Publications by authors named "Jianping Song"

93 Publications

Efficacy and Safety of Qinghao Biejia Decoction in the Treatment of Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis.

Front Pharmacol 2021 6;12:669269. Epub 2021 Aug 6.

Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.

This meta-analysis aimed to systematically assess the therapeutic efficacy and safety of Qinghao Biejia decoction combined with conventional chemical medicine in patients with systemic lupus erythematosus (SLE), and to provide reference for clinical medication. Multiple databases were retrieved by computer for randomized controlled trials (RCTs) of treating SLE with Qinghao Biejia decoction combining chemical medicine, from the establishment of the database to January 2021. Study screening, data collection, and quality assessment were performed independently by two reviewers. RevMan 5.4 and Stata 15.1 software were used for Meta-analysis. Nine eligible studies, involving 655 SLE participants, were included. Meta-analysis showed that the additional use of Qinghao Biejia decoction superior to chemical medicine alone in people with SLE in improving the overall response rate (RR = 1.30, 95% CI [1.19, 1.41], < 0.00001, heterogeneity = 0.61, = 0%), and can decrease SLE Disease Activity Index (SLEDAI) and TCM symptom scores, improve immunological indexes (C3, C4, IgG, IgA, IFN-γ, IL-4, Th1/Th2), reduce the occurrence of adverse events in treatment ( ≤ 0.05). Based on this meta-analysis, the additional use of Qinghao Biejia decoction has more advantages in the treatment of SLE than conventional chemical medication alone, which could enhance the efficacy and reduce adverse reactions, and is worthy of clinical promotion. However, more and higher quality RCTs are still need to confirm our findings.
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http://dx.doi.org/10.3389/fphar.2021.669269DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8378134PMC
August 2021

Mass Drug Administration With Artemisinin-Piperaquine for the Elimination of Residual Foci of Malaria in São Tomé Island.

Front Med (Lausanne) 2021 12;8:617195. Epub 2021 Jul 12.

Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.

Mass drug administration with artemisinin-piperaquine (AP-MDA) is being considered for elimination of residual foci of malaria in Democratic Republic of São Tomé and Principe. Three monthly rounds of AP-MDA were implemented from July to October 2019. Four zones were selected. A and B were selected as a study site and a control site, respectively. C and D were located within 1.5 and 1.5 km away from the study site, respectively. Parasite prevalence, malaria incidence, and the proportion of the malaria cases were evaluated. After 3 monthly rounds of AP-MDA, the parasite prevalence and the gametocyte carriage rate of in zone A decreased from 28.29(‰) to 0 and 4.99(‰) to 0, respectively. Compared to zone B, the relative risk for the population with malaria in zone A was lower (RR = 0.458, 95% CI: 0.146-1.437). Malaria incidence fell from 290.49(‰) (the same period of the previous year) to 15.27(‰) (from the 29th week in 2019 to the 14th week in 2020), a decrease of 94.74% in zone A, and from 31.74 to 5.46(‰), a decline of 82.80% in zone B. Compared to the data of the same period the previous year, the cumulative number of malaria cases were lower, decreasing from 165 to 10 in zone A and from 17 to 4 in zone B. The proportion of the malaria cases on the total malaria cases of the country decreased of 90.16% in zone A and 71.34% in zone C. AP-MDA greatly curbed malaria transmission by reducing malaria incidence in the study site and simultaneously creating a knock-on effect of malaria control within 1.5 km of the study site and within the limited time interval of 38 weeks.
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http://dx.doi.org/10.3389/fmed.2021.617195DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311023PMC
July 2021

Presence of L1014F Knockdown-Resistance Mutation in From São Tomé and Príncipe.

Front Cell Infect Microbiol 2021 7;11:633905. Epub 2021 Jul 7.

Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.

Malaria, one of the most serious parasitic diseases, kills thousands of people every year, especially in Africa. São Tomé and Príncipe are known to have stable transmission of malaria. Indoor residual spraying (IRS) of insecticides and long-lasting insecticidal nets (LLIN) are considered as an effective malaria control interventions in these places. The resistance status of from Agua Grande, Caue, and Lemba of São Tomé and Príncipe to insecticides, such as dichlorodiphenyltrichloroethane (DDT) (4.0%), deltamethrin (0.05%), permethrin (0.75%), fenitrothion (1.0%), and malathion (5.0%), were tested according to the WHO standard protocol. DNA extraction, species identification, as well as and genotyping were done with the surviving and dead mosquitoes post testing. They showed resistance to cypermethrin with mortality rates ranging from 89.06% to 89.66%. Mosquitoes collected from Agua Grande, Caue, and Lemba displayed resistance to DDT and fenitrothion with mortality rates higher than 90%. No other species were detected in these study localities other than . The frequency of L1014F was high in the three investigated sites, which was detected for the first time in São Tomé and Príncipe. No mutation was detected in all investigated sites. The high frequency of L1014F showed that L1014F mutation might be related to insecticide resistance to populations from São Tomé and Príncipe. Insecticide resistance status is alarming and, therefore, future malaria vector management should be seriously considered by the government of São Tomé and Príncipe.
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http://dx.doi.org/10.3389/fcimb.2021.633905DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8295031PMC
July 2021

Follow the Venous Path to the Hidden Lesion: A Technical Trick in Brainstem Cavernous Malformation Surgery.

World Neurosurg 2021 Jul 22;154:44-50. Epub 2021 Jul 22.

National Center for Neurological Disorders, Shanghai, China; Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China.

Objective: Deep-seated brainstem cavernous malformations (BSCMs) pose a particular challenge for brainstem entry intraoperatively and their treatment can require comprehensive application of neuronavigation, electrophysiological brainstem mapping and monitoring, and full knowledge of safe brainstem entry zones. In the present report, we have introduced a supplementary technical trick for localizing a hidden tiny lesion inside the brainstem when a developmental venous anomaly (DVA) is present on the brainstem surface.

Methods: A retrospective analysis of a 74-case cohort treated surgically from January 2011 to December 2019 was conducted. We identified 11 patients (14.9%) whose deep-seated BSCMs were exposed and removed following a brainstem surface DVA path as a supplementary technical trick. We have presented 2 typical cases to illustrate the operative nuances.

Results: Of the 11 patients, 5 were male and 6 were female. Their average age was 38.0 ± 14.0 years (range, 15-62 years). Most BSCMs were located in the pons (n = 5; 45.5%), followed by the pontomesencephalic area (n = 3; 27.3%), midbrain (n = 2; 18.2%), and medulla oblongata (n = 1; 9.1%). All BSCMs were successfully located and completely removed. In 5 cases, the DVA was impaired after lesion removal (45.5%). However, no aggravated postoperative brainstem edema occurred in any of the 11 patients. After 3.6 ± 2.0 years of follow-up (2 patients were lost to follow-up; follow-up rate, 81.8%), no rebleeding was found, and the modified Rankin scale score of the patients had improved from 2.7 ± 1.1 preoperatively to 1.7 ± 0.9 at follow-up (P = 0.031).

Conclusions: The presented method could help surgeons trace deep-seated BSCMs with minimal brainstem parenchyma impairment, avoiding unnecessary aggressive exploration.
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http://dx.doi.org/10.1016/j.wneu.2021.07.073DOI Listing
July 2021

How I do it? Posterior inferior cerebellar artery-intracranial vertebral artery reimplantation bypass and trapping of dissecting aneurysm involving the proximal posterior inferior cerebellar artery.

Acta Neurochir (Wien) 2021 Jul 23. Epub 2021 Jul 23.

Department of Neurosurgery, Huashan Hospital of Fudan University, No. 12 Wulumuqi Zhong Road, Shanghai, China.

Background: Proximal posterior inferior cerebellar artery (PICA) aneurysms are surgically challenging due to the high variability in the anatomy of the PICA origin, their deep-seated nature, and their entanglement with the lower cranial nerves. Direct or reconstructive clipping may not be achievable if the aneurysm is large, or dissecting, or exhibits atherosclerosis or calcification.

Method: We present a case of a proximal PICA lateral medullary segment (P2) aneurysm that was successfully cured by trapping the aneurysm and reconstructing the PICA using the PICA-intracranial vertebral artery (PICA-V4) via end-to-side reimplantation bypass with the far lateral approach.

Conclusion: This case demonstrates the feasibility and safety of PICA-V4 reimplantation bypass, especially if the origin of the PICA is highly seated and the intracranial VA, or V4 segment, is long enough and well-exposed supra or under hypoglossal nerves.
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http://dx.doi.org/10.1007/s00701-021-04918-9DOI Listing
July 2021

Microsurgical intracranial hypervascular tumor resection immediately after endovascular embolization in a hybrid operative suite: A single-center experience.

J Clin Neurosci 2021 Aug 24;90:68-75. Epub 2021 May 24.

Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China; State Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai 200032, China.

Background: This study was performed to investigate the safety and outcome of one-stage hybrid endovascular and microsurgical treatment of intracranial hypervascular tumors.

Methods: The blood supply of the tumor was endovascularly embolized just before microsurgery in a one-stage fashion. Clinical data regarding the preoperative neurological status, tumor characteristics, hybrid treatment details and complications, intraoperative blood loss, and postoperative outcomes were collected prospectively and then analyzed.

Results: Beginning in July 2016, 13 patients (5 women, 8 men) with intracranial hypervascular tumors were enrolled in this study, with a mean age of 48.2 ± 10.9 years. The patients' tumors comprised seven hemangioblastomas, three hemangiopericytomas, two meningiomas, and one mesenchymal chondrosarcoma. The mean maximum tumor diameter was 54.9 ± 21.5 mm. No major procedural complications occurred except catheterization-related bleeding in one patient. The mean percentage of tumor devascularization was 65.0%±17.5%. Gross total resection was achieved in 12 patients (92.3%). The mean blood loss volume during microsurgical resection was 703.8 ± 886.8 mL (range, 150-3600 mL). Symptoms improved in three patients and remained stable in six patients.

Conclusions: One-stage hybrid embolization before intracranial hypervascular tumor resection is a safe and effective procedure to decrease intraoperative blood loss. It can prevent or treat embolization-related complications in a timely manner and avoid the risk of multiple surgical procedures.
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http://dx.doi.org/10.1016/j.jocn.2021.05.026DOI Listing
August 2021

Clinical Application of a Modified Double Purse-String Continuous Suture Technique for Pancreaticojejunostomy: Reliable for Laparoscopic Surgery and Small Size Main Pancreatic Duct.

Biomed Res Int 2021 13;2021:6676999. Epub 2021 Mar 13.

Department of General Surgery, Qilu Hospital, Shandong University, No. 107, Wenhua Xi Road, Jinan 250012, China.

Background: The technical challenge of pancreatojejunostomy (PJ) is the greatest barrier for surgeons to complete pancreatoduodenectomy (PD). The authors present an easy-to-master PJ anastomosis technique with limited technical requirements. This technique uses two layers of sutures and double purse-string sutures to complete the entire anastomosis. This anastomosis technique has achieved good results in laparoscopic surgery (LS) and small size main pancreatic duct (MPD).

Methods: From February 2015 to August 2020, 63 patients who met the surgical indications underwent a modified double purse-string continuous suture pancreaticojejunostomy technique in our center. We collected patient demographic characteristics and perioperative outcomes and analyzed these data.

Results: A total of 63 patients underwent PD using our new anastomosis technique. Thirty-eight patients underwent LS, and 26 patients had a small MPD (<3 mm). The median operative time (OT) was 270 min, and the median estimated blood loss (EBL) was 200 ml. Ten patients had grade B postoperative pancreatic fistula (POPF), while no patients had grade C POPF. No 90-day mortality was observed. There were significant differences in the OT and postoperative hospital stay (PHS) among groups with different surgical procedures, while there were no significant differences among groups with different MPD sizes. Neither the surgical procedure nor the MPD size affected early postoperative complications.

Conclusion: This new technique can not only reduce the incidence of POPF but also is reliable for LS and surgeries with small size MPD. Therefore, this technique is worthy of clinical promotion and application in the future.
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http://dx.doi.org/10.1155/2021/6676999DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984902PMC
May 2021

Splicing factor USP39 promotes ovarian cancer malignancy through maintaining efficient splicing of oncogenic HMGA2.

Cell Death Dis 2021 03 17;12(4):294. Epub 2021 Mar 17.

Key Laboratory of Experimental Teratology, Ministry of Education, Department of Cell Biology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.

Aberrant expression of splicing factors was found to promote tumorigenesis and the development of human malignant tumors. Nevertheless, the underlying mechanisms and functional relevance remain elusive. We here show that USP39, a component of the spliceosome, is frequently overexpressed in high-grade serous ovarian carcinoma (HGSOC) and that an elevated level of USP39 is associated with a poor prognosis. USP39 promotes proliferation/invasion in vitro and tumor growth in vivo. Importantly, USP39 was transcriptionally activated by the oncogene protein c-MYC in ovarian cancer cells. We further demonstrated that USP39 colocalizes with spliceosome components in nuclear speckles. Transcriptomic analysis revealed that USP39 deletion led to globally impaired splicing that is characterized by skipped exons and overrepresentation of introns and intergenic regions. Furthermore, RNA immunoprecipitation sequencing showed that USP39 preferentially binds to exon-intron regions near 5' and 3' splicing sites. In particular, USP39 facilitates efficient splicing of HMGA2 and thereby increases the malignancy of ovarian cancer cells. Taken together, our results indicate that USP39 functions as an oncogenic splicing factor in ovarian cancer and represents a potential target for ovarian cancer therapy.
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http://dx.doi.org/10.1038/s41419-021-03581-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969951PMC
March 2021

Letter to the Editor Regarding "Surgical Anatomy of the Labyrinthine and Subarcuate Arteries and Clinical Implications".

Authors:
Jianping Song

World Neurosurg 2021 03;147:243-244

Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China; Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery (2018RU008), Chinese Academy of Medical Sciences, Shanghai, China. Electronic address:

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http://dx.doi.org/10.1016/j.wneu.2020.11.094DOI Listing
March 2021

How I do it: anatomical resection of a large diffusive recurrent high-grade glioma for preservation of the central core.

Acta Neurochir (Wien) 2021 05 7;163(5):1317-1321. Epub 2021 Mar 7.

Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Wulumuqi Zhong Road, Shanghai, 200040, China.

Background: Maximal safe surgical treatment of diffusive glioma without a clear boundary between the tumor and central core is challenging.

Method: We present a case of a large, diffusive, recurrent high-grade glioma with preservation of the central core following an anatomical resection protocol that aimed to maintain quality of life.

Conclusion: Knowing the key anatomical landmarks and following the anatomical resection protocol are fundamental to surgical safety for treatment of glioma.
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http://dx.doi.org/10.1007/s00701-021-04785-4DOI Listing
May 2021

Electrocardiographic effect of artemisinin-piperaquine, dihydroartemisinin-piperaquine, and artemether-lumefantrine treatment in falciparum malaria patients.

Rev Soc Bras Med Trop 2021 10;54:e05362020. Epub 2021 Feb 10.

Guangzhou University of Chinese Medicine, Artemisinin Research Center, Guangzhou, Guangdong, People's Republic of China.

Introduction: Artemisinin-based combination therapy (ACT), such as artemisinin-piperaquine (AP), dihydroartemisinin-piperaquine (DP), and artemether-lumefantrine (AL), is the first-line treatment for malaria in many malaria-endemic areas. However, we lack a detailed evaluation of the cardiotoxicity of these ACTs. This study aimed to analyze the electrocardiographic effects of these three ACTs in malaria patients.

Methods: We analyzed the clinical data of 89 hospitalized patients with falciparum malaria who had received oral doses of three different ACTs. According to the ACTs administered, these patients were divided into three treatment groups: 27 treated with AP (Artequick), 31 with DP (Artekin), and 31 with AL (Coartem). Electrocardiograms and other indicators were recorded before and after the treatment. The QT interval was calculated using Fridericia's formula (QTcF) and Bazett's formula (QTcB).

Results: Both QTcF and QTcB interval prolongation occurred in all three groups. The incidence of such prolongation between the three groups was not significantly different. The incidence of both moderate and severe prolongation was not significantly different between the three groups. The ΔQTcF and ΔQTcB of the three groups were not significantly different. The intra-group comparison showed significant prolongation of QTcF after AL treatment.

Conclusions: Clinically recommended doses of DP, AL, and AP may cause QT prolongation in some malaria patients but do not cause torsades de pointes ventricular tachycardia or other arrhythmias.
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http://dx.doi.org/10.1590/0037-8682-0536-2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891559PMC
February 2021

How I do it? Gravity-assisted endoscopic cingulate gyrus glioma resection.

Acta Neurochir (Wien) 2021 05 16;163(5):1323-1326. Epub 2021 Feb 16.

Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Wulumuqi Zhong Road, Shanghai, 200040, China.

Background: The cingulate gyrus is part of the limbic system with extensive connectivity to different anatomical and functional areas. The traditional transcortical approach for a cingulate gyrus glioma contains high risk of transient or even irreversible postoperative hemiplegia.

Method: We present a case of gravity-assisted, fully endoscopic resection of a cingulate gyrus glioma with improvement of motor dysfunction while preserving the paracentral lobule, corticospinal tracts, and supplementary motor area.

Conclusion: This case demonstrates the value of gravity-assisted endoscopic resection in the dominant cingulate gyrus tumor which is surrounded by eloquent parenchyma.
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http://dx.doi.org/10.1007/s00701-021-04741-2DOI Listing
May 2021

One-Stage Treatment in a Hybrid Operation Room to Cure Brain Arteriovenous Malformation: A Single-Center Experience.

World Neurosurg 2021 03 19;147:e85-e97. Epub 2020 Dec 19.

Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China; Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China.

Objective: To report the principles and techniques of using a hybrid operation room in the treatment of brain arteriovenous malformation (BAVM).

Methods: From October 1, 2016 to December 31, 2018, we treated 54 consecutive patients with nonemergent BAVM in a hybrid operation room. The clinical data, radiologic images, and outcomes were collected to establish a prospective database for evaluation.

Results: Thirty-two male and 22 female patients were enrolled with a mean age of 32.6 ± 13.1 years (range, 10-61 years). Bleeding (n = 32, 59.3%) was the main clinical presentation, followed by headache (n = 27, 50.0%), seizures (n = 14, 25.9%), neurofunctional deficits (n = 16, 29.6%), and no symptoms (n = 2, 3.7%). Thirty-one patients (57.4%) accepted resection without intraoperative embolization, 18 (33.3%) were treated with combined embolization and resection, and 5 (9.3%) were cured with intraoperative embolization and resection was cancelled. All patients achieved total BAVM obliteration confirmed with intraoperative angiography. There were no significant differences in outcomes between low-grade (Spetzler-Martin grades I, II, and modified grade III-) and high-grade (Spetzler-Martin grades ≥IV and modified grade III+) groups, except that the high-grade group had more blood loss (667.9 ± 647.5 vs. 284.3 ± 148.6 mL; P = 0.046) and longer postoperative hospitalization (17.1 ± 9.1 vs. 10.8 ± 5.4 days; P = 0.026). At discharge, 52 patients (96.3%) had favorable outcomes (Glasgow Outcome Scale score ≥4). Forty-three patients (79.6%) received 1 year follow-up after treatment; 97.7% (n = 42) of these had ongoing favorable outcomes. However, 4 patients with low-grade BAVM had recurrence.

Conclusions: The hybrid operation room can ensure safe, comprehensive treatment of BAVM, offering the opportunity for a favorable curative treatment in 1 stage.
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http://dx.doi.org/10.1016/j.wneu.2020.11.123DOI Listing
March 2021

Safety and Efficacy of Adjunctive Therapy With Artesunate in the Treatment of Severe Malaria: A Systematic Review and Meta-Analysis.

Front Pharmacol 2020 12;11:596697. Epub 2020 Nov 12.

Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.

The purpose of this meta-analysis of longitudinal studies is to determine the safety and efficacy of artesunate combined with other forms of adjunctive therapies for severe malaria. Following the PRISMA guidelines, we searched multiple databases with the search terms "artesunate" and "adjunctive therapy" and "severe malaria" in July 2020. If the search showed a randomized controlled trial, the study was included in this meta-analysis. The random-effects model was used to calculate the combined incidence rate and relative risk or risk difference. This meta-analysis included nine longitudinal studies with 724 participants. We found that the mortality rates in the artesunate monotherapy group and the artesunate + adjuvant therapy group are similar (RD = -0.02, 95% confidence interval: -0.06-0.02). The incidence of adverse reactions in the artesunate monotherapy group and the artesunate + adjuvant therapy group was also similar. No significant differences in safety and efficacy were observed between the artesunate monotherapy group and the artesunate + adjuvant therapy group. Higher quality and rigorously designed randomized controlled studies are needed to validate our findings.
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http://dx.doi.org/10.3389/fphar.2020.596697DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748123PMC
November 2020

Serum KIAA1199 is an advanced-stage prognostic biomarker and metastatic oncogene in cholangiocarcinoma.

Aging (Albany NY) 2020 11 10;12(23):23761-23777. Epub 2020 Nov 10.

Department of Surgery, School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.

Background: Cell proliferation and migration are the determinants of malignant tumor progression, and a better understanding of related genes will lead to the identification of new targets aimed at preventing the spread of cancer. Some studies have shown that KIAA1199 (CEMIP) is a transmembrane protein expressed in many types of noncancerous cells and cancer cells. However, the potential role of KIAA1199 in the progression of cholangiocarcinoma (CCA) remains unclear.

Results: Analysis of cancer-related databases showed that KIAA1199 is overexpressed in CCA. ELISA, immunohistochemistry, Western blotting and qPCR indicated high expression levels of KIAA1199 in serum, CCA tissues and CCA cell lines. In the serum (n = 41) and large sample validation (n = 177) cohorts, higher KIAA1199 expression was associated with shorter overall survival and disease-free survival times. At the cellular level, KIAA1199 overexpression (OE) promoted CCA growth and metastasis. Subcutaneous tumor xenograft experiments showed that KIAA1199 enhances CCA cell proliferation. Additionally, the expression levels of components in the EMT-related TGF-β pathway changed significantly after KIAA1199 upregulation and silencing.

Conclusion: KIAA1199 is a promising new diagnostic molecule and therapeutic target in CCA. The serum KIAA1199 level can be used as a promising clinical tool for predicting the overall postoperative outcomes of patients with CCA.

Methods: CCA-related KIAA1199 data were downloaded from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. To assess the prognostic impact of KIAA1199, an enzyme-linked immunosorbent assay (ELISA) was used to measure the serum level of KIAA1199 in 41 patients who underwent surgical resection. Immunohistochemical staining, Western blotting and qPCR were used to verify and retrospectively review the expression levels of KIAA1199 in cancer tissue specimens from 177 CCA patients. The effect of KIAA1199 on CCA was evaluated by cell-based functional assays and subcutaneous tumor xenograft experiments. The expression levels of proteins associated with epithelial-mesenchymal transition (EMT) and activation of relevant signaling pathways were measured via Western blotting.
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http://dx.doi.org/10.18632/aging.103964DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762501PMC
November 2020

How I do it? Anatomical multifocal high-grade glioma resection.

Acta Neurochir (Wien) 2021 04 12;163(4):953-957. Epub 2020 Nov 12.

Department of Neurosurgery, Huashan Hospital, Shanghai Medical Collage, Fudan University, No.12 Wulumuqi Zhong Road, Shanghai, 200040, China.

Background: If an awake surgery is somehow not available for gliomas at the language area, understanding the anatomy and well-designed surgical strategy are important.

Method: We present a case with left hemispheric multifocal high-grade gliomas located deeply at the left temporal pole, the Wernicke's area, and mesial temporal region. Because the patient could not endure the awake surgery and obtain practicable functional magnetic resonance imaging (MRI) for eloquent cortex evaluation, we removed the lesions following the anatomical resection strategy guided by diffusion tensor imaging (DTI).

Conclusion: This case demonstrates the value of DTI and the importance of anatomical resection strategies in glioma surgeries.
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http://dx.doi.org/10.1007/s00701-020-04637-7DOI Listing
April 2021

Safety and efficacy of artemisinin-piperaquine for treatment of COVID-19: an open-label, non-randomised and controlled trial.

Int J Antimicrob Agents 2021 Jan 2;57(1):106216. Epub 2020 Nov 2.

Institute of Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China; Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China. Electronic address:

Background: There are no effective therapies for patients with coronavirus disease-2019 (COVID-19).

Methods: Forty-one patients with confirmed COVID-19 were enrolled in the study and divided into two groups: artemisinin-piperaquine (AP) (n = 23) and control (n = 18). The primary outcome were the time taken to reach undetectable levels of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and the percentage of participants with undetectable SARS-CoV-2 on days 7, 10, 14, and 28. The computed tomography (CT) imaging changes within 10 days, corrected QT interval changes, adverse events, and abnormal laboratory parameters were the secondary outcomes.

Results: The mean time to reach undetectable viral RNA (mean ± standard deviation) was 10.6 ± 1.1 days (95% confidence interval [CI] 8.4-12.8) for the AP group and 19.3 ± 2.1 days (95% CI 15.1-23.5) for the control group. The percentages of patients with undetectable viral RNA on days 7, 10, 14, 21, and 28 were 26.1%, 43.5%, 78.3%, 100%, and 100%, respectively, in the AP group and 5.6%, 16.7%, 44.4%, 55.6%, and 72.2%, respectively, in the control group. The CT imaging within 10 days post-treatment showed no significant between-group differences (P > 0.05). Both groups had mild adverse events.

Conclusions: In patients with mild-to-moderate COVID-19, the time to reach undetectable SARS-CoV-2 was significantly shorter in the AP group than that in the control group. However, physicians should consider QT interval changes before using AP.
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http://dx.doi.org/10.1016/j.ijantimicag.2020.106216DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605811PMC
January 2021

Efficacy and Safety of Artemisinin-Piperaquine for the Treatment of Uncomplicated Malaria: A Systematic Review.

Front Pharmacol 2020 11;11:562363. Epub 2020 Sep 11.

Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.

Objective: The World Health Organization recommends artemisinin-based combination therapies (ACTs) for the treatment of uncomplicated malaria to improve the therapeutic efficacy and limit the choice of drug-resistant parasites. This systematic review and meta-analysis aimed to evaluate the comparative efficacy and safety of artemisinin-piperaquine (AP) in the treatment of uncomplicated malaria relative to other commonly used ACTs.

Methods: As per the PRISMA guidelines, the EMBASE, MEDLINE, the Google Scholar Library, and Cochrane library databases were systematically searched from inception until July 2020 with the following terms: "artemisinin-piperaquine" or "AP." Only randomized controlled trials (RCTs) were included. The competing interventions included dihydroartemisinin-piperaquine (DHA-PPQ), artemether-lumefantrine (AL, Coartem), artesunate-melfloquine (ASAM) and artesunate-amodiaquine (ASAQ, Artekin). Single-arm clinical trial on AP was also assessed. The reported outcomes, including the overall response, cure rate, fever and parasite clearance time, hematology, biochemistry, electrocardiogram (ECG), adverse events, recurrence rate, and sensitivity analyses, were systematically investigated. All data were analyzed using the Review Manager 5.3.

Results: A total of seven studies were reviewed, including five RCTs and two single-arm studies. A pooled analysis of 5 RCTs (n = 772) revealed a comparable efficacy on polymerase chain reaction (PCR)-confirmed cure rate between AP and competing interventions in treating uncomplicated malaria. As for the fever and parasite clearance time, due to the lack of complete data in some studies, only 3 studies' data could be used. The patients showed good tolerance to all drugs, and some side-effects (such as headache, anoxia, vomiting, nausea, and dizziness) were reported for every group, but they were self-limited and showed no significant difference.

Conclusions: AP appeared to show similar efficacy and safety, with a simpler mode of administration and easier compliance when compared with other ACTs used in the treatment of uncomplicated malaria. Considering that the potential evolution of drug resistance is of a great concern, additional RCTs with high-quality and more rigorous design are warranted to substantiate the efficacy and safety in different populations and epidemiological regions.
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http://dx.doi.org/10.3389/fphar.2020.562363DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516161PMC
September 2020

Trichinella spiralis co-infection exacerbates Plasmodium berghei malaria-induced hepatopathy.

Parasit Vectors 2020 Sep 3;13(1):440. Epub 2020 Sep 3.

Department of Parasitology, Zhongshan School of Medicine; Key Laboratory of Tropical Disease Control of Ministry of Education, Sun Yat-sen University, Guangzhou, China.

Background: Although Plasmodium parasites and intestinal helminths share common endemic areas, the mechanisms of these co-infections on the host immune response remain not fully understood. Liver involvement in severe Plasmodium falciparum infections is a significant cause of morbidity and mortality. However, the effect of pre-existing Trichinella spiralis infection on the immune response and liver immune-pathogenesis in P. berghei ANKA (PbANKA)-infected mice needs to be elucidated.

Methods: Outbred Kunming mice were infected with T. spiralis and 9 days later were challenged with P. berghei ANKA (PbANKA), and the investigation occurred at 13 days after co-infection.

Results: Compared with PbANKA-mono-infected mice, T. spiralis + PbANKA-co-infected mice had similar survival rate but lower PbANKA parasitaemia; however, there were more severe hepatosplenomegaly, increased liver and spleen indexes, and increased liver pathology observed by hematoxylin and eosin staining; higher expression levels of galectin (Gal)-1, Gal-3, CD68 macrophages, and elastase-positive neutrophils measured by immunohistochemical staining; upregulated mRNA expression levels of Gal-1, Gal-3, cytokines (interferon-gamma (IFNγ) and interleukin (IL)-6), and M1 macrophage polarization marker (inducible nitric oxide synthase (iNOS)) in the liver, and increased expression levels of Gal-1, IFNγ, IL-6, eosinophil cationic protein, eosinophil protein X, and M1 (IL-1β and iNOS) and M2 (Ym1) macrophage polarization markers in the spleen of co-infected mice detected by using quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). In vitro study showed that compared with PbANKA-mono-infected mice, there were significantly increased expression levels of Gal-1, Gal-3, IL-6, IL-1β, and iNOS in the peritoneal macrophage isolated from co-infected mice detected by using qRT-PCR. Correlation analysis revealed significant positive correlations between Gal-3 and IL-1β in the peritoneal macrophages isolated from PbANKA-mono-infected mice, between Gal-3 and IFNγ in the spleen of co-infected mice, and between Gal-1 and Ym1 in the peritoneal macrophages isolated from co-infected mice.

Conclusions: Our data indicate that pre-existing infection of T. spiralis may suppress P. berghei parasitaemia and aggravate malaria-induced liver pathology through stimulating Gal-1 and Gal-3 expression, activating macrophages, neutrophils, and eosinophils, and promoting mediator release and cytokine production.
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http://dx.doi.org/10.1186/s13071-020-04309-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7469358PMC
September 2020

Immunogenicity and toxicokinetics assessment of the mono-PEGylated recombinant human interleukin-11 in cynomolgus monkeys.

Life Sci 2020 Oct 11;259:118244. Epub 2020 Aug 11.

Sci-tech Industrial Park, Guangzhou University of Chinese Medicine, Guangzhou 510445, China. Electronic address:

Aim: Protein therapeutics have potential to elicit immune responses resulting in undesirable anti-drug antibodies (ADA) that might affect product efficacy and patient safety, and should be assessed in animals before applying the treatment to humans. In this paper, we aim to assess the immunogenicity and toxicokinetics of the mono-PEGylated recombinant human interleukin-11 (rhIL-11), a novel protein therapeutic for the treatment of chemotherapy-induced thrombocytopenia, in repeated administration to cynomolgus monkeys.

Main Methods: Enzyme-linked immunosorbent assay (ELISA) methods were developed to measure ADA responses and plasma PEGylated IL-11 (PEG-IL11) concentration in monkeys. Assay parameters of immunogenicity and toxicokinetics methods were evaluated during validation in accordance with regulatory guidelines. We also employed cell-based assays to test the neutralizing activity of ADA provoked in monkeys.

Key Findings: The results showed that weak immunogenicity occurred in some monkeys after receiving repeated dose of 0.1-0.3 mg/kg by subcutaneous administration and disappeared after the recovery period. More pronounced immunogenicity occurred at high dose of 0.9 mg/kg, with a higher positive rate and titer, and some ADAs had neutralizing activity, but it can be greatly reduced after recovery. Such ADAs generated in monkeys may be accounted for the plasma toxicokinetics changes of PEG-IL11 and a minor reduction in systemic exposure.

Significance: These methods have been successfully applied to immunogenicity and toxicokinetic studies of PEG-IL11 in repeated dose toxicity following subcutaneous administration to monkeys, and could be successfully used in clinical trials after some modifications.
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http://dx.doi.org/10.1016/j.lfs.2020.118244DOI Listing
October 2020

Surveillance of the Efficacy of Artemisinin-Piperaquine in the Treatment of Uncomplicated Malaria Among Children Under 5 Years of Age in Est-Mono District, Togo, in 2017.

Front Pharmacol 2020 5;11:784. Epub 2020 Jun 5.

Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.

Background: Malaria is a major public health concern in Togo. The Est-Mono district of Togo has a population of 150,000. Accordingly, the Guangzhou University of Chinese Medicine, China and the Ministry of Health and Social Security, Togo launched a nationwide Mass Drug Administration Project with artemisinin-piperaquine (AP) in Est-Mono. Before launching this project, the sensitivity test of AP was conducted in a general clinic in Elawagnon, Togo. With this background, we evaluated the efficacy and safety of AP for the treatment of uncomplicated falciparum malaria in children under the age of 5 years.

Methods: Children aged 6-59 months with uncomplicated falciparum malaria were enrolled in this study. The selected patients were treated with a combination regime of artemisinin-piperaquine. The patients were followed up for 28 days, during which signs of the following were observed for: the duration for fever clearance, parasitemia density, gametophyte generation, cure rate, hemoglobin level, and ( polymorphism. The primary end point was a 28-day cure rate and polymerase chain reaction (PCR)-corrected reinfection and recrudescence. This research followed the standardized World Health Organization (WHO) protocol for the assessment of the efficacy of antimalarial drugs.

Results: A total of 91 children with uncomplicated falciparum malaria were enrolled in this study. Adequate clinical and parasitological responses (ACPRs) before and after PCR-correction were 66 (73%) and 90 (99%), respectively. The average hemoglobin level in the patient increased by 0.05 g/dl per day (p < 0.0001) after the treatment. The gametophyte generation did not decline at the beginning of the treatment; however, after 14 days, it declined (day 21: p < 0.05; day 28: p < 0.01). In the polymorphism study of 24 children treated for parasite infection, one case of with haplotype and haplotype was noted, indicating its recrudescence, with a frequency of 4%. The remaining 23 cases could have been of reinfection, with a frequency of 96%. No serious adverse reactions occurred, and AP was well-tolerated by all patients.

Conclusion: Artemisinin-piperaquine was found to be an effective combination for treating uncomplicated falciparum malaria in children aged <5 years in Togo, and the drugs were well-tolerated. In Togo, remains sensitive to artemisinin-piperaquine, necessitating its trial in this region.

Clinical Trial Registration: Trial registration: ECGPHCM No. B2017-054-01; MHSST AVIS N° 0001/2016/CBRS du 07 janvier 2016. Registered 17 March 2014, http://www.chinadrugtrials.org.cn/eap/main.
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http://dx.doi.org/10.3389/fphar.2020.00784DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291391PMC
June 2020

Transcription activation of circ-STAT3 induced by Gli2 promotes the progression of hepatoblastoma via acting as a sponge for miR-29a/b/c-3p to upregulate STAT3/Gli2.

J Exp Clin Cancer Res 2020 Jun 3;39(1):101. Epub 2020 Jun 3.

Department of Pediatric Surgery, PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China.

Background: Hepatoblastoma (HB) is a common liver malignancy in children. Our previous study has disclosed the crucial role of STAT3 (signal transducer and activator of transcription 3) in HB.

Aim Of The Study: Present study was designed to study the circular RNA (circRNA) STAT3 in HB.

Methods: Gel electrophoresis revealed the circular characteristics of circ-STAT3. Function assays like EdU, transwell and sphere formation assay disclosed the function of circ-STAT3 in HB cells. Mechanism assays including ChIP, RIP, RNA pull down assay demonstrated the macular mechanism underlying circ-STAT3.

Results: Circ_0043800, which was originated from STAT3, was up-regulated in HB tissues and cells. More importantly, silencing of circ-STAT3 led to the inhibition on HB cell growth, migration and stem-cell characteristics. Circ_0043800 was predominantly located in the cytoplasm of HB cells. Then, circ_0043800 was found to up-regulate STAT3 via sponging miR-29a/b/c-3p. Besides, we identified that STAT3 overexpression partially rescued silenced circ_0043800, while miR-29a/b/c-3p inhibition completely rescued silenced circ_0043800 on HB cellular biological behaviors. Subsequently, Gli2 (GLI family zinc finger 2) was identified as another target of miR-29a/b/c-3p. Circ_0043800 served as a competing endogenous RNA (ceRNA) to up-regulate both Gli2 and STAT3 via sponging miR-29a/b/c-3p. Moreover, we figured out that Gli2 overexpression completely rescued silenced circ_0043800 on HB cell malignant behaviors. After that, we discovered that Gli2 transcriptionally activated circ_0043800. The in-vivo assays further revealed that circ_0043800 promoted HB tumor growth by up-regulation of Gli2 and STAT3.

Conclusion: Gli2-induced circ_0043800 served as the ceRNA to promote HB by up-regulation of STAT3 and Gli2 at a miR-29a/b/c-3p dependent manner.
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http://dx.doi.org/10.1186/s13046-020-01598-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268652PMC
June 2020

Application of refined management in prevention and control of the coronavirus disease 2019 epidemic in non-isolated areas of a general hospital.

Int J Nurs Sci 2020 Apr 8;7(2):143-147. Epub 2020 Apr 8.

Huzhou University, Huzhou, Zhejiang, China.

Objective: This article summarizes the experience in the prevention and control of coronavirus disease 2019(COVID-19) epidemic in non-isolated areas in a general hospital.

Methods: Based on refined management theory, we professionally developed the standards for prevention and control of COVID-19 in non-isolated areas, systematically implemented various prevention and control measures, performed gridding audits, effectively communicated among teams and between medical staff and patients assisted by information techniques, and reported results for quality improvement.

Results: There was no hospital-acquired COVID-19 infections among staff in the hospital. The rates of mask-wearing, epidemiological history screening, and the medical supplies disinfection were all 100% in the hospital. The accuracy rate of mask-wearing of patients and their families was 73.79% and the compliance rate of their hand hygiene was 40.78%.

Conclusion: Refined management strategies for the prevention and control of COVID-19 infection in non-isolated areas of the general hospital are effective. The accuracy rate of mask-wearing and hand hygiene compliance of patients and their families need to be further improved.
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http://dx.doi.org/10.1016/j.ijnss.2020.04.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141553PMC
April 2020

MYC-regulated pseudogene HMGA1P6 promotes ovarian cancer malignancy via augmenting the oncogenic HMGA1/2.

Cell Death Dis 2020 03 3;11(3):167. Epub 2020 Mar 3.

Key Laboratory of Experimental Teratology, Ministry of Education, Department of Cell Biology, Shandong University School of Medicine, 44 Wenhua Xi Road, 250012, Jinan, Shandong Province, China.

Pseudogenes have long been considered as nonfunctional genomic sequences. Recent studies have shown that they can potentially regulate the expression of protein-coding genes and are dysregulated in diseases including cancer. However, the potential roles of pseudogenes in ovarian cancer have not been well studied. Here we characterized the pseudogene expression profile in HGSOC (high-grade serous ovarian carcinoma) by microarray. We identified 577 dysregulated pseudogenes and most of them were up-regulated (538 of 577). HMGA1P6 (High mobility group AT-hook 1 pseudogene 6) was one of the overexpressed pseudogenes and its expression was inversely correlated with patient survival. Mechanistically, HMGA1P6 promoted ovarian cancer cell malignancy by acting as a ceRNA (competitive endogenous RNA) that led to enhanced HMGA1 and HMGA2 expression. Importantly, HMGA1P6 was transcriptionally activated by oncogene MYC in ovarian cancer. Our findings reveal that MYC may contribute to oncogenesis through transcriptional regulation of pseudogene HMGA1P6 in ovarian cancer.
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http://dx.doi.org/10.1038/s41419-020-2356-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054391PMC
March 2020

Gravity-Assisted Ipsilateral Paramedian Approach for Parafalcine Meningioma Resection.

World Neurosurg 2020 Mar 19;135:234-240. Epub 2019 Dec 19.

Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.

Background: In our series, the gravity-assisted ipsilateral paramedian approach was shown to be safe and advantageous for the resection of parafalcine meningioma, because it does not result in contralateral brain impingement and does not require brain retraction. We have reported the technical details of this method and the outcomes of our patients.

Methods: From September 2018 to September 2019, 10 consecutive patients with parafalcine meningioma underwent microsurgery using the gravity-assisted ipsilateral paramedian approach. The clinical data, radiological images, and surgical outcomes were collected and analyzed.

Results: All 10 patients (5 men and 5 women, mean age, 55.8 ± 12.5 years) underwent safe tumor resection. Of the 10 tumors, 6 were located in the frontal area, 2 in the parietal area, and 2 in frontal and parietal area. The superior sagittal sinus wall had been affected in 6 patients. Obvious perilesional edema was observed in 60% of the patients. During surgery, bridging veins were encountered in 8 patients and were preserved, except for a small branch. Brain retraction or transgression was not required, and gross total resection was achieved in all 10 patients. No major postoperative complications occurred, except for an unexpected subacute subdural hematoma 1 month postoperatively. All 10 patients had achieved a favorable outcome (Glasgow outcome scale, ≥ 4) at discharge, which remained the same after a mean follow-up of 5.8 ± 3.7 months.

Conclusions: The results from the present case series have demonstrated the safety of the gravity-assisted ipsilateral paramedian approach for parafalcine meningioma resection. The approach provides good tumor exposure and clear identification and preservation of bridging veins, does not result in contralateral brain impingement, and does not require excessive brain retraction.
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http://dx.doi.org/10.1016/j.wneu.2019.12.067DOI Listing
March 2020

Sub-acute toxicological study of artemisinin-piperaquine tablets in rhesus monkeys.

Regul Toxicol Pharmacol 2019 Dec 30;109:104486. Epub 2019 Sep 30.

Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China. Electronic address:

Artemisinin-piperaquine tablet (trade name Artequick, ATQ), is a novel combination therapy for the treatment of malaria and especially for resistant P.falciparum malaria. The aim of our study was to assess the potential sub-acute toxicity profile of ATQ by oral administration route in rhesus monkeys. Monkeys were administrated once daily with doses of ATQ (39.1, 78.2, 156.4 mg/kg) for 21 days and then followed-up a 56-day recovery period. The administration of ATQ at high dose produced significant changes in the clinical signs primarily involved in gastrointestinal and nervous systems. Body weight loss, significant decrease in food consumption and body temperature were observed in monkeys at high dose. Various hematological and biochemical parameters changes, and significant pathological lesions (adrenal gland, thymus and femur epiphyseal) were observed in the middle and high dose group at the end of the treatment period. However, the toxic effects of ATQ were reversed and delayed adverse drug reaction did not occur during the recovery period. Based on the results of this study, the no-observed-adverse-effect level for ATQ was considered to be 39.1 mg/kg in rhesus monkeys.
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http://dx.doi.org/10.1016/j.yrtph.2019.104486DOI Listing
December 2019

Paeoniflorin Inhibits Mesangial Cell Proliferation and Inflammatory Response in Rats With Mesangial Proliferative Glomerulonephritis Through PI3K/AKT/GSK-3β Pathway.

Front Pharmacol 2019 9;10:978. Epub 2019 Sep 9.

Department of Pharmacology, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China.

Mesangial proliferative glomerulonephritis (MPGN) is the most common type of chronic kidney disease in China, characterized by mesangial cell proliferation and inflammatory response. Paeoniflorin, an effective composition extracted from Alba, has been used for various kinds of kidney diseases. However, there are no studies reporting the effects of paeoniflorin on MPGN. The present study aims to investigate whether paeoniflorin plays a role in MPGN and confirm the underlying molecular mechanisms. Our results manifested that paeoniflorin strongly restrained 24 h urinary protein and promoted renal function and dyslipidemia in a MPGN rat model. Moreover, paeoniflorin attenuated mesangial cell proliferation and inflammation both in MPGN rats and human mesangial cells (HMCs) treated with lipopolysaccharide (LPS). In detail, paeoniflorin decreased the number of mesangial cells and expressions of proliferation marker Ki67 in MPGN rats. Paeoniflorin also inhibited HMC proliferation and blocked cell cycle progression. In addition, the contents of inflammatory factors and the expressions of macrophage marker iNOS were decreased after paeoniflorin treatment. Furthermore, we found that the protective effect of paeoniflorin was accompanied by a strong inhibition of the phosphatidylinositol 3-kinase (PI3K)/AKT/glycogen synthase kinase (GSK)-3β pathway. Paeoniflorin enhanced the inhibitory effect of PI3K inhibitor LY294002 and suppressed the activated effect of PI3K agonist insulin-like growth factor 1 (IGF-1) on PI3K/AKT/GSK-3β pathway. In conclusion, these results demonstrated that paeoniflorin ameliorates MPGN by inhibiting mesangial cell proliferation and inflammatory response through the PI3K/AKT/GSK-3β pathway.
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http://dx.doi.org/10.3389/fphar.2019.00978DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6745507PMC
September 2019

Brainstem Tumor Resection via Occipital Interhemispheric Transtentorial Infracollicular Approach: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2020 Jun;18(6):E238-E239

Department of Neurosurgery, Huashan Hospital, Shanghai Medical Collage, Fudan University, Shanghai, China.

A brainstem tumor located at the upper pons or pontomesencephalic region is surgically challenging because of the deep-seated location and difficulty to approach, especially if the lesion is intra-axial and extends anteriorly without appearing on the pia surface. In our experience, the infracollicular entry point is feasible for such lesions and can be approached by an occipital interhemispheric transtentorial corridor through a straightforward trajectory, which ensures surgical ergonomics. Herein, we present a case of a 55-yr-old woman with a pontomesencephalic lesion removed via an occipital interhemispheric transtentorial infracollicular approach. Informed consent was obtained from the patient. Her preoperative medical course and radiological findings strongly indicated the lesion as a brainstem cavernous malformation. Although the overlying brainstem parenchyma was thin, the lesion did not appear on the pial surface. The lesion was removed via an occipital interhemispheric transtentorial infracollicular approach. During the operation, the lesion was observed to have an old hemorrhagic component and an obvious gliotic boundary, resembling the typical macropathology of a brainstem cavernous malformation. We easily dissected the lesion circumferentially off the brainstem parenchyma after thorough debulking, and a gross total resection was performed en bloc. However, postoperative pathology confirmed a diagnosis of a metastatic neuroendocrine tumor, and further systematic examination revealed cancerous lesions in the lungs. The patient experienced slight hypophrasia but recovered within 3 d postoperatively and then was discharged for further treatment. This case demonstrates the safety and efficacy of an occipital interhemispheric transtentorial infracollicular approach for brainstem tumor resection.
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http://dx.doi.org/10.1093/ons/opz232DOI Listing
June 2020

Thalamus Cavernous Malformation Resection of via Contralateral Anterior Interhemispheric Transcallosal Approach: Two-Dimensional Operative Video.

World Neurosurg 2019 Dec 11;132:389. Epub 2019 Sep 11.

Department of Neurosurgery, Huashan Hospital, Shanghai Medical Collage, Fudan University, Shanghai, China. Electronic address:

Thalamic cavernous malformations (CM) are highly challenging surgically. In this illustrative video (Video 1), we present the case of a 36-year-old man with a CM at the left medial thalamus, which was successfully treated by a contralateral anterior interhemispheric transcallosal approach. Informed consent was obtained from the patient. Preoperative imaging demonstrated that the CM appeared to have reached the pial surface superiorly and medially, and diffusion tensor imaging showed the pyramidal tracts to be traveling laterally to the CM. Based on the "Two-point" principle and to avoid pyramidal tract impingement, an anterior interhemispheric transcallosal approach was chosen. Furthermore, to avoid excessive retraction on the ipsilateral hemisphere, we selected the contralateral trajectory over the ipsilateral trajectory. The head was positioned with the right side down; thus, the space between the right hemisphere and the falx could expand because of gravity autoretraction, which could minimize the need of retraction during the interhemispheric dissection. A small incision on the corpus callosum was performed under the guidance of neuronavigation, and the left ventricle was subsequently entered. After a thin layer of hemosiderin-stained pia was opened on the superior surface of the left thalamus, some sandlike old hemorrhagic component was removed for decompression, and the lesion was carefully dissected away from the normal parenchyma within the surrounding gliosis boundary. The CM was removed en bloc, and the deep venous anomaly was well protected. The patient did not experience any intraoperative changes shown by electrophysiologic monitoring, and he recovered well postoperatively.
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http://dx.doi.org/10.1016/j.wneu.2019.09.010DOI Listing
December 2019

Renoprotective effects of artemisinin and hydroxychloroquine combination therapy on IgA nephropathy via suppressing NF-κB signaling and NLRP3 inflammasome activation by exosomes in rats.

Biochem Pharmacol 2019 11 26;169:113619. Epub 2019 Aug 26.

Department of Pharmacology, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China. Electronic address:

Immunoglobulin A nephropathy (IgAN) is an autoimmune kidney disease with complex pathogenesis leading to end-stage renal damage. The prime pathological characteristics of IgAN are IgA immune complexes deposition accompany with mesangial cell proliferation and urine protein elevation. Artemisinin (ART) is extracted from traditional Chinese medicine Artemisia annua L. Hydroxychloroquine (HCQ) is a classical antimalarial drug applied in the treatment of autoimmune diseases. Both of them possess anti-inflammatory and immunomodulatory properties. The purpose of this research was to investigate the pharmacological effects of ART combined with HCQ (AH) and discuss thoroughly the potential molecular mechanisms in IgAN. In vivo, our results demonstrated that AH could efficiently ameliorate kidney damage by improving kidney dysfunction and reducing the levels of 24 h urine protein, IgA and IgG immune complexes deposition in glomerulus of IgAN rats. Interestingly, AH obviously promoted the secretion of exosomes in renal tissues, inhibited the expressions of nuclear factor-κB (NF-κB) signaling and NLRP3 inflammasome-related proteins, including IκB-α, p-p65, NLRP3, ASC, IL-1β and caspase-1 in IgAN rats. In vitro, further mechanistic study illustrated that exosomes derived from human renal tubular epithelial cells (HK-2) were significantly enhanced by AH, which could be utterly taken up in human mesangial cells (HMCs) and inhibited the activation of NF-κB pathway and NLRP3 inflammasome after AH intervention. However, GW4869 interdicted the promotive effect of AH on exosomes from HK-2 cells and the suppression of exosomes on NF-κB/NLRP3 activation in HMCs. Taken together, this study demonstrated that there was an inhibitory effect of AH therapy on NF-κB/NLRP3 signaling via mediating exosomes release in IgAN rats, which provided an alternative approach for IgAN treatment.
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http://dx.doi.org/10.1016/j.bcp.2019.08.021DOI Listing
November 2019
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