[Modified reverse puncture technique for esophagojejunostomy during totally laparoscopic total gastrectomy for gastric cancer]

Objective: To evaluate the value of implementing a modified reverse puncture procedure for esophagojejunostomy during totally laparoscopic total gastrectomy. Methods: This was a descriptive case series. Relevant clinical data, including the operative procedure, recovery, and pathological findings of 35 patients with gastric cancer who had undergone esophagojejunostomy with a modified reverse puncture technique during totally laparoscopic total gastrectomy in the Department of Gastrointestinal Surgery, Fujian Provincial Hospital, from June 2022 to January 2023, were prospectively collected and retrospectively analyzed. The age of all patients in the group was (64.9±8.0) years old, with 22 males (62.9%) and a body mass index of (23.2±2.4) kg/m2. The tumors were located in the upper and middle parts of the stomach in 24 cases (68.6%) and in the junction of the esophagus and stomach in 11 cases (31.4%). Important technical aspects of the modified reverse puncture procedure are as follows. (1) Site of the esophageal incision: a transverse incision is made across the right lateral wall of the esophagus at the expected site of esophageal disjunction. (2) Technique for inserting an anvil: after threading a silk thread through the tip of anvil, the end of the thread is knotted and fixed as the traction thread, after which an anvil is inserted into the esophagus through the esophageal incision, leaving the end of the traction line exposed. Next, a 60-mm linear cutter is placed through the right midclavicular trocar to straighten the opened esophagus vertically, after which the rod of the anvil is pulled out of a small incision that has been made in the esophagus by pulling the traction thread, thus completing anvil placement. (3) Jejunal binding: the jejunum on the central bar of the stapler is fastened with silk thread to the stump of the jejunum, and then tied to the output loop of the jejunum with a gauze strip. Results: All 35 surgeries were successful, with no mortality or conversion to laparotomy. The operation time, anvil insertion time, and digestive tract reconstruction time were (232.7±34.4), (8.5±1.4), and (40.5±4.8) minutes, respectively. The intraoperative blood loss was 100 (20-250) mL and the incision was (5.3±0.9) cm long. The upper surgical margin was negative in all patients and the mean distance between the upper and tumor margins was (3.5±1.2) cm. The mean number of lymph nodes dissected per patient was 33.9±7.1. The times to initial ambulation, initial passage of flatus , postoperative fluid intake, and length of postoperative hospital stay were (3.2±1.1), (3.7±1.5), (4.6±2.3), and (9.8±3.2) days, respectively. Postoperative complications occurred in five patients: one case of anastomotic leak, two of anastomotic stenosis, one of pulmonary infection, and one of incomplete intestinal obstruction, all of which were successfully managed conservatively. Conclusion: Esophagojejunostomy using a modified reverse puncture technique during totally laparoscopic total gastrectomy is safe and feasible for gastric cancer, requiring only a small incision and achieving higher upper esophageal resection margins and good postoperative recovery, and therefore warrants further implementation.

A prospective multicentre controlled study of Gaoweikang (Chinese multiherb extract-based tincture) used in high-risk HPV infections

OBJECTIVE

The aim of the study was to investigate the safety and antiviral efficacy of a Chinese multiherb extract-based tincture (GWK) on a population of patients with high-risk human papilloma (hrHPV) infections and hrHPV-caused cervical low-grade squamous intraepithelial lesions (LSILs).

PATIENTS AND METHODS

Patients with persistent hrHPV infection were enrolled in Group A, including A1 subjects, who received the intervention, and A2 subjects, who received the control. Patients with hrHPV infection causing cervical LSIL were enrolled in Group B, which included B1 subjects, who received the intervention, and B2 subjects, who served as the control. For Groups A1 and B1, hrHPV was tested at 3 months (M3) and 6 months (M6) after the intervention. The side effects were also analyzed.

RESULTS

At baseline (D0), a total of 99 patients were enrolled in Group A, with 50 subjects in Group A1 and 49 subjects in Group A2. A total of 91 patients were enrolled in Group B, with 45 subjects in Group B1 and 46 subjects in Group B2. There was no significant difference in the characteristics, including average age, age stratification, and HPV genotype. At M6, both Group A1 and Group B1 had a higher hrHPV clearance rate than the control group (A1/A2: 80.0% vs. 20.4%; B1/B2: 64.4% vs. 15.2%, p<0.001). At M6, the effective rates of Group A1 and Group B1 were 84% (42/50) and 68.9% (31/45), respectively. The side effect rates of Groups A1 and B1 were 11.5% (6/52) and 11.1% (5/45), respectively. Most adverse reactions involved local discomfort, including vulvar erythema, vulvar itch, increased vaginal discharge, cervical bleeding, and mild pain in the lower abdomen. Univariate logistic regression analysis showed that the intervention had an OR of 12 (95% CI 4.431-32.50) for clearing persistent HPV infection (p<0.001). For cervical LSIL, the intervention had an OR of 10.1 for clearing persistent HPV infection (95% CI 3.68-27.7) (p<0.001).

CONCLUSIONS

The results of this study suggest that the Chinese multiherb extract-based tincture GWK is safe and well tolerated. Furthermore, this preliminary study showed that this Chinese multiherb extract-based tincture is helpful for promoting HPV clearance in cases of persistent HPV and HPV-induced LSIL.

[Hemophagocytic syndrome secondary to COVID-19: a case report and literature review]

Objective: To improve the awareness of hemophagocytic syndrome(HPS) secondary to COVID-19 (COVID-sHPS). Methods: We reported an adult case of COVID-sHPS, including clinical presentation, laboratory examinations, histopathological findings, treatment strategy, and outcome. We also conducted literature research in PubMed database and Wanfang database using the keywords "COVID-19" and "hemophagocytic syndrome" and subsequently summarized relevant literature. Results: A 49-year-old man was admitted to our hospital after 4 weeks of recurrent fever. Prior to this hospitalization, he had received an empiric combination therapy with antibiotics and antiviral drugs against SARS-CoV-2. His vital signs were within the normal range and no abnormalities were found on physical examination on admission. After admission, throat swab nucleic acid tests were weakly positive for SARS-CoV-2, and negative for influenza and respiratory syncytial virus. Blood nucleic acid tests for cytomegalovirus and EB virus were negative, as was blood mNGS. Laboratory tests showed a series of abnormalities, including leukopenia, thrombocytopenia, low fibrinogen, elevated serum ferritin, elevated transaminase, decreased NK cell activity, and hemophagocytosis in bone marrow. According to the HPS-2004 diagnostic criteria, he was diagnosed with hemophagocytic syndrome, which was high likely to be caused by COVID-19 infection due to the lack of evidence of genetic risk factors and other clear triggers. He was initially treated with dexamethasone at a dose of 10 mg·m-2·d-1 and his condition improved rapidly. The literature search identified twenty-three articles on COVID-sHPS, 22 of which were in English. A total of 89 patients had COVID-sHPS and 55 (61.7%) were male. COVID-sHPS could occur at any age, but mainly in adults (86/89, 96%). Fever was reported in the literature with a clear description of the course of the disease. Most HPS occurred during the acute phase of COVID-19, but 3 patients developed HPS during the convalescent phase. Almost all reported cases presented with increased ferritin, elevated transaminases, elevated triglycerides, and cytopenia, mainly anemia and thrombocytopenia. In the retrieved literature, HS-score≥169 was frequently used to diagnose COVID-sHPS, and glucocorticoid in combination with immunoglobulin was the most common treatment strategy. COVID-sHPS had a poor prognosis and a high mortality rate (84.2%, 75/89). Conclusions: The prognosis of COVID-sHPS is poor, so clinicians should raise their awareness of the disease, identify high-risk suspected populations, and arrange reasonable relevant examinations for definite diagnosis and early initial treatment to improve their outcome.

[A new perspective on Su Wen re-collated in the Song Dynasty]

The government of the Northern Song Dynasty collated and annotated Su Wen four times from 1026-1118. It examined a large number of errors in the collated edition by Wang Bing, and corrected the edition. However, for reasons of time and conditions, there still existed some mistakes, even serious ones, such as the selection of the original texts and the determination of the titles and many other details as well. Among these mistakes, the one which seriously prevented learning medical classics for following generations was that the quoted texts from early medical books were modified based on the Su Wen collated by Wang Bing and Jia Yi Jing on Acupuncture and Moxibustion. This led to the distortion of some early important medical books. This paper examines the re-collation of Su Wen by the officials of the Song Dynasty in a specific historical background and environment, focuses on the errors that have not been perceived today, and pays attention to the investigation and analysis of the causes of those errors, so as to provide a reference for collation of ancient medical classics today.

[A new perspective and discovery of Su Wen noted by Wang Bing]

Wang Bing's perspective included two aspects. One was the annotation of the classical text, focusing on the medical interpretation and the precise interpretation of concepts and terminology, in particular, the annotation of the scriptures related to acupuncture and moxibustion which had a wide and far-reaching influence on the acupuncture and moxibustion literature in the Song Dynasty. Another was the adaptation of classical text which can be divided into two categories: the adaptation for revealing the original meaning and applying esoteric language; the adaptation of his own understanding. In the second type of adaptation, Wang Bing deliberately concealed the supplementary style of "Words written in red".Wang Bing most likely wrote and annotated the "Seven Chapters of Su wen", which was an important pawn in his adaptation of Suwen. In terms of history and logic, Wang Bing's problems in his large-scale adaptation of Suwen look far more than his achievements. The deception and misdirection caused by the second kind of adaptation concealed deliberately by Wang Bing is still unknown.

[The version and literature value of 45 volumes of Yixue Gangmu in the Ming Dynasty]

The existing 45 volumes of Yixue Gangmu(, Compendium of Medicine) in Ming dynasty is the most similar to its original book by Lou Ying. The discovery of these volumes is of just as great significance to the study of Yixue Gangmu, as the discovery of The New Version of Sun Zhenren Qianjin Fang (, The Immortal Sun's Precious Formulary) in Song Dynasty was to the study of Beiji Qianjin Yao Fang (, Essential Recipes for Emergent Use Worth A Thousand Gold). The discovery of the 45 volumes of Yixue Gangmu in Ming Dynasty has a unique literature value for the annotation of medical classics, identification and collation of medical books in Jin and Yuan Dynasties.

Knockdown of HJURP inhibits non-small cell lung cancer cell proliferation, migration, and invasion by repressing Wnt/β-catenin signaling

OBJECTIVE

Holliday junction-recognizing protein (HJURP) was found to be upregulated in several tumors, including non-small cell lung cancer (NSCLC), and the effect of HJURP on NSCLC remains unknown. The objective of the present study was to explore the clinical significance of HJURP and its function in regulating the progression of NSCLC.

PATIENTS AND METHODS

Reverse Transcriptions-Polymerase Chain Reaction (RT-PC) and Western blot were performed to detect the expression levels of HJURP in NSCLC tissues and cell lines. The association of HJURP expression level with various important clinicopathological parameters was evaluated. Then, the effects of HJURP expression on tumor cell behavior in vitro were analyzed by the Cell Counting Kit-8 (CCK-8), EdU assays, colony formation, flow cytometry, and transwell assays. The protein levels of related proteins of the Wnt/β-catenin pathway were determined using the Western blot assay.

RESULTS

Our study showed that HJURP was significantly upregulated in both NSCLC tissues and cell lines. The higher expression of HJURP was associated with advanced TNM stage, distant metastasis, and poor prognosis. Our data from in vitro assays confirmed that the knockdown of HJURP suppressed NSCLC cells proliferation, migration, invasion, epithelial-mesenchymal transition (EMT) progress, and induced cells apoptosis. Notably, through Western blot analysis, we found that HJURP suppression remarkably decreased β-catenin, cyclin D1 and c-myc expression level in NSCLC cell lines.

CONCLUSIONS

Our findings provide clues regarding the role of HJURP as a tumor promoter in NSCLC via the activation of the Wnt/β-catenin pathway, indicating HJURP may be a promising therapeutic target for NSCLC.

[Puzzle Solution of the compilation and circulation of Classics on Acupuncture and Plain Questions]

Through mining and collecting the compiling thought of Miraculous Pivot (《》) and Plain Questions (《》), which were handed down from ancient times, it is discovered that these two ancient works refer to two components of one integrity book. With regard to the character and relationship, Miraculous Pivot is the main section and the essence, focusing on theoretic innovation. "Writing" is predominated in its statement. Plain Questions is the supplementary opinions to the main section, containing clinical application and material collection. "Compiling" is predominated in its statement. Both of two works were completed between the late Western Han Dynasty and the Eastern Han Dynasty. The author was a leading scholar and had worked in a national library for a long time. Before the Song Dynasty, Plain Questions had been widely circulated, while the spreading of Miraculous Pivot was limited. In the process of inheritance, some of the content of these two works were lost or supplemented, and the chapters were disarranged or adjusted artificially. But, in general, the original is not distorted seriously, especially the essential section, Miraculous Pivot.

Pharmacokinetics of diclofenac sodium injection in swine

The pharmacokinetics of a diclofenac sodium was investigated in swine. A single intravenous (i.v.) or intramuscular (i.m.) injection of 5% diclofenac sodium (concentration = 2.5 mg · kg-1) was administered to 8 healthy pigs according to a two-period crossover design. The pharmacokinetic parameters were calculated by non-compartmental analysis with DAS2.1.1 software. After a single i.v. administration, the main pharmacokinetic parameters of diclofenac sodium injection in swine were as follows: the elimination half-time (T1/2β) was 1.32±0.34 h; the area under the curve (AUC) was (55.50±5.50 μg · mL-1 h; the mean residence time (MRT) was 1.60±0.28 h; the apparent volume of distribution (Vd) was 0.50±0.05 L · kg-1; and the body clearance (CLB) was 0.26±0.04 L · (h · kg)-1. After the single i.m. administration, the pharmacokinetic parameters were as follows: peak time (Tmax) was 1.19±0.26 h; and peak concentration (Cmax) was 11.61±5.99 μg mL-1. The diclofenac sodium has the following pharmacokinetic characteristics in swine: rapid absorption and elimination; high peak concentration; and bioavailability.

[Evaluation of the effect of electrical stimulation combined with biofeedback therapy for postpartum pelvic organ prolapse: a static and dynamic magnetic resonance imaging study]

Objective: To explore the clinical value of static and dynamic magnetic resonance imaging (MRI) in evaluating the effect of electrical stimulation combined with biofeedback in the treatment of pelvic organ prolapse postpartum. Methods: A total of 50 primiparas diagnosed as pelvic organ prolapse postpartum from February 2016 to November 2017 were randomly divided into treatment group (24 cases) and control group (26 cases). The control group recovered spontaneously, and the treatment group received electric stimulation combined with biofeedback therapy (6 weeks). All subjects underwent static and dynamic MRI before and after treatment. The thickness of bilateral puborectal muscles, levator ani hiatus area (LHA), H line, M line and levator ani plate angle (LPA) were respectively measured in rest state and strain state at 42 days and 12 weeks postpartum, and the differences of parameters were compared between two groups. Results: (1) Compared with 42 days postpartum, the effective rate of pelvic organ prolapse was 15.4% (4/26) in the control group and 62.5% (15/24) in the treatment group, which was significantly higher than that of the control group (P<0.01). (2) Compared with 42 days postpartum, the thickness of bilateral puborectal muscles in the treatment group increased at 12 weeks postpartum, while that of the H line, LHA, M line and LPA in strain state decreased. (3) At 12 weeks postpartum, the thickness of the bilateral puborectal muscle in the treatment group was greater, and LHA, M line, and LPA in strain state were less than that in the control group (all P<0.05). Conclusion: Electrical stimulation combined with biofeedback therapy can improve pelvic organ prolapse due to vaginal delivery, and the static and dynamic MRI can objectively evaluate the effect of pelvic floor rehabilitation therapy on improving the pelvic floor supporting structure and function, providing an important support and guidance for restoration of postpartum pelvic organ prolapse.

[An Interpretation of the bamboo slips of acupuncture prescriptions excavated from the Han Dynasty Tomb at Laoguanshan]

The bamboo slips of acupuncture prescriptions unearthed from the Han Dynasty Tomb at Laoguanshan include both theoretical elaborations and formulae. Specifications for diagnosis and treatment, standards for needles and a variety of acupuncture techniques are discussed. The 40 acupuncture prescriptions recorded are based on presupposed summaries of theory and experience, rather than empirical formulae. Among them, 28 have needling sites that are maishu (vessel points), with proper names and specific locations. The names of these maishu adopt the pattern of 'the name of the site + the name of one of the three yin and three yang meridians'. Needling numbers are indicated for the majority of the sites of acupuncture stimulation, no matter whether for maishu or for sites at pathological areas. These statements fully embody the distinct characteristics of Bianque acupuncture.

Effects of smoking and alcohol consumption on lipid profile in male adults in northwest rural China

OBJECTIVES

To determine the individual and combined influences of smoking and alcohol consumption on lipid profile in male adults in northwest rural China.

DESIGN

Cross-sectional study.

METHODS

In total, 4614 subjects were enrolled in the cross-sectional study, performed between 2008 and 2012. The present study examined males aged ≥18 years from northwest rural China (n = 707). Data on current smoking and drinking status were collected. Logistic regression was used to estimate the individual and combined influences of smoking and alcohol consumption on lipid profile. Age, ethnic group, educational background, smoking (or alcohol consumption), waist circumference, body mass index, blood pressure and fasting blood glucose were adjusted as confounders.

RESULTS

Total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio, triglycerides (TG)/HDL-C ratio, low-density lipoprotein cholesterol (LDL-C)/HDL-C ratio and visceral adiposity index (VAI) were significantly higher in smokers than in non-smokers, whereas HDL-C was lower in smokers. TG/HDL-C ratio, LDL-C/HDL-C ratio, TG, lipid accumulation product and VAI were significantly higher in drinkers than non-drinkers. After adjustment for confounders, significant relationships were observed between smoking status and any dyslipidemia, low HDL-C and high VAI (odds ratios [ORs]: 2.53 [95% confidence interval {CI}: 1.25-5.15], 6.13 [95% CI: 2.84-13.25] and 4.39 [95% CI: 2.02-9.54], respectively). The OR for any dyslipidaemia was 1.94 (95% CI: 1.09-3.48) for subjects who smoke and drank alcohol compared with subjects who did not smoke or drink alcohol.

CONCLUSIONS

Abnormalities in lipid profile are correlated with smoking and alcohol consumption, which calls for intervention strategies to prevent dyslipidaemia and control risk factors for cardiovascular disease.

[The affinity between Le family of Tong Ren Tang and acu-moxibustion as viewed from Mian xue tang zhen jiu ji cheng (Mian Xuetang's Synthetic Work of Acu-moxibustion)]

This compilation process of Mian xue tang zhen jiu ji cheng(Mian Xuetang's Synthetic Work of Acu-moxibustion)was quite mysterious, the book's advent coincidentally met with several major historical events which made its value of decoding its historical functions far beyond its academic value. The editor of this book is Le Xianyang, the founder of Tong Ren Tang. While compiling this book, he also made a replica of Ming-Dynasty's Zhengtong bronze statue. More than 200 years later, Le Jingyu, the 12th generation of the Le family revised Ming Tang Tuinherited from his ancestors and engraved Ming Tang Tuon the stone for its standardization. This great achievement of Le family was no less than the recasting of the Tiansheng bronze statue and the reengraving Tong ren shu xue zhen jiu tu jing(Illustrated Manual of Acupuncture Points of the Bronze Figure) by support of state power for building the Beijing Imperial Hospital in the eighth year of the Zhengtong reign (1443).

[Study on the excavated wooden carved acupuncture statue of the Western Han Dynasty in Laoguanshan]

The painted red lines on the wooden carved acupuncture statue of Western Han Dynasty in Laoguanshan, illustrate the running courses of the"eleven meridians"on the body surface in the early meridian doctrine. The carved white lines show the body surface running courses of the"twelve meridians"in the meridian doctrine and the Sanjiao images in Sanjiao doctrine. The dots on the wooden carved acupuncture statue are of two categories, one of them is of regulatory, round and concave spots, which are carved before the process of lacquer undercoat. The other category is of different sizes and in irregular forms, which are carved simultaneously with those white lines. Altogether there are over one hundred dots in these two categories, representing the mai shu (transport point of vessels). The wooden carved acupuncture statue reflects the distinct characteristics on the running courses of meridians, Sanjiao doctrine, the nomenclature and localization of"mai shu"in Bianque medicine, which provides the most powerful evidence for the confirmation of the correlation between Laoguanshan excavated documents and Bianque medicine.

Nutrient assessment of olive leaf residues processed by solid-state fermentation as an innovative feedstuff additive

AIMS

Olive leaf residue feedstuff additives were prepared by solid-state fermentation (SSF), and its feeding effects on broiler chickens were examined.

METHODS AND RESULTS

The fermentation's nutrient value, that is, protein enrichment, cellulase activity, tannic acid degradation and amino acid enhancement, was determined. The effect of different strains, including molds (Aspergillus niger, Aspergillus oryzae and Trichoderma viride) and yeasts (Candida utilis, Candida tropicalis and Geotrichum candidum), and the fermentation time on the nutrient values of the feedstuff additives was investigated. The experimental results showed that the optimal parameters for best performance were A. niger and C. utilis in a 1 : 1 ratio (v/v) in co-culture fermentation for 5 days. Under these conditions, the total content of amino acids in the fermented olive leaf residues increased by 22·0% in comparison with that in the raw leaf residues. Both Glutamic acid and Aspartic acid contents were increased by more than 25·4%. Broiler chickens fed with different amounts of feedstuff additives were assessed. The results demonstrated that the chicken weight gains increased by 120%, and normal serum biochemical parameters were improved significantly after 10% of the feedstuff additives were supplemented to the daily chicken feed for 28 days.

CONCLUSIONS

The co-culture combination of A. niger and C. utilis with SSF for olive leaf residue had the best nutrient values. The addition of 10% fermented olive leaf residue facilitated the chicken growth and development.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study reveals that olive leaf residues fermented by SSF exhibited considerable potential as feed additives for feeding poultry.

Hsp70 and small Hsps are the major heat shock protein members involved in midgut metamorphosis in the common cutworm, Spodoptera litura

Heat shock proteins (Hsps) are important chaperones, which are involved in various signal pathways and regulate lots of physiological processes. Early research suggested that some Hsps are involved in insect development. However, few studies have been carried out to explore the roles of Hsps, especially in larval-pupal metamorphosis. In the present study, 49 Hsp unigenes were identified in the Spodoptera litura transcriptome and their mRNA expression profiles during midgut metamorphosis were examined using a tag-based digital gene expression system. The genes with the most different levels of expression were then cloned and their expression patterns in midguts from sixth instar larvae to pupae were analysed using real time quantitative PCR. The responses of these genes to juvenile hormone (JH) and 20-hydroxyecdysone (20E) were also studied. The results showed that the mRNA levels of 22 Hsp unigenes changed significantly during midgut metamorphosis. Amongst these 22 unigenes, hsp70, hsp20.4 and hsp20.8 were the most up-regulated members, and hsp15.9, hsp19.3 and hsp22.0 were the most down-regulated ones. Further studies showed that hsp70, hsp20.4 and hsp20.8 were remarkably up-regulated by JH. In addition, 20E slightly increased the mRNA levels of both hsp20.4 and hsp20.8. However, hsp15.9, hsp19.3 and hsp22.0 did not respond to either JH or 20E. These results indicate that Hsp70 and small Hsps (sHsps) are probably the major players in midgut metamorphosis in S. litura. The current findings provide valuable insights into the roles of the Hsp superfamily in insect metamorphosis.

A numerical investigation of the effect of vertex geometry on localized surface plasmon resonance of nanostructures

Advances in nanofabrication and nano-scale measurement methods now allow for fabrication of highly detailed nanometer-scale topographic features. As geometric features greatly impact the formation of an electromagnetic field in response to incident light, this in turn calls for the study of the effects of new features of nanostructures on their performance in applications such as localized surface plasmon resonance (LSPR) sensing. This paper studies the effects of vertex features of a single nanostructure on its LSPR properties. A general relationship between the LSPR spectra and the vertex features of a nanoparticle is established. The results of electrodynamics calculations show that a delta-star with a relatively small vertex angle exhibits a bigger resonant wavelength than one with a large vertex angle. Moreover, the sensing performance initially increases, and then decreases as angular size of the vertices increases, with a turning point of 30 degrees. It is also shown that for nanostars with different numbers of vertices, the resonant wavelength undergoes a blue shift and the sensing performance grows poorer as the number of vertices increases. A regular vertex angle of 30 degrees displays the greatest figure of merit (FOM) value for LSPR applications, approximately 9.5 RIU(-1).

Genomic variations within DEFB1 are associated with the susceptibility to and the fatal outcome of severe sepsis in Chinese Han population

Sepsis is a systemic inflammatory response syndrome to infection. Human beta-defensin 1 (DEFB1) is a multifunctional mediator in infection and inflammation, which has been largely explored in ex vivo studies. The present case-control study was designed to investigate whether DEFB1 genomic variations are associated with the susceptibility to and the outcome of severe sepsis in 211 patients with severe sepsis and 157 ethnic-matched healthy controls. After correcting for multiple testing, the -44G/C was the only polymorphism found to show significant associations with both the susceptibility to and the fatal outcome of severe sepsis (P=0.0049, odd ratio (OR) 1.971 and P=0.002, OR 2.406, respectively). Haplotype -20A/-44C/-52G showed a protective role against severe sepsis (P=0.0066, OR 0.6751), whereas haplotype -20G/-44G/-52G served as a risk factor for the fatal outcome of severe sepsis (P=0.0052, OR 2.427). These findings provide further evidence that beta-defensin 1 may play a role in the pathogenesis of severe sepsis.

Loss of heterozygosity and its correlation with clinical outcome and Epstein-Barr virus infection in nasopharyngeal carcinoma

Sixty-one human nasopharyngeal carcinomas (NPC) were examined by allelotype analysis for the purposes of detecting potential association between loss of heterozygosity (LOH), clinicopathological parameters and Epstein-Barr virus (EBV) infection. LOH was performed using 257 polymorphic markers on 22 chromosomes. High frequency LOH (> or = 60%) was observed on 12 chromosome arms including 1p, 2p, 2q, 3p, 3q, 5q, 9p. 9q, 11q, 13q, 14q and 17q, with the highest LOH frequency of 91% on 3p. Seventy-three loci presented LOH frequency > or = 30%; most of these loci clustered on 1p36 p34, 2p25-p24, 3p14-p21, 3p24-p26, 5q11-q14, 5q31-q33, 9p21-p23, 9q33-q34, 11q23-q25, 13q12 q14, 13q31-q33, 14q13-q11, 14q32 and 19q13. On 1p36-p34, 2p25-p24, 5q13-q11, 5q31-q33 and 19q13 are reported for the first time. LOH was correlated with specific clinicopathological parameters including tumor T-stage, N-stage, TNM-stage, tumor differentiation and serum antibody titers of IgA against virus capsid antigens (VCA) and early antigen (EA) of EBV in NPC (LOH frequency > or = 30%). Significantly high LOH frequency was observed on 9p21 (56%) and 19q13 (50%) in NPC with stage T3+T4, while significantly higher LOH frequency was observed on 12p11 (65%) in NPC with stage T1 + T2. Significantly higher LOHfrequency on 19q13 was also observed in NPC with advanced TNM-stage (III+IV). High fractional allelic loss (FAL) value and high antibody titers of EBV IgA/VCA and/or IgA/EA were significantly correlated with T3 + T4-stage, distant lymph node metastasis and advanced TNM-stage of NPC. We also found that NPC patients with high titers of IgA/VCA and IgA/EA showed high LOH frequency on 16q (48%) and 19q13 (48%). These results suggest that LOH on 9p21, l6q and 19q13 may be responsible for the aggressiveness and progression of NPC; there may be an interaction between allelic loss and EBV infection in the etiology of NPC. High frequency of LOH on 4q21 and 14q11-q12 were alsofound to be correlated with WHO type III NPC histopathology, suggesting that LOH on these regions may cause poor NPC differentiation. Our data also may be useful for the development of a NPC molecular staging system, a system which may augment the use of clinical pathological features in the diagnosis and prognosis of this disease.

Genome-wide analyses on loss of heterozygosity in hepatocellular carcinoma in Southern China

BACKGROUND/AIMS

To conduct a genome-wide analysis of loss of heterozygosity (LOH) and its clinical significance in hepatocellular carcinoma (HCC) in Southern China where high incidence of HCC was documented.

METHODS

LOH of 382 microsatellite loci on all autosomes were detected with polymerase chain reaction-based microsatellite polymorphism analyses in 104 HCC tumor tissues.

RESULTS

High frequency of LOH (>55.7%) was observed on chromosome 1p, 1q, 2q, 3p, 4q, 6q, 8p, 9p, 13q, 16q, and 17p. LOH rates on loci D4S2964 (4q21.21), D8S277 (8p23.1-pter) and D17S938 (17p13.1-p13.3) were significantly higher in cases with positive HBsAg than in those with negative HBsAg. Similarly, LOH on loci D1S214 (lp36.3), D1S2797 (1p34) and D3S3681 (3p11.2-p14.2) were more frequently detected in tumors with intrahepatic metastasis than in those without.

CONCLUSIONS

Status of LOH in HCC in Southern China is similar to that reported previously in other countries and areas. However, we firstly identified high-frequency LOH on chromosome 3p in HCC. Furthermore, HBV infection, as well as tumor intrahepatic metastasis, may be correlated with allelic losses on certain chromosome regions.

Genome-wide allelotype analysis of sporadic primary nasopharyngeal carcinoma from southern China

Nasopharyngeal carcinoma (NPC) is one of the most common malignant tumors in Southern China, especially in the Guangdong area. To demonstrate a comprehensive profile of loss of heterozygosity (LOH) in NPC, we applied a large panel of 382 microsatellite polymorphism markers covering all the 22 autosomes in 98 cases of sporadic primary NPC. Of the 335 informative markers, 83 loci showed high level of LOH (presence in equal to or more than 30% cases) and most of the high frequent loci were clustered to chromosome 1p36 and 1p34, 3p14-p21, 3p24-p26, 3q25-q26 and 3q27, 4q31 and 4q35, 5q15-21 and 5q32-q33, 8p22-p23, 9p21-p23 and 9q33-q34, 11p12-p14, 13q14-q13 and 13q31-q32, 14q13-q11, 14q24-q23 and 14q32. High frequency of LOH was found in chromosomes 3, 5, 9 and 11 (>/=50%), while medium frequency of LOH was found in chromosomes 1, 4, 6, 14, 17 and 19 (40-49%). Several new regions showing high frequency of LOH were found in chromosome 1p36, 3q25-q26, 3q27, 5q15-q21, 8p22-p23 and 11p12-14. The relationship between LOH and TNM stage of NPC was evaluated. Regions 6p23 (D6S289), 8p23.1 (D8S549) and 9q34.2 (D9S1826) showed higher frequency of LOH in later stages (III and IV) than in earlier stages (I and II) (P<0.05). Thus, our study provides a global view on allelic loss in the development of NPC and should shed light on the way for localization of putative tumor suppressor genes associated with the pathogenesis of NPC.

Characterization of outward potassium current in embryonic chick heart cells

AIM

To characterize a voltage-dependent outward K+ current in cultured heart cells of 14-16-day-old embryos of yellow chick.

METHODS

The patchclamp technique in the whole-cell configuration was used.

RESULTS

The kinetics and the pharmacology of the outward K+ current in our cell mold were different from those described in white chick. Like the calcium-activated K+ current, blocker of calcium channel, CdCl2, eliminated the current of more than 95%. Isoproterenol provoked an increase of peak amplitude (137% +/- 47%, n = 16 cells) and acceleration of activation kinetics in the outward K+ current (the time reaching a peak current reduced from 36 ms +/- 10 ms to 16 ms +/- 9 ms). This effect of isoproterenol was mimiced by cAMP. In addition, a frequency-dependent decrease in peak amplitude of the current occurred after cAMP-induced phosphorylation.

CONCLUSION

There are species- and/or cell-type-specific difference in the K+ channels properties. In embryonic yellow chick heart cells, the phospholation of channel could not only modulate the activation kinetic properties of the calcium-activated potassium channel, but also change their recovery kinetics.

Involvement of medullary tail-flick related neurons in descending facilitation evoked by chemical stimulation of rat lateral habenular nucleus

AIM

To study effects of sodium L-glutamate microinjection into lateral habenular nucleus (LHN) of rats on the firing of medullary tail-flick related neurons and tail-flick reflex (TF).

METHODS

Using synchronous recording of unitary neuronal discharges and TF induced by noxious heat.

RESULTS

Chemical stimulation of LHN induced an excitement of the on-cell spontaneous activity, an inhibition of the off-cell spontaneous activity with an enhancement of their TF related responses. The spontaneous firing rate of on-cells increased from 5.8 +/- 2.2 Hz to 10.9 +/- 3.4 Hz while the spontaneous firing rate of off-cells decreased from 11.8 +/- 2.2 Hz to 6.1 +/- 2.2 Hz. Meanwhile the TFL was shortened from 4.04 +/- 0.17 s to 2.97 +/- 0.13 s.

CONCLUSION

The chemical stimulation of LHN produced a facilitating action on nociceptive spinal defensive reflex. This effect is brought out by the cooperation of on- and off-cells.

[Involvement of medullary tail-flick related neurons in the descending facilitating effects evoked by stimulation of lateral habenular nucleus]

In lightly anesthetized rats 3 classes of neurons in the rostral ventromedial medulla (RVM) were in relation to tail-flick reflex (TF) recorded, i. e. the TF triggired on-cells, the TF triggered off-cells and the non-responsive or neutral cells. When lateral habenular nucleus (LHb) was stimulated the on-cells were excited, the off-cells inhibited while the neutral cells unaffected. The fact that stimulation of LHb facilitated tail-flick reflex appears to be quite well explained by its enhancement effect on the tail-flick related response of both the on- and the off-cells. These results indicate that the facilitating action of LHb on spinal defensive reflex is probably brought out by participation of the medullary tail-flick related cell activity.

[Angiocardiographic diagnosis of membranous ventricular septal aneurysm in childhood]

121 patients with isolated VSD were investigated by left ventriculography in long axial oblique projections at Xinhua hospital. In this group, 26 cases (21%) had conal septal defects, one (1%) had a muscular VSD and 94 (78%) membranous VSD. Among the 94 patients, 41 cases (44%) had membranous ventricular septal aneurysm. The angiocardiographic manifestations, pathology, associated left ventricular-right atrial shunt of membranous septal aneurysm and the differential diagnosis were discussed.