Facilitation of spinal α-motoneuron excitability by histamine and the underlying ionic mechanisms / 生理学报

Spinal α-motoneurons directly innervate skeletal muscles and function as the final common path for movement and behavior. The processes that determine the excitability of motoneurons are critical for the execution of motor behavior. In fact, it has been noted that spinal motoneurons receive various neuromodulatory inputs, especially monoaminergic one. However, the roles of histamine and hypothalamic histaminergic innervation on spinal motoneurons and the underlying ionic mechanisms are still largely unknown. In the present study, by using the method of intracellular recording on rat spinal slices, we found that activation of either H or H receptor potentiated repetitive firing behavior and increased the excitability of spinal α-motoneurons. Both of blockage of K channels and activation of Na-Ca exchangers were involved in the H receptor-mediated excitation on spinal motoneurons, whereas the hyperpolarization-activated cyclic nucleotide-gated (HCN) channels were responsible for the H receptor-mediated excitation. The results suggest that, through switching functional status of ion channels and exchangers coupled to histamine receptors, histamine effectively biases the excitability of the spinal α-motoneurons. In this way, the hypothalamospinal histaminergic innervation may directly modulate final motor outputs and actively regulate spinal motor reflexes and motor execution.

The characteristics and outcome of Stenotrophomonas maltophilia bacteremia in patients with neutropenia / 天津医药

@#Objective To investigate the characteristics and outcome of Stenotrophomonas maltophilia bacteremia in patients with neutropenia. Methods The clinical data of Stenotrophomonas maltophilia bacteremia in patients with neutropenia from January 2006 to December 2016 were respectively analyzed. Results In 32 patients with neutropenia, there were 20 cases with acute leukemia, 7 cases with severe aplastic anemian (SAA), and 5 cases of non-hodgkin lymphoma. All patients had long time to use broad-spectrum antibiotic history. Twenty-one patients had central venous catheters and eleven had peripheral venous catheters in situ. Twenty-five patients were found neutropenia due to chemotherapy, and seven cases with bone failure attributed to SAA. Seventeen patients were dead, and fifteen recovered. Drug susceptibility tests showed multiple drug resistance. Stenotrophomonas maltophilia were partially susceptive to tigercycline, trimethoprim - sulfamethoxazole, levofloxacin, cefoperazone-sulbactam. ceftazidime, minocycline and piperacillin-tazobactam. The severe neutropemia, thrombocytopenia, long duration of granulocyte reduction and polymicrobial infection were the adverse prognostic factors. Conclusion Stenotrophomonas maltophilia bacteremia in patients with neutropenia has a high mortality rate, which needs to timely diagnose and treatment with effective antibiotics.

Comparison of two different renorrhaphy techniques in retroperitoneal laparoscopic partial nephrectomy for complex tumor / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Partial nephrectomy is currently the standard treatment for clinical T1 renal neoplasms, as it can provide oncologic outcomes equivalent to radical nephrectomy. The aim was to evaluate the efficacy of self-retaining suture (SRS) in renorrhaphy technique in retroperitoneal laparoscopic partial nephrectomy (LPN) for a single renal mass of moderate or high complexity by assessing peri-operative outcomes.</p><p><b>METHODS</b>A retrospective analysis was done of 64 patients between 2010 and 2012 for complex renal mass (RENAL score ≥ 7) in whom retroperitoneal LPN was performed with two layers using continuous knotless barbed suture (Quill PDO SRS group; n = 34) and absorbable vicryl (non-SRS group; n = 30), respectively. Cases were matched for RENAL score. All the surgical procedures were performed by the same surgeon with experience of more than 500 cases of LPN. Comparisons were made in patients and preoperative outcomes and peri-operative complications between SRS group and non-SRS group.</p><p><b>RESULTS</b>Mean warm ischemia time (WIT) in SRS group was less than non-SRS group (18.0 vs. 24.8 minutes, P = 0.021). Renorrhaphy suture cost in SRS group was lower than non-SRS group ($269.6 vs. $335.8, P = 0.001). There were no significant differences between the two groups for postoperative changes in creatinine and estimated glomerular filtration rate and the rate of peri-operative complications.</p><p><b>CONCLUSION</b>SRS was safe for complex renal tumor with two layers, continuous and unknot suture, during LPN and would reduce the WIT and renorrhaphy suture cost significantly.</p>

Retroperitoneal laparoscopic living donor nephrectomy: report of 58 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To review a single-institution experience with retroperitoneal laparoscopic living donor nephrectomy (RLDN).</p><p><b>METHODS</b>Fifty-eight donors underwent RLDN at our institution (including 32 male and 26 female donors aged 20-61 years, mean 42 years). Left nephrectomy was performed in 56 cases. The first 35 patients underwent total RLDN, and the latter 23 received modified RLDN.</p><p><b>RESULTS</b>RLDN was performed successfully in all the patients without conversion to open surgery. The mean surgical time was 93 min (range 70-130 min), and the mean blood loss was 20 ml (range 10-50 ml), with a mean warm ischemia time of 2.8 min (1.3-6 min). Retroperitoneal hematoma occurred postoperatively in one case. The mean hospital stay of the donors was 6.4 days (5-10 days). Two recipients showed delayed graft function, and one graft was lost because of acute rejection. The other recipients had normal renal function in two weeks except for 3 having normal renal function in 4 weeks.</p><p><b>CONCLUSION</b>RLDN is a safe procedure with minimal invasiveness, and the modified RLDN lowers the learning curve of the surgery.</p>

Prostate androgen-regulated gene: a novel potential target for androgen-independent prostate cancer therapy / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To investigate the involvement of the prostate androgen-regulated (PAR) gene in the androgen receptor (AR) signaling pathway and the malignant phenotype of androgen-independent prostate cancer (PCa) cells.</p><p><b>METHODS</b>The difference in PAR expression between LNCaP and PC3 cells was detected by reverse transcription-polymerase chain reaction (RT-PCR). Androgen and anti-androgen effects on PAR expression were evaluated by RT-PCR in LNCaP, PC3 cells and PC3 cells stably transfected with vector containing wild-type AR. To determine the importance of PAR in the malignant proliferation of androgen-independent PCa cells, we used small interfering RNA (siRNA) transfection to knock down the expression of the gene in PC3 cells. The changes in the malignant phenotype of PCa cells after transfection were analyzed by cell count, colony formation in soft agar and flow cytometry.</p><p><b>RESULTS</b>PAR expression was 3-fold higher in PC3 cells than that in LNCaP cells. Dihydrotestosterone (DHT) regulated PAR mRNA expression in LNCaP cells and the effect was inhibited by the AR antagonist, flutamide. By contrast, DHT did not affect PAR expression in PC3 cells. The reintroduction of AR into PC3 cells by stable transfection restored the androgen effect on PAR upregulation. After the knockdown of the PAR gene by siRNA, PC3 cells exhibited a reversal of the malignant phenotype.</p><p><b>CONCLUSION</b>Because of the possibility that PAR is downstream from the AR, and because of its contribution to malignant proliferation in androgen-independent PCa cells, the gene could be a potential therapeutic target for androgen-independent PCa with AR signaling pathway alteration.</p>

Retroperitoneoscopic subcapsular nephrectomy for infective nonfunctioning kidney with dense perinephric adhesions.

OBJECTIVE: To evaluate the feasibility and clinical efficacy of retroperitoneoscopic subcapsular nephrectomy for infective nonfunctioning kidneys with dense perinephric adhesions. PATIENTS AND METHODS: Twelve patients underwent retroperitoneoscopic subcapsular nephrectomy; the operative duration, blood loss, intestinal functional recovery time, complications during surgery and efficacy were recorded. Dissociation and ligation of the renal pedicle was the most important step, at which the renal capsule was cut near the renal hilum using a harmonic scalpel, and the fatty tissue around the renal hilum dissected carefully. The renal pedicle was then ligated and divided using an endoscopic linear stapler-cutter after the renal pedicle tissues had been separated to an adequate thickness. RESULTS: All 12 operations were successful and none required conversion to open surgery. The mean (SD, range) operative duration was 82.9 (22.3, 45-120) min, the blood loss 51.4 (12.2, 30-75) mL and the intestinal functional recovery time 12-48 h. There were no complications during or after the surgery, and in the follow-up of 1-15 months the short-term results were satisfactory. CONCLUSION: Retroperitoneoscopic subcapsular nephrectomy can be used safely to remove an infected and heavily adhesive nonfunctioning kidney, with minimal trauma and blood loss, and with faster recovery than after an open subcapsular nephrectomy.

Retroperitoneal laparoscopic management of primary aldosteronism with report of 130 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate retroperitoneal laparoscopic partial or total adrenalectomy for primary aldosteronism.</p><p><b>METHODS</b>From February 2000 to September 2003, 130 patients (76 women and 54 men) with a confirmed diagnosis of primary aldosteronism underwent retroperitoneal laparoscopic operation. Of the 130 cases, there were 119 cases with Aldosterone-producing Adenoma and 11 cases with Idiopathic Adrenal Hyperplasia (unilateral of 2 cases). Eleven cases with Idiopathic Adrenal Hyperplasia underwent unilateral adrenalectomy. Of the 119 cases with Aldosterone-producing Adenoma, 61 cases underwent total adrenalectomy, and 58 cases underwent partial adrenalectomy. All cases were with preoperatively high plasma aldosterone, low plasma rennin and hypokalemia and arterial hypertension.</p><p><b>RESULTS</b>Operations were successfully performed in all cases. The operative time ranged from 15 to 225 min (mean 52 +/- 40 min, Md = 43 min) and the operative bleeding ranged from 0 to 200 ml (mean 23 +/- 34 ml, Md = 20 ml, zero bleeding means that less than 5 ml) without blood transfusion. The hospital length of stay was ranged from 3 to 9 d (mean 5.1 +/- 1.3 d). No major complication occurred. Kalemia was normalized within one month and aldosterone/PRA ratio was decreased obviously in all cases. Postoperatively blood pressure was normalized within 2 month in 88 cases without using any drug.</p><p><b>CONCLUSION</b>It is safe and practical to perform retroperitoneal laparoscopic partial on total adrenalectomy on the patients with primary aldosteronism.</p>

Production in Pichia pastoris and characterization of genetic engineered chimeric HBV/HEV virus-like particles / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the presentation of a neutralization epitope-containing peptide antigen of hepatitis E virus (HEV) on chimeric virus-like particles (VLPs) of hepatitis B surface antigen (HBsAg).</p><p><b>METHODS</b>The gene fragment corresponding to amino acids (aa) 551-607 (HEnAg) of HEV capsid protein, which contains the only neutralization epitope identified to date, was fused via a synthetic glycine linker in frame with the gene of HBsAg. The resulted fusion gene was then integrated through transformation into the genome of Pichia pastoris under the control of a methanol-induced alcohol oxidase 1 (AOX1) promoter and expressed intracellularly. The expression products in the soluble cell extracts were characterized by Western blot, ELISA, CsCl density gradient analysis, and electron microscopic visualization.</p><p><b>RESULTS</b>The novel fusion protein incorporating HBsAg and the neutralization epitope-containing HEnAg was expressed successfully in Pichia pastoris with an expected molecular weight of approximately 32 kD. It was found to possess the ability to assemble into chimeric HBV/HEV VLPs with immunological physical and morphological characteristics akin to HBsAg particles. Not only did the chimeric VLPs show high activity levels in a HBsAg particle-specific ELISA but they were also strongly immunoreactive with hepatitis E (HE) positive human serum in a HEV specific ELISA, indicating that HEnAg peptide fragments were exposed on VLP surfaces and would be expected to be readily accessible by cells and molecules of the immune system. Similarity between chimeric VLPs to highly immunogenic HBsAg particles may confer good immunogenicity on surface-displayed HEnAg.</p><p><b>CONCLUSION</b>The chimeric HBV/HEV VLPs produced in this study may have potential to be a recombinant HBV/HEV bivalent vaccine candidate.</p>