[A case of lymphatic vessel abnormality with chylous pneumonia]

Chylous pneumonia is a rare respiratory disease. The main clinical manifestation is coughing up chylous sputum with a variety of causes which can be clarified by lymphangiography. The lack of understanding of the disease, and infrequent lymphangiography have led to a high rate of misdiagnosis and missed diagnosis. Here, we reported a case of bronchial lymphatic fistula caused by lymphatic abnormality that led to the diagnosis and treatment of chylous pneumonia, with the aim of improving clinicians' understanding of this disease.

[Effects of unsafe sexual behavior and sexual orientation on previous HIV testing and HIV testing willingness among college students in Harbin]

Objective: To analyze the effects of unsafe sexual behavior and sexual orientation on previous HIV testing and HIV testing willingness among college students in Harbin, to provide a theoretical basis for promoting and promoting HIV testing among them. Methods: A cross-sectional survey design was used to place the automatic vending machine of HIV urine test kit in 9 universities in Harbin from December 2017 to January 2018. The questionnaire star was used to design and recruit college students to carry out an anonymous online survey. The estimated sample size was 6 659. A multivariate logistic regression model was used to analyze the effects of unsafe sexual behavior and sexual orientation on previous HIV testing and HIV testing willingness among college students. WPS 2016 was used to sort out the database, and SPSS 21.0 software was used for statistical analysis. Results: A total of 60 849 valid questionnaires were collected. 19.1% (11 189/58 605) of college students reported having sex. College students who used condoms correctly every time, occasionally or never during sex in the past six months 58.5% (6 206/10 603), 25.2%(2 669/10 603)and 16.3% (1 728/10 603), respectively. Heterosexuality, homosexuality and bisexuality accounted for 94.1% (54 393/57 823), 2.4% (1 369/57 823) and 3.5% (2 061/57 823), respectively. The HIV testing willingness of college students was 73.3% (44 572/60 849). The proportion of previous HIV testing was 10.3% (951/9 241). Results of the multivariate logistic analysis showed that compared with the college students who used condoms correctly whenever they had sex in the past six months, there was no significant difference in the proportion of previous HIV testing among college students who sometimes/occasionally used or never used condoms (OR=0.94,95%CI:0.69-1.29; OR=1.11,95%CI:0.73-1.67), but their willingness to HIV testing was lower (OR=0.79, 95%CI:0.71-0.89; OR=0.48, 95%CI:0.42-0.55); Compared with heterosexual college students, homosexual or bisexual college students have a higher proportion of previous HIV testing (OR=2.62, 95%CI:1.62-4.24; OR=2.04, 95%CI:1.25-3.32), but have lower HIV testing willingness (OR=0.76, 95%CI: 0.62-0.93; OR=0.64, 95%CI: 0.53-0.77). Conclusions: Unsafe sexual behavior existed among college students in Harbin, and college students with weak awareness of HIV prevention also have weak awareness of testing. Behavioral intervention should be strengthened and HIV testing promoted. Compared with heterosexuals, homosexual or bisexual college students had a higher proportion of previous HIV testing, but their willingness to test was lower. The HIV detection mode with better concealment, accuracy, and convenience should be promoted on the college's campus.

[Association of body mass index and waist circumference with risk of ischemic stroke in adults in China: a prospective cohort study]

Objective: To explore the relationship between body mass index (BMI), waist circumference (WC) and the risk for ischemic stroke in adults in China. Methods: A total of 36 632 adults were selected from 60 surveillance areas (25 urban surveillance areas and 35 rural surveillance areas) in China Chronic Disease Surveillance Project in 2010 for a follow up study from 2016 to 2017 based on the baseline data in 2010. The follow up was completed for 27 762 adults. Cox proportional hazard regression model was used to analyze the association of body mass index and waist circumference with the risk for ischemic stroke in different populations. The death and hypercholesterolemia cases were excluded by sensitivity analysis. Results: A total of 26 907 adults were included in the analysis. During the follow up period, 1 128 ischemic stroke events were observed (491 in men and 637 in women). After adjusting the related confounding factors and taking normal BMI/normal WC group as the reference, the risk for ischemic stroke increased by 50% in normal BMI/abdominal obesity group (HR=1.50, 95%CI:1.07-2.08), 51% in overweight/abdominal obesity group (HR=1.51, 95%CI:1.20-1.91), 46% in obesity/abdominal obesity group (HR=1.46, 95%CI:1.09-1.96), and 63% in normal BMI/abdominal obesity group (HR=1.63, 95%CI:1.12-2.38), 56% in overweight/abdominal obesity group (HR=1.56, 95%CI: 1.20-2.03) and 45% in obesity/abdominal obesity group (HR=1.45, 95%CI: 1.05-2.01) respectively in men and in men with CVD risk factors. There was no increased risks in the overweight/normal WC group. The risk increased by 40% in overweight/abdominal obesity group (HR=1.40, 95%CI:1.15-1.72) and 46% in obesity/abdominal obesity group (HR=1.46, 95%CI:1.16-1.83), and 35% in overweight/abdominal obesity group (HR=1.35, 95%CI:1.08-1.69) and 30% in obesity/abdominal obesity group (HR=1.30, 95%CI:1.01-1.67) respectively in women and women with CVD risk factors. There were no risk increases in overweight/normal WC group and normal BMI/abdominal obesity group. Sensitivity analysis results showed no change. Conclusion: Overweight/obesity with abdominal obesity or abdominal obesity alone could increase the risk for stroke in men, and overweight/obesity with abdominal obesity could increase the risk for ischemic stroke in women; suggesting that BMI and WC should be used jointly to evaluate obesity in population for weight control to prevent ischemic stroke.

Effects of dietary Enteromorpha powder supplementation on productive performance, egg quality, and antioxidant performance during the late laying period in Zi geese

This study investigated the effects of dietary Enteromorpha powder supplementation on the productive performance, egg quality, and antioxidant performance of Zi geese during the late laying period. Three hundred twelve Zi geese (1 yr old) were randomly allocated into 2 cohorts to form a control group and an experimental group (with each cohort including 6 replicates and 21 female geese and 5 male geese in each replicate). The control group was fed a basal diet, and the experimental group was fed a diet containing 3% Enteromorpha powder. The data showed that Enteromorpha powder supplementation significantly improved egg production, laying rate, average daily egg weight (P < 0.01), and egg yolk color (P < 0.05). Supplementation decreased the ADFI and feed conversion rate (P < 0.01). Compared with the control group, glutathione peroxidase (GSH-Px) activity was significantly higher in serum and ovary tissue (P < 0.05), but GSH-Px activity was lower in liver tissue (P < 0.01). Malondialdehyde was reduced in liver and ovary tissue (P < 0.05) in the Enteromorpha powder supplementation group. Meanwhile, the expression of the CAT gene was significantly upregulated in the liver (P < 0.01) in the Enteromorpha group. These results indicate that dietary Enteromorpha powder supplementation improved productive performance and reduced the level of lipid peroxidation in Zi geese during the late laying period.

Electroacupuncture Attenuates Limb Ischemia-Reperfusion-Induced Lung Injury Via p38 Mitogen-Activated Protein Kinase-Nuclear Factor Erythroid-2-Related Factor-2/Heme Oxygenase Pathway

BACKGROUND

Electroacupuncture has been reported to protect the body from organ damages, but its mechanisms remain to be explored. This research was designed to investigate the function of electroacupuncture in lung injury resulted from hind limb ischemia-reperfusion (LIR) and whether p38 mitogen-activated protein kinase (p38 MAPK)-mediated nuclear factor erythroid-2-related factor-2 (Nrf2)/heme oxygenase (HO)-1 pathway contributes to the protective effect of electroacupuncture on LIR-originated lung damage.

MATERIALS AND METHODS

Rabbits were subjected to occluding femoral artery for 2 h. Then they received reperfusion for 4 h to establish lung injury model. Electroacupuncture stimulation was performed bilaterally at Feishu and Zusanli acupoints for 15 min once a day for 5 d before the experiment and throughout the hind LIR model performing in the experimental day. Blood samples and lung tissues were collected to examine the role of electroacupuncture treatment in inflammatory response, oxidative stress, and lung injury. Both the protein expression and the messenger RNA level of Nrf2 and HO-1 were detected.

RESULTS

The results showed that electroacupuncture treatment remarkably alleviated lung injury, decreased inflammatory cytokines secretion, attenuated lung oxidative stress, increased the amount of Nrf2 and HO-1, and increased the ratio of phospho-p38 MAPK to p38 MAPK after LIR. However, the protective effects exerted by electroacupuncture were reversed to some extent by the preconditioning with SB203580, a p38 MAPK-specific inhibitor.

CONCLUSIONS

These results suggested that electroacupuncture could attenuate lung injury in rabbits subjected to LIR by inhibition of proinflammatory cytokine response and oxidative stress through activating p38 MAPK-mediated Nrf2/HO-1 pathway.

[Congenital middle ear malformation: clinical analysis and discussion of classification]

Objective: To analyze the clinical characteristics and appropriate surgical procedures, and discuss the classification of congenital middle ear malformation. Methods: All cases were from the Center of Otorhinolaryngology, the Sixth Medical Center of Department of PLA General Hospital. All of these cases, including 26 male patients (ears) , 10 female patients (11 ears) , aged from 7 to 57 years old, had normal external auditory canal, tympanic membrane, conductive hearing loss, type A tympanogram and negative Gelle's test. Tympanoplasty was performed in all cases. The deformity was classified to three types,i.e., Type I (stapes foot plate mobility): Ⅰa, ossicular chain deformity with normal stapes suprastructure; Ⅰb, ossicular chain deformity with abnormal stapes suprastructure; Type Ⅱ (stapes foot plate fixation): Ⅱ a,normal ossicular chain, Ⅱ b, ossicular chain malformation; and Type Ⅲ: vestibular window osseous atresia or undeveloped, or with round window atresia. The malformation of type Ⅱ and Ⅲ may be accompanied with abnormal facial nerve. In addition, the papers on middle ear malformation published from 1982 to 2017 were analyzed retrospectively. The clinical data of 451 ears malformation were summarized. Results: According to the revisional classification criteria in 37 ear samples from our hospital, 20 ears were type I. 6 type Ⅰa cases were used PORP (partial ossicular replacement prosthesis) to reconstruct the ossicular chain; 14 type Ⅰb cases were used TORP (total ossicular replacement prosthesis) to reconstruct the ossicular chain. For the 5 ears of type Ⅱ, 2 of which were type Ⅱ a and 3 were type Ⅱ b. 4 ear samples of type Ⅱ were implanted with Piston ossicular prosthesis, 1 was implanted with TORP in which the ossificated foot plate was removed with periosteum preserved. 12 ear samples were type Ⅲ, with vestibular window osseous atresia, facial nerve malformation, and stapes suprastructure malformation. The pistons ossicular prosthesis were implanted in vestibular window in 3 ears with facial nerve covering vestibular window partially. The surgery had to be given up in 5 ears, and TORP was implanted in 4 ears at the opening with preserved periosteum at the beginning of the tympanic scala because of facial nerve covering vestibular window totally. 30 ears with complete follow-up data had no sensorineural hearing loss and the average air-bone conduction decreased 23.3±10.7 dB (P<0.05).There were 234 ears of type Ⅰ in 451 ears of congenital middle ear malformation reported in the literature. 113 of which were type Ⅰa, the basic surgery was ossicular chain shaking and artificial or autogenous PORP implantation. Type Ⅰb was 121 ears, with autogenous or artificial TORP and PORP. Type Ⅱ was125 ears, including type Ⅱa 22 ears, Ⅱb 60 ears, and no subclassification for 43 ears. The surgery of type Ⅱ was the same as otosclerosis. The vestibular window atresia of type Ⅲ was 92 ears, the surgery of 17 ears had to be abandoned, the other ears underwent vestibular window, promontory or semicircular canal opening to reconstruct hearing with Piston, autogenous or artificial TORP. Conclusion: Referring to the classification of congenital middle ear malformation combining with appropriate surgical materials and methods, otologists can better understand and choose appropriate surgical method to the middle ear malformation.

Determination of 23 perfluorinated alkylated substances in water and suspended particles by ultra-performance liquid chromatography/tandem mass spectrometry

A practical multi-residue method based on ultra-performance liquid chromatography/tandem mass spectrometry was developed for the simultaneous determination of 23 perfluorinated alkylated substances (PFASs) in water and suspended particles. Suspended particle samples were extracted with 1% formic acid-acetonitrile and cleaned by matrix solid phase dispersion extraction using a C₁₈ sorbent and graphitized carbon black. Water samples were filtered through 0.7-μm glass fiber membranes and enriched utilizing weak anion exchange cartridges. The eluent was dried under a gentle stream of N₂ at 45°C and suspended in 1 mL acetonitrile-5 mM ammonium acetate (1:1, vol:vol). Gradient elution for chromatographic separation utilized acetonitrile and 5 mM ammonium acetate as mobile phases on a reverse phase C₁₈ column. The compounds were quantified using an internal standard method in multiple reaction-monitoring mode. Limits of detection and quantitation of the 23 PFAS test compounds in water samples were 0.5-10 ng L^-1 and 2-20 ng L^-1, respectively. Recoveries at three fortified levels of 20, 50, and 200 ng L^-1 ranged from 68.5% to 118% with relative standard deviations below 9.6%. We used this method to determine PFAS levels in real water and suspended particle samples and found high sensitivity and good reproducibility.

[Clinicopathologic and molecular genetic analysis of secretory carcinoma of salivary gland]

Objective: To investigate the clinicopathologic and molecular genetic features of secretory carcinoma of salivary gland (SCSG). Methods: Six cases of SCSG were collected from Zhejiang Provincial People's Hospital from January 2011 to March 2018. The clinical, histopathological and immunohistochemical features were analyzed and fluorescence in situ hybridization (FISH) was used to detect ETV6 gene rearrangement. Results: Four out of 6 tumors originated in the parotid gland and one of each in the minor salivary glands of soft palate and the buccal mucosa. Grossly, 4 cases were solid and 2 were partially cystic with maximum diameter ranging from 1.0 to 4.0 cm. Microscopically, 5 tumors showed typical features of low grade SCSG with tumor divided by thin fibrous septa into lobules composed of solid acinar, microcystic, follicular and papillary structures with abundant extracellular mucinous secretions. The tumor cells had cuolated or hobnail cytoplasm with low-grade nuclei and scarce mitoses. Perineural invasion was present in 1 case. The remaining tumor showed about 30% of the tumor areas with high-grade transformation characterized by proliferation of a distinct population of anaplastic cells arranged in irregular glandular, small nested and single cell patterns that were surrounded by desmoplastic stroma and invaded into surface mucosa with ulceration. Immunohistochemistry showed that all 6 tumors had diffuse and strong reactivities to S100 protein and cytokeratin 7, and 4 cases showed focal reactivity to gross cystic disease fluid protein 15 (GCDFP15), all were negative for discovered on gist 1 (DOG1), cytokeratin 20, p63 and calponin. High grade transformation cases were analysed, the high grade SCSG components showed a significantly increased Ki-67 index and cyclin D1 positive tumor cells compared to the conventional SCSG components. FISH analyses showed that 4 cases had ETV6 gene rearrangement. Eleven to seventy one months' follow-up showed no evidence of tumor recurrence nor metastasis. Conclusions: SCSG harbors characteristic genetic abnormalities with ETV6 gene rearrangement and typically shows a low grade morphology with occasionally, high grade transformation can be present.

[Clinicopathologic and molecular characterizations of Sertoli cell tumor, not otherwise specified of the testis]

Objective: To investigate the histomorpholgic spectrum, immunophenotypic, and molecular genetic features of Sertoli cell tumor, not otherwise specified (SCT, NOS) of the testis. Methods: Seven cases of SCT, NOS of the testis were analyzed(4 from Peking University Third Hospital and 3 from Zhejiang Provincial People's Hospital) between 2008 and 2017. The histopathologic features were examined based on HE staining, and EnVision method was used for immunohistochemistry staining of calretinin, inhibin, β-catenin, cyclinD1, CD10, CKpan, neuroendocrine markers, WT1, Melan A, vimentin, SALL4, GATA3, PAX8, and S-100 protein. Mutational analysis of exon 3 of the CTNNB1 gene by polymerase chain reaction (PCR)-amplified sequences and direct sequencing was performed. Results: Patients ages ranged from 22 to 65 years (mean 43 years). The clinical manifestation in all was a slowly enlarging, painless testicular mass.The maximum diameter of the tumor ranged from 1.5 cm to 3.0 cm (mean 2.1 cm). Sectioning usually disclosed a tan-gray to white mass with vague lobular cut-surface. Microscopically, the tumors were well circumscribed and non-encapsulated; the tumor cells were rearranged in multiple growth patterns from diffuse solid sheets to trabeculae and cords, ribbon and solid or hollow tubules setting in variable amount of acellular fibrous stroma. Two cases showed acellular collagenous stroma constituted >50% of the tumor confirming to the diagnosis of sclerosing SCT. One case demonstrated a prominent myxoid stromal change. The tumor cells typically had moderate amounts of pale to lightly eosinophilic cytoplasm, 2 tumors had variable cells with abundant lipid-rich cytoplasm, and 1 other tumor showed scattered aggregates of multinucleated tumor cells. The tumor cells were bland-appearing without any evidence of atypia, mitoses were noted in 2 tumors (both were 1/50 HPF), but necrosis was absent. Immunohistochemical staining results as follows: vimentin (diffuse, 7/7), CD10 (diffuse membrane, 7/7); diffuse β-catenin nuclear and cytoplasm staining in 5 of 7 cases, and all the 5 cases showed diffuse cyclin D1 nuclear staining, β-catenin membrane staining in 2 of 7 cases, CKpan (5/7, focal or diffuse), calretinin (focal, 5/6), inhibin (focal, 3/7), synaptophysin (focal, 2/6), CD56 (focal or diffuse, 4/5), WT1 (diffuse nuclear, 4/5), and S-100 protein (diffuse, 3/7), and chromogranin A, Melan A, PAX8, GATA3 and SALL4 all were negative. Molecular genetic studies of PCR and direct sequencing showed CTNNB1 mutations in 4 of 7 (4/7) cases, 4 of the four mutation-carrying cases showed diffuse β-catenin nuclear and cytoplasm immunoreactivity and diffuse cyclin D1 nuclear immunoreactivity in the tumor cells. Conclusions: SCT, NOS of the testis typically shows significant heterogeneities in both morphology and immunohistochemistry, thus causing differential diagnostic confusions. Molecular analyses showed mutations of exon 3 of CTNNB1 in more than half of these tumors, and nuclear accumulation of β-catenin and over expression of cyclin D1 can be useful for the differential diagnosis of SCT, NOS.

[Relationship between hyperuricemia and prognosis in patients with heart failure of coronary heart disease after revascularization]

Objective: To explore the effect of hyperuricemia on prognosis in patients with heart failure of coronary heart disease (CHD) after revascularization. Methods: A single-center retrospective study of all subjects who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) as revascularization for CHD at Beijing Anzhen Hospital, Capital Medical University, between January 2005 and December 2014 was performed.Patients were divided into two groups by with or without hyperuricemia.The average follow-up was 1 818 d. Results: The Logistic regression analysis revealed that hyperuricemia was independent risk factors of readmission of heart failure(P=0.018, OR=1.499, 95%CI 1.071-2.098). The Cox regression analysis revealed that hyperuricemia was independent risk factor of all-cause mortality(P=0.002, RR=1.520, 95%CI 1.166-1.982), cardiovascular (CV) mortality(P=0.001, RR=1.811, 95%CI 1.279-2.566), heart failure mortality(P=0.006, RR=2.151, 95%CI 1.247-3.711). Conclusions: There is negative correlation between level of uric acid and left ventricular ejection fraction (LVEF). The patients with heart failure of coronary heart disease complicated with hyperuricemia have high risk of readmission of heart failure, all-cause mortality, CV mortality andheart failure mortality than patients with normal uric acid level. Hyperuricemia is an independent risk factor for patients with heart failure of coronary heart disease after revascularization.

[Clinicopathologic and molecular genetic characterizations of biphenotypic sinonasal sarcoma]

Objective: To investigate the clinicopathologic characteristics, immunophenotypes, molecular genetics, and diagnostic and differential diagnostic features of biphenotypic sinonasal sarcoma (BSNS). Methods: Three cases of BSNS were retrieved, the histomorphology, immunophenotype and molecular genetics were analyzed with review of literature. Results: There were 2 male and 1 female patient aged 45, 29 and 40 years, respectively.Computed tomography and magnetic resonance imaging examinations showed a large polypoid mass occupying the sinonasal cavity in all 3 patients. Microscopically, these tumors were un-circumscribed and composed of cellular spindle-shaped cells arranged in long and interlaced fascicles. A hemangiopericytoma-like growth pattern was frequently identified. The overlying hyperplastic respiratory epithelium invaginated down into the tumor forming a cystic (2 cases), glandular (1 case) structures and inverted in a papilloma-like (1 case)pattern, and foci of eosinophilic metaplasia were also noted in 2 of the three cases. The tumor nuclei were bland-appearing, mitoses were scarce and necrosis was absent. Immunohistochemically, the tumor cells showed co-expression of neural and myogenic markers in all the 3 cases, including that 3/3 showed diffuse and strong positivity of S-100 protein, 3/3 positivity of smooth muscle actin (1 diffuse and 2 focal), 1/2 diffuse positivity of calponin, 1/3 focal positivity of desmin, and 1/1 focal positivity of MyoD1.In addition, 1 detected for β-catenin showed focal nuclear positivity. None of the 3 showed positivity to cytokeratin, CD34 or SOX10 in the tumor cells.Ki-67 showed an index <5%, 10% and <2%, respectively. Fluorescence in situ hybridization analysis showed rearrangements of PAX3 gene in all 3 cases. In case 3, reverse transcription polymerase chain reaction, followed by Sanger sequencing, demonstrated an in-frame fusion between PAX3 and FOXO1.Follow-up information (range 3-15 months)showed no evidence of local recurrence or distant metastasis in three cases. Conclusions: BSNS is a newly described entity which can be readily confused with a variety of benign and malignant spindle cell tumors encountered in the sinonasal cavity; immunohistochemistry co-expression of neural and myogenic markers and PAX3 gene rearrangement can help distinguish this tumor from its many mimickers.

[Anomalous systemic arterial supply to normal basal segments of the lower lobe: three cases reports and literature review]

Objective: To improve the clinical recognition of anomalous systemic arterial supply to normal basal segments of the lower lobe in clinical manifestations, diagnosis and treatment. Methods: Three cases were presented and related literatures were reviewed. A literature review was performed with"anomalous systemic arterial supply to normal lower lobe of the lung","anomalous systemic arterial supply to normal basal segments of the lower lobe"and"anomalous systemic arterial supply to normal basal segments of the left lower lobe of the lung"as key words in Pubmed, Embase, Ovid, Wanfang database and CNKI. Result: Our 3 cases were male, with an average age of 36 years old; all of them were admitted with hemoptysis. Left lower lobectomy was performed in 2 cases, and the other 1 case underwent endovascular embolization. 26 related articles were retrieved and our 3 cases were included in this study with a total of 57 cases. The ratio of male to female was 2∶1 (38∶19), with an average age of about 35 years old. The most common symptom was hemoptysis (26/57), followed by asymptomatic (22/57). The main treatments included left lower lobectomy (17/47) and endovascular embolization of anomalous systemic artery (13/47). Conclusions: This disease is more common in male, and the most common symptom is hemoptysis. When chest CT scan shows a nodular retrocardiac density with hemoptysis symptom, clinicians and radiologists should raise suspicion of anomalous systemic arterial supply to normal basal segments of the lower lobe. Chest contrast-enhanced CT scan is an appropriate imaging method to confirm diagnosis. The main treatments include left lower lobectomy and endovascular embolization. For asymptomatic patient, observation may be an acceptable option.

[Clinicopathologic analysis of Ewing-like BCOR-CCNB3 undifferentiated sarcoma]

Objective: To investigate the morphologic, immunohistochemical, genetic, clinical features and prognosis of Ewing-like BCOR-CCNB3 gene fusion undifferentiated sarcoma (BCOR-CCNB3 fusion sarcoma). Method: Seventeen Ewing-like sarcoma cases were screened for CCNB3 expression and BCOR-CCNB3 fusion transcripts by immunohistochemistry and RT-PCR among 260 cases of Ewing-like sarcomas collected during Jan, 2006 to Dec, 2015. Three cases of BCOR-CCNB3 fusion sarcoma were found among 17 atypical Ewing sarcomas, and follow-up were conducted. Results: The harboring of BCOR-CCNB3 fusion transcript was confirmed by RT-PCR and directly sequencing results. The three patients aged between 8 and 11 years old. Two of them were male and the other one was female. One patient achieved a complete response after chemotherapy, the other two died without chemotherapy after surgical excision in 12 months. Tumor cells in all 3 cases showed diffuse nuclear CCNB3, TLE1 and cyclin D1 positivity, while CCNB3 (0/12), TLE1 (1/12) and cyclin D1 (4/12) positivity was infrequent in the 12 cases of classical Ewing's sarcoma. The oval or plump spindle tumor cells with fine chromatin arranged in solid pattern, the nucleoli was inconspicuous. The delicate capillary networks were obvious in the tumor. Conclusion: With a detailed description of the histological spectrum, immunohistochemical features and clinical characteristic of BCOR-CCNB3 sarcoma, justify distinction from Ewing sarcoma could be possible.

A case report of a patient with high β-hCG levels after operation because of primary broad ligament pregnancy

INTRODUCTION

A broad ligament pregnancy is an extremely rare condition and diagnosis is frequently missed and finally made during laparotomy. This is a case of a young patient with high serum beta-human chorionic gonadotropin (β-hCG) levels after operation because of broad ligament pregnancy.

CASE REPORT

A 31-year-old multipara complained of intermittent lower abdominal pain with vaginal bleeding for four months. A color ultrasonography revealed a cystic mass in the left attachment area, indicating an interstitial tubal pregnancy. However, trophoblastic disease could not be excluded. She accepted conservative treatment with methotrexate (MTX) at first, but observation showed that conservative treatment was slow and accompanied with liver function damage. Therefore, exploratory laparotomy was performed. Intraoperative situations and postoperative pathology confirmed broad ligament pregnancy. Her serum p- hCG was sustained at a high level for three months after operation. Her examinations of serum, CT, and ultrasonography could explain this situation.

CONCLUSION

Primary broad ligament pregnancy refers to pregnancy where implantation of the fertilized ovum occurs directly between the two leaves of the broad ligament. The gravid substance was removed, however serum β-hCG could not gradually re- turn to normal levels. This case should be followed-up closely to prevent adverse outcomes.

[PTPS gene analysis and prenatal diagnosis in patients with 6-pyruvoyl-tetra hydropterin synthase deficiency]

Objective: To analyze the variations of PTPS gene in patients with suspected 6-pyruvoyl-tetra hydropterin synthase deficiency (PTPSD) and to make prenatal diagnosis in high-risk families. Methods: Chemiluminescence was used for phenylalanine detection in blood or dried blood spots.Patients with phenylalanine concentration over 120 μmol/L were detected by urine pterin analysis, and the activity of dihydropteridine reductase (DHPR) was detected. tetrahydrobiopterin loading tests were performed in suspected patients with abnormal urinary pterin profiles. PTPS gene variation analysis was performed by direct Sanger sequencing based on PCR amplification. Prenatal diagnosis in 7 high-risk families was performed by chorionic villus sampling when the genotype was identified. Results: In 656 patients with hyperphenylalanine, 22 cases were diagnosed as PTPSD clinically. 16 variations were detected in the 22 PTPSD cases. The 5 variations, p.Lys77Arg, p.Ile84Phe, c.315-2A>G, c.244-2A>T, c.187-1G>T, were identified as novel variations. Two fetuses carried the same mutation with the proband and therefore were thought to be PTPSD fetuses. Three fetuses carried only one mutant allele and thus were thought to be PTPSD carriers. The other 2 fetuses carried no mutations and were presumed normal. Conclusions: PTPS gene variation analysis is necessary to confirm the diagnosis. Prenatal diagnosis could help avoiding the defect birth in PTPSD families.

Pharmacokinetics, bioavailability and PK/PD relationship of cefquinome for Escherichia coli in Beagle dogs

The pharmacokinetics and bioavailability of cefquinome in Beagle dogs were determined by intravenous (IV), intramuscular (IM) or subcutaneous (SC) injection at a single dose of 2 mg/kg body weight (BW). The minimum inhibitory concentrations (MIC) of cefquinome against 217 Escherichia coli isolated from dogs were also investigated. After IV injection, the plasma concentration-time curve of cefquinome was analyzed using a two-compartmental model, and the mean values of t1/2α (h), t1/2β (h), Vss (L/kg), ClB (L/kg/h) and AUC (μg·h/mL) were 0.12, 0.98, 0.30, 0.24 and 8.51, respectively. After IM and SC administration, the PK data were best described by a one-compartmental model with first-order absorption. The mean values of t1/2Kel , t1/2Ka , tmax (h), Cmax (μg/mL) and AUC (μg·h/mL) were corresponding 0.85, 0.14, 0.43, 4.83 and 8.24 for IM administration, 0.99, 0.29, 0.72, 3.88 and 9.13 for SC injection. The duration of time that drug levels exceed the MIC (%T > MIC) were calculated using the determined MIC90 (0.125 μg/mL) and the PK data obtained in this study. The results indicated that the dosage regimen of cefquinome at 2 mg/kg BW with 12-h intervals could achieve %T > MIC above 50% that generally produced a satisfactory bactericidal effect against E. coli isolated from dogs in this study.

Effect of biological behavior and clinical significance of maspin gene on cervical squamous carcinoma SiHa cell

OBJECTIVE

This study was performed to evaluate the effect of mammary serine protease inhibitor (maspin) overexpression on human cervical squamous carcinoma (SCC) SiHa cell proliferation and apoptosis in vitro.

MATERIAL AND METHODS

Recombinant plasmid pcDNA3-maspin was stably transfected into human cervical SCC SiHa cell. Maspin mRNA was determined by RT-PCR, whereas maspin protein was detected by Western blot analysis and immunocytochemistry (IHC). Cell proliferation activity was measured by MTT method. Apoptosis rate and cell cycle distribution were detected by flow cytometry to understand the changes in the cell biological characteristics.

RESULTS

The strengthened expression of the maspin gene in the SiHa cell was confirmed by RT-PCR, Western blot, and immunocytochemistry (IHC) (p < 0.05). Suppressed proliferation activity and increased apoptosis rate of SiHa-m (maspin stable transfected) versus SiHa and SiHa-vector cell (SiHa-pc3) were shown by MTT and flow cytometry (p < 0.05). SiHa and SiHa-pc3-had no statistical significance (p > 0.05).

CONCLUSION

The results showed that maspin gene can significantly inhibit human cervical SCC SiHa cell proliferation and effectively slow cancer growth. Maspin may be a new molecular target in the gene therapy of human cervical SCC.

Postantibiotic effect and postantibiotic sub-minimum inhibitory concentration effect of valnemulin against Staphylococcus aureus isolates from swine and chickens

The postantibiotic effect (PAE) and postantibiotic sub-minimum inhibitory concentration (MIC) effect (PA-SME) of valnemulin against Staphylococcus aureus were investigated in vitro using a spectrophotometric technique and classic viable count method. A standard curve was constructed by regression analysis of the number of colonies and the corresponding optical density (OD) at 630 nm of the inoculum. After exposure to valnemulin at different concentrations for an hour, the antibiotic was removed by centrifuging and washing. The PA-SMEs were measured after initial exposure to valnemulin at 4 × the MIC, and then, valnemulin was added to reach corresponding desired concentrations in the resuspended culture. Samples were collected hourly until the culture became turbid. The results were calculated by converting the OD values into the counts of bacteria in accordance with the curve. The MIC of valnemulin against eight strains was identically 0.125 μg ml(-1) . The mean PAEs were 2.12 h (1 × MIC) and 5.06 h (4 × MIC), and the mean PA-SMEs were 6.85 h (0.1 × MIC), 9.12 h (0.2 × MIC) and 10.8 h (0.3 × MIC). The results showed that the strains with identical MICs exhibited different PAEs and PA-SMEs. Valnemulin produced prolonged PAE and PA-SME periods for Staph. aureus, supporting a longer dosing interval while formulating a daily administration dosage.

SIGNIFICANCE AND IMPACT OF THE STUDY

In this study, valnemulin demonstrated prolonged postantibiotic effects and postantibiotic sub-MIC effects on strains of Staphylococcus aureus. The strains with identical MICs of valnemulin exhibited different PAEs and PA-SMEs. Staphylococcus aureus isolated from different species has little impact on the postantibiotic effect of valnemulin. The result suggests a longer dosing interval while formulating a daily administration dosage, and it may play a valuable role of valnemulin in treating Staph. aureus infections in animals.

Mycoplasma gallisepticum and Escherichia coli mixed infection model in broiler chickens for studying valnemulin pharmacokinetics

A Mycoplasma gallisepticum-Escherichia coli mixed infection model was developed in broiler chickens, which was applied to pharmacokinetics of valnemulin in the present experiment. The velogenic M. gallisepticum standard strain S6 was rejuvenated to establish the animal model, and the wild E. coli strain O78 was injected as supplementary inoculum to induce chronic respiratory disease in chickens. The disease model was evaluated based on its clinical signs, histopathological examination, bacteriological assay, and serum plate agglutination test. The pharmacokinetics of valnemulin in infected chickens was determined by intramuscular (i.m.) injection and oral administration (per os, p.o.) of a single dose of 10 mg/kg body weight (BW). Plasma samples were analyzed by liquid chromatography-tandem mass spectrometry. The plasma concentration-time curve of valnemulin was analyzed using the noncompartmental method. After the i.m. administration, the mean values of Cmax , Tmax , AUClast , MRT, CLβ /F, Vz /F, and t1⁄2β , were 27.94 μg/mL, 1.57 h, 171.63 μg·h/mL, 4.51 h, 0.06 L/h/kg, 0.56 L/kg, and 6.50 h, respectively. By contrast, the corresponding values after p.o. administration were 5.93 μg/mL, 7.14 h, 47.60 μg·h/mL, 9.80 h, 0.22 L/h/kg, 3.35 L/kg, and 10.60 h. The disposition of valnemulin was retarded in infected chickens after both modes of extravascular administration as compared to the healthy controls. More attention should be given to monitoring the therapeutic efficacy and adverse effects of mixed infection because of higher required plasma drug concentration and enlarged AUC with valnemulin treatment.

Population pharmacokinetics of valnemulin in swine

This study was carried out in 121 pigs to develop a population pharmacokinetic (PPK) model by oral (p.o.) administration of valnemulin at a single dose of 10 mg/kg. Serum biochemistry parameters of each pig were determined prior to drug administration. Three to five blood samples were collected at random time points, but uniformly distributed in the absorption, distribution, and elimination phases of drug disposition. Plasma concentrations of valnemulin were determined by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The concentration-time data were fitted to PPK models using nonlinear mixed effect modeling (NONMEM) with G77 FORTRAN compiler. NONMEM runs were executed using Wings for NONMEM. Fixed effects of weight, age, sex as well as biochemistry parameters, which may influence the PK of valnemulin, were investigated. The drug concentration-time data were adequately described by a one-compartmental model with first-order absorption. A random effect model of valnemulin revealed a pattern of log-normal distribution, and it satisfactorily characterized the observed interindividual variability. The distribution of random residual errors, however, suggested an additive model for the initial phase (<12 h) followed by a combined model that consists of both proportional and additive features (≥ 12 h), so that the intra-individual variability could be sufficiently characterized. Covariate analysis indicated that body weight had a conspicuous effect on valnemulin clearance (CL/F). The featured population PK values of Ka , V/F and CL/F were 0.292/h, 63.0 L and 41.3 L/h, respectively.

Population pharmacokinetics of cefquinome in pigs

This study was performed in 145 pigs to develop a population pharmacokinetics (PPK) model by i.m. administration of cefquinome (CEQ) at the dose of 2 mg/kg in the neck muscle. Serum physiological and biochemical parameters for each pig were determined before administration. After administration, 2-4 samples were collected at random, with the sampling point evenly distributed in the three periods (<1 h, 1-4 h and >4 h). The plasma concentration of CEQ was determined by high performance liquid chromatography with UV detector. The pharmacostatistical analyses of concentration-time data, weight, age, gender, serum physiological and biochemical parameters were performed with nonlinear mixed effect modeling (NONMEM). A one-compartmental model with first-order absorption and elimination adequately described the data from the study group. The optimal random effect model of pharmacokinetics parameters was of log-normal distribution and the residual errors assumed a mixed-type model (proportional and additive) to best explain intra-individual variability. Covariate analysis showed that body weight is positively correlated with apparent volume of distribution (V/F) and body clearance (CL/F). The typical PPK parameters of Ka , CL, and V were 0.564/h, 5.15 L/h, and 1.36 L, respectively.

Causes of inpatient death for patients with warfare-related limb trauma and logistic regression analysis of the risk factors

OBJECTIVES

To explore the causes and risk factors of inpatient death for patients with warfare-related limb trauma.

METHODS

A retrospective study involving 339 patients with warfare-related limb trauma who were admitted to our hospital from 1998 to 2002 was conducted. Autopsy was performed for 15 cases who died in order to investigate the cause of death. Furthermore, based on the clinical features of warfare-related trauma patients, 11 factors were selected for further analysis: X1: causes of trauma, X2: shock after injury, X3: time from injury to hospital admission, X4: injured sites, X5: combined trauma (including head, thorax, abdomen, and vascular injury), X6: number of surgical procedures, X7: foreign body remaining, X8: fracture, X9: amputation, X10: duration of tourniquet homeostasis, X11: infection. All variables were available in all cases, and all parameters were quantified and fed into a computer. Multivariate statistical analysis was performed with a logistic regression model to elucidate the risk factors influencing death.

RESULTS

Fifteen of the 339 inpatient cases died (4.4%). The causes were primarily acute renal failure (ARF) (seven cases, 46.7%), pulmonary embolism (PE) (three cases, 20.0%), multiple organ system failure (MOSF) (two cases, 13.3%), and gas gangrene (three cases, 20.0%). There was one case of gas gangrene with concomitant ARF, and one of gas gangrene with MOSF. The primary risk factors influencing death included shock, amputation, and complicating infection (P < 0.05).

CONCLUSION

The primary cause of death from warfare-related limb trauma is ARF. The appropriate and prompt management of shock patients, the correct timing of amputation, and the prevention and correct handling of infection are important in reducing mortality.

[Synthesis of benzodihydropyran derivatives and evaluation of their preliminary biological activities on bone and vascular tissues]

AIM

To screen optimal drugs against postmenopausal osteoporosis with cardiovascular protective activities.

METHODS

A series of benzodihydropyran derivatives were designed and synthesized in view of comprehensive observations of raloxifene and ipriflavone. The antiosteoporosis activities of compounds a-e (10(-7) mol.L-1) on the proliferation of human osteoblast cell HOS TE85 were studied. The cardiovascular protective activities were evaluated by observing their effects on proliferation of human vascular endothelium cell ECV-304 and their protective effects on ECV-304 damaged by H2O2.

RESULTS

Their structures were determined by spectrums. Compounds a, b and c (10(-7) mol.L-1) were shown to significantly help proliferation of HOS TE85. In addition, b, d and e (10(-8) mol.L-1) helped proliferation of ECV-304 significantly. Compounds b and c (10(-6) mol.L-1) showed strong protective activity on ECV-304 damaged by H2O2. Compounds b and c shifted the KCl dose-response curves to the right and decreased the maximal response.

CONCLUSION

Compounds b and c showed some bone and vascular protective activities which benefit postmenopausal and cardiovascular diseases.

Delivery of glucocorticoid conjugate in rat gastrointestinal tract and its treatment for ulcerative colitis

AIM

To evaluate colonic delivery and therapeutic effect of the newly synthesized dexamethasone (DX)-dextran (500 000) conjugate (DXD50) in the rat.

METHODS

The amount of dexamethasone was measured in the contents from different parts of rat gastrointestinal tract and in plasma after ig conjugate. Therapeutic effect of conjugate and DX was tested in trinitrobenzenesulfonic acid-induced colitis in rat. Repair of colitis was assessed by measuring colonic ulceration area, colon weight, and colonic myeloperoxidase (MPO) activity. Systemic immunosuppression of DX was evaluated with weight of thymus and spleen and lymphocyte count in peripheral blood from rat with ulcerative colitis.

RESULTS

Dexamethasone released from conjugate was mainly distributed in contents of cecum and colon. When DXD50 and DX 0.25 micromol . kg-1 . d-1 were used ig to treat ulcerative colitis in rat, the ulcerative area of colon was reduced by 55.6 % and 33.3 %, respectively whereas colon weight was reduced by 17.9 % and 2.6 %, respectively. The conjugate had no effect on lymphocyte count in peripheral blood, spleen weight, and thymus weight of rat which could be reduced markedly by the same dose of DX (P < 0.05 vs control).

CONCLUSION

DXD50, which could specifically deliver DX to large intestine, is a promising agent in the treatment of human inflammatory bowel disease.

[Pharmacokinetics of site-specific delivery of dexamethasone-dextran prodrug in rat gastrointestinal tract]

AIM

To explore whether dexamethasone-dextran (260,000) has the characteristics of site-specific delivery in rat gastrointestinal tract.

METHODS

Dexamethasone prodrug and dexamethasone were administered to rat ig at the dose of 5 mumol.kg-1. The distribution of dexamethasone in the contents and mucosa of different parts of the rat GI tract at different time intervals and its concentration in plasma were determined by HPLC.

RESULTS

Dexamethasone was mainly released in the cecum and colon contents and mucosa after oral administration of dexamethasone prodrug. The absorption was reduced significantly. The peak time of the drug in plasma was 8.1 h, and the peak concentration was 32 micrograms.L-1. However, free dexamethasone was found mainly in the contents and mucosa of the stomach, proximal and distal small intestine. The peak time of the drug in plasma was 2.2 h, and the peak concentration was 2120 micrograms.L-1.

CONCLUSION

Dexamethasone can be specifically delivered to the large intestine by using dexamethasone-dextran (260,000). It appears that the prodrug has a potential in the treatment of inflammatory bowel disease.

Effects of MN-9202 on platelet aggregation, 5-HT release, TXB2 synthesis, and calcium mobilization in rabbit platelets in vitro

AIM

To study the effects of MN-9202, a new effective Ca2+ channel blocker, on platelet aggregation, 5-HT and TXB2 release, and calcium transport induced by platelet activators.

METHODS

The mobilization of cytosolic-free calcium induced by thrombin in washed platelets was observed by Ca(2+)-sensitive fluorescent indicator, Fura-2 AM and time scan measurement. Aggregation induced by ADP and thrombin in rabbits citrate platelet-rich plasma (PRP) was measured by aggregometer. 5-HT and TXB2 were assayed by HPLC/ECD and RIA, respectively.

RESULTS

MN-9202 inhibited platelet aggregation induced by ADP and thrombin in a concentration-dependent manner. MN-9202 1 mumol.L-1 inhibited release of 5-HT in PRP induced by collagen at 15 mg.L-1 (113 +/- 15 vs 178 +/- 18, P < 0.05), however, MN-9202 did not have effect on 5-HT secreted by high dose of collagen. MN-9202 0.1 and 1 mumol.L-1 blocked extracellular calcium influx and sarcoplasmic calcium release, and the suppression on extracellular calcium influx was more obvious. Furthermore, treatment with MN-9202 0.01, 0.1, and 1 mumol.L-1 markedly decreased ADP-induced TXB2 (pg/10(8) platelet) release from PRP (906 +/- 200, 881 +/- 131, and 793 +/- 169 vs 1264 +/- 202, P < 0.01).

CONCLUSION

MN-9202 acts as an effective Ca2+ antagonist and blocks platelet activation by inhibiting platelet Ca2+ influx and arachidonic acid metabolism.

Mitigation of endotoxin-induced acute lung injury in ventilated rabbits by surfactant and inhaled nitric oxide

OBJECTIVE

To evaluate the efficacy of surfactant and inhaled nitric oxide (iNO) in endotoxin-induced acute lung injury (ALI).

DESIGN

Prospective, randomised, controlled experimental study.

SETTING

A medical university hospital research laboratory.

INTERVENTION

Twenty-nine adult rabbits (2.4-3.4 kg) were given two doses of intravenous endotoxin (Escherichia coli) (0.01 mg/kg and, 12 h later, 0.1 mg/kg), and then subjected to mechanical ventilation. After 8 h these animals were allocated to four treatment groups: (1) control, (2) iNO at 20 ppm (NO), (3) surfactant at 100 mg/kg (Surf) and (4) both surfactant and iNO as in groups 2 and 3 (SNO), and ventilated for a further 6 h followed by broncho-alveolar lavage (BAL), analysis of surfactant contents in BAL fluid and histological examination of the lungs.

MEASUREMENTS AND RESULTS

All the animals had developed ALI with respiratory failure 8 h after the second dose of endotoxin as evidenced by a decrease of PaO2/FIO2 from 520 +/- 30 to 395 +/- 19 mmHg and dynamic compliance (Cdyn) from 1.20 +/- 0.11 to 0.73 +/- 0.05 ml/ cmH2O x kg, and an increase of intrapulmonary shunting (Qs/Qt) from 7.5 +/- 0.8% to 12.9 +/- 1.0% (all measurements p < 0.01 versus baseline). In the SNO group, values for PaO2/FIO2, Cdyn and Qs/Qt after 6 h were 301 +/- 15 mmHg, 0.67 +/- 0.05 ml/cmH2O x kg and 16.5 +/- 0.8%, compared to 224 +/- 26 mmHg, 0.53 +/- 0.04 ml/ cmH2O x kg and 24.1 +/- 2.0%, respectively, in the control group (all measurements p < 0.01). Both Surf and NO groups showed intermediate levels of these parameters. In both Surf and SNO groups, the minimum surface tension of BAL fluid was lower, and the content of disaturated phosphatidylcholine/total protein higher, than in the control and NO groups (p < 0.01). Histological features of lung injury were less prominent and wet/dry lung weight ratio lower in the NO, Surf and SNO groups. Decreased surfactant protein A (SP-A) and its mRNA expression were found in all endotoxin-exposed groups, but the SP-A content of the SNO group was moderately improved in comparison to the control group. Surfactant aggregate size was not affected.

CONCLUSION

Early application of surfactant and iNO moderately mitigated ALI as reflected by improvement of lung mechanics, pulmonary perfusion and morphology.

Pharmacokinetics of m-nifedipine in rabbits after intravenous injection

AIM

To study the dose effects on pharmacokinetics of m-Nif.

METHODS

Fifteen rabbits were divided into 3 groups receiving i.v. m-Nif 0.5, 1, and 2 mg.kg-1. Plasma levels of m-Nif were determined with HPLC method.

RESULTS

The concentration-time data were fitted with 2-compartment model. After i.v. 1 mg.kg-1, the parameters were: Vd = 0.37 +/- 0.10 L.kg-1, T1/2 alpha = 6.4 +/- 2.9 min, T1/2 beta = 84 +/- 22 min, AUC = 94 +/- 16 mg.min.L-1, Cl = 0.65 +/- 0.13 L.kg-1.h-1. No statistically significant difference was found in Cl and T1/2 beta between 3 dose groups. AUC (standardized to body weight) was correlated with doses.

CONCLUSIONS

m-Nif was distributed widely and eliminated at a fairly rapid rate in the rabbits. No dose-dependent pharmacokinetics was found after i.v. m-Nif 0.5-2 mg.kg-1. m-Nifedipine, 2, 6-dimethyl-3, 5-dicarbomethoxy-4-(3'-nitrophenyl)-1, 4-dihydropyridine (m-Nif) is a new calcium channel blocker. Dihydropyridine calcium channel antagonists are mainly used for the treatment of hypertension and angina[1]. Nifedipine is susceptible to photodegradation, but m-Nif is stable when exposed to light. The 2 drugs have the same antihypertensive effect[2]. So far, no report has been found on pharmacokinetics of m-Nif. Using a high performance liquid chromatographic (HPLC) method, we studied the dose effects on the pharmacokinetics of i.v. m-Nif 0.5, 1, and 2 mg.kg-1 in conscious rabbits.

Effects of isoprenaline on delayed rectifier potassium current in isolated guinea pig ventricular myocytes

AIM

To study the effects of isoprenaline (Iso) on the delayed rectifier potassium current (Ik) in isolated guinea pig ventricular myocytes.

METHODS

Single cells were isolated from guinea pig ventricle. Ik was studied under voltage clamp conditions.

RESULTS

When Ik was activated by depolarizing pulses to +40 mV of increasing duration (40-300 ms), Iso 1 mumol . L-1 caused an enhancement in Ik which was larger for longer pulses (150-300 ms). This was also seen when the intracellular calcium was buffered by 1,2-bis(2-aminophenoxy) ethane-N, N, N1, N1-tetraacetic acid (BAPTA). Intracellular application of BAPTA caused a decrease in Ik activated by longer pulses.

CONCLUSION

There were two components of Ik, one of which was modulated by Iso and intracellular Ca2+.

[The changes in copper contents and its clinical significance in patients with liver cirrhosis and hepatocarcinoma]

Copper contents (Cu) in bodies and serum ceruloplasmin (Cp) were assayed in patients with liver cirrhosis (LC) and hepatocarcinoma (HCC) with atomic absorption and other methods. The results were shown as follows: 1. The mean levels of serum Cp and urine Cu in LC were higher than those of normal (P < 0.05 and 0.01). 2. Serum Cu and Cp levels were consistently high in HCC. Urine Cu level was also elevated and had positive correlation with that of serum Cu (r = 0.567, P < 0.01). 3. Cirrhotic liver Cu content was almost the same as that of pericarcinomatous liver Cu, being higher than that of normal and carcinomatous liver. 4. Hair Cu level in both LC and HCC was apparently lower than that of normal subjects. 5. Serum Cu level in patients with tumor more than 5 cm in size was higher than that in patients with tumor less than 5 cm (P < 0.05). 6. Serum Cu level decreased along with the reduction of tumor size after treatment. 7. Serum Cu and Cp levels may be used as markers for detection of HCC, especially for AFP-negative HCC. Serum Cu estimation is valuable in assessment of the therapeutic effect and prognosis in patients with HCC.

Protective effects of 3,6-dimethylamino-dibenzopyriodonium edetate on global ischemia reperfused isolated rat hearts

The effects of 3,6-dimethylamino-dibenzopyriodonium edetate (IHC-72) on global ischemia reperfused rat hearts were investigated. In the isolated working rat heart, 40-min global ischemia followed by 30-min reperfusion resulted in increases of ventricular tachycardia (VT) and ventricular fibrillation (VF), increases of creatine kinase (CK) release and malondialdehyde (MDA) contents, but decreased superoxide dismutase (SOD) activity. Following ischemia and reperfusion, the accumulation of myocardial calcium increased. IHC-72 50 mumol.L-1 given 10 min before ischemia and during reperfusion decreased the cardiac CK release, VT, and VF, reduced the MDA contents, prevented the reduction of SOD activity and attenuated the accumulation of myocardial calcium and sodium vs control. These results indicated that IHC-72 protected myocardial reperfused injury.

[Effects of furyl-dihydropyridine on action potential ventricular myocardium of rabbit in vivo and isolated guinea pig left atrium in vitro]

Effects of furyl-dihydropyridine (FDP) on action potential of rabbit ventricular myocardium in vivo were observed with floating microelectrode technique. FDP 0.5 mg.kg-1 i.v. increased APD30 from 104 +/- 7 to 127 +/- 7 ms, APD90 from 146 +/- 10 to 177 +/- 9 ms (P < 0.01, n = 7), decreased the heart rate from 230 +/- 18 to 203 +/- 20 bpm (P < 0.05). Nifedipine (Nif) 0.5 mg.kg-1 i.v. reduced APD and increased the HR in rabbit. In guinea pig left atrium, FDP and Nif decreased the APD, the effects of acetylcholine to shorten the APD was antagonized by FDP 1 mumol.L-1. In rabbit's sinoatrial nodes, FDP 0.5, 1 mumol.L-1 also suppressed the APA and increased the spontaneous sinus cycle length (SCL) and APD50. These results indicate that FDP may inhibit the Ca2+ and K+ currents of myocardium.

Effects of 3,6-dimethylamino-dibenzopyriodonium edetate on action potentials in guinea pig papillary muscles

The effects of 3,6-dimethylamino-dibenzopyriodonium edetate (IHC-72) on action potentials (AP) and slow response action potentials of guinea pig papillary muscles were studied with intracellular microelectrodes. IHC-72 12.7, 25.4, and 50.8 mumol.L-1 decreased the maximal upstroke velocity (Vmax), amplitude of action potential (APA), over shot (OS), and resting potential (RP) while prolonged the action potential duration at 30%, 50%, 90%, and 100% repolarization (APD30, APD50, APD90, and APD100). IHC-72 25.4 and 50.8 mumol.L-1 decreased the APA, Vmax, and prolonged APD50 and APD90 under high K+ superfusion. IHC-72 25.4 and 50.8 mumol.L-1 depressed the automaticity, APA, and maximal diastolic potential (MDP) of the slow response action potentials induced by BaCl2. The results indicated that IHC-72 might nonspecifically inhibit the transmembrane movement of Ca2+, Na+, and K+.

DNA content and its relationship with pathology and prognosis of colorectal carcinoma

The DNA content of 181 colorectal cancers was investigated by flow cytometry on paraffin-embedded specimen. The relationship of flow cytometric DNA patterns of colorectal cancer to Dukes's stage, histological type and grade, tumor size and patient's prognosis were analysed. The DNA aneuploid carcinomas were found in 53.04% of the patients (hypodiploid 22.10%, hyperdiploid 20.99%, polyploid 9.94%). Diploidy was found in 46.96% of the patients with colorectal cancer. The proportions of aneuploidy were significantly lower in the patients with Dukes' stage A (25.00%) and B (47.14%) than those with Dukes' stage C (64.71%) and D (68.42%). Aneuploid frequency was higher in the patients with poorly differentiated adenocarcinoma (84.62%), mucinous adenocarcinoma (62.50%) and tubular adenocarcinoma (52.75%) than those with villous adenocarcinoma (22.86%). The proportion of aneuploidy was significantly higher in the patients with poorly differentiated tumor (71.79%) than in those with moderately (50.00%) and well differentiated tumors (44.83%). Five-year survival rate of the patients with DNA aneuploid tumors was 33.80% compared with 66.67% of those with diploid tumors. Analysis of Cox regression revealed that DNA ploidy and Dukes' stage significantly influenced the patient's prognosis. It is suggested that DNA ploidy might be an important prognostic factor in colorectal cancer.

Prevention of global myocardial reperfusion injury on isolated rabbit hearts with furyl-dihydropyridines I

In the isolated rabbit heart of recirculating nonpulsatile perfusion circuit, furyl-dihydropyridines I 20 mumol.L-1 greatly reduced the leakage of myocardial enzymes and the concentration of malondialdehyde (MDA) in plasma, decreased the myocardial calcium and sodium contents, maintained normal coronary vascular resistance and prevented reperfusion arrhythmias of global postischemic reperfusion hearts. Its mechanism of protecting the ischemic-reperfused myocardium might be associated with the diminution of calcium influx of myocardial cells and cellular lipid peroxidation induced by oxygen free radicals.

Positive inotropic effect of apomorphine on guinea pig myocardium is mediated by dopamine DA1 receptors

Dopaminergic agonist apomorphine (Apo, 1-100 mumol.L-1) had a concentration-dependent positive inotropic effect on guinea pig left atria. This effect was not changed obviously when the influences of sympathetic and parasympathetic nerves were eliminated by reserpine and atropine, respectively. Apo had little inotropic action on guinea pig papillary muscles. The time course of positive inotropic effect of Apo was different from that of isoprenaline and phenylephrine. Apo influenced the isometric contraction curves in a different way from isoprenaline. Dopaminergic antagonist haloperidol antagonized the positive inotropic effect of Apo. This effect was also competitively antagonized by dopamine DA1 antagonist SCH 23390. While dopamine DA2 antagonist domperidone, beta-adrenergic antagonist propranolol and alpha-adrenergic antagonist phentolamine did not obviously influence the effect of Apo. We concluded that the positive inotropic effect of Apo was mediated by postsynaptic dopamine DA1 receptors in guinea pig left atria.

[Effects of furyl-dihydropyridines I on lipid peroxides of ischemic myocardium and ATPases activity of erythrocyte membranes in rats]

Acute myocardial ischemia and reperfusion in rats increased glutamic oxalacetic transaminase (GOT), non-esterified fatty acid (FFA), malondialdehyde (MDA) content. Furyl-dihydropyridines I 10 mg.kg-1 decreased the release of GOT, FFA, MDA of ischemic myocardium, and prevent ischemia-reperfusion arrhythmia. Furyl-dihydropyridines I increased Na, K-ATPase activity and N-acethylneuraminic acid (NANA) content of erythrocyte membranes, inhibited Ca-ATPase activity of erythrocyte membranes in rats. The results suggested that the mechanism of protecting the ischemic-reperfused myocardium might be associated with the inhibition of cellular lipid peroxidation and Ca-ATPase activity of cell membranes.

[Protective effects of nicorandil on lipid peroxidation in ischemic and reperfused myocardium of rabbits]

The experiments of recirculating blood perfusion device showed that nicorandil (Nic) 0.15 mmol/L significantly decreased the content of malondialdehyde (MDA), inhibited the release of creatine kinase (CK), counteracted the increase of coronary vascular resistance (CR), and abolished the reperfusion-induced arrhythmias in isolated rabbit hearts during ischemia and reperfusion. The results indicate that Nic has protective effects on myocardial ischemic and reperfused damage, which may relate to the prevention of lipid peroxidation.

[Effects of bis(dimethyl amino)-diphenyl methane (BDDM) on action potentials in guinea pig papillary muscle]

The effects of BDDM on action potentials and slow response action potentials in guinea pig papillary muscle were investigated by microelectrode technique. BDDM prolonged action potentials duration at 30, 50, 90, and 100% repolarization (APD30, APD50, APD90, APD100) and prolonged the effective refractory period (ERP), so ERP/APD value became greater. BDDM (51.6 mumol/L) decreased the APA, Vmax and prolonged APD50, APD90. In barium-induced ventricular autorhythmicity, BDDM suppressed the maximal diastolic potential (MDP), APA and reduced the rate of spontaneous rhythm. The results suggest that BDDM may unspecifically inhibit the currents of Ca2+, K+, and Na+.

[Clinical research on the relation of chronic gastritis and intragastric bile acids]

Intragastric bile acids on fasting for 1 hour have been determined by radioimmunoassay and thin-layer chromatographic scanning in 102 cases of chronic gastritis. The results showed that all of intragastric conjunction bile acids were higher in chronic atrophic gastritis group than those in chronic superficial gastritis group. Both of their intragastric bile acids and nitrite levels increased significantly in patients whose gastric mucosa appeared acute inflammation, glandular atrophy and moderate or severe intestinal metaplasia. These findings suggest that bile acids may be implicated in premalignant histological changes of gastric mucosa such as chronic atrophic gastritis. Determining intragastric bile acids will reflect the degree and injurious effect of duodenogastric reflux.

Rett syndrome in China: report of 9 patients

This is the first report of Rett syndrome in China. Clinical and laboratory data were obtained from 9 girls with Rett syndrome. In addition to the previously reported clinical manifestations (i.e., early deterioration of intelligence, microcephaly, peculiar stereotypic hand movements, and epilepsy), 2 other features were observed in these patients: abnormal evoked response audiometry and low content of the elements, copper and zinc in the hair. The cause of these associated phenomena is unknown.