[Breakthrough of invasive fungal disease with posaconazole as primary prophylaxis after induction chemotherapy for acute myeloid leukemia]

Objective: To investigate the breakthrough incidence of invasive fungal disease(IFD) and side effects of posaconazole as primary prophylaxis during induction chemotherapy for acute myeloid leukemia(AML). Methods: A total of 206 newly diagnosed AML patients admitted to our department during January 2016 and December 2018 were enrolled in the study. Exclusive criteria were as followings including patients diagnosed as acute promyelocytic leukemia; those who received intravenous antifungal therapy after admission or had history of IFD one month before induction chemotherapy, or those with functional insufficiency of vital organs and those older than 65. Forty-seven patients received posaconazole (posaconazole group), 61 cases received voriconazole (voriconazole group) and 98 cases did not receive any prophylaxis (control group) during induction chemotherapy. Prophylactic efficacy and safety between posaconazole and voriconazole were compared. Results: During induction chemotherapy, five possible cases of IFD occurred in posaconazole group (10.6%); while 11 cases (18.0%) were in voriconazole group including 7 possible, 3 probable and 1 proven. Thirty-five cases (35.7%) in control group were diagnosed as IFD including 19 possible, 11 probable and 5 proven ones. The incidences of IFD in posaconazole and voriconazole group were significantly lower than that in control group (P<0.05). The difference of posaconazole group and voriconazole group was not significant (P>0.05). The reported adverse events in posaconazole group were significantly lower than those in voriconazole group [12.8%(6/47) vs. 32.8%(20/61), P<0.05]. Conclusions: Posaconazole and voriconazole decrease IFD as primary prophylaxis during induction chemotherapy in patients with AML. The prophylactic effect of IFD with posaconazole is similar as voriconazole, but posaconazole shows better safety.

[Ikaros family zinc finger 1 mutation is a poor prognostic factor for adult Philadelphia chromosome positive acute lymphoblastic leukemia]

Objective: To analyze the prognostic impact of Ikaros family zinc finger 1(IKZF1) mutation on adult Philadelphia chromosome (Ph1) positive acute lymphoblastic leukemia (ALL) patients. Methods: IKZF1 mutation was detected in 63 adult Ph1 positive ALL patients at diagnosis using capillary electrophoresis. Recruited patients were treated in our center and other three hospitals in Ningbo from January 2014 to January 2017. Clinical data were collected and retrospectively analyzed. Results: Thirty-nine (61.9%) patients were positive IKZF1 mutation in this cohort. The white blood cell (WBC) count in IKZF1 mutation group was significantly higher than that of mutation negative group [(64.6±11.3)×10(9)/L vs. (33.7±5.6)×10(9)/L, P<0.05]. Patients with WBC count over 30×10(9)/L accounted for 56.4% in IKZF1 mutation group. Complete remission (CR) rate in the IKZF1 mutation group was also lower than that of negative group after induction chemotherapy (64.1% vs. 75.0%, P>0.05). IKZF1 was a negative prognostic factor but not independent factor for survival by univariate and multivariate analyses. Patients were divided into chemotherapy and allogeneic transplantation groups. The 3-year overall survival (OS) rate and 3-year leukemia-free survival (LFS) rate in IKZF1 mutation group were significantly lower than those of negative group in both transplantation group (42.3% vs. 59.3%; 31.2% vs. 50.0%; respectively, both P<0.05) and chemotherapy group (24.8% vs. 40.0%; 19.0% vs. 34.3%; respectively, both P<0.05). Conclusion: IKZF1 mutation is a poor prognostic factor for adult Ph1 positive ALL patients.

[Effect of FLT3-ITD with DNMT3A R882 double-mutation on the prognosis of acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation]

目的

探讨FLT3-ITD和DNMT3A R882双突变对急性髓系白血病（AML）患者allo-HSCT预后的影响。

方法

使用直接测序法检测206例接受allo-HSCT的AML患者（M₃和使用分子靶向药物索拉菲尼的病例除外）初诊时骨髓中常见的基因突变组套（包括FLT3-ITD、DNMT3A、c-kit、CEBPA、FLT3-TKD、NPM1），回顾性分析患者的临床资料，比较各基因突变组的移植预后。

结果

①206例AML患者中男104例，女102例，中位年龄38（3~63）岁。FAB分型：M₀ 6例，M₁ 24例，M₂ 56例，M₄ 39例，M₅ 63例，M₆ 6例，不能分类12例。②全部206例患者根据初诊时的突变基因情况分为4组：FLT3-ITD⁺ DNMT3A R882⁺组（A组）19例，FLT3-ITD⁺ DNMT3A R882⁻组（B组）38例，FLT3-ITD⁻DNMT3A R882⁺组（C组）21例，FLT3-ITD⁻DNMT3A R882⁻组（D组）128例。四组间性别、年龄、初诊时白细胞计数、FAB分型、移植前疾病状态、染色体核型、供者类型、预处理方案及GVHD发生率比较，差异无统计学意义（P>0.05）。③A组和B、C、D组比较，2年累积复发率较高[分别为（72.2±2.6）%、（38.6±0.6）%、（36.8±1.6）%、（27.8±0.1）%，P值均<0.05]，总生存率较低[分别为（30.9±13.3）%、（67.5±7.8）%、（61.4±12.4）%、（80.1±3.7）%，P值均<0.05]，无白血病生存率较低[分别为（11.3±10.2）%、（47.9±8.4）%、（56.8±12.5）%、（79.7±3.6）%，P值均<0.05]。

结论

伴有FLT3-ITD与DNMT3A R882双突变的AML患者移植后累积复发率较高，总生存率和无白血病生存率较差。

Silencing ECHS1 attenuates the proliferation and induces the autophagy of hepatocellular carcinoma via impairing cell metabolism and activating AMPK

Hepatocellular carcinoma (HCC) is among the most common cancers in the world with a low survival rate. Our previous study showed Short chain enoyl-CoA hydratase (ECHS1) could bind to HBsAg (HBs) and that ECHS1's localization in mitochondria induced HepG2 cell apoptosis. However, the role of the ECHS1 in energy metabolism and autophagy during hepatocellular carcinoma development remains undefined. We aimed to determine what ECHS1 does to energy metabolism and its effects on HCC progression. We performed CCK-8, EdU assays in hepatocellular carcinoma cell lines (HepG2 and HuH7) with stable ECHS1 knock-down. ATP and NADP+/NADPH levels were measured using an colorimetric assay. Our data demonstrated that ECHS1 silencing inhibited cell proliferation and induced autophagy. ECHS1 knockdown did not increase fatty acid synthesis, but decreased cellular ATP. This resulted in AMP-activated protein kinase (AMPK) activation and induced HCC cell autophagy. Our results showed that silencing ECHS1 to attenuate proliferation and induce autophagy may make it a novel cancer therapy target.

Development of 5Ns chromosome-specific SCAR markers for utilization in future wheat breeding programs

In previous studies, we developed a wheat-Psathyrostachys huashanica Keng disomic addition line 3-8-10-2, which exhibited high stripe rust resistance and could be used as a donor source for introducing novel disease resistance gene(s) into wheat in future breeding programs. It was identified using cytology, genomic in situ hybridization (GISH), EST-SSR, EST-STS and morphological analyses. However, these techniques are not suitable for breeding programs that require the rapid screening of large numbers of genotypes because they are highly technical and time-consuming. In this study, three Ns genome-specific SCAR markers were developed via random amplified polymorphic DNA (RAPD) markers. These SCAR markers were further validated using a complete set of wheat-P. huashanica disomic addition lines, which segregated the 5Ns disomic addition line individuals. Our results indicated that the SCAR markers associated with the 5Ns chromosome of P. huashanica and they provide a low cost, high efficiency, alternative tool for screening 5Ns chromosomes in a wheat background. These newly developed SCAR markers that species-specificity of the markers was proved by analysis of a wide range of cereal species, and specific for 5Ns chromosome, which should be useful in marker-assisted selection for wheat breeders who want to screen genotypes that may contain 5Ns chromatin.

AKR1B10, a good prognostic indicator in gastric cancer

BACKGROUND AND OBJECTIVES

The aim of the study was to investigate the correlation between AKR1B10 expression and clinicopathological features of gastric cancer (GC).

METHODS

Real-time polymerase chain reaction (RT-PCR) was performed to determine AKR1B10 mRNA expression. AKR1B10 protein levels were measured by immunohistochemistry.

RESULTS

RT-PCR analysis confirmed that AKR1B10 was significantly down-regulated in gastric cancer compared with paired, normal mucosa. Immunohistochemistry revealed that the percentage of AKR1B10-positive specimens was lower in gastric carcinoma compared with normal specimens. The frequency of AKR1B10-positive GC specimens was higher in patients with tumor size <5 cm, no lymph node metastasis, no distant metastasis and lower tumor stages The mean survival time for patients in the AKR1B10-positive group was significantly higher compared with the AKR1B1-negative group. The 5-year survival rate for the AKR1B10-positive group was also significantly higher than for the AKR1B1-negative group. Cox regression analysis revealed that AKR1B10 expression is an independent prognostic factor of GC.

CONCLUSIONS

Expression of AKR1B10 in gastric cancer was significantly associated with tumor size, lymph node metastasis, distance metastasis and TNM stage, and AKR1B10 may be a good prognostic indicator in gastric cancer.

Note: optical optimization for ultrasensitive photon mapping with submolecular resolution by scanning tunneling microscope induced luminescence

We report the development of a custom scanning tunneling microscope equipped with photon collection and detection systems. The optical optimization includes the comprehensive design of aspherical lens for light collimation and condensing, the sophisticated piezo stages for in situ lens adjustment inside ultrahigh vacuum, and the fiber-free coupling of collected photons directly onto the ultrasensitive single-photon detectors. We also demonstrate submolecular photon mapping for the molecular islands of porphyrin on Ag(111) under small tunneling currents down to 10 pA and short exposure time down to 1.2 ms/pixel. A high quantum efficiency up to 10(-2) was also observed.

Fabrication of silver tips for scanning tunneling microscope induced luminescence

We describe a reliable fabrication procedure of silver tips for scanning tunneling microscope (STM) induced luminescence experiments. The tip was first etched electrochemically to yield a sharp cone shape using selected electrolyte solutions and then sputter cleaned in ultrahigh vacuum to remove surface oxidation. The tip status, in particular the tip induced plasmon mode and its emission intensity, can be further tuned through field emission and voltage pulse. The quality of silver tips thus fabricated not only offers atomically resolved STM imaging, but more importantly, also allows us to perform challenging "color" photon mapping with emission spectra taken at each pixel simultaneously during the STM scan under relatively small tunnel currents and relatively short exposure time.

Circadian renal rhythms influenced by implanted encapsulated hANP-producing cells in Goldblatt hypertensive rats

Renal excretion in experimental hypertensive rats implanted with encapsulated human atrial natriuretic peptide (hANP)-producing cells is circadian periodic. Chinese hamster ovary (CHO) cells transfected with the plasmid hANP-cDNA were encapsulated in biocompatible polycaprolactone capsules for intraperitoneal implantation into two-kidney, one-clip (2K1C) hypertensive rats. During a 12:12 light-dark cycle, as compared to control CHO cells, the implantation of encapsulated hANP-producing CHO cells was associated with an increase in the net excretion of water, sodium and potassium, and with a reversal of the advanced circadian phases related to renovascular hypertension in 2K1C rats. The increase in blood pressure postimplantation was delayed, and increases in renal blood flow, glomerular filtration rate, sodium output, urinary excretion and urinary cyclic GMP concentrations were also found. Implantation of encapsulated hANP-producing cells affects circadian rhythms in kidney excretion functions of 2K1C rats, and may be useful for the treatment of cardiovascular disease.

Camelliin B induced apoptosis in HeLa cell line

Gordonia axillaris (Roxb.) Dietrich (Theaceae) is a native to Taiwan and the leaves have been used as an astringent folk medicine. Camelliin B (CB), a macrocyclic hydrolyzable tannin, was isolated from G. axillaris and showed cytotoxic effects in human carcinoma cells. Among the target cells (SKHep-1, Ha-22T, DU-145, AGS, and HeLa), the cervical carcinoma cell line, HeLa, was more sensitive to CB than were Chang normal liver cells and primary-cultured normal gingival and cervical fibroblasts. Furthermore, the cytotoxic effects of CB showed dose-dependency at 3.2-100.0 microg/ml in HeLa for 1,24,48, and 72 h and with an IC(50) value of 46.3 microg/ml for 48 h. However, the IC(50) value of CB in primary-cultured normal cervical fibroblasts was 108.0 microg/ml. Therefore, the selectivity shown by CB was ascribed to the difference in growth speed between normal and tumor cells. HeLa cells and primary-cultured normal cervical fibroblasts were treated with 50.0 and 100.0 microg/ml CB for 48 h, respectively, and exhibited chromatin condensation, indicating the occurrence of apoptosis. Flow cytometric analysis demonstrated the presence of apoptotic cells with low DNA content, a decrease of cell population at the G(1) phase, and a concomitant increase of cell population at the G(2)/M phase. CB also caused DNA fragmentation and inhibited PARP degradation in HeLa cells. However, CB did not significantly inhibit Bcl-2 expression in HeLa cells at 50.0 microg/ml, only at 100.0 microg/ml for 48 h. These results suggest that CB induced apoptosis, without direct inhibition of Bcl-2 expression in HeLa cells.

[Two complementary dominant genes controlling apomixis in genus Citrus and poncirus]

Apomixis is very common in Citrus genus and its related genus. Two monoembryonic tangerine varieties (C. reticulata Blanco) Clementine and Wilking were used as seed parents to cross with four polyembryonic orange varieties [C. sinensis (L.) Osbeck]. Both sexual and apomictic progenies were found in each F1 population with different segregation ratios. In a total of 74 Wilking progenies, 23 were monoembryonic and 51 polyembryonic and the ratio of sexual and apomictic progenies was about 1:2 tested either in each individual cross or in the whole Wilking cross combionations. In Clementine progenies, 84 were monoembryonic and 71 polyembryonic and the ratio was about 1:1 tested either in each individual cross or in the whole Clementine cross combionations. According to the results together with other data published, a possible apomixis controlling mechanism was proposed, which involves two complementary dominant genes named as A1 and A2 that control apomixis in genus Citrus and Poncirus. Trees of genotype A1-A2-, except for homozygous of dominant gene A1 (which is lethal), can produce apomixis seeds. And those of other genotypes will produce sexual seeds. The segregation and recombination of these two genes accorded with Mendel's genetic laws. The proposed mechanism could explain genotypes controlling polyembryony-monoembryony existing both in nature species and artificial hybridization progenies as well as most of the known hybridization results.

Enhanced external counterpulsation improved myocardial perfusion and coronary flow reserve in patients with chronic stable angina; evaluation by(13)N-ammonia positron emission tomography

AIMS

The mechanism by which enhanced external counterpulsation therapy exerts its beneficial effects on chronic and symptomatic stable angina is largely unknown. To clarify the mechanism of action of enhanced external counterpulsation, we used(13)N-ammonia positron emission tomography to evaluate myocardial perfusion.

METHODS AND RESULTS

This was not a randomized controlled study. Eleven patients (eight male, age: 61.6+/-9.7) with angina pectoris underwent enhanced external counterpulsation therapy for 35 1 h sessions. They underwent a treadmill exercise test and(13)N-ammonia positron emission tomography, both at rest and with dipyridamole, before and after enhanced external counterpulsation therapy. Neurohumoral factors and nitric oxide were also evaluated. Myocardial perfusion increased at rest after therapy (0.69+/-0.27 to 0.85+/-0.47 ml x min(-1) x g(-1), P<0.05). In ischaemic regions, particularly the anterior region, myocardial perfusion at rest and with dipyridamole and coronary flow reserve improved significantly after therapy (at rest: 0.71+/-0.26 to 0.86+/-0.31;P<0.05, with dipyridamole: 1.26+/-0.65 to 1.84+/-0.94;P<0.02, coronary flow reserve: 1.75+/-0.24 to 2.08+/-0.28;P<0.04). Exercise time was prolonged and the time to 1-mm ST depression improved markedly (P<0.01). After therapy, nitric oxide levels increased (P<0.02) and neurohumoral factors decreased.

CONCLUSIONS

Enhanced external counterpulsation therapy improved myocardial perfusion at rest and with dipyridamole and was associated with an increased exercise tolerance with(13)N-ammonia positron emission tomography and increased nitric oxide levels. These results suggest that one of the enhanced external counterpulsation mechanisms is development and recruitment of collateral vessels.

Serial evaluation of fatty acid metabolism in rats with myocardial infarction by pinhole SPECT

BACKGROUND

Iodine 123-labeled 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) is mainly trapped in the myocardium as triglyceride, depending on the adenosine triphosphate level. Ten percent to 20% of it is metabolized through alpha-oxidation after beta-oxidation; however, the precise mechanism of the regulatory pathways of BMIPP is yet to be clarified.

METHODS AND RESULTS

A brief left coronary artery occlusion (10-30 minutes) was performed in 28 male Wistar-Kyoto rats. Dual single photon emission computed tomography images of BMIPP and thallium 201 were obtained 3 days and 24 days after the operation. The activities of 3-hydroxyacyl-coenzyme A dehydrogenase (HAD), citrate synthase (CS), and alpha-glycerol-phosphate dehydrogenase (GPD) were then measured in both ischemic and nonischemic regions. BMIPP and Tl-201 chloride severity scores were also evaluated conventionally. CS and HAD levels were significantly lower in the ischemic region than in the nonischemic region in the chronic group (CS, 102.9 +/- 28.1 vs 138.7 +/- 33.7 micromol/g/min, respectively, P =.0051; HAD, 54.7 +/- 20.1 vs 78.6 +/- 18.7 micromol/g/min, respectively, P =.0031). There was no difference in GPD between the ischemic and nonischemic regions. The BMIPP severity score had closer inverse relations with HAD (acute, r = -0.82; chronic, r = -0.80) and CS (acute, r = -0.87; chronic, r = -0.81), but not with GPD, than did Tl-201 chloride severity score.

CONCLUSIONS

BMIPP imaging correlates well with the activities of HAD and CS, suggesting that a decrease in BMIPP uptake reflects deterioration of both fatty acid metabolism and citrate cycle and shows information other than regional myocardial perfusion.

Wogonin, baicalin, and baicalein inhibition of inducible nitric oxide synthase and cyclooxygenase-2 gene expressions induced by nitric oxide synthase inhibitors and lipopolysaccharide

We previously reported that oroxylin A, a polyphenolic compound, was a potent inhibitor of lipopolysaccharide (LPS)-induced expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2). In the present study, three oroxylin A structurally related polyphenols isolated from the Chinese herb Huang Qui, namely baicalin, baicalein, and wogonin, were examined for their effects on LPS-induced nitric oxide (NO) production and iNOS and COX-2 gene expressions in RAW 264.7 macrophages. The results indicated that these three polyphenolic compounds inhibited LPS-induced NO production in a concentration-dependent manner without a notable cytotoxic effect on these cells. The decrease in NO production was in parallel with the inhibition by these polyphenolic compounds of LPS-induced iNOS gene expression. However, these three compounds did not directly affect iNOS enzyme activity. In addition, wogonin, but not baicalin or baicalein, inhibited LPS-induced prostaglandin E2 (PGE2) production and COX-2 gene expression without affecting COX-2 enzyme activity. Furthermore, N-nitro-L-arginine (NLA) and N-nitro-L-arginine methyl ester (L-NAME) pretreatment enhanced LPS-induced iNOS (but not COX-2) protein expression, which was inhibited by these three polyphenolic compounds. Wogonin, but not baicalin or baicalein, similarly inhibited PGE2 production and COX-2 protein expression in NLA/LPS or L-NAME/LPS-co-treated RAW 264.7 cells. These results indicated that co-treatment with NOS inhibitors and polyphenolic compounds such as wogonin effectively blocks acute production of NO and, at the same time, inhibits expression of iNOS and COX-2 genes.

Inducible nitric oxide synthase inhibitors of Chinese herbs. Part 2: naturally occurring furanocoumarins

Inducible nitric oxide synthase (iNOS)-dependent production of nitric oxide (NO) plays an important role in inflammation. The effects of various naturally occurring furanocoumarins on NO production in lipopolysaccharide (LPS)-activated RAW 264.7 macrophage cells were evaluated in vitro. The results showed that angelicin, pimpinellin, sphondin, byakangelicol, oxypeucedanin, oxypeucedanin hydrate, xanthotoxin, and cnidilin are potential NO production inhibitors, and their IC50 values for inhibition of nitrite production were 19.5, 15.6, 9.8, 16.9, 16.8, 15.8, 16.6, and 17.7 microg/mL, respectively. Distinct structure-activity relationships were also revealed for the NO production inhibitory activities of these furanocoumarins. Activities of the angelicin type such as pimpinellin and sphondin were more potent than those of the psoralen type. Presence of a methoxy at the C6 position in the angelicin type seemed to be essential to augment the activity. Western blot analysis demonstrated that only sphondin dose-dependently inhibited the expression of the iNOS protein at 2.5-20 microg/mL. However, iNOS enzyme activity was stimulated with LPS for 12 h and sphondin was administered (20 microg/mL) for 24 h, which did not reasonably inhibit iNOS enzyme activity. L-NAME (100 microM), a known specific inhibitor of iNOS, was employed as a positive control with the same protocol and showed more than 50% inhibition activity. The results demonstrate that the NO production inhibitory activity of sphondin is due to the effect of iNOS expression, but not by direct inhibition of iNOS enzyme activity. Thus, sphondin may act as a potent inhibitor of NO production under tissue-damaging inflammatory conditions.

Evaluation of coronary blood flow reserve by 13N-NH3 positron emission computed tomography (PET) with dipyridamole in the treatment of hypertension with the ACE inhibitor (Cilazapril)

PURPOSE

The purpose of this study was to evaluate the effect of treatment with an angiotensin-converting enzyme (ACE) inhibitor (Cilazapril) for early hypertensive patients in terms of coronary blood flow reserve evaluated by 13NH3-positron emission tomography (PET).

METHODS

Before and after 12 weeks of ACE inhibitor treatment, 13NH3-PET with dipyridamole provocation test was performed, and definite myocardial perfusion and coronary flow reserve (CFR) were calculated.

RESULTS

Compared to our normal subjects previously reported (2.61+/-0.74), average coronary flow reserve was decreased (1.70+/-0.64 in hypertensive patients), and improved after treatment (1.77+/-0.52), but not significantly. Of 12 patients, five (42%) showed improved coronary flow reserve from 1.34 to 1.99 without a significant change in the resting flow. Only one patient (8%) showed deterioration after the ACE inhibitor treatment. The coronary vascular resistance (CVR) after ACE inhibitor treatment of the patients with CFR < 2.0 decreased significantly compared with those with CFR> or = 2.0 (p < 0.03).

CONCLUSIONS

These results indicate that hypertensive patients at the early stage show decreased coronary flow reserve despite having normal resting flow. Treatment with an ACE inhibitor (Cilazapril) for 12 weeks improved coronary flow reserve in 42% of our patients. The CVR of the patients with CFR < 2.0 showed improvement compared to those with CFR> or = 2.0. This result indicates that an ACE inhibitor (e.g., Cilazapril) should be one of the choices for improving CFR if hypertensive patients in early stage show signs of ischemia or diastolic dysfunction, which may be one of the sequels of reserve restriction.

The prevalence of NIDDM and IGT and related factors among residents in some areas of Hubei Province, China

The epidemiological survey of prevalence of NIDDM (non-insulin dependent diabetes mellitus) and IGT(impaired glucose tolerance) was conducted among 9450 residents aged 25-70 in some areas of Hubei Province, China. The results show that NIDDM and IGT prevalences are 2.62% and 4.48%, respectively. There is no significant difference between male and female (P > 0.05). The NIDDM prevalence in cities is slightly higher than that in countryside, but the difference is not significant (P > 0.05). However, the IGT prevalence in city is significantly higher than that in countryside (P < 0.01). The prevalence of both NIDDM and IGT is increasing along with the age of the population. It is also significantly related to the family history of NIDDM, hypertension, and high body mass index (BMI). By using stepwise logistic regression to analyse the risk factors of NIDDM, age (OR = 1.86), BMI(OR = 2.69), family history (OR = 2.84) and hypertension (OR = 2.23) entered the model (significance level is alpha = 0.05).

Cuphiin D1, the macrocyclic hydrolyzable tannin induced apoptosis in HL-60 cell line

Cuphiin D1 (CD1), a new macrocyclic hydrolyzable tannin isolated from Cuphea hyssopifolia, has been shown to exert antitumor activity both in vitro and in vivo. In this study, we explored the mechanism of the CD1-induced antitumor effect on human promyelocytic leukemia (HL-60) cells. The results showed that CD1 induced cytotoxicity in HL-60 cells and the IC50 was 16 microM after 36 h treatment. HL-60 cells treated with CD1 for 36 h decreased the uptake of [3H]-labeled thymidine, uridine and leucine in a dose dependent manner. Electron micrographs demonstrated that HL-60 cells treated with 16 microM CD1 for 36 h exhibited chromatin condensation, indicating the apoptosis occurrence. Flow cytometric analysis demonstrated the presence of apoptotic cells with low DNA content, a decrease of cell population at G2/M phase, and a concomitant increase of cell population at G1 phase. CD1 also caused DNA fragmentation and inhibited Bcl-2 expression in the HL-60 cells. These results suggest that the inhibition of Bcl-2 expression in HL-60 cell might account for the mechanism of CD1-induced apoptosis.

Inducible nitric oxide synthase inhibitor of the Chinese herb I. Saposhnikovia divaricata (Turcz.) Schischk

L-Arginine derived nitric oxide (NO) and its derivatives, such as nitrogen dioxide and peroxynitrite, play a role in inflammation and also possibly in the multistage process of carcinogenesis. Four furanocoumarins and eight chromones isolated from the dried root of Saposhnikovia divaricata (Fang Feng in Chinese) and evaluated for their effects on the synthesis of NO induced by lipopolysaccharide (LPS) in macrophage cell line RAW 264.7. The inhibition of nitrite production, as an index for NO released from the macrophage cells, was quantitatively analyzed by Griess reaction. The results showed that imperatorin and deltoin are potential NO production inhibitor, and their IC50 values for inhibition of nitrite production were 17.3 and 11.6 microg/ml, respectively. Western-blot analysis demonstrated that iNOS enzyme activity was not inhibited by treatment with imperatorin or deltoin, but revealed that both compounds inhibited the expression of the iNOS protein.

Antitumor activity of four macrocyclic ellagitannins from Cuphea hyssopifolia

We evaluated the antitumor activities of four macrocyclic hydrolyzable tannin dimers, cuphiin D1, cuphiin D2, oenothein B and woodfordin C isolated from Cuphea hyssopifolia (Lythraceae). All significantly inhibited the growth of the human carcinoma cell lines KB, HeLa, DU-145, Hep 3B, and the leukemia cell line HL-60, and showed less cytotoxicity than adriamycin against a normal cell line (WISH). All four compounds inhibited the viability of S-180 tumor cells in an in vitro assay and an in vivo S-180 tumor-bearing ICR mice model. Oenothein B demonstrated the greatest cytotoxicity (IC50 = 11.4 microg/ml) against S-180 tumor cells in culture, while cuphiin D1 resulted in the greatest increase in survival on S-180 tumor-bearing mice (%ILS = 84.1%). Our findings suggest that the antitumor effects of these compounds are not only related to their cytotoxicity on carcinoma cell lines, but also depended on a host-mediated mechanism; they may therefore have potential for antitumor applications.

Primary aldosteronism due to unilateral adrenal hyperplasia: a case report

Primary aldosteronism is one of the differential diagnosis of secondary hypertension. This is usually caused by an aldosterone producing adenoma or bilateral adrenal hyperplasia which comprise about 65% and 30% of the cases, respectively. However, less than 1% of primary aldosteronism is caused by unilateral adrenal hyperplasia which is a relatively rare subset of primary aldosteronism. The clinical and biochemical manifestations of the disorder are indistinguishable from aldosterone-producing tumor, and a definitive diagnosis can only be made by pathological finding. A 33-year-old male Chinese patient presented with hypertension, hypokalemia, metabolic alkalosis, and the hypersecretion of aldosterone associated with suppressed plasma renin activity which is a typical hallmark of primary aldosteronism. Image studies including both magnetic resonance imaging (MRI) and 131I NIP-59 scan as well as postural test suggested an aldosterone-producing tumor of the right adrenal gland. Unilateral adrenectomy and pathological examination of the right adrenal gland eventually proved a case of unilateral adrenal hyperplasia. Blood pressure, plasma potassium, aldosterone and renin activity levels returned to normal two weeks after operation and had remained normal at up to one year of follow up. In addition, a saline loading test showed normal suppression of plasma aldosterone level one year after the operation, suggesting that the function of the left adrenal gland remains normal. The etiology of unilateral adrenal hyperplasia is unclear and the future recurrence of the disease is possible. Long-term follow-up is necessary to ensure the cure of this disorder.

[Experimental study on the processed drug of castor seeds in the therapy of pulmonary carcinoma]

In this study, castor seeds were processed by one of the traditional Chinese methods, LD50 was measured and tumor inhition tests in nude mice bearing human pulmonary carcinoma were conducted. The results showed that the processing method was able to lower the toxicity of castor seeds and maintain their antitumor effect, thus providing an experimental basis for oral administration of castor seeds in the therapy of pulmonary carcinoma.

[Dilatation of anastomotic stricture by Nd:YAG laser beam under endoscopy]

Anastomotic stricture has become a common complication following surgical treatment of upper gastrointestinal cancers. A technique was devised to alleviate the stricture with Nd. YAG laser beam under endoscopy. The laser beam was applied at 3-4 different points near the anastomotic stoma. The thermal effect of the beam would cut the scar tissues in and underneath the mucosa, leading to dilatation of the stoma. A total of 48 patients with cancer of the esophagus (n = 21), gastric cardia (n = 20), body of stomach (n = 6) and gastric stump (n = 1) with postoperative anastomotic stricture was so treated. According to the degree of dilatation, the result of treatment upon longterm follow-up was good (the anastomotic stoma was enlarged more than 6 mm) in 41 (85.4%), fair (the stoma enlarged 4-5 mm) in 5 (10.4%) and poor in the remaining 2. Due precautions should be made to avoid bleeding and perforation.