CT quantification of pulmonary vessels in lung aging

AIM

To evaluate the effect of aging on pulmonary vessels based on computed tomography (CT) quantification and analyse the correlation between quantitative pulmonary vascular volume and pulmonary function during aging.

MATERIALS AND METHODS

A total of 330 healthy adult volunteers, including 161 men (53 aged 20-39 years, 61 aged 40-59 years, and 47 aged ≥60 years) and 169 women (53 aged 20-39 years, 63 aged 40-59 years, and 53 aged ≥60 years) were recruited in this study. AVIEW software was used to quantitatively measure pulmonary vascular volume, including pulmonary total blood vessel volume (TBV) and small blood vessel volume with a cross-sectional area of <5 mm2 (BV5). Pulmonary vascular volume parameters were standardised using the ratio of vascular volume to the body surface area (BSA; TBV/BSA and BV5/BSA). Subsequently, the effect of aging on the pulmonary vessels was analysed.

RESULTS

The pulmonary vascular volume parameters TBV/BSA and BV5/BSA of the whole lung, right lung, and left lung decreased significantly with increasing age (p<0.05). Additionally, TBV/BSA and BV5/BSA of the whole lung were higher in men than in women. The declining trend of pulmonary vascular volume was consistent in men and women and increased with age.

CONCLUSIONS

The pulmonary vascular volume parameters, TBV/BSA and BV5/BSA, decreased with age and were weakly positively correlated with pulmonary function.

[Effects of miniature free groin perforator flaps in repairing small wounds on hands]

Objective: To investigate the effects of miniature free groin perforator flaps in repairing small wounds on hands. Methods: The retrospective observational study was conducted. Fifteen patients with 16 small wounds on hands were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital from July 2020 to October 2022, including 12 males and 3 females, aged 19 to 56 years. The size of skin and soft tissue defect was 2.0 cm×1.5 cm to 6.0 cm×3.0 cm after debridement. According to size and shape of the wounds, 13 single-lobe perforator flaps and 2 bilobed perforator flaps were designed in the groin region, with the flap size of 4.5 cm×2.5 cm to 7.5 cm×3.5 cm. According to the condition of the recipient area, the arteries and veins at the pedicle of the flap were anastomosed to the arteries and veins of the recipient area respectively. The wounds in the donor area of the flap was closed by layered and tension-reducing suture. The thickness of the flap was measured during operation. The survival of the flap was observed, and the complications in the donor and recipient areas were recorded after operation. The appearance and texture of the flap were observed during follow-up. At the last follow-up, the sensory recovery of the affected hand was evaluated, the function of the affected hand was evaluated according to the trial standard of the upper limb partial function evaluation of the Hand Surgery Society of the Chinese Medical Association, the scar in the donor and recipient areas were observed, and the satisfaction of patients for the curative effects was inquired. Results: The thickness of the flap was ranged from 0.3 to 1.0 cm, with an average thickness of 0.6 cm. After operation, 11 single-lobe flaps and 2 bilobed flaps survived well; in the left 2 single-lobe flaps, one flap had venous crisis but returned to normal after removing stitches to reduce tension and bloodletting of flaps, while the other one flap had a little necrosis on tip but healed after dressing change. No complications occurred in donor and recipient areas. During follow-up of 8 to 35 months after operation, the flaps had good elasticity and soft texture; 8 flaps were slightly bloated and were trimmed 3 to 8 months after operation, while the appearances of the other flaps were good. At the last follow-up, all flaps recovered protective feeling; the function of the affected hand was evaluated as excellent in 10 cases, good in 4 cases, and fair in 1 case; only linear scar remained in the donor and recipient areas; the patients were satisfied with the appearance and function recovery of the affected hand. Conclusions: The miniature free groin perforator flaps in repairing small wounds on hands have the advantages of high survival rate of flaps, hidden flap donor area, little damage, few complications, good repair effect, etc., showing clinical application value. It is recommended for repairing non-functional wounds on hands.

Screening and bioinformatics analysis of senile osteoporosis genes based on GEO database

OBJECTIVE

Despite improvements in research on osteoporosis in the elderly, the specific mechanism remains unknown. In order to develop better treatment regimens with better efficacy and fewer adverse reactions (ARs), it is vital to unravel the pathogenesis of osteoporosis in the elderly. The GEO chip was used to screen differential genes in senile osteoporosis and analyze their interaction mechanisms in order to obtain potential therapeutic pathways and targets.

MATERIALS AND METHODS

GSE35956 was downloaded from GEO database and used as the research object for KEGG pathway enrichment analysis, GO enrichment analysis and protein-protein interaction (PPI) network analysis, respectively, to explore the related mechanisms of the occurrence and development of osteoporosis in the elderly.

RESULTS

There were 156 differentially expressed genes in the elderly (72 years old) and middle-aged (42 years old) diagnosed with osteoporosis, of which 6 were up-regulated and 150 were down-regulated. An analysis of gene enrichment using GO (gene body) revealed that differentially expressed genes (DEG) were mainly distributed in extracellular matrix (ECM) and other cell structures. Its functions include ossification, parathyroid hormone metabolism, multicellular biological signaling pathway, vitamin catabolism, interleukisn-5 metabolism, transmembrane transporter activity, receptor signaling pathway, calcium metabolism and other molecular functions. According to the Kyoto Encyclopedia of Genes and Genomes (KEGG), an online resource, signaling pathways associated with age-related osteoporosis (OP) are significantly enriched. The DEG enrichment pathways include Wnt, ECM-receptor interaction, cGMP-PKG, GAG degradation, and calcium signaling. A protein and protein interaction (PPI) network was constructed for 14 key genes, including CD44, GRIA1, KNG1 and IL7R.

CONCLUSIONS

The findings of this study indicate that CD44, GRIA1, KNG1, IL7R, and other differential genes affect the Wnt signaling pathway in the elderly, which can provide new targets for the follow-up basic research and treatment of osteoporosis in the elderly.

Сyclooxygenase-2 Inhibitor Parecoxib Reduces LPS-Induced Activation of BV2 Microglia Cells

We studied the inhibitory effect of cyclooxygenase-2 inhibitor parecoxib on LPS-induced activation of BV2 microglia cells. The optimal dose of parecoxib (80 μmol/liter) was evaluated by the Cell Counting Kit-8. The cells were divided into the following groups: control (intact cells without treatment); LPS (treatment with 1 μg/ml LPS for 6 h), and experimental (pretreatment with 80 μmol/liter parecoxib for 24 h followed by incubation with 1 μg/ml LPS for 6 h). Cell morphology and proliferation and the expression of NLRP3, caspase-1, pro-caspase-1, and IL-1β were assessed. LPS induced significant morphological changes and decreased proliferation of primary BV2 cells in comparison with the control. These changes were prevented by parecoxib pretreatment. LPS significantly increased NLRP3 inflammatory vesicle activation and expression of NLRP3, caspase-1, pro-caspase-1, and IL-1β in comparison with the control group; pretreatment with parecoxib prevented all these changes. Our results suggest that pretreatment with parecoxib inhibited LPS-induced activation of BV2 microglial cells and probably inhibited NLRP3 inflammasome activation.

[Retrospective analysis of 35 burn patients in different stages of pregnancy]

Objective: To summarize the clinical outcomes of burn patients in different stages of pregnancy and explore a rational therapeutic scheme for burns during pregnancy. Methods: A retrospective observational study was conducted. From June 2010 to June 2020, 21 patients who met the inclusion criteria were admitted to the Department of Burns of Wuhan Third Hospital and 14 patients who met the inclusion criteria were admitted to the Department of Burns of the First Affiliated Hospital of Nanchang University. Based on the pregnancy period when patients suffered burns, the 35 patients were divided into early pregnancy group with 18 patients (aged (26±4) years, with 8 (4, 11) weeks of gestation), middle pregnancy group with 10 patients (aged (26±3) years, with 21 (14, 27) weeks of gestation), and late pregnancy group with 7 patients (aged (30±5) years, with 32 (29, 35) weeks of gestation). All the patients received treatment including fluid resuscitation, anti-infection, wound treatment, and multidisciplinary comprehensive managements. The burn-related complications during the treatment, maternal outcomes, fetal outcomes, fetal delivery mode, gestational weeks at delivery, and newborn weight of patients in the 3 groups were recorded. Data were statistically analyzed with one-way analysis of variance, Kruskal-Wallis test, and Fisher's exact probability test. Results: During the treatment, there were 4, 4, and 2 patients who suffered wound infections and 1, 3, and 2 patients who developed shock symptoms, respectively, in early pregnancy group, middle pregnancy group, and late pregnancy group. There were no statistically significant differences in them among the 3 groups (P>0.05). One patient in late pregnancy group developed into multiple organ dysfunction syndrome after debridement. At last, all the pregnant women survived, and no statistically significant difference existed among the 3 groups (P>0.05). In early pregnancy group, middle pregnancy group, and late pregnancy group, the survived fetus cases were 9, 8, and 6, respectively, and the differences between them were not statistically significant (P>0.05). Variables including stillbirth and full-term birth were close in patients in the 3 groups (P>0.05), while the preterm birth and miscarriage in patients in the 3 groups were statistically different (P<0.05 or P<0.01), with the early pregnancy group having the most miscarriage cases and the fewest preterm birth cases. There were no statistically significant differences in fetal delivery mode, gestational weeks at delivery, and newborn weight among the patients with survived fetus in 3 groups (P>0.05). Conclusions: For patients suffering burns during early, middle, and late pregnancy, superior rates of maternal and fetal survival can be achieved after timely and adequate treatments including fluid resuscitation, anti-infection, wound treatment, and multidisciplinary comprehensive managements.

[Sex disparities in clinical characteristics of Chinese patients with systemic sclerosis]

Objective: To evaluate the differences in clinical characteristics between different genders of Chinese patients with systemic sclerosis(SSc). Methods: The data of SSc patients registered in Chinese Rheumatism Data Center between August 2008 and June 2020 were retrospectively analyzed. Results: A total of 1 844 patients with SSc were enrolled in the study. The ratio of males to females was 289 to 1 555. The onset age was (48.6±13.7) years in males and (45.5±13.1) years in females(P<0.001). Male patients represented shorter disease duration [2.0(0.0, 4.0)years vs.3.0(1.0, 7.0) years, P<0.001],higher proportion of diffuse cutaneous SSc (dcSSc) [63.0% (182/289)vs.44.2%(688/1 555), P<0.001]. Although more man patients experienced smoking [47.4%(137/289) vs. 1.7%(27/1 555), P<0.001] and exposure to harmful environments [7.6%(22/289) vs. 2.1%(33/1 555), P<0.001], there was no statistically significant difference in interstitial lung disease between male and female patients [69.3%(181/261) vs. 74.5%(1 085/1 457), P=0.084].Otherwise, Raynaud's phenomenon [87.7% (1 364/1 555) vs.75.4%(218/289), P<0.001], arthritis [11.1%(173/1 555) vs.6.9%(20/289), P=0.032], gastroesophageal reflux disease [22.0%(342/ 1 555) vs.13.1%(38/289), P=0.001], and leucopoenia [10.7(161/1 511)% vs. 6.1%(17/279), P=0.019] were more common in female patients, but finger ulcer was less common [22.5%(350/1 555) vs. 30.4%(88/289), P=0.004]. Antinuclear antibody(ANA) positivity rate [85.6%(1 310/1 531) vs. 78.6%(221/281), P=0.003], anti-RNP antibody positivity rate [23.1%(342/1 479) vs.14.0%(38/271), P=0.001], anti-SSA antibody positivity rate [28.2%(419/1 487) vs.13.9%(38/274), P<0.001] were higher in female patients. Physician's global assessment(PGA) scores [1.4 (1.0, 2.0) vs. 1.0 (0.3, 1.6), P<0.001] and modified Rodnan Skin Score(mRSS) [18.0 (9.5, 28.0) vs. 14.0 (5.0, 28.0), P=0.003] were higher in males. Conclusion: Even though male SSc patients account for a small proportion, more extensive skin involvement, finger ulcers and higher PGA are manifested in males. Physicians need pay attention to these clinical disparities between different genders in SSc.

[Curative effect analysis of ultrasound-guided percutaneous radiofrequency ablation for caudate lobe hepatocellular carcinoma]

Objective: To investigate the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation (RFA) for caudate lobe hepatocellular carcinoma (HCC) and the failure factors of incomplete tumor ablation. Methods: Twenty-four cases with caudate lobe hepatocellular carcinoma who underwent ultrasound-guided percutaneous RFA in the Affiliated Tumor Hospital of Zhengzhou University from January 2017 to October 2019 were enrolled. The ablation effect and complications conditions were recorded, and the primary technical effectiveness and local tumor progression (LTP) were evaluated. Results: Among 24 cases, 20 cases had complete ablation at one session, 4 cases had incomplete ablation, and after supplementary radiofrequency ablation all cases had achieved complete ablation. There was no evidence of local tumor progression in 24 cases after one-month postoperative evaluation. The primary technical effectiveness rate was 100%. The postoperative follow-up was 2 to 29 months (median follow-up time was 18 months). Of the 24 cases after ablation, LTP were detected in 11 cases, of which only 3 cases had distant intrahepatic recurrence, 1 case had distant intrahepatic recurrence and distant metastasis, and 5 cases had only distant metastasis, 2 cases died, and 4 cases had SIR grade B complications related to ablation. Conclusion: Ultrasound-guided percutaneous radiofrequency ablation was safe and effective for caudate lobe hepatocellular carcinoma. In addition, the distance between the tumor and the inferior vena cava < 0.5cm is a suspected risk factor for incomplete ablation of caudate lobe hepatocellular carcinoma (P < 0.05).

[Implementation and controversies of enhanced recovery after surgery in pancreaticoduodenectomy]

The concept of enhanced recovery after surgery(ERAS) has been widely accepted and applied in clinical practice.However,as one of the most complex surgical procedures in abdominal surgery,pancreaticoduodenectomy is characterized by long operation time,high incidence rate of postoperative complications and delayed recovery,there still remain some controversies about application of ERAS approaches in perioperative managements of pancreaticoduodenectomy.Although more and more studies has revealed the safety and efficacy of ERAS approaches in pancreaticoduodenectomy,the implementation of ERAS approaches should be still individualized in clinical practice to ensure safety of the patients.

[Renal mucinous tubular and spindle cell carcinoma: clinicopathological and whole exome sequencing analyses]

Objective: To explore the clinicopathological characteristics, immunophenotype, diagnosis and differential diagnosis of renal mucinous tubular and spindle cell carcinoma (MTSCC), and to explore the all-exon mutations, microsatellite stability and tumor mutational burden (TMB) in MTSCC cases. Methods: The data of 5 patients with MTSCC that were submitted to the Department of Pathology, First Affiliated Hospital of Soochow University, China from January 2008 to May 2020, were reviewed and analyzed. The whole exome sequencing (WES) was conducted in all patients, while 3 of them were subject to the analyses of microsatellite stability and TMB. Results: Among the 5 patients, 3 were males and 2 were females. They were 37-76 years old. The maximum diameter of the tumor was 3.5-6.0 cm. The borders of the tumors were well defined. Microscopically, MTSCC was characterized by tubular structure, spindle cell and mucinous stroma, and the nuclear grade of tumor cells was overall low. The average follow-up was 15 months, and no recurrence or metastasis was found. Immunohistochemistry showed that all 5 cases were positive for broad-spectrum cytokeratin (CKpan), cytokeratin (CK)7, CK19, vimentin, PAX8, and P504s (varying expression levels), and the Ki-67 positive index was low. The WES of 5 cases showed that NF2 and PTPN14 exhibited higher mutation rates, which were 3/5 and 2/5, respectively. The microsatellite stability analysis indicated that the 3 cases were all microsatellite stable, and the TMB analysis showed that the TMB of the 3 cases were all <9 mut/Mb. Conclusions: MTSCC is a unique, low-grade pleomorphic kidney tumor. The WES analyses suggest that NF2 and PTPN14 have a higher mutation rate, indicating that the occurrence and development of MTSCC may be closely related to the Hippo pathway. The analysis of microsatellite stability indicates that there is no significant relationship between microsatellite stability and MTSCC, and the TMB analysis suggests that MTSCC patients may not benefit from immunotherapy.

[Use of new diagnostic criteria for reclassification of polyarteritis nodosa]

With the recognition of antineutrophil cytoplasmic antibodies (ANCA)-related vasculitis and widespread vaccination against viral hepatitis B, the prevalence of polyarteritis nodosa (PAN) varied considerably. In our study, patients diagnosed as polyarteritis nodasa (PAN)based on the 1990 American College of Rheumatology(ACR) criteria were reclassified using 2007 European Medicines Agency(EMA) algorithm modified by 2012 Chapel Hill Consensus Conference(CHCC) definitions, aiming to evaluate the new classification criteria for the diagnosis of PAN. A total of 113 PAN patients admitted to Peking Union Medical College Hospital from January 2002 to December 2018 were retrospectively analyzed, who were classified into three subtypes including 9 patients with cutaneous, 80 with classic and 24 Hepatitis B virus (HBV) associated PAN. All patients were reclassified according to 2007 EMA algorithm using CHCC 2012 definitions. As a result, 7 patients were diagnosed as microscopic polyangiitis(MPA) and 19 patients with unclassified vasculitis based on the new classification criteria. The diagnostic rate of PAN was gradually declined as the classification criteria of vasculitides was update. However, there are quite a few PAN patients in China, whom rheumatologists should pay attention to the early diagnosis and treatment.

[Agreement of EV-A71 neutralization assay: serial 4-fold versus 2-fold dilution comparison]

Objective: To evaluate consistency between 2-fold serial and 4-fold serial diluted neutralization tests against Enterovirus A71 (EV-A71) in estimating titer, Geometric mean titer (GMT), seroprevalence, and seroincidence. Methods: Based on a prospective cohort of 1-9 years old children, mothers and infants established in Anhua County, Hunan Province, during 2013-2018, from which 92 participants with a total of 386 blood specimens were sampled and tested with a 2-fold serial dilution and a 4-fold serial dilution neutralization tests against EV-A71 at the same time. Agreement was estimated using the Bland-Altman method. Stratified analysis was conducted to estimate effect dilution approach on GMT, seroprevalence and seroincidence. Results: The mean difference (0.04, 95%CI:-0.02-0.10) between the two dilution approaches was not significant. However, the limits of agreement (LOA) (-1.12-1.21), with the 95% confidence interval of upper LOA (1.10-1.31) and of lower LOA (-1.22--1.02), significantly exceeded the Clinic accept interval (-1, 1) indicating insufficient agreement between the two approaches in practice. While the dilution approaches did not affect estimates of GMT of the total population and the positive population, and seroincidence with seroconversion only, the differences were 2, 6 and 2%, respectively (P>0.05). Estimates of seroincidence with at least 4-fold increase and seroconversion/4-fold increase were significantly higher using a 4-fold dilution neutralization test compared to the 2-fold dilution neutralization test with 8% (95%CI: 1%-12%) and 9% (95%CI: 1%-17%), respectively. Conclusion: The 2-dilution and 4-dilution neutralization tests yielded comparable results when estimating the population's GMT; however, the difference between the two is not negligible when assessing the seroincidence.

[Advances in the research of diagnosis and treatment of ventilator-induced lung injury after burn]

As one of the important means for saving severely burned patients, mechanical ventilation can not only improve the function of important organs such as heart, lung, and kidney, but also stabilize the homeostasis of the body, thus promoting the recovery of patients. Improper use of mechanical ventilation, however, can lead to many complications, among which the ventilator-induced lung injury (VILI) is one of the most common and serious complications, accompanying with a high mortality rate. The target of preventing VILI is to minimize the risk of lung injury caused by mechanical ventilation. This article reviews the pathogenesis, diagnosis, and early prevention and treatment of VILI caused by mechanical ventilation in burned patients.

The optimal peripheral oxygen saturation may be 95-97% for post-cardiac arrest patients: A retrospective observational study

BACKGROUND

Current post-resuscitation guidelines recommend oxygen titration in adults with the return of spontaneous circulation after cardiac arrest. However, the optimal peripheral oxygen saturation (SpO₂) is still unclear for post-cardiac arrest care.

METHODS

We conducted a retrospective observational study of prospectively collected data of all cardiac arrest patients admitted to the intensive care units between 2014 and 2015. The main exposure was SpO₂, which were interfaced from bedside vital signs monitors as 1-min averages, and archived as 5-min median values. The proportion of time spent in different SpO₂ categories was included in separate multivariable regression models along with covariates. The primary outcome measure was hospital mortality and the proportion of discharged home as the secondary outcome was reported.

RESULTS

2836 post-cardiac arrest patients in ICUs of 156 hospitals were included. 1235 (44%) patients died during hospitalization and 818 (29%) patients discharged home. With multivariate regression analysis, the proportion of time spent in SpO₂ of ≤89%, 90%, 91%, and 92% were associated with higher hospital mortality. The proportion of time spent in SpO₂ of 95%, 96%, and 97% were associated with a higher proportion of discharged home outcome, but not associated with hospital mortality.

CONCLUSIONS

In this retrospective observational study, the optimal SpO₂ for patients admitted to the intensive care unit after cardiac arrest may be 95-97%. Further investigation is warranted to determine if targeting SpO₂ of 95-97% would improve patient-centered outcomes after cardiac arrest.

MOTS-c accelerates bone fracture healing by stimulating osteogenesis of bone marrow mesenchymal stem cells via positively regulating FOXF1 to activate the TGF-β pathway

OBJECTIVE

To elucidate the function of MOTS-c in accelerating bone fracture healing by inducing BMSCs differentiation into osteoblasts, as well as its potential mechanism.

MATERIALS AND METHODS

Primary BMSCs were extracted from rats and induced for osteogenesis. The highest dose of MOTS-c that did not affect BMSCs proliferation was determined by CCK-8 assay. After 7-day osteogenesis, the relative levels of ALP, Bglap, and Runx2 in MOTS-c-treated BMSCs influenced by FOXF1 were examined. ALP staining and alizarin red S staining in BMSCs were performed as well. The interaction between FOXF1 and TGF-β was analyzed by ChIP assay. At last, rescue experiments were performed to uncover the role of FOXF1/TGF-β axis in MOTS-c-induced osteogenesis.

RESULTS

1 μM MOTS-c was the highest dose that did not affect BMSCs proliferation. MOTS-c treatment upregulated the relative levels of ALP, Bglap, and Runx2, and stimulated mineralization ability in BMSCs, which were attenuated by the silence of FOXF1. TGF-β was proved to interact with FOXF1, and its level was positively mediated by FOXF1. The silence of FOXF1 attenuated the accelerated osteogenesis and TGF-β upregulation in BMSCs because of MOTS-c induction, and these trends were further reversed by the overexpression of TGF-β.

CONCLUSIONS

MOTS-c treatment markedly induces osteogenesis in BMSCs. During MOTS-c-induced osteogenic progression, the upregulated FOXF1 triggers the activation of TGF-β pathway, thus accelerating bone fracture healing.

MicroRNA-615-3p promotes the osteoarthritis progression by inhibiting chondrogenic differentiation of bone marrow mesenchymal stem cells

OBJECTIVE

To investigate whether microRNA-615-3p participates in the development and progression of osteoarthritis by regulating chondrogenic differentiation of bone marrow mesenchymal stem cells.

MATERIALS AND METHODS

Bone marrow mesenchymal stem cells (BMSCs) were isolated from rat bone marrow and identified by flow cytometry. After chondrogenic differentiation was induced in BMSCs, expression levels of chondrogenic-specific genes were then detected by quantitate Real-time polymerase chain reaction (qRT-PCR). Expression levels of inflammatory cytokines were detected by enzyme-linked immunosorbent assay (ELISA). Protein expression of SOX9 after overexpression or knockdown of microRNA-615-3p was detected by Western blot, respectively.

RESULTS

MicroRNA-615-3p was down-regulated in the process of chondrogenic differentiation of BMSCs. The mRNA expressions of chondrogenic-specific markers, COL2A1, COL10A1, ACAN and MATN3 were decreased after microRNA-615-3p overexpression in BMSCs. Overexpressed microRNA-615-3p down-regulated protein expression of SOX9. Expression levels of inflammatory cytokines, including interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-α (IL-α) were increased after overexpression of microRNA-615-3p, while inhibition of microRNA-615-3p expression obtained the opposite result. In addition, overexpression of SOX9 rescued the effect induced by microRNA-615-3p on inflammatory cytokines.

CONCLUSIONS

MicroRNA-615-3p participates in the development and progression of osteoarthritis by increasing the expressions of inflammatory cytokines and inhibiting chondrogenic differentiation of BMSCs.

Clinical outcomes and predictive relapse factors of IgG4-related disease following treatment: a long-term cohort study

OBJECTIVES

The aim of this study was to investigate the predictive factors for relapse of IgG4-related disease (IgG4-RD) and observe the long-term clinical outcomes in patients with IgG4-RD.

METHODS

We included in the present analysis 122 patients who were newly diagnosed with IgG4-RD, treated with glucocorticoid (GC) monotherapy or GC and immunosuppressant combination therapy, and followed for at least 3 years. Clinical relapse, response and side effects were recorded.

RESULTS

The cumulative relapse rates of patients in this study were 10.66%, 22.95% and 27.87% at 12, 24 and 36 months, respectively. Complete drug withdrawal was an independent risk factor for disease relapse. Higher serum IgG4 concentrations, involvement of more organs, higher IgG4 RI scores and elevation of eosinophils at baseline were closely associated with disease relapse. Re-elevation of serum IgG4 concentrations and low GC maintenance dosage during the follow-up period were significantly associated with clinical relapse. The GC dosage should be more than 6.25 mg day^-1 as monotherapy during the maintenance stage; moreover, combining with immunosuppressants can reduce the GC dosage. Adding GC or immunosuppressants for patients with re-elevation of serum IgG4 levels could prevent later disease relapse. No serious complications were noted during long-term follow-up.

CONCLUSIONS

The combination of GC with immunosuppressants was more effective than GC monotherapy during the steroid tapering and maintenance stages. Higher serum IgG4 levels, involvement of more organs, higher IgG4 RI scores, history of allergy, eosinophil elevation at baseline, re-elevation of serum IgG4 levels and lower GC maintenance dosage at follow-up might be predictive of relapse.

[Clinical characteristics of 57 patients with polyarteritis nodosa and renal involvement]

Objective: To investigate the clinical characteristics of polyarteritis nodosa (PAN) patients with renal involvement. Methods: PAN patients admitted to the department of rheumatology, department of pediatrics, department of nephrology, general internal medicine department and department of vascular surgery at Peking Union Medical College Hospital from June 2012 to August 2018 were enrolled in this study and were divided into two groups according to renal involvement or not. The clinical characteristics were analyzed. Results: A total of 94 PAN patients were finally enrolled and 57 (60.64%) presented kidney manifestation. The mean age of onset was (37.76±17.40) years old and the interval from onset to diagnosis was 10 (0 to 240) months. Forty patients were misdiagnosed once or more times. In patients with renal involvement, 9 cases suffered from renal ischemia or infarction, 31 with microscopic haematuria, 26 with proteinuria, renal artery or its branch involved in 17 cases, renal vein thrombosis in 1 case, 4 cases with pyeloureterectasis, one case with renal fascia thickening, 33 cases with impaired renal function (serum creatinine>84 μmol/L) including creatinine>140 μmol/L in 10 patients. Renal artery branch stenosis was the most common presentation [9 cases (52.94%)] of renal vascular involvement, other abnormalities including nodular dilatation [4 cases (23.53%)], occlusion [3 cases (17.65%)]. There were significant differences (P<0.05) in the PAN patients with and without renal involvement in the following: age of onset [(33.72±16.13) years vs. (43.97±17.66) years, t(2)=2.901, P=0.005], weight loss(≥4kg since PAN onset) [25(43.86%) vs. 7(18.92%), χ(2)=6.216, P=0.013], elevation of diastolic blood pressure [22(38.60%) vs. 7(18.92%), χ(2)=4.072, P=0.044], acromegaly gangrene [18(31.58%) vs. 21(56.76%), χ(2)=5.859, P=0.015], and gastrointestinal artery involvement [20(35.09%) vs. 6(1.22%), χ(2)=3.993, P=0.046]. Laboratory parameters and the application of glucocorticoid and cyclophosphamide therapies were similar in two groups (all P>0.05). Conclusion: Young PAN patients are more likely to be associated with renal involvement, especially gastrointestinal arteries.

[The clinical value of China Savin pollen extract used for skin prick test]

Objective:The aim of this study is to evaluate the effectiveness and safety of China Savin pollen extract which was used for skin prick test (SPT) in the diagnosis of China Savin pollen allergy. Method:Patients with diagnosis of allergic diseases were collected from Allergy Department of Peking Union Medical College Hospital. All patients were given SPT with China Savin pollen extract, and the mean wheal diameter (MWD) was measured after 15 minutes. Receiver operating characteristic curve (ROC) analysis was performed based on the results of serum specific immunoglobulin E (sIgE). The effectiveness of SPT in the diagnosis of China Savin pollen allergy was evaluated under different diagnostic cutoff values. Adverse events were also recorded to evaluate the safety. Result:A total of 1 029 patients were enrolled in this study without drop out case. There were 1 007 patients in full analysis set (FAS) and 765 patients in per protocol analysis set (PPS). The elimination rate was 25.66%. The area under the ROC curve of FAS is 0.814 (95%CI: 0.788-0.839); which of PPS is 0.829 (95%CI: 0.801-0.857). Based on the ROC curve of PPS, the optimal and the 95% specificity diagnostic cutoff values of MWD were 3.25 mm and 4.75 mm respectively. Based on different diagnostic cutoff value (3.00, 3.25 and 4.75 mm), the sensitivities of SPT with China Savin pollen extract were 0.740 0 (95%CI: 0.701 6-0.778 4), 0.700 (95%CI: 0.659 8-0.740 2) and 0.532 (95%CI: 0.488 3-0.575 7) respectively, whereas the specificity was gradually increased in sequence, which was 0.769 8 (95%CI: 0.719 1-0.820 5), 0.826 4 (95%CI: 0.780 8-0.872 0) and 0.950 9 (95%CI: 0.924 9-0.976 9) respectively. There were 7 adverse events observed among 6 patients (rate: 0.583%, 6/1 029). The manifestation was mild. There was no severe adverse event. Conclusion:SPT with China Savin pollen extract is an effective and safe tool for the diagnosis of China Savin pollen allergy. The effectiveness of diagnosis could be improved based on integration of medical history and different diagnostic threshold values of SPT.

GC/MS-based metabolomic analysis of alleviated renal ischemia-reperfusion injury induced by remote ischemic preconditioning

OBJECTIVE

Dysfunctional metabolisms have contributed towards ischemia-reperfusion (I/R) injury. However, the role of remote ischemic preconditioning (RIP) in I/R injury is not well known. The present study showed alleviated I/R injury in kidneys treated with RIP.

MATERIALS AND METHODS

We utilized GC/MS-based metabolomics to characterize the variation of metabolomes.

RESULTS

Metabolic category using differential metabolites showed the lower percentage of amino acids in I/R group in comparison to RIP+I/R group, confirming the importance of amino acid metabolism in RIP-treated rat kidney. Further, pathway enrichment analysis showed alanine, aspartate and glutamate metabolism to be involved in the beneficial effects of RIP during renal I/R injury. Furthermore, another crucial enrichment pathway is biosynthesis of unsaturated fatty acids. Other vital metabolites detected in independent component analysis (ICA) analysis were d-glucose, lactic acid and cholesterol. The variation tendency of above-mentioned metabolites was overall consistent with the protective nature of RIP.

CONCLUSIONS

These findings elicited a viewpoint that metabolic strategy affected by RIP are linked to underlying mechanisms of RIP and highlighted the importance of metabolic strategy against I/R injury.

The gas density measurement of one long distance supersonic molecular beam

The gas density of the supersonic molecular beam (SMB) is a crucial parameter for the fueling or diagnostic process in the tokamak experiments. Using the microphone, one improved method of gas density measurement is proposed, which can greatly improve the measurement capacity by about 3 orders of magnitude by studying the pulsed signal characteristic of the microphone when it is pushed by the SMB. The gas density of the SMB is measured within the axial range of 20-2000 mm, and the axial central density at 2000 mm is about 100 times less than that at 20 mm. It is also found that the radial density distribution follows the Gaussian function in both free expansion (where the SMB can expand freely without any influence from the vacuum chamber) and restricted expansion (where the expansion of the SMB is restricted inside the flight tube of the vacuum system). And the axial central density decreases with the axial distance, which follows the inverse square law in the free expansion, but it deviates from this law in the restricted expansion.

Construction of KHV-CJ ORF25 DNA vaccine and immune challenge test

KHV ORF25 fragments were cloned from Koi Herpes Virus-CJ (KHV-CJ) strains isolated in our laboratory. The amplified products were inserted into the eukaryotic expression vector pIRES-neo, forming recombinant plasmid pIRES-ORF25. The recombinant plasmid pIRES-ORF25 at 1 μg per koi, 10 μg per koi and 50 μg per koi was intramuscularly injected into healthy kois, respectively. The results showed that the recombinant pIRES-ORF25 could induce the production of specific antibodies in koi determined by indirect ELISA. The differences of immune effect between three doses were not significant (P > 0.05), but all of them could induce the production of neutralizing antibodies. The immune challenge test showed that the mortality of koi injected with PBS, blank pIRES-neo vector and nothing was 90%, 92.5% and 85% at 25 days. While the mortalities of koi injected with eukaryotic expression plasmid pIRES-ORF25 were 20%, 17.5% and 12.5%. Differences in comparison with the control group were highly significant (P < 0.01). Histopathological staining revealed that the tissues of the immunized koi did not change apparently. In conclusion, the DNA vaccine pIRES-ORF25 construct could well protect koi against KHV and had the potential to be applied in practice.

Stability and chaotification of vibration isolation floating raft systems with time-delayed feedback control

This paper presents a systematic study on the stability of a two-dimensional vibration isolation floating raft system with a time-delayed feedback control. Based on the generalized Sturm criterion, the critical control gain for the delay-independent stability region and critical time delays for the stability switches are derived. The critical conditions can provide a theoretical guidance of chaotification design for line spectra reduction. Numerical simulations verify the correctness of the approach. Bifurcation analyses reveal that chaotification is more likely to occur in unstable region defined by these critical conditions, and the stiffness of the floating raft and mass ratio are the sensitive parameters to reduce critical control gain.

Use of cerebral state index monitoring to detect purposeful movement in unsedated brain-injured patients

To test whether the cerebral state index (CSI) can be used as a measurement of the level of consciousness in unsedated brain-injured patients, 21 brain-injured adults were prospectively assessed in 77 separate sessions. After CSI monitoring was set up, the patient's motor responses to verbal and/or painful stimuli were assessed. CSI values were recorded before and after external stimulation. Purposeful movement in response to external stimuli was defined as command obeying and pain localization. Mean maximal CSI values increased significantly after external stimulation: from 71 to 89 and 49 to 62 in patients exhibiting purposeful and non-purposeful movements, respectively. The CSI value showed a high prediction probability (P(K) > 0.8) for detecting purposeful movement to external stimuli, especially after external stimulation (P(K) > 0.9). These results suggest that CSI monitoring might be a valid method for detecting purposeful movement in response to external stimuli in unsedated brain-injured patients.

Protein crystal growth on board Shenzhou 3: a concerted effort improves crystal diffraction quality and facilitates structure determination

The crystallization of 16 proteins was carried out using 60 wells on board Shenzhou 3 in 2002. Although the mission was only 7 days, careful and concerted planning at all stages made it possible to obtain crystals of improved quality compared to their ground controls for some of the proteins. Significantly improved resolutions were obtained from diffracted crystals of 4 proteins. A complete data set from a space crystal of the PEP carboxykinase yielded significantly higher resolution (1.46A vs. 1.87A), I/sigma (22.4 vs. 15.5), and a lower average temperature factor (29.2A(2) vs. 42.9A(2)) than the best ground-based control crystal. The 3-D structure of the enzyme is well improved with significant ligand density. It has been postulated that the reduced convection and absence of macromolecule sedimentation under microgravity have advantages/benefits for protein crystal growth. Improvements in experimental design for protein crystal growth in microgravity are ongoing.

Dynamic changes in blood solubility of desflurane, isoflurane, and halothane during cardiac surgery

OBJECTIVE

To determine an estimate of blood/gas partition coefficients of volatile anesthetics during cardiac surgery.

DESIGN

Descriptive

SETTING

University hospital

PARTICIPANTS

Six adult patients undergoing valvular replacement with hypothermic cardiopulmonary bypass.

MEASUREMENTS AND MAIN RESULTS

Blood samples were obtained from patients at 6 time points: before induction, at skin incision, at aortic cannulation, at rewarming during bypass, at weaning off bypass, and at skin suture. Measured blood/gas partition coefficients were plotted against corresponding solubilities estimated according to the combined effects of hypothermia and hemodilution. Significant differences were found in blood/gas partition coefficients of the 3 anesthetics at different times during surgery (p < 0.05). Blood/gas partition coefficients at weaning off bypass were the lowest, about 75% of that before anesthetic induction. A direct linear relationship for estimated solubility against measured solubility was found (r2 = 0.94; p < 0.05).

CONCLUSION

Dynamic changes in blood/gas partition coefficients of volatile anesthetics were found during cardiac surgery. They could be estimated by using multiple linear regression equations reflecting the combined effects of hypothermia and hemodilution.

Blood solubilities of volatile anesthetics in cardiac patients

OBJECTIVE

To determine and compare the effects of hematocrit and serum constituents on the blood solubilities of volatile anesthetics in different cardiac surgical patients.

DESIGN

Descriptive

SETTING

University hospital.

PARTICIPANTS

Twenty healthy adult volunteers, 40 adult cardiac patients, and 20 pediatric cardiac patients.

MEASUREMENTS AND MAIN RESULTS

Blood/gas partition coefficients of desflurane, isoflurane, and halothane; hematocrit; and serum concentrations of cholesterol, triglyceride, albumin, and globulin were determined in healthy adult volunteers, adult patients with coronary artery disease or rheumatic heart disease, and pediatric patients with cyanotic or acyanotic congenital heart disease. Statistical analysis was used to determine the difference in serum constituents and blood solubility of each anesthetic among volunteers and patients with different cardiac diseases. Triglyceride and blood/gas partition coefficients of the 3 volatile anesthetics in the patients with coronary artery disease were significantly higher than those in healthy volunteers and the patients with rheumatic heart disease (p < 0.05). Hematocrits were significantly higher in cyanotic children than acyanotic children (p < 0.05), but the serum constituents and anesthetic solubilities were not different between the 2 groups (p > 0.05).

CONCLUSION

Patients with coronary artery disease have significantly higher serum triglyceride and blood/gas partition coefficients for desflurane, isoflurane, and halothane than healthy volunteers and patients with rheumatic heart disease. Although cyanotic children have higher hematocrits compared with acyanotic children, no significant difference in anesthetic blood gas solubilities was found between the 2 groups.

The effect of temperature on solubility of volatile anesthetics in human tissues

Hypothermia often occurs during surgery, a factor influencing anesthetic pharmacokinetics through its influence on solubility. Information on the tissue solubility of volatile anesthetics under hypothermia is limited. The present study supplies this information for the solubility of volatile anesthetics in human tissues. Tissue specimens of brain, heart, liver, muscle, and fat were obtained from 10 postmortem males (27 +/- 8 yr). Tissue/gas partition coefficients of desflurane, sevoflurane, enflurane, isoflurane and halothane were measured at 37 degrees C, 33 degrees C, 29 degrees C, 25 degrees C, 21 degrees C, and 17 degrees C. For each given tissue, the order of tissue/gas partition coefficient was halothane >enflurane >isoflurane >sevoflurane >desflurane. Tissue/gas partition coefficients at 37 degrees C differed significantly (P < 0.05) across drugs, except that liver/gas partition coefficients for isoflurane and enflurane did not differ. The logarithm of all tissue/gas partition coefficients increased linearly with decreasing temperature (P < 0.05). In conclusion, hypothermia increases tissue/gas partition coefficients of volatile anesthetics. The increases are proportional to those for blood/gas partition coefficients, and therefore tissue/blood partition coefficients will not change during hypothermic conditions.

IMPLICATIONS

Volatile anesthetics are often used during hypothermic conditions, and tissue solubility of volatile anesthetics is an important determinant for the wash-in and washout of the anesthetics in tissue. Tissue/gas partition coefficients during hypothermia have implications for understanding the pharmacokinetics of volatile anesthetics at hypothermic conditions.

Mechanisms of G1 checkpoint loss in resected early stage non-small cell lung cancer

Loss of the G1 checkpoint appears to be extremely common among virtually all neoplasms. A variety of genetic and epigenetic mechanisms have been demonstrated to play significant roles in this process. In a consecutive series of early stage non-small cell lung cancer (NSCLC), we have established the loss of expression of the G1 Cdk inhibitors p15INK4b) and p16INK4a by DNA methylation is very common (37%), and methylation of p16INK4a is tightly correlated with loss of expression of p16INK4a protein (P = 0.0018). Furthermore, methylation of p15INK4b and p16INK4a appear inversely correlated, although methylation of p15INK4b is an infrequent event in this cohort (4%). Methylation was detected in all stages of NSCLC equally, and did not correlate with survival in these patients. Evidence for methylation was more frequent in squamous cell carcinomas in comparison to other tumor histologies (P = 0.0156). In addition, over-expression of cyclin D1 was found to be tightly restricted (P = 0.0032) to those tumors that had retained wild-type expression of pRB, and did not correlate with methylation or expression of p16INK4a gene product. Although loss of p16INK4a function remains tightly correlated with pRB expression, loss of other regulatory elements in NSCLC such as p53 mutation and cyclin D1 over-expression appear independent of loss of the p16INK4a gene product.

Prediction of volatile anaesthetic solubility in blood and priming fluids for extracorporeal circulation

Volatile anaesthetics are often used during cardiopulmonary bypass (CPB). To understand the kinetics of inhaled anaesthetics during CPB, anaesthetists should understand changes in blood solubility caused by fluid use. We set out to predict the solubility of three volatile anaesthetics, desflurane, isoflurane and halothane, during CPB by determining: (i) their solubility in fresh whole blood and eight CPB priming fluids at 37 degrees C; (ii) the effect of temperature on the solubility of these anaesthetics in lactated Ringer's, gelofusin, banked blood and plasma; (iii) their solubility in different mixtures of these four priming fluids at different temperatures; and (iv) their estimated and actual solubility in blood during hypothermic CPB. We calculated solubility using a concept of volume fraction partition coefficient and compared estimated and measured solubilities. For the three anaesthetics tested, solubilities are in the order: fresh whole blood approximately = plasma > banked blood > normal saline approximately = lactated Ringer's approximately = gelofusin approximately = Haemaccel approximately = hydroxyethyl starch > mannitol. The solubilities of the anaesthetics in all priming fluids increased logarithmically at lower temperatures (P<0.05). The volume-fraction estimates of the partition coefficients were within approximately +/-20% of the measured values for all values of solubility. The corresponding estimates of solubility for CPB blood samples were between -36% and +24% of the measured values. During normothermic CPB, blood solubility of volatile anaesthetics would be unchanged when using plasma, slightly reduced when using banked blood and markedly reduced when using crystalloids and colloids.

Gene therapy of established mesothelioma xenografts with recombinant p16INK4a adenovirus

The absence of expression of the p16INK4a gene product is observed in virtually all mesothelioma tumors and cell lines, whereas wild-type pRB expression is maintained. We have examined the potential therapeutic role of re-expressing the p16INK4a gene product in mice with established human mesothelioma xenografts. Experiments using Adp16 treatments in mesothelioma xenografts demonstrated prolonged survival and potential cure following treatment with p16INK4a-based gene therapy. These results demonstrate that p16INK4a gene transfer may play a therapeutic role in the treatment of mesothelioma.

[A preliminary study of developmental genetics of polymorphic serum esterase in domestic fowls]

Polymorphism of serum esterase was examined in 3 Super-Y 2000 broiler breeding populations differing in developmental stages (i.e. day 120, 180 and 300) using vertical polyacrylamide gel electrophoresis. The results indicated that both Es-1 and Es-2 loci exhibited polymorphism. Two to three polymorphic enzyme bands were detected at zone Es-1, and one band at zone Es-2 after electrophoresis. It was first discovered in this work that obvious developmental difference in products of Es-1 alleles existed with female birds, polymorphic bands of which disappeared after onset of lay. An individual tracing experiment conducted in a Super-Y 380 commercial layer population and an extensive experiment carried out in 2 ISA B380 parent CD stocks supported the previous finding. It could thus be inferred that phenotype "O" (no band at Es-1) discovered in hens was not genetically controlled by the recessive allele Es-1(0), which itself did not exist, but might be an evidence of gene regulation at laying period. For female birds, expression of Es-1 alleles was active before sexual maturity, and depressed after onset of lay, to meet their physiological need of high level of blood esterase for laying. It could also be inferred that this developmental difference in serum esterase polymorphism might be a common phenomenon in all avian species. If this hypothesis were true, the synthesis of esterase inside avian bodies could be a desirable model for investigating expression, and regulation of expression, of genes in avian populations.

Electrochemical generation of ferrylmyoglobin during oxidation of styrene with films of DNA and a poly (ester sulfonic acid) ionomer

The chemistry of electrochemically-driven myoglobin-catalyzed oxidation of styrene was investigated in films of DNA or Eastman AQ ionomer on optically transparent electrodes. Conversion of styrene to styrene oxide proceeded via a ferrylmyoglobin radical intermediate. Ferrylmyoglobins were clearly detected by spectroelectrochemistry in films of 1-4 mm thick. The ferrylmyoglobin radical is produced by reaction of metmyoglobin (Mb) in the films with hydrogen peroxide formed by electrochemical catalytic reduction of oxygen catalyzed by Mb. Thus, electrochemically-driven styrene oxidation with these films proceeds by a 'doubly catalytic' electrode-driven reduction-oxidation pathway. Ferrylmyoglobin formation during electrolysis of Mb-DNA films in aerobic solutions was much faster, and styrene oxidation occurred with less Mb decomposition compared to the Mb-AQ films. The better performance of Mb-DNA films is correlated with a larger fraction of electroactive Mb and better stability than for the Mb-AQ films.

Equilibrium intermediates in the unfolding pathway of creatine kinase

The unfolding of creatine kinase in various concentrations of guanidine hydrochloride of increasing concentrations has been investigated by combination of size-exclusion chromatography (SEC) with other methods. There are two peaks in the profiles of SEC in GuHCl at moderate concentrations, showing that unfolding of creatine kinase goes through dimeric and monomeric intermediates with increasing guanidine hydrochloride concentrations. Both intermediates have relatively compact structure and retain considerable ordered structure.

Histone acetyltransferase activity and interaction with ADA2 are critical for GCN5 function in vivo

Yeast GCN5 is one component of a putative adaptor complex that includes ADA2 and ADA3 and functionally connects DNA-bound transcriptional activators with general transcription factors. GCN5 possesses histone acetyltransferase (HAT) activity, conceptually linking transcriptional activation with enzymatic modification at chromatin. We have identified the minimal catalytic domain within GCN5 necessary to confer HAT activity and have shown that in vivo activity of GCN5 requires this domain. However, complementation of growth and transcriptional activation in gcn5- cells required not only the HAT domain of GCN5, but also interaction with ADA2. The bromodomain in GCN5 was dispensable for HAT activity and for transcriptional activation by strong activators; however, it was required for full complementation in other assays. Fusion of GCN5 to the bacterial lexA DNA binding domain activated transcription in vivo, and required both the HAT domain and the ADA2 interaction domain. These results suggest that both functions of GCN5, HAT activity and interaction with ADA2, are necessary for targeting and acetylation of nucleosomal histones.

Characterization of a tunable optical parametric oscillator laser system for multielement flame laser excited atomic fluorescence spectrometry of cobalt, copper, lead, manganese, and thallium in buffalo river sediment

A pulsed (10 Hz) optical parametric oscillator (OPO) laser system based on beta-barium borate (BBO) crystals and equipped with a frequency-doubling option (FDO) was characterized for use in laser excited atomic fluorescence spectrometry (LEAFS). This all-solid-state laser has a narrow spectral line width, a wide spectral tuning range (220-2200 nm), and a rapid, computer-controlled slew scan of wavelength (0.250 nm s-1 in the visible and infrared, and 0.125 nm s-1 in the ultraviolet). The output power characteristics (15-90 mJ/pulse in the visible, 1-40 mJ in the infrared, and 1-11 mJ in the ultraviolet), laser pulse-to-pulse variability (3-13% relative standard deviation, RSD, of the laser pulses), conversion efficiency of the FDO (2-17%), and spectral bandwidth in the visible spectrum (0.1-0.3 cm-1) were measured. The laser was used as the excitation source for a flame LEAFS instrument for which rapid, sequential, multielement analysis was demonstrated by slew scan of the laser. The instrument allowed about 640 measurements to be made in about 6 h, with triplicate measurements of all solutions and aqueous calibration curves, which yielded accurate analyses of a river sediment (National Institute of Standards and Technology, Buffalo River Sediment, 2704) for five elements with precisions < 5% RSD. Comparable or improved flame LEAFS detection limits over literature values were obtained for cobalt (2 ng mL-1), copper (2 ng mL-1), lead (0.4 ng mL-1), manganese (0.2 ng mL-1), and thallium (0.9 ng mL-1) by flame LEAFS.

VH and VL gene analysis in sporadic Burkitt's lymphoma shows somatic hypermutation, intraclonal heterogeneity, and a role for antigen selection

Tumor cell lines and one tumor biopsy from seven cases of Epstein-Barr virus (EBV) genome-negative sporadic Burkitt's lymphoma (BL) have been investigated for usage and mutational pattern of Ig variable region genes. The VH genes were derived from the VH 3 (one) and VH4 (six) families and both the IgM-positive (six) and the IgA-positive (one) were all mutated from their germline counterparts. The VL genes were derived from V kappa 1 (one), V kappa 3 (one), V lambda 1 (four), and V lambda 2 (one) families and were also somatically hypermutated. Biopsy material from one of the IgM-positive cases showed VH and VL sequences that matched the derived cell line, with additional intraclonal sequence heterogeneity, indicating that the tumor cells had undergone posttranformation somatic mutation. Mutational patterns in V(H) genes did not show a conventional role for antigen in selecting tumor cell sequences. In contrast, patterns in VL sequences were consistent with a role for antigen in five of seven cases. The pattern of extensive scattered somatic hypermutation and intraclonal variation is similar to that in VH sequences of EBV genome-positive endemic BL, although the degree of mutational activity is less. These common features indicate that B cells involved in the two variants of BL may share a common clonal history.

Creatine kinase: the characteristics of the enzyme regenerated from the thio-methylated creatine kinase reflect a differentiation in function between the two reactive thiols

The activity of S-thiomethyl-modified creatine kinase is due to regeneration of the free thiol (Hou and Vollmer, Biochim Biophys Acta (1994) 1205, 83-88). Characteristics of enzyme regenerated from the S-thiomethyl-modified creatine kinase are reported in the present study. The intrinsic fluorescence of the regenerated enzyme is similar to that of the native enzyme in the presence or absence of the dead-end complex. Regenerated CK (rCK) with full activity has only one reactive thiol. The rate constant of the rCK-reactive thiol reacting with DTNB is close to that of the slow phase of the reactive thiols of the native enzyme. If the IAM-modified rCK is treated with the same method as that for obtaining the rCK, the thiol-methylated reactive thiol of the rCK is reduced to a free SH and a regenerated enzyme, RCK, is produced with about 10% of the rCK activity. Therefore, the different roles of the two reactive thiols of creatine kinase may stem from the characteristics of the rCK, which suggests that only one of the two reactive thiols is related to the activity of the enzyme and the slower phase thiol (the first SH) in the modification reaction with DTNB is directly related to the enzymatic activity, while the faster phase thiol (the second SH) assists the first SH. This compensatory mechanism is proposed in the present study to interpret the dispute on the reactive SH role in the enzymatic catalysis.

Isolation and some properties of glycated D-glyceraldehyde-3-phosphate dehydrogenase from rabbit muscle

Glycated D-glyceraldehyde-3-phosphate dehydrogenases (GAPDH) from rabbit muscle and human erythrocytes have been investigated. The specific activity of the non-glycated GAPDH from rabbit muscle is approx. 180 units. (One unit is defined as the specific activity required to convert 1 microM of substrate/min per mg of enzyme.) The activity of the glycated enzyme, consisting of two sugars per tetramer, is lower than that of the non-glycated GAPDH. Non-enzymic transamination of the N-termini of glycated GAPDH (gGAPDH) indicates that they are not blocked by glycation. The rate of modification of thiols (Cys-149) with 5,5'-dithiobis-(2-nitrobenzoic acid) was greater for the glycated than the non-glycated enzymes. The rate of modification of amino groups of Lys residues of gGAPDH with o-phthalaldehyde was greater for the non-glycated enzyme. In 0.18 M guanidine-HC1 solution, the emission intensity at 410 nm of a fluorescent NAD+ derivative introduced into the active site decreased to 80%, whereas that of gGAPDH decreased to 50%. This suggests that the glycated sites are near the active site; glycation of the enzyme leads to a change of the microenvironment of Cys-149, alters the conformation of the active site and decreases the activity.

[Experimental study on kidney invigorating and lipid reducing decoction-yishen jiangzhi tang in the treatment of chronic renal failure]

In exploring the effect of treatment of supporting the body resistance on chronic renal failure, a chronic renal failure model of rat was created by gastroperfusion of adenine and evaluation was made on the therapeutic effect of Kidney Invigorating and Lipid Reducing Decoction (KILRD). The mental state and body weight of the treated group have recovered well with polyuria and proteinurea improving, BUN and Creatinine decreasing, which appeared to be superior to the naturally recovered group. Renal pathological examination showed that: although the renal parenchymal damage was not reversed but its compensation was satisfactory with compensatory hypertrophy appearing in unaffected nephron. The dominant reaction in the affected area was polynucleomacrocytosis, foreign body granulamatosis, and interstitial lymphocytic infiltration, the fibrosis was inevident, while the above-mentioned condition in the naturally recovered group was relatively more serious, with fibrosis being observed. It was indicated that KILRD could increase the compensatory capacity and immunity, promote protein synthetization and improve renal function. The study on KILRD proved to be a significant conservative medical treatment for chronic renal failure.

Mass spectrometry software for biochemical analysis in electrospray and fast atom bombardment modes

New mass spectrometry techniques, such as electrospray ionization (ESI), allow the study of large biomolecules and peptide mixtures. The data produced are complex and interpretation can be a long and tedious process. A new suite of data-processing software is described which allows many of these operations to be carried out in a rapid, automated way. Software is described for the deconvolution of the spectra of multiply charged ions, for both pure compounds and mixtures. The rapid peptide mapping of protein digests from h.p.l.c.-m.s. data and peptide sequence confirmation from multiple-stage (MS)-m.s. data using tandem quadrupole m.s. are also described. In addition preliminary results are presented on first principle sequencing of unknown peptides from MS-m.s. experiments.

[Clinical and CT analysis of 35 cases of lumbar disc herniation before and after non-operative treatment]

35 cases of lumbar disc herniation were examined by clinical diagnosis and CT scanning. The results showed that there were 36 disc herniation (1 case of dual disc herniation). The radius vector of disc was 6.3 mm and the transverse diameter was 18.6 mm. There were 30 cases with sac of dura mater of spinal cord or nerve roots pressed and adhesive, yellow ligaments pachismus, lateral recessus filling and narrow bony lumbar vertebral canal. All patients were treated by means of manipulation. The clinical results showed that 29 cases (82.8%) had superior effects and 33 cases were effective. The clinical effective rate was 94.2%. CT re-scanning showed that disc reposition completely returned was 6 cases, and partially returned was 24 cases. The successful rate of the reposition by manipulation was 83.3%. The clinical analysis and CT showed that herniation of lumbar disc could be repositioned by means of manipulation. The reposition of herniation of disc was a key factor in clinical results but was by no means the only one. With regard to long duration of illness, repeated invasion, combined narrow bony lumbar vertebral canal, and non-improved central type herniation after a long period of treatment, the herniation of disc should be treated by operation.

[Influence of laurocapram on ultrastructures of mouse skin and sarcoma 180 membrane]

Laurocapram (Lau), 1-dodecyl-hexahydro-2 H-azepin-2-one, (azone) is a new percutaneous penetration enhancer. However, the mechanism of its action for absorption promoter of other agents is still unknown. In this paper the effect of Lau on ultrastructures of skin surface and tumor cell membrane were studies. Lau (2%) suspension was applied to abdominal skin of ICR/JCL, C 57 BL mice or one side of abdominal skin of nude mouse with drug and other side with the vehicle solvent once daily for 2-3 d. The skin was excised at 4 h after the final medication for examination under scanning electron microscope (SEM). The results showed the numerous small infolding lines which divided the skin surface into small areas with vesiculation and peeled the epidermal surface to form a few minor holes. The cuticles of the hair shaft dropped off and became thinner. Numerous desquamated cells around the orifice of the hair were fractured, detached and widened. Sarcoma 180 cells were incubated with Lau 25 micrograms/ml at 37 degrees C for 4 h. The microvilli of some cells dropped off and the size of villi became thinner and shorter. The top of some villi of the cells appeared occasionally thick to make the profile as a bat. The surface of numerous naked cells became rugged and rough and showed many black minor holes in the area of denuded cell membrane or dropped microvilli. More than 100 holes in the exposed surface of the naked cell were seen. It seemed that the Lau drilled holes on the biomembrane and enlarged the orifice of hair follicles and thus enhanced the transdermal absorption.

Effectiveness of amodiaquine, sulfadoxine-pyrimethamine, and combinations of these drugs for treating chloroquine-resistant falciparum malaria in Hainan Island, China

The study was carried out in 1985-86 in Hainan Island where Plasmodium falciparum is resistant to chloroquine. Fifty cases of falciparum malaria were treated with 1800 mg amodiaquine for 3 days: the cure rate was 65.3%, and the mean time to clear fever and asexual parasitaemia was 30.7 and 60.3 hours, respectively; 34.7% of cases showed RI or RII recrudescence, and one patient's temperature did not come down to normal within 7 days.Twenty-one cases were treated with sulfadoxine-pyrimethamine (1500 mg and 75 mg, respectively): 19 were cured, I showed RI and another had an S or RI response; the mean time for fever control was 56.1 hours.Fifty cases were treated with amodiaquine plus sulfadoxine and 49 received amodiaquine plus sulfadoxine-pyrimethamine: the cure rate was 97.9% and 100%, respectively; the mean time for fever clearance was 25.0 and 25.7 hours and for parasite clearance 57.1 and 52.8 hours, respectively. These drug combinations gave much better results for cure and for symptom control than amodiaquine or sulfadoxine-pyrimethamine alone, and may be considered for treatment of chloroquine-resistant falciparum malaria.

[Changes in protein in bile excretion from rat liver inoculated with BERH-2 hepatoma]

Rocket immunoelectrophoresis was used to assay the change in alpha fetoprotein (AFP) and albumin (Alb) in bile of rats 10 to 14 days after intrahepatic or intraperitoneal inoculation of BERH-2 hepatoma. The bile was collected from the common bile duct cannula. Total protein was determined by the Lowry method. The results showed that the excretion of total protein and Alb was reduced to 54% and 24% of the control in the intrahepatic group, and 65% and 56% of the control in the intraperitoneal group. Bile-AFP can be detected in rats in both groups and its concentration increased gradually during the tumor progression. In the hepatic group, the bile-AFP content per gram of tumor tissue was 29% of that in the intraperitoneal group. It suggests that decreased excretion of AFP, Alb and total protein in bile of rat bearing tumor in the liver be related to local obstruction of excretion by the tumor mass leading to constriction of biliary canaliculi.