Efficacy and safety of lubiprostone for the treatment of functional constipation in Chinese adult patients: A multicenter, randomized, double-blind, placebo-controlled trial

OBJECTIVES

Functional constipation is a gastrointestinal disorder prevalent around the world. Lubiprostone is the first locally acting type-2 chloride channel activator to be used for treating constipation. This study aimed to evaluate the efficacy and safety of lubiprostone in Chinese adults with functional constipation.

METHODS

This was a multicenter, randomized, double-blind, placebo-controlled study. Patients with functional constipation were randomized to receive either lubiprostone (24 mcg twice daily) or placebo for 4 weeks. The primary end-point was the frequency of spontaneous bowel movements (SBMs) during the first week of treatment. The secondary end-points included the median time of the first SBM, SBM frequency at weeks 2, 3 and 4, weekly response rate of SBMs, the stool consistency score and average number of complete spontaneous bowel movements (CSBMs) per week.

RESULTS

In total, 259 patients were randomized, with 130 in the lubiprostone group and 129 in the placebo group. SBM frequency was higher in the lubiprostone group (4.88 ± 4.09/wk) than that in the placebo group (3.22 ± 2.01/wk) at week 1 (P < 0.0001). SBM frequency was also higher in the lubiprostone group at weeks 2, 3 and 4. The average number of CSBMs and the stool consistency score in the lubiprostone group were significantly higher than that in the placebo group at each week. No drug-related serious adverse events (AEs) occurred. The most commonly reported AE was nausea.

CONCLUSION

Lubiprostone was superior to placebo in treating Chinese patients with functional constipation, together with good safety profile.

[Comparison of different critical care scoring systems in prognosis evaluation of heat stroke]

Objective: To evaluate the prognostic value of different critical care scoring systems in 28-day survival rate of patients with heat stroke. Methods: A retrospective analysis was conducted on the clinical data of 71 patients with heat stroke admitted to the department of emergency medicine of Beijing Luhe Hospital. Capital Medical University from July 2015 to September 2018. The general information and the worst values of vital signs and related pathophysiological indicators within 24 hours were collected and the sequential organ failure assessment (SOFA) , multiple organ dysfunction (MODS) , simplified acute physiological scoreⅡ (SAPS Ⅱ) and acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) were calculated. The patients were divided into the survival group (n=45) and the non-survival group (n=26) according to 28-day prognosis, and the clinical data and scores of the two groups were compared.The ROC curve was drawn to analyze the evaluation value of each scoring system on the survival rate of patients at 28-day. Kaplan-Meier method was used to plot the survival curve of patients. Results: There were no significant differences in age, sex, vital signs and laboratory parameters between two groups (P>0.05) . In non-survival patients, SOFA, SAPS Ⅱ, APACHE Ⅱ scores were significantly elevated in the survival group (P<0.05) . ROC curve analysis showed that the area under ROC curve (AUC) of SOFA score for predicting 28-day survival rate was the highest, which was significantly higher than the APACHE Ⅱ, SAPS Ⅱ, MODS score. When the best cut-off value of SOFA score was 9.0, the sensitivity was 84.6%, and the specificity was 71.1%. Kaplan-Meier survival analysis showed that 28-day survival rate after hospital discharge in patients with SOFA score<9 (n=27) was significantly higher than that in patients with SOFA score ≥9.0 (χ(2)=1.0, P<0.01) . Conclusion: SOFA, APACHE Ⅱ, SAPS Ⅱ on admission have been proved to have good prognostic ability to predict 28-day prognosis in heat stroke patients. Among them, SOFA score system has more accurate prediction value.

[Comparison of short-term and long-term efficacy between robot-assisted and thoracoscopy-laparoscopy-assisted radical esophageal cancer surgery]

Objective: To explore the safety and short-term and long-term efficacy of robot-assisted radical esophageal cancer surgery. Methods: A prospective randomized controlled trial was conducted. Patients who were preoperatively diagnosed as stage 0-IIIB esophageal squamous cell carcinoma and suitable for minimally invasive surgery in our hospital from January 1, 2014 to June 30, 2018 were prospectively enrolled. Those of age ≥75 years having received preoperative neoadjuvant therapy, contradicted to anesthesia or operation due to severe complications, with history of thoracotomy or laparotomy, with concurrent malignant tumors, without complete informations or refusing to participate in this study were excluded. Participants were randomly divided into the thoracoscopy-laparoscopy group and the robot group using a random number table in ratio of 1:1. Preoperative clinicopathological data, surgical data and postoperative outcomes were recorded. The patients were followed up mainly by telephone. Follow-up endpoint was recurrence of esophageal cancer and death. Kaplan-Meier method was used to estimate survival rate. The survival difference between the two groups was analyzed using the log-rank test. Results: According to above criteria, a total of 192 esophageal cancer patients were enrolled finally, including 144 males and 48 females with mean age of (61.9±8.6) years. The robot group had 94 cases, including 72 males and 22 females with mean age of (61.3±8.2) years, and the thoracoscopy-laparoscopy group had 98 cases, including 72 males and 26 females with mean age of (62.4±9.1) years. There were no significant differences in baseline data between the two groups (all P>0.05). Operation was abandoned in one case in each group due to extensive pleural cavity metastasis and one case in each group was converted to thoracotomy. The success rate of operation was 97.9% (92/94) in the robot group and 98.0% (96/98) in the thoracoscopy-laparoscopy group (χ(2)=0.002, P=0.996). The number of lymph nodes dissected in the robot group was significantly higher than that in the thoracoscopy-laparoscopy group (29.2±12.5 vs. 22.8±13.3, t=3.433, P=0.001), while there were no significant differences in operative time, intraoperative blood loss, R0 resection rate, postoperative 30-day mortality, postoperative hospital stay, ICU stay, time to withdrawal of chest drainage tube, ICU readmission, and postoperative morbidity of complications between the two groups (all P>0.05). The median follow-up time was 21 (3 to 57) months. During the follow-up, 3 cases and 4 cases were lost, and 2 cases and 3 cases died of other diseases in the robot group and in the thoracoscopy-laparoscopy group respectively. Recurrence occurred in 39 cases during follow-up, including 14 recurrences in the robotic group with 1- and 3-year recurrence-free survival rates of 92.4% and 87.6% respectively and the median recurrence time of 15 (9 to 42) months. There were 25 recurrences in the thoracoscopy-laparoscopy group with 1- and 3-year recurrence-free survival rates of 81.7% and 67.9% respectively and the median recurrence time of 9 (3 to 42) months. There was significant difference in recurrence-free survival between the two groups (χ(2)=4.193, P=0.041). Conclusions: The robotic surgical system has good oncology effect and surgical safety in the radical operation of esophageal cancer, which deserves further research and promotion.

Successfully endoscopic retrieval of ingested toothpicks in colorectum : a report of four cases

BACKGROUND

Toothpick ingestion is a rare event, but due to the low efficacy of radiographic examination, it can induce severe complications including perforation, abscess, and sepsis.

CASE REPORT

Four patients with either defecation problems or abdominal/anal pain were admitted to our hospital. Colonoscopy showed all four cases had a toothpick impacted in the colorectal wall without perforation. Direct retrieval of the toothpick under endoscopy was achieved. All four patients were relieved and remained well during the follow-up.

CONCLUSION

Endoscopy is the most effective method to discover or retrieve ingested wooden foreign bodies when there are no severe complications.

Comparison between tunneling and standard endoscopic submucosal dissection for treatment of large esophageal superficial neoplasm

BACKGROUND AND STUDY AIMS

Endoscopic submucosal dissection (ESD) has been established as a standard endoscopic method for treating esophageal superficial neoplasms, and it can be performed using a conventional or a tunneling method. The aim of the present study was to compare the safety and efficacy of tunneling ESD (t-ESD) and standard ESD (s-ESD) for treating large esophageal superficial neoplasms and to explore the risk factors for postoperative strictures.

PATIENTS AND METHODS

Fifty-five consecutive patients with large esophageal superficial neoplasms were treated by t-ESD or s-ESD. Demographics, lesion characteristics, procedure-related parameters, and follow-up results were retrospectively collected to compare the efficacy and safety of these procedures. Multivariate analyses were conducted to determine the potential risk factors for postoperative strictures.

RESULTS

Of the 55 patients, 13 underwent t-ESD and 42 underwent s-ESD. The dissection speed of t-ESD was significantly faster than that of s-ESD (7.42±1.99 min/cm2 vs. 9.01±2.11 min/cm2, P<0.05). En bloc resection was achieved in 98.2% (54/55) of the cases, while R0 resection was achieved in 92.7% (51/55). Curative resection was achieved in 78.2% (43/55) of the cases. Fourteen patients (25.5%) had postoperative strictures, which resolved with endoscopic dilation and/or stent insertion. Circumferential involvement of >3/4 and lesion length of >3 cm were independent risk factors for strictures.

CONCLUSIONS

T-ESD is a safe and effective method for treating large esophageal superficial neoplasms with a faster dissection speed than s-ESD, but postoperative strictures may be encountered for lesions involving more than three-fourths of the circumference or longer than 3 cm.

[A clinican linical analysis of 29 cases of chronic pulmonary aspergillosis]

Objective: To improve the understanding of chronic pulmonary aspergillosis (CPA) by analyzing the clinical manifestations, imaging and pathological features, diagnosis, treatment and prognosis of this disease. Methods: Cases of CPA, proven by microbiological evidence based on pathological study in Fuzhou General Hospital of the People's Liberation Army and Affiliated Fuzhou City First Hospital of Fijian Medical University from January 2006 to October 2016 were retrospectively analyzed. Results: The patients consisted of 17 males and 12 females, aged 24 to 75 years, mean (42±16) years. The underlying disorders included post-tuberculosis infection (n=11), bronchiectasis (n=8), chronic obstructive pulmonary disease (n=3) and diabetes mellitus (n=2). The main clinical symptoms included productive cough (n=25), chronic sputum production (n=18) and hemoptysis (n=15). Serum GM antigen tests were performed in 19 cases, and the result was positive in 12 patients. BALF GM antigen tests were performed in 2 cases, both of which were positive. Chest CT showed that the lesions were located predominantly in the upper lobes (n=24). Single cavity with interior irregular intraluminal material (n=16) and multiple cavities with interior irregular intraluminal material (n=10) were the most frequent CT findings, while the "air crescent sign" was found in 13 cases. In the 22 patients who underwent surgical treatment, Aspergillus filaments were found in the cavity (n=20) or the bronchi (n=2) of lung samples, and histological examination didn't show tissue invasion by fungi. Surgical therapy was performed in 22 patients, with complete remission in 19 cases, and death in 3 cases. Anti-fungal therapy was administered in 6 patients, with partial remission in 4, and stable disease in 2 cases. One patient was not treated. Conclusions: CPA is more frequently seen in patients with underlying chronic pulmonary diseases. The common CT findings are single or multiple cavities with interior irregular intraluminal materials. Aspergillus filament in the cavity or bronchi of lung samples, without parenchymal invasion, is the proof of CPA. The surgical cure rate for simple aspergilloma and aspergillus nodule is high, while the risk of operation for chronic cavitary disease is high. GM antigen test may be an evidence for diagnosing CPA.

[Characteristics analysis of patients with benign paroxysmal positional vertigo-spontaneously cured]

Objective:To analyze the characteristics of patients with benign paroxysmal positional vertigo which were spontaneously cured. Method: A total of 1 257 patients with chief complaint of positional vertigo were included and analyzed retrospectively, in which 921 cases were diagnosed as BPPV with the diagnosis standard of Guiyang meeting, and the other 336 cases were negative in the positional test diagnosed as BPPV-spontaneously cured. The age，gender and history course of the two groups were analyzed respectively.Result:①Among the 1 257 cases of BPPV, 336 (111 male and 225 female) were diagnosed as BPPV-spontaneously cured, with total self remission rate of 26.7%. And the female self remission rate is lower than men slightly（25.9% vs 28.5%）.②The ratio of male to female was 1∶2 in patients with BPPV-spontaneously cured and 1∶2.3 in patients with BPPV. Patients of the two groups were mostly female, and there was no significant difference in gender distribution. ③There was no significant difference in age distribution between patients of BPPV-spontaneously cured and BPPV, and patients of ＞50-70 years old were common in both groups.④The history course of patients in BPPV-spontaneously cured and BPPV both were mostly within 2 weeks at their first visit to hospital,each accounting for 75.3% and 69.3%.But the ratio of patients with BPPV-spontaneously cured for 1-2 weeks was higher than that of the BPPV (20.5% vs 15.1%), and the difference was statistically significant.Conclusion:Whether patients with BPPV can cure spontaneously is not related to age or gender, while women may have a tendency of lower self remission rate. The natural course of patients with BPPV-spontaneously cured is mostly within 2-4 weeks. The duration of natural course may be related to the type of semicircular canal involved.

[Epidemiological investigation and analysis of an outbreak of mycoplasma pneumoniae pneumonia in adult]

Objective: To conduct an epidemiological investigation and analysis of an outbreak of mycoplasma pneumonia in adults. Methods: The first case was a 23-year-old male came from the Third Military Medical University, who served as an intern in the Fuzhou General Hospital of PLA and presented on July 16, 2015 with a history of low-grade fever, dizziness, fatigue and chest tightness. Chest CT revealed pulmonary nodules shadow. It was found that other 11 individuals who had been in close contact with the first patient also had similar pulmonary nodules shadow after chest CT examination. Immediately, the health and epidemic prevention department of the ministry of health of Nanjing Military Command and the disease prevention and control center of the Nanjing Military Command received a phone call from Fuzhou General Hospital of PLA. Upon arrival, the prevention and control team conducted a series of epidemiological investigations and on-site prevention, control and disposal of the event, and conducted chest CT screening for other 289 students and staff who volunteered to be examined living in the same area. After the patients with similar pulmonary nodules shadow were screened out, mycoplasma antibody titer detection and chest CT re-scanning were performed for compliance patients. Results: There were 301 students living in the dormitories (Building A and B) of the student living area, and they were screened by chest CT, and it was found that 27 of them had pulmonary nodules shadow, including single pulmonary nodules shadow (48.1%, 13 out of 27) and multiple pulmonary nodules shadow (51.9%, 14 out of 27). And halo sign was observed in 25 of 27 patients (92.6%). The majority of the 27 patients were asymptomatic, only 2 patients got cough, a few of them had systemic symptoms such as fever, dizziness, fatigue. The positive rate of pulmonary nodules shadow was 32.8% (22/67) in building A (poor environmental hygiene), 2.14% (5/234) in building B, and the total incidence rate was 8.97%. Four-fold increase in the mycoplasma pneumoniae (MP) antibody titer in the paired sera was observed in first 12 patients. Measures such as disinfection, isolation and sanitation were taken to control the spread of the epidemic. There was no serious and death cases on the basis of active treatment on the affected patients. Conclusions: The outbreak of mycoplasma pneumoniae pneumonia often occur in crowded places. And the clinical and imaging features of mycoplasma pneumoniae pneumonia are atypical. Standard epidemiological intervention should be adopted for the sudden onset of respiratory diseases with unknown causes.

[Flunarizine in the prophylaxis of vestibular migraine:a randomized controlled trial]

Objective:To evaluate the efficacy and safety of flunarizine in patients with vestibular migraine（VM）as a prophylactic medication. Method:This randomized control trial was undertaken in patients with definite VM. Behavior changes were advocated to all the patients to avoide certain foods and beverages, as well as changes in lifestyle and habits.Patients in arm A received 10-mg flunarizine daily for 3 months along with betahistine 12 mg Tid for 48 h during episodes, and arm B received only betahistine for 48 h during episodes. Frequency. duration and intensity of vertiginous episodes and the main sideeffects were noted at the start of the study and at the end of 3 months.Result:A total of 23 patients who were diagnosed with definitive migrainous vertigo completed the study. The frequency,duration and intensity of vertiginous episodes showed a significan improvement in both group(P <0.05).Analysis of the frequency, duration and intensity between arm A and arm B showed that frequency improved to a significant degree(P <0.05),but the duration and intensity of vertigo between the two groups did not improve to a significant degree(P >0.05). Severe adverse events were not found. Conclusion:Flunarizine is safe and effective for the prophylaxis treatment of VM.

Clinical significance of fibrotic, haemostatic and endotoxic changes in patients with liver cirrhosis

BACKGROUND AND STUDY AIMS

To investigate the relationship among fibrotic, haemostatic and endotoxic changes in patients with different degrees of liver cirrhosis.

PATIENTS AND METHODS

Liver fibrotic markers, including hyaluronic acid (HA), Ccollagen IV (Col-IV), laminin (LN), and N-terminal pro-peptide of collagen type III (PIIINP), were determined by radioimmunoassay. A series of haemostatic tests, including prothrombin time (PT), international normalized ratio, activated partial thromboplastin time, antithrombin-III, thrombin time, fibrinogen, fibrin(ogen) degradation product and D-dimer were determined using an automatic coagulation analyszer. Plasma levels of endotoxin were detected quantitatively using an endotoxin detection kit. Correlation analysis of the data was performed.

RESULTS

Based on Child-Pugh classification, statistically significant differences in fibrotic markers and haemostatic parameters were found in 249 patients with liver cirrhosis, while no significant differences in endotoxin levels were observed. Based on ascites classification, statistically significant differences in fibrotic markers (such as HA, Col-IV and PIIINP, except for LN) and haemostatic parameters were found. As for endotoxin levels, there were significant differences between the ascites, spontaneous bacterial peritonitis (SBP) and no-ascites groups, while no significant differences were observed between the ascites and SBP groups. Correlation analysis demonstrated some correlation among fibrotic markers, haemostatic parameters and endotoxin.

CONCLUSIONS

A close relationship exists between the severity of cirrhosis and fibrotic changes, as well as haemostatic changes. Endotoxin may be an important contributing factor to the development of ascites in cirrhosis. Some correlation may exist between fibrosis, haemostatic and endotoxin.

[Etiological characteristics analysis of 3 137 outpatients with vertigo or dizziness in ENT department]

Objective: To analyze the etiological characteristics of patients in department of ENT with chief complaint of vertigo or dizziness in order to reduce the rate of misdiagnosis and wrong treatment. Method: A total of 3 137 patients in department of ENT with chief complaint of vertigo or dizziness from Sep 2015 to Sep 2017 were included and the etiologies were clarified retrospectively. And in which with any of the 8 kinds of disease including benign paroxysmal positional vertigo(BPPV), vestibular neuritis, vestibular migraine (VM), Meiniére disease, recurrent vestibular disease, sudden deafness with vertigo, psychogenic vertigo, posterior circulation ischemia (PCI) together 2 138 patients were further stratified analyzed by gender and age. Result: ①Etiological characteristics of patients with vertigo or dizziness：among the 3 137 patients with vertigo or dizziness in ENT department in our hosipital, the peripheral diseases of vestibular were the most common disease with a total of 1 607 cases, accounting for 51.23%. And there were 506 cases of the central diseases of vestibular accounting for 16.13%, 382 cases of other systemic diseases accounting for 12.18%, 85 cases（2.71%）of psychogenic vertigo, 557 cases （17.76%）of unknown etiology. ②Analysis of the frequent and serious causing of patients with vertigo or dizziness: among the 2 138(68.15%) patients with vertigo or dizziness, BPPV with a total of 827 cases (26.36%) was the most prevalent,while 215(25.99%) of them were diagnosed as self-cured BPPV,vestibular neuritis and VM were the second prevalent with 420 cases (13.39%) and 329 cases (10.49%) respectively, Meiniére disease, recurrent vestibular disease, sudden deafness with vertigo were the third prevalent with 209 cases (6.66%), 144 cases (4.59%), 102 cases (3.25%), respectively; well psychogenic vertigo and PCI were relatively rare, with respectively 85 cases (2.71%) and 22 cases (0.70%). Eotiology analysis stratified by age: The causes of vertigo or dizziness were ranged with age, and patients of 50-70 years old were most common with a total of 1 011 cases, accounting for 49.6%. Etiology analysis stratified by gender: There was gender difference in patients with vertigo or dizziness,such as BPPV, VM, recurrent vestibular disease, sudden deafness with vertigo and psychogenic vertigo were common in female, while PCI in male insteadly. Conclusion: ①Among the patients with vertigo or dizziness, the pheripheral diseases of vestibular are the most prevalent, in which BPPV takes the highest accidence. ②Patients ranging from 50 to 70 years old take the main parts in patients with vertigo or dizziness. And there is an obvious gender difference in patients with BPPV, VM, recurrent vestibular disease, sudden deafness with vertigo, psychogenic vertigo and PCI.

[Analysis of risk factors for postsurgical gastroparesis syndrome (PGS) after operation for gastric cancer]

Objective: To investigate the risk factors for postsurgical gastroparesis syndrome (PGS) after surgery for stomach cancer. Methods: A total of 684 patients with gastric cancer who underwent surgery for stomach cancer from Jan. 1, 2010 to Dec. 31, 2014 in Tai'an Tumor Prevention and Treatment Hospital, including 475 males and 209 females, with an average age of 59.9 years were identified and included in this study. There were 206 cases of gastric cardia and gastric fundus cancers and 478 cases of gastric antrum cancer. 206 cases underwent proximal radical subtotal gastrectomy and D2 lymph node dissection, 478 distal radical subtotal gastrectomy, 206 residual esophagogastric anastomosis, 311 Billroth-Ⅰ anastomosis, 99 Billroth-Ⅱ anastomosis, and 68 Billroth-Ⅱ plus Roux-en-y anastomosis. The incidence and risk factors of PGS were analyzed. Results: All of the 684 patients were successfully operated.Among them, 48 (7.0%)encountered PGS. The univariate analysis showed that age, smoking index, alcohol consumption index, HP infection, scores of anxiety, preoperative albumin level, preoperative pyloric obstruction, site of resection, mode of anastomosis, whether to preserve the vagus nerve trunk, perioperative blood glucose level, abdominal cavity infection, and usage of postoperative analgesia pump were related to the occurrence of PGS (P<0.05 for all), while sex, hypertension, diabetes, perioperative hemoglobin level, perioperative electrolyte imbalance, operation duration, intraoperative blood loss, size of gastric remnant and number of dissected lymph nodes were not significantly related to the occurrence of PGS(P>0.05 for all). The multivariate binary logistic regression analysis showed that age, HP infection, scores of anxiety, perioperative albumin level, preoperative pyloric obstruction, site of resection, mode of anastomosis, whether to preserve the vagus nerve trunk, perioperative blood glucose level and abdominal cavity infection were risk factors for PGS (P<0.05 for all); while the age (<67 years old), perioperative albumin level (>35 g/L) and preservation of the vagus nerve trunk were protective factors of PGS (P<0.05 for all). Conclusions: The occurrence of PGS is affected by many factors. Detailed evaluation of patients'symptoms and physical signs before operation and rectifying and eliminating risk factors are important to prevent and reduce the occurrence of PGS in patients with gastric cancer.

[Study of the relevant factors of behavioral development among 30-month-old infants in rural area of Shaanxi Province]

Objective: To explore the relevant factors of behavioral development among 30-month-old infants in rural area, Shaanxi Province. Methods: The behavioral development among 977 infants aged 30-month-old was evaluated in Changwu and Binxian of Shaanxi province from July 2006 to August 2008. The inclusion criteria included single live birth between January 2004 and February 2006, mother had participated in a community-based intervention study named "Impact of multi-micronutrient supplementation during pregnancy on low birth weight and premature delivery" . Infants who had obvious deformity or other birth defects, infants who could not complete the questionnaire survey, physical examination were excluded from the study. The self-designed questionnaire was used to investigate the information of feeding patterns, disease status, physical development, and immunization status of the infants, and their behavioral development were assessed by Bayley scales of infant development (BSID). General Linear Model was used to adjust the possible confounding factors, and the analysis of variance was performed to explore the effects on the behavioral development among infants aged 30-month-old. Results: Among the infants in the study, the average age was (30.6±0.6) months old, the mean birth weight was (3 199.1±405.9)g. After adjusted the mothers' age of delivery, educational level and occupation of the parents, family ecnomic conditions and the number of children, infants whose mother exposed to toxic chemicals during pregnancy had lower score in activity (-0.179±0.961) and lower score in concentration (-0.177±1.099) compared with infants with unexposed mother (0.058±1.006, P=0.001; 0.057±0.960, P=0.003). Similarly, infants whose mother took drugs during pregnancy had lower score in persistent behaviors (-0.070±1.000) compared with infants whose mother did not(0.085±1.006, P=0.017). Compared with normal birth infants(0.043±0.981, P=0.007; 0.021±0.984, P=0.034), infants less than gestational age and low birth weight had lower score in concentration(-0.198±1.063 and-0.389±1.285, respectively). After adjusted the delivery gestational age of mothers, the months of infants, the mothers' age of delivery, educational level and occupation of the parents, family ecnomic conditions, the number of children, and the main orderlies of infants, the score of activity of infants suffered from diseases in early month age was-0.049±0.992, which was lower than those who did not(0.207±1.011, P=0.001). The infants with Rickets signs had lower score in motor coordination (-0.218±0.896) than normal infants (0.031±1.011, P=0.013). Infants whose mother with adequate micronutrient supplementation in pregnancy had higher score in concentration (0.066±0.966) than those whose mother with insufficient supplementation (-0.062±1.027, P=0.043). Furthermore, infants with fine protein added and minerals and vitamins added had higher score in activity and concentration compared with those insufficient, who scored 0.078±1.013 and 0.496±0.872 (-0.254±0.924, P<0.001; 0.001±0.997, P=0.033), respectively. Conclusion: Micronutrient supplementation during pregnancy and reasonable nutrition added during childhood could affect behavioral development among infants.

[Vestibular function tests for vestibular migraine: clinical implication of video head impulse and caloric tests]

Objective:To review the results of caloric test and the video head impulse test (vHIT) in a cohort of VM patients and assessed the value of each for predicting the prognosis in VM patients. Method:A retrospective analysis was performed on VM patients in our vertigo clinic, vestibular function were assessed by caloric test and vHIT at the initial visit and 6 months after treatment. Complete response (CR) was defined as no need for continued medication, uncomplete response (UR) as improved symptoms but need for continued medication, no symptomatic improvement. Result:At the initial evaluation, 15 of 75 (15.0%) exhibited abnormal caloric test results, 9 of 75 patients (12.0%) exhibited abnormal vHIT results. Six months later, 58 of 75 patients (77.3%) no longer required medication (CR), while 17 (22.7%）UR patients need for continued medication. The ratio of abnormal vHIT gain and abnormal caloric results were significantly different between group (CR) and group (UR) (P<0.05). Conclusion:Abnormal vHIT and caloric test results revealed semicircular canal dysfunction in VM patients, peripheral vestibular abnormalities are closely related to the development of vertigo in VM patients and predicted prolonged preventive medication and vestibular rehabilitation requirement.

Development of a valid Simplified Chinese version of the International Hip Outcome Tool (SC-iHOT-33) in young patients having total hip arthroplasty

OBJECTIVE

The International Hip Outcome Tool (iHOT-33) is a questionnaire designed for young, active patients with hip disorders. It has proven to be a highly reliable and valid questionnaire. The main purpose of our study was to adapt the iHOT-33 questionnaire into simplified Chinese and to assess its psychometric properties in Chinese patients.

METHOD

The iHOT-33 was cross culturally adapted into Chinese and 138 patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the EuroQol-5D (EQ-5D), and the Chinese version of the iHOT-33(SC-iHOT-33) pre- or postoperatively within 6 months' follow-up. The Cronbach's alpha, intraclass correlation coefficient (ICC), Pearson's correlation coefficient (r), effect size (ES), and standardized response mean (SRM) were calculated to assess the reliability, validity, and responsiveness of the SC-iHOT-33, respectively.

RESULTS

Total Cronbach's alpha was 0.965, which represented excellent internal consistency of the SC-iHOT-33. The ICC ranges from 0.866 to 0.929, which shows excellent test-retest reliability. The subscales of SC-iHOT-33 had the highest correlation coefficient (r = 0.812) with the physical function subscales of the WOMAC, as well as good correlation between the social/emotional subscale of the SC-iHOT-33 and the EQ-5D (r = 0.740, r = 0.743). No floor or ceiling effects were found. The ES and SRM values indicated good responsiveness of 2.44 and 2.67, respectively.

CONCLUSION

The SC-iHOT-33 questionnaire is reliable, valid, and responsive for the evaluation of young, Chinese, active patients with hip disorders.

[Bilateral laryngocele:a case report]

A 71 years old male with throat discomfort, shortness of breath, irritating cough admission. Fiberoptic laryngoscope: bilateral glottis ventricular zone with about quail egg size smooth cystic masses. Throat enhanced CT: infrahyoid margin level about bilateral aryepiglottic fold inside have package containing gas shadow, communicated with the laryngeal chamber. Support laryngoscope under coblation radiofrequency ablation assisted laryngeal cyst excision were done and postoperative pathology consistent with laryngocele.

[Regulatory role of calcium activated chloride channel in pulmonary vascular structural remodeling in rats with pulmonary arterial hypertension induced by high pulmonary blood flow]

OBJECTIVE

To explore the regulatory role of calcium activated chloride channel (CaCC) in vascular structural remodeling in pathogenesis of pulmonary arterial hypertension (PAH) induced by high pulmonary blood flow.

METHOD

An abdominal aorta and inferior vena cava shunting operation was used to induce high pulmonary blood flow and establish a PAH rat model.Seventy-five SD rats were randomly divided into normal, sham, shunt, niflumic acid (NFA) 1(0.2 mg/(kg·d))and NFA 2 (0.4 mg/(kg·d)) groups. There were 15 rats in each group. Pulmonary artery pressure and vascular structural remodeling were measured, arteriole contraction ratio among these groups were compared using vascular tone analysis system, and the electrophysiology of pulmonary artery smooth muscle cell (PASMC) was recorded using patch clamp technology. Differences between multiple groups were compared through variance analysis and that between groups with q test.

RESULT

Compared with normal ((14.4±1.3 ) mmHg, 1 mmHg=0.133 kPa)and sham groups ((13.5±2.3 ) mmHg), mean pulmonary artery pressure in shunt group ((27.4±2.4 ) mmHg) increased significantly (P<0.05). Compared with shunt group, mean pulmonary artery pressure in NFA 1 group ((21.2±2.0) mmHg) and NFA 2 group ((22.3±2.0) mmHg) decreased significantly (P<0.05). Pulmonary vascular structural remodeling including pulmonary artery stenosis presented in shunt group. Compared with normal ((114.3±1.2)%) and sham ((115.5±1.1)%) groups, arteriole contraction ratio to 10(-5) mol/L phenylephrine in shunt group ((132.6±1.4)%) increased significantly (P<0.05). Compared with shunt group, pulmonary vascular structural remodeling alleviated in NFA 1 and NFA 2 groups. Arteriole contraction ratio in NFA 1 group ((126.4±1.3)%) and NFA 2 group ((124.6±1.0)%) decreased significantly compared with shunt group (P<0.05). Patch clamp technique recorded typical CaCC currents. Compared with normal ((32.3±2.3 ) pA/pF) and sham groups ((35.3±1.2) pA/pF), the CaCC current density of PASMC in shunt group ((51.3±2.7) pA/pF) increased significantly (P<0.05). Compared with shunt group, the CaCC current density of PASMC in NFA 1 group ((40.2±1.5 ) pA/pF) and NFA 2 group ((42.7±2.2) pA/pF) decreased significantly (P<0.05).

CONCLUSION

CaCC is involved in pulmonary arterial hypertension induced by high pulmonary blood flow through regulating membrane potential. NFA attenuate pulmonary vascular structural remodeling and pulmonary pressure through decreasing CaCC current density of PASMC membrane.

Construction of a genetic linkage map and identification of QTL associated with growth traits in Malus sieversii

110 F(1) individuals of apple were obtained by crossing between a good quality cultivar'Red Fuji'ofMalus domestica and an accession'Hongrou Apple'ofMalus sieversi. Using Joinmap3.0, a molecular genetic linkage map of Malus sieversii was constructed by 175 SSR and 105 SRAP markers which were integrated into 17 linkage groups and spanned 1299.67cM in genome with an average distance of 4.6cM between the markers. By using interval mapping method,17 QTLs for eight growth traits of Malus sieversii were detected, including 2 QTLs for tree height on cl and c16, 2 QTLs for stem height on c7, 2 QTLs for stem thickness on c3, 2 QTLs for new shoot length on c15 and c16, 2 QTLs for new shoot diameter on c2, 3 QTLs for internode number on c1, c2 and c2, 2 QTLs for internode length on c 1 and c2, 2 QTLs for lenticel density on c17, respectively. The phenotypic variations explained by each QTL ranged from 10.15% to 41.66%, and their LOD values varied from 2.54 to 4.53, of which five QTLs were major effect genes (LOD≥3.5).

[Overexpression, homology modeling and coenzyme docking studies of the cytochrome P450nor2 from Cylindrocarpon tonkinense]

Cytochrome P450nor catalyzes an unusual reaction that transfers electrons from NADP/NADPH to bound heme directly. To improve the expression level of P450nor2 from Cylindrocarpon tonkinense (C.P450nor2), Escherichia coli system was utilized to substitute the yeast system we constructed for expression of the P450nor2 gene, and the protein was purified in soluble form using Ni(+)-NTA affinity chromatography. In contrast to P450nor from Fusarium oxysporum (F.P450nor) and P450nor1 from Cylindrocarpon tonkinense (C.P450nor1), C.P450nor2 shows a dual specificity for using NADH or NADPH as electron donors. The present study developed a computational approach in order to illustrate the coenzyme specificity of C.P450nor2 for NADH and NADPH. This study involved homology modeling of C.P450nor2 and docking analyses of NADH and NADPH into the crystal structure of F.P450nor and the predictive model of C.P450nor2, respectively. The results suggested that C.P450nor2 and F.P450nor have different coenzyme specificity for NADH and NADPH; whilst the space around the B'-helix of the C.P450nor2, especially the Ser79 and Gly81, play a crucial role for the specificity of C.P450nor2. In the absence of the experimental structure of C.P450nor2, we hope that our model will be useful to provide rational explanation on coenzyme specificity of C.P450nor2.

[Significance of five symptoms scoring sheet in the clinical diagnosis of BPPV]

Objective:To identify the validity of five symptoms scoring sheet that based on the patients who are suffering from benign paroxysmal positional vertigo(BPPV), and explore its effects and significance in the clinical diagnosis of BPPV.Method:A total of 484 patients with vertigo were included. All the patients were firstly assessed with five symptoms scoring sheet(repeated transient vertigo or aggravating vertigo during looking up, bending, getting out of bed, rolling over in bed and quick head movements) before being confirmed by Dix-Hallpike test and rolling test. Evaluating the predictive ability of this scoring sheet in the diagnosis of BPPV with ROC analysis.Result:According to the ROC analysis , the sensitivity and specificity were 95.4% and 80.3% respectively when the score >7, and an area under receiver operating characteristic curve(AUC) was 0.923.Conclusion:Five symptoms scoring sheet is useful and convenient in diagnosing BPPV, which can be used in BPPV screening and guide the vertigo patients to receive further test and treatment.

MicroRNA-154 functions as a tumor suppressor and directly targets HMGA2 in human non-small cell lung cancer

MicroRNA-154 (miR-154) is dysregulated in some human malignancies and is correlated with tumor progression. However, its expression and function in non-small cell lung cancer (NSCLC) remain unclear. Therefore, we explored the effects of miR-154 on NSCLC tumorigenesis and development. Using quantitative reverse transcription-polymerase chain reaction, we detected miR-154 expression in NSCLC cell lines and primary tumor tissues. The association between miR-154 expression and clinicopathological factors was investigated, and the effects of miR-154 on the biological behavior of NSCLC cells were examined. Ultimately, the potential regulatory effect of miR-154 on high-mobility group A2 protein (HMGA2) expression was confirmed. miR-154 was significantly downregulated in NSCLC cell lines and clinical specimens. Reduced miR-154 expression was significantly associated with lymph node metastasis, advanced TNM stage, and shorter overall survival. Multivariate regression analysis confirmed that downregulation of miR-154 was an independent unfavorable prognostic factor for patients with NSCLC. Overexpression of miR-154 inhibited NSCLC cell proliferation, invasion, and migration, and promoted cell apoptosis in vitro. Furthermore, a luciferase reporter assay identified HMGA2 as a direct target of miR-154. Our findings indicate that miR-154 may act as a tumor suppressor in NSCLC and would serve as a novel therapeutic agent for miR-based therapy.

Genome sequencing and systems biology analysis of a lipase-producing bacterial strain

Lipase-producing bacteria are naturally-occurring, industrially-relevant microorganisms that produce lipases, which can be used to synthesize biodiesel from waste oils. The efficiency of lipase expression varies between various microbial strains. Therefore, strains that can produce lipases with high efficiency must be screened, and the conditions of lipase metabolism and optimization of the production process in a given environment must be thoroughly studied. A high efficiency lipase-producing strain was isolated from the sediments of Jinsha River, identified by 16S rRNA sequence analysis as Serratia marcescens, and designated as HS-L5. A schematic diagram of the genome sequence was constructed by high-throughput genome sequencing. A series of genes related to lipid degradation were identified by functional gene annotation through sequence homology analysis. A genome-scale metabolic model of HS-ML5 was constructed using systems biology techniques. The model consisted of 1722 genes and 1567 metabolic reactions. The topological graph of the genome-scale metabolic model was compared to that of conventional metabolic pathways using a visualization software and KEGG database. The basic components and boundaries of the tributyrin degradation subnetwork were determined, and its flux balance analyzed using Matlab and COBRA Toolbox to simulate the effects of different conditions on the catalytic efficiency of lipases produced by HS-ML5. We proved that the catalytic activity of microbial lipases was closely related to the carbon metabolic pathway. As production and catalytic efficiency of lipases varied greatly with the environment, the catalytic efficiency and environmental adaptability of microbial lipases can be improved by proper control of the production conditions.

A rare PAX6 mutation in a Chinese family with congenital aniridia

Aniridia is an autosomal dominant disorder characterized by the complete or partial loss of the iris and is almost associated with mutations in the paired box gene 6 (PAX6). We examined three generations of a Chinese family with congenital aniridia and observed genetic defects. Exons of PAX6 from 12 family members were amplified by polymerase chain reaction, sequenced, and compared with reference sequences in NCBI reference sequence database (http://www.ncbi.nlm.nih.gov/nuccore/NG_008679.1?from=5001&to=38170&report=genbank). A rare mutation c.2T>A (M1K) in exon 4 of PAX6 was identified in all affected family members but not in unaffected family members. Our results suggest that the c.2T>A (M1K) mutation may be responsible for the pathogenesis of congenital aniridia in this family. To our knowledge, this is the first report of the M1K mutation in PAX6 in a Chinese family with this disease and the second report worldwide.

Allelopathy, chemical communication, and plant defense

Allelopathy is identified particularly with chemical activity between plants; entomologists refer to allelochemicals in a broader context. Recent work shows that several groups of compounds associated with allelopathy also play a part in communication between plants and other organisms. It is argued that such communication is part of the similarities in plant and animal responses to stress and may contribute to plant defense.

Biologically active secondary metabolites of barley. II. Phytotoxicity of barley allelochemicals

The release of alkaloids by barley was quantified by HPLC. Hordenine was released from the roots of barley in a hydroponic system for up to 60 days. The amount reached a maximum, 2μg/plant/day, at 36 days, then declined. Effects on white mustard by hordenine and gramine included reduction of radicle length and apparent reduction in health and vigor of radicle tips. Transmission electron microscopic examination of white mustard radicle tips exposed to hordenine and gramine showed damage to cell walls, increase in both size and number of vacuoles, autophagy, and disorganization of organelles. The evidence of the morphological and primary effects of barley allelochemicals at the levels released by living plants indicates that the biologically active secondary metabolites of barley may lead to a significant role in selfdefense by the crop.

Outcomes and patterns of secondary relapse in platinum-sensitive ovarian cancer: implications for tertiary cytoreductive surgery

AIM

To evaluate the outcomes and patterns of patients with secondary relapsed ovarian cancer.

METHODS

A retrospective study was conducted. The cases comprised 83 patients who underwent tertiary cytoreductive surgery (TCS) followed by chemotherapy, whereas the controls consisted of 76 patients who received chemotherapy alone.

RESULTS

The median survival was 20 months in 159 patients. Patients with microscopic residual disease after TCS had a median survival of 32.9 months compared with 14.6 months in those with macroscopic residual disease [hazard ratio (HR), 2.82; P = 0.001) and 15.0 months in patients with chemotherapy alone (HR, 2.23; P = 0.001). When stratified by a progression-free interval (PFI) after secondary cytoreduction (SCR), TCS showed no benefit in patients with a PFI ≤12 months or a PFI >12 months compared with those with chemotherapy alone. TCS improved survival in patients with recurrent disease in the pelvis compared with those with recurrent disease in the middle or upper abdomen, with a median survival of 34.9 months and 14.6 months, respectively (HR, 2.94; P = 0.010). However, TCS was not a survival determinant by multivariate analysis. A multivariate analysis identified a PFI after SCR (≤12 mos vs. >12 mos; HR, 2.34; 95% CI, 1.29-4.24; P = 0.005), mesenteric lymph node metastasis at SCR (yes vs. no; HR, 4.18; 95% CI, 1.93-9.03; P < 0.001) and treatment arms at secondary relapse (chemotherapy alone vs. TCS; HR, 1.56; 95% CI, 1.03-2.38; P = 0.037) as independent predictors of survival.

CONCLUSIONS

Limited survival benefit from tertiary cytoreductive surgery was observed in patients with platinum-sensitive secondary relapsed ovarian cancer.

Analogous effects of recombinant human full-length amelogenin expressed by Pichia pastoris yeast and enamel matrix derivative in vitro

OBJECTIVES

Amelogenins are proposed to be responsible for enamel matrix derivative (EMD)-induced periodontal regeneration; however, heterogeneity of amelogenins makes it challenging to purify the full-length proteins. This study has been carried out to express and purify a recombinant full-length human amelogenin protein (rHhAm175) in the eukaryotic yeast Pichia pastoris, and further compare biological responses of human periodontal ligament fibroblasts (PDLFs) to rHhAm175 and porcine EMD (pEMD).

MATERIALS AND METHODS

Human cDNA encoding a 175-amino acid amelogenin was subcloned into the pPIC3.5K vector. The rHhAm175 expressed in P. pastoris GS115 (Mut+) was purified and characterized. We examined cell attachment, migration and proliferation responses of human PDLFs to rHhAm175 and pEMD respectively, and characterized associated changes of proliferation-related intracellular signalling molecules, including extracellular signal response kinase (ERK) and Akt kinases/protein kinase B (Akt/PKB) kinases.

RESULTS

The purified rHhAm175 was confirmed to be molecular mass 22 021.13 Da, phosphorylated human amelogenin, and alone significantly promoted proliferation and migration of human PDLFs to an extent comparable to that of pEMD. Cell attachment was increased over the first 60 min incubation with rHhAm175 or pEMD. Both rHhAm175 and pEMD induced PDLF mitogenesis via extracellular signal response kinase (ERK1/2), but not by Akt kinases/protein kinase B (Akt/PKB).

CONCLUSIONS

rHhAm175 modulated cell activities of human PDLFs, to a comparable extent as porcine EMD. These data suggest that rHhAm175 might be used to induce periodontal tissue regeneration.

Prevalence and molecular diversity of Archaea in subgingival pockets of periodontitis patients

INTRODUCTION

The aim of this study was to investigate the prevalence and molecular diversity of Archaea in the subgingival crevices of patients with chronic periodontitis.

METHODS

Subgingival plaque was collected from 41 patients with chronic periodontitis and 15 healthy subjects. The prevalence of Archaea in those plaque samples was tested by polymerase chain reaction with two broad-range archaeal primer sets. Amplicons from eight Archaea-positive plaque samples were cloned and sequenced for molecular diversity analysis using one of these two primer sets and a novel third primer set.

RESULTS

Archaea were detected in the subgingival plaque of patients with chronic periodontitis at a prevalence of 70.7-73.2%, but were not detected in healthy subjects. Using one primer set, all sequences of the archaeal amplicons were identified as Methanobrevibacter oralis-like species. With another primer set, the amplicons were also found to be identical to the uncultured M. oralis-like species except one phylotype was found to belong to the class Thermoplasmata.

CONCLUSION

Archaea might be correlated with periodontal diseases. The diversity of Archaea associated with periodontitis was limited. Almost all sequenced amplicons fell into the genus Methanobrevibacter of the Euryarcheota phylum. M. oralis-like species was the predominant but non-exclusive archaeon in the subgingival dental plaque of patients with periodontitis.

Second-generation anti-carcinoembryonic antigen designer T cells resist activation-induced cell death, proliferate on tumor contact, secrete cytokines, and exhibit superior antitumor activity in vivo: a preclinical evaluation

PURPOSE

This report describes the development and preclinical qualification tests of second-generation anti-carcinoembryonic (CEA) designer T cells for use in human trials.

EXPERIMENTAL DESIGN

The progenitor first-generation immunoglobulin-T-cell receptor (IgTCR) that transmits Signal 1-only effectively mediated chimeric immune receptor (CIR)-directed cytotoxicity, but expressor T cells succumbed to activation-induced cell death (AICD). The second-generation CIR (termed "Tandem" for two signals) was designed to transmit TCR Signal 1 and CD28 Signal 2 to render T cells resistant to AICD and provide prolonged antitumor effect in vivo.

RESULTS

A CIR was created that combines portions of CD28, TCRzeta, and a single chain antibody domain (sFv) specific for CEA into a single molecule (IgCD28TCR). As designed, the gene-modified Tandem T cells exhibit the new property of being resistant to AICD, showing instead an accelerated proliferation on tumor contact. Tandem T cells are more potent than first generation in targeting and lysing CEA+ tumor. Tandem T cells secrete high levels of interleukin-2 and IFNgamma on tumor contact that first-generation T cells lacked, but secretion was exhaustible, suggesting a need for interleukin-2 supplementation in therapy even for these second-generation agents. Finally, second-generation T cells were more effective in suppressing tumor in animal models.

CONCLUSION

An advanced generation of anti-CEA designer T cells is described with features that promise a more potent and enduring antitumor immune response in vivo. These preclinical data qualify the human use of this agent that is currently undergoing trial in patients with CEA+ cancers.

Whole-range assessment: a simple method for analysing allelopathic dose-response data

Based on the typical biological responses of an organism to allelochemicals (hormesis), concepts of whole-range assessment and inhibition index were developed for improved analysis of allelopathic data. Examples of their application are presented using data drawn from the literature. The method is concise and comprehensive, and makes data grouping and multiple comparisons simple, logical, and possible. It improves data interpretation, enhances research outcomes, and is a statistically efficient summary of the plant response profiles.

Mechanics of patterned helical Si springs on Si substrate

The elastic response, including the spring constant, of individual Si helical-shape submicron springs, was measured using a tip-cantilever assembly attached to a conventional atomic force microscope. The isolated, four-turn Si springs were fabricated using oblique angle deposition with substrate rotation, also known as the glancing angle deposition, on a templated Si substrate. The response of the structures was modeled using finite elements, and it was shown that the conventional formulae for the spring constant required modifications before they could be used for the loading scheme used in the present experiment.

Production, purification, and characterization of an intracellular aflatoxin-detoxifizyme from Armillariella tabescens (E-20)

Some Armillariella tabescens (E-20) multienzymes have previously been reported to present detoxifying activities against aflatoxins. In this paper, we describe the isolation purification of an intracellular enzyme, named aflatoxin-detoxifizyme, which exhibited detoxification activity on aflatoxin B(1) (AFB(1)). This aflatoxin-detoxifizyme exhibited a specific activity of 7.09 nmol min/mg at pH 6.0 and 28 degrees C. The apparent molecular mass was 51.8 kDa as determined by SDS-PAGE. The isoelectric point was estimated to be 5.4 and optimum activity for the enzyme was found at pH 6.8 and 35 degrees C. The activity of the purified enzyme was confirmed by Ames test.

A k-space method for large-scale models of wave propagation in tissue

Large-scale simulation of ultrasonic pulse propagation in inhomogeneous tissue is important for the study of ultrasound-tissue interaction as well as for development of new imaging methods. Typical scales of interest span hundreds of wavelengths; most current two-dimensional methods, such as finite-difference and finite-element methods, are unable to compute propagation on this scale with the efficiency needed for imaging studies. Furthermore, for most available methods of simulating ultrasonic propagation, large-scale, three-dimensional computations of ultrasonic scattering are infeasible. Some of these difficulties have been overcome by previous pseudospectral and k-space methods, which allow substantial portions of the necessary computations to be executed using fast Fourier transforms. This paper presents a simplified derivation of the k-space method for a medium of variable sound speed and density; the derivation clearly shows the relationship of this k-space method to both past k-space methods and pseudospectral methods. In the present method, the spatial differential equations are solved by a simple Fourier transform method, and temporal iteration is performed using a k-t space propagator. The temporal iteration procedure is shown to be exact for homogeneous media, unconditionally stable for "slow" (c(x) < or = c0) media, and highly accurate for general weakly scattering media. The applicability of the k-space method to large-scale soft tissue modeling is shown by simulating two-dimensional propagation of an incident plane wave through several tissue-mimicking cylinders as well as a model chest wall cross section. A three-dimensional implementation of the k-space method is also employed for the example problem of propagation through a tissue-mimicking sphere. Numerical results indicate that the k-space method is accurate for large-scale soft tissue computations with much greater efficiency than that of an analogous leapfrog pseudospectral method or a 2-4 finite difference time-domain method. However, numerical results also indicate that the k-space method is less accurate than the finite-difference method for a high contrast scatterer with bone-like properties, although qualitative results can still be obtained by the k-space method with high efficiency. Possible extensions to the method, including representation of absorption effects, absorbing boundary conditions, elastic-wave propagation, and acoustic nonlinearity, are discussed.

Alpha1A- and alpha1B-adrenoceptors are the major subtypes in human saphenous vein

In this study we analyzed the different alpha1-adrenoceptor (AR) subtypes present in human saphenous vein (HSV) using reverse transcription polymerase chain reaction (RT-PCR), DNA-DNA hybridization analysis and functional affinities for alpha-AR antagonists. DNA-DNA hybridization analysis of RT-PCR amplification products confirmed the presence of alpha1A- and alpha1B-ARs, and low levels of alpha1D-AR in HSV. The functional results showed: (1) prazosin, the selective alpha1-AR antagonist, phentolamine, the alpha1- and alpha2-ARs antagonist, WB 4101 and 5-MU, the selective alpha1A-AR subtype antagonists were potent, competitive antagonists of noradrenaline (NA)-induced contraction (pA2 values of 11.03, 8.06, 9.02 and 8.34, respectively). (2) Alpha1-AR-induced contraction was sensitive to the alkylating effects of CEC (the alpha1B and alpha1D-AR subtypes antagonist) and (3) The selective alpha1D-AR subtype antagonist BMY displayed low affinity (pA2 values of 6.44). This indicates that the contractile response of the HSV to alpha1-AR-induced is predominantly mediated by both alpha1A and alpha1B-AR subtypes. This was also supported by the good relationship between pA2 values from the present study and reported binding affinities (pKi) values of various alpha1-AR subtype antagonists with cloned human alpha1A- and alpha1B-AR subtypes (r=0.89 and r=0.98, respectively), but not the alpha1D-AR subtype (r=0.67). Our results indicate that alpha1A- and alpha1B-ARs are the main functional and expressed receptor subtypes in HSV.

Effects of micromolar concentrations of manganese, copper, and zinc on alpha1-adrenoceptor-mediating contraction in rat aorta

To determine the influences of the Mn, Cu, and Zn on alpha1-adrenoceptor (AR)-mediated vasoconstriction, we investigated their effects on vasoconstriction produced by the alpha1-AR agonist phenylephrine in isolated rings of rat thoracic aorta. The cumulative concentration-contraction curves for phenylephrine were obtained in the absence and presence of Mn (0.3, 1, 3 microM), Cu (1, 10, 16 microM), and Zn (0.3, 1, 10 microM). Mn, Cu, and Zn each inhibited phenylephrine-mediated contraction in a dose-dependent manner. The maximal phenylephrine-induced contraction was significantly reduced by the pretreatment of the arterial rings with 10 and 16 microM Cu (p<0.05). The results suggest that variations in the plasma concentrations of metal might lead to changes in alpha1-AR-mediated constrictive response.

[Determination of ferulic acid in chuanxiong and in animal serum and cerebrospinal fluid by reversed-phase high performance liquid chromatography]

An easy, rapid and sensitive method for the determination of ferulic acid(FA) in Chuanxiong extracts, animal (mouse) serum and cerebrospinal fluid by RP-HPLC has been developed. The FA was separated on an ODS column, Nova-Pak C18(3.9 mm i.d. x 150 mm) and detected at the wavelength of 320 nm. The mobile phase was methanol-water-acetic acid (35:65:0.5, V/V), with a flow rate of 0.8 mL/min. The detection limit of FA was 1.7 micrograms/L(S/N = 3) and the calibration curve was linear within the range of 0.85 mg/L-4.00 mg/L(r = 0.99904, n = 6). The mean recovery from animal serum and cerebrospinal was 95%-102%.

[Importance of the posterior and lateral arterial network of elbow on the super-regional and mutual-pedicled axial flap]

OBJECTIVE

To explore the importance of the posterior and lateral arterial network of elbow in the application of the super-regional and mutual-pedicled axial flap.

METHODS

Twenty-seven upper extremities of adult cadavers were prepared as casts of Acrylomintril Batradiene Styrene(ABS) resin and corroded in a strong solution of NaOH according to natural layers of human tissue. The source, site and structure of the posterior and lateral arterial network of elbow were observed, the number and total sectional area of anastomosing branches crossing the line between two humeral epicondyles were measured and compared with the medial and anterior region.

RESULTS

There are 8.64 +/- 2.74(36.42%) and 8.30 +/- 1.19(35.0%) anastomosing branches crossing the posterior and lateral regions, and total section areas are (0.48 +/- 0.11) mm2 and (0.37 +/- 0.03) mm2 respectively. So there is very rich arterial network around the elbow.

CONCLUSION

The enough number of anastomosing branches and their section areas of the posterior and lateral region of the elbow make it possible to connect super-regional and mutual-pedicled axial flaps crossing the elbow.

Laser Doppler perfusion imaging: new technique for determination of perfusion and reperfusion of splanchnic organs and tumor tissue

BACKGROUND AND OBJECTIVE

Several investigations indicated that laser Doppler flowmetry on the liver surface reflects relative changes of the total liver blood flow. In this study, Laser Doppler Perfusion Imaging (LDI), monitoring the surface only, was used for measurements of tissue perfusion of normal and/or impaired liver, pancreas, spleen, stomach and intestines, and the blood flow of hepatic tumors in rats.

STUDY DESIGN/MATERIALS AND METHODS

Eighty Wistar/Furth rats were divided into five groups. Group I served as controls. Groups II and III underwent ischemic injury of the liver and intestine with or without the administration of WEB2170, a platelet-activating factor receptor antagonist. Laser-induced photodynamic therapy (PDT) utilizing delta-amino levulinic acid sensitization was performed in Groups IV and V.

RESULTS

Normal pancreas and intestine had a high LDI perfusion value and the liver and stomach exhibited a medium perfusion value whereas the perfusion value from the spleen was low. WEB2170 improved the reperfusion of the postischemic liver and intestine. An immediate decrease in surface blood flow of hepatic tissue treated by laser-induced PDT and a decreased blood flow in large tumors were observed.

CONCLUSION

LDI is a useful technique for the measurement of tissue perfusion of various splanchnic organs or tumor tissues.

[Determination of furostanol saponins in Bulbus Allii Macroste]

OBJECTIVE

To establish an Ehrlich reaction-colorimetry method for determining furostanol saponins in Bulbus Allii Macroste.

METHOD

Based on the coloration reaction between furostanol saponins and p-dimethylaminobenzaldehyde, the UV detection wavelength used was 515 nm, and the optimum conditions were selected on homogeneous design principle.

RESULT

The standard curve of macrostemonoside G was linear in the concentration range of 0.1975-0.9880 mg.ml-1. The average recovery was 97.7% (RSD = 3.65%).

CONCLUSION

The method is rapid, accurate and easy to operate.

[Determination of tetramethylpyrazine in animal serum and cerebrospinal fluid by high performance liquid chromatography]

A reversed-phase high performance liquid chromatographic (RP-HPLC) method for the determination of the tetramethylpyrazine(TMP) in Chuanxiong extract, the animal(mouse) serum and cerebrospinal fluid has been developed. The TMP was separated on an ODS column Zorbax SB-C18(4.6 mm i.d. x 250 mm, 5 microns) at room temperature and detected by using UV detector at 270 nm. The mobile phase was methanol-water (50:50, V/V) containing 0.2 mmol/L of NH4H2PO4 flowing at a rate of 0.8 mL/min and 20 microL samples were injected. The detection limit of TMP was 1 mg/L and the calibration curve is linear between 5 and 500 mg/L with a correlation coefficient (r) of 0.999. The recovery of TMP ranged 98%-103%. The extract of Chuanxiong and pretreated serum and cerebrospinal fluid sample are stable for a week at room temperature.

[Transposition of expanded superficial cervical artery skin flaps for the repair of cicatricial contracture of neck]

OBJECTIVE

In order to reduce the complication of the transposition of superficial cervical artery skin flap for the repair of neck defect, the method of pre-expanded skin flap was designed, and its clinical result was observed.

METHODS

From March 1995 to October 1997, 12 cases with cicatricial contracture of the neck were treated by the following methods, preexpanded superficial cervical artery skin flap, and then transposed it for the reconstruction the cervical scar after burns. There were 8 males and 4 females and the age ranged from 6 to 32 years. A maximal size of flap was 35 cm x 14 cm and a minimal size was 16 cm x 7 cm.

RESULTS

All the flaps were survived except one, which partial necrosis occurred in the tip. Postoperative follow-up for 6 months to 3 years showed that the physiological angle of cervico-mandibular angle was recovered and the appearance of flap was satisfactory without swelling and contracture.

CONCLUSION

The preexpanded superficial cervical artery skin flap has many advantages, and it is particularly suitable for reconstruction of severe cervical contracture after extensive burns.

Detoxification of aflatoxin B1 by enzymes isolated from Armillariella tabescens

Detoxification of aflatoxin B1 (AFB1) by Armillariella tabescens multienzyme, which was isolated from mycelium pellets of A. tabescens, was confirmed by thin-layer chromatography (TLC) and rat assay. The results of toxicology and pathology studies showed that toxicity of AFB1 was minimized after treatment with A. tabescens multienzyme. The result of the Ames test indicated that the mutagenic activity of multienzyme-treated AFB1 was greatly reduced (or inactivated) compared with that of untreated controls. TLC determinations showed that AFB1 at an initial concentration of 16 microM was completely detoxified (100%) by the fungal multienzyme. The infrared spectrum suggests that the multienzyme is responsible for opening the difuran ring of AFB1.