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Shang WF, Chen DC. [Prone positioning ventilation therapy in acute respiratory distress syndrome: knowns and unknowns in clinical efficacy]. Zhonghua Yi Xue Za Zhi 2024; 104:1236-1241. [PMID: 38637162 DOI: 10.3760/cma.j.cn112137-20231012-00720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Prone positioning ventilation (PPV) is considered one of the essential therapeutic approaches in the management of acute respiratory distress syndrome (ARDS). Several randomized controlled clinical trials have demonstrated the efficacy of PPV in the treatment of patients with ARDS. However, it is not clear whether PPV treatment can reduce mortality in patients with veno-venous extracorporeal membrane oxygenation (VV-ECMO)-supported ARDS and corona virus disease 2019 (COVID-19)-associated ARDS. This review aims to discuss the known and unknown aspects of the mechanism of PPV for ARDS, the clinical efficacy of PPV for ARDS, VV-ECMO-supported ARDS, and COVID-19-related ARDS.
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Affiliation(s)
- W F Shang
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - D C Chen
- Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Si D, Su B, Zhang J, Zhao K, Li J, Chen D, Hu S, Wang X. Low-level laser therapy with different irradiation methods modulated the response of bone marrow mesenchymal stem cells in vitro. Lasers Med Sci 2022; 37:3509-3516. [PMID: 36066778 DOI: 10.1007/s10103-022-03624-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/03/2022] [Indexed: 10/14/2022]
Abstract
Low-level laser therapy (LLLT) also known as photobiomodulation is a treatment to change cellular biological activity. The exact effects of LLLT remain unclear due to the different irradiation protocols. The purpose of this study was to investigate the effects of LLLT by three different irradiation methods on the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in vitro. BMSCs were inoculated in 24-well plates and then irradiated or not (control) with a laser using three different irradiation methods. The irradiation methods were spot irradiation, covering irradiation, and scanning irradiation according to different spot areas (0.07 cm2 or 1.96 cm2) and irradiation areas (0.35 cm2 or 1.96 cm2), respectively. The laser was applied three times at energy densities of 4 J/cm2. The cell proliferation by CCK-8. ALP activity assay, alizarin red, and quantitative real-time polymerase chain reaction (RT-PCR) were performed to assess osteogenic differentiation and mineralization. Increases in cell proliferation was obvious following irradiation, especially for covering irradiation. The ALP activity was significantly increased in irradiated groups compared with non-irradiated control. The level of mineralization was obviously improved following irradiation, particularly for covering irradiation. RT-PCR detected significantly higher expression of ALP, OPN, OCN, and RUNX-2 in the group covering than in the others, and control is the lowest. The presented results indicate that the biostimulative effects of LLLT on BMSCs was influenced by t he irradiation method, and the covering irradiation is more favorable method to promote the proliferation and osteogenic differentiation of BMSCs.
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Affiliation(s)
- Daiwei Si
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Bo Su
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Jingwei Zhang
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Kui Zhao
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - JinMeng Li
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - DeChun Chen
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - ShiQi Hu
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Xintao Wang
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, China.
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Cui L, Xiang S, Chen D, Fu R, Zhang X, Chen J, Wang X. A novel tissue-engineered bone graft composed of silicon-substituted calcium phosphate, autogenous fine particulate bone powder and BMSCs promotes posterolateral spinal fusion in rabbits. J Orthop Translat 2020; 26:151-161. [PMID: 33437634 PMCID: PMC7773983 DOI: 10.1016/j.jot.2020.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 11/15/2022] Open
Abstract
Background Autogenous bone graft is the gold standard bone grafting substrate available in spinal fusion because of its osteoconductive, osteogenic, and osteoinductive properties. However, several shortcomings including bleeding, infection, chronic pain, and nerve injury are known to be associated with the procedure. Bone tissue engineering has emerged as an alternative therapeutic strategy for bone grafts. New materials have been developed and tested that can substitute for the autogenous bone grafts used in the spinal fusion. The purpose of this study is to evaluate the role of a novel tissue-engineered bone graft with silicon-substituted calcium phosphate (Si-CaP), autogenous fine particulate bone powder (AFPBP), and bone marrow mesenchymal stem cells (BMSCs) using a rabbit posterolateral lumbar fusion model based on bone tissue engineering principles. The application of this graft can represent a novel choice for autogenous bone to reduce the amount of autogenous bone and promote spinal fusion. Methods BMSCs from New Zealand white rabbits were isolated and cultured in vitro. Then, BMSCs were marked by the cell tracker chloromethyl-benzamidodialkylcarbocyanine (CM-Dil). A total of 96 New Zealand White rabbits were randomly divided into four groups: (a) AFPBP, (b) Si-CaP, (c) Si-CaP/AFPBP, (d) Si-CaP/AFPBP/BMSCs.The rabbits underwent bilateral posterolateral spine arthrodesis of the L5-L6 intertransverse processes using different grafts. Spinal fusion and bone formation were evaluated at 4, 8, and 12 weeks after surgery by manual palpation, radiology, micro-computed tomography (micro-CT), histology, and scanning electronic microscopy (SEM). Results The rate of fusion by manual palpation was higher in the Si-CaP/AFPBP/BMSCs group than the other groups at 8 weeks. The fusion rates in the Si-CaP/AFPBP/BMSCs and the AFPBP groups both reached 100%, which was higher than the Si-CaP/AFPBP group (62.5%) (P > 0.05) and Si-CaP group (37.5%) (P < 0.05) at 12 weeks. New bone formation was observed in all groups after implantation by radiology and micro-CT. The radiographic and CT scores increased in all groups from 4 to 12 weeks, indicating a time-dependent osteogenetic process. The Si-CaP/AFPBP/BMSCs group showed a larger amount of newly formed bone than the Si-CaP/AFPBP and Si-CaP groups at 12 weeks. Bone formation in the Si-CaP/AFPBP/BMSCs group was similar to the AFPBP group. Histology showed that new bone formation continued and increased along with the degradation and absorption of Si-CaP and AFPBP from 4 to 12 weeks in the Si-CaP, Si-CaP/AFPBP, and Si-CaP/AFPBP/BMSCs groups. At 4 weeks, a higher proportion of bone was detected in the AFPBP group (23.49%) compared with the Si-CaP/AFPBP/BMSCs group (14.66%, P < 0.05). In the Si-CaP/AFPBP/BMSCs group at 8 weeks, the area percentage of new bone formation was 28.56%, which was less than the AFPBP group (33.21%, P < 0.05). No difference in bone volume was observed between the Si-CaP/AFPBP/BMSCs group (44.39%) and AFPBP group (45.06%) at 12 weeks (P > 0.05). At 12 weeks, new trabecular were visible in the Si-CaP/AFPBP/BMSCs group by SEM. CM-Dil-positive cells were observed at all stages. Compared with histological images, BMSCs participate in various stages of osteogenesis by transforming into osteoblasts, chondrocytes, and osteocytes. Conclusion This study demonstrated for the first time that Si-CaP/AFPBP/BMSCs is a novel tissue-engineered bone graft with excellent bioactivity, biocompatibility, and biodegradability. The graft could reduce the amount of autogenous bone and promote spinal fusion in a rabbit posterolateral lumbar fusion model, representing a novel alternative to autogenous bone. The Translational potential of this article The translational potential of this article lies in that this graft will be a novel spinal fusion graft with great potential for clinical applications.
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Affiliation(s)
- LiHuang Cui
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - ShouYang Xiang
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - DeChun Chen
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Rui Fu
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xin Zhang
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - JingTao Chen
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - XinTao Wang
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Zhong QH, Huang XY, Li Y, He YJ, Qin QY, Wang HM, Chen DC, Wang H, Ma TH. [Feasibility and safety of laparoscopic Parks procedure for chronic radiation proctopathy]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:745-751. [PMID: 32810945 DOI: 10.3760/cma.j.issn.441530-20200521-00294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To preliminarily evaluate the feasibility and safety of laparoscopic Parks procedure for chronic radiation proctopathy (CRP). Methods: A descriptive cohort study was carried out. The clinical and follow-up data of 19 patients who received laparoscopic Parks procedure due to CRP in the Sixth Affiliated Hospital of Sun Yat-sen University from July 2013 to March 2019 were retrospectively analyzed. Inclusion criteria: (1) serious late complications occurred after pelvic radiotherapy, e.g.serious intractable hematochezia (hemoglobin <70 g/L), intractable anal pain (numerical rating scale >7), rectostenosis, perforation, and fistula. (2) imaging examinations including colonoscopy, pelvic MRI and/or chest, abdomen and pelvic CT were performed before surgery to confirm the lesions. Exclusion criteria: (1) preoperative or intraoperative diagnosis of tumor recurrence; (2) only ostomy was performed after laparoscopic exploration; (3) after neoadjuvant radiotherapy for rectal cancer; (4) incomplete medical records. Surgical procedures: (1) Laparoscopic exploration: tumor recurrence was excluded, and the range of radioactive damage in the intestine was determined. Marks were made on the proximal sigmoid colon without grossly obvious edema, thickening or radioactive injuries. (2) Abdominal operation: the right mesentery of sigmoid colon and rectum was opened, inferior mesenteric vein and inferior mesenteric artery were divided and the Toldt gap was expanded inwards and cephalad. The outside of left hemicolon was freed, the gastrocolic ligament was opened, the splenic flexure was fully mobilized, and the rectum was separated from the rear, side and front to the lowest point. Then perineal operation was performed. (3) Perineal operation: the whole layer of rectum wall was cut thoroughly at 1cm below the lesion's lower margin, the space around the rectum was fully separated, the rectum and sigmoid colon was pulled out through the anus and cut off at the site of the grossly normal intestine, the diseased bowel was removed and a coloanal anastomosis was made. (4) A protective stoma was performed. Conditions of operation, complication and symptom relief were summarized. A descriptive statistic method was used to analyze the results. Results: All the 19 patients were female with a median age of 53 (interquartiles, 50, 56) years old, of whom 18 patients had primary cervical cancer. Surgical indications: 9 cases were rectovaginal fistula; 9 cases were intractable anal pain, among whom 7 were complicated with deep rectal ulcer; and 1 case was intractable hematochezia with deep rectal ulcer. Eighteen cases completed laparoscopic Parks procedure, while 1 case was converted to laparotomy. The median operative time was 215 (131, 270) minutes, the median bleeding volume was 50 (50, 100) ml, and the median hospital stay was 12 (11, 20) days. There was no perioperative death. Ten cases had postoperative complications, including 3 cases of serious complications (CD grade IIIb and above) within 30 days after operation, of whom one case developed pelvic infection caused by rectovaginal, rectovesical and rectourethral fistula and acute renal failure (IVa); 2 cases developed orifice prolapse and parastomal hernia (IIIb). Seven cases had anastomosis-related complications, including 4 cases of grade A anastomotic leakage and 3 cases of anastomotic stenosis. Symptoms of CRP in the whole group were significantly relieved or disappeared after one year of the operation. Five cases achieved stoma closure. Conclusions: Laparoscopic Parks procedure for chronic radiation proctopathy is safe and feasible, and can effectively improve symptoms. However, the incidence of anastomotic complications is high, so the surgical indications should be strictly controlled.
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Affiliation(s)
- Q H Zhong
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou, Guangdong 510655, China
| | - X Y Huang
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou, Guangdong 510655, China
| | - Y Li
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou, Guangdong 510655, China
| | - Y J He
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou, Guangdong 510655, China
| | - Q Y Qin
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou, Guangdong 510655, China
| | - H M Wang
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou, Guangdong 510655, China
| | - D C Chen
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou, Guangdong 510655, China
| | - H Wang
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou, Guangdong 510655, China
| | - T H Ma
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou, Guangdong 510655, China
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Chen DC, Zhong QH, Chen S. [Basics of vascular damage and progress of diagnosis and treatment in radiation intestinal injury]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:817-822. [PMID: 32810958 DOI: 10.3760/cma.j.cn.441530-20200511-00270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Radiation intestinal injury is one of the most common complications after abdominal pelvic radiotherapy, which seriously affects the quality of life for patients. According to the site of occurrence, it is divided into radiation enteritis, colitis and proctitis. The pathological characteristics of radiation intestinal injury mainly include interstitial fibrosis, mucosal edema, ulcers, and inflammatory cell infiltration, and significant vascular lesions as well. It showed telangiectasia and hemorrhage under endoscopy. Under ultrasound examination, it showed diffusive thickening of the intestinal wall and increased blood flow signals. In addition, it also has other features such as increased thickness of the distal sigmoid colon and rectal wall, and increased width of the presacral space. The key factors in the incidence and development of radiation intestinal injury include angiostatin, PDGF, CXCL16, etc. The mechanisms to be clarified include abnormally heightened angiostatin through which signal pathways specifically affect vascular endothelial cells and inhibit angiogenesis and vascular homeostasis, how CXCL16 expressed by macrophages interacting with receptor promotes the transformation of fibroblasts and vascular smooth muscle cells into myofibroblasts, etc. Therapy targeted on basics of vascular damage will be a promising field of radiation intestinal injury research.
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Affiliation(s)
- D C Chen
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, China
| | - Q H Zhong
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, China
| | - S Chen
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510655, China
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Konschake M, Zwierzina M, Moriggl B, Függer R, Mayer F, Brunner W, Schmid T, Chen DC, Fortelny R. The inguinal region revisited: the surgical point of view : An anatomical-surgical mapping and sonographic approach regarding postoperative chronic groin pain following open hernia repair. Hernia 2019; 24:883-894. [PMID: 31776877 PMCID: PMC7395915 DOI: 10.1007/s10029-019-02070-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/11/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Inguinodynia or chronic post-herniorrhaphy pain, defined as pain lasting longer than 3 months after open inguinal hernia repair, has become the most important complication after inguinal surgery and therefore compromises the patient´s quality of life. A major reason for inguinodynia might be the lack of neuroanatomical knowledge and suboptimal "management" of the nerves during surgery. METHODS We present a detailed neuroanatomic mapping of the inguinal region by dissection including the most important surgical landmarks with all nerves confirmed by immunohistochemistry, ultrasound guided visualization of the iliohypogastric, ilio-inguinal, and genital branch of the genitofemoral nerve, and a practical (preoperative) algorithm for clinical management. RESULTS Surgically and ultrasonographically relevant structures ("landmarks") in open hernia repair are the anterior-superior iliac spine, pubic tubercle, Camper´s fascia (superficial layer of the superficial abdominal fascia), External oblique aponeurosis, Internal oblique muscle, Transversus abdominis muscle, superficial inguinal ring, external spermatic fascia, cremasteric fascia with cremaster muscle fibers, internal spermatic fascia, cremasteric vein (=external spermatic vein = "blue line"), ductus deferens, pampiniform plexus, inguinal ligament and the inferior epigastric vessels. CONCLUSION A detailed understanding of inguinal anatomy is an indispensable basic requirement for all surgeons to perform inguinal ultrasonography as well as open inguinal hernia repair, avoiding complications, especially postoperative inguinodynia.
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Affiliation(s)
- M Konschake
- Department of Anatomy, Histology and Embryology, Division of Clinical and Functional Anatomy, Medical University of Innsbruck, Müllerstr. 59, 6020, Innsbruck, Austria.
| | - M Zwierzina
- Department of Plastic, Reconstructive and Aesthetic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - B Moriggl
- Department of Anatomy, Histology and Embryology, Division of Clinical and Functional Anatomy, Medical University of Innsbruck, Müllerstr. 59, 6020, Innsbruck, Austria
| | - R Függer
- Department of Surgery, Elisabethinen Hospital, Linz, Austria
| | - F Mayer
- Department of Surgery, Paracelsus Medical University, Salzburg, Austria
| | - W Brunner
- Department of Surgery, Kantonspital St. Gallen, St. Gallen, Switzerland
| | - T Schmid
- Department for Visceral-, Transplantation- and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - D C Chen
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Lichtenstein Amid Hernia Clinic, Santa Monica, CA, USA
| | - R Fortelny
- Department of General-, Visceral- and Oncological Surgery, Wilhelminenspital, Vienna, Austria
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Wen ZL, Chen DC. [Clinical significance of intestinal micro-ecological symbiosis disruption in critically ill patients]. Zhonghua Yi Xue Za Zhi 2019; 99:1921-1924. [PMID: 31269590 DOI: 10.3760/cma.j.issn.0376-2491.2019.25.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Z L Wen
- Department of Intensive Care Medicine, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 201821, China
| | - D C Chen
- Department of Intensive Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Yin MG, Wang XT, Liu DW, Chao YG, Guan XD, Kang Y, Yan J, Ma XC, Tang YQ, Hu ZJ, Yu KJ, Chen DC, Ai YH, Zhang LN, Zhang HM, Wu J, Liu LX, Zhu R, He W, Zhang Q, Ding X, Li L, Li Y, Liu HT, Zeng QB, Si X, Chen H, Zhang JW, Xu QH, Chen WJ, Chen XK, Huang DZ, Cai SH, Shang XL, Guan J, Du J, Zhao L, Wang MJ, Cui S, Wang XM, Zhou R, Zeng XY, Wang YP, Lyu LW, Zhu WH, Zhu Y, Duan J, Yang J, Yang H. [Technical specification for clinical application of critical ultrasonography]. Zhonghua Nei Ke Za Zhi 2018; 57:397-417. [PMID: 29925125 DOI: 10.3760/cma.j.issn.0578-1426.2018.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound, the examiner and interpreter of the image are critical care medicine physicians. The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes. With the idea of critical care medicine as the soul, it can integrate the above information and clinical information, bedside real-time diagnosis and titration treatment, and evaluate the therapeutic effect so as to improve the outcome. CUS is a traditional technique which is applied as a new application method. The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept, implementation and application of CUS. It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure. At the same time, the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications, and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS. Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group, based on the rich experience of clinical practice in critical care and research, combined with the essence of CUS, to learn the traditional ultrasonic essence, established the clinical application technical specifications of CUS, including in five parts: basic view and relevant indicators to obtain in CUS; basic norms for viscera organ assessment and special assessment; standardized processes and systematic inspection programs; examples of CUS applications; CUS training and the application of qualification certification. The establishment of applied technology standard is helpful for standardized training and clinical correct implementation. It is helpful for clinical evaluation and correct guidance treatment, and is also helpful for quality control and continuous improvement of CUS application.
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Affiliation(s)
| | | | - D W Liu
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Wang XT, Liu DW, Zhang HM, Long Y, Guan XD, Qiu HB, Yu KJ, Yan J, Zhao H, Tang YQ, Ding X, Ma XC, Du W, Kang Y, Tang B, Ai YH, He HW, Chen DC, Chen H, Chai WZ, Zhou X, Cui N, Wang H, Rui X, Hu ZJ, Li JG, Xu Y, Yang Y, Ouyan B, Lin HY, Li YM, Wan XY, Yang RL, Qin YZ, Chao YG, Xie ZY, Sun RH, He ZY, Wang DF, Huang QQ, Jiang DP, Cao XY, Yu RG, Wang X, Chen XK, Wu JF, Zhang LN, Yin MG, Liu LX, Li SW, Chen ZJ, Luo Z. [Experts consensus on the management of the right heart function in critically ill patients]. Zhonghua Nei Ke Za Zhi 2018; 56:962-973. [PMID: 29202543 DOI: 10.3760/cma.j.issn.0578-1426.2017.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle. (2) Right heart function management is a key step of the hemodynamic therapy in critically ill patients. (3) Fluid resuscitation means the process of fluid therapy through rapid adjustment of intravascular volume aiming to improve tissue perfusion. Reversed fluid resuscitation means reducing volume. (4) The right ventricle afterload should be taken into consideration when using stroke volume variation (SVV) or pulse pressure variation (PPV) to assess fluid responsiveness.(5)Volume overload alone could lead to septal displacement and damage the diastolic function of the left ventricle. (6) The Starling curve of the right ventricle is not the same as the one applied to the left ventricle,the judgement of the different states for the right ventricle is the key of volume management. (7) The alteration of right heart function has its own characteristics, volume assessment and adjustment is an important part of the treatment of right ventricular dysfunction (8) Right ventricular enlargement is the prerequisite for increased cardiac output during reversed fluid resuscitation; Nonetheless, right heart enlargement does not mandate reversed fluid resuscitation.(9)Increased pulmonary vascular resistance induced by a variety of factors could affect right heart function by obstructing the blood flow. (10) When pulmonary hypertension was detected in clinical scenario, the differentiation of critical care-related pulmonary hypertension should be a priority. (11) Attention should be paid to the change of right heart function before and after implementation of mechanical ventilation and adjustment of ventilator parameter. (12) The pulmonary arterial pressure should be monitored timingly when dealing with critical care-related pulmonary hypertension accompanied with circulatory failure.(13) The elevation of pulmonary aterial pressure should be taken into account in critical patients with acute right heart dysfunction. (14) Prone position ventilation is an important measure to reduce pulmonary vascular resistance when treating acute respiratory distress syndrome patients accompanied with acute cor pulmonale. (15) Attention should be paid to right ventricle-pulmonary artery coupling during the management of right heart function. (16) Right ventricular diastolic function is more prone to be affected in critically ill patients, the application of critical ultrasound is more conducive to quantitative assessment of right ventricular diastolic function. (17) As one of the parameters to assess the filling pressure of right heart, central venous pressure can be used to assess right heart diastolic function. (18). The early and prominent manifestation of non-focal cardiac tamponade is right ventricular diastolic involvement, the elevated right atrial pressure should be noticed. (19) The effect of increased intrathoracic pressure on right heart diastolic function should be valued. (20) Ttricuspid annular plane systolic excursion (TAPSE) is an important parameter that reflects right ventricular systolic function, and it is recommended as a general indicator of critically ill patient. (21) Circulation management with right heart protection as the core strategy is the key point of the treatment of acute respiratory distress syndrome. (22) Right heart function involvement after cardiac surgery is very common and should be highly valued. (23) Right ventricular dysfunction should not be considered as a routine excuse for maintaining higher central venous pressure. (24) When left ventricular dilation, attention should be paid to the effect of left ventricle on right ventricular diastolic function. (25) The impact of left ventricular function should be excluded when the contractility of the right ventricle is decreased. (26) When the right heart load increases acutely, the shunt between the left and right heart should be monitored. (27) Attention should be paid to the increase of central venous pressure caused by right ventricular dysfunction and its influence on microcirculation blood flow. (28) When the vasoactive drugs was used to reduce the pressure of pulmonary circulation, different effects on pulmonary and systemic circulation should be evaluated. (29) Right atrial pressure is an important factor affecting venous return. Attention should be paid to the influence of the pressure composition of the right atrium on the venous return. (30) Attention should be paid to the role of the right ventricle in the acute pulmonary edema. (31) Monitoring the difference between the mean systemic filling pressure and the right atrial pressure is helpful to determine whether the infusion increases the venous return. (32) Venous return resistance is often considered to be a insignificant factor that affects venous return, but attention should be paid to the effect of the specific pathophysiological status, such as intrathoracic hypertension, intra-abdominal hypertension and so on. Consensus can promote right heart function management in critically ill patients, optimize hemodynamic therapy, and even affect prognosis.
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Affiliation(s)
| | - D W Liu
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Zhong QH, Wu PH, Qin QY, Kuang YY, Ma TH, Wang HM, Zhu YX, Chen DC, Wang JP, Wang L. [Pathological insights of radiotherapy-related damage to surgical margin after preoperative radiotherapy in patients with rectal cancer]. Zhonghua Wai Ke Za Zhi 2017; 55:507-514. [PMID: 28655079 DOI: 10.3760/cma.j.issn.0529-5815.2017.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of irradiation to anastomosis from preoperative radiotherapy for patients with rectal cancer by studying the pathological changes. Methods: In this retrospective study, patients enrolled in the FOWARC study from January 2011 to July 2014 in the Sixth Affiliated Hospital of Sun Yat-Sen University were included. In the FOWARC study, enrolled patients with local advanced rectal cancer were randomly assigned to receive either neoadjuvant chemo-radiotherapy or chemotherapy. Among these patients, 23 patients were selected as radiation proctitis (RP)group, who fulfilled these conditions: (1) received neoadjuvant chemo-radiotherapy followed by sphincter-preserving surgery; (2) developed radiation proctitis as confirmed by preoperative imaging diagnosis; (3) had intact clinical samples of surgical margins. Twenty-three patients who had received neoadjuvant chemo-radiotherapy but without development of radiation proctitis were selected as non-radiation proctitis (nRP) group. Meanwhile, 23 patients received neoadjuvant chemotherapy only were selected as neoadjuvant chemotherapy (CT) group. Both nRP and CT cases were selected by ensuring the basic characteristics such as sex, age, tumor site, lengths of proximal margin and distal margin all maximally matched to the RP group. Both proximal and distal margins were collected for further analysis for all selected cases. Microscopy slices were prepared for hematoxylin & eosin staining and Masson staining to show general pathological changes, and also for immunohistochemistry with anti-CD-34 as primary antibody to reveal the microvessel. Microvessel counting in submucosal layer and proportion of macrovessel with stenosis were used to evaluate the blood supply of the proximal and distal end of anastomosis. A modified semi-quantitative grading approach was used to evaluate the severity of radiation-induced injury. Either ANOVA analysis, Kruskal-Wallis rank-sum test or χ(2) test was used for comparison among three groups, and Mann-Whitney U test was used for comparison between two groups. Results: Compared to group of neoadjuvant chemotherapy only, patients receiving neoadjuvant chemo-radiotherapy had lower microvessel count in both proximal and distal margins (M(Q(R)): proximal, 25.5 (19.6) vs. 50.0 (25.0), Z=3.915, P=0.000; distal, 20.5 (17.5) vs. 49.0 (28.0), Z=3.558, P=0.000), higher proportions of macrovessel with stenosis (proximal, 9.5% (23.8%) vs. 0, Z=3.993, P=0.000; distal, 11.5%(37.3%) vs. 0 (2.0%), Z=2.893, P=0.004), higher histopathologic score (proximal, 4.0 (2.0) vs. 1.0 (2.0), Z=6.123, P=0.000; distal, 5.0 (3.0) vs. 2.0 (1.0), Z=4.849, P=0.000). In patients receiving neoadjuvant chemo-radiotherapy, compared to nRP group, RP group had lower microvessel count in both proximal and distal margins (proximal, 19.0 (23.0) vs. 30.4 (38.0), Z=2.845, P=0.004; distal, 19.0 (13.0) vs. 30.0(29.1), Z=2.022, P=0.043), higher proportions of macrovessel with stenosis (proximal, 23.0% (40.0%) vs. 0(11.0%), Z=3.248, P=0.001; distal, 27.0% (45.0%) vs. 3.0% (19.0%), Z=2.164, P=0.030). Rate of anastomotic leakage for CT, nRP and RP group were 8.7% (2/23), 30.4% (7/23), and 52.2% (12/23), and the differences among three groups were statistically significant (χ(2)=10.268, P=0.007). Conclusion: Radiation-induced injury existed on both margins of the resected rectal site after preoperative radiotherapy, and those diagnosed as radiation proctitis had more severe microvascular injury.
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Affiliation(s)
- Q H Zhong
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou 510655, China
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Bjurström MF, Álvarez R, Nicol AL, Olmstead R, Amid PK, Chen DC. Quantitative validation of sensory mapping in persistent postherniorrhaphy inguinal pain patients undergoing triple neurectomy. Hernia 2017; 21:207-214. [PMID: 28091815 DOI: 10.1007/s10029-017-1580-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 01/06/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE Neurectomy of the inguinal nerves may be considered for selected refractory cases of chronic postherniorrhaphy inguinal pain (CPIP). There is to date a paucity of easily applicable clinical tools to identify neuropathic pain and examine the neurosensory effects of remedial surgery. The present quantitative sensory testing (QST) pilot study evaluates a sensory mapping technique. METHODS Longitudinal (preoperative, immediate postoperative, and late postoperative) dermatomal sensory mapping and a comprehensive QST protocol were conducted in CPIP patients with unilateral, predominantly neuropathic inguinodynia presenting for triple neurectomy (n = 13). QST was conducted in four areas on the affected, painful side and in one contralateral comparison site. QST variables were compared according to sensory mapping outcomes: (o)/normal sensation, (+)/pain, and (-)/numbness. Diagnostic ability of the sensory mapping outcomes to detect QST-assessed allodynia or hypoesthesia was estimated through calculation of specificity and sensitivity values. RESULTS Preoperatively, patients exhibited mechanical hypoesthesia and allodynia and pressure allodynia and hyperalgesia in painful areas mapped (+) (p < .05); sensory mapping outcome (+) demonstrated high ability to detect mechanical allodynia [sensitivity 0.74 (95% CI 0.61-0.86), specificity 0.94 (0.84-1.00)] and pressure allodynia [sensitivity 0.96 (0.89-1.00), specificity 1.00 (1.00-1.00)], but not thermal allodynia. Postoperatively, mapped areas of numbness (-) were associated with mechanical and thermal hypoesthesia (p < .05); (-) showed high sensitivity and specificity to detect mechanical and cold hypoesthesia. CONCLUSIONS Sensory mapping provides an accurate clinical neuropathic assessment with strong correlation to QST findings of preoperative mechanical and pressure allodynia, and postoperative mechanical and thermal hypoesthesia in CPIP patients undergoing neurectomy.
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Affiliation(s)
- M F Bjurström
- Department of Anesthesiology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA. .,Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), 300 UCLA Medical Plaza, Suite 3132, Los Angeles, CA, 90095-7076, USA.
| | - R Álvarez
- Department of Abdominal Wall Surgery, Proben Hernia Clinic, Universidad de Monterrey (UDEM), Guadalajara, Mexico
| | - A L Nicol
- Department of Anesthesiology, University of Kansas, Kansas City, KS, USA
| | - R Olmstead
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), 300 UCLA Medical Plaza, Suite 3132, Los Angeles, CA, 90095-7076, USA
| | - P K Amid
- Department of Surgery, Lichtenstein Amid Hernia Clinic at UCLA, Los Angeles, CA, USA
| | - D C Chen
- Department of Surgery, Lichtenstein Amid Hernia Clinic at UCLA, Los Angeles, CA, USA
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12
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Chen DC, Du XD, Yin GZ, Yang KB, Nie Y, Wang N, Li YL, Xiu MH, He SC, Yang FD, Cho RY, Kosten TR, Soares JC, Zhao JP, Zhang XY. Impaired glucose tolerance in first-episode drug-naïve patients with schizophrenia: relationships with clinical phenotypes and cognitive deficits. Psychol Med 2016; 46:3219-3230. [PMID: 27604840 DOI: 10.1017/s0033291716001902] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Schizophrenia patients have a higher prevalence of type 2 diabetes mellitus with impaired glucose tolerance (IGT) than normals. We examined the relationship between IGT and clinical phenotypes or cognitive deficits in first-episode, drug-naïve (FEDN) Han Chinese patients with schizophrenia. METHOD A total of 175 in-patients were compared with 31 healthy controls on anthropometric measures and fasting plasma levels of glucose, insulin and lipids. They were also compared using a 75 g oral glucose tolerance test and the homeostasis model assessment of insulin resistance (HOMA-IR). Neurocognitive functioning was assessed using the MATRICS Consensus Cognitive Battery (MCCB). Patient psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). RESULTS Of the patients, 24.5% had IGT compared with none of the controls, and they also had significantly higher levels of fasting blood glucose and 2-h glucose after an oral glucose load, and were more insulin resistant. Compared with those patients with normal glucose tolerance, the IGT patients were older, had a later age of onset, higher waist or hip circumference and body mass index, higher levels of low-density lipoprotein and triglycerides and higher insulin resistance. Furthermore, IGT patients had higher PANSS total and negative symptom subscale scores, but no greater cognitive impairment except on the emotional intelligence index of the MCCB. CONCLUSIONS IGT occurs with greater frequency in FEDN schizophrenia, and shows association with demographic and anthropometric parameters, as well as with clinical symptoms but minimally with cognitive impairment during the early course of the disorder.
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Affiliation(s)
- D C Chen
- Beijing HuiLongGuan Hospital,Peking University,Beijing,People's Republic of China
| | - X D Du
- Suzhou Psychiatric Hospital,Suzhou,Jiangsu Province,People's Republic of China
| | - G Z Yin
- Suzhou Psychiatric Hospital,Suzhou,Jiangsu Province,People's Republic of China
| | - K B Yang
- Beijing HuiLongGuan Hospital,Peking University,Beijing,People's Republic of China
| | - Y Nie
- Beijing HuiLongGuan Hospital,Peking University,Beijing,People's Republic of China
| | - N Wang
- Beijing HuiLongGuan Hospital,Peking University,Beijing,People's Republic of China
| | - Y L Li
- Beijing HuiLongGuan Hospital,Peking University,Beijing,People's Republic of China
| | - M H Xiu
- Beijing HuiLongGuan Hospital,Peking University,Beijing,People's Republic of China
| | - S C He
- Department of Psychology,Peking University,Beijing,People's Republic of China
| | - F D Yang
- Beijing HuiLongGuan Hospital,Peking University,Beijing,People's Republic of China
| | - R Y Cho
- Department of Psychiatry and Behavioral Sciences,The University of Texas Health Science Center at Houston,Houston, TX,USA
| | - T R Kosten
- Department of Psychiatry and Behavioral Sciences,Baylor College of Medicine,Houston, TX,USA
| | - J C Soares
- Department of Psychiatry and Behavioral Sciences,The University of Texas Health Science Center at Houston,Houston, TX,USA
| | - J P Zhao
- Mental Health Institute of the Second Xiangya Hospital, Central South University,Changsha,People's Republic of China
| | - X Y Zhang
- Beijing HuiLongGuan Hospital,Peking University,Beijing,People's Republic of China
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Zhang ZL, Liao EY, Xia WB, Lin H, Cheng Q, Wang L, Hao YQ, Chen DC, Tang H, De Peng Y, You L, He L, Hu ZH, Song CL, Wei F, Wang J, Zhang L, Santora AC. Erratum to: Alendronate sodium/vitamin D₃ combination tablet versus calcitriol for osteoporosis in Chinese postmenopausal women: a 6-month, randomized, open-label, active-comparator-controlled study with a 6-month extension. Osteoporos Int 2015; 26:2719-20. [PMID: 26377424 PMCID: PMC4713924 DOI: 10.1007/s00198-015-3247-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Z L Zhang
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, The Sixth People's Hospital, Shanghai Jiaotong University, 600 Yi-Shan Road, Shanghai, 200233, China.
| | - E Y Liao
- The Second Xiangya Hospital, Central South University, Changsha, China
| | - W B Xia
- Peking Union Medical College Hospital, Beijing, China
| | - H Lin
- Nanjing Drum Tower Hospital, Nanjing, China
| | - Q Cheng
- Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - L Wang
- Tianjin Hospital, Tianjin, China
| | - Y Q Hao
- Shanghai Ninth People's Hospital, Shanghai, China
| | - D C Chen
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - H Tang
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Y De Peng
- Shanghai First People's Hospital, Shanghai, China
| | - L You
- Shanghai First People's Hospital, Shanghai, China
| | - L He
- Beijing Jishuitan Hospital, Beijing, China
| | - Z H Hu
- Peking University People's Hospital, Beijing, China
| | - C L Song
- Peking University Third Hospital, Beijing, China
| | - F Wei
- Global Medical Affairs, Merck Sharp & Dohme China, Shanghai, China
| | - J Wang
- Global Medical Affairs, Merck Sharp & Dohme China, Shanghai, China
| | - L Zhang
- Global Medical Affairs, Merck Sharp & Dohme China, Shanghai, China
| | - A C Santora
- Merck Research Laboratories, Rahway, NJ, USA
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Zhang ZL, Liao EY, Xia WB, Lin H, Cheng Q, Wang L, Hao YQ, Chen DC, Tang H, De Peng Y, You L, He L, Hu ZH, Song CL, Wei F, Wang J, Zhang L, Santora AC. Alendronate sodium/vitamin D3 combination tablet versus calcitriol for osteoporosis in Chinese postmenopausal women: a 6-month, randomized, open-label, active-comparator-controlled study with a 6-month extension. Osteoporos Int 2015; 26:2365-74. [PMID: 25929192 PMCID: PMC4532726 DOI: 10.1007/s00198-015-3141-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 04/13/2015] [Indexed: 12/13/2022]
Abstract
UNLABELLED This study compares efficacy of ALN/D5600 versus that of calcitriol in osteoporotic Chinese postmenopausal women. ALN/D5600 produced greater bone mineral density (BMD) increases, greater bone turnover marker decreases, and less vitamin D insufficiency. This study provided detailed clinical information regarding ALN/D5600 treatment versus calcitriol 0.25 μg/day. The study did not evaluate fracture risk. INTRODUCTION The aim of this study is to investigate efficacy of alendronate 70 mg/vitamin D3 5600 IU combination tablets (ALN/D5600) versus calcitriol in osteoporotic Chinese postmenopausal women. METHODS This study is a 6-month, randomized, open-label, active-comparator study with 6-month extension (clinicaltrials.gov number NCT01350934) in postmenopausal women aged >55 years with osteoporosis (low bone mineral density (BMD) with/without prior fragility fracture). Patients were randomized to ALN/D5600 once weekly or calcitriol 0.25 μg daily. The primary efficacy end point of the base study was percent change from baseline in lumbar spine BMD (month 6). Hypercalcemia and hypercalciuria were safety events of special interest. RESULTS A total of 219 patients (ALN/D5600 n = 111, calcitriol n = 108) were randomized. Baseline characteristics were similar, 30.3 % baseline 25-hydroxyvitamin D (25(OH)D) ≤15 ng/mL. At months 6 and 12, changes in lumbar spine BMD from baseline were 3.5 versus 1.6 % and 5.2 versus 2.3 % for ALN/D5600 versus calcitriol (between-group differences p < 0.001), respectively. Between-group differences for ALN/D5600 versus calcitriol were significant (p < 0.001) at months 6 and 12 for change from baseline in procollagen type 1 N-terminal propeptide (-59.1 versus -16.8 %, -68.1 versus -17.0 %) and serum C-telopeptides (-79.2 versus -27.2 %, -76.2 versus -24.2 %). Drug-related adverse events (AEs) and discontinuations due to drug-related AEs occurred in 15 (14.0 %) versus 8 (7.4 %) patients and 3 (2.8 %) versus 0 patients in the ALN/D5600 and calcitriol group, respectively. Hypercalciuria 12-month incidence (24-h urine Ca >300 mg) was 8.4 (ALN/D5600) versus 13.9 % (calcitriol) (p > 0.05). One patient (calcitriol) had hypercalcemia. CONCLUSIONS ALN/D5600 produced greater increases in lumbar spine BMD and greater decreases in bone turnover markers versus calcitriol in osteoporotic Chinese women. It is not known whether the greater increase in BMD results in fewer fractures. ALN/D5600 was generally well tolerated in Chinese patients.
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Affiliation(s)
- Z L Zhang
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, The Sixth People's Hospital, Shanghai Jiaotong University, 600 Yi-Shan Road, Shanghai, 200233, China,
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Zhang XY, Chen DC, Xiu MH, Haile CN, He SC, Luo X, Zuo L, Rosenheck R, Kosten TA, Kosten TR. Cigarette smoking, psychopathology and cognitive function in first-episode drug-naive patients with schizophrenia: a case-control study. Psychol Med 2013; 43:1651-1660. [PMID: 23149169 DOI: 10.1017/s0033291712002590] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although patients with chronic schizophrenia have substantially higher smoking rates than either the general population or patients with other mental illnesses, drug-naive patients with a first episode of schizophrenia have received little systemic study. This study examined smoking rates, the association between smoking and symptom severity and cognitive function in Chinese first-episode schizophrenia (FES) patients using cross-sectional and case-control designs. METHOD Two hundred and forty-four drug-naive FES patients and 256 healthy controls matched for gender, age and education completed the Fagerström Test for Nicotine Dependence (FTND) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Patients were also rated on the Positive and Negative Symptom Scale (PANSS). RESULTS The rate and quantity of smoking were not significantly higher among FES patients compared to the general population. Among patients, smokers scored higher than non-smokers on the total PANSS and the positive symptom subscale scores. There were no significant associations between cognitive function and smoking in either FES patients or healthy controls. CONCLUSIONS In contrast to studies in patients with chronic schizophrenia, drug-naive FES patients did not smoke more frequently than the general population. Furthermore, patients with psychotic disorders who smoked did not exhibit significant cognitive differences compared with those who did not smoke. However, smoking may have other detrimental effects on physical and mental health, for example on positive symptoms.
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Affiliation(s)
- X Y Zhang
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, TX, USA.
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Chen DC, Amid PK. Chronic pain and quality of life after transinguinal preperitoneal (TIPP) inguinal hernia repair: a few tips on TIPP. Hernia 2013; 17:693-5. [PMID: 23877347 DOI: 10.1007/s10029-013-1138-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Accepted: 07/06/2013] [Indexed: 10/26/2022]
Affiliation(s)
- D C Chen
- Division of General Surgery, Lichtenstein Amid Hernia Clinic at UCLA, David Geffen School of Medicine at UCLA, 1304 15th Street Suite 213, Santa Monica, CA, 90404, USA,
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Wang CY, Yang SF, Wang Z, Tan JM, Xing SM, Chen DC, Xu SM, Yuan W. PCAF acetylates Runx2 and promotes osteoblast differentiation. J Bone Miner Metab 2013; 31:381-9. [PMID: 23468178 DOI: 10.1007/s00774-013-0428-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 01/17/2013] [Indexed: 10/27/2022]
Abstract
Osteoblasts play a crucial role in bone formation. However, the molecular mechanisms involved in osteoblast differentiation remain largely unclear. Runt-related gene 2 (Runx2) is a master transcriptional factor for osteoblast differentiation. Here we reported that p300/CBP-associated factor (PCAF) directly binds to Runx2 and acetylates Runx2, leading to an increase in its transcriptional activity. Upregulation of PCAF in MC3T3-E1 cells increases the expression of osteogenic marker genes including alkaline phosphatase (ALP), osteocalcin (Ocn), and Osteopontin (Opn), and ALP activity was stimulated as well. Consequently, the mineralization of MC3T3-E1 cells was remarkably improved by PCAF. In contrast, PCAF knockdown decreases the mRNA levels of ALP, Ocn, and Opn. ALP activity and the mineralized area were attenuated under PCAF knockdown conditions. These results indicate that PCAF is an important regulator for promoting osteoblast differentiation via acetylation modification of Runx2.
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Affiliation(s)
- Chao-Yang Wang
- Department of Orthopaedics, 98 Hospital of PLA, Zhejiang, 313000, Huzhou, China.
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Tan JM, Wu J, Shi JG, Shi GD, Liu YL, Liu XH, Wan CY, Chen DC, Xing SM, Shen LB, Jia LS, Ye XJ, Li JS. Brain-derived neurotrophic factor is up-regulated in severe acute cauda equina syndrome dog model. Int J Clin Exp Med 2013; 6:431-437. [PMID: 23844266 PMCID: PMC3703113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 05/29/2013] [Indexed: 06/02/2023]
Abstract
To determine the level of brain-derived neurotrophic factor (BDNF) in experimental dog model of severe acute cauda equina syndrome, which was induced by multiple cauda equina constrictions throughout the entire lumbar (L), sacral (S) and coccygeal (Co) spinal cord and their central processes of the dorsal root ganglia neurons. Adult male mongrel dogs were randomly divided into 2 groups. The experiment group (n=4) was subjected to multiple cauda equina constrictions. The control group (n=4) was subjected to cauda equina exposure without constrictions. Level of BDNF in the spinal cord and the dorsal root ganglion cells (L7, S1-S3) was assessed 48 hours after multiple constrictions by immunohistochemical and histopathological analyses. 48 hours after multiple constrictions of cauda equina, up-regulation of BDNF within lumbosacral (L7-S3) spinal cord and dorsal root ganglion was observed in experimental group as compared to control group. Our result suggests that BDNF might play a role in the inflammatory and neuropathic pain as a result of multiple cauda equina constrictions. Regulation of BDNF level could potentially provide a therapy for treating cauda equina syndrome.
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Affiliation(s)
- Jun-Ming Tan
- Center of Trauma Repair and Reconstruction of Chinese PLA and Department of Orthopedics of the 98th Hospital of Chinese PLA Huzhou 313000, Zhejiang Province, China
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Li JT, Yang J, Chen DC, Zhang XL, Tang ZS. An optimized mini-preparation method to obtain high-quality genomic DNA from mature leaves of sunflower. Genet Mol Res 2007; 6:1064-1071. [PMID: 18273799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In order to investigate the mutation characteristics and to further examine the genetic variation of mutant sunflower (Helianthus annuus) obtained in plants grown from seeds exposed to space conditions, only the mature tissues such as leaf and flower could be used for DNA extraction after mutation characteristics were confirmed. The rich contents of polysaccharides, tannins, secondary metabolites, and polyphenolics made it difficult to isolate high-quality DNA from mature leaves of sunflower according to previous reports. Based on the comparison of the differences in previously reported protocols, a modified method for the extraction of high-quality DNA was developed. Using this protocol, the DNA isolated from sunflower was high in quality and suitable for restriction digestion (EcoRI, HindII, BamHI), random amplified polymorphic DNA study and further molecular research. Therefore, the modified protocol was suitable for investigating the genetic variation of sunflower using mature leaf DNA.
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Affiliation(s)
- J T Li
- School of Life Sciences, China West Normal University, Nanchong, Sichuan, PR China
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Shen PP, Shi Q, Hua ZC, Kong FX, Wang ZG, Zhuang SX, Chen DC. Analysis of microcystins in cyanobacteria blooms and surface water samples from Meiliang Bay, Taihu Lake, China. Environ Int 2003; 29:641-647. [PMID: 12742407 DOI: 10.1016/s0160-4120(03)00047-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Taihu Lake is the third largest freshwater lake in China. In recent years, the water pollution of cyanobacteria blooms has become a severe problem in this area. Microcystins (MCs) are an important group of toxic compounds mainly produced by some cyanobacteria species and have both acute and chronic hepatotoxic effects on animals and humans. This paper presents the first data on the identification and detection of MCs in both natural occurring cyanobacteria blooms and surface water samples (0-0.5 m), collected from Meiliang Bay, Taihu Lake, China. A conventional method for extraction and isolation of MCs from cyanobacteria blooms was applied. High-performance liquid chromatography (HPLC) analysis showed that the main toxic component in the cyanobacteria materials was MC-LR. The monoclonal antibody (mAb) against MC-LR produced by hybridoma technique was employed for direct competitive ELISA to detect the concentrations of MCs in bloom and water samples collected in 2001. The results not only revealed the presence of MCs but also temporal variations of MCs levels of three sampling stations in Meiliang Bay in 1 year. It is obvious that the MC contents were relatively higher during warm months and related with the status of eutrophication. Our study indicates the threat associated with MCs in water body of Taihu Lake. To prevent the MCs potential hazard on public health in this area, some necessary measures of monitoring and control of growth of cyanobacteria are urgently needed.
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Affiliation(s)
- P P Shen
- Department of Biochemistry, State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, 210093 Nanjing, People's Republic of China
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21
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Chen DC, Lai YL, Chen HL, Lee SY. Effect of circumferential undercut placement in the root canal wall on the retention of a tapered post in large and small root canals. J Dent 2003; 31:247-52. [PMID: 12735918 DOI: 10.1016/s0300-5712(03)00047-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES This study examined the influence of root canal space and circumferential undercut placement in the dentine wall on the retention of a prefabricated Root Keeper post. METHODS Twenty-four extracted single-rooted teeth, having narrow root canal spaces, were decoronated, treated endodontically, and then centrally embedded in resin blocks. All canal spaces were prepared with a no. 2 Peeso reamer to an 8mm depth, and half the specimens were successively treated with a no. 3 Peeso to depths of 5 and 8mm for the small canal group (SC) and large canal group (LC), respectively. An L-type keeper post (Aichi Steel Co.) was luted to each canal with resin cement. The assembly was thermocycled 2000 times (4-60 degrees C), and post retention was measured. Afterwards the dislodged post with the intact structure was sandblasted, and the canal was cleaned and slightly undercut using an inverted cone bur. Six treated posts were recemented for both grooved large canal (GLC) and grooved small canal (GSC) groups, and the repaired retentive strengths were measured. RESULTS Keeper posts cemented in SC (84.26+/-31.85N) showed better (p<0.05) retention than those cemented in LC (41.92+/-22.36N). Interestingly, the repaired strengths of the recemented post increased in both GSC (104.29+/-11.89N) and GLC (96.65+/-6.91N). All posts, except for one in the GLC, failed at the keeper-post joint. CONCLUSIONS Prefabricated Root Keeper posts had lower retentive strength in roots with a large canal space. Placement of a circumferential undercut in the root canal wall significantly enhanced the retention of the short tapered posts.
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Affiliation(s)
- D C Chen
- School of Dentistry, National Yang-Ming University, 112, Taipei, Taiwan, ROC
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Affiliation(s)
- D C Chen
- New York University School of Medicine; New York, NY 10016, USA
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23
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Affiliation(s)
- D C Chen
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, 325 Section 2, Cheng-Kung Road, Neihu, 114, Taipei, Taiwan
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Lu Y, Zheng QT, Wu N, Wang GL, Tian JG, Zhang J, Chen DC. [Studies on X-ray diffraction pattern of traditional Chinese medicinal materials]. Yao Xue Xue Bao 2001; 32:193-8. [PMID: 11327020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Traditional Chinese medicine(TCM) as prescribed by Chinese traditional physicians is usually available as "decoction slices" which calls for a ready method for assessment of quantity or even genuineness. Three groups of TCM drugs (radix Rubiae, bulbus Fritillariae and rhizoma Dioscoreae) were selected by using powder X-ray diffraction analysis with complete absorption profile. Topological regularity and characteristic peaks of the absorption profile were obtained as fingerprint in X-ray diffraction diagrams of the pertinent medicinal materials. We have discovered the similarities of 3 radix Rubiae samples gathered from different localities and their differences with Rubia tinctorum, the similarities and differences between 7 species belonging to Fritillaria Genus, the similarities of 2 rhizoma Dioscoreae samples from different localities and their differences with 2 counterfeits. The result points to a promising prospect in achieving an objective assessment of genuineness at TCM drugs.
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Affiliation(s)
- Y Lu
- Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College
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Abstract
An oversecreting mutant of Saccharomyces cerevisiae was obtained from about 400 meiotic segregants derived from thediploid cells made by crossing the HBsAg-induced mutant NI-C with the wild-type strain Sey6211. When transformed with a plasmid containing mouse alpha-amylase cDNA, the mutant (NI-C-D4) exhibited an increased capacity (up to 13-fold) for the secretion of mouse alpha-amylase, higher than the parental strains and other standard wild-type strains. It was also shown that alpha-amylase secreted by the oversecreting mutant had a higher activity and contained more of the non-glycosylated form than the glycosylated form. This isolated oversecreting, low-glycosylation mutant may prove to be a potential S. cerevisiae host for the production of foreign proteins. Further genetic analysis suggested that the mutation responsible for the mutant's oversecretion was partially dominant and that both the oversecretion and low-glycosylation phenotypes were governed by a single chromosome mutation. These pleiotrophic phenotypes may be attributed to a defect in the synthesis of an ER-resident chaperone.
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Affiliation(s)
- B D Wang
- Institute of Molecular Biology, Academia Sinica, Nankang, Taipei, Taiwan.
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26
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Chen DC. Display resolution enhancement with optical scanners. Appl Opt 2001; 40:636-643. [PMID: 18357040 DOI: 10.1364/ao.40.000636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We have developed a novel, low-cost, and effective technique for display resolution and fill-factor enhancement. By using optical scanners with fast nematic liquid-crystal polarization switches and birefringent materials, we have increased the perceived pixel count of a low-resolution display and also its display fill factor. The resulting display resolution was quadrupled by the optical scanners without increasing the display die sizes or input-output counts. The display optical system architecture, scanner design, packaging, and experimental results of the display system performance are discussed.
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Chen DC, Zhan DZ, Cheng CW, Liu AC, Chen CH. Determination of urine catecholamines by capillary electrophoresis with dual-electrode amperometric detection. J Chromatogr B Biomed Sci Appl 2001; 750:33-9. [PMID: 11204221 DOI: 10.1016/s0378-4347(00)00388-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Demonstrated in this study is that without pretreatment and preconcentration nanomolar-level catecholamines in human urine samples can be quantitatively determined with ease by utilizing capillary electrophoresis coupled with amperometric detection. The detector employs a parallel-opposed dual-electrode scheme assembled with an on-capillary electrode and a disk electrode and takes advantage of the redox cycling of analytes between the two working electrodes to improve the limit of detection. The matrix effect of urine samples significantly decreases the detection sensitivity from that obtained in standard solutions. Therefore, calibration curves derived from standard solutions cannot be used in quantitative determination of catecholamines. Methods of standard addition and internal standard have been studied. The results suggest that isoproterenol is a good internal standard to facilitate the measurements of dopamine, epinephrine, and norepinephrine in human urine samples.
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Affiliation(s)
- D C Chen
- National Sun Yat-Sen University, Department of Chemistry, Kaohsiung, Taiwan.
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Lee HM, Tyan SW, Leu WM, Chen LY, Chen DC, Hu NT. Involvement of the XpsN protein in formation of the XpsL-xpsM complex in Xanthomonas campestris pv. campestris type II secretion apparatus. J Bacteriol 2001; 183:528-35. [PMID: 11133946 PMCID: PMC94908 DOI: 10.1128/jb.183.2.528-535.2001] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The xps gene cluster is required for the second step of type II protein secretion in Xanthomonas campestris pv. campestris. Deletion of the entire gene cluster caused accumulation of secreted proteins in the periplasm. By analyzing protein abundance in the chromosomal mutant strains, we observed mutual dependence for normal steady-state levels between the XpsL and the XpsM proteins. The XpsL protein was undetectable in total lysate prepared from the xpsM mutant strain, and vice versa. Introduction of the wild-type xpsM gene carried on a plasmid into the xpsM mutant strain was sufficient for reappearance of the XpsL protein, and vice versa. Moreover, both XpsL and XpsM proteins were undetectable in the xpsN mutant strain. They were recovered either by reintroducing the wild-type xpsN gene or by introducing extra copies of wild-type xpsL or xpsM individually. Overproduction of wild-type XpsL and -M proteins simultaneously, but not separately, in the wild-type strain of X. campestris pv. campestris caused inhibition of secretion. Complementation of an xpsL or xpsM mutant strain with a plasmid-borne wild-type gene was inhibited by coexpression of XpsL and XpsM. The presence of the xpsN gene on the plasmid along with the xpsL and the xpsM genes caused more severe inhibition in both cases. Furthermore, complementation of the xpsN mutant strain was also inhibited. In both the wild-type strain and a strain with the xps gene cluster deleted (XC17433), carrying pCPP-LMN, which encodes all three proteins, each protein coprecipitated with the other two upon immunoprecipitation. Expression of pairwise combinations of the three proteins in XC17433 revealed that the XpsL-XpsM and XpsM-XpsN pairs still coprecipitated, whereas the XpsL-XpsN pair no longer coprecipitated.
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Affiliation(s)
- H M Lee
- Graduate Institute of Agricultural Biotechnology, National Chung Hsing University, Taichung, Taiwan, Republic of China
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Abstract
OBJECTIVES A decrease in mandibular arch width during forced opening has been documented. However, the contributing factors of mandibular deformations are still unclear. This study investigated the mandibular deformation during mouth opening, and searched for contributing factors related to this phenomenon. METHODS Sixty-two dental students volunteered for this study. A linear variable differential transducer (LVDT) was cemented on the mandibular first molars to record mandibular deformation during mouth opening. Proposed factors including geometric factors of the mandible such as lower gonial angle, mandibular length, symphyseal width and height were measured from cephalometric analysis. Densitometric analysis was performed to detect symphyseal area and bone density. RESULTS The changes in width between the mandibular first molars ranged from 20 to 437 microm, which was negatively correlated to the symphyseal width, area, and bone density. Where the lower gonial angle had a positive influence, the arch width changed during mouth opening. A multifactorial model showed a significant correlation between the set of predictor variables (symphyseal area, bone density, and mandibular length) and mandibular deformation. CONCLUSIONS Mandibular arch width narrowed during forced opening. Subjects with smaller symphysis, lower bone density and longer mandible tend to have larger arch width changes.
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Affiliation(s)
- D C Chen
- School of Dentistry, National Yang-ming University, Taipei, Taiwan, ROC
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Chen DC, Yu MH, Yu CP, Liu JY. Verrucous carcinoma of the uterine cervix. Zhonghua Yi Xue Za Zhi (Taipei) 2000; 63:765-9. [PMID: 11076434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Verrucous carcinoma is a variant of squamous cell carcinoma that is often found in the oral cavity, skin and larynx. It rarely occurs in the genital tract, especially in the cervix. A 66-year-old postmenopausal female had undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy at a local hospital 1 year previously, due to carcinoma in situ of the cervix. The patient complained of profuse discharge from the vagina. Under the impression of chronic inflammation and suspicion of cancer recurrence, the patient was transferred to the Tri-Service General Hospital. A pelvic examination revealed a cauliflower-like, fungating mass about 4 cm in diameter located in the anterior vaginal vault. A biopsy disclosed verrucous carcinoma. Cystoscopy with bladder biopsy also confirmed direct tumor invasion into the bladder trigone. Anterior exenteration was performed including radical cystectomy, ileal conduit, vaginectomy, bilateral pelvic lymph node dissection and appendectomy. The final pathology report was verrucous carcinoma with bladder invasion. The margins of the ureters and vaginal cutting end were free of cancerous cells. Surgical excision is the treatment of choice for verrucous carcinoma. Radiotherapy is contraindicated because it may induce anaplastic transformation with subsequent regional and distant metastasis. Further surgical excision, even exenteration, is required for recurrent tumors.
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Affiliation(s)
- D C Chen
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
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31
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Lee HM, Wang KC, Liu YL, Yew HY, Chen LY, Leu WM, Chen DC, Hu NT. Association of the cytoplasmic membrane protein XpsN with the outer membrane protein XpsD in the type II protein secretion apparatus of Xanthomonas campestris pv. campestris. J Bacteriol 2000; 182:1549-57. [PMID: 10692359 PMCID: PMC94451 DOI: 10.1128/jb.182.6.1549-1557.2000] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
An xps gene cluster composed of 11 open reading frames is required for the type II protein secretion in Xanthomonas campestris pv. campestris. Immediately upstream of the xpsD gene, which encodes an outer membrane protein that serves as the secretion channel by forming multimers, there exists an open reading frame (previously designated ORF2) that could encode a protein of 261 amino acid residues. Its N-terminal hydrophobic region is a likely membrane-anchoring sequence. Antibody raised against this protein could detect in the wild-type strain of X. campestris pv. campestris a protein band with an apparent molecular mass of 36 kDa by Western blotting. Its aberrant slow migration in sodium dodecyl sulfate-polyacrylamide gels might be due to its high proline content. We designated this protein XpsN. By constructing a mutant strain with an in-frame deletion of the chromosomal xpsN gene, we demonstrated that it is required for the secretion of extracellular enzyme by X. campestris pv. campestris. Subcellular fractionation studies indicated that the XpsN protein was tightly associated with the membrane. Sucrose gradient sedimentation followed by immunoblot analysis revealed that it primarily appeared in the cytoplasmic membrane fractions. Immune precipitation experiments indicated that the XpsN protein was coprecipitated with the XpsD protein. In addition, the XpsN protein was co-eluted with the (His)(6)-tagged XpsD protein from the metal affinity chromatography column. All observations suggested that the XpsN protein forms a stable complex with the XpsD protein. In addition, immune precipitation analysis of the XpsN protein with various truncated XpsD proteins revealed that the C-terminal region of the XpsD protein between residues 650 and 759 was likely to be involved in complex formation between the two.
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Affiliation(s)
- H M Lee
- Graduate Institute of Agricultural Biotechnology, National Chung Hsing University, Taichung, Taiwan, Republic of China
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32
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Abstract
A modified chemically defined medium was achieved by using asparagine as a nitrogen source to increase the production of secreted mouse alpha-amylase in several Saccharomyces cerevisiae protease A-deficient (pep4) strains. The specific productivity (quantity) and the 53 kDa non-glycosylated active form (quality) of mouse salivary alpha-amylase in liquid medium containing asparagine was remarkably improved compared to media containing other nitrogen sources, including ammonium sulphate, glutamic acid, arginine, casamino acids, yeast extract and peptone. Similar improvement was also observed on starch solid agar regarding the clarity and size of the halo zone formed by alpha-amylase activity. Compared with ammonium sulphate, advantages of using asparagine as the nitrogen source in liquid or solid medium included increasing the cell mass of test strains, recovering the viability of protease-deficient strains to levels similar to the wild-type strain, and increasing the copy number of the mouse alpha-amylase expression vector in test strains. In turn, these advantages apparently contributed to the increase of secretion of mouse alpha-amylase in several test strains and especially in the protease A-deficient strains. In addition to demonstrating the use of modified chemically defined medium to improve the quality and quantity of secreted mouse alpha-amylase, this study also provides a new strategy to improve the secretion of heterologous proteins in protease A deficient strains.
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Affiliation(s)
- D C Chen
- Institute of Molecular Biology, Academia Sinica, Nankang, Taipei, Taiwan, Republic of China
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Abstract
OBJECTIVES This investigation sought to improve the handling and physical properties of a commonly used temporary zinc oxide-eugenol cement by changing the base/accelerator (B/A) ratio or combining it with a petroleum jelly or fluoride varnish. METHODS Twelve modifications of a temporary cement were evaluated in terms of retentive strength, compressive strength at 24 h, film thickness and by scanning electron microscopy. RESULTS Decreasing the B/A mixing ratio increased the retentive and compressive strengths, but reduced the film thickness of the cement. By increasing the percentage of incorporated petroleum jelly or fluoride varnish in the cement, there was a progressive decrease in the retentive and compressive strengths and in film thickness. CONCLUSIONS Modifications of a zinc oxide-eugenol temporary cement to change the B/A ratio or to incorporate additives resulted in variations in physical properties. All modified forms of the cement had a film thickness less than 25 microns and a compressive strength below 35 MPa. With a wide range of retentive strength, modified forms of zinc oxide-eugenol cement may be found to have diverse clinical applications.
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Affiliation(s)
- S Y Lee
- School of Dentistry, National Yang-ming University, Taipei, Taiwan, Republic of China.
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Li W, Lin JS, Chen DC, Yang C, An JY. [Studies on individual characters of juvenile delinquents in Fujian province]. Fa Yi Xue Za Zhi 1999; 15:211-3, 255. [PMID: 12536436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Ashenk's Character Questionnaire was adopted to study the relationship between juvenile delinquency and individual characters. 621 delinquents at the age of 13-19 and 1371 school students (as control group) were questioned, and results were statistically analyzed. For male delinquents of 16-19, scores of extroversion, psychosomatic and nervosity were significantly higher than for control group (P < 0.01). For male delinquents of 13-15, scores of psychosomatic and nervosity were significantly higher than for control group (P < 0.01). For female delinquents of 16-19, score of nervosity was lower than for control group (P < 0.05). Different types of delinquency had no statistical relations with characters. The study reveals that characters of psychosomatic and nervosity might be related with male delinquent crimes, and that stabilization with female delinquent crimes.
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Affiliation(s)
- W Li
- Intermediate Court of Nanping City, Nanping 353000, P. R. China
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Abstract
To investigate sex-related differences in vasoconstrictor responses to postjunctional alpha2-adrenoceptor activation, isolated ring segments of tail arteries from Fischer-344 rats were studied. Addition of the alpha2-adrenoceptor agonist, UK-14304 [5-bromo-6-(2-imidazoline-2yl)-aminol-quinoxaline], enhanced vasoconstriction to the selective alpha1-adrenoceptor agonist, methoxamine, in arteries from both males and females. The response to UK-14304 was significantly greater in arteries from males as compared to female arteries. Addition of alpha2-adrenoceptor antagonist, idazoxan or rauwolscine, shifted norepinephrine concentration response curves to the right. Antagonist effects also tended to be greater in arteries from males as compared to females. After gonadectomy, male-female differences persisted; thus, removal of sex hormones in either males or females did not alter responses to either agonists or antagonists of alpha2-adrenoceptors. These findings suggest that sex differences in alpha2-adrenoceptor function are not maintained by either male or female gonadal steroid hormones but may be developmentally regulated.
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Affiliation(s)
- D C Chen
- Department of Pharmacology, College of Medicine, University of California, Irvine 92697-4625, USA
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Alderson PO, Chen DC, Fleishman MJ, Hoh CK, Kim CK, Lee VW, Mellins RB, Miller JH, Moore WH, Peavy HH, Shah A, Treves ST. Radioaerosol scintigraphy in infants and children born to mothers with HIV disease. Pediatric Pulmonary and Cardiovascular Complications (of Vertically Transmitted Human Immunodeficiency Virus) Study Group. Radiology 1999; 210:815-22. [PMID: 10207486 DOI: 10.1148/radiology.210.3.r99mr09815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine the usefulness of technetium 99m diethyltriaminepentacetic acid (DTPA) radioaerosol inhalation-clearance scintigraphy for early detection of pulmonary complications of human immunodeficiency virus (HIV) disease in children. MATERIALS AND METHODS A total of 301 studies were performed in 132 HIV-positive children (group 1; mean age, 46.6 months). In children born to HIV-positive mothers (group 2), 273 studies were performed in 160 children who eventually were proved to be HIV negative (mean age, 10.3 months), and 80 studies were performed in 47 HIV-positive children (mean age, 15.6 months). Radioaerosol studies were performed by using commercially available radioaerosol nebulizers. Pulmonary clearance half-time was measured by using conventional gamma camera computer systems. Radioaerosol results were correlated with indexes of pulmonary health and function. RESULTS The HIV-negative, group 2 children had a mean radioaerosol clearance half-time (58.1 minutes; 162 studies in 108 children) similar to that reported in healthy adults. Group 1 children with pulmonary involvement exhibited a faster mean clearance half-time (28.6 minutes) than did children without evidence of pulmonary involvement from either group 1 or group 2 (P < .05). A faster pulmonary clearance rate did not simply reflect the presence of chest disease that also was detectable on radiographs (P = .3). CONCLUSION Quantitative DTPA radioaerosol clearance studies may provide useful information about pulmonary involvement in selected children with HIV disease.
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Affiliation(s)
- P O Alderson
- Dept of Radiology, Columbia-Presbyterian Medical Center, New York, NY 10032, USA
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Abstract
PURPOSE To determine the diagnostic performance of specific ultrasonographic (US) features in discriminating endometriomas from other adnexal masses. MATERIALS AND METHODS Two sonologists independently reviewed the sonograms of 252 adnexal masses in 226 women and recorded US features by using a standardized checklist. The diagnostic performance of specific US features and overall reviewer impression in discriminating endometriomas from other adnexal masses were evaluated. RESULTS There were 40 endometriomas. Diffuse low-level internal echoes were present in 38 (95%) endometriomas and 40 (19%) nonendometriomas (positive likelihood ratio, 5). The positive likelihood ratio for the diagnosis of endometrioma increased to 8 if masses with neoplastic features at gray-scale US were excluded, allowing identification of 30 endometriomas (75%). The presence of multilocularity or hyperechoic wall foci further increased the positive likelihood ratio to 48, allowing the identification of 18 endometriomas (45%). CONCLUSION An adnexal mass with diffuse low-level internal echoes and absence of particular neoplastic features is highly likely to be an endometrioma if multilocularity or hyperechoic wall foci are present. A patient with a mass with diffuse low-level internal echoes and other US features may benefit from additional imaging.
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Affiliation(s)
- M D Patel
- Department of Radiology, University of California, San Francisco, USA
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Qiu HB, Chen DC, Pan JQ, Liu DW, Ma S. Inhibitory effects of nitric oxide and interleukin-10 on production of tumor necrosis factor alpha, interleukin-1 beta, and interleukin-6 in mouse alveolar macrophages. Zhongguo Yao Li Xue Bao 1999; 20:271-5. [PMID: 10452106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
AIM To observe the effects of nitric oxide and interleukin-10 (IL-10) on inflammatory reaction in mouse alveolar macrophages (AM). METHODS AM from mice were stimulated by lipopolysaccharides (LPS) 10 mg.L-1 and nitric-oxide synthase inhibitor, S-methylisothiorea sulfate (SMT) or nitric-oxide donor, S-nitroso-N-acetyl-D, L-penicillamine (SNAP). The production of tumor necrosis factor alpha (TNF alpha), IL-1 beta, IL-6, and IL-10 by AM were measured by ELISA. RESULTS After LPS-stimulation, TNF alpha, IL-1 beta, and IL-6 peaked at 6, 12, and 24 h, respectively by AM. SMT inhibited LPS-induced nitric oxide release and increased IL-1 beta and IL-6 secretions in AM, but the TNF alpha levels remained unchanged. SNAP had inhibitory effects on IL-1 beta and IL-6 secretions in a concentration-dependent manner, but exerted no effect on TNF alpha release. TNF alpha, IL-1 beta, and IL-6 secretions were inhibited by recombinant IL-10, but the cytokines release was upregulated by anti-IL-10 monoclonal antibody. CONCLUSION Both endogenous and exogenous nitric oxide and IL-10 had inhibitory effects on the LPS-induced TNF alpha, IL-1 beta, and IL-6 secretions in mouse AM.
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Affiliation(s)
- H B Qiu
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
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Chen DC, Chen SY, Gee MF, Pan JT, Kuo TT. A variant of Saccharomyces cerevisiae pep4 strain with improved oligotrophic proliferation, cell survival and heterologous secretion of alpha-amylase. Appl Microbiol Biotechnol 1999; 51:185-92. [PMID: 10091324 DOI: 10.1007/s002530051380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A variant of Saccharomyces cerevisiae pep4 strain 20B12, with improved oligotrophic proliferation, cell survival and secretion of heterologous mouse alpha-amylase, is described. Previously we reported a procedure to enrich NI transformants that are not inhibited by cytotoxic expression of hepatitis B virus surface antigen in the secretion pathway of the protease-A-deficient (pep4) strain. To use the NI cells as a host for heterologous expression, we tried to amend the introduced pYAS/12S vector and obtain a host strain, NI-C, with stable NI phenotype and trp1 marker restored. Southern analysis of genomic DNA of NI-C suggested that the original pYAS/12S was abnormally rearranged and not completely corrected. Further assay showed that the viability and mitotic ability of the NI-C strain were increased. While using the NI-C strain as host for plasmid transformation and heterologous expression of mouse alpha-amylase, we observed that transformed colonies grew more quickly and secreted more alpha-amylase than general yeast strains. A further test showed that the NI-C strain was able to use mouse alpha-amylase as a positive selection marker to form transformed colonies on nitrogen-starved plates that contain starch as the sole carbon source. The results imply that the NI-C variant is an improved pep4 strain that can be used for heterologous expression and for the development of new selective markers in the yeast transformation system.
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Affiliation(s)
- D C Chen
- Institute of Molecular Biology, Academia Sinica, Taipei, Taiwan, ROC.
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Abstract
OBJECTIVE This study was undertaken to determine if the diagnosis of cystic teratomas of the ovary can be made by experienced sonologists using only specific associated sonographic features. MATERIALS AND METHODS Two sonologists independently reviewed the sonograms of 252 adnexal masses. For each mass, each sonologist recorded sonographic features using a standardized checklist, which included four descriptions associated with cystic teratomas. From a list of diagnostic possibilities, each reviewer chose one specific conclusion, with emphasis on achieving the highest combination of sensitivity and positive predictive value for any particular diagnosis. The sensitivity, positive predictive value, and positive likelihood ratio for the diagnosis of cystic teratoma were evaluated for each sonographic finding and for each sonologist's interpretation. RESULTS Of the 252 masses, 74 cystic teratomas were found, 55 of which showed two or more associated sonographic features. Each reviewer had a 98% positive predictive value with 85% sensitivity for the diagnosis and identification of cystic teratomas (positive likelihood ratio = 152). The positive predictive value was 100% when an adnexal mass had two or more sonographic features associated with dermoid masses. The positive predictive value for individual sonographic features associated with dermoid masses was 80% for a shadowing echodensity, 75% for regionally bright echoes, 50% for hyperechoic lines and dots, and 20% for a fluid-fluid level. CONCLUSION An adnexal mass showing two or more of the sonographic features associated with cystic teratomas can be confidently diagnosed as a cystic teratoma.
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Affiliation(s)
- M D Patel
- Department of Radiology, Mayo Clinic Scottsdale, AZ 85259, USA
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41
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Abstract
The amount of stress experienced by both the mother and fetus during labor and delivery varies considerably and is likely to be different in primiparous and multiparous women. In this study we explored relations between the birth experience and lactation performance of 40 women. Stress hormones were measured in serum or plasma during pregnancy, parturition (cord and maternal blood), and lactation. Milk samples were obtained and breast-feeding frequency was recorded each day during the first 2 wk postpartum. Four outcomes were used as markers of lactogenesis: the time when the subject first felt fullness in the breasts, 24-h milk volume on day 5 postpartum, milk lactose concentration on day 5, and the day of appearance of casein in the milk as determined by gel electrophoresis. There were significant intercorrelations among the outcome variables, except for milk lactose. Compared with multiparous women, primiparous mothers experienced a delay in breast fullness and lower milk volume on day 5. In multiple regression analyses excluding subjects who had cesarean deliveries (n = 5), markers of both fetal and maternal stress during labor and delivery (cord glucose concentration and maternal exhaustion score) were associated with delayed breast fullness and casein appearance; delayed casein appearance was also associated independently with a longer duration of labor. Milk volume on day 5 was lower in women with higher exhaustion scores, and, in multiparous women, those who breast-fed less frequently on day 2. The milk lactose concentration was inversely related to pregnancy weight gain. These results indicate that primiparity, long labor, stress to the mother and fetus during labor and delivery, and elevated cord glucose concentrations are risk factors for delayed lactogenesis.
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Affiliation(s)
- D C Chen
- Department of Nutrition, University of California, Davis 95616-8669, USA
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42
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Abstract
Lithium is one of the most widely used drugs for treating bipolar (manic-depressive) disorder. Despite its efficacy, the molecular mechanism underlying its action has not been elucidated. One recent study has proposed that lithium inhibits glycogen synthase kinase-3 and thereby affects multiple cellular functions. Because glycogen synthase kinase-3 regulates the phosphorylation of tau (microtubule-binding protein that forms paired helical filaments in neurons of the Alzheimer's disease brain), we hypothesized that lithium could affect tau phosphorylation by inhibiting glycogen synthase kinase-3. Using cultured human NT2N neurons, we demonstrate that lithium reduces the phosphorylation of tau, enhances the binding of tau to microtubules, and promotes microtubule assembly through direct and reversible inhibition of glycogen synthase kinase-3. These results provide new insights into how lithium mediates its effects in the central nervous system, and these findings could be exploited to develop a novel intervention for Alzheimer's disease.
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Affiliation(s)
- M Hong
- Department of Pharmacology, the Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA
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43
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Abstract
An efficient one-step transformation method for the dimorphic yeast Yarrowia lipolytica is described. Using cells grown overnight on agar plates, the whole process is carried out within 1 h. The transformant clones could be recovered on selective plates as early as 36-48 h after plating. The efficiency was better than 10(5) transformants/micrograms replicative plasmid DNA. Effects of cell density, dithiothreitol, heat shock, poly(ethylene glycol) 4000 concentration and the wetness of selective plates were investigated.
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Affiliation(s)
- D C Chen
- Laboratoire de Genétique Moléculaire et Cellulaire, Institut National de la Recherche Agromique-CNRS, Institut National Agronomique Paris-Grignon, Thiverval-Grignon, Paris, France
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44
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Qiu HB, Pan JQ, Zhao YQ, Chen DC. Effects of dexamethasone and ibuprofen on LPS-induced gene expression of TNF alpha, IL-1 beta, and MIP-1 alpha in rat lung. Zhongguo Yao Li Xue Bao 1997; 18:165-8. [PMID: 10072973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
AIM To study the kinetics of tumor necrosis factor alpha (TNF alpha), interleukine-1 (IL-1 beta), and macrophage inflammatory protein-1 alpha (MIP-1 alpha) gene expression in rat lung after i.p. lipopolysaccharides (LPS) and the effect of dexamethasone (Dex) and ibuprofen (Ibu) on the cytokines gene expression. METHODS The amount of Evans blue in lung was measured by fluorescence method. The mRNA levels of TNF alpha, IL-1 beta, and MIP-1 alpha in rat lung were assessed by slot blot analysis. RESULTS The mRNA levels of TNF alpha, IL-1 beta, and MIP-1 alpha in rat lung after i.p. LPS increased in a dose-dependent manner, and peaked at 2, 6, and 12 h, respectively. Both Dex 50 mg.kg-1 and Ibu 90 mg.kg-1 injected at 1 h before i.p. LPS markedly decreased the content of Evans blue in lung at 1 h after i.p. LPS. After Dex or Ibu pretreatment, the peak levels of TNF alpha, IL-1 beta, and MIP-1 alpha mRNA decreased markedly compared with LPS alone. CONCLUSION The gene expression of TNF alpha, IL-1 beta, and MIP-1 alpha in rat lung increased after i.p. LPS. Dex and Ibu prevented LPS-induced lung injury through inhibiting the cytokines gene expression.
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Affiliation(s)
- H B Qiu
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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45
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Qiu HB, Pan JQ, Du B, Zhao YQ, Chen DC. Effects of dexamethasone, ibuprofen, and ligustrazini on lipopolysaccharides-induced tumor necrosis factor alpha production. Zhongguo Yao Li Xue Bao 1997; 18:67-70. [PMID: 10072898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
AIM To study the influence of dexamethasone (Dex), ibuprofen (Ibu), and ligustrazini (Lig) on lipopolysaccharides (LPS)-induced tumor necrosis factor alpha (TNF alpha) gene expression (both mRNA and protein). METHODS TNF alpha in supernatants of human whole blood was measured by ELISA; The TNF alpha mRNA was assessed by slot blot analysis. RESULTS LPS-induced TNF alpha production was in a dose-dependent manner. TNF alpha levels in the whole blood increased markedly at 3 h and peaked at 6 h. The induction of TNF alpha mRNA was very rapid, peaking at 2 h after LPS challenge. Dex exerted inhibitory effects on TNF alpha production in a dose-dependent manner. Ibu and Lig had 2-phase effects on TNF alpha release. CONCLUSION Dex, Ibu, and Lig affected TNF alpha gene expression, so they may be new approaches of anti-TNF alpha for treatment of sepsis.
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Affiliation(s)
- H B Qiu
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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47
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Abstract
OBJECTIVES To study the prevalence of byssinosis and other respiratory abnormalities in workers exposed to cotton dust in Guangzhou in two factories that processed purely cotton. METHODS All the 1320 workers exposed were included. The controls were 1306 workers with no history of occupational dust exposure. Total dust and inhalable dust were measured by Chinese total dust sampler and American vertical elutriator respectively. A World Health Organisation questionnaire was used. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were measured by a Vitalograph spirometer. RESULTS The median inhalable dust concentrations ranged from 0.41 to 1.51 mg/m3 and median total dust concentrations from 3.04 to 12.32 mg/m3. The prevalence of respiratory abnormalities in the cotton workers were (a) typical Monday symptoms 9.0%; (b) FEV1 fall by > or = 5% after a shift 16.8%; (c) FEV1 fall by > or = 10% after a shift 4.2%; (d) FEV1 < 80% predicted 6.1%; (e) FEV1/FVC < 75% 4.0%; (f) cough or phlegm 18.2%; (g) chronic bronchitis 10.9%; and (h) byssinosis, defined by (a) plus (b) 1.7%. With the exception of (d), most of the prevalences increased with increasing age, duration of exposure, and cumulative inhalable dust exposure. No increasing trends of respiratory abnormalities were found for current total dust, inhalable dust, and cumulative total dust concentrations. Compared with controls, after adjustment for sex and smoking, with the exception of (d), all the pooled relative risks of respiratory abnormalities were raised for cotton exposure. CONCLUSION It is concluded that cumulative inhalable cotton is likely to be the cause of byssinotic symptoms, acute lung function decrements, cough, or phlegm, and chronic bronchitis.
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Affiliation(s)
- C Q Jiang
- Guangzhou Occupational Diseases Prevention and Treatment Centre, Bai Yun Mountain, Guangzhou, China
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48
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Abstract
The toxicity of HBsAg in the secretion pathway of pep4 strains can be progressively reduced in modified SD media containing lower concentrations of ammonium sulphate. A procedure, combining a reduction of ammonium sulphate concentration in SD media with the disruption of the PEP4 gene of the host strain, was developed to enrich transformants which are not inhibited by HBsAg expressed in the secretion pathway. Abnormal growth of these non-inhibited transformants is characterized by the enlargement of cell morphology, a transition to pseudohyphal-like growth in nitrogen-starved media, an increase in HBsAg particle production, and the enhancement of growth rate in liquid media. This suggests a new approach to overcoming the toxicity of heterologous protein in the yeast secretion pathway.
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Affiliation(s)
- D C Chen
- Institute of Molecular Biology, Academia Sinica, Taipei, Taiwan, Republic of China
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49
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Abstract
Cutaneous B cell lymphoma is not commonly seen and occurs in only 8.2% of non-Hodgkins lymphoma. Although Ga-67 uptake by cutaneous T cell lymphoma has been reported, the literature on Ga imaging in cutaneous, B cell lymphoma is limited. The authors report the gallium scan and clinical findings on 2 cases of cutaneous B cell lymphoma.
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Affiliation(s)
- G S Assassa
- Department of Radiology, Los Angeles County-University of Southern California Medical Center
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50
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Zhao SJ, Liang DZ, Ma SC, Chen DC. [Study on the history and current status of the processing of Gardenia jasminoides Ellis]. Zhongguo Zhong Yao Za Zhi 1994; 19:119-21. [PMID: 8011135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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