The evaluation of testicular histomorphology is an important part of investigations of
reproductive pathology, growth, and development of laboratory animals. The testis morphology
directly reflects reproductive diseases such as testicular cancer[1], Sertoli cell-only syndrome[2], and spermatogenesis failure[3]. Furthermore, specific antigen markers in Sertoli, Leydig, and germ cells
can be used to both identify and evaluate the developmental process of animals and cellular
functions[4]. Prior to testicular
evaluation, testes should be fixed appropriately.Testes are more difficult to fix than other organs and tissues due to their lower protein
content and less linked structure in the seminiferous epithelium[5]. Based on previous studies, researchers typically chose 4%
paraformaldehyde (PFA), modified Davidson’s fluid (mDF), and Bouin’s fluid (BF) to fix
mammalian testes[6], [7], since histomorphological details can be better
preserved, and tissue processing is also easy. Recently, 4% PFA has been favored by
researchers due to its convenience and satisfactory antigen preservation[8], [9], [10]. A
further related study showed that 4% PFA-fixed nucleoprotein antigens offered remarkable
immunohistochemistry (IHC) performance compared with 10% neutral buffered formalin
(NBF)-fixed antigens[11]. However, several
studies have reported that 4% PFA-fixed tissue samples showed tissue shrinkage and
mislocalization of target proteins[12],
[13], [14]. For testes, the main morphological
differences were the shrinkage of both seminiferous epithelium and interstitial compartment
after fixation[13]. Cell structures and
morphological details of testes can be better preserved with BF[15], [16]. However, the main ingredient of BF (the residual picric acid) is assumed
to be a health and safety hazard after fixation, causes laboratory waste disposal problem,
and needs to be removed by multiple alcohol rinses[15], [17].
Consequently, in 2002, the Society of Toxicologic Pathology recommended the use of mDF to
fix animal testes[15]. Later, researchers
found that mDF-fixed testes showed slight shrinkage of morphological details compared with
BF-fixed testes[15]. IHC is a technique for
the study of localization and quantification of proteins; however, its sensitivity is easily
affected by tissue fixatives, antigen retrieval methods, and detection systems (especially
fixatives)[18], [19], [20]. For example, IHC based detection of mDF- and BF-fixed mouse
testes have shown that specific antigen expression is more easily detected with mDF fixation
than with BF fixation[15].Fixatives used in common laboratory animal tissues have considerably matured. However, the
use of fixatives and reproductive toxicology models remains unassessed in domestic animals
such as pigs. The Xiang pig is a rare breed of Chinese miniature pig, which is renowned for
its small size, early sexual maturity, and favorable meat quality as well as its
similarities to human physiology. The Xiang pig is widely bred in the border area of Guizhou
and Guangxi in China, and has been used for domestic animal breeding and reproduction, in
addition to clinical medical research[21].
Several molecular mechanisms of precocious puberty have been reported before in Xiang
pigs[22]. However, the morphological
characteristics and protein function have not been reported. To select an optimal fixative
for Xiang pig testes and establish a stable system for morphological examination and protein
expression, the present study evaluated the performance of two fixatives with respect to
morphological and antigen preservation. Hematoxylin-eosin (HE) staining of cross-sections
and IHC of specific marker proteins were conducted using Xiang pig testes that had been
fixed with either mDF or 4% PFA. The results of this study will be useful for the
comparative anatomical study on the male reproductive organs of domestic animals and thus,
will provide useful information to improve Xiang pig breeding soundness and fertility
potential assessment.
Materials and Methods
Animals and tissue preparations
Six health male Xiang pigs (weighing 10.53 ± 1.38 kg at 4 months of age) were chosen for
this study. The pigs were obtained from Guiyang Lvshengyuan Animal Husbandry Technology
Development Co., Ltd. (SCXK: 20160007, SYXK (Qian) 2018-0010, Guiyang, China). Testes
samples were collected via orchiectomy after the animals were anesthetized by 0.04mg/kg
atropine sulfate salt monohydrate (A0257; Sigma-Aldrich. St. Louis, MO, USA). According to
the experimental design, testes were divided into four parts, and trimmed to 5 × 5 × 3
mm3. Two parts were fixed in mDF for HE staining and IHC, and the remainder
was fixed with 4% PFA for the same assays. The ingredients of mDF and 4% PFA are listed in
Table 1. All procedures were performed by a veterinarian and strictly followed the
approved guidelines of the laboratory animal ethics committee of Guizhou University, China
(Grant No. 1801227).
Table 1.
Ingredients (for 1,000 mL) and Fixing Conditions of mDF and 4% PFA
HE staining
Tissue samples measuring 5 × 5 × 3 mm3 were collected from the center of
testes and were routinely fixed, embedded, and sectioned as described by Dutta et
al.[23]. To analyze testes
morphology, testicular cross-sections were stained using a commercial HE staining kit
(G1120; Solarbio Co., Ltd., Beijing, China), and photographed using a Nikon
ECLIPSE-Ni+DS-Ri2 (Nikon Instruments Inc., Tokyo, Japan) with NIS-Elements BR analysis
software version 5.01 (Nikon Instruments Inc.). The area of 100 round seminiferous tubules
at stage I–II of the seminiferous epithelial cycle[24] was quantified using NIS-Elements BR and the relative shrinkage rate
was calculated according to the following formula:
Immunohistochemistry
Germ cells, Leydig cells, and Sertoli cells in the testis were, respectively, identified
using the following antibodies: DEAD-box helicase 4 (DDx4; ab13840, diluted 1:200; Abcam
Inc., Cambridge, UK), 3beta-hydroxysteroid dehydrogenase/Delta5–Delta4 isomerase (3β-HSD;
sc-515120, diluted 1:100; Santa Cruz Biotechnology, Inc., Dallas, TX, USA), and
transcription factor GATA-binding factor 4 (GATA4; sc-1237, diluted 1:100; Santa Cruz
Biotechnology)[25]. These were used in
reference to the previously reported IHC protocol[26], [27] to
compare the antigen preservation abilities in both fixatives. Specifically, 5 μm
testicular cross sections were dewaxed with xylene, hydrated by a gradient ethanol series,
immersed in sodium citrate (pH=6.0), and heated in a microwave oven at about 100°C for 5
min for antigen retrieval. Then, endogenous peroxidase activity was quenched with 3%
H2O2 in methanol for 1 h at room temperature (about 23°C) and
nonspecific activity was blocked using 5% bovine serum albumin (BSA; SW3015, Solarbio Co.,
Ltd.) for 30 min at 37°C. Thereafter, sections were treated overnight with primary
antibodies (DDx4, 3β-HSD, and GATA4) at 4°C, respectively. After primary antibody
treatment, these specific antigens were detected using HRP-labeled Goat Anti-Rabbit IgG or
HRP-labeled Goat Anti-Mouse IgG-SABC kits (SA2001, Booster Biological Technology Co.,
Ltd., Wuhan, China) and the results were visualized with 3,3’-Diaminobenzidine kit (D6190,
Sigma-Aldrich). Subsequently, all sections were counterstained with hematoxylin for 50 s
and embedded in neutral resin. In negative control groups, the sections were treated with
phosphate buffered saline (PBS; P1031, Solarbio Co., Ltd.) instead of primary antibodies.
All images were captured using Nikon ECLIPSE-Ni+DS-Ri2 and qualitatively analyzed with
NIS-Elements BR software. To quantify the intensity of the immune reaction, the average
intensity was used to represent the positive IHC rate as previously described[28]. Forty positive immunohistochemical digital
images (DDx4: stage III; 3β-HSD: stage V; GATA4: stage V; n=10 per group) were used to
calculate the integrated optical densities (IOD) and the area of interest (AOI) using
Image Pro Plus 6.0 (Media Cybernetics, Inc., Rockville, MD, USA). The following formula
was used to calculate the average intensity:
Statistical analysis
All results were expressed as means ± standard deviation (SD); GraphPad Prism 6 (GraphPad
Software Inc., San Diego, CA, USA) and SPSS 18.0 (SPSS Inc., Chicago, IL, USA) were used
to visualize the results and T-tests were used to assess the seminiferous tubule area and
testicular weight (left-hand vertical axis), length, and width (right-hand vertical axis).
Differences were considered significant at P<0.05 and different letters (a and b) in
the same column indicate significant differences.
Results
Changes in testis tissue processing for paraffin embedding
The color of testes immediately began fading after placing in mDF solution, while the
color of 4% PFA fixed-testes did not change (Fig.
1A). After fixing for 24 h, the 4% PFA-fixed testes were darker in color than the
mDF-fixed testes (Fig. 1B). After 4% PFA
fixation, the testes weight decreased by 68.71% independent of the testis length and width
(Fig. 1C) Tissue sizes were not statistically
different (including testis weight, length, and width) after mDF fixation for 24 h (Fig. 1D). Table
2 shows a testis weight comparison after dehydration via alcohol gradient for
mDF- and 4% PFA-fixed testes. A decrease in testes weight loss was found for mDF-fixed
tissues compared with that for 4% PFA-fixed tissues, which may be because mDF contains
alcohol and dehydrated in advance.
Fig. 1.
Effects of testicular cross-section processing. Testis color change in response to
modified Davidsonʼs fluid (mDF) and 4% paraformaldehyde (PFA) after fixation for (A)
1 min and (B) 24 h. Testicular weight, length, and
width change before and after (C) 4% PFA and (D) mDF fixation for 24 h (n=6 in each
group). The testis weight decreased significantly in response to 4% PFA fixation
compared with that in response to mDF fixation (*, T-test; P<0.05).
Table 2.
Changes of Testicular Weight in 4% PFA and mDF-fixed Testes after
Dehydration
Effects of testicular cross-section processing. Testis color change in response to
modified Davidsonʼs fluid (mDF) and 4% paraformaldehyde (PFA) after fixation for (A)
1 min and (B) 24 h. Testicular weight, length, and
width change before and after (C) 4% PFA and (D) mDF fixation for 24 h (n=6 in each
group). The testis weight decreased significantly in response to 4% PFA fixation
compared with that in response to mDF fixation (*, T-test; P<0.05).
Morphology of Xiang pig testis preserved in two different fixatives
The histomorphology of testes fixed with either 4% PFA or mDF were assessed by HE
staining. The results showed that the area of seminiferous tubules fixed with 4% PFA was
clearly smaller than that fixed with mDF (see Table 3). For morphological details, the shrinkage of seminiferous tubules (i.e.,
intercellular clefts) and interstitial compartments (i.e., intercellular spaces and
cytoplasmic vacuolation) was more pronounced in 4% PFA-fixed testes than in mDF-fixed
tested (Fig. 2). Specifically, a severe seminiferous epithelial cleft was present in 4% PFA-fixed
testes due to the loosening of connections between germ cells, especially late
spermatogenic cells (marked with a “square box” in Fig. 2A2). Large intercellular spaces
were found between Leydig cells (marked with an “oval box” in Fig. 2A3). With regard to
cell structure, cytoplasmic vacuolization was observed in testes fixed with both fixatives
and the difference was not significant (marked with an “asterisk” in Fig. 2A3).
Furthermore, in 4% PFA-fixed testes, the tissue was slightly darker, similar to
erythrolysis (marked with a “triangle” in Fig. 2A3 and B3) and nuclear staining of primary
spermatocyte in the interphase (marked with an “arrow” in Fig. 2A3 and B3), than in
mDF-fixed testes. This affected the observation of nucleus chromosomes of germ cells. In
conclusion, mDF-fixed testes showed better morphological details both in tubular and
interstitial compartments of testis than 4% PFA-fixed testes.
Table 3.
Area of Seminiferous Tubules Fixed with 4% PFA and mDF
Fig. 2.
Effects of modified Davidsonʼs fluid (mDF) and 4% paraformaldehyde (PFA) on Xiang
pig testis morphology. The testes were removed from 120-day-Xiang pigs and fixed
with mDF and 4% PFA at 4°C for 24 h. A1, A2, and A3 show testes fixed with 4% PFA,
while B1, B2, and B3 show testes fixed with mDF. Shrinkage of the spermatogenic
epithelium (marked with a “square box” in A2); shrinkage of Leydig cells (marked
with an “oval box” in A3); cytoplasmic vacuolization (marked with an “asterisk” in
A3); nuclear staining of the primary spermatocyte in interphase (marked with an
“arrow” in A3 and B3); erythrolysis (mark with a “triangle” in A3 and B3); bars =
500 μm (A1 and B1), 50 μm (A2 and B2), and 10 μm (A3 and B3).
Effects of modified Davidsonʼs fluid (mDF) and 4% paraformaldehyde (PFA) on Xiang
pig testis morphology. The testes were removed from 120-day-Xiang pigs and fixed
with mDF and 4% PFA at 4°C for 24 h. A1, A2, and A3 show testes fixed with 4% PFA,
while B1, B2, and B3 show testes fixed with mDF. Shrinkage of the spermatogenic
epithelium (marked with a “square box” in A2); shrinkage of Leydig cells (marked
with an “oval box” in A3); cytoplasmic vacuolization (marked with an “asterisk” in
A3); nuclear staining of the primary spermatocyte in interphase (marked with an
“arrow” in A3 and B3); erythrolysis (mark with a “triangle” in A3 and B3); bars =
500 μm (A1 and B1), 50 μm (A2 and B2), and 10 μm (A3 and B3).
IHC differences between 4% PFA- and mDF-fixed testes
To analyze the effects of the two fixatives on antigen preservation, IHC was conducted in
the present study. The results showed that regardless of whether mDF or 4% PFA was used to
fix Xiang pig testes, germ cells (Fig. 3A1–B4), Leydig cells (Fig. 3C1–D4), and Sertoli cells (Fig. 3E1–F4) stained positive for
DDx4, 3β-HSD, and GATA4, respectively. However, due to the effect of the fixatives on
antigen preservation, immunoreactions with the DDx4 antibody were decreased (by about
39.8%) at the nucleus of germ cells fixed with mDF compared with those in cells fixed with
4% PFA (Fig. 3A1 and B4). The strong 3β-HSD antibody-specific staining in the cytoplasm of
Leydig cells in 4% PFA-testes was significantly deeper (about 27.8%) than in mDF-fixed
testes (Fig. 3C4 and B4). Accordingly, GATA-4 antibody-specific staining was apparent in
4% PFA-fixed Sertoli cells and its IOD was about 76.4% higher than that of mDF-fixed
Sertoli cells (Fig. 4). Furthermore, GATA4 was also weakly positively expressed in 4% PFA-fixed Leydig
cells, but not in mDF-fixed (Fig. 3E4 and F4). In summary, 4% PFA is the better fixative
of testis for IHC analysis.
Fig. 3.
Effects of modified Davidsonʼs fluid (mDF) and 4% paraformaldehyde (PFA) on
antigen preservation in Xiang pig testes. L and H represent low and high
magnification, respectively. Testes were removed from 120-day Xiang pigs (n=6) and
fixed with mDF and 4% PFA at 4°C for 24 h. A1–A4, C1–C4, and E1–E4 represent images
of mDF-fixed testes, while B1–B4, D1–D4, and F1–F4 represent images of 4% PFA-fixed
testes. Testicular cross-sections were immunostained with primary antibodies for
DDx4 (A3–A4 and B3–B4), 3β-HSD (C3–C4 and D3–D4), and GATA-binding factor 4 (GATA4)
(E3–E4 and F3–F4). Negative controls used phosphate buffered saline (PBS) for
incubation (A1–A2, B1–B2, C1–C2, D1–D2, E1–E2, and F1–F2). Bars = 200 μm (A1–F1) and
(A3–F3) and 10 μm (A2–F2) and (A4–F4). Positive immunostaining is shown in brown
color after counterstaining with hematoxylin. DDx4 and 3β-HSD expressions were
evident in germ and Leydig cells of 4% PFA-fixed testes but not in mDF-fixed testes.
GATA4 was clearly expressed in 4% PFA-fixed Sertoli cells and weakly in Leydig cells
(F4, Rectangle mark), but mDF-fixed testes showed inconspicuous immunostaining in
these cells.
Fig. 4.
Comparison of DDx4, 3β-HSD, and GATA-binding factor 4 (GATA4) expressions in
modified Davidsonʼs fluid (mDF)- and 4% paraformaldehyde (PFA)-fixed testes.
Immunohistochemistry (IHC) testicular cross-sections (n=6) of DDx4, 3β-HSD and GATA4
were used for the integrated optical densities (IOD) analysis. Testes fixed with 4%
PFA showed significantly higher IOD of IHC compared with mDF-fixed testes for all
three proteins (*, T-test; P<0.05).
Effects of modified Davidsonʼs fluid (mDF) and 4% paraformaldehyde (PFA) on
antigen preservation in Xiang pig testes. L and H represent low and high
magnification, respectively. Testes were removed from 120-day Xiang pigs (n=6) and
fixed with mDF and 4% PFA at 4°C for 24 h. A1–A4, C1–C4, and E1–E4 represent images
of mDF-fixed testes, while B1–B4, D1–D4, and F1–F4 represent images of 4% PFA-fixed
testes. Testicular cross-sections were immunostained with primary antibodies for
DDx4 (A3–A4 and B3–B4), 3β-HSD (C3–C4 and D3–D4), and GATA-binding factor 4 (GATA4)
(E3–E4 and F3–F4). Negative controls used phosphate buffered saline (PBS) for
incubation (A1–A2, B1–B2, C1–C2, D1–D2, E1–E2, and F1–F2). Bars = 200 μm (A1–F1) and
(A3–F3) and 10 μm (A2–F2) and (A4–F4). Positive immunostaining is shown in brown
color after counterstaining with hematoxylin. DDx4 and 3β-HSD expressions were
evident in germ and Leydig cells of 4% PFA-fixed testes but not in mDF-fixed testes.
GATA4 was clearly expressed in 4% PFA-fixed Sertoli cells and weakly in Leydig cells
(F4, Rectangle mark), but mDF-fixed testes showed inconspicuous immunostaining in
these cells.Comparison of DDx4, 3β-HSD, and GATA-binding factor 4 (GATA4) expressions in
modified Davidsonʼs fluid (mDF)- and 4% paraformaldehyde (PFA)-fixed testes.
Immunohistochemistry (IHC) testicular cross-sections (n=6) of DDx4, 3β-HSD and GATA4
were used for the integrated optical densities (IOD) analysis. Testes fixed with 4%
PFA showed significantly higher IOD of IHC compared with mDF-fixed testes for all
three proteins (*, T-test; P<0.05).
Discussion
IHC and histopathology can be used for comparative pathology and translational studies.
When tissue samples are separated from the blood supply, they will undergo autolysis.
Consequently, tissue must be fixed to preserve its morphology and antigenicity or RNA
structure. Poor fixation can cause poor morphology and reduce the specificity of IHC or in
situ hybridization (ISH). However, over-fixation may result in antigen masking or strong
non-specific background staining.Testes, eyes, and fat tissues are difficult to fix due to their specific structure.
Inappropriate fixatives are considered to be susceptible to loss of glycogen, nucleic acid,
and tissue protein, which will affect morphological observations and protein expression
studies[29]. As an important component
of the male reproductive system, appropriately fixed testes contribute to histopathological
examination, reproductive toxicology, and developmental biology studies in animals. The
Xiang pig is a rare Chinese miniature breed with small size and favorable meat. In previous
studies, Xiang pigs were frequently used as an experimental animal model for clinical
research due to their similar anatomical and physiological characteristics to those of
humans. Moreover, due to their small size, the sample size can be increased and this breed
is more manageable than larger animals[21], [22].
Consequently, a reproductive toxicology model of the Xiang pig and their histological
features, as well as the interactions of testis-related proteins are worth investigating.
This study showed that mDF works as a better fixative than 4% PFA for HE staining of testes,
while 4% PFA fixation is preferable for IHC. For many animals, it has been reported that
different fixatives show distinct morphological details of testes. For example,
formalin-fixed mouse testes showed severe shrinkage of both, germ cells and Sertoli cells,
as well as wide gaps and vacuoles in the spermatogenic epithelium[30]. The results of another study showed that testicular
cross-sections were difficult to fix and suffered from seminiferous epithelium shrinkage
after 10% NBF fixation[15]. For BF fixation,
even if the morphological evaluation was not affected by the shrinkage of intra-tubule and
inter-tubule compartments of mouse and human testes, it is not recommended due to the
existence of picric acid[31],
[32]. Instead, mDF, modified from
traditional Davidson’s Fluid (DF), was found to achieve less shrinkage of the seminiferous
tubules and superior overall morphologic details of testes for histopathological evaluation.
The underlying reason for this is the rapidly penetrating dehydrating effect of the
coagulative fixative ethanol and acetic acid present in this fixative. However, the drawback
is that the seminiferous epithelium at stages I and VII shrunk in mDF-fixed mouse testes,
while they were perfect in BF-fixed mouse testes[13], [15],
[31]. Consistently, mDF was found
to be suitable for HE staining as indicated by the satisfactory morphological details of
Xiang pig testes in the present study. The change of testis color and weight was likely
related to strong mDF penetration. In contrast, as a single-component fixative, 4% PFA-fixed
testes were flesh-red-like and soft and showed altered testis weight and area of
seminiferous tubules after fixation. The weak penetration of formaldehyde in 4% PFA likely
caused tissue debris in the fixative, which may be an acceptable explanation. Generally,
shrinkage of spermatogenic epithelium and interstitium is considered the main challenge in
morphological evaluation of 4% PFA-fixed testes. Several studies have reported that this
unsatisfactory performance is due to weak fixative penetration. These results suggest that
4% PFA may not be as good as mDF for the testicular morphological analysis of Xiang
pigs.IHC staining of GATA4, 5-bromo-2-deoxy Uridine (BrdU), and proliferating cell nuclear
antigen (PCNA) by using mDF fixative have been reported in many studies[33], [34]; however, which of these are the best fixatives for testes
remains controversial. For example, mDF-fixed testes provided better IHC stain intensity
than BF-fixed testes for PCNA and neuron cytoplasmic protein 9.5 (PGP 9.5)
antigens[15]. In addition, androgen
receptor (AR) expression was detected in the peripheral and central seminiferous tubules in
mDF-fixed testes, but was observed only in peripheral seminiferous tubules in BF-fixed
testes[15]. Moreover, it was reported
that mDF-fixed testes showed more satisfactory effects of vimentin-IHC than did 10%
NBF-fixed testes[30]. However, another study
argued that the actin of Drosophila melanogaster and reproductive and
respiratory syndrome virus (PRRSV) of porcine were better preserved than organic solvents,
since the free amino acids can chemically cross-link with 4% PFA[9], [10]. Although the comparison of IHC differences between 4% PFA- and mDF-fixed
mouse testes was reported via qualitative description in recent studies[33], [35], quantitative evidence is not yet available. In Xiang pigs,
GATA4, 3β-HSD, and DDx4 expressions were detected in Sertoli cells, Leydig cells, and germ
cells, respectively, in both mDF-and 4% PFA-fixed testes; however, IHC staining achieved the
better results in 4% PFA-fixed testes than in mDF-fixed testes in the present study. When
Xiang pig testes were fixed with mDF, specific antibodies (GATA4, 3β-HSD, and DDx4) showed a
weak positive signal compared with that in 4% PFA-fixed testes. In fact, previous studies
have reported that cytoskeletal proteins can be destroyed by the absolute ethanol and acetic
acid present in mDF, resulting in antigen dispersion and loss[20]. In addition, GATA4, a specific marker antigen of Sertoli
cells involved in testicular development and regulation of biological function[36], [37]. The weakly positive GATA4 expression in Leydig cells was only
detected in 4% PFA-fixed testes. Overall, although mDF fixation provides a considerable
advantage over the morphological preservation of Xiang pig testes, it cannot match the
result of 4% PFA fixation in IHC detection. In summary, mDF fixation better preserves the
morphological details of Xiang pig testes than 4% PFA fixation. Although 4% PFA-fixed testes
showed morphological shrinkage, IHC-positive staining for testicular proteins was superior
than that in mDF-fixed testes.
Disclosure of Potential Conflicts of Interest
The authors declare no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Author Contributions
WYW analyzed the data for this study and drafted the manuscript; TG and YY designed the
study and revised the manuscript; LJM performed the immunohistochemistry and
hematoxylin–eosin staining; YJX prepared the tissue and testicular cross-sections.
Authors: Hélio Chiarini-Garcia; Mirna Y S Lima; Augusto B Reis; Reginaldo Martello; Fabíola Nihi; Marcos L M Gomes; Fernanda R C L Almeida Journal: Histol Histopathol Date: 2016-04-07 Impact factor: 2.303
Authors: Catherine A Picut; Amera K Remick; Eveline P C T de Rijk; Michelle L Simons; Donald G Stump; George A Parker Journal: Toxicol Pathol Date: 2014-09-11 Impact factor: 1.902
Authors: Diana Ferrara; Nina Hallmark; Hayley Scott; Richard Brown; Chris McKinnell; I Kim Mahood; Richard M Sharpe Journal: Endocrinology Date: 2006-08-17 Impact factor: 4.736
Authors: Oh-Joon Kwon; Joseph M Valdez; Li Zhang; Boyu Zhang; Xing Wei; Qingtai Su; Michael M Ittmann; Chad J Creighton; Li Xin Journal: Nat Commun Date: 2014-07-22 Impact factor: 14.919