Reorganization characteristics of speech cortex during speech restoration following total laryngectomy A functional magnetic resonance imaging follow-up

During speech restoration following laryngectomy, language-related cortical areas develop connections with new primary motor neurons. The present study followed up 18 patients after total resection of laryngeal carcinoma. According to an evaluation of pronunciation, patients were assigned to three groups： poor, moderate and good pronunciation. Functional magnetic resonance imaging revealed significant increases in the number of activated voxels and the intensity of activation changes in the left middle frontal gyrus, left precentral gyrus, left postcentral gyrus, left supplementary motor area, left anterior cingulate gyrus and right fusiform gyrus between the moderate pronunciation group compared with the poor and good pronunciation groups. We propose that these brain regions play an important role in the progress of speech restoration, and improvements in pronunciation learning for patients following laryngectomy. However, during the later period of speech restoration, the number of activated voxels and intensity changes in these regions decreased to the level of healthy controls, indicating that the learning and instruction effects weakened once patients had mastered pronunciation techniques

Evolution of Proinflammatory Cytokines in Hepatocellular Carcinoma Patients Undergoing Orthotopic Liver Transplantation

OBJECTIVE To analyze the expression and levels of serum proinflammatory cytokines including tumor necrosis factor alpha （TNF-α）, and interleukin （IL）-6 in patients with hepatocellular carcinoma （HCC）, who received orthotopic liver transplantation （OLT）.METHODS The blood samples of 20 consecutive HCC patients who underwent liver transplantation were detected and analyzed for the clinical serum biochemical parameters, TNF-α and IL-6.Blood samples were drawn from the radial artery at planned time points： preoperatively, intraoperatively, and postoperatively.Levels of serum TNF-α and IL-6 were detected with enzymelinked immunosorbent assay （ELISA）.RESULTS The levels of serum TNF-αand IL-6 increased significantly at reperfusion phase compared with those detected preoperatively （P 〈 0.01）, and the level of serum IL-6 remained significantly higher until the third day after the liver transplantation. There was a significant correlation between TNF-αand IL-6 （P〈0.001）.CONCLUSION This research into the effects of the proinflammatory cytokines on liver transplantation has provided new insights into the mechanisms of ischemia and reperfusion injury to OLT.

miR-30b inhibits autophagy to alleviate hepatic ischemiareperfusion injury via decreasing the Atg12-Atg5 conjugate

AIM: To explore the role and potential mechanism of miR-30 b regulation of autophagy in hepatic ischemiareperfusion injury(IRI).METHODS: An animal model of hepatic IRI was generated in C57BL/6 mice. For in vitro studies, AML12 cells were immersed in mineral oil for 1 h and then cultured in complete Dulbecco's Modified Eagle's Medium(DMEM)/F12 to simulate IRI. Mice and cells were transfected with miR-30 b agomir/mimics or antagomir/inhibitor to examine the effect of miR-30 b on autophagy to promote hepatic IRI. The expression of miR-30 b was measured by real-time polymerase chain reaction. Apoptotic cells were detected by terminal uridine nickend labeling(TUNEL) staining, and cell viability was detected by methylthiazole tetrazolium assay. The expression of light chain 3, autophagy-related gene(Atg)12, Atg5, P62, and caspase-3 were detected by western blotting analysis.RESULTS: miR-30 b levels were significantly downregulated after hepatic IRI, and the numbers of autophagosomes were increased in response to IRI both in vivo and in vitro. These findings demonstrate that low levels of miR-30 b could promote hepatic IRI. Furthermore, we found that miR-30 b interacted with Atg12-Atg5 conjugate by binding to Atg12. Overexpression of miR-30 b diminished Atg12 and Atg12-Atg5 conjugate levels, which promoted autophagy in response to IR. In contrast, downregulation of miR-30 b was associated with increased Atg12-Atg5 conjugate levels and increased autophagy.CONCLUSION: miR-30 b inhibited autophagy to alleviate hepatic ischemia-reperfusion injury via decreasing the Atg12-Atg5 conjugate.

Interleukin-22 contributes to liver regeneration in micewith concanavalin A-induced hepatitis after hepatectomy

AIM: To investigate the therapeutic effects and mechanisms of interleukin(IL)-22 in liver regeneration in mice with concanavalin A(Con A)-induced liver injury following 70% hepatectomy.METHODS: Mice were injected intravenously with Con A at 10 μg/g body weight 4 d before 70% hepatectomy to create a hepatitis model, and recombinant IL-22 was injected at 0.125 μg/g body weight 30 min prior to 70% hepatectomy to create a therapy model. Control animals received an intravenous injection of an identical volume of normal saline.RESULTS: IL-22 treatment prior to 70% hepatectomy performed under general anesthesia resulted in reductions in the biochemical and histological evidence of liver injury, earlier proliferating cell nuclear antigen expression and accelerated recovery of liver mass. IL-22 pretreatment also significantly induced signal transducer and activator of transcription factor 3(STAT3) activation and increased the expression of a variety of mitogenic proteins, such as Cyclin D1. Furthermore, alpha fetal protein m RNA expression was significantly elevated after IL-22 treatment.CONCLUSION: In this study, we demonstrated that IL-22 is a survival factor for hepatocytes and prevents and repairs liver injury by enhancing pro-growth pathways via STAT3 activation. Treatment with IL-22 protein may represent a novel therapeutic strategy for preventing liver injury in patients with liver disease who have undergone hepatectomy.

Autoimmune hepatitis-primary biliary cirrhosis concurrent with biliary stricture after liver transplantation

Although the development of de novo autoimmune liver disease after liver transplantation(LT)has been described in both children and adults,autoimmune hepatitis(AIH)-primary biliary cirrhosis(PBC)overlap syndrome has rarely been seen in liver transplant recipients.Here,we report a 50-year-old man who underwent LT for decompensated liver disease secondary to alcoholic steatohepatitis.His liver function tests became markedly abnormal 8 years after LT.Standard autoimmune serological tests were positive for anti-nuclear and antimitochondrial antibodies,and a marked biochemical response was observed to a regimen consisting of prednisone and ursodeoxycholic acid added to maintain immunosuppressant tacrolimus.Liver biopsy showed moderate bile duct lesions and periportal lymphocytes infiltrating along with light fibrosis,which confirmed the diagnosis of AIH-PBC overlap syndrome.We believe that this may be a case of post-LT de novo AIH-PBC overlap syndrome;a novel type of autoimmune overlap syndrome.

Clinical Features and Clonal Origin of Diffuse Hepatocellular Carcinoma

To the Editor：Diffuse hepatocellular carcinoma （D-HCC）,also known as cirrhosis-like HCC,is a rare and peculiar type of HCC.[1] The World Health Organization （WHO） defines D-HCC as follows：small tumor nodules distributed diffusely all over the liver presents like cirrhotic-associated regenerative nodules.[2] Surgical resection,radiotherapy,and medication cannot bring good results for D-HCC,and the prognosis of D-HCC is poor.