[Research advances on size selection and vault prediction of posterior chamber phakic intraocular lens]

Posterior chamber phakic intraocular lens (pIOL) implantation has been widely adopted for the correction of refractive errors. Among pIOLs, the Implantable Collamer Lens is the most common choice. The selection of the appropriate pIOL size and achieving the desired postoperative vault to minimize complications has consistently been a focal point in academic research. With the advancement of ophthalmic biometric measurement technology and the application of artificial intelligence in the field of medicine, numerous new technologies and methods for pIOL size selection and vault prediction have emerged in recent years. This paper provides a comprehensive review on the topic of how to choose the pIOL size and predict the vault.

[Clinical characteristics of children with SARS-CoV-2 Omicron variant infection in Kunming]

Objective: To investigate the clinical characteristics of hospitalized children infected with the Omicron variant in Kunming after the withdrawal of non-pharmaceutical interventions (NPI) and analyze the risk factors of severe cases. Methods: Clinical data was retrospectively collected from 1 145 children with SARS-CoV-2 Omicron infection who were hospitalized in six tertiary grade A hospitals in Kunming from December 10th, 2022 to January 9th, 2023. According to clinical severity, these patients were divided into the general and severe SARS-CoV-2 groups, and their clinical and laboratory data were compared. Between-group comparison was performed using t-test, chi-square test and Mann-Whitney U test. Spearman correlation test and multivariate Logistic regression analysis were used to determine the risk factors of severe illness. Results: A total of 1 145 hospitalized patients were included, of whom 677 were male and 468 female. The age of these patients at visit was 1.7 (0.5, 4.1) years. Specifically, there were 758 patients (66.2%) aged ≤3 years at visit and 387 patients (33.8%) aged >3 years. Of these children, 89 cases (7.8%) had underline diseases and the remaining 1 056 cases (92.2%) had no combined diseases. Additionally, of all the patients, 319 cases (27.9%) were vaccinated with one or two doses of SARS-CoV-2 vaccine, 748 cases (65.3%) had acute upper respiratory tract infection (AURTI), and six cases died (0.5%). A total of 1 051 cases (91.8%) were grouped into general SARS-CoV-2 group and 94 cases (8.2%) were grouped into severe SARS-CoV-2 group. Compared with the general cases, the severe cases showed a lower rate of SARS-CoV-2 vaccination and younger median age, lower lymphocyte count, as well as proportions of CD8+T lymphocyte (36 cases (38.3%) vs. 283 cases (26.9%), 0.5 (2.6, 8.0) vs. 1.6 (0.5, 3.9) years, 1.3 (1.0, 2.7) ×109 vs. 2.7 (1.3,4.4)×109/L, 0.17 (0.12, 0.24) vs. 0.21 (0.15, 0.16), respectively, χ2=4.88, Z=-2.21,-5.03,-2.53, all P<0.05). On the other hand, the length of hospital stay, proportion of underline diseases, ALT, AST, creatine kinase isoenzyme, and troponin T were higher in the severe group compared to those in the general group ((11.6±5.9) vs. (5.3±1.8) d, 41 cases (43.6%) vs. 48 cases (4.6%), 67 (26,120) vs. 20 (15, 32) U/L, 51 (33, 123) vs. 44 (34, 58) U/L、56.9 (23.0, 219.3) vs. 3.6 (1.9, 17.9) U/L, 12.0 (4.9, 56.5) vs. 3.0 (3.0, 7.0) ×10-3 pg/L,respectively, t=-20.43, χ2=183.52, Z=-9.14,-3.12,-6.38,-3.81, all P<0.05). Multivariate regression analysis indicated that increased leukocyte count (OR=1.88, 95%CI 1.18-2.97, P<0.01), CRP (OR=1.18, 95%CI 1.06-1.31, P<0.01), ferritin (OR=1.01, 95%CI 1.00-1.00, P<0.01), interleukin (IL)-6 (OR=1.05, 95%CI 1.01-1.08, P=0.012), D-dimer (OR=2.56, 95%CI 1.44-4.56, P<0.01) and decreased CD4+T lymphocyte (OR=0.84, 95%CI 0.73-0.98, P=0.030) were independently associated with the risk of severe SARS-CoV-2 in hospitalized children with Omicron infection. Conclusions: After the withdrawal of NPI, the pediatric inpatients with Omicron infection in Kunming were predominantly children younger than 3 years of age, and mainly manifested as AURTI with relatively low rate of severe SARS-CoV-2 infection and mortality. Elevated leukocyte counts, CRP, ferritin, IL-6, D-dimer, and decreased CD4+T lymphocytes are significant risk factors for developing severe SARS-CoV-2 infection.

[Epidemiological characteristics of adenovirus infection in hospitalized children with acute respiratory tract infection in Kunming during 2019]

Objective: To investigate the epidemiology and clinical characteristics of adenovirus (ADV)-caused acute respiratory tract infection among hospitalized children in Kunming, China. Methods: Clinical and laboratory data were collected from 467 children with adenovirus infection who were hospitalized from January 1, 2019 to December 31, 2019 in 6 grade A class Ⅲ hospitals in Kunming area. The basic characteristics, epidemiology, mixed infection and adenovirus genotypes of the patients were retrospectively analyzed. The patients diagnosed with adenovirus pneumonia (AP) were divided into two groups, severe AP (SAP) group and general AP(GAP) group according to the severity of illness. Mann-Whitney U test or χ² test was used for comparison between groups, while multivariate regression was applied to analyze the risk factors of SAP. Results: Among 15 635 hospitalized children with respiratory tract infection, 467 cases were adenovirus positive, with a detection rate of 2.99%. Of the 467 patients with adenovirus infection, 284 were male and 183 female, the age was 2.4 (1.1,3.9) years, including 44 cases (9.4%) < 0.5 years, 59 cases (12.6%) of 0.5 to<1.0 years, 176 cases (37.7%) of 1.0 to <3.0 years, 150 cases (32.1%) of 3.0 to <7.0 years, and 38 cases (8.1%) of 7.0 to 14.0 years. Adenovirus infection was common in autumn and winter, and the high incidence months were October to December, which accounted for 51.6% (241/467) of the whole year cases. Co-infection was detected in 226 cases (48.4%) out of 467 patients, in which one pathogen co-infection was the most frequent form (172 cases, 76.1%). Of the 262 pathogen detected 108 (41.2%) were Mycoplasma pneumoniae. In 144 of ADV-positve cases (30.8%) were taken geno-typing was done by PCR amplification, the results showed that 74 cases (51.4%) were ADV 3, 7 subtypes and 65 cases (45.1%) of ADV 1, 2,6 subtypes. Of the 467 cases of ADV infection, 320 (68.5%) were diagnosed with pneumonia, 82 (17.6%) with upper respiratory tract infection and pharyngeal tonsillitis, and 65 (13.9%) with bronchitis, laryngeal bronchitis, and asthmatic bronchitis. Among the 320 patients with AP, 56 cases were severe and 264 cases were general. Two cases (3.6%) in severe group died. Compared with the GAP group, the age was young [17 (11,42) months vs. 24 (14,44) months, Z=2.222, P=0.026], the fever duration was long [8 (5,14) days vs. 6 (3,9) days, Z=3.380, P<0.01], and the proportions of preterm birth and having underlying diseases were high [respectively 19.6% (11/56) vs. 6.1% (16/264), 26.8% (15/56) vs. 10.2% (27/264), χ²=8.965,11.109, P<0.05] in SAP group. Referring to laboratory markers, white blood cell count, C-reactive protein, creatine kinase-MB and lactate dehydrogenase were significantly increased in SAP group as compared to GAP group(all P<0.05). Multivariate Logistic regression analysis showed that preterm birth (OR=3.284, 95%CI 1.079-9.993, P=0.036), underlying disease (OR=3.284, 95%CI 1.079-9.993, P=0.036), fever duration ≥10 d (OR=2.523,95%CI 1.195-5.328, P=0.015) and C-reactive protein ≥50 mg/L (OR=3.156, 95%CI 1.324-7.524, P=0.010) were positively correlated with the risk of SAP. Conclusions: The incidence of adenovirus infection among hospitalized children in Kunming was lower than the national level, and no outbreak occurred in 2019. Subtype 3 and 7 of ADV are the predominant strains for infection, which usually occurs in autumn and winter and mainly causes pneumonia. Premature birth, underlining diseases, long fever duration and markedly increased C-reactive protein are the risk factors for developing into severe pneumonia. This paper presents the prevalence and clinical characteristics of adenovirus infection in children at high altitude area.

[Formaldehyde and xylene levels and protective effects in the pathology department of a hospital]

Objective: To investigate the status of exposure to xylene and Formaldehyde of medical and technical personnel in Pathology Department of a hospital, and to provide references for prevention of occupational hazards. Methods: From July to October in 2019, 52 medical workers and working places in Pathology Department of a third-class hospital in Jiangxi Province were selected as survey objects, the distribution of occupational hazards, protective measures and personal protective equipment were investigated, and the control wind speed of Formaldehyde, xylene and ventilation facilities were detected and analyzed statistically. Results: It showed that the detection rate of xylene and formaldehyde was 82.1% (23/28) , and the detection rate of xylene C(STEL) in the two sampling posts was 14.3% (2/14) , the local suction device on each side and the control wind speed of the fume hood do not meet the national standards. Conclusion: It is necessary to strengthen the prevention and control of the occupational hazards in the Department of Pathology to prevent the occurrence of occupational diseases.

Patients with chronic urticaria have a higher risk of psychiatric disorders: a population-based study

BACKGROUND

The prevalence of psychiatric comorbidities in patients with chronic urticaria (CU) in a national population is largely unknown.

OBJECTIVES

To investigate the prevalence of psychiatric disorders and psychiatric medication use in patients with CU in Taiwan.

METHODS

Data were sourced from Taiwan's National Health Insurance Research Database for 2011. Patients who had a primary/secondary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of 708·1, 708·8 or 708·9 during 2011 with at least two outpatient visits and an antihistamine prescription were identified as CU cases. Patients with CU were classified into three disease severity groups according to their medication types. Psychiatric disorders were identified by patients having three outpatient visits with a primary or secondary diagnosis of a given psychiatric disease. Psychiatric medication use was defined by having at least four outpatient visits with prescriptions for anxiolytics, antidepressants or sleeping pills in 2010 or 2011.

RESULTS

Of the 167 132 patients with CU, 82·5% had mild CU, 17·0% had moderate CU and 0·4% had severe CU. Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication prescription than control groups. The relative risk (RR) of psychiatric disorders was 1·43 for patients with mild, 1·50 for patients with moderate and 2·32 for patients with severe CU vs. the controls (P < 0·001). For psychiatric medication prescription, the RRs were 1·95, 2·70 and 2·09, respectively, vs. controls (P < 0·001).

CONCLUSIONS

Patients with CU had a higher prevalence and risk of psychiatric disorders and psychiatric medication prescription than control groups. What's already known about this topic? Previous studies have shown a high prevalence of psychiatric comorbidities in patients with chronic urticaria (CU), with rates ranging from 35% to 60%. Anxiety, depression and somatoform disorders have been reported as the most prevalent mental disorders in patients with CU. What does this study add? Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication use than control groups in the general population. The relative risk (RR) of psychiatric disorders was 1·43 for those with mild CU, 1·50 for those with moderate CU and 2·32 for those with severe CU vs. controls. The RR for psychiatric medication use was 1·95 for those with mild CU, 2·70 for those with moderate CU and 2·09 for those with severe CU vs. controls. Mental health evaluations and management are important elements in CU management.

Inhibition of Human Dendritic Cell ER Stress Response Reduces T Cell Alloreactivity Yet Spares Donor Anti-tumor Immunity

Acute graft- vs. -host disease (GVHD) is an important cause of morbidity and death after allogeneic hematopoietic cell transplantation (HCT). We identify a new approach to prevent GVHD that impairs monocyte-derived dendritic cell (moDC) alloactivation of T cells, yet preserves graft- vs.-leukemia (GVL). Exceeding endoplasmic reticulum (ER) capacity results in a spliced form of X-box binding protein-1 (XBP-1s). XBP-1s mediates ER stress and inflammatory responses. We demonstrate that siRNA targeting XBP-1 in moDCs abrogates their stimulation of allogeneic T cells. B-I09, an inositol-requiring enzyme-1α (IRE1α) inhibitor that prevents XBP-1 splicing, reduces human moDC migration, allo-stimulatory potency, and curtails moDC IL-1β, TGFβ, and p40 cytokines, suppressing Th1 and Th17 cell priming. B-I09-treated moDCs reduce responder T cell activation via calcium flux without interfering with regulatory T cell (Treg) function or GVL effects by cytotoxic T lymphocytes (CTL) and NK cells. In a human T cell mediated xenogeneic GVHD model, B-I09 inhibition of XBP-1s reduced target-organ damage and pathogenic Th1 and Th17 cells without impacting donor Tregs or anti-tumor CTL. DC XBP-1s inhibition provides an innovative strategy to prevent GVHD and retain GVL.

Abstract 4756: Secretory IgM exacerbates tumor progression by inducing accumulations of myeloid-derived suppressor cells in mice

To explore the role of B cell receptor (BCR) in promoting malignant progression of chronic lymphocytic leukemia (CLL) in mice, we generate MD4/Eμ-TCL1 mice, whose B cells harbor a monoclonal BCR against hen egg lysozyme (HEL) and secrete IgM against HEL. MD4/Eμ-TCL1 mice survive significantly shorter than Eμ-TCL1 mice. While precancerous B cells in young MD4/Eμ-TCL1 mice recognize HEL, CLL cells developed in older MD4/Eμ-TCL1 mice fail to recognize HEL. Nevertheless, MD4/Eμ-TCL1 CLL cells can be activated by goat F(ab')2 anti-mouse IgM and respond by phosphorylation of Igα, Syk and ERK1/2, indicating reactivation of a parental Ig gene allele. MD4/Eμ-TCL1 CLL cells also produce large quantities of secretory IgM (sIgM), which does not react with HEL. Compared with age-matched Eμ-TCL1 mice, MD4/Eμ-TCL1 mice also generate a significantly increased population of CD11b+/Ly6G+ granulocytic cells in the peripheral blood, spleens and bone marrow. CD11b+/Ly6G+ granulocytic cells purified from spleens of MD4/Eμ-TCL1 mice can suppress CD3/CD28-mediated proliferation of CD8+ T cells and gp100-loaded class I MHC-mediated proliferation of CD8+ T cells from PMEL-1 mice, qualifying these cells as myeloid-derived suppressor cells (MDSCs). Increased MDSCs may account for significantly decreased T cells and poor prognosis in CLL-bearing MD4/Eμ-TCL1 mice. Because MD4/Eμ-TCL1 mouse CLL cells and human CLL cells can produce sIgM, we hypothesize that sIgM may account for the accumulation of MDSCs. To test this hypothesis, we cross μS-/- mice, which cannot produce sIgM, with Eμ-TCL1 mice. The μS-/-/Eμ-TCL1 mice indeed develop significantly lower numbers of MDSCs, and survive significantly longer than Eμ-TCL1 mice. We decide to target the synthesis of sIgM by deleting the function of XBP-1, because the synthesis of sIgM is tightly regulated by a mechanism called regulated IRE-1-dependent decay (RIDD), which is hyperactivated in B cells as a response to XBP-1 deficiency. We cross B cell-specific XBP-1KO mice with MD4/Eμ-TCL1 mice, and the resultant XBP-1KO/MD4/Eμ-TCL1 mice indeed produce significantly reduced amounts of sIgM and decreased numbers of MDSCs. In addition, μS-/- mice grafted with Lewis lung carcinoma exhibit reduced functions of MDSCs in suppressing T cells, resulting in significantly slower tumor growth. These results clearly demonstrate that sIgM produced by B cells can upregulate the immunosuppressive functions of MDSCs in tumor-bearing mice to aggravate cancer progression.

Citation Format: Chih-Hang Tang, Shiun Chang, Ayumi Hashimoto, Yi-Ju Chen, Chang Won Kang, Anthony Mato, Juan Del Valle, Dmitry Gabrilovich, Chih-Chi Andrew Hu. Secretory IgM exacerbates tumor progression by inducing accumulations of myeloid-derived suppressor cells in mice [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4756.

Secretory IgM Exacerbates Tumor Progression by Inducing Accumulations of MDSCs in Mice

Chronic lymphocytic leukemia (CLL) cells can secrete immunoglobulin M. However, it is not clear whether secretory IgM (sIgM) plays a role in disease progression. We crossed the Eμ-TCL1 mouse model of CLL, in which the expression of human TCL1 oncogene was driven by the V(H) promoter-Ig(H)-Eμ enhancer, with MD4 mice whose B cells produced B-cell receptor (membrane-bound IgM) and sIgM with specificity for hen egg lysozyme (HEL). CLL cells that developed in these MD4/Eμ-TCL1 mice reactivated a parental Ig gene allele and secreted IgM, and did not recognize HEL. The MD4/Eμ-TCL1 mice had reduced survival, increased myeloid-derived suppressor cells (MDSC), and decreased numbers of T cells. We tested whether sIgM could contribute to the accumulation of MDSCs by crossing μS^-/- mice, which could not produce sIgM, with Eμ-TCL1 mice. The μS^-/-/Eμ-TCL1 mice survived longer than Eμ-TCL1 mice and developed decreased numbers of MDSCs which were less able to suppress proliferation of T cells. We targeted the synthesis of sIgM by deleting the function of XBP-1s and showed that targeting XBP-1s genetically or pharmacologically could lead to decreased sIgM, accompanied by decreased numbers and reduced functions of MDSCs in MD4/Eμ-TCL1 mice. Additionally, MDSCs from μS^-/- mice grafted with Lewis lung carcinoma were inefficient suppressors of T cells, resulting in slower tumor growth. These results demonstrate that sIgM produced by B cells can upregulate the functions of MDSCs in tumor-bearing mice to aggravate cancer progression. In a mouse model of CLL, production of secretory IgM led to more MDSCs, fewer T cells, and shorter survival times for the mice. Thus, secretory IgM may aggravate the progression of this cancer. Cancer Immunol Res; 6(6); 696-710. ©2018 AACR.

Development of stable Pickering emulsions/oil powders and Pickering HIPEs stabilized by gliadin/chitosan complex particles

In this paper, we demonstrate the use of gliadin/chitosan complex particles (GCCPs) as particulate stabilizers of oil-in-water emulsions of natural oils and water. For this purpose, we fabricated GCCPs through a facile anti-solvent procedure and demonstrated their usage in the formation of Pickering emulsions and Pickering high internal phase emulsions (HIPEs). The GCCPs can be used to produce surfactant-free o/w Pickering emulsions and Pickering HIPEs; unfortunately these emulsions were labile to coalescence. NaCl addition and/or pH regulation, and the combination were used to modify the surface wettability of the complex particles to achieve stable emulsions. The microstructures, e.g., interfacial frameworks, GCCP partition between the continuous phase and interfacial region, and the state of the droplets, of Pickering emulsions were visualized by confocal laser scanning microscopy (CLSM), confirming that the inclusion of NaCl and slightly adjusting pH toward 4.0 and/or 5.0 benefited the adsorption and accumulation of colloid particles at the droplet surface to form an engineered interfacial structure, bridging droplets together through a percolating layer of colloidal particles at the oil/water interface. A schematic representation for the formation route of the emulsions is proposed to relate the physical performance and rheological property with the interfacial structures and aggregate behaviors in the Pickering system stabilized by the complex particles. Interestingly, direct freeze-drying of the emulsions transformed unstable Pickering emulsions into stable oil powders. This study opens a promising route based on Pickering HIPEs or oil powders to structure liquid oils into solid-like fats without artificial trans-fat, which outlines new directions for future fundamental research.

Abstract LB-336: Specific serine phosphorylation of IRE-1 controls enhanced splicing of XBP-1 and regulated IRE-1-dependent decay (RIDD)

The endoplasmic reticulum (ER) stress sensor IRE-1 is critical for cancer survival and anti-tumor immunity. IRE-1 splices the mRNA of XBP-1 to activate the functional XBP-1s transcription factor or engages regulated IRE-1-dependent decay (RIDD) to degrade tissue-specific mRNAs. It is unclear how IRE-1 RNase activity is regulated to perform the two functions. Upon XBP-1 deficiency, IRE-1 switches to perform RIDD. We examined IRE-1 in XBP-1-deficient B cells, and discovered that IRE-1 undergoes glycosylation at asparagine 178 (N178) and phosphorylation at serine 729 (S729). We generated an anti-phospho-S729 antibody and confirmed that S729 is indeed phosphorylated in XBP-1-deficient B cells. Different from conventional ER stress inducers or Toll-like receptor ligands, subtilase cytotoxin (SubAB), an AB5 toxin produced by Shiga-toxigenic E. coli, has an unusual capability in causing rapid and strong phosphorylation of S729. To further understand the function of N178 and S729 of IRE-1, we generated two knock-in mouse models (N178Q and S729A). Compared with wild-type B cells and those carrying the N178Q mutation, B cells carrying the S729A mutation similarly respond to cues of differentiation by expressing XBP-1s, but they completely fail to respond to pharmacological ER stress inducers or SubAB, suggesting that phosphorylation of S729 is critically important for secondary ER stress response. To evaluate the role of N178, S729 and the kinase domain of IRE-1 in regulating RIDD, we crossed N178Q, S729A and ΔIRE-1 (deletion of amino acids 652 to 751 in the kinase domain) mice with B cell-specific XBP-1KO (CD19Cre/XBP-1f/f) mice to induce RIDD. RIDD was evidenced by the decreased mRNA levels of secretory immunoglobulin (Ig) μ heavy chains in XBP-1-deficient B cells. RIDD was blocked in S729A/XBP-1KO and ΔIRE-1/XBP-1KO but not in N178Q/XBP-1KO B cells. While deleting the kinase function of IRE-1 blocks both XBP-1 splicing and RIDD, mutating S729 only blocks RIDD, highlighting an important role of S729 in regulating RIDD. Since SubAB can efficiently trigger phosphorylation of S729 of IRE-1, we further demonstrated that exposure to SubAB indeed causes RIDD of secretory Ig μ heavy chains in wild-type B cells but not in those carrying the S729A mutation, further supporting the role of S729 in regulating RIDD. In addition, we showed that a potent inhibitor of the IRE-1 RNase, B-I09, can inhibit RIDD. The identification of phosphorylated S729 as a control for RIDD may help scientists devise new ways to specifically target this phosphorylation, contributing to the control of human cancer.

Citation Format: Chih-Hang Tang, Shiun Chang, Adrienne Paton, James Paton, Dmitry Gabrilovich, Hidde Ploegh, Juan Del Valle, Chih-Chi Andrew Hu. Specific serine phosphorylation of IRE-1 controls enhanced splicing of XBP-1 and regulated IRE-1-dependent decay (RIDD) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr LB-336. doi:10.1158/1538-7445.AM2017-LB-336

All optical mode controllable Er-doped random fiber laser with distributed Bragg gratings

An all-optical method to control the lasing modes of Er-doped random fiber lasers (RFLs) is proposed and demonstrated. In the RFL, an Er-doped fiber (EDF) recoded with randomly separated fiber Bragg gratings (FBG) is used as the gain medium and randomly distributed reflectors, as well as the controllable element. By combining random feedback of the FBG array and Fresnel feedback of a cleaved fiber end, multi-mode coherent random lasing is obtained with a threshold of 14 mW and power efficiency of 14.4%. Moreover, a laterally-injected control light is used to induce local gain perturbation, providing additional gain for certain random resonance modes. As a result, active mode selection of the RFL is realized by changing locations of the laser cavity that is exposed to the control light.

Effects of transglutaminase on sorption, mechanical and moisture-related properties of gelatin films

Biodegradable and edible protein films have received considerable research interest due to the increase in environment protection consciousness. However, protein films always have poor mechanical properties and water-resistant ability compared with synthetic films. Thus, the effects of transglutaminase on sorption characteristics including adsorption kinetics and sorption isotherm, mechanical properties, moisture content, total soluble matter and surface hydrophobicity (S0) of gelatin films were analyzed in this article. Relative humidity and plasticizer content significantly affected the moisture equilibration time. The lower the relative humidity and plasticizer content, the shorter the moisture equilibration time. Transglutaminase treatment significantly decreased moisture adsorption rate and balance moisture content of gelatin films. The sorption isotherm data were mathematically fitted to the GAB model. Transglutaminase treatment increased the tensile strength value and the mean contact angle by 8.4–25.6% and 2.1–2.3°, respectively; while decreasing the moisture content value by 2.6–9%. These results show that transglutaminase treatment could be an effective and practical method to modify moisture sorption characteristics, moisture content and surface hydrophobicity of gelatin films, which suggests that the water-barrier ability of gelatin films can be improved by transglutaminase treatment.

Reconstruction of the Thumb by Free Skin Flap of the Big Toe

Experience with 12 cases of thumb reconstruction is reported, utilizing a free skin flap from the big toe and remodelled iliac bone graft, to create metacarpal and phalangeal configuration. Results show that the reconstructed thumbs have good functional recovery, cosmetic appearance, and varying degrees of sensation. The procedure preserves the big toe of the donor foot and produces minimal impairment.

The effect of environmental salinity on the protein expression of Na+/K+-ATPase, Na+/K+/2Cl- cotransporter, cystic fibrosis transmembrane conductance regulator, anion exchanger 1, and chloride channel 3 in gills of a euryhaline teleost, Tetraodon nigroviridis

Chloride transport mechanisms in the gills of the estuarine spotted green pufferfish (Tetraodon nigroviridis) were investigated. Protein abundance of Na(+)/K(+)-ATPase (NKA) and the other four chloride transporters, i.e., Na(+)/K(+)/2Cl(-) cotransporter (NKCC), cystic fibrosis transmembrane conductance regulator (CFTR), Cl(-)/HCO(3)(-) anion exchanger 1 (AE1), and chloride channel 3 (CLC-3) in gills of the seawater- (SW; 35 per thousand) or freshwater (FW)-acclimatized fish were examined by immunoblot analysis. Appropriate negative controls were used to confirm the specificity of the antibodies to the target proteins. The relative protein abundance of NKA was higher (i.e., 2-fold) in gills of the SW group compared to the FW group. NKCC and CFTR were expressed in gills of the SW group but not in the FW group. In contrast, the levels of relative protein abundance of branchial AE1 and CLC-3 in the FW group were 23-fold and 2.7-fold higher, respectively, compared to those of the SW group. This study is first of its kind to provide direct in vivo evidence of the protein expression of CLC-3 in teleostean gills, as well as to examine the simultaneous protein expression of the Cl(-) transporters, especially AE1 and CLC-3 of FW- and SW-acclimatized teleosts. The differential protein expression of NKA, chloride transporters in gills of the FW- and SW-acclimatized T. nigroviridis observed in the present study shows their close relationship to the physiological homeostasis (stable blood osmolality), as well as explains the impressive ionoregulatory ability of this euryhaline species in response to salinity challenges.

The novel correlation of carbonic anhydrase II and anion exchanger 1 in gills of the spotted green pufferfish,Tetraodon nigrovirids

A novel relationship between branchial carbonic anhydrase II (CAII) and anion exchanger 1 (AE1) was investigated in the euryhaline spotted green pufferfish (Tetraodon nigroviridis). The immunoblots revealed that AE1 was only detected in the membrane fraction of gills while CAII can be probed both in the membrane and cytosol fractions of gills. CAII protein abundance in the membrane fraction is salinity dependent. Immunological detection of the membrane fraction CAII protein in gills showed 3.9-fold higher in the hyposmotic (freshwater) group than the hyperosmotic (seawater;35 per thousand) group. In contrast, there was no change in the protein level of cytosolic CAII between seawater and freshwater groups. The whole-mount immunocytochemical staining demonstrated that both AE1 and CAII were colocalized to the Na(+)/K(+)-ATPase-immunoreactive cells in gill epithelium of the pufferfish. The interaction between CAII and AE1 was further identified by co-immunoprecipitation because AE1 was detected in the immunoprecipitates of CAII and vice versa. Our results showed that in pufferfish gills CAII was not only expressed in the cytosol to produce the substrate for AE1 transport during Cl(-) influx but also associated with the plasma membrane via AE1. Obviously, it is essential for the physiological function of AE1 to interact with CAII in the membrane of gill Na(+)/K(+)-ATPase-immunoreactive cells. To our knowledge, this is the first study to demonstrate the interaction of branchial CAII and AE1 in fish. The novel correlation proposed a new model of Cl(-)/HCO(3) (-) transport in gills of the teleosts.

A survey of food hygiene knowledge and attitudes among Chinese food handlers in Fong Song Tong district

The purpose of this study was to find out the knowledge and attitudes concerning food hygiene among Chinese food handlers in Fong Song Tong district, and to analyze the impact of variables on the degree of knowledge and attitudes. Face-to-face interviews were conducted within Chinese food handlers in Fong Song Tong district using a self-designed questionnaire, which contained food hygiene knowledge and attitudes. Main knowledge outcome measures included food handling, personal hygiene and legislation issues. Questionnaires were completed by 580 (72.0%) Chinese food handlers from 91% premises of the district. 71.2% Chinese food handlers could respond correctly to eight or more out of 11 knowledge questions and 1.4% respondents only achieved full scores of knowledge. Fully correct response of personal hygiene knowledge was statistically and significantly higher than food handling knowledge (p<0.05). 79.0% of respondents showed their need of more food hygiene education. Male respondents, age less than 30, secondary education or above, five years or more of working experience, or who had previously attended a health training within the last two years, generally performed better on the knowledge of food hygiene. Chinese food handlers working in the kitchen and owners' beliefs on 'cleaning the kitchen before getting off duty' was reasonable. Those with secondary education at least, or who had prior participation in a health training within the last two years would need more food hygiene knowledge than the people aged over 30 or who were the owners. It would be more motivated by changing the traditional training model, community-based education in an optimum situation, additional authoritative information, attitudes and intentions of learning on food hygiene.

XX-agonadism in a fetus with multiple congenital anomalies

We report on an 18-week gestation fetus with 46,XX karyotype, gonadal agenesis, meningo-encephalocele, spina bifida, omphalocele, webbing of right upper limb, deformed right clavicle and right sided ribs, absent interventricular septum, hypoplastic aorta, hypoplastic spleen, and single umbilical artery. This case is similar to the one previously described by Kennerknecht et al. in 1997 and may represent a unique syndrome.

Caspase activation in response to cytotoxic Rana catesbeiana ribonuclease in MCF-7 cells

Rana catesbeiana ribonuclease (RC-RNase) and onconase were proven to own anti-tumor activity. While molecular determinants of onconase-induced cell death have become more explicit, the RC-RNase-induced death pathway remains presently unknown. Here we demonstrated that RC-RNase-induced molecular cascades in caspase-3-deficient MCF-7 cells did not include activation of initiation caspase-8 and -9. Cleavage timing suggested that procaspase-2 and -6 might be processed by active caspase-7 in MCF-7 cells. Caspase-7 was also responsible for cleavage of the poly(ADP-ribose) polymerase. Furthermore, we reported that overexpression of Bcl-X(L) could raise the survival rates of MCF-7 cells treated with RC-RNase and onconase.

Demand for traditional medicine in Taiwan: a mixed Gaussian-Poisson model approach

Hurdle count models are used to examine the participation and consumption decisions in Chinese medicine use. Motivated by a household production model, a second censoring mechanism is introduced into existing single-hurdle models, and the resulting specification accommodates conscientious abstainers, as well as economic non-consumers, and admits excessive zeros in the sample. In contrast to previous studies that found few predictors, empirical results based on a Taiwanese national sample suggest that Western medicine is a gross substitute to Chinese medicine, and both time price and money price play more important roles than income. Insurance, lifestyle and demographics also determine the use of Chinese medicine.

Synergistic cytotoxicity of Rana catesbeiana ribonuclease and IFN-gamma on hepatoma cells

RC-RNase purified from Rana catesbeiana (bullfrog) oocytes is a pyrimidine-guanine sequence-specific ribonuclease. RC-RNase is derived from the RNase superfamily genes exerting distinct ribonucleolytic activity and possesses cytotoxicity to tumor cells, but rarely to primary cells. In this study, we utilized RC-RNase to function with antiproliferative cytokines. The combination with TNF-alpha or TNF-beta would not aggravate cell death. However, the combination with IFN-gamma could induce synergistic cytotoxicity verified by XTT assays toward three hepatoma cell lines bearing different differentiation stages. The distinct cytotoxicity from RC-RNase or RC-RNase/IFN-gamma on different hepatoma cells was correlated with the differentiation extent but not the proliferation rate of the cells. Despite the synergistic cytotoxicity and severe mitochondrial disruptions in the RC-RNase/IFN-gamma-treated cells, we scarcely detected any significant feature of apoptosis or necrosis by FACS analysis on annexin-V/propidium iodide staining. The mechanisms of cell death triggered by RC-RNase or RC-RNase/IFN-gamma require further investigation.

Characterization of human copine III as a phosphoprotein with associated kinase activity

The copines, first described by Creutz et al. [(1998) J. Biol. Chem. 273, 1393-1402], comprise a two C2 domain-containing protein family and are known to aggregate phosphatidylserine membranes in a calcium-dependent manner. No enzymatic function has been attributed to copines yet. Due to a cross-reacting activity of Mikbeta1, an antibody to the IL-2Rbeta chain, we were able to serendipitously purify, partially microsequence, and clone human copine III. The 5 kb copine III transcript is expressed ubiquitously as determined by a multitissue Northern blot analysis. Phosphoamino acid analysis revealed phosphorylation of copine III on serine and threonine residues. In vitro kinase assays were performed with immunoprecipitated endogenous copine III, chromatography-purified endogenous copine III, and recombinant copine III expressed in Saccharomyces cerevisiae. The exogenous substrate myelin basic protein was phosphorylated in all in vitro kinase assays containing copine III immunoprecipitate or purified copine III. A 60-kDa band was observed in corresponding in gel kinase assays with staurosporine-activated cells. Cell lines expressing high levels of copine III protein had correspondingly high kinase activity in copine III antiserum immunoprecipitate. However, the copine amino acid sequences lack the traditional kinase catalytic domain. Therefore, the data suggest copine III may possess an intrinsic kinase activity and represent a novel unconventional kinase family.

Poisoning due to an over-the-counter hypnotic, Sleep-Qik (hyoscine, cyproheptadine, valerian)

The clinical features and risk of hepatotoxicity of 'Sleep-Qik' (valerian dry extract 75 mg, hyoscine hydrobromide 0.25 mg, cyproheptadine hydrochloride 2 mg) were determined in 23 patients treated in our hospital between 1988 and 1991. The main clinical problems were central nervous system depression and anticholinergic poisoning. There was no clinical evidence of acute hepatitis in the 23 patients after taking an average of 2.5 g of valerian (range 0.5 to 12 g). There was no evidence of subclinical liver damage in 12 patients who had routine liver function tests performed approximately 6-12 hours after ingestion. Delayed onset of severe liver damage was excluded in 10 patients in whom a telephone follow-up was possible. However, subclinical liver dysfunction in the acute stage (onset after 12-24 hours) and in the intervening period after discharge from hospital could not be excluded. To establish the risk of hepatotoxicity in long-term users and in those taking an overdosage of valerian, a much larger study of longer duration with serial liver function tests is clearly needed.

[Relationship between illumination and growth of the stroma of Cordyceps sinensis (Berk.) Sacc]

The growth of the stroma of Cordyceps sinensis largely depends upon the illumination in its growth period. By increasing illumination time and light intensity, its growth height can be controlled, growth rate slowed down and the corrosion time of larva body of host insect prolonged. Ultraviolet light is able to affect the growth of stroma too. The stroma also shows the strong phototaxis in its growth period. The arrangement and formation of the perithecium vary with the illumination.

Reconstruction of the bones and joints of the upper extremity by vascularized free fibular graft: report of 46 cases

The vascularized free fibular graft was applied in reconstructing bone and joint structures of the upper extremity in 46 cases between August, 1977 and December, 1989. Among these, 30 were grafts of the fibular shaft and 16 were grafts of the fibular head. There were 19 bony defects after trauma or osteomyelitis, 18 bony or articular defects after resection of tumors, five congenital deformities or defects, and four replacements for fibrous dysplasia. The longest grafted fibula was 22 cm and the shortest, 5 cm. Thirty-one cases were followed for more than two years, and these were evaluated for functional ability in daily living, roentgenologic appearance, and 99mTc scan during follow-up. The results revealed quite sufficient functional restoration, solid bone healing, and adequate blood supply, in most cases. The vascularized free fibular head graft appears to be an ideal procedure for the reconstruction of defects of the lower end of the radius or the upper humerus, including the humeral head. The stability of the reconstructed wrist or shoulder joint was maintained by suturing the lateral collateral ligament, the palmar collateral ligament around the wrist, or by passing the long head of the biceps brachii through the grafted fibula at the shoulder. Methods for fixation of the fibular shaft to the recipient bone and the selection of vessels for anastomoses, both in the graft and at the recipient site, are discussed. The importance of postoperative functional exercise is emphasized.

Report on Shanghai norms for the Chinese translation of the Wechsler Intelligence Scale for Children-Revised

The Chinese translation of the Wechsler Intelligence Scale for Children--Revised (WISC-RC) was administered to 660 children (ages 6 through 16 yr.) in the city of Shanghai. The obtained norms represent children's intelligence levels in big cities where the economic and cultural development is advanced. The norms are reported as "Scaled Score Equivalents of Raw Scores" for each age group and as "IQ Equivalents of Sums of Scaled Scores." The reliability and validity of the norms indicate that the WISC-R is suitable for use with school-age children in China. The difference between the results for our Shanghai sample (WISC-RCs) and a USA sample (WISC-R) is also discussed.

Cross-bridge free skin flap transfer: case report

The authors present a procedure that can be used in cases of massive skin and soft tissue defect accompanied by extensive vascular injury. The technique involves the use of two donor components (a free skin flap and a vascular donor) which form a single unit postoperatively. The free flap is stretched over crossed limbs, with its major lateral portion serving to cover the defect, and the margin of its medial portion containing the flap pedicle sutured to a pedicled skin flap from the healthy contralateral limb. End-to-end anastomoses of vessels from both components are performed within the skin bridge that connects the crossed limbs. A temporary cross-over vascular supply to the free flap from vessels of the healthy limb is thus created. The procedure is offered as a satisfactory solution to the problem of transferring free flaps in cases where recipient site vessels are absent or unusable.