NR Group Research Articles

A 48-month Clinical Evaluation of Fissure Sealants Placed With Different Adhesive Systems

To compare the retention rates of a nanofilled occlusal fissure sealant placed with the use of an etch-and-rinse or a self-etch adhesive over 48 months. The authors enrolled 244 teeth, each with no restoration or sealant and no detectable caries, from 16 patients. The sealants were placed with Solobond M two-step etch-and-rinse adhesive or Futurabond NR one-step self-etch adhesive by four previously calibrated dentists using a table of random numbers. After completion of the adhesive application, a nanofilled sealant, Grandio Seal, was applied and light-cured. Two other calibrated examiners, who were unaware of which adhesive had been used, independently evaluated the sealants at baseline and at 12-, 24-, 36-, and 48-month recalls. Each sealant was evaluated in terms of caries formation being present or absent and retention using the following criteria: 1 = completely retained, 2 = partial loss, and 3 = total loss. The Pearson χ (2) test was used to evaluate differences in retention rates among the sealants used with different adhesives for each evaluation period. The retention rates for sealants in the Solobond M group were significantly higher than those in the Futurabond NR group in all periods of evaluation (p<0.05). No statistically significant difference between the retention rates for premolars and molars was found at each evaluation period (p>0.05). There was no new caries formation throughout the 48-month recall period. Fissure sealants placed with etch-and-rinse adhesive showed better retention rates than those placed with self-etch adhesive.

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Introduction: Previous results suggest maternal gestational under nutrition selectively impairs right ventricular mitochondrial response to acute hypoxia. Hypothesis: After an acute ischemic event, ventricular cardiomyocyte viability in intrauterine growth restricted (IUGR) rat pups is lower than controls (CTR) while mitochondrial reactive oxygen species (ROS) production is increased. RV cardiomyocytes have less viability, and increased ROS, post ischemia compared to left ventricular (LV), and the IUGR RV group with the least. Methods: Pregnant Sprague Dawley rats were subjected to caloric restriction in the 3rd trimester- an established caloric restrictive diet to model IUGR (NR). NR and CTR neonatal hearts were harvested from age 2-3 day pups. RV and LV cardiomyocytes were cultured separately. On day 5 of culture, cells underwent 6 hours of oxygen glucose deprivation (OGD), and cell viability was assessed using an MTT Cell Proliferation Assay 18 hour later. Mitochondrial ROS production was measured by total superoxide production using confocal microscopy. Results: Baseline cell viability in CTR RV was 47% (p?0.01-19) of CTR LV.and NR RV was 30% NR LV (p?0.01-23). Total ROS in CTR RV was 118% of CTR LV (p?0.34) and NR RV was 140% NR LV (p?0.001). A significant increase in ROS production was seen in NR compared to CTR. Total ROS in NR LV was 174% CTR LV (p?0.01) and NR RV was 170% CTR RV (p?0.0001).No difference in cell viability was found following OGD (each group compared to its baseline), CTR LV=56%, CTR RV=61%, NR LV=53% and NR RV=56% (p?0.17). All cells for confocal microscopy died post OGD. Conclusions: Cell viability, using primary neonatal rat cardiomyocyte cultures, is significantly less in RV cardiomyocytes compared to LV. Cell viability was further reduced in cardiomyocytes isolated from NR pups, least in NR RV. OGD, simulating ischemia, decreased cell viability in both NR and CTR. ROS production is greater in mitochondria from cardiomyocytes isolated from NR pups. ROS production was greater NR RV compared to NR LV. Less viability and increased ROS production within the NR group may indicate a defect in bioenergetics as a result of intrauterine nutritional restriction.

Prognostic improvement of reexcision for positive resection margins in patients with advanced gastric cancer

AimThe aim of this study was to investigate the effect of reexcision for advanced gastric cancer (GC) with positive resection margins on prognosis and to identify the selection criteria for the reexcision of patients with positive margins. Patients and methodsThis was a retrospective study of 122 patients with positive margins who underwent potentially curative resection for locally advanced GC. The clinicopathological factors and survival among 50 patients who were reexcised to a negative resection margin (NR group) and 72 patients who were left with a positive resection margin (PR group) were compared using univariate and multivariate analyses. ResultsMedian survival in the PR group was 18 months compared with 23 months in the NR group (p = 0.019). In the ≤pN2-category subset, the PR group had a significantly worse prognosis compared with the NR group (median survival of 25 months vs. 44 months; p = 0.021). This difference was not observed in the pN3-category subset. In the univariate analysis, variables including pTNM stage, pN-category, and positive resection margin had adverse effects on OS among the entire population of 122 patients. A positive margin was confirmed as an independent prognostic factor for OS in the multivariate analysis. ConclusionsThe reexcision of a positive margin improves the prognosis of patients with advanced GC, especially in those paitents with ≤pN2-category disease and in patients undergoing D2 lymphadenectomy. Obtaining routine frozen sections of samples from the resection margin should be mandatory in the treatment of all GC patients undergoing potentially curative surgery.

The Expression Profile of Glycolysis Associated Molecules and Chemoresistance in Acute Myeloid Leukemia

Abstract 4318 BackgroundThe drug resistance of leukemic cells remains a major obstacle to chemotherapy in patients with AML, which always leads to treatment failure consequently. However, the complex mechanism in chemoresistance causes a growing concern to looking for some new therapeutic targets and improving the sensitivity of chemotherapy. Recently, researchers have used metabolomics technology to explore the differences of metabolomics between imatinib (IM)-resistant and sensitive chronic myeloid leukemia (CML) cells, and thus to clarify the mechanism of IM resistance, provide new targets to the treatment of IM resistance. The data showed that increased glycolytic activity related with IM drug resistance. As glycolytic rate directlly correlates with tumorigenesis and chemoresistance, it provides a new idea for cancer treatment. Some studies confirmed that there was also abnormal glycolysis in hematopoietic tumor cells. Thus, the study was expected to investigate the relations between the altered energy metabolism and chemoreisitance in AML. Furthermore, the effect of inhibition of glycolysis on chemoresistance in myeloid leukemia cells was evaluated. MethodsThe bone marrow samples obtained from with newly diagnosed (n=45) and relapsed (n=9) patients with AML (M3 excluded) in our hospitals from October 2010 to November 2011. The AML blasts in every sample was exceed to 80 percent. The total 54 AML cases with average age of 41.6±17.8 years were included in 31 male and 23 female patients. The expression differences of glycolysis associated molecules (e.g. HIF-1α, HK-II, GLUT1, CD147 and LDH) and β subunit of human F1-F0 ATP synthase (ATP5B) in different drug-sensitive AML cells were analyzed. Adriamycin (ADM)-sensitive AML cell line HL-60 and resistant cell line HL-60/ADM were used to evaluate the glycolytic activities and the effect of glycolysis inhibition on cellular proliferation. ResultsThe drug-resistant HL-60/ADM cells exhibited a significantly higher glycolysis rates than the drug-sensitive AML cell line HL-60 (97.4%±0.70% vs. 55.0%±3.16%, P<0.01). The levels of HIF-1α and GLUT1 mRNA expression of the drug-resistant HL-60/ADM cells was higher than that of drug-sensitive HL-60 cells (HIF-1α: 3.70±0.084 vs. 1.0±0.075, P<0.01, GLUT1: 3.36±0.149 vs. 1.0±0.080, P<0.01). Likewise, the levels of HIF-1α, HK-IIand GLUT1 mRNA expression in AML patients with NR were higher than those in groups of health control, CR and PR (P<0.01). Also, the serum level of LDH in AML patients with NR was higher than that in groups of health control, CR and PR (1211.57±456.99 vs. 490.75±278.35 vs. 490.63±213.94 vs. 149.90±31.66, P<0.01). Furthermore, the expression of CD147 on bone marrow blasts from NR group was higher than that in groups of CR and PR (97.75%±4.17% vs. 89.41%±14.22%, P<0.01). Additionally, the expression of ATP5B protein were decreased in the drug-resistant HL-60/ADM cells (0.1388 vs 0.1192), and the level of ATP5B protein in patients with NR was lower than that in CR group (0.0092±0.0042 vs. 0.0540±0.0482, P<0.01). 2-DG or 3BrPA, the glycolysis inhibitors, acts in synergy with ADM in ADM-resistant HL-60/ADM leukemic cells, whereas it didn’t increase ADM-induced toxicity in HL-60 cells. Treatment of the cell lines HL-60/ADM and HL-60 with sublethal concentrations of 2-DG or 3 BrPA, either alone or in combination with ADM, resulted in a considerable reduction of glucose uptake compared with non-treated cells. With these treatments for 24h, the cellular apoptosis rate in these two cell lines showed no significant difference (P>0.05). However, the glycolysis inhibitors in combination with ADM increased markedly the necrosis in these cell lines. ConclusionThe chemoresistance was associated with increased glycolytic activity and low efficiency of oxidation phosphorylation in AML cells, regarding as the elevated expression of glycolysis associated molecules, i.e. HIF-1α□AHK-II□AGLUT1□ALDH and CD147. Inhibition of glycolysis can reverse the chemoresistance of drug-resistant AML cell line HL-60/ADM. The enhancements of ADM-induced cytotoxicity by 2-DG or 3BrPA may be due to the activation of nonapoptotic, programmed cell death. Disclosures:No relevant conflicts of interest to declare.

Long-term supplementation of high pigmented rice bran oil (Oryza sativa L.) on amelioration of oxidative stress and histological changes in streptozotocin-induced diabetic rats fed a high fat diet; Riceberry bran oil

Diabetes is a serious health problem. Searching for alternative natural antioxidants is considered important strategy to manage diabetes. This study evaluated the effect of Riceberry bran oil (RBBO) supplementation on oxidative stress and organ histology in streptozotocin-induced diabetic rats fed a high fat (HF) diet. Adult male Sprague-Dawley rats with hyperglycemia were divided into four groups: DM group fed a HF diet alone; DMRL group fed a HF diet and 5% RBBO; DMRM group fed a HF diet and 7.5% RBBO; DMRH group fed a HF diet and 15% RBBO. Normal rats were used as normal control and were divided into NC and NR group fed a normal diet containing either 5% corn oil or 5% RBBO, respectively. After 12weeks, RBBO significantly decreased malondialdehyde and restored superoxide dismutase, catalase, glutathione peroxidase, coenzyme Q10 and ORAC levels in diabetic rats. RBBO additionally improved the regenerative changes of the pancreas, kidneys, heart and liver. These findings indicate that pigmented RBBO could provide beneficial effect on diabetes by decreasing oxidative stress and recovering organ histology.

Virological response for recurrent hepatitis C improves long-term survival in liver transplant recipients

Recurrent hepatitis C virus (HCV) infection occurs universally and is regarded as a major cause of mortality after liver transplantation (LT) for HCV-related end-stage liver disease. We conducted this large, single-center, retrospective study to ascertain the long-term impact of virological response to treatment of recurrent hepatitis C on survival of LT recipients. From August 1987 to October 2011, 285 patients have received interferon-based antiviral therapy for recurrent hepatitis C. Of these 285, 245 patients were enrolled in this study. One hundred and twenty-six patients (51.4%) achieved sustained virological response (SVR). Relapsers (undetectable HCV-RNA at end of treatment, becoming positive afterward) comprised 9.0% (22/245), and nonresponse (NR; never achieving undetectable HCV-RNA) 39.6% (97/245). The median follow-up after completion of antiviral treatment was 2081 days. Using Kaplan-Meier method, patients who achieved SVR were shown to have significantly better 5-year patient survival (95.2%) than the NR group (49.9%) (P < 0.001), and a trend toward better 5-year survival than relapsers (87.5%) (P = 0.14); relapsers had a significantly longer survival than NR group (P = 0.005). When compared with NR, SVR and relapse appeared to be significant predictors of better survival, independent of underlying characteristics. In conclusion, virological response, especially SVR, translates into markedly improved long-term patient outcomes in patients transplanted for hepatitis C.

Impact of Pretransplant Rituximab on Kidney Graft in Highly-Sensitized Recipients; Compared with Non-Rituximab Group

Background: Highly sensitized patients with a high level of panel reactive antibody (PRA) can have more episodes of antibody-mediated rejection (AMR) and poorer graft survival than non-sensitized patients. Rituximab is a well known monoclonal anti-CD20 antibody for the depletion of B lymphocyte. The study aim was to compare a rituximab-administered group with a non-administered group in highly sensitized recipients. Methods: We enrolled 43 patients with over 50% PRA (class I or II), who underwent living donor kidney transplantation. Sixteen patients (group R) received one dose (375mg/m2) of rituximab at 2 days prior to transplantation and 27 patients (group NR) did not. ABO-incompatible kidney transplantations were excluded. Results: Mean follow-up duration was 14.9 and 38.1 months in groups R and NR, respectively. The patients' demographics such as age, sex, dialysis duration and kind of immunosuppressive agent were not different between the two groups. There were no side effects from rituximab administration in group R. Class I PRA of group R (75.6±37.7%) was higher than that of group NR (45.7±35.8%; p=0.013). There were more acute rejection episodes within 1 year in group NR but the difference with group R was not significant (Table 1). However, two AMR episodes occurred only in group NR. The renal function of the two groups was not different. In group R, CD19 and CD20 rapidly decreased 2 days after rituximab infusion.[Figure 1.]Conclusion: There were no differences in cell-mediated rejection from the administration of rituximab. However, AMR tended to decrease in the rituximab group. To confirm the long-term anti-rejection and beneficial effect of rituximab, further study should be performed in a larger cohort. Rituximab administration 2 days prior to transplantation can be effective and safe.

A longitudinal study of the quantitative evaluation of patella cartilage after total knee replacement by delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T2 mapping at 3.0 T: preliminary results

To characterize the quantitative changes of patella cartilage over time after total knee arthroplasty (TKA) by delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T2 mapping at 3.0 T. Twenty-six knees of 26 patients (23 women and three men, mean age, 75 years) with primary osteoarthritis and osteonecrosis of the knee underwent TKA with a zirconia ceramic implant in this prospective study. Twelve patients without patella resurfacing (NR group) and 14 patients with patella resurfacing (R group) had TKA with cemented fixation. The implant position was examined by radiograph, computed tomography (CT) and magnetic resonance imaging (MRI). The clinical scores were checked pre-operatively, 1 year post-operatively and at the final follow-up. Patella cartilage and its thickness were evaluated pre-operatively and 1 year after TKA by dGEMRIC and T2 mapping in the NR group only. Patella cartilage was divided into eight regions of interest: the deep and superficial layers of the outer lateral and medial half, and the inner lateral and medial half from the central ridge. The implant position was appropriate in all cases and clinical scores were not significantly different between the two groups. The post-operative dGEMRIC value of the outer medial half superficial zone in the NR group was significantly decreased compared with the pre-operation value (P<0.05), whereas T2 mapping was not significantly changed in all zones. The cartilage thickness of the outer zone was significantly thinner post-operatively (P<0.05). These findings indicate that osteoarthritic changes in the outer zone of patella cartilage occurred 1 year after TKA.

Object habituation in horses: The effect of voluntary versus negatively reinforced approach to frightening stimuli

The ability of horses to habituate to novel objects influences safety in the horse-human relationship. However, the effectiveness of different habituation techniques has not been investigated in detail. 1) To investigate whether horses show increased stress responses when negatively reinforced to approach novel objects, compared with horses allowed to voluntarily explore the objects and 2) whether a negatively reinforced approach facilitates object habituation. Twenty-two 2-3-year-old Danish Warmblood geldings were included. Half of the horses (NR group) were negatively reinforced by a familiar human handler to approach a collection of novel objects in a test arena. The other half were individually released in the arena and were free to explore the objects (VOL group). On the next day, the horses were exposed to the objects again without a human handler, to investigate the rate of habituation. Behavioural and heart rate responses were recorded. All VOL horses initially avoided the unknown objects, whereas the handler was able to get all NR horses to approach and stand next to the objects within the first 2 min session. The NR horses had a significantly longer duration of alertness and a higher max heart rate in the first session. On the next day, however, NR horses spent significantly less time investigating the objects and had a shorter latency to approach a feed container, placed next to the objects, indicating increased habituation. A negatively reinforced approach to novel objects increases stress responses during the initial exposure but facilitates habituation in young horses. Although a negatively reinforced approach appears beneficial for habituation, the procedure should be carefully managed due to increased stress responses in the horse, which may constitute a safety risk. Further experiments should aim to investigate differences in stimulus intensity.

Prognostic effect of postoperative resection-margin status for intraoperative positive resection margins in patients with advanced gastric cancer

To investigate prognostic effect of postoperative resection-margin status for intraoperatively positive resection margin in advanced gastric cancer and discuss the treatment choice for intraoperatively positive resection margins. A retrospective study was investigated in 64 advanced gastric cancer patients with positive resection margin after potentially curative resection. The survival between 50 patients who was re-excised to a negative resection margin (NR group) and 14 patients who were left with positive resection margin (PR group) was compared. Prognostic factors were analyzed using univariate and multivariate Cox regression model analysis. The median survival in the PR group was 17.0 months (95%CI: 11.6 - 22.4) as compared with 23.0 months (95%CI: 20.5 - 25.5) in the NR group (P = 0.045). However, resection-margin status lost significance on multivariate analysis. In the subgroup of D2 lymphadenectomy, the median survival in the PR group and NR group were 17.0 months (95%CI: 12.0 - 22.0) and 24.0 months (95%CI: 19.8 - 28.1) respectively; multivariate analysis further identified resection margin status as an independent prognostic factor. Re-excision for intraoperatively positive margin to negative margin improves the prognosis of the patients with advanced gastric cancer, and re-excision is the first choice when intraoperative frozen section detects a positive margin. Routine frozen section of resection margin should be mandatory in all advanced gastric cancer undergoing potentially curative surgery.

Increased Serum Circulatory Levels of Interleukin 17F in Type 1 Reactions of Leprosy

Leprosy is a chronic infectious disease caused by Mycobacterium leprae affecting mainly skin and peripheral nerves. Acute inflammatory episodes in the borderline immunological spectrum of the disease cause severe nerve and tissue damage leading to deformities. Finding of any serological marker for leprosy reactions will help in prediction of reactions and in early treatment intervention. The objective of this study was to measure the serum circulatory levels of Interleukin 17F (IL 17F) and to correlate the levels with type 1 and type 2 reactional states and with clinico-histopathological spectrum of leprosy. We studied IL 17F to delineate its role and its clinical implications in leprosy reactions. Patients were classified based on the Ridley DS and Jopling WH Classification and blood samples (5ml each) were collected from 80 active untreated leprosy cases in Type 1 reaction (T1R), 21 cases in Type 2 (Erythema Nodosum Leprosum ENL) reaction (T2R), 80 cases without reaction (NR), and 94 non-leprosy cases (NL). Serum was separated and measured for IL 17F levels using ELISA (Commercial Kits, R&D Systems Inc., USA). IL 17F levels were significantly higher in the T1R group when compared to the NR group (p < 0.001). The borderline lepromatous group showed the highest levels of IL 17F among the other groups in the disease spectrum. Bacteriological index (BI) showed negative correlation with the IL 17F levels. The results specify that serum circulatory levels of IL 17F are elevated during T1Rs in the borderline spectrum of the disease and thus may play a role in the regulation of inflammatory responses associated with reactions in leprosy.

Role of opioid receptors in remifentanil-induced attenuation of renal ischemia/reperfusion injury in rats

Objective To investigate the role of opioid receptors in remifentanil-induced attenuation of renal ischemia/reperfusion (I/R) injury in rats.Methods Seventy-five male Sprague-Dawley rats weighing 250-300 g were randomly divided into 5 groups ( n =15 each):sham operation group (group S),group I/R,remifentanil group (group R),naloxone group (group N),and naloxone + remifentanil group (group NR).Renal ischemia was induced by clamping the bilateral renal arteries for 45 min using an atraumatic clamp followed by reperfusion.In groups R and NR,remifentanil was infused at 1.0 μg· kg-1 · min-1 via the caudal vein starting from 15 min before ischemia until 30 min of reperfusion,while groups S,I/R and N received the equal volume of normal saline instead of remifentanil.In groups N and NR,naloxone 0.3 mg/kg was injected via the caudal vein at 20 min before ischemia and at 35 min after ischemia respectively,while groups S,I/R and R received the equal volume of normal saline instead of naloxone.Blood and urine samples were collected from the femoral vein and urinary bladder respectively at 24 h of reperfusion for determination of the levels of serum creatinine (Cr) and blood urea nitrogen (BUN),urinary N-acetyl-β-D-glucosaminidase (NAG) and γ-glutamyl transpeptidase (γ-GT).The rats were sacrificed at 24 h of reperfusion and the renal tissues were removed for determination of nalondialdehyde (MDA) content and superoxide dismutase (SOD) activity.Pathological changes in renal tissues were observed with light microscope.Results Compared withgroup S,the levels of serum Cr and BUN,urinary NAG and γ-GT,and MDA were significantly increased,while the activity of SOD was significantly decreased in the other 4 groups ( P ＜ 0.05 or 0.01 ) and pathological changes in renal tissues were observed in the other 4 groups.Compared with group I/R,the levels of serum Cr and BUN,urinary NAG and γ-GT levels,and MDA were significantly decreased,while the activity of SOD was significantly increased ( P ＜ 0.01 ),and the pathological changes were reduced in group R,and no significant change was found in the parameters mentioned above in groups N and NR ( P ＞ 0.05).The pathological changes were similar in groups I/R,N and NR.Compured with group R,serum Cr and BUN concentrations,urinary NAG and γ-GT levels and MDA concent were increased,while SOD activity were decreased ( P ＜ 0.05 or 0.01 ).Conclusion Opioid receptors mediate remifentanil-induced attenuation of renal I/R injury in rats. Key words: Receptors, opioid; Piperidines; Kidney; Reperfusion injury

The effects of high temperature and roof modification on physiological responses of swamp buffalo (Bubalus bubalis) in the tropics

The objective of the experiments reported here was to measure the effects of cooling techniques (Modified roof vs Normal roof) on the performance and physiology of 12 young male buffaloes with a similar live weight of 160 kg. The study was conducted at Chainat Agriculture and Technology College, Chainat Province, Thailand. The animals were divided randomly into two groups, each group comprising six buffaloes, and the two groups were studied to evaluate the effects of modified roofing (normal roof fitted with woven polypropylene shade cloth) on the subjects' physiological responses to heat stress under hot humid conditions. The modified roof resulted in lowered heat stress in buffaloes compared to those under a standard roof. The difference was shown by the buffaloes having a significantly lower mean rectal temperature (39.14 ± 0.07 vs 40.00 ± 0.10°C) and plasma cortisol (2.14 ± 0.24 vs 3.38 ± 0.37 ng/ml). The average daily water consumption was significantly lower in the MR group (MR, 29.71 ± 0.86 vs NR, 34.14 ± 1.06 L head (-1) day(-1)), while there was a tendency for the roughage intake to be higher in the MR group compared to that of the NR group (MR, 5.88 ± 0.18 vs NR, 6.44 ± 0.19 kg head-1 (-1) day(-1); P = 0.0508). It was concluded that roof modification facilitated a reduction in heat load from roof re-radiation, and was an effective means of alleviating thermal stress in young buffaloes.

Tricuspid valve repair: is ring annuloplasty superior?†

Tricuspid regurgitation (TR) secondary to left heart disease is the most common aetiology of tricuspid valve (TV) insufficiency. Valve annuloplasty is the primary treatment for TV insufficiency. Several studies have shown the superiority of annuloplasty with a prosthetic ring over other repair techniques. We reviewed our experience with different surgical techniques for the treatment of acquired TV disease focusing on long-term survival and incidence of reoperation. A retrospective analysis of 717 consecutive patients who underwent TV surgery between 1975 and 2009 with either a ring annuloplasty [Group R: N = 433 (60%)] or a De Vega suture annuloplasty [Group NR: no ring; N = 255 (36%)]. Twenty-nine (4%) patients underwent other types of TV repair. A ring annuloplasty was performed predominantly in the late study period of 2000-09. TV aetiology was functional in 67% (479/717) of the patients. Ninety-one percent of the patients (n = 649) underwent concomitant coronary artery bypass grafting and/or mitral/aortic valve surgery. Patients who received a ring annuloplasty were older (67 ± 13 vs 60 ± 13 years; P < 0.001). Overall 30-day mortality was 13.8% (n = 95) [Group R: n = 55 (12.7%) and Group NR: n = 40 (15.7%)]. Ten-year actuarial survival after TV repair with either the De Vega suture or ring annuloplasty was 39 ± 3 and 46 ± 7%, respectively (P = 0.01). Twenty-eight (4%) patients required a TV reoperation after 5.9 ± 5.1 years. Freedom from TV reoperation 10 years after repair with a De Vega annuloplasty was 87.9 ± 3% compared with 98.4 ± 1% after the ring annuloplasty (P = 0.034). Patients who require TV surgery either as an isolated or a combined procedure constitute a high-risk group. The long-term survival is poor. Tricuspid valve repair with a ring annuloplasty is associated with improved survival and a lower reoperation rate than that with a suture annuloplasty.

Effects of TLR4-siRNA on hyperoxia-induced secretion of inflammatory factors from human alveolar epithelial cell line A549

Objective To investigate the effects of special siRNA targeting TLR4 gene (TLR4-siRNA) on hyperoxia-induced secretion of inflammatory factors from human alveolar epithelial cell line A549.Methods Human alveolar epithelial cell line A549 was purchased from Chongqing Children Hospital and cultured in six-well tissue culture plates and randomly divided into 4 gorups:A549 cells + ambient air group (group C) ; A549 cell + hyperoxia group (group H); A549 cells transfected with TLR4-siRNA + hyperoxia group (group TR) and A549 cells transfected with control-siRNA + hyperoxia group (group NR).TLR4-siRNA and control-siRNA were transfected into A549 cells through lipofectamine 2000.The efficiency of transfection was assessed by detection of FAM expression using flow cytometry.The cells were exposed to 95％ O2-5％ CO2 delivered at 1 L/min for 30 min in groups H,TR and NR.TLR4 mRNA and protein expression was detected by RT-PCR and cytometry respectively.The NF-κB activity in A549 cells was measured by EMSA and the IL-6 and IL-8 levels in supernatant were determined by ELISA.Restults Hyperoxia significantly up-regulated TLR4 mRNA and protein expression and increased NF-κB activity in cells and IL-8 and IL-6 concentrations in supematant in group H as compared with group C.Transfection with TLR4-siRNA significantly attenuated hyperoxia-induced up-regulation of TLR4 mRNA and protein expression and increase in NF-κB activity in the cells and IL-6 and IL-8 concentrations in supernatant in group TR as compared with group H,but transfection with control-siRNA did not.Conclusion TLR4-siRNA could significanly inhibit hyperoxia-induced secretion of inflammatory factors from human alveolar epithelial cell line A549. Key words: Toll-Like receptor4; RNA, small interfering; Hyperoxia; NF-kappa B; Interleukins

A chromosome 19 locus positively influences the number of retrieved oocytes during stimulated cycles in Brazilian women

To evaluate if several genetic loci that are associated with variation in normal menopause age and early menopause can account for a poor response to controlled ovarian stimulation. A total of 71 patients age ≤35years old who were undergoing intracytoplasmic sperm injection were genotyped for four genetic variants that are associated with normal variation in menopausal age and early menopause. The patients were divided into two groups based upon treatment response: a poor responder group (PR group, n = 21) and a normal responder group (NR group, n = 50). The genetic variants rs244715, rs9379896, rs4806660 and rs16991615 were analyzed. There was no significant difference in the incidence of the genetic variants between the NR and PR group. The risk allele for the chromosome 19 variant (rs4806660) demonstrated a protective effect for a poor ovarian response. The presence of a risk allele was associated with an increased response to COS, which resulted in an elevated number of follicles (Coef: 2.54, P = 0.041) and retrieved oocytes (Coef: 1.41, P = 0.041). The genetic variants rs244715, rs9379896, rs4806660 and rs16991615 are not risk factors for poor ovarian response in Brazilian women. In contrast, rs4806660 is associated with higher number of follicles and retrieved oocytes. rs4806660 may be associated with an increased response to gonadotrophin stimulation in this population.

Comparison of a Lymph Node Ratio–Based Staging System With the 7th AJCC System for Gastric Cancer

The American Joint Committee on Cancer (AJCC) staging system for gastric cancer bases N status on absolute number of metastatic nodes, regardless of the number of examined nodes. We examined a modified staging system utilizing node ratio (Nr), the ratio of metastatic to examined nodes. A total of 18,043 gastric cancer patients who underwent gastrectomy were identified from the US Surveillance, Epidemiology, and End Results (SEER) database. A training set was divided into 5 Nr groups, and a TNrM staging system was constructed. Median survival and overall survival, based on 7th edition AJCC and TNrM staging systems, were compared, and the analysis was repeated in a validation set. Median examined nodes were 10 to 11. For the training set, overall survival for all 5 AJCC N categories was significantly different when subgrouped into 15 or fewer versus more than 15 examined nodes, but overall survival was similar regardless of the number of examined nodes in 4 of 5 Nr categories. Seven AJCC stages had statistically different overall survival between subgroups, whereas only 1 TNrM stage had statistically different overall survival between subgroups. When misclassification was defined as any subgroup in which median survival fell outside the 95% confidence interval of the group's overall median survival, AJCC staging misclassified 57% of patients and TNrM staging misclassified only 12%. Similar results were found in the validation set. The AJCC system classifies SEER gastric cancer patients into stages in which subgroups often have wide variations in survival. For patients undergoing limited lymph node analysis, the proposed TNrM system may predict survival more accurately.

Efeito da perda de peso sobre a hemodinâmica renal em portadores da síndrome metabólica

We investigated the impact of weight loss on urinary albumin excretion (UAE) and creatinine clearance in obese patients with metabolic syndrome. Thirty-five obese patients undertook a 12-week calorie-restricted diet. The patients underwent a metabolic (oral glucose tolerance test, plasma lipids, and uric acid) and renal hemodynamic evaluations (creatinine clearance and urinary albumin excretion) before (phase 1), and after the 12-week diet (phase 2). After the dietary intervention, the subjects were divided into two groups: patients who achieved the target weight reduction (R: responders, n = 14), and patients who did not (NR: non-responders, n = 21). The patients in Group R showed an improvement in lipid profile, a decrease in UAE (median = 162.5 mg/24 hours, range: 0.8 to 292 mg/24 hours, at phase 1 versus 10.4 mg/24 hours, range: 1.6 to 22.4 mg/24 hours, at phase 2), and a significant reduction in creatinine clearance (121.4 ± 66.5 mL/min. in phase 1 to 92.9 ± 35.6 mL/min. at the end of phase 2, p = 0.001). In Group NR, no statistically significant differences were observed between phases 1 and 2. Body weight reduction has a positive impact on renal hemodynamics, decreasing urinary albumin excretion as well as glomerular hyperfiltration in obese patients with metabolic syndrome.

The evaluation of surgical treatment for gastric cancer patients with noncurative resection

This study aims to analyze the results of treatment in a series of 233 gastric cancer patients who underwent a noncurative resection. We performed a retrospective study of patients with noncurative treatment for advanced gastric cancer who were divided into three treatment groups: total gastrectomy (TG, n=150), distal gastrectomy (DG, n=44), and nonresection (NR, bypass procedure or chemotherapy only, n=39). In multivariate analysis, surgical treatment (TG) and an absence of chemotherapy were significant independent prognostic factors for a poor survival. In the late period, the overall survival rate was significantly lower in the TG group than in the DG group (p=0.005) and was marginally lower than in the NR group (p=0.054). The resection group had a poorer compliance for chemotherapy than the NR group, and the TG group had a poorer compliance than the DG group (p<0.01). The morbidity rate was higher in the TG group than in the DG group (p<0.05). TG is considered to be inappropriate for the treatment of noncurative gastric cancer because of the poor prognosis, high morbidity rates, and poor compliance for chemotherapy associated with the procedure. However, noncurative DG was acceptable and postoperative chemotherapy should be used in selected patients.

Factors and Outcomes Associated with Recanalization Timing after Thrombolysis

Background: A substantial number of acute stroke patients do not respond immediately to aggressive intra-arterial (IA) recanalization therapy. The factors and outcomes associated with timing of recanalization after IA thrombolysis, however, have not yet been determined. Methods: Factors and outcomes in 75 acute ischemic stroke patients treated with IA urokinase (± intravenous tissue plasminogen activator) within 6 h of onset were retrospectively assessed. Immediate recanalization (IR) was assessed by the angiogram at the end of the IA procedure, and delayed (DR) and no (NR) recanalization were assessed by 5-day MR angiography. Modified Rankin Scale (mRS) scores were determined at 7 days and 3 months. Results: Of the 75 patients, 32 (42.7%) achieved IR, 21 (28%) achieved DR, and 22 (29.3%) showed NR. Good functional outcomes (mRS score ≤2) at 7 days and 3 months were observed in 59.4 and 62.5%, respectively, of the IR group, 14.3 and 38.1% of the DR group, and 22.7 and 27.3% of the NR group (p = 0.001 for 7 days, p = 0.028 for 3 months). Multivariate analysis showed that cardioembolism [odds ratio (OR), 3.74; 95% confidence interval (CI), 1.15–12.19] and middle cerebral artery occlusion (OR, 3.23; 95% CI, 1.04–10.04) were independent predictors of IR or DR compared with NR. Age (OR, 0.86; 95% CI, 0.77–0.95) and initial NIHSS score (OR, 1.20; 95% CI, 1.04–1.37) were independent predictors of DR compared with IR. Conclusions: Patients receiving IA thrombolysis show different clinical and radiological characteristics according to the timing of recanalization. Earlier identification of DR patients and their more efficient recanalization may improve overall clinical outcomes after IA thrombolysis.