Deciphering the in situ phonon evolution of potassium sodium niobate under varying temperature and electric fields

The application of in situ Raman spectroscopy under multiple fields is widely recognized as an effective approach for investigating the physical mechanism of phase transitions in ferroelectrics, because it can directly provide the detailed information about the vibration evolution of various phonon modes within lattices, such as bond stretching and rotation. Based on this technique, our work aims to thoroughly probe the dynamics of phase transitions in traditional ferroelectric potassium sodium niobate [(K,Na)NbO3, KNN] under external fields, by analyzing the in situ dependence of wavenumber and intensity of phonon modes under the varying temperature and electric fields. The results indicate that different vibration modes respectively relating to the A-site ions and NbO6 octahedra in KNN exhibit distinct and abrupt distortion behavior during the orthorhombic-tetragonal and tetragonal-cubic transitions. Moreover, a certain degree of distortion can still be observed in the cubic phase above the Curie temperature. With an applied electric field, KNN presents quite different electrostriction in orthorhombic and tetragonal phases. Particularly, more than one kind of phonon mode undergoes non-linear variations under the varying electric fields, accompanied by the mutations at some fixed fields. These findings will be conducive to further understanding the phase transition mechanism in KNN from the perspective of phonon evolution. Simultaneously, it will also give crucial guidance for the design and development of KNN-based ferroelectrics as well as functional devices.

[Analysis of absorbed constituents and network pharmacology research of Xiaoer Fupi Granules]

Xiaoer Fupi Granules, a refined version of the classical prescription Shenling Baizhu Powder, has the effect of invigora-ting spleen, replenishing Qi, harmonizing stomach and resolving accumulation and is commonly used to treat Qi deficiency in spleen and stomach, disordered transportation and transformation, and indigestion of children. However, its medicinal constituents and mechanism remain unclear. We studied the main active constituents and action mechanism of Xiaoer Fupi Granules by integrating network pharmacology and prototype constituent analysis in vivo. This study will help to increase the reliability of database analysis results and lay a foundation for precise medication and mining of quality control markers. On the basis of Bioinformatics Analysis Tool for Molecular mechanism of Traditional Chinese Medicine(BATMAN-TCM), the "key chemical constituents-target" network was constructed. Ultra-performance liquid chromatography coupled with linear ion trap-orbitrap mass spectrometry(UPLC-LTQ-Orbitrap-MS) was employed to analyze the absorbed constituents in rat urine and plasma, so as to validate the network. Further, we used BATMAN-TCM to construct the "absorbed constituents-target-pathway" network and explore the functioning mechanism of Xiaoer Fupi Granules. A total of 86 chemical constituents of Xiaoer Fupi Granules were predicted via BATMAN-TCM, among which only 18.6% were detected in rat plasma and urine. Accor-ding to the "absorbed constituents-target-pathway" network, 8 chemical constituents such as stearic acid and caprylic acid capable of regulating gastric acid and insulin secretion may be the critical constituents of Xiaoer Fupi Granules in invigorating spleen and harmonizing stomach. This study identified the critical active constituents and predicted the action mechanism of Xiaoer Fupi Granules, providing the reference for the research on the material basis of Xiaoer Fupi Granules.

In situ lattice tuning of quasi-single-crystal surfaces for continuous electrochemical modulation

The ability to control the atomic-level structure of a solid represents a straightforward strategy for fabricating high-performance catalysts and semiconductor materials. Herein we explore the capability of the mechanically controllable surface strain method in adjusting the surface structure of a gold film. Underpotential deposition measurements provide a quantitative and ultrasensitive approach for monitoring the evolution of surface structures. The electrochemical activities of the quasi-single-crystalline gold films are enhanced productively by controlling the surface tension, resulting in a more positive potential for copper deposition. Our method provides an effective way to tune the atom arrangement of solid surfaces with sub-angstrom precision and to achieve a reduction in power consumption, which has vast applications in electrocatalysis, molecular electronics, and materials science.

We reported a new method capable of adjusting the lattice structure of solid surfaces with sub-angstrom precision and achieved in situ and continuous control over electrochemical activity.

The lipid homeostasis regulation study of arenobufagin in zebrafish HepG2 xenograft model and HepG2 cells using integrated lipidomics-proteomics approach

ETHNOPHARMACOLOGICAL RELEVANCE

Arenobufagin (ArBu) is an important anti-tumor ingredient of Chan'su which has long been used as traditional Chinese medicine in clinic for tumor therapy in China.

AIM OF THE STUDY

The purpose of our study is to investigate the lipid homeostasis regulation effects of ArBu on zebrafish model of liver cancer and hepatoma cells, and to provide a reference for further clarifying its active mechanisms.

MATERIALS AND METHODS

The zebrafish xenograft model was established by injecting HepG2 cells stained with CM-Dil red fluorescent dye. Both the xenograft model and HepG2 cells were used to evaluate the anti-hepatoma activity of ArBu. High performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was the main method to study lipidomics, proteomics and the semiquantification of endogenous metabolites. Bioinformatics was used as an assistant tool to further explore the antitumor mechanism of ArBu.

RESULTS

The lipidomics analysis revealed that ArBu caused differential lipids changes in a dose-dependent manner, including PCs, PEs, TGs, SMs, DGs, Cer and PA. PCs, PEs, SMs and TGs were markedly altered in both two models. The influence of glycerophospholipid metabolism was the major and commonly affected pathway. Notably, DGs and Cer were significantly changed only in HepG2 cells. Furthermore, the proteomics research in HepG2 cells fished the target proteins related to lipid homeostasis abnormalities and tumor suppression. ArBu reduced the expression of 65 differential proteins associated with the lipid metabolism, apoptosis and autophagy, such as LCLAT1, STAT3, TSPO and RPS27. Meanwhile, 7 amino acids of 29 determined metabolites were significantly changed, including tyrosine, glutamate, glutamine, leucine, threonine, arginine and isoleucine.

CONCLUSION

ArBu has a significant anti-hepatoma effect in vitro and a therapeutic effect on zebrafish xenograft model. It regulated the lipid homeostasis. Activated SM synthase and arginine deiminase, inhibited sphingomyelinase, amino acid supply and JAK-STAT3 signaling pathway, and the affected glycerophospholipid metabolism might explain these results.

[Research advances in chemical constituents and pharmacological activities of different parts of Eucommia ulmoides]

To date, 205 compounds have been identified from different medicinal parts of Eucommia ulmoides, including lignans, iridoid terpenoids, phenols, flavonoids, terpenoids and steroids, polysaccharides and others. Their pharmacological effects include blood pressure-lowering, blood sugar-lowering, blood lipids-regulating, prevention of osteoporosis, anti-inflammation, liver protection, anti-cancer and so on. Their efficacy and mechanism from different parts are slightly different. In this paper, the chemical composition, pharmacological action and mechanism of different parts of E. ulmoides were systematically summarized, as well as its quality control and processing research, to provide theoretical basis for further rational development and utilization of E. ulmoides.

[Possible pharmaceutical effect and active components in different parts of Eucommia ulmoides based on network pharmacology]

The difference in pharmacological activities and active components between leaves, barks and flowers of Eucommia ulmoides(EU) are still unclear. However, clarifying the differences in pharmacological effects of different parts of EU is of great significance for the development of EU products, and their corresponding active components provide basis for quality control of different parts of EU. Based on the chemical compositions of different parts of EU, integrated strategy of target prediction and target analysis of the compounds was used to investigate the difference in the pharmacological effects of leaves, barks and followers. The "component-target-function" association network was constructed to mine the specific material basis corresponding to specific efficacy of different parts of EU. In this study, the author found that EU may have the activities of anti-oxidation, neuromodulation, blood pressure regulation, myo-cardial expansion, and anti-apoptosis according to target prediction and function analysis. However, the effects of different parts of EU were different. Leaves were involved in the process of bone development such as osteoblast differentiation and bone mineralization in a specific way. In addition, the leaves may affect the process of bone development by regulating the metabolism of vitamin D and affecting the absorption of calcium. Leaves may also specifically act on estrogen and estradiol response processes where estrogen receptors were involved. Regarding its protective function for the liver, leaves may play a role by regulating vitamin A-related pathways. As compared with leaves, the specific pharmacological effects of barks may be related to the development of the urinary system. Flowers specifically participate in functions related to pain sensation, glutamate signaling pathway, and excitatory postsynaptic potential. Based on the hie-rarchical network of "component-target-pathway", we further found that specific activities of different parts of EU were inseparable from its specific chemical compositions. Phenylpropanoids, terpenoids and rings, iridoids, flavonoids and other components which are specific in leaves can target the specific effects of leaves, while the flavonoids in barks and the quinones in flowers may be the material basis for their respective specific effects. The prediction of the activities of different parts of EU provides a new basis for the focuses and differences in subsequent Eucommia product development. At the same time, the material basis research based on differential efficacy also provides a basis for the quality control of Eucommia differentiated products.

[Clinical characteristics and prognostic factors of 40 cases of primary systemic anaplastic large cell lymphoma]

目的

分析原发系统型间变性大细胞淋巴瘤（ALCL）的临床特征及预后因素。

方法

回顾性分析2013年1月至2018年12月期间在浙江大学医学院附属第一医院住院治疗的40例ALCL患者的临床资料，总结其临床特征并分析其预后相关因素。

结果

①40例患者中男29例，女11例，中位年龄41（14～67）岁，Ann Arbor分期Ⅲ～Ⅳ期36例（90.0％），IPI评分中高危、高危23例（57.5％）；25例（62.5％）有B症状，发热最为常见，其次为消瘦、盗汗；38例（95.0％）有结外侵犯；25例（62.5％）LDH升高；25例（62.5％）Ki-67≥80％；ALK阳性22例（55.0％），中位年龄29（14～67）岁，ALK阴性18例（45.0％），中位年龄51.5（19～67）岁，年龄差异有统计学意义（P＝0.003）。②40例患者均接受化疗，采用CHOP（环磷酰胺+多柔比星+长春地辛+泼尼松）方案18例，ECHOP（依托泊苷+CHOP）方案12例，其他方案10例；26例（65.0％）获得完全缓解（CR），ALK阴性（P＝0.029，OR＝13.458）和Ki-67≥80％（P＝0.04，OR＝14.453）是CR的独立影响因素，ECHOP方案的CR率高于CHOP方案［83.3％（10/12）对38.9％（7/18），P＝0.026］。③LDH水平、IPI评分、ALK表达情况以及化疗方案的选择对无进展生存（PFS）和总生存（OS）影响有统计学意义（P<0.05）。

结论

ALCL发病男性居多，青少年至中老年均有发病，ALK阳性中年轻患者居多，诊断时临床分期晚，多数患者有结外侵犯，半数以上患者有B症状、LDH升高、Ki-67高表达；ALK表达与否、Ki-67表达水平以及化疗方案的选择可影响疗效，LDH水平、IPI评分、ALK表达与否以及化疗方案的选择可影响PFS和OS；ECHOP是较优的化疗方案，可改善预后。

Effects of different types of zinc supplement on the growth, incidence of diarrhea, immune function, and rectal microbiota of newborn dairy calves

Neonatal diarrhea in dairy calves causes huge economic and productivity losses in the dairy industry. Zinc is an effective anti-diarrheal agent, but high doses may pose a threat to the environment. Therefore, we aimed to evaluate the effects of low-dose zinc supplementation on the growth, incidence of diarrhea, immune function, and rectal microbiota of newborn Holstein dairy calves. Thirty newborn calves were allocated to either a control group (without extra zinc supplementation), or groups supplemented with either 104 mg of zinc oxide (ZnO, equivalent to 80 mg of zinc/d) or 457 mg of zinc methionine (Zn-Met, equivalent to 80 mg of zinc/d) and studied them for 14 d. The rectal contents were sampled on d 1, 3, 7, and 14, and blood samples were collected at the end of the study. Supplementation with ZnO reduced the incidence of diarrhea during the first 3 d of life, and increased serum IgG and IgM concentrations. The Zn-Met supplementation increased growth performance and reduced the incidence of diarrhea during the first 14 d after birth. The results of fecal microbiota analysis showed that Firmicutes and Proteobacteria were the predominant phyla, and Escherichia and Bacteroides were the dominant genera in the recta of the calves. As the calves grew older, rectal microbial diversity and composition significantly evolved. In addition, dietary supplementation with ZnO reduced the relative abundance of Proteobacteria in 1-d-old calves, and increased that of Bacteroidetes, Lactobacillus, and Faecalibacterium in 7-d-old calves, compared with the control group. Supplementation with Zn-Met increased the relative abundance of the phylum Actinobacteria and the genera Faecalibacterium and Collinsella on d 7, and that of the genus Ruminococcus after 2 wk, compared with the control group. Thus, the rectal microbial composition was not affected by zinc supplementation but significantly evolved during the calves' early life. Zinc supplementation reduced the incidence of diarrhea in young calves. In view of their differing effects, we recommend ZnO supplementation for dairy calves during their first 3 d of life and Zn-Met supplementation for the subsequent period. These findings suggest that zinc supplementation may be an alternative to antibacterial agents for the treatment of newborn calf diarrhea.

Single-Molecule Measurement of Adsorption Free Energy at the Solid-Liquid Interface

Adsorption plays a critical role in surface and interface processes. Fractional surface coverage and adsorption free energy are two essential parameters of molecular adsorption. However, although adsorption at the solid-gas interface has been well-studied, and some adsorption models were proposed more than a century ago, challenges remain for the experimental investigation of molecular adsorption at the solid-liquid interface. Herein, we report the statistical and quantitative single-molecule measurement of adsorption at the solid-liquid interface by using the single-molecule break junction technique. The fractional surface coverage was extracted from the analysis of junction formation probability so that the adsorption free energy could be calculated by referring to the Langmuir isotherm. In the case of three prototypical molecules with terminal methylthio, pyridyl, and amino groups, the adsorption free energies were found to be 32.5, 33.9, and 28.3 kJ mol^-1 , respectively, which are consistent with DFT calculations.

[Marker genes of geniposide-induced hepatotoxicity based on genomic strategy]

The aim of this paper was to screen out relevant genes of geniposide-induced hepatotoxicity based on genomics,in order to provide a scientific basis for the non-clinical evaluation of drugs containing Gardeniae Fructus and geniposide. Fifty-five SD rats were randomly divided into normal control group,24 h group and 72 h group. The changes of appearance,behavior and weight of rats were observed after administration by gavage for 3 days. The activities of ALT and AST were detected. Molecular mechanism of geniposideinduced hepatotoxicity was investigated by Affymetrix miRNA 4. 0 and Affymetrix Rat Gene 2. 0 to examine the gene expression levels in Sprague-Dawley rat livers at 24 h and 72 h after administration of overdose-geniposide( 300 mg·kg-1 daily),and then verified by Realtime quantitative PCR. Compared with the normal control group,the activities of ALT and AST were markedly increased. In addition,experimental results indicated that 324 genes were differentially expressed,among which 259 were up-regulated and 65 down-regulated.Nine candidate genes were verified by qRT-PCR,including Bcl2,Il1 b,Tpm3,MMP2,Col1α1,Ifit1,Aldob,Nr0 b2,Cyp2 c23. And Bcl2,Col1α1,Aldob,Nr0 b2 and Cyp2 c23 were found to be correlated with geniposide-induced hepatotoxicity. This study provides an important clue for mechanism of geniposide-induced hepatotoxicity.

[Safety and efficacy of DCV-based DAAs therapy for chronic HCV infection in China]

Objective: To evaluate the efficacy and safety of DCV-based DAAs therapy for chronic HCV infected Chinese patients. Methods: An open-label, non-randomized, prospective study was designed. Fifty-two patients with chronic HCV infection were enrolled. Among them, there was one patient after liver transplantation, 2 patients after kidney transplantation, 3 patients with hepatocellular carcinoma, and 4 patients with HBV infection. Thirteen cases with chronic hepatitis C (one compensated cirrhosis) who were negative for resistance-related variants [NS5A RAS (-)] of gene 1b and NS5A were treated with daclatasvir (DCV) + asunaprevir (ASV) for 24 weeks. Twenty-five cases of CHC (six compensated cirrhosis) with GT 1b, 2a, 3a, 3b, 6a were treated with DCV + SOF ± RBV for 24 weeks. 8 cases with decompensated cirrhosis of gene 1b and NS5A RAS(-) were given DCV + SOF + RBV regimen for 12 weeks. Six cases with decompensated cirrhosis, of gene 2a, 1b, 2a, 3a, 3b, were given DCV + SOF + RBV regimen for 24 weeks. HCV RNA, blood routine test, liver and kidney function, and upper abdominal ultrasound/MRI were measured at baseline, 4 weeks of treatment, end of treatment, and 12 weeks of follow-up. The incidence of adverse events and laboratory abnormalities during treatment were recorded. A t-test was used to compare the measurement data between two groups, and analysis of variance was used to compare the measurement data between multiple groups. Results: Sixteen patients (100%) achieved SVR12 after treatment, with 0% recurrence rate. Rapid virological response (RVR) of the four treatment regimens were 76.92%, 54.17%, 87.50%, and 83.33%, respectively, and 32 patients achieved 100% virological response after the completion of treatment. The incidence of adverse events of chronic hepatitis C with cirrhosis and decompensated cirrhosis was 62.5% and 64.29%, respectively. The most common adverse event was fatigue in CHC (25.00%), and elevated indirect bilirubin in decompensated cirrhosis (42.86%). No serious adverse drug events, deaths or adverse reactions occurred. Conclusion: DCV-based DAAs regimen is promising option for the treatment of HCV genotypes, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and HCV infection after liver/kidney transplantation in china. Above all, it has high SVR12 with good tolerability and safety profile.

[HIV and syphilis infection and related medical treatment status of low-fee female sex workers in three provinces of China, 2012-2015]

Objective: To understand the HIV and syphilis infection and related treatment status of low-fee female sex workers (FSWs) in 3 provinces of China. Methods: Four cross-sectional survey data of low-fee FSWs from six cities (counties) in Guangxi, Yunnan and Hunan Province between October 2012 and July 2015 were obtained from the national science and technology major special project intervention study for reducing sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS) in low-fee FSWs' database, which included social demographic characteristics, sexual service characteristics and related medical care seeking behaviors, etc. A total of 2 050 subjects were included in the database. Results: The age of the subjects was (35.16±9.76) years old, with a minimum age of 15 and a maximum age of 67. Those who use condoms every time in commercial sex accounted for 58.9% (n=1 206). Among the reasons of not using condom, the proportion of client reluctant to use was the highest (81.0% (n=682)). Only 38.1% (n=782) was tested for HIV in the last six months. HIV confirmed positive rate was 6.8% (n=139), previous positive accounts for 76.3% (n=106). Rate of antiviral therapy was 55.4% (n=77). By the end of 2015, the loss rate of antivirus treatment was 18.2% (n=14). Those who self-reported symptoms of sexually transmitted diseases in the last 6 months accounted for 9.4% (n=191). 50.3% (n=96) of reporters chose to go to formal hospitals, 23.0% (n=44) chose to go to private clinics and 20.4% (n=39) chose their own medication. The syphilis infection rate was 13.5% (n=277), among them, 91.3% (n=253) were asymptomatic. Conclusion: Among low-fee FSWs, the rates of HIV and syphilis infection are higher, the condom consistent use rate, HIV antibodies and syphilis test rate are lower. In this group, active seeking medical idea is poor, the rate of anti-virus treatment and the rate of seeking medical treatment in formal medical institutions is low.

Short communication: Effects of different selenium supplements on rumen fermentation and apparent nutrient and selenium digestibility of mid-lactation dairy cows

The aim of this study was to evaluate the dose-dependent effects of a hydroxy-analog of selenomethionine (HMSeBA) on rumen fermentation, apparent nutrient digestibility, and total selenium absorption in mid-lactation dairy cows, and to compare the effects with those of sodium selenite (SS). Fifty mid-lactation dairy cows with similar milk yields, days in milk, and parity were randomly assigned to 1 of 5 treatments according to a randomized complete block design. The cows were fed a basal diet containing 0.06 mg/kg dry matter (DM) of Se (control) or the same basal diet supplemented with SS, yielding 0.3 mg of Se/kg of DM (SS-0.3), or HMSeBA, yielding 0.1, 0.3, or 0.5 mg of Se/kg of DM (SO-0.1, SO-0.3, and SO-0.5, respectively), during the experimental period. The final content of Se in control, SS-0.3, SO-0.1, SO-0.3, and SO-0.5 was 0.06, 0.34, 0.15, 0.33, and 0.52 mg of Se/kg of DM. The experiment lasted for 10 wk, with a pretrial period of 2 wk. Supplementation with HMSeBA altered rumen fermentation by linearly increasing total volatile fatty acids and the molar proportions of propionate and butyrate but decreasing rumen pH, ammonia content, and the ratio of acetate to propionate. Compared with SS, HMSeBA enhanced the molar proportion of propionate in the rumen and the apparent digestibility of crude protein, neutral detergent fiber, acid detergent fiber, and selenium. We demonstrated that HMSeBA promoted rumen fermentation, apparent nutrient digestibility, and selenium absorption, implying that HMSeBA has a greater apparent absorption than SS.

[A preliminary study on the outcome of lower-risk myelodysplastic syndrome by low-dose decitabine]

目的

评价小剂量地西他滨治疗较低危骨髓增生异常综合征（MDS）患者的初步疗效及安全性，探讨MDS相关基因突变的临床意义。

方法

纳入浙江省4所医院收治的62例较低危MDS患者，治疗分2组，地西他滨组（地西他滨12 mg·m⁻²·d⁻¹，连续5 d）和支持治疗组，检测与MDS预后相关的15项基因突变情况。比较两组患者的总体有效率（ORR）和无进展生存（PFS）时间，分析其与基因突变的相关性。

结果

62例患者中，可评估患者51例，其中地西他滨组24例，支持治疗组27例。与支持治疗组相比，地西他滨组的ORR（66.7%对29.6%，χ²=6.996，P=0.008）和中位PFS时间显著改善（未达到对13.7个月，P=0.037）。51例患者中20例（39.2%）检测到基因突变阳性，其中4例患者单纯SF3B1阳性，均在支持治疗组。与基因突变阴性患者相比，16例基因突变阳性（除单纯SF3B1阳性）患者中位PFS时间显著缩短（9.2个月对18.5个月，P=0.008），其中地西他滨组8例患者中6例有效，支持治疗组无一例（0/8）有效。地西他滨治疗期间主要不良反应为3~4级粒细胞减少（45.8%），3~4级感染发生率为33.3%（8/24）。

结论

该研究小系列患者的初步结果表明应用小剂量地西他滨治疗较低危MDS患者可能有效，对于基因突变患者也可获益，且患者耐受，值得临床试验进一步明确其临床意义。

DanHong injection targets endothelin receptor type B and angiotensin II receptor type 1 in protection against cardiac hypertrophy

Cardiac hypertrophy (CH) is an independent risk factor for cardiovascular diseases (CVDs). Mitigating or preventing CH is the most effective strategy for the treatment of CVDs. DanHong injection (DH) is a Chinese herbal medicine preparation (CHMP) widely used in clinical treatment of several CVDs in China. However, the direct targets and cellular mechanisms for these protective effects remain unclear. This study was designed to illustrate the direct targets of DH in protecting against CH and investigate CH molecular pathogenesis. A hypertrophic cell model was induced by endothelin-1 (ET-1) on human induced pluripotent stem cell-derived cardiomyocytes (hiPS-CMs). Real time cellular analysis (RTCA) cardio system and high content analysis (HCA) were used to detect the changes in contractile function, morphology and protein level of hypertrophic hiPS-CMs. Agonist and antagonist assay on receptors were performed using calcium mobilization high-throughput screening (HTS). DH significantly attenuated CH by modulating myocardial contractility, suppressing cell area enlargement and down-regulating ET-1-induced brain natriuretic peptide (BNP), actinin alpha 2 (ACTN2) and cardiac muscle troponin T (TNNT2) protein expression (P < 0.05). Endothelin receptor type B (ETBR) and angiotensin II receptor type 1 (AT1R) were DH direct targets, with IC50 value of 25.67 μL/mL and 1.10 μL/mL, respectively. Proteomics analysis showed that proteins involved in cell cycle inhibition, RNA processing, mitochondrial translation and cytoskeleton are significant regulated by DH treatment. These data revealed that ETBR and AT1R are DH direct targets on protecting against CH, providing a strategy to explore direct targets of CHMPs.

[Efficacy and safety analysis of different dose idarubicin plus cytarabine regimen as induction chemotherapy for young patients with de-novo acute myeloid leukemia]

目的

探讨不同剂量去甲氧柔红霉素（IDA）联合阿糖胞苷诱导方案（IA）治疗年轻初发急性髓系白血病（AML）（除外急性早幼粒细胞白血病）的临床疗效、安全性和长期预后。

方法

回顾性分析2009年1月至2014年7月收治的采用IA方案治疗的149例<55岁初发AML患者临床资料，根据IDA剂量分为高标准剂量组（10~12 mg·m⁻²·d⁻¹）、低标准剂量组（8~9 mg·m⁻²·d⁻¹）和低剂量组（<8 mg·m⁻²·d⁻¹），比较各组患者的化疗反应、血液学及非血液学不良事件，并分析预后。

结果

高标准剂量组34例，低标准剂量组53例，低剂量组62例。三组第1个疗程完全缓解（CR）率分别为79.4%、75.5％和46.8%，第1个疗程有效率分别为97.1%、94.3％和64.5%，总CR率分别为85.3%、81.1％和54.8%，高标准剂量组、低标准剂量组均显著高于低剂量组（P值均<0.05），前两者间差异无统计学意义（P值均>0.05）。多因素分析证实标准IDA剂量的确在诱导缓解疗效上优于低剂量（P<0.05）。在不良反应方面，化疗期间WBC最低值三组间差异有统计学意义（P=0.002），其余差异均无统计学意义。低标准剂量组在总生存（OS）上显著优于低剂量组（P=0.030），高标准剂量组与低剂量组相比，OS也有改善的趋势（P=0.054）。三组间在无事件生存、无复发生存差异均无统计学意义（P值均>0.05）。

结论

对于年轻（<55岁）初发AML患者，标准剂量IA方案可显著提高CR率，且患者的耐受性良好。标准剂量IA方案在一定程度上能改善年轻（<55岁）AML患者OS。

[Human selenium-containing single-chain variable fragment with glutathione peroxidase activity protects NIH3T3 fibroblast against oxidative damage]

Ultraviolet B (UVB medium wave, 280-315 nm) induces cellular oxidative damage and apoptosis by producing reactive oxygen species (ROS). Glutathione peroxidase functions as an antioxidant by catalyzing the reduction of hydrogen peroxide, the more important member of reactive oxygen species. A human selenium-containing single-chain variable fragment (se-scFv-B3) with glutathione peroxidase activity of 1288 U/μmol was generated and investigated for its antioxidant effects in UVB-induced oxidative damage model. In particular, cell viability, lipid peroxidation extent, cell apoptosis, the change of mitochondrial membrane potential, caspase-3 activity and the levels of intracellular reactive oxygen species were assayed. Human se-scFv-B3 protects NIH3T3 cells against ultraviolet B-induced oxidative damage and subsequent apoptosis by prevention of lipid peroxidation, inhibition of the collapse of mitochondrial membrane potential as well as the suppression of the caspase-3 activity and the level of intracellular ROS. It seems that antioxidant effects of human se-scFv-B3 are mainly associated with its capability to scavenge reactive oxygen species, which is similar to that of the natural glutathione peroxidase.

Cardiotoxicity evaluation of nine alkaloids from Rhizoma Coptis

PURPOSE

Alkaloids derived from Rhizoma Coptis (RC) has been widely applied to clinical treatments in China. However, the toxicity of RC and the alkaloids from RC remained controversial. The research is designed to clarify the cardiotoxic compounds found in RC.

METHODS

In this study, the real-time cellular analysis cardio system and the high-content analysis were applied to monitor the function of cardiomyocytes (CMs) in the treatment of nine alkaloids in RC. Luciferase-coupled adenosine triphosphate (ATP) assay was used to detect cell viability.

RESULTS

The results showed that berberine, palmatine, berbamine, and oxyberberine were cardiotoxic, which resulted in arrhythmia and cardiac arrest on CMs in a time- and dose-dependent manner. Meanwhile, berbamine and oxyberberine caused shrinkage and detachment on CMs at 10 μM. Cytotoxicity was induced by these two compounds with decline in cell index and ATP depletion. Cardiotoxicity or cytotoxicity was not observed in the other five alkaloids within 10 μM.

CONCLUSION

For the first time, the cardiotoxicity of the nine alkaloids was evaluated to clarify the cardiotoxic components in RC. Furthermore, the experimental evidences were provided to support the safety of drug application.

p49/STRAP, a Serum Response Factor Binding Protein (SRFBP1), Is Involved in the Redistribution of Cytoskeletal F-Actin Proteins during Glucose Deprivation

The functional decline that usually accompanies adult aging also encompasses cellular changes including cytoplasmic architecture. In addition to their role in cytoskeletal structure, actin microfilaments have important roles in various cellular processes, including cell-to-cell communication and intracellular signaling. Age-related diseases and late-stage cellular morphological appearances often correlate with altered f-actin structure, which has been observed most notably in cancer. What remains less clear are the molecular pathways that may be involved in normal and premature aging-induced f-actin changes. We report herein that p49/STRAP, a serum response factor binding protein (SRFBP1), is increased with normal aging and appears to be sensitive to low glucose-exposure. Our study results suggest that increased levels of p49/STRAP expression tend to correlate with f-actin redistribution genes, particularly cofilin, while siRNA-mediated knockdown of p49/STRAP resulted in a reduction of thymosin-β4. Furthermore, with the redistribution of f-actin, we observed an increase in the intermediate filament vimentin, compatible with the notion that vimentin may be increased due to its greater role in cytoskeletal dynamics during advancing population doubling levels (PDLs) and in response to a low-glucose exposure. Taken together, these data suggest that p49/STRAP may play a role in glucose-deprivation associated cytoskeletal changes.

Physiological Content and Intrinsic Activities of 10 Cytochrome P450 Isoforms in Human Normal Liver Microsomes

Due to a lack of physiologic cytochrome P450 (P450) isoform content, P450 activity is typically only determined at the microsomal level (per milligram of microsomal protein) and not at the isoform level (per picomole of P450 isoform), which could result in the misunderstanding of variations in P450 activity between individuals and further hinder development of personalized medicine. We found that there were large variations in protein content, mRNA levels, and intrinsic activities of the 10 P450s in 100 human liver samples, in which CYP2E1 and CYP2C9 showed the highest expression levels. P450 gene polymorphisms had different effects on activity at two levels: CYP3A5*3 and CYP2A6*9 alleles conferred increased activity at the isoform level but decreased activity at the microsomal level; CYP2C9*3 had no effect at the isoform level but decreased activity at the microsomal level. The different effects at each level stem from the different effects of each polymorphism on the resulting P450 protein. Individuals with CYP2A6*1/*4, CYP2A6*1/*9, CYP2C9*1/*3, CYP2D6 100C>T TT, CYP2E1 7632T>A AA, CYP3A5*1*3, and CYP3A5*3*3 genotypes had significantly lower protein content, whereas CYP2D6 1661G>C mutants had a higher protein content. In conclusion, we first offered the physiologic data of 10 P450 isoform contents and found that some single nucleotide polymorphisms had obvious effects on P450 expression in human normal livers. The effects of gene polymorphisms on intrinsic P450 activity at the isoform level were quite different from those at the microsomal level, which might be due to changes in P450 protein content.

[Analysis on composition principles of formulae containing Gardeniae Fructus in dictionary of traditional Chinese medicine prescriptions]

Gardeniae Fructus, which is widely used in health foods and clinical medicines, is a type of edible food and medicine. Dictionary of traditional Chinese medicine prescriptions provides good materials for prescription analysis and the R&D of traditional Chinese medicines. The composition regularity of formulae containing Gardeniae Fructus in dictionary of traditional Chinese medicine prescriptions was analyzed on the basis of the traditional Chinese medicine inheritance support system(TCMISS), in order to provide reference for clinical application and the R&D of new drugs. TCMISS was applied to establish a database of prescriptions containing Gardeniae Fructus. The software's frequency statistics and association rules and other date mining technologies were adopted to analyze commonly used drugs, combination rules and core combined formulae containing Gardeniae Fructus. Totally 3 523 prescriptions were included in this study and involved 1 725 Chinese herbs. With a support degree of 352(10%) and confidence coefficient of 90%, 57 most commonly used drug combinations were screened. Drugs adopted in core combinations were relatively concentrated and selected according to definite composition methods. They were used to mainly treat 18 diseases. Gardeniae Fructus have often been combined with herbs for heat-clearing and detoxification, expelling pathogenic wind, relieving exterior syndrome, invigorating the circulation of blood and gas and promoting blood circulation for removing blood stasis to mainly treat jaundice, typhoid, headache and other syndromes.

Abstract P1-15-02: Gene expression profiling of doxorubicin cardiotoxicity in peripheral blood cells of breast cancer patients

Background: Doxorubicin (DOX), a widely used anti-cancer drug for treatment of breast cancer is known for its cardiotoxicity. DOX cardiotoxicity is cumulative-dose-dependent and begins with the first dose of chemotherapy. To date, no biomarker for early presymptomatic detection of DOX cardiotoxicity has been validated. Our previous data indicated that peripheral blood mononuclear cells (PBMCs) can be used as a surrogate tissue for identification of biomarkers for DOX cardiotoxicity. The aim of this study was to analyze PBMC gene expression induced by a single dose of DOX-based chemotherapy in breast cancer patients and correlated the data with DOX-induced cardiotoxicity.

Materials and Methods. Blood samples of 33 women treated for breast cancer with DOX-based chemotherapy were collected before the start and after the first cycle of chemotherapy. Total RNA was isolated from PBMC and whole-genome gene expression was performed using Illumina HumanHT-12 v4 Expression BeadChip array. Gene expression data were log2 – transformed and gene transcripts with average log2-intensities &gt; 7 were considered to be expressed. The group-specific means were analyzed via repeated-measures with ANOVA for expression changes after DOX. Genes with p-value&lt;0.05 were considered differentially expressed. Cardiac function was assessed before and after the completion of chemotherapy by echocardiogram and/or multigated acquisition scan. An absolute decrease of left ventricle ejection fraction &gt;10% or &lt;55% was considered abnormal. Differentially expressed genes (DEG) of patients who developed abnormal LVEF decrease were compared with DEG of patients who did not.

Results. A single dose of DOX-based chemotherapy resulted in 235 DEG in PBMC (P&lt;0.05, FDR&lt;0.05), mapped to cell death, oxygen transport and iron ion binding. Further analysis identified 87 DEG in the PBMC of eight (n=8) women who developed abnormal decline in LVEF from the baseline in comparison with women who did not (n=25). Most of the 87 DEG encode proteins secreted by activated neutrophils, such as alpha-defensins, arginase, cathepsin G, elastase, haptoglobin. The functional analysis of the 87 DEG showed enrichment for inflammatory response, immune response, cell death and peptidase activity.

Discussion. The results from this study indicated that elevated neutrophil-associated transcripts in the early stages of DOX-based chemotherapy were independent of the neutrophil count. These data suggest an association between the neutrophils activation after a single dose of DOX-based chemotherapy and later impairment of cardiac function. The early PBMC transcriptome signature can be used in the future development of biomarkers for DOX-associated cardiotoxicity.

Citation Format: Todorova VK, Siegel ER, Makhoul I, Marquette M, Wei JY, Klimberg VS. Gene expression profiling of doxorubicin cardiotoxicity in peripheral blood cells of breast cancer patients. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-15-02.

Riboflavin supplementation improves energy metabolism in mice exposed to acute hypoxia

This study investigated the effects of riboflavin on energy metabolism in hypoxic mice. Kunming mice were fed diets containing riboflavin at doses of 6, 12, 24 and 48 mg/kg, respectively for 2 weeks before exposure to a simulated altitude of 6000 m for 8 h. Changes of riboflavin status and energy metabolism were assessed biochemically. Simultaneously, a (1)H nuclear magnetic resonance (NMR) based metabolomic technique was used to track the changes of plasma metabolic profiling. It was found that the content of hepatic riboflavin was decreased and erythrocyte glutathione activation coefficient was elevated significantly under hypoxic condition. Meanwhile, increased plasma pyruvate, lactate, beta-hydroxybutyrate and urea, as well as decreased plasma carnitine were observed. Riboflavin supplementation improved riboflavin status remarkably in hypoxic mice and decreased plasma levels of pyruvate, free fatty acids and beta-hydroxybutyrate significantly. Plasma carnitine was increased in response to riboflavin supplementation. Results obtained from (1)H NMR analysis were basically in line with the data from biochemical assays and remarkable changes in plasma taurine, choline and some other metabolites were also indicated. It was concluded that riboflavin requirement was increased under acute hypoxic condition and riboflavin supplementation was effective in improving energy metabolism in hypoxic mice.

Isolation and characterization of two VpYABBY genes from wild Chinese Vitis pseudoreticulata

The establishment of abaxial-adaxial polarity is an important feature of the development of lateral organs in plants. Members of the YABBY gene family may be specific to seed-plant-specific transcriptional regulators that play critical roles in promoting abaxial cell fate in the model eudicot, Arabidopsis thaliana. However, recent study has shown that the roles of YABBY genes are not conserved in the development of angiosperms. The establishment of abaxial-adaxial polarity has not been studied in perennial fruit crops. Grapes are an important fruit crop in many regions of the world. Investigating YABBY genes in grapevines should help us to discover more about the key genetic and molecular pathways in grapevine development. To understand the characterization of YABBY genes in grapevines, two YABBY genes, VpYABBY1 (GenBank accession No. KC139089) and VpYABBY2 (GenBank accession No. KC139090), were isolated from the wild Chinese species Vitis pseudoreticulata. Both of these encode YABBY proteins. Sequence characterization and phylogenetic analyses show that VpYABBY1 is group classified into the FIL subfamily while VpYABBY2 is a member of the YAB2 subfamily of Arabidopsis thaliana. Subcellular localization analysis indicates that VpYABBY1 and VpYABBY2 proteins are localized in the nucleus. Tissue specific expressional analysis reveals that VpYABBY1 is expressed strongly in young leaves of grape but only weakly in the mature leaves. Meanwhile, VpYABBY2 is expressed in grape stems, flowers, tendrils, and leaves. Transgenic Arabidopsis plants ectopically expressing VpYABBY1 caused the partial abaxialization of the adaxial epidermises of leaves, behaving similarly to those over-expressing FIL or YAB3 with abaxialized lateral organs. By contrast, ectopic expression of VpYABBY2 in Arabidopsis did not cause any alteration in the adaxial-abaxial polarity. Sequence characterization and phylogenetic analysis revealed that VpYABBY1 and VpYABBY2 are group-classified into two different subfamilies. They have diverged functionally in the control of lateral organ development. VpYABBY1 may have a function in leaf development, while VpYABBY2 may play a specific role in carpel development and grape berry morphogenesis. It is further possible that during the evolution of different species, YABBY family members have preserved different expression regulatory systems and functions.

Desloratadine prevents compound 48/80-induced mast cell degranulation: visualization using a vital fluorescent dye technique

BACKGROUND

Desloratadine is a selective H1-antihistamine used in the treatment of allergic rhinitis and chronic idiopathic urticaria. Desloratadine inhibits the release of allergic inflammatory mediators in vitro. We studied the impact of desloratadine on mast cell degranulation due to activation and re-activation by the secretagogue, compound 48/80.

METHODS

Rat peritoneal eluate containing 5-6% mast cells were activated by a low concentration of compound 48/80 in a medium containing the vital fluorescent dye, Sulforhodamine-B (SFRM-B, 200 microg/ml), which is engulfed by activated mast cells. The fluorescent image of activated mast cells was captured digitally and the total fluorescent area was analyzed when desloratadine was applied before or after compound 48/80.

RESULTS

Mast cells were not activated by desloratadine (10(-4) M), SFRM-B (200 microg/ml), or diluent alone. A low concentration of compound 48/80 (0.125 microg/ml) induced fluorescence, while mast cells lost fluorescent images due to further degranulation on re-exposure to compound 48/80. Desloratadine (10(-8)-10(-4) M), inhibited compound 48/80-induced mast cell degranulation in a concentration-dependent manner. Desloratadine also reduced the loss of fluorescent images due to re-exposure to compound 48/80.

CONCLUSIONS

Desloratadine may have a mast cell stabilizing effect at low concentrations in response to repeated mast cell activation in vitro.

Differential vulnerability to oxidative stress in rat cardiac myocytes versus fibroblasts

OBJECTIVES

This study was designed to test the hypothesis that cardiac myocytes have greater vulnerability to oxidative stress compared with cardiac fibroblasts.

BACKGROUND

The function of cardiac myocytes differs from that of fibroblasts in the heart, but differences in their response to oxidative stress have not been extensively studied.

METHODS

Cardiomyocytes and fibroblasts from F344 neonatal rat hearts were cultured and exposed to different concentrations of hydrogen peroxide (H(2)O(2)) and menadione (superoxide generator). The mitogen-activated protein kinase (MAPK) proteins were assayed after oxidative stress; cell death was determined by trypan blue staining and deoxyribonucleic acid (DNA) ladder electrophoresis.

RESULTS

The cardiac myocytes were significantly more vulnerable than the fibroblasts to oxidative damage, showing substantial DNA fragmentation and consistently poor cell survival after exposure to H(2)O(2) (100 to 800 microM), while the cardiac fibroblasts demonstrated little or no DNA fragmentation, and superior cell survival rates both over time (from 1 to 72 h after 100 microM) and across increasing doses of H(2)O(2) (100 to 800 microM). The p42/44 extracellular signal-regulated kinases were phosphorylated in both cell types after exposure to H(2)O(2), but significantly more in cardiac fibroblasts. However, p38 MAPK and c-jun NH(2)-terminal kinase were phosphorylated more in the cardiac myocytes compared to cardiac fibroblasts. This was also the case after exposure to menadione.

CONCLUSION

Taken together, these results suggest that oxidative stress causes greater injury and cell death in cardiac myocytes compared with cardiac fibroblasts. It is possible that the signaling differences via the MAPK family may partly mediate the observed differences in vulnerability and functional outcomes of the respective cell types.

Early postnatal cardiac changes and premature death in transgenic mice overexpressing a mutant form of serum response factor

Serum response factor (SRF) is a key regulator of a number of extracellular signal-regulated genes important for cell growth and differentiation. A form of the SRF gene with a double mutation (dmSRF) was generated. This mutation reduced the binding activity of SRF protein to the serum response element and reduced the capability of SRF to activate the atrial natriuretic factor promoter that contains the serum response element. Cardiac-specific overexpression of dmSRF attenuated the total SRF binding activity and resulted in remarkable morphologic changes in the heart of the transgenic mice. These mice had dilated atrial and ventricular chambers, and their ventricular wall thicknesses were only 1/2 to 1/3 the thickness of that of nontransgenic mice. Also these mice had smaller cardiac myocytes and had less myofibrils in their myocytes relative to nontransgenic mice. Altered gene expression and slight interstitial fibrosis were observed in the myocardium of the transgenic mice. All the transgenic mice died within the first 12 days after birth, because of the early onset of severe, dilated cardiomyopathy. These results indicate that dmSRF overexpression in the heart apparently alters cardiac gene expression and blocks normal postnatal cardiac growth and development.

Clinical implications of physiological changes in the aging heart

Elderly individuals experience a disproportionate burden from cardiovascular disease. Global changes in aging will have a significant impact on the future of medical practice. However, most physicians have little formal training in geriatric medicine and sometimes fail to distinguish disease states from normal aging. Increasingly, it is recognised that a sedentary lifestyle may be responsible for a large fraction of the so-called 'age-related' changes in the cardiovascular system. Nonetheless, well characterised changes do occur in most individuals with aging. Loss of myocytes with subsequent hypertrophy of the remaining cells is usually observed. Calcification involving the conduction and valvular apparatus is seen in most elderly individuals and may predispose to the common arrhythmias of old age. Age-related loss of arterial compliance contributes to isolated systolic hypertension and left ventricular hypertrophy. Despite these changes, for the majority of healthy older adults, cardiac output is well maintained in the basal state through use of the Frank-Starling principle, in the setting of reduced early diastolic filling. Myocardial relaxation is slowed in part due to age-related changes in the sarcoplasmic reticulum Ca2+ ATPase pump. Elevated blood levels of catecholamines contribute to desensitisation to noradrenergic stimulation and this is associated with an age-related decline in maximum achievable heart rate. Changes in the baroreceptor reflex function and decreased sodium conservation may predispose some individuals to orthostatic and postprandial hypotension. The aetiology of cardiovascular aging is under intense study. The most likely mechanisms involve the result of cumulative damage mediated through a variety of insults. Oxidative stress, non-enzymatic glycation, inflammation and changes in cardiovascular gene expression all seem to influence cardiovascular aging. The benefits of exercise continue to be discovered. Endurance-type training has been shown to have a dramatic impact on parameters of cardiovascular aging. Favourable effects are seen in maximum oxygen consumption, diastolic filling, relaxation and arterial stiffness. Some changes such as the maximum heart rate response do not appear to change with conditioning. Pharmacotherapy may afford the opportunity to influence the aging process. Drugs that can reduce age-associated arterial stiffness, cardiac fibrosis and ventricular hypertrophy should prove useful. Antioxidants continue to be a topic of great interest and require more study. Despite some well described changes with aging, most elderly individuals maintain the opportunity for improved cardiovascular function through conditioning. Early recognition and treatment of diseases that are distinguishable from normal aging, including hypertension and atherosclerosis, together with preventive efforts, should reduce the predicted trends in cardiovascular morbidity and mortality among the aged.

[Effects of zinc on the free radical signals and apoptosis in liver with ischemia/ reperfusion injury]

AIM

In order to explore the preventive mechanism of zinc, the changes of free radical signals and apoptosis in hepatic ischemia/reperfusion injury (HIR) rats were observed.

METHODS

The MDA levels in serum were measured by fluorophotometry, free radical signals in liver were analyzed with electron spin resonance (ESR) method; and apoptosis was assayed by flow cytometry (FCM).

RESULTS

MDA levels in serum and free radical contents in liver were both increased in rats with HIR. After zinc supplementation, they were decreased. After HIR, the percentage of subdiploid cells was 57.72% while it was reduced to 40.85% after zinc supplementation.

CONCLUSION

Zinc may protect against HIR injury by inhibiting the production of free radicals in liver and hepatocellular apoptosis.

Miniature postsynaptic currents depend on Ca2+ released from internal stores via PLC/IP3 pathway

Miniature postsynaptic currents (mPSCs) were examined on autaptic innervation of single rat retinal ganglion cells in low density cultures. Removal of Ca2+ from bath solution or blocking of Ca2+ channels by Cd2+ had no detectable effect on mPSC frequency or amplitude. Thapsigargin, an agent for mobilization of Ca2+ from internal stores, increased mPSC frequency 3-5-fold in control, Ca2+-free or Cd2+-containing solutions. The inositol 1,4,5-triphosphate (IP3) receptor antago- nist, heparin; the phospholipase C (PLC) inhibitor, U73122; and caffeine abolished mPSC or decreased mPSCs frequency. Calcium imaging showed that cytosolic Ca2+ was increased by thapsigargin and decreased by caffeine. These data demonstrate that internal store-released Ca2+ regulated by the PLC/IP3/IP3-receptor pathway has critical contribution to generation and control of miniature release in retinal ganglion cells.

Endogenous anticholinergic substances may exist during acute illness in elderly medical patients

BACKGROUND

The purpose of this study was to determine if serum anticholinergic activity (SACA) arises from endogenous substances produced during illness.

METHODS

Elderly medical inpatients (N = 612) were screened for anticholinergic medication use in the week prior to the study by interviews of subjects and proxies and review of emergency room, hospital, and nursing home medication administration records. Of 24 subjects without a recent anticholinergic medication history, 15 were recruited and 10 completed the study. Serum samples were obtained on Day 2 of hospital admission. SACA was measured using a radionuclide displacement assay. Medications taken by subjects were assayed for central muscarinic receptor binding at therapeutic concentrations. Results. Eight of the ten subjects had SACA detectable in the serum. No medication used by these subjects had anticholinergic activity at usual therapeutic concentrations.

CONCLUSIONS

Endogenous anticholinergic substances may exist during acute illness. Characterization of such substances may increase the depth of our understanding of delirium and lead to useful intervention strategies.

[Function of the leaky UGA codon in ssRNA plant virus genomes]

The opal mutation (UGA) at nucleotide 2670-2672 in the replicase gene of the attenuated tomato mosaic virus K (ToMV-K) mainly contributes to the virus attenuation based on a series of studies on the viral attenuation mechanism. From analysis and comparison between the replicase gene mutation point of ToMV-K and the related regions of all plant viruses containing the leaky UGA, we have found that some characters, including the CGG motif, alpha-helix structure and some specific amino acids, are, presumably, able to helpfully confer the readthrough mechanism. Finally, some other ssRNA plant viruses like PVX, PVY, CMV have been analyzed. We found that their genomic modifications and viral attenuations could be explored according to the mutation mode of the ToMV-K replicase.

Cardiomyopathy in transgenic mice with cardiac-specific overexpression of serum response factor

Serum response factor (SRF), a member of the MCM1, agamous, deficiens, SRF (MADS) family of transcriptional activators, has been implicated in the transcriptional control of a number of cardiac muscle genes, including cardiac alpha-actin, skeletal alpha-actin, alpha-myosin heavy chain (alpha-MHC), and beta-MHC. To better understand the in vivo role of SRF in regulating genes responsible for maintenance of cardiac function, we sought to test the hypothesis that increased cardiac-specific SRF expression might be associated with altered cardiac morphology and function. We generated transgenic mice with cardiac-specific overexpression of the human SRF gene. The transgenic mice developed cardiomyopathy and exhibited increased heart weight-to-body weight ratio, increased heart weight, and four-chamber dilation. Histological examination revealed cardiomyocyte hypertrophy, collagen deposition, and interstitial fibrosis. SRF overexpression altered the expression of SRF-regulated genes and resulted in cardiac muscle dysfunction. Our results demonstrate that sustained overexpression of SRF, in the absence of other stimuli, is sufficient to induce cardiac change and suggest that SRF is likely to be one of the downstream effectors of the signaling pathways involved in mediating cardiac hypertrophy.

The utilization of intravenous therapy programs in community long-term care nursing facilities

OBJECTIVE

To determine if non-federal Boston-area long-term care nursing facilities are actively using intravenous (IV) therapy as a form of treatment, the specific design of such programs and to assess the availability of central line IVs, percutaneous endoscopic gastrostomy (PEG) tubes and hypodermoclysis for hydration in this setting. DESIGN/SETTINGS: A prospective telephone survey of 100 Boston-area skilled nursing facilities, each with a minimum of 50 beds and representing a total of 12,763 beds, certified to provide both Medicaid (Title-19) and Medicare services, to ascertain their ability to provide IV and other modes of hydration for their residents.

METHODS

A series of questions were asked of a member of the staff knowledgeable in the operations of the nursing facility. Questions included whether an IV program was in existence, duration of the program, provider of IV training for nurses, presence of a subacute unit, whether IVs were administered in non-subacute areas, frequency of IV usage, the ability to manage central lines and the use of PEG tubes or hypodermoclysis for hydration.

RESULTS

A total of 100 nursing facilities were surveyed between September and October of 1996. A total of 79 nursing facilities had active IV programs (79%) and 54 of those (68%) also managed central lines. However, in those facilities with active IV programs, 73% (N = 58) reported administering a total of less than five IVs per month. Training for 82% of the nursing facilities (N = 65) was by an outside vendor pharmacy and initial training ranged from one to three days in duration. Of the 19 nursing facilities with IV programs available only in subacute or equivalent units, only 26% (N = 5) did not allow direct transfer of residents from other wards into these units. Of the 79 nursing facilities having IV capability, a total of 91% (N = 72) have also used PEG tubes for hydration and nutritional needs although only 6% (N = 5) have ever used hypodermoclysis for hydration.

CONCLUSIONS

The majority of nursing facilities in the Boston area provide IV programs for their residents, although in limited numbers on a monthly basis. Residents with central lines are admitted in the majority of these nursing facilities although total staff training time is only one to three days. The use of PEG tubes for hydration is quite frequent, although the use of hypodermoclysis was extremely low. Further work is necessary to fully elucidate the clinical implications of whether these programs decrease the need for acute hospitalization or are used mainly in the post-hospitalization (Medicare A-covered) period.

Disparate effects of socioeconomic status on physical function and emotional well-being in older adults

We tested the hypothesis that among community living older adults with relatively low and high socioeconomic status (SES), low SES is associated with both poorer emotional well-being and physical function. Ambulatory, community living older men and women (70-89 years of age) were recruited from outpatient geriatric assessment clinics in relatively high socioeconomic areas of greater Boston (High SES, N=47), and from an urban senior center in the inner city (Low SES, N=66). We assessed health status, mental health, upper and lower extremity strength and physical function. We found that health status was not significantly different in the two groups. Quadriceps strength (Low SES: 199+/-57 N; High SES: 190+/-56 N; p=0.531) and Up and Go times (Low SES: 14.3+/-3.1 sec; High SES: 16.7+/-9.5 sec; p=0.068) were not significantly different in the two groups, while grip strength was slightly higher in the Low SES group (Low SES: 22.8+/-6.45 kg; High SES: 20.07+/-7.55 kg; p=0.049). In contrast, subjects with Low SES tended to have an increased tendency towards depression. Scores on the Geriatric Depression Scale were 3.8+/-3.0 in Low SES, and 1.8+/-2.8 in High SES (p<0.001). We conclude that while health status and physical function were not worse in subjects with low SES, emotional well-being was markedly less compared to seniors with high SES. SES may have disparate effects on physical function and mental health, perhaps due to different compensatory mechanisms.

Quantification and sequencing of somatic deleted mtDNA in single cells: evidence for partially duplicated mtDNA in aged human tissues

Single-cell PCR of the whole mitochondrial genome provides detailed information about intracellular clonal expansions of deleted mitochondrial DNA (DeltamtDNA), which contribute to aging of the muscle and possibly other tissues. Analysis of approximately 1400 cells from heart, diaphragm and skeletal muscle from 20 individuals without mitochondrial disease revealed that up to 25% of cells in a tissue sample may bear clonally expanded DeltamtDNA. Sequence analysis of >50 clonal DeltamtDNA reveals that about half of them lack the light strand origin of replication. This observation is puzzling since these molecules must have retained the ability to replicate in order to be able to undergo clonal expansion. We present evidence that such DeltamtDNA molecules may in fact exist in the cell as partially duplicated mtDNA (pdmtDNA) previously described in certain mtDNA disorders. In contrast to the 'originless' DeltamtDNA, the corresponding pdmtDNA do possess a light strand origin required for their propagation. Most pdmtDNA also possess an extra heavy strand origin, which may result in higher replication rate and thus provide a mechanism for expansion. Importantly, pdmtDNA are indistinguishable from DeltamtDNA in PCR assays routinely used to detect somatic mtDNA deletions in tissues of normally aged individuals. These results indicate that a substantial proportion of age-related mtDNA deletions reported in the literature may exist as or be derived from pdmtDNA.

Suppression of stress kinase JNK is involved in HSP72-mediated protection of myogenic cells from transient energy deprivation. HSP72 alleviates the stewss-induced inhibition of JNK dephosphorylation

Since protection of cells from stress-induced apoptosis by the heat shock protein Hsp72 involves suppression of stress kinase JNK, we suggested that Hsp72-mediated JNK inhibition might also be critical for myocardial protection from ischemia/reperfusion. Transient energy deprivation of H9c2 myogenic cells, used as an in vitro model of myocardial ischemia, led to cell death that had morphological features of apoptosis and necrosis and was independent of caspases. Surprisingly, this unusual type of cell death was regulated by JNK and ERK kinases. In fact, specific inhibition of JNK increased cell survival; specific inhibition of ERKs enhanced deleterious consequences of energy deprivation, whereas inhibition of p38 kinase had no effect. Hsp72 suppressed activation of JNK and did not increase ERK activity, suggesting that inhibition of JNK is the important component of Hsp72-mediated protection. Upon transient energy deprivation, activation of JNK proceeds via two distinct pathways, stimulation of JNK phosphorylation by a protein kinase SEK1 and inhibition of JNK dephosphorylation. Remarkably, in cells exposed to transient energy deprivation, Hsp72 enhanced the rate of JNK dephosphorylation but did not affect SEK1 activity. Therefore, it appears that Hsp72 specifically down-regulates JNK by accelerating its dephosphorylation, which reduces the susceptibility of cardiac cells to simulated ischemia/reperfusion.

Peripheral corticotropin-releasing factor and stress-stimulated colonic motor activity involve type 1 receptor in rats

BACKGROUND & AIMS

Corticotropin-releasing factor (CRF) exerts its action through CRF receptors 1 and 2 (CRF-R1 and CRF-R2). CRF has preferential affinity for CRF-R1, whereas urocortin displays high affinity for both. We investigated changes in colonic motor function after intraperitoneal (IP) injection of CRF-related peptides.

METHODS

Colonic motility was recorded in vivo in conscious rats equipped with electrodes chronically implanted in the cecum and proximal colon or in vitro in distal colon; fecal output was monitored in naive rats.

RESULTS

Rat CRF, rat urocortin, and amphibian sauvagine (10 microg/kg, IP) induced a new pattern of cecocolonic myoelectric activity characterized by clustered spike bursts of long duration; the percentage of occurrence was highest after CRF. The rank order of potency to increase fecal pellet output after IP peptide injection (0.3-10 microg/kg, IP) was CRF > urocortin = sauvagine. The CRF-R1/R2 antagonist astressin (33 microg/kg, IP) and the CRF-R1 antagonist CP-154,526 (20 mg/kg, subcutaneously) inhibited IP CRF-induced changes in cecocolonic myoelectric activity and IP CRF- and water avoidance stress-induced fecal output. In vitro, CRF injected into the inferior mesenteric artery increased distal colonic myoelectric activity compared with saline injection.

CONCLUSIONS

These results demonstrate that CRF acts peripherally to stimulate colonic motility and that CRF-R1 is primarily involved in mediating IP CRF/urocortin- and water avoidance stress-induced colonic motor response.

One-year follow-up of medication management capacity in highly functioning older adults

BACKGROUND

We tested the hypothesis that impairment in the ability to take medication independently predicts early functional decline.

METHODS

A 12-month, prospective cohort study was performed at two continuing-care retirement facilities using the Drug Regimen Unassisted Grading Scale (DRUGS). This geriatric screening tool utilizes a stepwise progression of four tasks: (i) identification, (ii) access. (iii) dosage, and (iv) timing.

RESULTS

Forty-seven (86%) of the eligible participants completed the 12-month follow-up assessment; three were transferred to skilled nursing facilities. The mean age at study entry was 84.2+/-5.1 years; 72% of the participants were women, and 68% were college educated. At 12 months there was a decline in the Mini-Mental State Examination (MMSE) score (p = .029), an increase in the timed "Up and Go" test (p = .023), and a decline in the DRUGS score (p .029). Nine (18%) of the participants resided in assisted- versus independent-living situations compared with three participants (5%) at study entry (p = .031). Both 12-month DRUGS score and 12-month self-reported medication management capacity were associated with 12-month MMSE (p = .0001 and p = .019, respectively). Baseline DRUGS score was associated with 12-month MMSE and Geriatric Depression Scale scores (p = .0002 and p = .002, respectively). Both baseline DRUGS score and self-reported medication management capacity were also associated with residence in assisted-living communities at 6 months (p = .029 and p = .040, respectively). MMSE was not associated with any of the clinical outcomes.

Effect of CCK pretreatment on the CCK sensitivity of rat polymodal gastric vagal afferent in vitro

To prevent the blood-borne interference and reflex actions via neighboring organs and the central nervous system, the study was conducted in an in vitro isolated stomach-gastric vagus nerve preparation obtained from overnight-fasted, urethan-anesthetized rats. Afferent unit action potentials were recorded from the gastric branch of the vagus nerve. The left gastric artery was catheterized for intra-arterial injection. In vitro we found that 1) 55/70 gastric vagal afferents (GVAs) were polymodal, responding to CCK-8 and mechanical stimuli, 13 were mechanoreceptive, and 2 were CCK-responsive; 2) sequential or randomized intra-arterial injections of CCK-8 (0.1-200 pmol) dose-dependently increased firing rate and reached the peak rate at 100 pmol; 3) the action was suppressed by CCK-A (Devazepide) but not by CCK-B (L-365,260) receptor antagonist; 4) neither antagonist blocked the mechanosensitivity of GVA fibers. These results are consistent with corresponding in vivo well-documented findings. Histological data indicate that the layered structure of the stomach wall was preserved in vitro for 6-8 h. Based on these results, it seems reasonable to use the in vitro preparation for conducting a study that is usually difficult to be performed in vivo. For instance, because there was no blood supply in vitro, the composition of the interstitial fluid, i.e., the ambient nerve terminals, can be better controlled and influenced by intra-arterial injection of a defined solution. Here we report that acutely changing the ambient CCK level by a conditioning stimulus (a preceding intra-arterial injection of increasing doses of CCK-8) reduced the CCK sensitivity of GVA terminals to a subsequent test stimulus (a constant dose of CCK-8 intra-arterial injection).

Synergistic interaction between CCK and leptin to regulate food intake

Leptin administered (either intracerebroventricularly, icv, or intraperitoneally, ip) acts in synergy with CCK to suppress food intake and body weight in lean mice or rats. The potentiating effect induced by the co-injection of ip CCK and leptin to inhibit food consumption in mice is mediated by the CCK-A receptor and capsaicin sensitive afferents. In vitro, studies in rats showed that a subset of gastric vagal afferent fibers responded to leptin injected directly into the gastric artery only after a prior intra-arterial CCK injection. Moreover, the tonic activity of gastric-related neurons in the nucleus tractus solitarius (NTS) increased when leptin was delivered into the gastric chamber of an in vitro stomach-brainstem preparation. CCK co-injected with leptin potentiated Fos expression selectively in the area postrema, NTS and paraventricular nucleus of the hypothalamus (PVN), which points to the PVN as part of the afferent and efferent limbs of the circuitry involved in the synergistic interaction between leptin and CCK. The dampening of CCK or leptin inhibitory action on ingestive behavior when either factor is not present or their receptors are non functional supports the notion that such leptin-CCK interaction may have a physiological relevance. These observations provide a mean through which leptin and CCK integrate short- and mid-term meal-related input signals into long-term control of energy balance.

Reducing cardiovascular stress with positive self-stereotypes of aging

We examined whether aging self-stereotypes, or older individuals' beliefs about elderly people, can influence cardiovascular function. Older individuals were subliminally exposed to either positive or negative aging stereotypes. Then all participants faced mathematical and verbal challenges. Those exposed to the negative aging stereotypes demonstrated a heightened cardiovascular response to stress, measured by systolic blood pressure, diastolic blood pressure, and heart rate, compared with those exposed to positive aging stereotypes. The aging stereotypes appeared to influence the outcome variable of skin conductance in the same way. It appears that the negative aging stereotypes acted as direct stressors, whereas the positive aging stereotypes reduced cardiovascular stress. These findings indicate that negative aging stereotypes may contribute to adverse health outcomes in elderly persons without their awareness. The results also suggest that positive aging stereotypes could be used in interventions to reduce cardiovascular stress.

Physician perceptions of HMO care for older persons. Health Maintenance Organization

OBJECTIVE

Physician attitudes may be a key factor in effective managed care for older patients. We sought to explore physicians' views of the influence of health maintenance organization (HMO) policies on the care of their older patients.

DESIGN

A self-administered one-page questionnaire consisting of questions about physician demographics, the impact of HMOs on physician practice, patient care, HMO policies, and respondents' personal use of managed health care plans.

PARTICIPANTS

The survey was mailed to 838 randomly selected primary care physicians affiliated with two large, nonprofit, academically-oriented, Medicare HMOs in Massachusetts.

RESULTS

Completed surveys were received from 516 of 797 eligible primary care physicians, affiliated with either Secure Horizons (Tufts Associated Health Plan) or First Seniority (Harvard Pilgrim Health Care). About half (55%) of the physician respondents reported they had sufficient time to spend with their older patients. Most (81%) respondents indicated that overall, patients aged 65 and older received either better care or no change in care after joining an HMO. The majority of physicians reported that HMO affiliation had increased the frequency with which they addressed geriatric issues with their older patients. There were several patterns of response that emerged with respect to beliefs about key HMO policies.

CONCLUSIONS

The majority of physicians working in two nonprofit, academically oriented Medicare HMOs in Massachusetts believed that the overall quality of care that older patients received after joining an HMO either did not change or improved.

Neutrophilia and congestive heart failure after acute myocardial infarction

BACKGROUND

Inflammation associated with acute myocardial infarction (AMI) is frequently marked by a peripheral leukocytosis and relative neutrophilia. Whether this process may contribute to the development of postinfarction congestive heart failure (CHF) is not established. The objective of this study was to examine the association between hospital admission peripheral total leukocyte count and the neutrophil percentage and the subsequent development of CHF in patients with AMI. The study was designed as a retrospective cohort study in the setting of a tertiary referral hospital. Participants included 185 patients discharged with a diagnosis of AMI between May 1 and Sept 30, 1996.

METHODS AND RESULTS

Outcome measures included clinical episodes of CHF with confirmatory chest roentgenogram findings and/or echocardiographic evidence of contractile dysfunction. Multivariable logistic regression analyses were performed to examine the relation between the total leukocyte count, neutrophil percentage, and the development of CHF in the first 4 days after AMI while controlling for baseline characteristics and early therapeutic interventions. Thirty-one percent of the cohort had a leukocyte count >11.0 x10(9)/L on admission to the hospital; 65% had a neutrophil percentage >65%, and 61% had a lymphocyte percentage </=25%. CHF developed in 43% of the cohort. Of these, 92. 5% had relative neutrophilia (neutrophil percentage >65%) compared with 45% of those in whom CHF did not develop. Multivariable analysis revealed a highly significant association between relative neutrophilia and the subsequent development of CHF (odds ratio 14.3; 95% confidence interval 5.2 to 39.3).

CONCLUSIONS

Relative neutrophilia on admission to the hospital in patients with AMI is significantly associated with the early development of CHF. This association may help in the identification of individuals at high risk who might benefit from more aggressive interventions to prevent or reduce the risk of CHF.

Influence of age on hypoxia/reoxygenation-induced DNA fragmentation and bcl-2, bcl-xl, bax and fas in the rat heart and brain

To test the hypothesis that the aging mammalian heart and brain might have increased vulnerability to acute stress, DNA fragmentation was studied after hypoxia-reoygenation in young adult (6 months) and old (22-24 months) F344 rats. Heart and brain tissue were examined at the following time points: 30, 60, or 90 min of hypoxia (H, 5% O2, 95% N2) plus 2 h of reoxygenation (R, room air, 21% O2). With increasing duration of hypoxia preceding the reoxygenation, the extent of DNA fragmentation (in situ terminal dUTP nick end labeling, TUNEL, positive cells) was progressively higher in both age groups, greater in the old compared to that of the young adult rat. The levels of the anti-apoptotic proteins bcl-2 and bcl-xL, were similar in young and old at baseline and tended to increase in both age groups after hypoxia/reoxygenation. The pro-apoptotic protein, bax, was higher at baseline in the old; it rose after hypoxia/reoxygenation in the young adult heart and brain, but was unchanged in the old heart and was decreased in the old brain. The ratios of bcl-2/bax and of bcl-xL/bax were higher in the old heart and brain compared to that in the young adult after hypoxia/reoxygenation. Thus, compared to that of the young adult, the heart and brain of the old rat have lower thresholds and are more vulnerable to injury induced by hypoxia/reoxygenation, despite rapid and heightened expression of the anti-apoptotic proteins bcl-2 and bcl-xl. This could be due partly to the age-associated increase in the basal expression of the pro-apoptotic protein bax, as well as possibly other factors.

The power of ageism on physical function of older persons: reversibility of age-related gait changes

OBJECTIVE

To test the hypothesis that age-associated changes in physical function, particularly walking performance, are influenced by ageism and that the activation of positive sterotypes of aging can partially reverse these changes.

DESIGN

Randomized intervention study.

SETTING

General community.

PARTICIPANTS

Forty-seven community-dwelling men and women (63-82 years old) who walked independently and described themselves as healthy.

INTERVENTION

Thirty-minute exposure to the subconscious reinforcement of either a positive or negative stereotype of aging while subjects played a computer game.

MEASUREMENTS

Pre- and postintervention measures of gait speed and percent swing time (the time spent with one foot in the air during walking). Health and psychosocial status were also evaluated.

RESULTS

Significant increases in walking speed (9%+/-2%; P < .001) and percent swing time (percent change: 1.1%+/-0.4%; P = .023) were observed in subjects who received reinforcement of positive stereotypes of aging. Gait speed and swing time did not change in those who received reinforcement of negative stereotypes of aging. The observed improvements in gait were related to the positive intervention, but were not related to age, gender, health status, or psychosocial status.

CONCLUSIONS

Stereotypes of aging apparently have a powerful impact on the gait of older persons. Interventions designed to enhance perceptions of old age may prove beneficial in helping to improve gait and functional independence among older persons. In the future, positive changes in society's view of aging may also help to reduce and prevent age-related declines in function and the associated deleterious consequences.

Estrogen therapy and aggressive behavior in elderly patients with moderate-to-severe dementia: results from a short-term, randomized, double-blind trial

The authors used a randomized, double-blind, placebo-controlled clinical trial study design to investigate the efficacy and safety of short-term estrogen therapy in decreasing aggressive behaviors in elderly patients with moderate-to-severe dementia. Estrogen therapy was associated with lower total aggression scores (P<0.030) and with decreased frequency of physical aggression (P<0.019) over the 4-week trial. Verbally aggressive behaviors were decreased relative to control subjects, although this effect was not statistically significant. No drug-vs.-placebo differences were found for resistive, sexual, or self-directed aggressive behaviors. No adverse effects from the estrogen were observed during the course of the study.

Ischemia-reperfusion in the adult mouse heart influence of age

Age-related changes in the mouse heart after ischemia-reperfusion have not been well characterized. To test the hypothesis that advanced age was associated with increased susceptibility to myocardial injury after ischemia/reperfusion, we studied the hearts of young adult and old mice. In young adult (6-8 months) and aged (22-24 months) C57 BL/6 mice, we performed left anterior descending coronary artery ligation and subjected the hearts to 45 min of ischemia followed by varying periods of reperfusion of 15 min, 1 h, 4 h, and 24 h. We found that there was a significant age difference in the size of the infarct between the young adult and old hearts. There was also greater damage in the old hearts in terms of contraction band necrosis, myofiber tears, DNA fragmentation, and mitochondrial disruption. Thus, the old heart is more susceptible to injury after ischemia-reperfusion. This may be partly due to an age-associated decrease in coronary circulation and collateral flow, as well as other factors.

Congestive heart failure with preserved systolic function: is it a woman's disease?

Congestive heart failure with preserved systolic function is increased in prevalence with advancing age, especially in women, indicating the strong impact of gender on this common disease.