitor) and PDTC (NF-κB inhibitor), particularly under the synergistic effects of the two drugs (P=0.03). Moreover, IKKα and IKKß, the active components in the NF-κB pathway, were markedly inhibited following prolonged treatment with GSI and PDTC. These results suggested that NOTCH1 mutations constitutively activate the NF-κB signaling pathway in CLL, which is likely related to ICN overexpression, indicating NOTCH1 and NF-κB as potential therapeutic targets in the treatment of CLL.

Multiple proteins of White spot syndrome virus involved in recognition of beta-integrin.

The recognition and attachment of virus to its host cell surface is a critical step for viral infection. Recent research revealed that beta-integrin was involved in White spot syndrome virus (WSSV) infection. In this study, the interaction of beta-integrin with structure proteins of WSSV and motifs involved in WSSV infection was examined. The results showed that envelope proteins VP26, VP31, VP37, VP90 and nucleocapsid protein VP136 interacted with LvInt. RGD-, YGL- and LDV-related peptide functioned as motifs of WSSV proteins binding with beta-integrin. The beta-integrin ligand of RGDT had better blocking effect compared with that of YGL- and LDV-related peptides. In vivo assay indicated that RGD-, LDV- and YGL-related peptides could partially block WSSV infection. These data collectively indicate that multiple proteins were involved in recognition of beta-integrin. Identification of proteins in WSSV that are associated with beta-integrin will assist development of new agents for effective control of the white spot syndrome.

Histological and mechanical properties of autologous living tissue biotubes.

The aim of this study was to explore and evaluate biotubes consisting of autologous tissues. The biotubes were prepared by intra-abdominally embedding silicon rods as moulds. The specimens were analyzed by mechanical tests, histological observation and superficial study. The intra-abdominal implantation of the silicone tubes readily stimulated the development of the biotubes. The biotubes consisted of collagen-rich extracellular matrices. Myofibroblasts appeared as elongated cells with circumferential or longitudinal orientations. Subsequent to one month of embedding, the thickness of the tube wall was 70-250 µm. The burst strength was 1100±187 mmHg and the suturability was excellent. Biotubes that have the ability to be widely variable in their shapes are composed of autologous cells and glomerular extracellular matrices. Biotubes are ideal grafts for tissue engineering as they are able to avoid immunological rejection and are of sufficient mechanical strength.

[Studies on the chemical constituents in fruits of Acanthopanax gracilistylus].

OBJECTIVE: To study the chemical constituents in the fruits of Acanthopanax gracilistylus. METHODS: The chemical components were isolated and purified by silica gel, ODS C-18, and Sephadex LH-20 column chromatogram. The chemical structures were elucidated on the basis of physicochemical properties and spectral data. RESULTS: Ten compounds were isolated and identified as acankoreoside D(1), 3alpha, 11alpha-dihydroxylup-20(29)-en-28-oic acid(2), 3/3-([O-beta-D-glucopyranuronosyl] oxy) -olean-12-ene-28-olc acid (3),3beta-([O-beta-D-glucopyranuronosyl]oxy)-28-O-P3-D-glucopyranosyl-olean-12-ene-28-olc acid(4),oleanolic acid-3-O-6'-O-methyl-beta-D-glucuronopyranoside(5), acantrifoside A(6), acankoreoside A(7), (-)-kaur-16-en-19-oic acid(8), protocatechuic acid (9),beta-sitosterol(10). CONCLUSION: Compounds 2-5 are obtained from the fruits of the plant for the first time.

Clinical research into Qufeng Zhidong Recipe used to treat 31 children with tic disorder.

OBJECTIVE: To assess the therapeutic effect and adverse reaction of Qufeng Zhidong Recipe (a recipe for dispelling wind to stop abnormal movement) used to treat children with tic disorder (TD). METHODS: The enrolled patients were randomized into a TCM group (31 cases) treated with Qufeng Zhidong Recipe and a Western medicine group (30 cases) treated with haloperidol and trihexyphenidyl. Two courses of treatment were observed with 12 weeks as one course. The therapeutic effect and adverse reaction were assessed with Yale Global Tic Severity Scale (YGTSS), Tic Symptom Score Scale (TSSS), TCM Syndrome Score Scale (TCMSSS), Treatment Emergent Symptom Scale (TESS) and laboratory examinations. RESULTS: The total effective rate was 100% in the TCM group and 60% in the Western medicine group with statistical significance in difference (P < 0.05). All the scores in the TCM group were better than those in the Western medicine group (P < 0.05). CONCLUSION: Qufeng Zhidong Recipe can obviously relieve the symptoms and signs of TD children without toxic side-effects.

[Clinical observation of Flos magnoliae volatile oil nano-liposome nasal drops in treating pediatric allergic rhinitis].

OBJECTIVE: To observe the clinical efficacy of Flos Magnoliae volatile oil nano-liposome nasal drops (FMO) in treating pediatric allergic rhinitis (PAR). METHODS: Adopting parallel controlled method, the 191 patients with PAR were randomized into two groups. The observation group was treated with FMO, and the control group with Cetirizine. The clinical efficacy, main symptoms, signs, syndromes scores of Chinese medicine, and peripheral eosinophil (EOS) count were observed after 3-week treatment. RESULTS: In the observation group, the total effective rate was 94.84%, which was higher than that in the control group (78.72%); the effective rate on alleviating main symptoms (sneezing, nasal obstruction), signs (nasal mucosa edema, pallor) and the EOS count were significantly lowered, all were better than those in the control group (P <0.05). CONCLUSION: FMO has some positive effects on PAR, it might be realized by lowering the peripheral EOS.

Multicenter clinical study on the treatment of children's tic disorder with Qufeng Zhidong Recipe.

OBJECTIVE: To assess the effect and adverse reaction of Qufeng Zhidong Recipe (QZR) in treating children's tic disorder (TD). METHODS: With multicenter randomized parallel open-controlled method adopted, the patients enrolled were assigned to two groups, 41 cases in the Chinese medicine (CM) group and 40 in the Western medicine (WM) group. They were treated by QZR and haloperidol plus trihexyphenidyl respectively for 12 weeks as one course. In total, two courses of treatment were given. The curative effect and adverse reactions were evaluated by scoring with Yale Global Tic Severity Scale (YGTSS), Traditional Chinese Medicine Syndrome Scale (TCMSS), and Treatment Emergent Symptom Scale (TESS), as well as results of laboratory examinations. RESULTS: After one course of treatment, the markedly effective rate in the CM and the WM group was 14.6% and 17.5%, respectively, and the total effective rate 43.9% and 47.5%, respectively, which showed insignificant difference between groups (P>0.05). However, after two courses of treatment, markedly effective rate in them was 73.2% and 7.5%, and the total effective rate was 100.0% and 57.5%, both showing significant differences between groups (P<0.05). Besides, the adverse reactions occurred in the CM group was less than that in the WM group obviously. CONCLUSION: QZR has definite curative effect with no apparent adverse reaction in treating TD, and it can obviously improve the symptoms and signs and upgrade the quality of life and learning capacities in such patients.

A novel neurotrophic peptide: APP63-73.

The objective of this study was to find out which N-terminal segment/s of amyloid precursor protein (APP) has any neurotrophic properties, since soluble APP-alpha (sAPP-alpha) has neurotrophic effects. We investigated neurotrophic properties of eight peptide segments of N-terminal APP. The APP63-73 was able to enhance neuronal growth; augment axonal and cell body growth in human neuroblastoma cell line, SH-SY5Y. Neurotrophic effects of chronic APP63-73 treatment were assessed in vivo using streptozotocin-induced diabetes and ovariectomized rats. Thus, this study demonstrated that APP63-73 peptide has neurotrophic effects both in vivo and in vitro.

[The effect of lishi No.5 formula on the growth of human neuroblastoma cell line SY5Y].

OBJECTIVE: To investigate the effect of Lishi No.5 formula on the growth of human neuroblastoma cell line SY5Y and find out the most effective drug dose. METHOD: SY5Y cells were administrated by Lishi No.5 formula in different concentration. MTT metabolic rate was measured as the cell survival rate, then the dose-effect curve was made. LDH leakage rate, axonal length and area of cell body were used as the indicators. RESULT: In 0.125-0.75 g x L(-1) Lishi No. 5 formula could increase the cell survival rate and MTT metabolic rate, decreased LDH leakage rate, and enhance axonal length and area of cell body, compared with control group. CONCLUSION: Lishi No.5 formula has the neurotrophic effect and can induce the survival of neuron.

[The effect of jiunaoyizhi capsul on signal transduction pathway of SY5Y cell lines].

OBJECTIVE: To observe the effect of Jiunaoyizhi capsul on the signal transduction pathway of SY5Y cell lines and explore the mechanism of the function of the capsul's enhancing neuronal growth. METHOD: Human neuroblastoma was used as cell models and they were divided into control group and experimental group. Supernatant of cell lysate was taken and immunoprecipitation was done with antibodies to proteins related to signal transduction pathway, and the immunoprecipitates were analyzed by Western blotting. RESULT: After treatment with Jiunaoyizhi capsul, expression of Akt/PKB, CREB, P-CREB was clearly increased and expression of cytochrome C decreased more than the control group. CONCLUSION: Jiunaoyizhi capsul can promote expression of some proteins related with signal transduction pathway in SY5Y cell lines. Mechanism of Jiunaoyizhi capsul's enhancing neuronal growth is relevant to expression of some proteins in signal transduction pathway.