Sulforaphane protects liver injury induced by intestinal ischemia reperfusion through Nrf2-ARE pathway

AIM: To investigate the effect of sulforaphane (SFN) on regulation of NF-E2-related factor-2 (Nrf2)-antiox-idant response element (ARE) pathway in liver injury induced by intestinal ischemia/reperfusion (I/R). METHODS: Rats were divided randomly into four ex-perimental groups: control, SFN control, intestinal I/R and SFN pretreatment groups (n = 8 in each group). The intestinal I/R model was established by clamping the superior mesenteric artery for 1 h and 2 h reperfu-sion. In the SFN pretreatment group, surgery was performed as in the intestinal I/R group, with intraperitoneal administration of 3 mg/kg SFN 1 h before the op-eration. Intestine and liver histology was investigated. Serum levels of aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were measured. Liver tissue superoxide dismutase (SOD), myeloperoxidase (MPO), glutathione (GSH) and glutathione peroxidase (GSH-Px) activity were assayed. The liver transcription factor Nrf2 and heme oxygenase-1 (HO-1) were determined by immunohistochemical analysis and Western blotting analysis.RESULTS: Intestinal I/R induced intestinal and liver injury, characterized by histological changes as well as a signif icant increase in serum AST and ALT levels (AST: 260.13 ± 40.17 U/L vs 186.00 ± 24.21 U/L, P < 0.01; ALT: 139.63 ± 11.35 U/L vs 48.38 ± 10.73 U/L, P < 0.01), all of which were reduced by pretreatment with SFN, respectively (AST: 260.13 ± 40.17 U/L vs 216.63 ± 22.65 U/L, P < 0.05; ALT: 139.63 ± 11.35 U/L vs 97.63 ± 15.56 U/L, P < 0.01). The activity of SOD in the liver tissue decreased after intestinal I/R (P < 0.01), which was enhanced by SFN pretreatment (P < 0.05). In ad-dition, compared with the control group, SFN markedly reduced liver tissue MPO activity (P < 0.05) and elevat-ed liver tissue GSH and GSH-Px activity (P < 0.05, P < 0.05), which was in parallel with the increased level of liver Nrf2 and HO-1 expression.CONCLUSION: SFN pretreatment attenuates liver injury induced by intestinal I/R in rats, attributable to the antioxidant effect through Nrf2-ARE pathway.

Three-dimensional dynamic contrast-enhanced MR angiography for evaluating recipient vessels in orthotopic liver transplantation

BACKGROUND: With the improvement of MR technology, three-dimensional dynamic contrast-enhanced MR angiography (3D-DCE-MRA) may be the optimal vascular imaging method for preoperative evaluation of liver transplantation candidates. This study was undertaken to determine the value of 3D-DCE-MRA in the assessment of recipient vessels in orthotopic liver transplantation (OLT). METHODS: The surgical and pathological records were taken as the 'gold standards'. Eighteen cases of OLT were retrospectively analyzed to assess the image quality of MRA, including the signal-to-noise ratio (SNR) in arteries and veins, depiction of vascular variation and vessel disease, and the accuracy of vascular diameter measurement. RESULTS: 3D-DCE-MRA of 34 cases was carried out before OLT. The rates (excellent and good) showing hepatic arteries and portal vein for 3D-DCE-MRA were 94.1% (32/34) and 88.2% (30/34), respectively. The SNRs of the celiac axis and portal vein measurements from 3D-DCE-MRA were 20.58 +/- 3.74 and 13.43 +/- 4.12, and the mean diameters were 3.4 +/- 0.3 rum and 13.1 +/- 3.2 mm, respectively. There were 5 cases of vessel variation according to the Michel's classification. Of the 34 patients, 18 were compared radiologically and pathologically. The accuracy of depiction of the hepatic artery and portal vein with 3D-DCE-MRA was 100% for both; 3D-DCE-MRA precisely assessed 4 cases of more than moderate stenosis in hepatic arteries, 2 cases of small-caliber hepatic artery, 3 cases of venous stenosis at the second porta hepatis, 6 cases of collateral vasculature, I case of portal vein thrombosis and I case of portal vein aneurysm; all were confirmed pathologically. CONCLUSION: 3D-DCE-MRA may be the first choice for recipient vascular assessment before OLT.

Protective effects of pLNCX-SOD gene transfection on hepatocyte injury induced by obstructive jaundice in rats

BACKGROUND: Hydrophobic bile acids lead to the generation of oxygen free radicals in mitochondria. Accordingly, this study is to investigate if gene delivery of superoxide dismutase (SOD) will reduce hepatocyte injury caused by experimental cholestasis. METHODS: The recombinant of pLNCX-SOD gene packaged with lipofection of AMINE was transfected into hepatocytes in vitro, which stably expressed the SOD gene. RESULTS: After transfection, hepatocytes enhanced the protective effect against injury to bile and the toxicity of serum in obstructive jaundice. The inhibition of bile at the concentration of 2% (v: v, bile: DMEM 1: 50) decreased obviously from (78.80 +/- 12.35)% to (43.35 +/- 9.69)% in 12 hours, from (82.55 +/- 11.27)% to (-26.64 +/- 7.66)% in 24 hours, and from (83.83 +/- 18.69)% to (-19.27 +/- 14.38)% in 48 hours, compared with that of the untransfected cells (P < 0.01). The inhibition of serum at the obstructive jaudice concentration of 2.5% was obviously decreased from (89.72 +/- 1.52)% to (14.68 +/- 14.33)% in 12 hours, from (92.2 +/- 11.27)% to (41.39 +/- 7.66)% in 24 hours, and from (94.25 +/- 8.96)% to (22.71 +/- 4.38)% in 48 hours (P < 0.01). CONCLUSION: Hepatocytes transfected with the pLNCX-SOD gene could obviously be resistant to the toxicity of bile and serum from rat with obstructive jaundice.

Detection and characterization of hepatocellular carcinoma in rats with liver cirrhosis:diagnostic value of combined use of MR positive and negative contrast agents

BACKGROUND: Gadolinium-enhanced multi-phase dynamic imaging has improved the accuracy of the diagnosis of hypervascular hepatocellular carcinoma (HCC), but using gadolinium-enhanced dynamic imaging alone is problematic in evaluating hypovascular HCC. This work aimed at evaluating the combined use of superparamagnetic iron oxide (SPIO)-enhanced and gadolinium set in distinguishing HCCs from regenerative nodules (RNs) in a rat model induced by diethylnitrosamine (DEN). METHODS: DEN-induced HCC model rats (n=40) and control rats (n=10) were studied. From weeks 16 to 19 after DEN administration, 4 animals were scanned every week. The hepatic changes were tested with a 1.5 Tesla magnet, and MR images of SPIO-enhanced and gadolinium set were obtained. According to the pathologic changes, the tumorigenesis was divided into HCC and RN (diameter of nodules >= 3 mm). Diagnostic accuracy of the combined SPIO-enhanced and gadolinium set and the gadolinium set alone was evaluated using receiver-operating characteristic curves. Sensitivity and specificity of the combined SPIO-enhanced and gadolinium set and the gadolinium set alone were calculated. RESULTS: The listed tests were completed in 29 rats (21 treated and 8 controls). One hundred and six nodules (82 HCCs, 24 RNs) were analyzed. The Az value and sensitivity with the combined SPIO-enhanced and gadolinium set (Az 0.94, sensitivity 0.96) were higher than those with the gadolinium set alone (Az 0.92, sensitivity 0.89). Using the combined SPIO-enhanced and gadolinium set led to detection of 6 nodules which were negative in the gadolinium set alone and 3 nodules were correctly characterized. CONCLUSION: Using the combined SPIO-enhanced and gadolinium set improved the detectability of HCCs and the SPIO-enhanced imaging compensated for the gadolinium set in differentiating HCCs from RNs in a rat model.

Chronic niacin overload may be involved in the increased prevalence of obesity in US children

AIM: To investigate nicotinamide’s action on glucose metabolism, and the association between niacin consumption and obesity prevalence. METHODS: Dynamic nicotinamide’s effect on plasma hydrogen peroxide and glucose metabolism was in- vestigated using oral glucose tolerance tests with or without nicotinamide in the same five healthy subjects.Lag-regression analysis was used to examine the association between the niacin consumption and the obesity prevalence among US children using the data from the Economic Research Service of the US Department of Agriculture and from US Centers for Disease Control and Prevention, respectively. RESULTS: Compared with the control oral glucose tolerance test, the 1-h plasma hydrogen peroxide (1.4 ± 0.1 μmol/L vs 1.6 ± 0.1 μmol/L, P = 0.016) and insulin levels (247.1 ± 129.0 pmol/L vs 452.6 ± 181.8 pmol/L, P = 0.028) were signif icantly higher, and the 3-h blood glucose was signif icantly lower (5.8 ± 1.2 mmol/L vs 4.5 ± 1.1 mmol/L, P = 0.002) after coadministration of glucose and 300 mg nicotinamide. The obesity prevalence among American children increased with the increasing per capita niacin consumption, the increasing grain contribution to niacin due to niacin-fortification, and the increasing niacin-fortified ready-to-eat cereal consumption, with a 10-year lag. The regression analyses showed that the obesity prevalence in the US children of all age groups was determined by niacin consumption (R2 = 0.814, 0.961 and 0.94 for 2-5 years, 6-11 years and 12-19 years age groups, respectively). CONCLUSION: The appetite-stimulating effect of nicotinamide appears to involve oxidative stress. Excess niacin consumption may be a major factor in the increased obesity prevalence in US children.

Non-traumatic diaphragmatic hernia of the liver in an adult:a case report

BACKGROUND: Diaphragmatic hernia of the liver is a rare clinical entity, usually found after trauma in adults. This study was undertaken to elucidate a misdiagnosis of non-traumatic diaphragmatic hernia of the liver in an adult. METHOD: The clinical data of one patient with non-traumatic diaphragmatic hernia of the liver was analyzed. RESULTS: A tumor in the right lower thorax was revealed by chest X-ray and computed tomography. Non-traumatic diaphragmatic hernia of the liver was not identified until the operation. Pathological analysis confirmed the finding. The patient recovered well. CONCLUSIONS: Non-traumatic diaphragmatic hernia of the liver in an adult is a rare right-sided diaphragmatic hernia, which can move up into the chest cavity. It should be distinguished from lung cancer. The diagnosis and evaluation of non-traumatic diaphragmatic hernia of the liver can help optimize surgical management.

Efficacy of solifenacin with or without tamsulosin in patients with overactive bladder

Objective To evaluate the efficacy of sollfenacin with or without tamsulosin in patients with overactive bladder ( OAB ) . Methods Fifty-three patients with OAB were randomly divided into two groups ( group

Investigation of the direct microsurgery of ICCA aneurysms via the carotid artery-cavernous sinus space approach

Objective To discuss the approach and technique of the direct microsurgery of intracavemous sinus carotid artery aneurysms (ICCAAns). Methods All the 15 cases of ICCAAns underwent the direct microsurgery via the carotid artery-cavernous sinus space approach. Results Immediate carotid arteriography after the surgery showed that the aneurysms disappeared and the carotid artery could be showed clearly and normall. In a follow up period ranged frcm 1 months to 9 years,it was showed that,among 5 cases with 333,IV,V a,VI nerve paralysis before the surgery, three completely recovered,one recovered incompletely. All patients regained the capability of undertaking mormal cativities. None experienced rebleeding or neuroparalysis. Conclusion Direct microsurgery via this is approach is an ideal treatment of ICCAAns. 6 refs.

Optimal margin in nephnm-sparing surgery for renal cell carcinoma 4 cm or less in diameter.

Objective To investigate the optimal margin in nephron-sparing surgery (NSS) for renal cell carcinoma (RCC) 4 cm or less in diameter. Methods Eighty-two kidneys with RCC 4 cm or less in diameter resected by radical nephrectomy were prospectively studied. The kidney samples were sectioned at 3 mm interval and examined for multicentricity. On each layer of tissue sectioned, parenchyma margin of 15 mm beyond pseudocapsule was continuously sectioned and examined for completeness of pseudocapsule and extra-pseudocapsule cancer lesion. The farthest distance between extra-pseudocapsule lesion and primary tumor was measured. PCNA expression was detected in 41 patients by using standard SP immunohistochemistry technique. Results The diameter of 82 primary tumors was 3. 4 ± 0. 8 cm (range 1.5-4.0 cm).Of these,31.7% (26/82) were found without intact pseudocapsules and 17.1% (14/82) with positive cancer lesions beyond pseudocapsule. The average distance between extra-pseudocapsule cancer lesion and primary tumor

The effects of intravesical therapy with elemene in preventing postoperative recurrence of bladder cancer

To investigate the effects of intravesical therapy with elemene in preventing postoperative recurrence of superficial bladder cancer and its toxic and side effects.Methods This series included 123 patients with superficial bladder cancer (T1),consisting of transitional cell carcinoma GⅠ in 37 cases,GⅡ in 73 and GⅢ in 13.They all underwent surgical treatment.Postoperatively,they were randomly assigned to 2 groups;63 patients in elemene group received instillation of elemene (400 mg,once a week) 2 weeks after operation and 60 patients in mitomycin C (MMC) group received instillation of MMC (40 mg,once a week) 2 weeks after operation.The instillations were repeated for 6 weeks and thereafter monthly for 1 year.The recurrence rates,side effects,and NK cell activity before and after treatment were evaluated.Results The recurrence rate of elemene group (mean follow-up of 19.7 months) was 7.9% (5 cases),which was significantly lower than that (25.0%,15 cases) of MMC group (mean follow-up of 19.4 months;P<0.05).The side effect in elemene group (3.2%,2 cases) was significantly milder than that in MMC group (25.0%,15 cases)(P<0.05).In elemene group,the NK cell activity after treatment (28±2)% was significantly higher than that before treatment(20±2)%(P<0.05).Conclusion Instillation of elemene after operation is effective and safe in preventing postoperative recurrence of bladder cancer.8 refs.

The influence of family history of diabetes and central obesity on prediabetes and their interaction

Objective To explore the influence of family history of diabetes and central obesity on prediabetes (Pre-DM)and their interaction.Methods Based on the REACTION study during August December 2011 in Dalian,2 587 individuals aged≥40 with normal blood glucose (BG)were divided into newly diagnosed Pre-DM (n=522) and BG normal group(NC,n=2 065) during follow-up.

Cbl-b and PI3K/Akt pathway are differently involved in oxygen- glucose deprivation preconditioning in PC12 cells

Background Transient sublethal ischemia is known as ischemic preconditioning, which enables cells and tissues to survive subsequent prolonged lethal ischemic injury. Ischemic preconditioning exerts neuroprotection through phosphatidylinositol 3-kinase （PI3K）/Akt pathway. Cbl-b belongs to the Casitas B-lineage lymphoma （Cbl） family, and it can regulate the cell signal transduction.The roles of ubiquitin ligase Cbl-b and PI3K/Akt pathway and the relationship between them in oxygen-glucose deprivation preconditioninq （OGDPC） in PC12 cells were investiaated in the ore.~e.nt study

Chinese twins both with aortic dissection

To the editor： We read with a great interest the article by Nienaber et al. They reported that Mayo Clinic has eight of240 patients with artery dissections who had doctnnented family history, and four of them were from German, English and Swedish t＇amilies with no Marfan＇s syndrome. We report Chinese twins both with aortic dissection. A 58-year-old Chinese man was admitted with the complaint of chest pain 10 days ago and reoccurring in 2 days. He experienced sudden onset of chest pain when he took rest at home 10 days ago. The pain was very sharp with oppression and extended to both sides of tooth, shoulder and back. It lasted for more than 90 minutes with sweating. He was sent to a local hospital and diagnosed as acute myocardial inthrction with a slight ST elevation in leads ii, 111, and aVF by electrocardiogram. The lbllowing laboratory tests, including cardiac biomarkers were all within normal limits. The pain re-occurred on the 9th day and migrated to his back. The ECG revealed the same as 9 days ago and he was diagnosed as acute myocardial re-inlhrction. The patient was transferred to our hospital without hypertension and diabetes mellitus （DM） history. He had a cigarette smoking history for 20 years with 30 cigarettes per day, drinking alcohol tbr 20 years with 250 ml per day and no cocaine abuse. There was no lhmily history of coronary artery diseases, but his lather had died of sudden death in his 40s. Nine siblings are all healthy and all in 1.8 m high but no near-sighted or skeleton abnormal development. Physical exalnination revealed normal vital signs with blood presstire 137/74 mmHg （1 mmHg=0.133 kPa） and no difference in both arms, body mass index 29.86 kg/m-~ and clear lungs. No aortic regurgitation murmur or pericardial friction rub was heard. No murmurs on back or abdomen were heard. He was performed cardioangiography （CAG） on arrival to our hospital and three coronary arteries revealed no stenosis or occlusion. The lbllowing contrast-enhanced spiral CT showed aortic dissection DeBakey I11 and Stanibrd A with left renal artery involved （Figure 1A, I B）. Echocardiogram finding was compatible with ascending aorta dissection with normal aortic valve. His renal t／lnction was getting worse and worse. Other laboratory tests were normal which include cardiac biomarkers. He was placed in cardiac care unit （CCU） and administrated of intravenous and oral medication lbr well controlling blood presstire. He was discharged alter 2 weeks with mild degree abnonnal renal timction. He was followed up lbr7 years and renal function was in border line.

Detection of carboxyhemoglobin in patients with hepatic encephalopathy due to hepatitis B virus-related cirrhosis

Background The heme oxygenase/carbon monoxide （HO/CO） system plays an important role in the development of hepatic fibrosis. The level of the HO/CO can be directly obtained by determining the carboxyhemoglobin （COHb） level. The aims of this study were to reveal the significance of COHb in patients with hepatitis B virus-related cirrhosis （HBC） complicated by hepatic encephalopathy （HE）, and to further investigate the influence of the HO/CO pathway on the end-stage cirrhosis, hoping to find a reliable indicator to evaluate the course of HBC. Methods According to the diagnostic criteria, 63 HBC inpatients with HE were enrolled in group H. Patients regaining awareness with current therapies were categorized into group P-H. Comparisons were made with a control group （group N） consisting of 20 health volunteers. The levels of COHb, partial pressure of oxygen （PaO2） and oxygen saturation （SaO2） were determined by arterial blood gas analysis method. The incidences of hepatorenal syndrome （HRS）, upper gastrointestinal bleeding, esophagogastric varices and spontaneous bacterial peritonitis （SBP） in group H were recorded. COHb levels in different groups were compared, and the correlations of COHb levels with HE grades （I, II, III, and IV）, PaO2, SaO2 and hypoxemia were analyzed. Results The COHb level in group P-H （（1.672＋0.761）%） was significantly higher than that in group N （（0.983±0.231）%） （P 〈0.01 ）, and the level in group H （（2.102±1.021）%） was significantly higher than groups P-H and N （P 〈0.01 ）. A positive correlation was observed between the COHb concentration and the grade of HE （rs=0.357, P=-0.004）. There were no significant differences of COHb levels between HE patients with and without complications such as esophagogastric varices （（2.302±1.072）% vs. （1.802±1.041）%, P 〉0.05） or the occurrence of SBP （（2.960±0.561）% vs. （2.030±1.021）%, P 〉0.05）. Compared with HE patients with HRS, the level of COHb was significantly higher in HE patients without HRS （（2.502±1.073）% vs. （1.981＋1.020）%, P=0.029）. The COHb level had a negative correlation with PaO2 （r=-0.335, P=0.007） while no statistically significant relationship was found with SaO2 （r=-0.071, P 〉0.05）. However, when the above two parameters met the diagnostic criteria of hypoxemia, the COHb concentration increased （（2.621±0.880）% vs. （1.910±0.931）%, P=0.011 ）. Conclusions COHb is a potential candidate to estimate the severity and therapeutic effect of HE. The levels of COHb may be tissue-specific in cirrhotic patients with different complications.

Effects of blocking Le^Y oligosaccharide on cell surface to MMPs secreted by blastocysts and epithelial cells in mouse in vitro

In order to understand the role of Le+Y oligosaccharide antigen (Le+Y) during implantation, the relationship of Le+Y on the cell surface with matrix metalloproteinase (MMPs) secreted by blastocysts and monolayer epithelial cells during implantation in the mouse %in vitro% was studied by monoclonal antibody (mAb) AH-6, directed to Le+Y[Fuc α1-2 Gal β1-4 (Fuc α1-3) GlcNAc-], and gelatin zymography. The results showed that MMPs secretion was reduced after Le+Y on the cell surface of either epithelial cells or trophoblasts was blocked. It indicated that MMPs expression which played an important function during the process of implantation were regulated by Le+Y. Therefore, it was considered that Le+Y could regulate embryos invasion by some mechanism.

Safety and efficacy of polymer-free paclitaxel-eluting microporous stent in real-world practice： 1-year follow-up of the SERY-I registry

Background Polymer coating on coronary stents induces vascular inflammatory response, reduces re-endothelialization, and affects long-term outcome after percutaneous coronary intervention （PCI）. The SERY-1 registry aimed to determine whether a novel polymer-free paclitaxel-eluting microporous Yinyi stent could improve 1-year outcome after index procedure in real-world clinical practice. Methods Clinical and angiographic data and follow-up outcome were collected in 1045 patients who underwent PCI with implantation of 〉1 Yinyi stents between June 2008 and August 2009 at 27 medical centers. The primary endpoint was the cumulative rate of composite major adverse cardiac events （MACE） and the secondary endpoint was the incidence of stent thrombosis at 1 year. Results Overall, 1376 lesions were treated successfully with 1713 Yinyi stents, and 1019 （98.7%） patients received dual antiplatelet therapy for at least 12 months. During 1-year follow-up, 8 patients （0.78%） had cardiac death, 6 （0.58%） suffered non-fatal myocardial infarction, and 46 （4.46%） underwent repeat PCI due to recurrence of angina, resulting in 1-year MACE-free survival of 94.09%. Stent thrombosis occurred in 10 （0.97%） patients, and the rate of Academic Research Consortium （ARC） definite or probable stent thrombosis was 0.78%. Conclusions Polymer-free paclitaxel-eluting microporous Yinyi stent is effective and safe for interventional treatment of coronary artery disease in real-world clinical practice, without recourse to carrier polymer. Potential long-term clinical advantages of this stent deserve further investigation.

Prevalence and correlative factors of atrial fibrillation in hospitalized patients with hypertension: A single-center retrospective study

Objective To evaluate the prevalence of atrial fibrillation(AF) in hospitalized patients with hypertension,and to identify the correlative factors associated with AFin these patients. Methods A total of 831 patients withhypertension,who were hospitalized in the Department ofCardiology from January 1,2015 to June 1,2016 at theSecond Affiliated Hospital of Dalian Medical Universitywere included in this study. Based on the ACC /AHA/ESC criteria, these patients were classified into twogroups: NAF group (patients without AF,n = 559) andAF group (n = 272). Clinical characteristics,laboratorydata were compared between the two groups. The correlativefactors for AF were analyzed by logistic regression.

Effect of β-sodium aescinate on hypoxia-inducible factor-1α expression in rat brain neurons after cardiopulmonary resuscitation

Objective To investigate the expression of the hypoxia-inducible factor(HIF)-1α in rat brain neuronsand the intervention of β-sodium aescinate after restoration of spontaneous circulation(ROSC).Methods

Low-density lipoprotein cholesterol target goal attainment rate and related factors in patients with acute coronary syndrome after percutaneous coronary intervention

Objective To observe the low-density lipoprotein cholesterol(LDL-C)target goal attainment rate and related factors in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods From March 2011 to March 2012,a total of832 ACS patients were retrospectively evaluated in the Cardiology Department of the First Affiliated Hospital of Dalian Medical University.The target goal

Predictive value of HATCH score on atrial fibrillation recurrence post radiofrequency catheter ablation

Objective To determine the predictive value of HATCH score on recurrence of atrial fibrillation(AF) after radiofrequency catheter ablation (RFCA). Methods The data of 123 consecutive AF patients(74 paroxysmal and 49 persistent AF) who underwent RFCA between April 2009 and December 2010 in our department were