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Zhao L, Zhang Y, Liu F, Yang H, Zhong Y, Wang Y, Li S, Su Q, Tang L, Bai L, Ren H, Zou Y, Wang S, Zheng S, Xu H, Li L, Zhang J, Chai Z, Cooper ME, Tong N. Urinary complement proteins and risk of end-stage renal disease: quantitative urinary proteomics in patients with type 2 diabetes and biopsy-proven diabetic nephropathy. J Endocrinol Invest 2021; 44:2709-2723. [PMID: 34043214 PMCID: PMC8572220 DOI: 10.1007/s40618-021-01596-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/18/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE To investigate the association between urinary complement proteins and renal outcome in biopsy-proven diabetic nephropathy (DN). METHODS Untargeted proteomic and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional analyses and targeted proteomic analysis using parallel reaction-monitoring (PRM)-mass spectrometry was performed to determine the abundance of urinary complement proteins in healthy controls, type 2 diabetes mellitus (T2DM) patients, and patients with T2DM and biopsy-proven DN. The abundance of each urinary complement protein was individually included in Cox proportional hazards models for predicting progression to end-stage renal disease (ESRD). RESULTS Untargeted proteomic and functional analysis using the KEGG showed that differentially expressed urinary proteins were primarily associated with the complement and coagulation cascades. Subsequent urinary complement proteins quantification using PRM showed that urinary abundances of C3, C9, and complement factor H (CFAH) correlated negatively with annual estimated glomerular filtration rate (eGFR) decline, while urinary abundances of C5, decay-accelerating factor (DAF), and CD59 correlated positively with annual rate of eGFR decline. Furthermore, higher urinary abundance of CFAH and lower urinary abundance of DAF were independently associated with greater risk of progression to ESRD. Urinary abundance of CFAH and DAF had a larger area under the curve (AUC) than that of eGFR, proteinuria, or any pathological parameter. Moreover, the model that included CFAH or DAF had a larger AUC than that with only clinical or pathological parameters. CONCLUSION Urinary abundance of complement proteins was significantly associated with ESRD in patients with T2DM and biopsy-proven DN, indicating that therapeutically targeting the complement pathway may alleviate progression of DN.
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Affiliation(s)
- L Zhao
- Division of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- Division of General Practice, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Y Zhang
- Key Laboratory of Transplant Engineering and Immunology, MOH, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- West China-Washington Mitochondria and Metabolism Research Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- Frontiers Science Center for Disease-Related Molecular Network, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
| | - F Liu
- Division of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China.
- Division of General Practice, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - H Yang
- Key Laboratory of Transplant Engineering and Immunology, MOH, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China.
- West China-Washington Mitochondria and Metabolism Research Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China.
- Frontiers Science Center for Disease-Related Molecular Network, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China.
| | - Y Zhong
- Key Laboratory of Transplant Engineering and Immunology, MOH, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- West China-Washington Mitochondria and Metabolism Research Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- Frontiers Science Center for Disease-Related Molecular Network, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
| | - Y Wang
- Division of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- Division of General Practice, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - S Li
- Division of General Practice, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Q Su
- Division of General Practice, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - L Tang
- Histology and Imaging Platform, Core Facility of West China Hospital, Chengdu, Sichuan, China
| | - L Bai
- Histology and Imaging Platform, Core Facility of West China Hospital, Chengdu, Sichuan, China
| | - H Ren
- Division of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- Division of General Practice, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Y Zou
- Division of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- Division of General Practice, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - S Wang
- Key Laboratory of Transplant Engineering and Immunology, MOH, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- West China-Washington Mitochondria and Metabolism Research Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- Frontiers Science Center for Disease-Related Molecular Network, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
| | - S Zheng
- Key Laboratory of Transplant Engineering and Immunology, MOH, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- West China-Washington Mitochondria and Metabolism Research Center, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- Frontiers Science Center for Disease-Related Molecular Network, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
| | - H Xu
- Division of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - L Li
- Division of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - J Zhang
- Histology and Imaging Platform, Core Facility of West China Hospital, Chengdu, Sichuan, China
| | - Z Chai
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia
| | - M E Cooper
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia
| | - N Tong
- Division of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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Wu Y, Zhang J, Wang Y, Wang T, Han Q, Guo R, Zhang R, Ren H, Zhu Y, Xu H, Li L, Tong N, Liu F. The association of hematuria on kidney clinicopathologic features and renal outcome in patients with diabetic nephropathy: a biopsy-based study. J Endocrinol Invest 2020; 43:1213-1220. [PMID: 32147762 DOI: 10.1007/s40618-020-01207-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 02/27/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE To investigate the relationships between hematuria, clinicopathological features and renal outcomes in patients with biopsy-proven diabetic nephropathy (DN). METHODS This cohort study included 261 patients with DN. Participants were divided into two groups according to number of red blood cells per high-power field (RBC/hpf) in urine sediment: the hematuria (-) group (≤ 3 RBC/hpf) and the hematuria (+) group (> 3 RBC/hpf). Basic clinical parameters were measured at the time of renal biopsy; relationships between hematuria and clinicopathological features and renal outcomes were analyzed. RESULTS Patients in the hematuria (+) group often had overt proteinuria. Interstitial inflammation was more severe in the hematuria (+) group than in the hematuria (-) group. Glomerular arteriolar hyalinosis, interstitial fibrosis and tubular atrophy were comparable between groups. For patients with early DN (eGFR ≥ 60 ml/min/1.73 m2), urinary RBC/hpf at baseline was positively correlated with glomerular classification, interstitial fibrosis/tubular atrophy scores and interstitial inflammation scores. In prognostic analysis, hematuria was associated with a higher risk of progression to end-stage renal disease. Hematuria remained an independent predictor after adjustment for confounding factors such as sex, age, duration of diabetes, serum glucose level, hypertension, cholesterol, eGFR and urine protein excretion, especially in patients with early DN and in male patients. CONCLUSION In this study, hematuria was associated with more severe renal pathologic lesions in patients with DN. The presence of hematuria could be an independent predictor of renal outcome in patients with early DN.
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Affiliation(s)
- Y Wu
- Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - J Zhang
- Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Y Wang
- Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - T Wang
- Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Q Han
- Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - R Guo
- Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - R Zhang
- Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - H Ren
- Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Y Zhu
- Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - H Xu
- Division of Pathology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, China
| | - L Li
- Division of Pathology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, China
| | - N Tong
- Division of Endocrinology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, China
| | - F Liu
- Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
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Abstract
INTRODUCTION Frail older adults residing in long-term care (LTC) facilities are among the most vulnerable to dental caries due to poor oral hygiene (OH), medication-related salivary hypofunction, carbohydrate-rich diets, and limited access to dental care. Providing dental restorations for LTC patients is challenging, and there are few studies investigating the longevity of restorations in this cohort. Multiple restorative materials have been used to restore tooth anatomy as well as address caries prevention using fluoride-based materials. OBJECTIVES This study examined the longevity of bonded direct restorations placed in LTC patients. Specifically, we examined whether a difference in survival exists between resin composite (RC) and glass ionomer cement (GIC) direct restorations in frail older adults residing in LTC. METHODS Tooth-colored restorations placed in LTC patients between 2007 and 2012, within the University of British Columbia Geriatric Dentistry Program, were followed annually up to 5 y or until they incurred an event (i.e., re-restoration or tooth extraction) or the patient was lost to follow-up or deceased. Restoration status was documented within the Clinical Oral Disorder in Elders (CODE) Index annual oral health assessments. Mixed-effect logistic regression was calculated to determine hazard ratios, address within-patient correlation, and measure the effect size of multiple covariates. RESULTS A total of 3,201 dental restorations placed in 846 LTC patients were followed. This cohort of patients had a mean age of 86 y and high levels of oral and systemic disease. Over half were wheelchair bound and had compromised ability to perform OH. The overall 5-y survival rate was 60.3%, and there was no statistically significant difference in survival between RC and GIC. CONCLUSION Tooth-colored restorations had reasonable longevity in LTC patients and had comparable survival to restorations placed in functionally independent, community-dwelling geriatric populations. No difference between RC and GIC was found with regards to restoration longevity in this population. KNOWLEDGE TRANSFER STATEMENT Direct restorations provided to frail older adults residing in LTC have reasonable longevity and should be expected to survive for the remainder of the patient's life. As no detectable difference exists in survival rates between RC and GIC, operators should select appropriate restorative materials based on clinical conditions, patient factors, physical properties, and personal preference.
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Affiliation(s)
- N Tong
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - C C L Wyatt
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
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Zhang Y, Zhang F, Chen D, Lü Q, Tang L, Yang C, Lei M, Tong N. A novel homozygous mutation in the solute carrier family 12 member 3 gene in a Chinese family with Gitelman syndrome. Braz J Med Biol Res 2016; 49:e5261. [PMID: 27783806 PMCID: PMC5089230 DOI: 10.1590/1414-431x20165261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 08/26/2016] [Indexed: 02/05/2023] Open
Abstract
Loss of function of mutated solute carrier family 12 member 3 (SLC12A3) gene is the most frequent etiology for Gitelman syndrome (GS), which is mainly manifested by hypokalemia, hypomagnesemia and hypocalciuria. We report the genetic characteristics of one suspicious Chinese GS pedigree by gene sequencing. Complete sequencing analysis of the SLC12A3 gene revealed that both the proband and his elder sister had a novel homozygous SLC12A3 mutation: c.2099T>C and p.Leu700Pro. Moreover, the SLC12A3 genes of his mother and daughter encoded the same mutated heterozygote. It was noted that in this pedigree, only the proband complained about recurrent episodes of bilateral lower limb weakness over 8 years, while his elder sister, mother and daughter did not present symptoms. The inconsistent clinical features of this pedigree implied that besides diverse phenotypes possibly originated from the same genotype, gender difference may also dominate the variant GS phenotypes. Further genetic and proteomic research are needed to investigate the precise mechanisms of GS, including the study of specific ethnicities.
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Affiliation(s)
- Y Zhang
- Division of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - F Zhang
- Division of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - D Chen
- Division of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Q Lü
- Division of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - L Tang
- Division of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - C Yang
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - M Lei
- School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - N Tong
- Division of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Lü Q, Zhang Y, Song C, An Z, Wei S, Huang J, Huang L, Tang L, Tong N. A novel SLC12A3 gene homozygous mutation of Gitelman syndrome in an Asian pedigree and literature review. J Endocrinol Invest 2016; 39:333-40. [PMID: 26260218 DOI: 10.1007/s40618-015-0371-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 07/24/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Gitelman syndrome (GS) is an autosomal recessive disease characterized by hypokalemic metabolic alkalosis in combination with significant hypomagnesemia and hypocalciuria which is caused by mutations in the SLC12A3 gene. In this study, we reported a case of GS pedigree and reviewed pertinent literature so as to explore the relationship between clinical characteristics and genotype meanwhile provide recommendations for the diagnosis and treatment of GS. DESIGN AND METHODS This is a pedigree-based genetic study of GS and 11 members from one family were included. We summarized their clinical features, analyzed laboratory parameters related to GS and SLC12A3 gene. RESULTS The proband experienced intermittent severe symptoms of weakness accompanied by significant hypokalemia, hypomagnesemia and hypocalciuria in laboratory test with poor treatments. His mother had more slight symptoms of weakness than him with mild hypokalemia and hypocalciuria. Mild hypomagnesemia was also observed in his sister with occasional weakness. All other pedigree members had normal laboratory test with no GS-related symptoms. A homozygous mutation of SLC12A3 gene (c.488C > T) was detected by genetic testing in three members, and six were carriers of this mutation. CONCLUSIONS Genotype and phenotype vary significantly among GS patients. Male patients tend to experience more severe symptoms and poor treatment effect. Further large-scale population, animal, and molecular biology experiments are required to investigate the complexity of GS and to find a better treatment regimen for this disease.
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Affiliation(s)
- Q Lü
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, China
| | - Y Zhang
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, China
| | - C Song
- West China School of Medicine, Sichuan University, No.17, the 3rd section of the south of Renmin road, Chengdu, 610041, China
| | - Z An
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, China
| | - S Wei
- West China School of Medicine, Sichuan University, No.17, the 3rd section of the south of Renmin road, Chengdu, 610041, China
| | - J Huang
- West China School of Medicine, Sichuan University, No.17, the 3rd section of the south of Renmin road, Chengdu, 610041, China
| | - L Huang
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, China
| | - L Tang
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, China
| | - N Tong
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, China.
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Ding L, Tong N, Feng XM, Chen D, Wang HS, Wang Y, Li Y, Zhu GQ, Zhou YB. Adipose afferent reflex response to insulin is mediated by melanocortin 4 type receptors in the paraventricular nucleus in insulin resistance rats. Acta Physiol (Oxf) 2015; 214:450-66. [PMID: 25846948 DOI: 10.1111/apha.12502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 11/27/2014] [Accepted: 04/01/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Adipose afferent reflex (AAR) contributes to sympathetic activation and hypertension. Paraventricular nucleus (PVN) plays an important role in AAR and sympathetic outflow. The aim of the present study was to determine whether PVN mediates AAR response to insulin in a rat model of insulin resistance (IR). METHODS Male Sprague-Dawley rats were randomly divided into Control and IR groups. Insulin resistance was induced by supplementing fructose (125 g L(-1) , 12 weeks) in the drinking water. Renal sympathetic nerve activity (RSNA) and mean arterial pressure (MAP) were recorded in anesthetized rats. AAR was evaluated by the RSNA and MAP responses to injection of capsaicin into four sites of right inguinal white adipose tissue. RESULTS Rats in IR group showed a rise in plasma noradrenaline (NE), glucose, insulin and triglyceride levels, left ventricular weight, systolic blood pressure, homeostasis model assessment of insulin resistance (HOMA-IR) and PVN glucose and insulin levels, melanocortin 4 type receptors (MC4Rs) protein expression, but not MC3Rs and insulin receptors. Compared with Control group, AAR in IR group was significantly enhanced, which contributed to the elevation of NE level; and insulin microinjection into the PVN or the third ventricle significantly strengthened AAR, which was attenuated by pre-treatment with MC4Rs antagonist HS024 and anti-insulin affibody, respectively, but not insulin receptors antagonist S961. CONCLUSION The enhanced AAR participates in sympathetic activation in IR, which can be strengthened by PVN insulin. PVN MC4Rs mediate the AAR response to insulin in IR, but not MC3Rs and insulin receptors.
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Affiliation(s)
- L. Ding
- Key Laboratory of Cardiovascular Disease and Molecular Intervention; Department of Physiology; Nanjing Medical University; Nanjing 210029 China
| | - N. Tong
- Department of Neurology of Heze Minicipal Hospital; Heze 274000 China
| | - X.-M. Feng
- Clinical Laboratory of Luyi People's Hospital; Zhoukou 466000 China
| | - D. Chen
- Key Laboratory of Cardiovascular Disease and Molecular Intervention; Department of Physiology; Nanjing Medical University; Nanjing 210029 China
| | - H.-S. Wang
- Department of Pediatrics; The Fourth Clinical Medical College of Nanjing Medical University; Nanjing 210029 China
| | - Y. Wang
- Department of Pediatrics; The Fourth Clinical Medical College of Nanjing Medical University; Nanjing 210029 China
| | - Y. Li
- Department of Pediatrics; The Fourth Clinical Medical College of Nanjing Medical University; Nanjing 210029 China
| | - G.-Q. Zhu
- Key Laboratory of Cardiovascular Disease and Molecular Intervention; Department of Physiology; Nanjing Medical University; Nanjing 210029 China
| | - Y.-B. Zhou
- Key Laboratory of Cardiovascular Disease and Molecular Intervention; Department of Physiology; Nanjing Medical University; Nanjing 210029 China
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Chen M, Zhou ZY, Chen JG, Tong N, Chen SQ, Yang Y, Zhang XW, Jiang H, Liu N, Liu J, Sha GZ, Zhu WD, Hua LX, Wang ZJ, Xu B. Effect of miR-146a polymorphism on biochemical recurrence risk after radical prostatectomy in southern Chinese population. Genet Mol Res 2014; 13:10615-21. [PMID: 25526182 DOI: 10.4238/2014.december.18.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Evidence has shown that miR-146a is involved in carcinogenesis and a common G/C variant (rs2910164) in the pre-miR-146a gene has been found to be associated with various cancers. We investigated the potential prognostic role of miR-146a polymorphism in prostate cancer after radical prostatectomy. Seventy-two southern Chinese with prostate cancer undergoing radical prostatectomy were included in this study. miR-146a polymorphism was analyzed by PCR-RFLP. Its prognostic role in biochemical recurrence was assessed using Kaplan-Meier analysis and Cox regression model. We did not find a significant association between miR-146a polymorphism and prostrate-specific antigen failure in the Chinese population [HR (95%CI): 0.83 (0.30-2.32) for CC vs GG/GC]. However, high Gleason score (over 8) was associated with increased biochemical recurrence and poorer PSA-free survival. This study was limited by the length of follow-up. Future studies with longer follow-up would allow evaluation of more direct metrics, such as disease-specific survival, metastasis-free survival, and overall survival.
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Affiliation(s)
- M Chen
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Z Y Zhou
- Department of Urology, The First People's Hospital of Suqian, Suqian, China
| | - J G Chen
- Department of Urology, 2nd Affliated Hospital of Nantong University, Nantong, China
| | - N Tong
- Department of Molecular and Genetic Toxicology, Cancer Center of Nanjing Medical University, Nanjing, China
| | - S Q Chen
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Y Yang
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - X W Zhang
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - H Jiang
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - N Liu
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - J Liu
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - G Z Sha
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - W D Zhu
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - L X Hua
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Z J Wang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - B Xu
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
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Li Y, Tong Y, Zhang Y, Huang L, Wu T, Tong N. Acarbose monotherapy and weight loss in Eastern and Western populations with hyperglycaemia: an ethnicity-specific meta-analysis. Int J Clin Pract 2014; 68:1318-32. [PMID: 24853116 DOI: 10.1111/ijcp.12467] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To demonstrate if weight loss achieved with acarbose in individuals with hyperglycaemia differs between Eastern and Western populations. METHODS Databases and reference lists of clinical trials on acarbose were searched. Eligible studies were randomised controlled trials of acarbose monotherapy in populations with hyperglycaemia of more than 12-week duration that provided data on body weight (BW) or body mass index (BMI). RESULTS A total of 34 trials (6082 participants) were included. The effect of acarbose on BW was superior to that of placebo [weighted mean difference (WMD) = -0.52, 95% confidence interval (CI) -0.78 to -0.25], nateglinide (WMD = -1.33, 95% CI -1.51 to -0.75) and metformin (WMD = -0.67, 95% CI -1.14 to -0.20). Compared with placebo, there was a significantly greater weight loss of 0.92 kg (p < 0.05, I(2) = 88.8%) with acarbose in Eastern populations (WMD = -1.20, 95% CI -1.51 to -0.75) than that in Western populations (WMD = -0.28, 95% CI -0.59 to 0.03). Across all studies, the acarbose group achieved a significantly larger absolute weight loss of (change from baseline) 1.35 kg (p < 0.05, I(2) = 94.3%) in Eastern populations (WMD = -2.26, 95% CI -2.70 to -1.81) than in Western populations (WMD = -0.91, 95% CI -1.36 to -0.47). Nevertheless, the possible risk of bias in Eastern studies may influence the results. CONCLUSION The effect of acarbose on weight loss seems to be more pronounced in Eastern than in Western populations with hyperglycaemia, and is superior to that of placebo, nateglinide and metformin across both ethnicities.
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Affiliation(s)
- Y Li
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China
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9
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Tang L, Tong Y, Cao H, Xie S, Yang Q, Zhang F, Zhu Q, Huang L, Lü Q, Yang Y, Li D, Chen M, Yu C, Jin W, Yuan Y, Tong N. The MTMR9 rs2293855 polymorphism is associated with glucose tolerance, insulin secretion, insulin sensitivity and increased risk of prediabetes. Gene 2014; 546:150-5. [PMID: 24937802 DOI: 10.1016/j.gene.2014.06.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Revised: 06/06/2014] [Accepted: 06/13/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND Polymorphism of rs2293855 in gene MTMR9 has been associated with obesity and metabolic syndrome. We aim to study the association of rs2293855 with type 2 diabetes mellitus (T2DM) intermediate phenotypes in a Han Chinese population. METHODS The polymorphism was genotyped in 838 Han Chinese individuals using Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS); all participants underwent a 75 g oral glucose tolerance test (OGTT); associations between the polymorphism and glucose tolerance, indices of insulin secretion and indices of insulin sensitivity were analyzed. RESULTS The frequency of genotypes and alleles differed significantly between normal glucose tolerance and prediabetes (P=0.043 and P=0.009, respectively). The GG homozygous presented higher fasting plasma glucose (P=0.009), higher 2-hour plasma glucose (P=0.024) and higher glucose area under the curve (AUC, P=0.01). Moreover, the G allele of rs2293855 was associated with glucose intolerance (fasting glucose, P=0.012; glucose AUC, P=0.006; 2-h glucose, P=0.024); it is also associated with decreased indices of insulin sensitivity (fasting insulin, P=0.043; insulin sensitivity index composite, P=0.009; homeostasis model assessment of insulin resistance, HOMA-IR, P=0.008) and decreased indices of insulin secretion (HOMA of beta cell function, HOMA-B, P=0.028; insulinogenic index, P=0.003). In addition, the minor allele G was also associated with increased risk of prediabetes (OR=1.463, 95%CI: 1.066-2.009, P=0.018). CONCLUSIONS Polymorphism of rs2293855 in MTMR9 is associated with measures of glucose tolerance, indices of insulin secretion and indices of insulin sensitivity. We also suggest that allele G is likely to increase the risk of prediabetes by influencing both insulin secretion and insulin sensitivity.
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Affiliation(s)
- L Tang
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Y Tong
- Department of Clinical Medicine, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - H Cao
- Division of Endocrinology and Metabolism, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - S Xie
- Chengdu Aerospace Hospital, Chengdu, Sichuan, China
| | - Q Yang
- Division of Endocrinology and Metabolism, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - F Zhang
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Q Zhu
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - L Huang
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Q Lü
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Y Yang
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - D Li
- Chengdu Yincao Community Hospital, Chengdu, Sichuan, China
| | - M Chen
- Chengdu Aerospace Hospital, Chengdu, Sichuan, China
| | - C Yu
- Chengdu Aerospace Hospital, Chengdu, Sichuan, China
| | - W Jin
- Chengdu Aerospace Hospital, Chengdu, Sichuan, China
| | - Y Yuan
- Chengdu Aerospace Hospital, Chengdu, Sichuan, China
| | - N Tong
- Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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10
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Sips M, Sciaranghella G, Tong N, Kwon D, Brouckaert P, Alter G. Natural Killer cells present in gut mucosa as potential ADCC effector cells. Retrovirology 2012. [PMCID: PMC3441523 DOI: 10.1186/1742-4690-9-s2-p188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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11
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Abstract
This study investigated the effects of berberine, a natural alkaloid, on doxorubicin-induced cardiotoxicity in mice. Mice were injected intraperitoneally with saline 10 ml/kg (n = 10), doxorubicin 2.5 mg/kg (n = 10), 60 mg/kg berberine 1 h before doxorubicin 2.5 mg/kg (n = 10), or 60 mg/kg berberine alone (n = 10) every other day for 14 days. Body weight, general condition and mortality were recorded over the 14-day study period. Electro cardiography was performed before the start of treatment and after 14 days and plasma lactate dehydrogenase (LDH) activity was measured after 14 days. At the end of the study period the heart was excised and examined histologically. An increase in mortality, an initial decrease in body weight, increased LDH activity, prolongation of QRS duration and increased myocardial injury were seen in the doxorubicin-treated group compared with the saline control group. These changes were significantly attenuated by pretreatment with berberine. The study suggests that berberine may have a potential protective role against doxorubicin-induced cardiotoxicity in mice.
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Affiliation(s)
- X Zhao
- School of Pharmaceutical Sciences, Southwest University, BeiBei District, Chongqing, China
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12
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Wang AX, Xu B, Tong N, Chen SQ, Yang Y, Zhang XW, Jiang H, Liu N, Liu J, Hu XN, Sha GZ, Chen M. Meta-analysis confirms that a common G/C variant in the pre-miR-146a gene contributes to cancer susceptibility and that ethnicity, gender and smoking status are risk factors. Genet Mol Res 2012; 11:3051-62. [DOI: 10.4238/2012.august.31.2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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13
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Xu B, Tong N, Li JM, Zhang ZD, Wu HF. ELAC2 polymorphisms and prostate cancer risk: a meta-analysis based on 18 case-control studies. Prostate Cancer Prostatic Dis 2010; 13:270-7. [PMID: 20231859 PMCID: PMC2922791 DOI: 10.1038/pcan.2010.6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Polymorphisms in the elaC homolog-2 (ELAC2)/HPC2 gene have been hypothesized to alter the risk of prostate cancer. However, the results of the related published studies remained conflicting. We performed a meta-analysis of 18 studies evaluating the association between ELAC2 Ser217Leu and Ala541Thr polymorphisms and prostate cancer risk. Overall, ELAC2 Leu217 allele was associated with increased prostate cancer risk as compared with the Ser217 allele (odds ratio (OR)=1.13, 95% confidence interval (CI): 1.03–1.24, P=0.019 for heterogeneity), as well as in the heterozygote comparison (OR=1.21, 95% CI: 1.07–1.36, P=0.034 for heterogeneity) and the dominant genetic model (OR=1.20, 95% CI: 1.07–1.35, P=0.025 for heterogeneity). Furthermore, the ELAC2 Thr541 allele was associated with increased prostate cancer risk as compared with the Ala541 allele (OR=1.22, 95% CI: 1.00–0.48, P=0.131 for heterogeneity). In the stratified analyses for Ser217Leu polymorphism, there was significantly increased prostate cancer risk in Asian and Caucasian populations, and studies using sporadic and familial prostate cancer cases. Similar result was found in the Asian population in the stratified analyses for Ala541Thr polymorphism. This meta-analysis showed evidence that ELAC2 Ser217Leu and Ala541Thr polymorphisms were associated with prostate cancer risk, and might be low-penetrance susceptibility markers of prostate cancer.
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Affiliation(s)
- B Xu
- Department of Urology, Nanjing BenQ Hospital, Affiliated Hospital of Nanjing Medical University, Nanjing, China
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14
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Abstract
BACKGROUND Emergency intubation has been widely advocated as a life saving procedure in severe acute illness and injury associated with real or potential compromises to the patient's airway and ventilation. However, some initial data have suggested a lack of observed benefit. OBJECTIVES To determine in acutely ill and injured patients who have real or anticipated problems in maintaining an adequate airway whether emergency endotracheal intubation, as opposed to other airway management techniques, improves the outcome in terms of survival, degree of disability at discharge or length of stay and complications occurring in hospital. SEARCH STRATEGY We searched the Cochrane Injuries Group Specialised Register (December 2006), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, Issue 4), MEDLINE (1950 to November 2006), EMBASE (1980 to week 50, December 2006), National Research Register (Issue 4, 2006), CINAHL (1980 to December 2006), BIDS (to December 2006) and ICNARC (to December 2006). We also examined reference lists of articles for relevant material and contacted experts in the field. Non-English language publications were searched for and examined. SELECTION CRITERIA All randomised (RCTs) or controlled clinical trials involving the emergency use of endotracheal intubation in the injured or acutely ill patient were examined. DATA COLLECTION AND ANALYSIS The full texts of 452 studies were reviewed independently by two authors using a standard form. Where the review authors felt a study may be relevant for inclusion in the final review or disagreed, the authors examined the study and a collective decision was made regarding its inclusion or exclusion from the review. The results were not combined in a meta-analysis due to the heterogeneity of patients, practitioners and alternatives to intubation that were used. MAIN RESULTS We identified three eligible RCTs carried out in urban environments. Two trials involved adults with non-traumatic out-of-hospital cardiac arrest. One of these trials found a non-significant survival disadvantage in patients randomised to receive a physician-operated intubation versus a combi-tube (RR 0.44, 95% CI 0.09 to 1.99). The second trial detected a non-significant survival disadvantage in patients randomised to paramedic intubation versus an oesophageal gastric airway (RR 0.86, 95% CI 0.39 to 1.90). The third included study was a trial of children requiring airway intervention in the prehospital environment. The results indicated no difference in survival (OR 0.82, 95% CI 0.61 to 1.11) or neurologic outcome (OR 0.87, 95% CI 0.62 to 1.22) between paramedic intubation versus bag-valve-mask ventilation and later hospital intubation by emergency physicians; however, only 42% of the children randomised to paramedic endotracheal intubation actually received it. AUTHORS' CONCLUSIONS The efficacy of emergency intubation as currently practised has not been rigorously studied. The skill level of the operator may be key in determining efficacy. In non-traumatic cardiac arrest, it is unlikely that intubation carries the same life saving benefit as early defibrillation and bystander cardiopulmonary resuscitation (CPR). In trauma and paediatric patients, the current evidence base provides no imperative to extend the practice of prehospital intubation in urban systems. It would be ethical and pertinent to initiate a large, high quality randomised trial comparing the efficacy of competently practised emergency intubation with basic bag-valve-mask manoeuvres (BVM) in urban adult out-of-hospital non-traumatic cardiac arrest.
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Affiliation(s)
- F Lecky
- Hope Hospital, Department of Emergency Medicine, Clinical Sciences Building, Eccles Old Road, Salford, UK, M6 8HD.
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15
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Abstract
AIMS This paper presents two cases of muscle infarction involving four major muscles of the anterior abdominal wall (case 1) and pectoralis major (case 2) in individuals with diabetes. METHODS Erythrocyte sedimentation rate (ESR) and creatine kinase (CK) were measured and Doppler ultrasound, an open muscle biopsy (case 1) and magnetic resonance imaging (MRI) (case 2) were performed. RESULT The diagnosis of muscle infarction was made by histological findings and MRI images with hyper-intensive signals on a gadolinium-enhanced T2-weighted sequence, respectively. Both patients were treated with bed rest, immobilization of the involved extremities, analgesia and intensive insulin therapy. In addition, anticoagulant drugs such as low molecular weight heparin sodium and cilostazol, and some traditional Chinese medicines such as ligustrazine and salvia miltiorrhiza were administered. The symptoms of both patients resolved gradually after 3 weeks. However, muscle infarction reoccurred in case 1 on the opposite side of the abdomen and recovered after 40 days. CONCLUSIONS This is the first report of muscle infarction involving the muscles of anterior abdominal walls and pectoralis major in diabetes. MRI is the best non-invasive technique and T2-weighted imaging is the most valuable method for the diagnosis. In addition to supportive therapy, administration of anticoagulant agents and some Chinese traditional medicine may be useful in symptom relief.
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Affiliation(s)
- X Ran
- Department of Endocrinology/Internal Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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16
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Ran X, Zhang L, Xiong P, Zhao T, Tong N, Li X. [Gigantism with low serum level of growth hormone: a case report]. Hua Xi Yi Ke Da Xue Xue Bao 2001; 32:621-3. [PMID: 12528568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Gigantism with low or normal basal concentrations of growth hormone (GH) is a rare condition, possibly due to abnormal GH secretory patterns, enhanced tissue sensitivity to GH, or the existence of an unidentified growth promoting factor. Here we report an 11 year-old female case of gigantism with a normal pituitary gland. Her height was 181 cm, body weight 77 kg, and bone age 11.1 years. Her basal serum GH levels were lower than 1 ng/ml. The levels of T3, T4, FT3, FT4, TSH, E2, LH, FSH, PRL, PTC and ACTH were normal. Serum GH response to insulin-induced hypoglycemia or arginine stimulation tests was blunted. In this case, non-pulsatile GH secretion and enhanced tissue sensitivity to GH may induce hypersecretion of IGF-1 and the existence of an unidentified growth promoting factor or biologically active anti-GH receptor antibodies may cause clinical gigantism.
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Affiliation(s)
- X Ran
- Endocrinology/Internal Medicine, First Affiliated Hospital, WCUMS, Chengdu 610041, China
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17
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Chi L, Li X, Tong N. [Progress in research on adult patients with slowly progressive auto-immune diabetes]. Zhonghua Yi Xue Za Zhi 2001; 81:955-7. [PMID: 11702673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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18
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Han G, Li X, Tian H, Tong N, Ouyang Q, Yin P. [Study on gastric motility and its relevant factors in type 2 diabetes]. Hua Xi Yi Ke Da Xue Xue Bao 2001; 32:296-9. [PMID: 12600114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVE In this study radionuclide semi-liquid gastric emptying (GE) study was adopted to test the gastric motility in 129 patients with type 2 diabetes. Further study was made to explore the relationship between gastric motility disorder of diabetes and the influential factors. METHODS The variables to be measured and analyzed were age, BMI, duration of illness, level of glycemia, HbAlc, plasma insulin, motilin, gastrin, glucagon and Mg2+. RESULTS Of the 129 cases, 80 had delayed GE with an occurrence of 62.02%, and there was a close correlation between gastric motility disorder and the duration of illness, BMI, FPG, PPG, serum insulin, motilin levels and HbAlc as well. CONCLUSION These findings imply that gastric motility disorder of diabetes is influenced by multiple factors. The results also suggest that gastric motiligy disorder is much more common than expected, and radionuclide gastric emptying test is a useful aid for the early detection of this clinical entity.
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Affiliation(s)
- G Han
- Department of Endocrinology, First Affiliated Hospital, WCUMS, Chengdu 610041, China
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19
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Tong N, Sanchez JF, Maggirwar SB, Ramirez SH, Guo H, Dewhurst S, Gelbard HA. Activation of glycogen synthase kinase 3 beta (GSK-3beta) by platelet activating factor mediates migration and cell death in cerebellar granule neurons. Eur J Neurosci 2001; 13:1913-22. [PMID: 11403684 DOI: 10.1046/j.0953-816x.2001.01572.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Children with vertically acquired HIV-1 can present with a rapidly progressive encephalopathy and neuronal apoptosis in the first 12-18 months of life. Furthermore, abnormal prenatal platelet activating factor (PAF) signalling may result in lissencephaly, a disorder of neuronal migration. PAF, produced from human immunodeficiency virus type 1 (HIV-1) -infected brain-resident macrophages, induces neuronal apoptosis in cultured cerebellar granule neurons (CGNs) in part by activating glycogen synthase kinase 3 beta (GSK-3beta). However, PAF can also inhibit migration of CGNs that are dispersed and allowed to reaggregate. Therefore, we investigated the biological effects following activation of GSK-3beta by PAF, and whether these effects were dependent on the culture conditions of the CGNs. We show here that activation of neuronal GSK-3beta by PAF is receptor-specific, with similar kinetics of activation in both monolayer cultures of CGNs that have ceased to migrate and reaggregate cultures of CGNs that are actively migrating. However, PAF receptor activation in reaggregated CGNs inhibits neuronal migration and induces approximately half the level of neuronal apoptosis compared with PAF-treated CGN cultures that have ceased to migrate. PAF-mediated inhibition of neuronal migration in reaggregated CGNs or induction of apoptosis in CGNs that have ceased to migrate can be reversed by either PAF receptor antagonists, or the GSK-3beta inhibitors lithium or valproic acid, in a dose-dependent manner. Abnormal PAF signalling that results in GSK-3beta overactivation may represent a common mechanism for pathological defects in neuronal migration in the prenatal period and neuronal apoptosis in the postnatal period.
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Affiliation(s)
- N Tong
- Center for Ageing and Developmental Biology, Aab Biomedical Institute, University of Rochester Medical Center, Box 645, 601 Elmwood Avenue, Rochester, NY 14642, USA
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20
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Tong N, Ran X, Chen P, Li G, Tian H. [A multicenter randomized controlled clinical trial on lipids regulating effects of domestic simvastatin]. Hua Xi Yi Ke Da Xue Xue Bao 2001; 32:111-3. [PMID: 12733372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE This clinical trial was designed to assess the lipids regulating effects of domestic simvastatin (DS, produced by Chengdu Huayu Pharmaceutical Co.) in patients with hyperlipidemia. METHODS 160 hyperlipidemic patients were randomly divided into 3 groups (A, B and C). Groups A and B were subjected to single-blind trial; group C was for open trial. Group A took DS 10 mg q.n., group B Zocor 10 mg q.n. and group C DS 10 mg q.n. respectively for 8 weeks. All the patients were followed up at the 4th week and 8th week. 155 patients finished the trial with 59 cases in group A, 47 cases in group B and 39 cases in group C. RESULTS At the 4th week, serum total cholesterol (TC) in group A, B and C decreased by 16.88%, 19.23% and 14.10%; serum triglycerides (TG) decreased by 19.27%, 15.66% and 17.96%; HDL-C increased by 7.69%, 7.46% and 6.69%; and LDL-C decreased by 23.02%, 27.84% and 24.43%, respectively; there was no significant difference among the three groups (P > 0.05). At the 8th week, serum TC in groups A, B and C decreased by 25.03%, 26.53% and 25.22%. TG decreased by 23.85%, 24.74% and 24.75%; HDL-C increased by 9.23%, 8.95% and 8.39%; and LDL-C decreased by 33.72%, 35.50% and 30.99%, respectively; still, no significant difference among the three groups was observed (P > 0.05). The incidence rates of side effects in the three groups were similar. The clinical effects were more significant at the 8th week than at the 4th week for Zocor and DS. CONCLUSION These data suggest that DS is as effective and safe as Zocor in clinical use for lipids regulating serum.
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Affiliation(s)
- N Tong
- Department of Endocrinology, First Affiliated Hospital, WCUMS, Chengdu 610041, China
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21
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Guo H, Tong N, Turner T, Epstein LG, McDermott MP, Kilgannon P, Gelbard HA. Release of the neuronal glycoprotein ICAM-5 in serum after hypoxic-ischemic injury. Ann Neurol 2000; 48:590-602. [PMID: 11026442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Intercellular adhesion molecule (ICAM)-5 (telencephalin) is unique among the ICAMs, because it is only expressed in somatodendritic membranes of telencephalic neurons. To investigate the fate of ICAM-5 during focal brain injury, we induced hypoxia-ischemia (HI) damage in adult mice by right common carotid artery ligation followed by hypoxia. ICAM-5 was detectable in serum within a 48-hour window after HI injury. In HI brain, dendritic ICAM-5 immunore-activity was abolished, but it was present in the neuropil and soma of hippocampal pyramidal, dentate granule, and some cortical and striatal neurons. After HI injury, levels of ICAM-5 protein and messenger RNA initially increased, and ICAM-5 messenger RNA expression then decreased, although protein levels continued to increase. Because HI injury induces microglial activation with increases in CD11a/CD18 (lymphocyte function antigen [LFA]-1) counterreceptors to ICAM-5, we investigated whether modulation of interactions between LFA-1 receptors and brain ICAM-5 during HI injury are associated with changes in levels of serum ICAM-5. Intracerebroventricular administration of lipopolysaccharide to activate microglia before HI injury resulted in elevated serum ICAM-5 levels compared with those in mice with only HI injury. Pretreatment with anti-LFA-1 antibodies before HI injury or LFA-1 receptor knockout mice with HI injury had markedly reduced levels of serum ICAM-5. Lipopolysaccharide levels increased, whereas LFA-1 receptor blockade or LFA-1 knockout decreased HI injury in the first 12 hours. These data suggest that during the necrotic phase of HI injury, serum ICAM-5 may be a potential marker for somatodendritic neuronal damage.
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Affiliation(s)
- H Guo
- Department of Neurology, University of Rochester Medical Center, NY, USA
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22
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Carley SD, Libetta C, Flavin B, Butler J, Tong N, Sammy I. An open prospective randomised trial to reduce the pain of blood glucose testing: ear versus thumb. BMJ 2000; 321:20. [PMID: 10875827 PMCID: PMC27419 DOI: 10.1136/bmj.321.7252.20] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2000] [Indexed: 11/03/2022]
Affiliation(s)
- S D Carley
- Department of Emergency medicine, Manchester Royal Infirmary, Manchester M13 9WL.
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Abstract
The results of a 1998 national survey of pharmaceutical services in hospitals throughout Australia are reported. A self-administered questionnaire was sent to all directors of hospital pharmacy services and senior hospital pharmacy managers to determine the extent of clinical and nonclinical pharmacy services provided by hospitals in Australia. Respondents chose the services their departments provide from a list of 26 commonly provided services. The response rate was 58.5%. Respondents were fairly evenly divided between teaching and nonteaching hospitals, but most of the respondents were from public (versus nongovernment) hospitals. The five most commonly provided services were imprest (a wordstock of frequently used medications that are regularly restocked by the pharmacy department), informal drug education for hospital staff, review of medication charts, control of drug purchasing, and inpatient dispensing. Review of medication charts and provision of drug education for the hospital staff were the most widely provided clinical pharmacy services. The most common services available from hospital pharmacies throughout Australia were imprest, informal drug education for hospital staff, review of medication charts, control of drug purchasing for the hospital, and inpatient dispensing.
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Affiliation(s)
- S G Wilson
- Department of Pharmacy Practice, Victorian College of Pharmacy, Monash University, Parkville, Australia
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24
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Tong N, Perry SW, Zhang Q, James HJ, Guo H, Brooks A, Bal H, Kinnear SA, Fine S, Epstein LG, Dairaghi D, Schall TJ, Gendelman HE, Dewhurst S, Sharer LR, Gelbard HA. Neuronal fractalkine expression in HIV-1 encephalitis: roles for macrophage recruitment and neuroprotection in the central nervous system. J Immunol 2000; 164:1333-9. [PMID: 10640747 DOI: 10.4049/jimmunol.164.3.1333] [Citation(s) in RCA: 156] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
HIV-1 infection of the brain results in chronic inflammation, contributing to the neuropathogenesis of HIV-1 associated neurologic disease. HIV-1-infected mononuclear phagocytes (MP) present in inflammatory infiltrates produce neurotoxins that mediate inflammation, dysfunction, and neuronal apoptosis. Neurologic disease is correlated with the relative number of MP in and around inflammatory infiltrates and not viral burden. It is unclear whether these cells also play a neuroprotective role. We show that the chemokine, fractalkine (FKN), is markedly up-regulated in neurons and neuropil in brain tissue from pediatric patients with HIV-1 encephalitis (HIVE) compared with those without HIVE, or that were HIV-1 seronegative. FKN receptors are expressed on both neurons and microglia in patients with HIVE. These receptors are localized to cytoplasmic structures which are characterized by a vesicular appearance in neurons which may be in cell-to-cell contact with MPs. FKN colocalizes with glutamate in these neurons. Similar findings are observed in brain tissue from an adult patient with HIVE. FKN is able to potently induce the migration of primary human monocytes across an endothelial cell/primary human fetal astrocyte trans-well bilayer, and is neuroprotective to cultured neurons when coadministered with either the HIV-1 neurotoxin platelet activating factor (PAF) or the regulatory HIV-1 gene product Tat. Thus focal inflammation in brain tissue with HIVE may up-regulate neuronal FKN levels, which in turn may be a neuroimmune modulator recruiting peripheral macrophages into the brain, and in a paracrine fashion protecting glutamatergic neurons.
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MESH Headings
- Adult
- Animals
- Astrocytes/immunology
- Brain/immunology
- Brain/metabolism
- Brain/pathology
- Cell Movement/immunology
- Cells, Cultured
- Chemokine CX3CL1
- Chemokines, CX3C/administration & dosage
- Chemokines, CX3C/biosynthesis
- Chemokines, CX3C/physiology
- Child
- Cytoplasm/metabolism
- Encephalitis, Viral/immunology
- Encephalitis, Viral/pathology
- Endothelium, Vascular/immunology
- Gene Products, tat/administration & dosage
- HIV Infections/immunology
- HIV Infections/pathology
- HIV Seronegativity/immunology
- HIV-1/immunology
- Humans
- Macrophage Activation/immunology
- Male
- Membrane Proteins/administration & dosage
- Membrane Proteins/biosynthesis
- Membrane Proteins/physiology
- Microglia/metabolism
- Microglia/pathology
- Monocytes/immunology
- Neurons/metabolism
- Neurons/pathology
- Neuroprotective Agents/pharmacology
- Platelet Activating Factor/administration & dosage
- Rats
- Rats, Sprague-Dawley
- Up-Regulation/immunology
- tat Gene Products, Human Immunodeficiency Virus
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Affiliation(s)
- N Tong
- Center for Aging and Developmental Biology, Program in Neurosciences, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
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Maggirwar SB, Ramirez S, Tong N, Gelbard HA, Dewhurst S. Functional interplay between nuclear factor-kappaB and c-Jun integrated by coactivator p300 determines the survival of nerve growth factor-dependent PC12 cells. J Neurochem 2000; 74:527-39. [PMID: 10646503 DOI: 10.1046/j.1471-4159.2000.740527.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Nerve growth factor (NGF) activates the transcription factors nuclear factor kappaB (NF-kappaB) and activator protein-1 (AP-1) in sympathetic neurons. Whereas NGF-inducible NF-kappaB is required for the survival of neurons, c-Jun has the ability to promote neuronal death. In this report, we have examined the effect of NGF withdrawal on c-Jun and NF-kappaB transcription factors in PC12 cells differentiated to a neuronal phenotype. We show that the withdrawal of NGF from these cultures results in de novo synthesis of c-Jun, increase in AP-1 activity, and down-regulation of NF-kappaB activity. To investigate how the signal transduction pathways activating c-Jun and NF-kappaB are differentially regulated by NGF, we performed transcriptional analyses. Expression of ReIA (NF-kappaB) suppressed the c-Jun-dependent transcription of c-jun, and this effect was reversed by overexpression of the coactivator p300. RelA's effects on c-Jun transcription were mediated by competitive binding of the carboxy-terminal region of RelA to the CH1 domain of p300, which also binds to c-Jun; deletion of this region abrogated the ability of RelA to inhibit c-Jun activity. Furthermore, the inhibition of endogenous NF-kappaB in NGF-maintained neuronal PC12 cells led to the induction of c-Jun synthesis and a marked increase in cell death. Together, these studies demonstrate a functional interaction between NF-kappaB and c-Jun and suggest a novel mechanism of NF-kappaB-mediated neuroprotection.
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Affiliation(s)
- S B Maggirwar
- Department of Microbiology and Immunology, University of Rochester Medical Center, New York 14642, USA.
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Tong N, Chen J, Huang H, Liang J. [A clinical study of sudden death in patients with type 2 diabetes mellitus]. Hua Xi Yi Ke Da Xue Xue Bao 1999; 30:331-3. [PMID: 12212301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
This study aimed to investigate the clinical characteristics of sudden death (SD) in type 2 diabetes mellitus (DM2). Clinical data from 1988 through 1996 in our hospital showed that 130 hospitalized patients with DM2 died, and 17 of them died of SD (13.08%). These 17 SD patients were pair-matched with 17 DM2 patients who were alive in the same period. The results revealed that the SD group had longer clinical DM duration, more chronic diabetic complications and higher blood pressure. In the direct causes of SD, cardiac SD accounted for 76.47%. The others were non-cardiac factors, including cerebral hemorrhage, hyperkalemia from diabetic nephropathy with renal failure and respiratory tract obstruction from lung infection. The triggering causes included eating, defecting, lung infection, strenuous attempt, hypoglycemia and surgical operation. To reduce the rate of SD in DM2, it is necessary and vital to treat the DM2 itself, and to take positive steps to prevent the onset of SD in high risk patients.
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Affiliation(s)
- N Tong
- Department of Endocrinology, First Affiliated Hospital, WCUMS, Chengdu 610041
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Maggirwar SB, Tong N, Ramirez S, Gelbard HA, Dewhurst S. HIV-1 Tat-mediated activation of glycogen synthase kinase-3beta contributes to Tat-mediated neurotoxicity. J Neurochem 1999; 73:578-86. [PMID: 10428053 DOI: 10.1046/j.1471-4159.1999.0730578.x] [Citation(s) in RCA: 141] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Human immunodeficiency virus type 1 (HIV-1) Tat induces neuronal apoptosis. To examine the mechanism(s) that contribute to this process, we studied Tat's effects on glycogen synthase kinase-3beta (GSK-3beta), an enzyme that has been implicated in the regulation of apoptosis. Addition of Tat to rat cerebellar granule neurons resulted in an increase in GSK-3beta activity, which was not associated with a change in protein expression and could be abolished by the addition of an inhibitor of GSK-3beta (lithium). Lithium also enhanced neuronal survival following exposure to Tat. Coprecipitation experiments revealed that Tat can associate with GSK-3beta, but direct addition of Tat to purified GSK-3beta had no effect on enzyme activity, suggesting that Tat's effects might be mediated indirectly. As the activation of platelet activating factor (PAF) receptors is critical for the induction of neuronal death by several candidate HIV-1 neurotoxins, we determined whether PAF can also activate GSK-3beta. Application of PAF to neuronal cultures activated GSK-3beta, and coincubation with lithium ameliorated PAF-induced neuronal apoptosis. These findings are consistent with the existence of one or more pathways that can lead to GSK-3beta activation in neurons, and they suggest that the dysregulation of this enzyme could contribute to HIV-induced neuronal apoptosis.
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Affiliation(s)
- S B Maggirwar
- Department of Microbiology and Immunology, University of Rochester Medical Center, New York 14642, USA
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Tong N, Xiao Y, Huang H, Wei S. [A pair-matched comparison and follow-up study of patients with euthytroid Graves ophthalmopathy and patients with hyperthyroid graves ophthalmopathy]. Hua Xi Yi Ke Da Xue Xue Bao 1999; 30:202-4, 207. [PMID: 12212060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
This study was intended to acquire a knowledge about the similarity and difference between euthyriod Graves ophthalmopathy (EGO) and hyperthyroid Graves ophthalmopathy (HGO), and about the outcome of the EGO cases. Twenty-seven EGO patients were pair-matched with 27 HGO patients, and 18 of the EGO patients were followed up for 1-6 years. The results showed that the EGO group had markedly more patients with diplopia, failure to close lids, limitation of eyeball movements, cornea involvement, and more patients with a difference of two eyes' exophthalmos degrees > or = 2 mm, but the HGO group had more patients with optic nerve involvement. No significant difference was found between the two groups' ophthalmopathic indexes by using the t-test. Drug therapy of the EGO group was more efficacious than that of the HGO group. The results of follow-up study showed that 61% of the EGO cases had hyperthyroidism and goiter within 5 months to 3 years, but 39% of the cases had no hyperthyroidism up to 6 years. These data suggest that EGO is associated with thyroid diseases and it can stand "alone" as an auto-immune disease.
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Affiliation(s)
- N Tong
- Department of Endocrinology, First Affiliated Hospital, WCUMS, Chengdu 610041
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Tong N, Nobusawa E, Morishita M, Nakajima S, Nakajima K. M protein correlates with the receptor-binding specificity of haemagglutinin protein of reassortant influenza A (H1N1) virus. J Gen Virol 1998; 79 ( Pt 10):2425-34. [PMID: 9780048 DOI: 10.1099/0022-1317-79-10-2425] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
From the reassortment experiments between A/Aichi/4/92 and A/WSN/33 (WSN) (H1N1) viruses, two different phenotype viruses which contained the haemagglutinin (HA) gene from A/Aichi/4/92 virus and the neuraminidase (NA) gene from WSN virus were obtained. PW13 and PW15 viruses agglutinated chicken red blood cells (CRBC), while PW10 and PW70 viruses did not. However, the expressed HA proteins of these viruses did not adsorb CRBC. The difference in gene constellation between PW13, PW15 and PW10, PW70 viruses was the membrane protein (M) gene. The former two had the M gene from A/Aichi/4/92 virus and the latter two had that from WSN virus. In PW15-infected cells, haemadsorption of CRBC was observed 30 min later than that of goose red blood cells and the M1 protein migrated from the nucleus to the cytoplasm 30 min earlier than adsorption of CRBC was observed. On the other hand, in PW10-infected cells, haemadsorption of CRBC was not observed through the virus replication and the M1 protein stayed in the nucleus after HA and NA activities reached maximum levels. Co-expression of the M and the HA proteins of A/Aichi/4/92 virus did not help the HA protein gain the ability to adsorb CRBC. However, neuraminidase treatment of COS cells expressing the HA protein of A/Aichi/4/92 virus or MDCK cells infected by PW10 virus restored the ability to adsorb CRBC. We discussed the possibility that the M1 protein helped the NA protein in its role to modify the HA protein on the cell surface.
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Affiliation(s)
- N Tong
- Department of Microbiology, National Institute of Public Health, Tokyo, Japan
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Tong N, Li Y, Liang J. [Changes of serum TNF-alpha level, t-PA activivty and PAI activity in patients with silent myocardial ischemia or silent cerebral ischemia]. Hua Xi Yi Ke Da Xue Xue Bao 1997; 28:81-3. [PMID: 10684070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Tumor necrosis factor-alpha (TNF-alpha) level, tissue-typed plasminogen activator(t-PA) activity and PA inhibitor (PAI) activity were determined in three groups: (1) 25 NIDDM patients with silent myocardial ischemia (SMI) or silent cerebral ischemia (SCI); (2) 18NIDDM patients without SMI or SCI; (3) 20 age-matched normal controls. Diagnosis of SMI or SCI was based on the finding of ischemic evidence by SPECT of myocardiotomograph or cerebrotomograph. All patients ECG and blood pressure were normal, and they had no history of clinical symptoms and signs of MI or CI. The result showed that the TNF-alpha level and PAI activity in the ischemia group were the highest and the t-PA activity in the ischemia group was the lowest, as compared with those in the other two groups respectively. It suggests that in NIDDM patients who have high TNF-alpha, high PAI activity, low t-PA, and even no symptoms and signs of MI or CI, anticoagulant therapy might be useful to prevent the progression of diabetic macroangiopathies.
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Affiliation(s)
- N Tong
- Department of Medicine, First Affiliated Hospital, Chengdu
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Wei S, Tong N, Luo Q, Tian H, Yu Y, Liu Y. [The effects of intensive DMPA regimen in the treatment of Graves' ophthalmopathy]. Hua Xi Yi Ke Da Xue Xue Bao 1996; 27:306-9. [PMID: 9389069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
35 patients with Graves' ophthalmopathy were treated with DMPA regimen which included dexamethasone (D) 20-30 mg and Methotrexate (M) 15-20 mg i.v. once a week and prednisone (P) 20 mg/d p. o. 4 times a week for 4 weeks followed by addition of azathioprine (A) or 6-MP 75-100 mg/d and the increment of prednisone (20 mg/d) to 5 times a week in the fifth and sixth weeks. The full intensive course of therapy lasted for 6 weeks. If necessary, the similar course of therapy might be repeated. Later on, each patient was mintainted on a therapy with P and A or P and 6-MP for another 1-2 months then the P and A or P and 6-MP for another 1-2 months, and then the P and A or 6-MP were tapered and finally discontinued at the end of sixth month. The symptoms and signs of the opthalmopathy were evaluated blindedly at the beginning and the end of the first and second courses of the therapy by two ophthalmologists. The results showed that the symptoms and signs were significantly improved in 33 (94.3%) cases. A decrease of eyeball protrusion of 1.22 +/- 1.15 and 1.28 +/- 1.15 mm in the left and right eyes respectively was shown by eophthalmometry reading (both P < 0.0005, compared with before and after the therapy). The decrease of exophthalmos was more remarkable in the cases with ophthalmopathy for < or = 1 year than that > 1 year. 11/22 patients recovered their ability to close eyes adequately. The diplopia was corrected in 8/15 cases. The mobility of eye ball returned to normal in 5/15 cases. Exposed lesion and/or ulceration of the cornea found in 7 patients were cured. Serious side and/or toxic effects of the drugs were not present during the course of therapy. It is suggested that DMPA regimen is an effective, safe and cheap approach to the treatment of Graves' ophthalmopathy.
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Affiliation(s)
- S Wei
- Department of Endocrinology, First Affiliated Hospital, Chengdu
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Tong N, Li H, Liang J. [Comparative analysis of clinical features of acute myocardial infarction in diabetic and non-diabetic patients]. Hua Xi Yi Ke Da Xue Xue Bao 1996; 27:314-6. [PMID: 9389071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We conducted match-control study to make a comparison between 20 diabetic and 20 non-diabetic patients in clinical features of acute myocardial infarction (AMI). There were 16 males and 4 females in each group. The mean age of diabetic group (DM) was 61.95 +/- 9.83 years, and that of non-diabetic group (NDM) was 61.45 +/- 9.38 years. We found the morbidity of silent myocardial infarction (MI) being 45% (DM) versus 10% (NDM); acute pulmonary edema being 40% (DM) versus 10% (NDM); cardiac shock, 35% (DM) versus 0% (NDM); arrhythmia, 70% (DM) versus 30% (NDM); the complication of cerebral infarction being 20% (DM) versus 0% (NDM); and complication of infection, 30% (DM) versus 10% (NDM). These revealed that DM had higher morbidity of silent MI and complications of AMI than NDM. Three diabetic patients had MI in two sites while one diabetic patient had myocardial remfarction, which showed DM had more serious damage in coronary artery than NDM. The mortality rate was 45% in DM and 15% in NDM. Multiple-organ functional failure was the main cause of death in DM.
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Affiliation(s)
- N Tong
- Department of Internal Medicine, First Affiliated Hospital, Chengdu
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Tong N, Nakajima K, Nakajima S. Identification of the sites for suppressor mutations on the hemagglutinin molecule to temperature-sensitive phenotype of the influenza virus. Microbiol Immunol 1995; 39:687-92. [PMID: 8577282 DOI: 10.1111/j.1348-0421.1995.tb03257.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A temperature-sensitive (ts) mutant of the influenza virus A/WSN/33 strain, ts-134, possessed a defect in intracellular transport at the nonpermissive temperature and marked thermolability of hemagglutinin (HA) activity at 51 C. These were caused by a change at amino acid residue 157 from tyrosine to histidine in the HA protein. We isolated 37 spontaneous revertant clones from ts-134 at the nonpermissive temperature and determined their HA sequences. The deduced amino acid sequences demonstrated that one was a true revertant and the others were revertants with suppressor mutations, each of which had an additional amino acid change besides those of ts-134. The changed amino acids were located at 14 positions on the HA molecule, and eight of them were found in multiple revertants. These were located in five to six distinct regions on the three-dimensional structure of the HA molecule. However, the heat stability of HAs in the revertants was recovered differently depending on the sites of the changed amino acids. The kinetics of transport of the HA protein in the revertants were slightly delayed compared to the wild-type both at permissive and nonpermissive temperatures.
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Affiliation(s)
- N Tong
- Department of Microbiology, Institute of Public Health, Tokyo, Japan
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Corvaia L, Li SC, Ioannides-Demos LL, Bowes G, Spicer WJ, Spelman DW, Tong N, McLean AJ. A prospective study of the effects of oral probenecid on the pharmacokinetics of intravenous ticarcillin in patients with cystic fibrosis. J Antimicrob Chemother 1992; 30:875-8. [PMID: 1289366 DOI: 10.1093/jac/30.6.875] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Li SC, Ioannides-Demos LL, Spicer WJ, Spelman DW, Tong N, McLean AJ. Prospective audit of an aminoglycoside consultative service in a general hospital. Med J Aust 1992; 157:308-11. [PMID: 1435470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To investigate the impact of the introduction of a consultative service on the use, efficiency of dosing and clinical toxicology of the aminoglycoside antibiotics, gentamicin and tobramycin, in a general hospital. METHODS Two audits were conducted six months and 18 months after the introduction of the consultative service. The audits reviewed the use of drug assay services, the adequacy of drug administration (as measured by serum antibiotic concentrations), indications for prescription, adverse outcomes (by noting markers of nephrotoxicity) and the antibiotic sensitivity of Gram-negative pathogens. The results were compared with the results of an audit conducted before the consultative service was instituted. RESULTS There was a significant (P < 0.001 by chi 2 test) increase in the use of assays, with drug assays performed in 67% (first audit) and 77% (second audit) of aminoglycoside courses compared with 48.2% in the pre-intervention audit. Sample timing was greatly improved, with more than 70% of the samples collected at the appropriate times. Assay wastage in terms of uninterpretable assay results decreased significantly (P < 0.001) from 42.9% of total assays to 6.3% at the first audit and 3.8% at the second audit. The percentage of assay results in the desirable range increased significantly (P < 0.001) from 39.1% to 71.9% (first audit) and 75.4% (second audit). Pharmacokinetic recommendations were made in 39.1% and 64% of all aminoglycoside courses during the first and second audits respectively, with clinician acceptance of dosage recommendations at 83.1% and 82.8% respectively. For aminoglycoside courses prescribed for therapeutic reasons, 97.9% (first audit, n = 325) and 98.6% (second audit, n = 280) of indications for use were judged as clinically appropriate. The incidence of suspected aminoglycoside-induced nephrotoxicity was reduced from 8.9% of patients to 1.6% (first audit, P < 0.001) and 2.4% (second audit). Bacterial sensitivity audits showed that the great majority of clinical isolates of target organisms (n = 3523, Year 1 and n = 3385, Year 2) were sensitive to gentamicin (92.2% and 91.5% respectively) and tobramycin (98.1% and 98.8% respectively); these aminoglycosides exceeded all alternative agents in effectiveness, including first and third generation cephalosporins. CONCLUSIONS The overall results indicate that introduction of the consultative service had a positive impact on the effective use of aminoglycosides, with a marked decrease in clinical toxicity. These influences were shown to persist for at least 18 months. The availability of reliable predictive techniques to reduce toxicity allows active promotion of aminoglycosides as the agents of choice on grounds of efficacy and economy.
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Affiliation(s)
- S C Li
- Alfred Hospital, Prahran, Vic
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Li SC, Bowes G, Ioannides-Demos LL, Spicer WJ, Hooper RE, Spelman DW, Tong N, McLean AJ. Dosage adjustment and clinical outcomes of long-term use of high-dose tobramycin in adult cystic fibrosis patients. J Antimicrob Chemother 1991; 28:561-8. [PMID: 1761450 DOI: 10.1093/jac/28.4.561] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A two-phase study was undertaken designed to investigate the impact of computer-aided drug monitoring on tobramycin concentrations and clinical outcomes in adult patients with cystic fibrosis. In phase one, a baseline (historical control) study of drug use patterns was performed. During the second phase, patients admitted for intravenous treatment with tobramycin for acute exacerbations of pseudomonal pulmonary infections were randomly allocated to one of two schedules. Group A patients had tobramycin dosage regimens decided by clinicians based on pre-existing protocols using serum tobramycin assay data determined three times weekly. Group B patients had dosage regimens determined by a computerized pharmacokinetic predictive program using both population-based pharmacokinetic parameter estimation and fitting of serum concentration-time data using Bayesian regression. The agreed therapeutic target was a peak serum tobramycin concentration of 8-10 mg/L and a trough concentration of 1-2 mg/L. There was a major difference between the two groups comparing the number of paired trough and peak concentrations within the target concentration ranges (group A-14%; group B-34.7%, chi 2 test, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S C Li
- Department of Clinical Pharmacology, Alfred Hospital, Prahran, Victoria, Australia
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Tong N, Liang J. [The effect of gemfibrozil on serum apo C II and C III in diabetic hyperlipidemia]. Hua Xi Yi Ke Da Xue Xue Bao 1991; 22:409-11. [PMID: 1814823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The effects of gemfibrozil on apolipoproteins C II and C III (apo C II, C III) were observed in 20 NIDDM hyperlipidemic patients. All of the patients continued their anti-diabetic treatment, gemfibrozil 900 mg/day for 4 weeks. The results revealed no significant change in fasting plasma glucose (FPG) and HbA1 before and after the study. But after the treatment with gemfibrozil, the following parameters changed significantly: total cholesterol (TC) decreased by 18.64% (P less than 0.01), total triglyceride (TG) decreased by 65.05% (P less than 0.001), VLDL-C decreased by 63.19% (P less than 0.001), HDL-C increased by 44.23% (P less than 0.001), apo C III decreased by 31.38% (P less than 0.02), and the ratio of apo C III/C II reduced by 35.49% (P less than 0.01). These findings suggest that gemfibrozil has excellent effect on decreasing apo C III and the ratio of apo C III/C II, thus facilitates the metabolism of chylomicron and decreases TG level in hyperlipidemic diabetic patients.
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Li SC, Ioannides-Demos LL, Spicer WJ, Berbatis C, Spelman DW, Tong N, McLean AJ. Prospective audit of aminoglycoside usage in a general hospital with assessments of clinical processes and adverse clinical outcomes. Med J Aust 1989; 151:224-32. [PMID: 2761465 DOI: 10.5694/j.1326-5377.1989.tb115996.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A comprehensive, multiphasic review of gentamicin and tobramycin utilization was undertaken with audits of the microbiological sensitivity of Gram-negative pathogens; indications for the prescription of aminoglycoside agents; the utilization of assay services; the adequacy of clinical drug delivery by measures of serum antibiotic levels; and the assessment of adverse outcomes by markers of nephrotoxicity. The great majority of clinical isolates of target organisms (n = 4208) was more sensitive to gentamicin (96%) and to tobramycin (99%) than to all alternative agents, including first- and third-generation cephalosporin agents. A review of the indications for the prescription of aminoglycoside agents by clinical criteria showed that in 85.6% of 278 documented cases, the choice of agent was appropriate by clinical and microbiological criteria. In a substantial (77.6%) proportion of the 511 patients who were receiving therapeutic courses of an aminoglycoside agent, serum drug assays had been performed. Assay data could not be interpreted adequately in 52.6% of 3079 assayed cases as a result of inadequate data on administration regimens (39.7%) or sampling regimens (12.9%). Where sampling was documented adequately, there was extreme variation (zero to five hours) in post-dose sampling. In only 33.2% of cases could it be concluded unambiguously that the patients were receiving safer, adequate therapy for clinically significant infections, 5.6% of patients were receiving potentially toxic doses, and 8.6% of patients showed suboptimal concentration profiles. The majority of potentially toxic levels were associated with adverse effects.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S C Li
- Amalgamated Alfred, Caulfield and Royal Southern Memorial Hospital, Alfred Campus, Prahran, Vic
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Ioannides-Demos LL, Horne MK, Tong N, Wodak J, Harrison PM, McNeil JJ, Gilligan BS, McLean AJ. Impact of a pharmacokinetics consultation service on clinical outcomes in an ambulatory-care epilepsy clinic. Am J Hosp Pharm 1988; 45:1549-51. [PMID: 3046349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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McMillan DA, Harrison PM, Rogers LJ, Tong N, McLean AJ. Polypharmacy in an Australian teaching hospital. Preliminary analysis of prevalence, types of drugs and associations. Med J Aust 1986; 145:339-42. [PMID: 3762460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A computer-based prescription retrieval system was used to study 21,521 prescriptions that had been provided to hospital patients who were receiving predominantly outpatient care. Over a three-month period 338 patients were found to be receiving 10 or more different drugs concomitantly. A further 338 patients were drawn at random from the same outpatient population for comparison. Age was linked significantly to polypharmacy (polypharmacy group: mean age, 63.7 years, SEM = 1.09; comparison group: mean age, 53.8 years, SEM = 1.00, P less than 0.05; chi 2 = 62.8, P less than 0.001). The relative risk of polypharmacy was related linearly to age. Admission to hospital was associated with increased prescribing rates in the polypharmacy sample (P less than 0.05), as was attendance at multiple clinics and multiple attendance at outpatient clinics (P less than 0.05 and P less than 0.05, respectively). Benzodiazepine agents were included in 63.7% of prescriptions in the polypharmacy group and in 37.3% of prescriptions in the comparison group. Non-prescription drugs were noted in 97.2% of prescriptions in the polypharmacy group and 58.0% of prescriptions in the comparison group, representing 34.7% and 27.3% of all items, respectively. In patients of less than 30 years of age agents for allergy/asthma/atopy contributed most to polypharmacy; agents that were associated with renal failure most in patients aged 31-50 years; and agents for cardiovascular disease contributed most in patients aged over 50 years. Our results suggest that a reduction in the use of non-prescription and psychotropic agents, heightened awareness of the dangers of polypharmacy and coordination and integration of over-all care and prescribing habits should reduce polypharmacy materially.
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Latgé JP, Fournet B, Cole G, Dubourdieu D, Tong N. Composition chimique et ultrastructure des parois des corps hyphaux et des azygospores de Conidiobolus obscurus. Can J Microbiol 1984. [DOI: 10.1139/m84-240] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The mycelial wall of Conidiobolus obscurus is essentially composed of β(1 → 3)-glucan (soluble in cold NaOH) associated with small amounts of protein and chitin. It is also characterized by the absence of galactose, uronic acids, and chitosan. The wall of the azygospore is different from that of the mycelium and is almost exclusively composed of a chitin–protein complex associated with a very small amount of hexoses. The mycelial wall is easily fractionated by cold or hot NaOH and hot acetic acid, whereas the spore wall is very resistant to both acid and alkali treatments. The composition of the various fractions is outlined. Chitin is present as short microfibrils while protein occurs in an amorphous form; β(1 → 3)-glucans are present in both amorphous and fibrillar forms. An architectural scheme of the mycelial and spore walls is proposed.
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McLean AJ, Barned J, Ioannides-Demos L, Nel D, Tong N, Mereer W, Wood T. Computer-based prescription audit as a research, educational and management tool. AUST HEALTH REV 1983; 7:260-8. [PMID: 10269944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
An existing dedicated pharmacy computer system (MIDAS system, Alfred Hospital and Health Computing Services, Victoria) used primarily for pharmacy labelling and dispensing, has been rewritten for an in-house minicomputer, with enhancements that allow it to be used in budgetary predictions, drug use monitoring, therapeutic audit and as a research tool. An automatically updated hard copy record of individual patient prescription profiles is generated and represents a valuable addition to the patient medical record. Allied to automatic "sorting" and retrieval techniques, all patients on nominated drugs can be identified and their records examined for particular combination use. Current application to assessment of nifedipine- beta blocker use will be presented, as will an application to cimetidine audit. Prescriptions can be scanned and segregated in terms of numbers of prescriptions in addition to segregation in terms of a particular therapeutic agent. Initial application to audit has detected an unacceptable level of polypharmacy (more than 26% of all prescriptions involve greater than or equal to 5 items and more than 3% involved greater than or equal to 10 items). Statistical information on the volume and unit cost of outpatient prescribing allows a precise estimate of ongoing budgetary commitments, while trends in discharge medication profiles allow a basis for prediction of budgetary trends, particularly with respect to the use of recent additions to the formulary. The system allows for expansion at minimal cost with potentially revolutionary applications, for example, interactive prescriber education if and when "on-line" capabilities are developed. Cross-linking with relevant data-bases will allow a major expansion of applied research into therapeutic drug use and its consequences.
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Abstract
Wound infection and isolation of anaerobic organisms before and after intravenous and rectal administration of metronidazole were studied in 24 505 surgical patients. In the 6303 patients who underwent "risk" surgery (bowel, biliary, gynaecological, or otolaryngological surgery) introduction of intravenous metronidazole was associated with a striking fall in wound infection and wound anaerobe isolation rates; and the changes were maintained when the majority of metronidazole used was in suppository form. In the 18 202 patients who underwent "clean" surgery (e.g., orthopaedic, ophthalmic, and plastic surgery) metronidazole use was associated with a small formulation-independent change in infection rate without change in anaerobe isolation rates. Without compromising clinical care the use of intravenous metronidazole can be limited to a minority of patients with special needs.
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Gan TE, Ellims PH, Tong N, Barned JM, Van der Weyden MB. Doxorubicin-associated delayed ventricular fibrillation in acute promyelocytic leukemia. Acta Haematol 1983; 69:52-5. [PMID: 6401894 DOI: 10.1159/000206839] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A 16-year-old schoolgirl presented with acute promyelocytic leukemia. 10 days after induction chemotherapy with doxorubicin and cytosine arabinoside together with heparinisation for the accompanying disseminated intravascular coagulopathy, she developed ventricular fibrillation. Following successful cardiac resuscitation a gated blood pool scan showed a left ventricular ejection fraction of 49%. Despite this event the patient was subsequently rechallenged with doxorubicin without any adverse cardiac effect. The exact mechanism for this delayed doxorubicin-associated cardiac arrhythmia is not clear, but electrolyte disturbance and heparin-doxorubicin interaction may have played a contributory role.
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McLean AJ, Ioannides-Demos L, Tong N, Mercer W, Barned J, Wood TJ. Audit and scientific management of drug use in an Australian teaching hospital. AUST HEALTH REV 1982; 5:12-5. [PMID: 10257300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Ioannides L, Somogyi A, Spicer J, Heinzow B, Tong N, Franklin C, McLean A. Rectal Administration of Metronidazole Provides Therapeutic Plasma Levels in Postoperative Patients. J Urol 1982. [DOI: 10.1016/s0022-5347(17)52836-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- L. Ioannides
- Clinical Pharmacology Laboratory, Baker Medical Research Institute; and Clinical Research Unit, Pharmacy Department, Bacteriology Department, and Monash University Department of Medicine, Alfred Hospital, Prahran, Melbourne, Australia
| | - A. Somogyi
- Clinical Pharmacology Laboratory, Baker Medical Research Institute; and Clinical Research Unit, Pharmacy Department, Bacteriology Department, and Monash University Department of Medicine, Alfred Hospital, Prahran, Melbourne, Australia
| | - J. Spicer
- Clinical Pharmacology Laboratory, Baker Medical Research Institute; and Clinical Research Unit, Pharmacy Department, Bacteriology Department, and Monash University Department of Medicine, Alfred Hospital, Prahran, Melbourne, Australia
| | - B. Heinzow
- Clinical Pharmacology Laboratory, Baker Medical Research Institute; and Clinical Research Unit, Pharmacy Department, Bacteriology Department, and Monash University Department of Medicine, Alfred Hospital, Prahran, Melbourne, Australia
| | - N. Tong
- Clinical Pharmacology Laboratory, Baker Medical Research Institute; and Clinical Research Unit, Pharmacy Department, Bacteriology Department, and Monash University Department of Medicine, Alfred Hospital, Prahran, Melbourne, Australia
| | - C. Franklin
- Clinical Pharmacology Laboratory, Baker Medical Research Institute; and Clinical Research Unit, Pharmacy Department, Bacteriology Department, and Monash University Department of Medicine, Alfred Hospital, Prahran, Melbourne, Australia
| | - A. McLean
- Clinical Pharmacology Laboratory, Baker Medical Research Institute; and Clinical Research Unit, Pharmacy Department, Bacteriology Department, and Monash University Department of Medicine, Alfred Hospital, Prahran, Melbourne, Australia
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Ioannides L, Somogyi A, Spicer J, Heinzow B, Tong N, Franklin C, McLean A. Rectal administration of metronidazole provides therapeutic plasma levels in postoperative patients. N Engl J Med 1981; 305:1569-70. [PMID: 7311996 DOI: 10.1056/nejm198112243052607] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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