Identification of status quo and association rules for chronic comorbidity among Chinese middle-aged and older adults rural residents

Background

Chronic comorbidity has become a major challenge in chronic disease prevention and control. This issue is particularly pronounced in rural areas of developing countries, where the prevalence of chronic disease comorbidity is high, especially among middle-aged and older adults populations. However, the health status of middle-aged and older adults individuals in rural areas of China has received inadequate attention. Therefore, it is crucial to investigate the correlation among chronic diseases to establish a reference basis for adjusting health policies aimed at promoting the prevention and management of chronic diseases among middle-aged and older adults individuals.

Methods

This study selected 2,262 middle-aged and older adults residents aged 50 years or older in Shangang Village, Jiangsu Province, China, as the study population. To analyze the chronic comorbidity of middle-aged and older adults residents with different characteristics, we used the χ² test with SPSS statistical software. Data analysis was conducted using the Apriori algorithm of Python software, set to mine the strong association rules of positive correlation between chronic disease comorbidities of middle-aged and older adults residents.

Results

The prevalence of chronic comorbidity was 56.6%. The chronic disease comorbidity group with the highest prevalence rate was the lumbar osteopenia + hypertension group. There were significant differences in the prevalence of chronic disease comorbidity among middle-aged and older adults residents in terms of gender, BMI, and chronic disease management. The Apriori algorithm was used to screen 15 association rules for the whole population, 11 for genders, and 15 for age groups. According to the order of support, the most common association rules of comorbidity of three chronic diseases were: {lumbar osteopenia} → {hypertension} (support: 29.22%, confidence: 58.44%), {dyslipidemia} → {hypertension} (support: 19.14%, confidence: 65.91%) and {fatty liver} → {hypertension} (support: 17.82%, confidence: 64.17%).

Conclusion

The prevalence of chronic comorbidity among middle-aged and older adults rural residents in China is relatively high. We identified many association rules among chronic diseases, dyslipidemia is mostly the antecedent, and hypertension is primarily the result. In particular, the majority of comorbidity aggregation patterns consisted of hypertension and dyslipidemia. By implementing scientifically-proven prevention and control strategies, the development of healthy aging can be promoted.

Clinical efficacy of palbociclib-based therapy in women with HR+/HER2- metastatic breast cancer in the real-world setting for Chinese women: a comparison with the IRIS study

OBJECTIVE

This retrospective study aimed to explore the clinical efficacy of palbociclib with endocrine therapy (ET) in women with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer in real-world practice.

PATIENTS AND METHODS

This retrospective study analyzed the medical records of patients to determine treatment outcomes. Progression-free survival (PFS) curves were generated using log-rank tests with the Kaplan-Meier method. Treatment outcomes in Chinese patients were compared with those in patients from the USA, Argentina, Canada, and Europe in the IRIS study.

RESULTS

In total, 69 patients were included in this study. The median PFS was 12.8 months (95% confidence interval: 10.1-15.5). A longer PFS was observed for patients with bone-only metastases, no liver metastases, no previous palliative chemotherapy, no previous palliative ET, and ET sensitivity. The overall response rate was 10.1%, and the clinical benefit rate was 78.3%. Nineteen patients (27.5%) received a reduced dose of palbociclib according to the decision of their physicians. Dose reduction did not affect the clinical efficacy of the combined treatment. Compared with those in the IRIS study, Chinese patients receiving palbociclib-based treatment were younger, and they had fewer bone-only metastases and more visceral and liver metastases. The clinical benefit rate and overall response rate for Chinese patients were lower than those observed for the patients in the IRIS study.

CONCLUSIONS

ET combined with palbociclib treatment was effective and well-tolerated in HR+/HER2- metastatic breast cancer patients in the real-world setting. Earlier use of palbociclib-ET was associated with more clinical benefits in HR+/HER2- metastatic breast cancer.

[Clinical characteristics of abdominal solitary fibrous tumor: an analysis of 18 cases]

Objective: To summarize the clinical manifestations, pathological features, diagnosis, and treatment of abdominal solitary fibrous tumor (SFT). Methods: The data of clinical manifestations, pathological features, diagnosis, and treatment of 18 patients with abdominal SFT admitted to Department of General Surgery, Peking Union Medical College Hospital between January 2000 and December 2016 were retrospectively reviewed. Results: Abdominal mass was first presented in 14 patients. The blood routine, liver, kidney, and coagulation function were normal in all the patients. Tumor markers were abnormal in 4 cases. Most SFT showed hypoechoic mass with regular shape under ultrasound. CT findings differed among the cases. All the 18 patients underwent surgical treatment, and the diagnosis was proved by the postoperative histopathology. SFT differed in general morphology. The positive rate of Ki-67, smooth muscle actin (SMA), CD34, and S-100 was high under immunohistochemistry. Conclusions: Early diagnosis of abdominal SFT is difficult, leading to a low preoperative diagnosis rate. Complete removal of the tumor is the only reliable method of radical treatment.

Next-generation sequencing of Chinese stage IV lung cancer patients reveals an association between EGFR mutation status and survival outcome

Large-scale genomic characterization of non-small cell lung cancer (NSCLC) has revealed several putative oncogenic driver mutations that may constitute druggable therapeutic targets. However, there are little data to suggest that such gene alterations have clinical relevance. Over 12 consecutive months, tumor biopsy samples from 80 patients with stage IV NSCLC were analyzed for mutations in selected exons of 508 cancer-related genes using next-generation sequencing. From 85 specimens referred for genomic characterization, 80 (94%) specimens were successfully genotyped, and all had identifiable somatic alterations. Epidermal growth factor receptor (EGFR) and TP53 genes contained the highest frequency of observed mutations (65% and 40%, respectively) in the stage IV NSCLC cases. Notably, patients with EGFR mutations showed a significantly shorter survival time compared with patients expressing wild-type EGFR (p = 0.0053). Moreover, of the 32 patients harboring EGFR mutations, EGFR-L858R mutant patients showed a significantly shorter survival time compared with patients with other EGFR mutations (p = 0.036). In conclusion, tumors from stage IV NSCLC patients harbor characteristic gene alterations, of which EGFR L858R in particular appears to be a poor prognostic factor for overall survival.

Myxoid leiomyosarcoma of the uterus: a case report and review of the literature

A para 1, 52-year-old female was admitted with complaints of irregular vaginal bleeding for the previous six months. Ultrasonography revealed a 4x6-cm tumor extending into the uterine cavity and cervical canal. On vaginal examination, a 2x2-cm tumor protruding from the cervical os was found, and an enlarged uterus was palpated. Vaginal intrauterine tumor resection was performed, and the patient was diagnosed with uterine myxoid leiomyosarcoma. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed, followed by postoperative chemotherapy. Twenty-one months after surgery, the patient died of tumor recurrence. Uterine myxoid leiomyosarcoma is an extremely rare variant of uterine sarcoma with a poor prognosis and malignant biological behavior.

DNA repair gene XRCC3 variants are associated with susceptibility to glioma in a Chinese population

The susceptibility to glioma is not well understood. It has been suggested that the X-ray cross complementing group 3 (XRCC3) gene influences the capacity to repair DNA damage, leading to increased glioma susceptibility. In this study, we evaluated the relationship between XRCC3 mutations and glioma risk. Genotypes were assessed in 389 Chinese glioma patients and 358 healthy controls. XRCC3 Thr241Met (rs861539) and 2 additional polymorphisms, rs3212112 (c.774+19T>G) and rs1799796 (c.562-14A>G), were directly sequenced. The frequency of the rs861539 T allele was significantly lower in the glioma group than in healthy controls [11.1 vs 17.7%, odds ratio = 0.62 (0.48-0.80), P < 0.001]; the frequencies of the CT or CT+TT genotypes differed between groups (18.5 vs 31%, 20.3 vs 33.2%, respectively). The frequency of the rs3212112 G allele was significantly higher in the glioma group than in healthy controls [15.8 vs 5.3%, odds ratio = 2.94 (2.07-4.17), P < 0.001]. The frequencies of the GT or TG+GG genotypes differed between groups (25.4 vs 7.8%, 28.5 vs 9.2%, respectively). This study demonstrates that the rs861539 and rs3212112 polymorphisms in the XRCC3 gene may influence the risk of glioma development in Chinese populations.

IL-6 secreted by cancer-associated fibroblasts induces tamoxifen resistance in luminal breast cancer

Cancer-associated fibroblasts (CAFs) have been implicated in the development of resistance to anticancer drugs; however, the role and mechanism underlying CAFs in luminal breast cancer (BrCA) tamoxifen resistance are unclear. We found that stromal fibroblasts isolated from the central or peripheral area of BrCA have similar CAF phenotype and activity. In vitro and in vivo experiments showed that CAFs derived from clinical-luminal BrCAs induce tamoxifen resistance through decreasing estrogen receptor-α (ER-α) level when cultured with luminal BrCA cell lines MCF7 and T47D. CAFs promoted tamoxifen resistance through interleukin-6 (IL-6) secretion, which activates Janus kinase/signal transducers and activators of transcription (JAK/STAT3) and phosphatidylinositol 3-kinase (PI3K)/AKT pathways in tumor cells, followed by induction of epithelial-mesenchymal transition and upregulation of E3 ubiquitin ligase anaphase-promoting complex 10 activity, which targeted ER-α degradation through the ubiquitin-proteasome pathway. Inhibition of proteasome activity, IL-6 activity or either the JAK/STAT3 or PI3K/AKT pathways markedly reduced CAF-induced tamoxifen resistance. In xenograft experiments of CAFs mixed with MCF7 cells, CAF-specific IL-6 knockdown inhibited tumorigenesis and restored tamoxifen sensitivity. These findings indicate that CAFs mediate tamoxifen resistance through IL-6-induced degradation of ER-α in luminal BrCAs.Oncogene advance online publication, 9 June 2014; doi:10.1038/onc.2014.158.

Tat-modified leptin is more accessible to hypothalamus through brain-blood barrier with a significant inhibition of body-weight gain in high-fat-diet fed mice

Obesity in human was found mainly due to the poor transportation of leptin through brain-blood barrier (BBB), called as leptin resistance. To produce a leptin capable of penetrating BBB, we have added Tat-PTD(9) to the C terminal of leptin to construct a fusion protein. The fusion Tat-leptin and native leptin genes were synthesized by single-step insertion of a polymerase chain reaction and expressed in Escherichia coli BL21 (Rosseta). The expressing products were purified and renatured by Ni-NTA affinity chromatography, and identified by the molecular size in SDS-PAGE gel and by its immunoreactivity to specific antibody with Western-blotting assay. To bio-functionally evaluate the fusion protein, Balb/c mice fed with high-fat diet (HFD) were given Tat-leptin, leptin or saline for 19 days. The immunohistochemical staining showed the increases in positive stains for the leptin in the region of hypothalamus of the HFD mice with either Tat-leptin or leptin as compared to saline group, but the staining intensity and frequency in the group with Tat-leptin were stronger and higher than those in the group with leptin. Furthermore, the most efficiency in preventing the body-weight gain caused by HFD was found in Tat-leptin group among these three groups. These results suggest that Tat-modified leptin may become a great potential candidate for the prevention or therapy of obese patients.

Sensitive biomarker of polycyclic aromatic hydrocarbons (PAHs): urinary 1-hydroxyprene glucuronide in relation to smoking and low ambient levels of exposure

The study was conducted in a Chinese population with occupational or environmental exposures to polycyclic aromatic hydrocarbons (PAHs). A total of 106 subjects were recruited from coke-oven workers (workers), residents in a metropolitan area (residents) and suburban gardeners (gardeners). All subjects were monitored twice for their personal exposures to PAHs. The biological samples were collected for measurements of 1-hydroxypyrene (1-OHP) and cotinine in urine. The geometric means of personal exposure levels of pyrene, benz(a)anthracene (BaA) and benzo(a)pyrene (BaP) in workers were 1.470, 0.978 and 0.805 microg m-3, respectively. The corresponding levels in residents were 0.050, 0.034 and 0.025 microg m-3; and those in gardeners were 0.011, 0.020 and 0.008 microg m-3, respectively. The conjugate of 1-OHP with glucuronide (1-OHP-G) is the predominant form of pyrene metabolite in urine and it showed strong associations with exposures not only to pyrene, but also to BaA, BaP and total PAHs. Most importantly, a significant difference in 1-OHP-G was even detected between the subgroups with exposures to BaP at < 0.010 and > 0.010 but < 0.020 microg m-3, suggesting that 1-OHP-G is a good marker that can be used for the risk assessment of BaP exposure at levels currently encountered in ambient air. Furthermore, multiple regression analyses of 1-OHP-G on PAHs exposure indicated that cigarette smoke was a major confounding factor and should be considered and adjusted for while using 1-OHP to estimate PAHs exposure.

Clinicopathological features, post-surgical survival and prognostic indicators of elderly patients with hepatocellular carcinoma

AIM

Comprehensive data regarding elderly patients with hepatocellular carcinoma (HCC) were limited. The present study aims to widen the knowledge based on patients in China.

METHODS

Fifty-four elderly (> or =65 years) and 125 non-elderly HCC patients undergoing hepatectomy were enrolled in this retrospective study. Clinicopathological features and post-surgical survival were compared between two groups. Prognostic indicators of elderly patients were defined by uni- and multivariate analyses.

RESULTS

Contrast to non-elderly patients, the elderly presented significantly lower rates of HBsAg positivity, Child-Pugh grade A, alpha-fetoprotein (AFP) marked elevation, portal vein tumour thrombosis (PVTT), satellite nodule, and intrahepatic recurrence, smaller tumour sizes, earlier TNM staging and better histological differentiation. No significant differences were found in perioperative mortality rate and post-surgical survival between two groups. PVTT and Edmondson-Steiner grading were identified as independent prognostic indicators of both overall and disease-free survival by multivariate analysis, whereas Child-Pugh grading independently affected the overall survival.

CONCLUSIONS

HCC in the elderly seemed to be less HBV-associated, less progressive and less aggressive than that in the non-elderly. Hepatectomy for the elderly could make a satisfactory prognosis and be well tolerated. Some tumour-related factors independently predict the prognosis of elderly HCC patients, and their liver function status should be further valued.

Osteoblast-like cells complete osteoclastic bone resorption and form new mineralized bone matrix in vitro

Bone remodeling involves old bone resorption by osteoclasts and new bone formation by osteoblasts. However, the precise cellular mechanisms underlying these consecutive events remain obscure. To address this question in vitro, we have established a cell culture model in which the resorption lacunae are first created by osteoclasts and osteoblast-like cells accomplish the subsequent bone formation. We isolated osteoclasts from rat bone marrow and cultured them on bovine bone slices for 48 hours to create resorption lacunae. After removing osteoclasts, confluent differentiated primary osteoblast cultures were trypsinized and the cells were replaced on the resorbed bone slices for up to 14 days. The cultures were then examined by confocal microscopy, field emission scanning electron microscopy (FESEM), and transmission electron microscopy (TEM). Our data suggest that after osteoclastic bone resorption, osteoblast-like cells, not macrophages, remove the remaining organic matrix in the lacuna. After cleaning the lacuna, osteoblast-like cells deposit new collagen fibrils at the bottom of the lacuna and calcify the newly formed matrix only, as visualized by labeled tetracycline accumulation merely in the lacuna during the osteoblast culture. Furthermore, an electron-dense layer rich in osteopontin separates the old and new matrices suggesting formation of the cement line. Since the morphology of the newly formed matrix is similar to the natural bone with respect to the cement line and osteoid formation as well as matrix mineralization, the present method provides for the first time a powerful in vitro method to study the cellular mechanisms leading to bone remodeling also in vivo.

[A survey of Echinococcus granulosus infection in Camelus bactrianus in north Xinjiang]

AIM

To determine the situation and characteristics of Echinococcus granulosus infection in camels (Camelus bacterianus) in our country.

METHODS

The camels slaughtered in abattoir were examined for visceral infection of larval cestode of Echinococcus. The number and diameter of cysts were recorded and the content of cysts were examined microscopically to detect the protoscoleces.

RESULTS

185 out of 375 camels were positive, the infection rate was 49.3%. The metacestodes parasitized mainly in the liver and lung, the ratio between liver and lung involved was 1:0.64. The fertile cyst rate was 39.2%, the fertile cyst-carrying rate of camels was 34.8%, the cyst index was 7.53. The cyst wall was relatively thin and the cysts located singly on the surface of liver. There was no daughter cyst seen in fertile cysts. The average diameter of fertile cysts was 5.6 +/- 2.65 cm in liver and 4.83 +/- 2.03 cm in lung. The percentage of animals harboring calcified cysts was 64.3%.

CONCLUSION

The infection rate of metacestodes of Echinococcus granulosus in Bactrian camel was very high in north Xinjiang and the characteristics of infection differ in some aspects from the local sheep and cattle and from dromedaries in Africa as well. Further study is needed to elucidate the significance of the infection of E. granulosus in Bactrian camels.

Inheritance of alleles for glutelin alpha-2 subunit genes in rice and identification of their corresponding cDNA clone

Rice glutelins consist of acidic (alpha) and basic (beta) subunits which are further separated into three polypeptide components assigned as alpha-1, alpha-2, and alpha-3 subunit components and beta-1, beta-2 and beta-3 subunit components. Nine rice mutant lines with a decreased amount of the glutelin alpha-2 subunit component (alpha-2L) were obtained by screening about 6,800 potential mutant lines derived from the fertilized egg treatment with N-methyl-N-nitrosourea (MNU) using the SDS-PAGE method. The mutants were classified into three types of the increased alpha-1 subunit (alpha-1H/alpha-2L), the decreased beta-2 subunit (beta-2L/alpha-2L) and the increased alpha-3 subunit (alpha-3H/alpha-2L) represented by EM278, CM1707 and EM659, respectively. Iso-electric focus (IEF) analysis revealed that all of the mutants had an extremely low amount of a polypeptide with a 6.71 pI value, whereas a polypeptide with either a 6.50 pI value or with a 6.90 pI value increased significantly in alpha-1H/alpha-2L mutants or in alpha-3H/alpha-2L mutants, respectively. The beta-2L/alpha-2L mutants had a decreased amount of a basic polypeptide with a 8.74 pI value. Genetic analysis revealed that the three types of mutants were controlled by a single incomplete dominant gene respectively, and the three are alleles. The gene was temporarily named glu4, which was found to be located on chromosome 1 linked with the eg and spl6 genes. Two-dimensional electrophoresis analysis revealed that the glu4 encoded polypeptides of pI 6.71/alpha-2 and pI 8.74/beta-2. Amino acid sequence analysis suggested that the mutated acidic polypeptide was the product of a GluA subfamily gene. Northern and RT-PCR analyses revealed that glu4 corresponded to the GluA-1 gene.

[Investigation on the mechanics of adhesion to the selective extracellular matrix coated surfaces of lung cancer cells]

The adhesion properties of tumor cells with extracellular matrix(ECM) are closely associated with their invasion and metastasis. Our work reported here was intended reveal the relevant biomechanical and biorheological manifestations of human lung cancer. Using micropipette aspiration technique, we investigated quantitatively the adhesive mechanics properties of high metastatic human giant cell carcinoma(PG) cells as well as low metastatic adenocarcinoma(PAa) cells of lung based on cell culture in vitro. The results showed that the adhesion forces of PAa and PG cells to collagen IV were significantly higher than those to glass surfaces, but at the lower concentrations(1.00 microgram/ml and 2.00 micrograms/ml) of collagen IV, the amplitude for the increase of adhesion forces of PG cells were less than the amplitude for that of PAa cells, and most of the adhesion force values of PAa cells to the coated surfaces of incorporation of laminin along with 2 micrograms/ml collagen IV were significantly greater than those of PG cells. At the lower concentrations(0.625 microgram/ml for PAa cells, and 0.625 microgram/ml, 1.25 micrograms/ml for PG cells) of laminin tested, the adhesion force values of PAa and PG cells all decreased, but the amplitude and level for the decreased values of adhesion forces of PG cells were greater than those for the PAa cells. In conclusion, the adhesive and proteolytic behaviour of cancer cells to extracellular matrix might be mediated mainly by tumor cell membrane receptors such as integrin receptors and laminin receptors, it might affect the biological characteristics and the metastasis of the tumor cells. The results may benefit to explain some questions in biomechanical views about how the highly metastatic PG cells are prone to migration and invasion.

Exploring the structure and function of the P-glycoprotein multidrug transporter using fluorescence spectroscopic tools

P-glycoprotein is an ABC protein that functions as an efflux pump for multiple drugs, natural products and peptides. It is proposed to operate as a hydrophobic vacuum cleaner, expelling non-polar compounds from the membrane bilayer to the exterior, driven by the energy of ATP hydrolysis. The nucleotide-binding domains of P-glycoprotein appear to operate by an alternating sites mechanism to power drug transport. In recent years, purification and functional reconstitution of the protein has allowed the application of fluorescence spectroscopic techniques. This approach has led to insights into the structural architecture of the P-glycoprotein molecule, and a more detailed understanding of the way in which it interacts with nucleotides and drugs.

FRET analysis indicates that the two ATPase active sites of the P-glycoprotein multidrug transporter are closely associated

Members of the ABC superfamily carry out the transport of various molecules and ions across cellular membranes, powered by ATP hydrolysis. Substantial evidence indicates that the two catalytic sites of the nucleotide binding domains function in a highly cooperative, alternating sites mode, which suggests the possibility that they interact with each other physically. In this study, fluorescence energy transfer experiments were used to estimate the distance between two fluors, each covalently linked to a highly conserved Cys residue (Cys428 and Cys1071) within the Walker A motif of the catalytic site. The vanadate.ADP.Mg(2+) complex was trapped in one catalytic site of membrane-bound or highly purified P-glycoprotein, and the other site was labeled with MIANS [2-(4'-maleimidylanilino)naphthalene-6-sulfonic acid]. Following loss of the trapped vanadate complex, the newly vacant site was then labeled with NBD-Cl (7-chloro-4-nitrobenzo-2-oxa-1,3-diazole). The fluorescence properties of the singly labeled P-glycoproteins showed that no energy transfer occurred between MIANS (the donor) and NBD (the acceptor) when they were simply mixed together. On the other hand, the fluorescence emission of the MIANS group in doubly labeled P-glycoprotein was highly quenched as a result of energy transfer to NBD, leading to an estimate of a donor-acceptor separation distance of approximately 16 A for P-glycoprotein labeled in the native plasma membrane and approximately 22 A for P-glycoprotein labeled in detergent solution. The separation of the two fluorophores is compatible with the recently reported crystal structure of the Rad50cd dimer, but not with that of the HisP dimer. These results suggest that the two catalytic sites of the P-glycoprotein nucleotide binding domains are relatively close together, which would facilitate cooperation between them during the catalytic cycle.

[The effect of vinblastine on the viscoelastic properties of lung cancer cells]

BACKGROUND

To explore the effect of vinblastine on the viscoelastic properties of highmetastatic human giant cell carcinoma cells ( PC) and low metastatic adenocarcinoma cells (PAa) of the lung and its biomechanical mechanisms.

METHODS

The viscoelastic properties of PG and PAa cells and their changes after treated with vinblastine (VCR, 0. 10-2. 00Lg/ml) were detected by micropipette aspiration technique. Viscoelasticity was analyzed by the special three-element standard linear solid model.

RESULTS

Before treated with VCR, the elastic coefficients K1 and K2 as well as viscous coefficient L of PAa were significantly higher than those of PG cells. The values of K1, K2 and L of PAa cells decreased along with the increase of VCR concentration. However, the viscoelastic coefficient values in PG cells decreased when the VCR concentration was lower than 1. 00Lg/ml and then turned to increase as concentration of VCR went on increasing. The microtubules and microfilaments were sparse random in the PAa cells and diminished in PG cells. After treated with VCR, they were cut down seriously in PAa cells, and manifestations of mitotic arrest of cell cycle increased unusually in PG cells.

CONCLUSIONS

The cytoskeleton structure component changes are related to the viscoelasticity of the tumor cells. The anti-neoplasm actions of cytoskeleton interferents such as VCR might be realized by mainly regulating the message of tumor cells growth and differentiation.

Validation of biomarkers in humans exposed to benzene: urine metabolites

BACKGROUND

The present study was conducted among Chinese workers employed in glue- and shoe-making factories who had an average daily personal benzene exposure of 31+/-26 ppm (mean+/-SD). The metabolites monitored were S-phenylmercapturic acid (S-PMA), trans, trans-muconic acid (t,t-MA), hydroquinone (HQ), catechol (CAT), 1,2, 4-trihydroxybenzene (benzene triol, BT), and phenol.

METHODS

S-PMA, t,t-MA, HQ, CAT, and BT were quantified by HPLC-tandem mass spectrometry. Phenol was measured by GC-MS.

RESULTS

Levels of benzene metabolites (except BT) measured in urine samples collected from exposed workers at the end of workshift were significantly higher than those measured in unexposed subjects (P < 0.0001). The large increases in urinary metabolites from before to after work strongly correlated with benzene exposure. Concentrations of these metabolites in urine samples collected from exposed workers before work were also significantly higher than those from unexposed subjects. The half-lives of S-PMA, t,t-MA, HQ, CAT, and phenol were estimated from a time course study to be 12.8, 13.7, 12.7, 15.0, and 16.3 h, respectively.

CONCLUSIONS

All metabolites, except BT, are good markers for benzene exposure at the observed levels; however, due to their high background, HQ, CAT, and phenol may not distinguish unexposed subjects from workers exposed to benzene at low ambient levels. S-PMA and t,t-MA are the most sensitive markers for low level benzene exposure.

[The inhibitory effect of bcl-2 antisense oligodeoxynucleotide/RNA on the growth of cervical carcinoma in vitro]

OBJECTIVE

To study the therapeutic effect of bcl-2 antisense oligodeoxynucleotide (ODN)/RNA human cervical carcinoma in vitro.

METHODS

To transfect bcl-2 antisense ODN/RNA into Hela cells with antisense technology and observe the growth and apoptotic modulation of Hela cells.

RESULTS

The expression of bcl-2 protein and mRNA was higher in Hela cells; the bcl-2 specific antisense ODN significantly decreased bcl-2 protein expression and inhibit the growth of Hela cells. The strongest inhibitory effect was at 24 hours after transfection, the optimal concentration of antisense ODN was 10 micromol/L. The results indicated that the inhibitory effect of bcl-2 antisense ODN on cell growth and survival rate is dose dependent; the recombinant retroviral vector pDOR-AB can transfer antisense bcl-2 gene into the genome of Hela cells, bcl-2 protein and mRNA expressions were significantly decreased after transfected, it demonstrated bcl-2 antisense RNA can significantly inhibit the growth of Hela cells and induce their apoptosis.

CONCLUSION

The results demonstrate the feasibility of bcl-2 gene as a target for antisense gene therapy of human cervical carcinoma and provide the theoretical foundation and experimental evidence for further study in vivo.

Selective estrogenic effects of a novel triphenylethylene compound, FC1271a, on bone, cholesterol level, and reproductive tissues in intact and ovariectomized rats

FC1271a is a novel triphenylethylene compound with a tissue-selective profile of estrogen agonistic and weak antagonistic effects. It specifically binds to the estrogen receptor alpha and beta with affinity closely similar to that of toremifene and tamoxifen. To study the in vivo effects of the compound, 4-month-old rats were sham operated (sham) or ovariectomized (OVX) and treated daily for 4 weeks with various doses of FC1271a or vehicle (orally). FC1271a was able to oppose OVX-induced bone loss by maintaining the trabecular bone volume of the distal femur. Accordingly, the OVX-induced loss of bone strength was prevented at doses of 1 and 10 mg/kg. FC1271a also prevented the OVX-induced increase in serum cholesterol in a dose-dependent manner. No significant changes in uterine wet weight or morphology were observed in the OVX-rats treated with 0.1 or 1 mg/kg FC1271a, but at a dose of 10 mg/kg it had a slightly estrogenic effect. In immature rats the effect of FC1271a on uterine wet weight was less stimulatory than that of toremifene or tamoxifen, but more stimulatory than that of raloxifene or droloxifene. The appearance of the dimethylbenzanthracene (DMBA)-induced mammary tumors was inhibited by treatment of DMBA-treated rats with FC1271a in a dose-dependent manner. In human MCF-7 breast cancer cell tumors raised in nude mice in the presence of estrogen, the growth and expression of pS2 marker gene could not be maintained after estrogen withdrawal by treatment with FC1271a. No formation of DNA adducts was observed in the liver of the FC1271a-treated rats. In conclusion, the bone-sparing, antitumor, and cholesterol-lowering effects of FC1271a combined with a low uterotropic activity and lack of liver toxicity indicate that FC1271a could be an important alternative in planning antiosteoporosis therapy for estrogen deficiency.

Conditioned medium of estrogen-treated osteoblasts inhibits osteoclast maturation and function in vitro

The increase of bone resorption and reduction of bone mass in postmenopausal women can be prevented by treatment with estrogen. Although it is well established that estrogen treatment normalizes the increased bone turnover, the mechanism by which estrogen exerts its protective influence at the cellular and molecular level in bone remains elusive. It has been shown that osteoblasts are involved in osteoclast development and osteoclastic bone resorption. In this work we examine the effect of estrogen (E2) on osteoclast-mediated bone resorption via the medium conditioned by osteoblast cultures. The conditioned medium collected from osteoblast cultures without (CM) or with 0.1 nmol/L 17beta-estradiol (E-CM) was mixed in a 1:1 ratio with fresh osteoclast culture medium. Osteoclasts were isolated from the bone marrow of 3-day-old NMRI mice and cultured on bovine bone slices. The total number of multinucleated tartrate-resistant alkaline phosphatase (TRAP)-positive cells in cultures with CM and E-CM was similar to that of cells incubated in control medium. However, the number of osteoclasts containing more than three nuclei was significantly smaller in the cultures containing E-CM. The total area of resorption was only slightly decreased in cultures containing CM, but was markedly inhibited in cultures with E-CM. In osteoblast cultures, the production of interleukin (IL)-1 and IL-6, but not of TNF-alpha, was reduced by 0.1 nmol/L E2. Our data suggest that E2 treatment of osteoblasts decreases the production of factor(s) that induces osteoclast differentiation to multinucleated cells with a higher capacity for bone resorption.

Comparative effects of estrogen and antiestrogens on differentiation of osteoblasts in mouse bone marrow culture

Estrogens as well as some antiestrogens have been shown to prevent bone loss in postmenopausal women. These compounds seem to inhibit bone resorption, but their anabolic effects have been less explored. In this study, bone marrow cultures were used to compare the effect of 17beta-estradiol (E2), and two triphenylethylene derivatives, tamoxifen (TAM), and FC1271a, and a benzothiophene derivative raloxifene (RAL) on differentiation of osteoblasts. All enhanced osteoblastic differentiation of 21-day cultures as indicated by increased mineralization and bone nodule formation. All, except RAL, stimulated cell proliferation during the first 6 days of the culture. However, in the presence of RAL the content of total protein was increased in 13-day cultures. SDS-PAGE and autoradiography of [14C]-proline labeled proteins revealed elevated level of the newly synthesized collagen type I. The pure antiestrogen ICI 182,780 abolished the increase of the specific activity of alkaline phosphatase by E2, TAM, and FC1271a but not the effect of RAL on protein synthesis. Our results show that E2 as well as TAM, FC1271a, and RAL stimulate bone formation in vitro but the mechanism of the anabolic action of RAL in bone clearly differs from that of E2, TAM, and FC1271a.

[ICAM-1 and HLA-DR expression in bronchial epithelial cells from patients with chronic obstructive pulmonary disease]

OBJECTIVE

To study the expression of adhesion molecules in epithelial cells from patients with COPD.

METHOD

The expression of ICAM-1 and HLA-DR in airway epithelial cells from 10 COPD patients, 7 asthmatic patients, 9 chronic bronchitis patients, and 10 healthy volunteers was evaluated using immunohistochemistry techniques. The cells were stained and analysed microscopically.

RESULT

The percentage of neutrophils in brushing cells from COPD(0.04) were significantly higher than those from asthma(0.01) and normal subjects (0.01). More goblet cells were found in COPD (mean 0.13) and chronic bronchitis (mean 0.11) as compared with asthma (0.03) and healthy volunteers. As to the expression of ICAM-1 in COPD, the percentage of cells expressing ICAM-1(15%) significantly increased in comparison with chronic bronchitis (6.28% P < 0.05), healthy volunteer(1.8%, P < 0.05), and asthma (8.8%, P > 0.05). The score of expression of ICAM-1 in COPD was significantly higher than those in asthma (P < 0.05), chronic bronchitis (P < 0.05) and normal subjects (P < 0.001). As to the expression of HLA-DR in COPD, the percentage of cells expressing HLA-DR(5.9%) significantly increased in comparison with normal subjects (0.6% P < 0.05), but there was no significant difference among COPD, asthma and chronic bronchitis. The score of expression of HLA-DR in COPD was significantly higher than those in healthy volunteers (P < 0.001), chronic bronchitis (P < 0.001) and asthma (P < 0.05). In addition, the percentage of neutrophils in brushing cells from COPD significantly correlated with the expression of ICAM-1 (r = 0.81, P < 0.01).

CONCLUSION

Upregulation of ICAM-1 in epithelial cell from COPD correlates with the neutrophil infiltration in COPD. Lymphocytes are in an active state in COPD and the use of brush biopsies of the bronchial epithelium may serve as a diagnostic tool for differentiation among COPD, chronic bronchitis and asthma.

Estrogen enhances differentiation of osteoblasts in mouse bone marrow culture

The effects of estrogen on bone are possibly mediated by several cell types. In the present study, the effect of 17beta-estradiol (E2) on osteoblast-like cells was investigated by using mouse bone marrow cultures. Bone marrow cells were harvested from the shafts of femurs of 10-week-old NMRI mice and cultured. On day 6, confluent primary cultures were trypsinized and subcultured. Under the conditions used (Keila, S., Pitaru, S., Grosskopf, A., and Wernreb, M. Bone marrow from mechanically unloaded rat bones expresses reduced osteogenic capacity in vitro. J Bone Miner Res 9:321-327; 1994), the bone marrow cultures showed differentiation towards the osteoblastic phenotype. This was demonstrated by the appearance of osteoblastic markers such as alpha1(I) collagen (COL1), alkaline phosphatase (ALP), osteocalcin (OCN), osteopontin (OP), and transforming growth factor-beta1 (TGFbeta1), which were detected by using reverse transcriptase polymerase chain reaction (RT-PCR). Bone nodule formation, including deposition of collagen fibers and matrix mineralization, was also studied at several time points of the 3-week culture period. The effect of E2 on the appearance of osteoblastic markers was studied by incubating cultures in the presence or absence of the hormone. The messenger ribonucleic acid (mRNA) for the estrogen receptor (ER) was found to be expressed at all time points as demonstrated by RT-PCR. When grown with E2, the rate of cell proliferation was increased in the early phase of cultures, but not after day 6. The addition of E2 in subcultures resulted in an increase of levels of mRNA for COL1, ALP, OCN, OP, and TGF-beta1. ALP activity was also increased. Bone nodule formation, as well as calcium contents, were significantly increased in the cultures grown in the presence of E2. All E2 concentrations used (0.01-10 nmol/L) were effective but the maximum response was obtained with 0.1 nmol/L E2. Addition of the antiestrogen ICI 182,780 abolished the E2-induced stimulation of proliferation and later an increase in ALP activity. Addition of ICI 182,780 without the hormone did not cause any changes when compared to control cultures. In conclusion, our results demonstrate that E2 stimulates sequential differentiation of osteoblasts and increases deposition and mineralization of matrix in mouse bone marrow cultures in an estrogen receptor-dependent manner.

[Characteristics of development and morphology of Echinococcus granulosus of camel origin in north Xinjiang]

AIM

To study the characteristics of development and morphology of E. granulosus of camel origin in north Xinjiang.

METHODS

Six dogs were infected with protoscolices and then purged with arecoline at days 35 and 45 p.i.

RESULTS

Six dogs were heavily infected, the worm burden were 14,780 to 135,900 at days 35 and 45 p.i. At day 35 p.i. 77% of the had developed three segments, 10% contained mature eggs with fully developed "thickshelled" embryophores. Morphological studies revealed the following characteristics for 35-day-old worms; the mean length of the terminal segment accounted for 56% of the total worm length; the position of the sexually mature segment was always terminal (77%); the female reproductive system possessed an enlongated ovary with compact lobules; the Mehlis gland was covered by the vitelline gland and the testes were distributed throughout the segment arranging in a row posterior to the vitelline gland.

CONCLUSION

The E. granulosus of camel isolate in north Xinjiang can readily be distinguished from the horse, sheep, cattle and pig strains, but is similar to the camel (Camelus dromedarius) strain distributed in North Africa.

Direct in vivo inhibition of the nuclear cell cycle cascade in experimental mesangial proliferative glomerulonephritis with Roscovitine, a novel cyclin-dependent kinase antagonist

Glomerular injury is characterized by mesangial cell (MC) proliferation and matrix formation. We sought to determine if reducing the activity of cyclin-dependent kinase 2 (CDK2) with the purine analogue, Roscovitine, decreased MC proliferation in vitro and in vivo. Roscovitine (25 microM) inhibited FCS-induced proliferation (P < 0.0001) in cultured MC. Rats with experimental mesangial proliferative glomerulonephritis (Thy1 model) were divided into two groups. A prevention group received daily intraperitoneal injections of Roscovitine in DMSO (2.8 mg/kg) starting at day 1. A treatment group received daily Roscovitine starting at day 3, when MC proliferation was established. Control Thy1 rats received DMSO alone. MC proliferation (PCNA +/OX7 + double immunostaining) was reduced by > 50% at days 5 and 10 in the Roscovitine prevention group, and at day 5 in the treatment group (P < 0.0001). Early administration of Roscovitine reduced immunostaining for collagen type IV, laminin, and fibronectin at days 5 and 10 (r = 0.984; P < 0.001), which was associated with improved renal function (urinary protein/creatinine, blood urea nitrogen, P < 0.05). We conclude that reducing the activity of CDK2 with Roscovitine in experimental glomerulonephritis decreases cell proliferation and matrix production, resulting in improved renal function, and may be a useful therapeutic intervention in disease characterized by proliferation.

Ozone inactivates cyclooxygenase in human tracheal epithelial cells without altering PGHS-2 mRNA or protein

Exposure of human tracheal epithelial (TE) cells to ozone (0.1-0.5 ppm) leads to a transient increase followed by decreased production of prostaglandin (PG) E2 concomitant with dose-dependent loss and delayed recovery of cyclooxygenase (CO) activity [S.E. Alpert and R.W. Walenga. Am. J. Physiol. 269 (Lung Cell. Mol. Physiol. 13): L734-L743, 1995]. Formation of reactive oxygen species (ROS) in cultured tracheobronchial epithelial cells during ozone exposure was recently demonstrated (L.C. Chen and Q.Qu. Toxicol. Appl. Pharmacol. 143: 96-101, 1997). In the present study, we investigated if ROS generated by ozone-exposed human TE cells contribute to PGE2 production and/or CO inactivation and whether the delay in recovery of CO activity after ozone reflects impaired gene transcription and/or protein synthesis. Rapid, dose-dependent ROS generation, assessed by fluorescence of dihydrorhodamine 123, was detected in human TE monolayers exposed to 0.21-0.63 ppm ozone. In a different system, TE cells were exposed to air or 0.5 ppm ozone for 1 h by serial renewal/collection of an adherent film of media. Ozone-induced ROS formation, the transient increase and decline in PGE2, and CO inactivation were attenuated by an intracellular hydroxyl radical scavenger, 1,3-dimethyl-2-thiourea. Ibuprofen, a reversible CO inhibitor, prevented PGE2 release during ozone exposure (and hence autocatalytic CO inactivation) but not loss of CO activity. Although CO activity remained depressed for hours after ozone exposure, compared with air-exposed cultures, no differences were detected in mRNA and protein levels of prostaglandin endoperoxide G/H synthase 2 (PGHS-2), the only CO isoform present in human TE cells, or in the rate of de novo PGHS-2 synthesis. Our findings suggest that ozone-induced PGE2 production and CO inactivation are primarily the result of formation of intracellular oxidant molecules and that delayed recovery of CO activity in human TE cells after short-term ozone exposure is due to persistent inactivation of PGHS-2, rather than to interference with its synthesis.

Formation of intracellular free radicals in guinea pig airway epithelium during in vitro exposure to ozone

In vivo exposure to ozone (O3) has been shown to cause airway epithelial damage and lipid peroxidation. The oxidation of polyunsaturated fatty acids has been shown to produce hydrogen peroxide and aldehydes with reactive oxygen species (ROS) as intermediates. These products of ozonation may react with other bioorganic molecules and cause cellular damage. To assess the production of ROS, confluent primary cultures of guinea pig airway epithelial cells were grown on Costar membrane with a liquid-air interface and exposed to 0.2, 0.4, and 0.6 ppm O3. The concentrations of intracellular ROS during the exposure were monitored using the fluorescent dye dihydrorhodamine-123. The intracellular concentration of ROS increased immediately upon the commencement of the O3 exposure and persisted until the end of the exposure period (up to 1 hr). The concentration of ROS increased with increasing O3 concentration. To determine the species of ROS produced during O3 exposure, airway epithelial cells were perfused with dimethyl sulfoxide (DMSO), sodium formate (hydroxyl radical scavengers), NaN3 (catalase inhibitor), or diethyl-dithio carbamate (DEDC, superoxide dismutase inhibitor) prior to and during the exposure period and the fluorescent intensity was monitored continuously. While both DMSO and sodium formate decreased the concentration of ROS, DEDC and NaN3 had no effect. We concluded that hydroxyl radicals instead of H2O2 or superoxide anions were produced immediately following the commencement of O3 exposure in guinea pig airway epithelial cells in an exposure concentration-dependent fashion.

Effects of ozone upon macrophage-interferon interactions

Lung cell populations may be directly exposed to environmental airbone toxicants such as ozone (O3). Since pulmonary macrophages (M phi) play a pivotal role in host pulmonary immunocompetence, their function in this regard may be compromised by pollutant exposure thereby giving rise to an increased incidence of pulmonary disease. The current in vitro study was designed to provide some insight into possible mechanisms by which O3 induces decreased host pulmonary resistance against microbial pathogens. Specifically, this study investigated the impact of an acute O3 exposure upon the ability of a cultured mouse M phi cell line (WEHI-3) to interact with, and respond to, the major M phi-activating cytokine, interferon-gamma (IFN gamma). The results of this study indicate that WEHI-3 exposure to 1 ppm O3 for 4 h reduced both the binding of, and responsivity to, IFN gamma. Among the functional parameters affected by this inability to properly bind/respond to IFN gamma were: reactive oxygen intermediate production, phagocytic activity, and cellular calcium ion elevation; IFN gamma-enhanced expression of surface histocompatibility antigens was unaffected by O3 exposure. The reduced activity of any one of these critical M phi functions could provide a basis for previously-documented increases in microbial pathogen survival in the lungs, and overall compromise of host health following O3 exposure.

Vanadium affects macrophage interferon-gamma-binding and -inducible responses

Mouse WEHI-3 cells were exposed overnight to vanadium [V; ammonium metavanadate (NH4VO3) or vanadium pentoxide (V2O5)] to determine whether documented V-induced immunomodulation might arise from altered macrophage (M phi) interactions with interferon-gamma (IFN gamma) or altered IFN gamma-inducible responses. Binding studies performed at 22 degrees C indicated that although NH4VO3-pretreated cells had approximately 48% fewer actively-binding Class I IFN gamma receptors, binding affinities were 1.5-fold greater than that of control cell receptors; Class II expression was unaffected but affinities were reduced 2-fold. Postbinding IFN gamma-receptor complex internalization was unaffected by V pretreatment. Spontaneous production of both hydrogen peroxide and superoxide anion was significantly increased by treatment with both V compounds. Total hydrogen peroxide and superoxide production was increased by stimulation of IFN gamma-primed cells with zymosan, but relative increases in primed V-treated cells were lower than that in controls. Vanadium-treated cells also displayed decreased rates of IFN gamma-induced changes in [Ca2+]i levels secondary to increased resting [Ca2+]i levels. Although V-treated cells did not display significant increases in I-A expression after IFN gamma treatment, increased numbers of I-A+ cells (irrespective of priming) and lower maximal antigen densities than observed on I-A+ control cells were evident. Results from this study show that V exposure may produce alterations in M phi-mediated functions, in part, by modifying cell interactions with IFN gamma and subsequent IFN gamma-dependent functional parameters.

[Surgical management of severe hemorrhage and retroperitoneal perforation after endoscopic sphincterotomy]

From 1990 to 1993, 5 patients with severe hemorrhage and retroperitoneal perforation following endoscopic sphincterotomy (EST) were surgically treated. Two patients with hemorrhage and one with perforation survived. The remaining two died of hemorrhage plus perforation. Early diagnosis and surgical intervention was very important to lower the mortality, especially in those with common bile duct stones retention, acute pancreatitis, or cholangitis. For patients with late stage perforation or recurrent hemorrhage, palliative procedure aimed at isolating the EST incision from the digestion of bile and pancreatic juice should be performed.

Alteration of pulmonary macrophage intracellular pH following inhalation exposure to sulfuric acid/ozone mixtures

Recent studies have demonstrated that additive and synergistic effects on rabbit pulmonary macrophages (PM phi) function can occur after combined exposures to acid aerosols and ozone. This study investigated intracellular pH (pHi) homeostasis and H+ extrusion mechanisms of PM phi from rabbits exposed to sulfuric acid, ozone, and their mixtures. Animals were exposed for 3 h to 125 micrograms/m3 sulfuric acid, 0.1, 0.3, 0.6 ppm ozone, or combinations of acid with each concentration of ozone, and the pHi was determined by a fluorescent dye ratioing technique. Exposure to 125 micrograms/m3 acid reduced pHi and exposure to ozone resulted in a concentration-dependent reduction in pHi. Ozone generally tended to mitigate the effect of the acid aerosol on pHi. Other groups of rabbits were exposed to 50 micrograms/m3 sulfuric acid, 0.6 ppm ozone, or their mixture, for 3 h, and PM phi were again harvested. The pHi of PM phi following exposure to each of the pollutant atmospheres was not different from control. However, H+ extrusion with an imposed internal acid load was found to be significantly depressed following exposure to either sulfuric acid or ozone alone, while the mixture produced a significant interaction.

[Surgical treatment of hemolytic anemia]

The therapeutic effect of splenectomy in 70 cases of hemolytic anemia are reported. The diagnosis and therapeutic effects were analysed. It was evident that the effects were related to different types of hemolytic anemia. The HS type had the best result. Gallstones were detected in 6 cases of this series. Splenectomy and cholecystectomy were performed together in 5 cases. The median incision of upper abdomen was selected. The authors believe that the causes of infection after splenectomy are complicated and they cannot be explained by Igs alone.

Treatment of the thalassemia syndrome with splenectomy

Splenectomy was performed on 152 patients with thalassemia (thal), including 90 cases with Hb H disease, 48 cases with homozygous beta-thal, and 14 cases with Hb E-beta-thal. The therapeutic effect in Hb H disease was 83.3%, and 32.3% in Hb E-beta-thal and beta-thal. In Hb H disease, the hemoglobin (Hb) level increased 30 g/l in 14 of 29 cases. After splenectomy, the life-span (T1/2) of 51Cr RBC in Hb H and Hb E-beta-thal increased to 18.2 +/- 2.6 and 18.2 days, respectively. The number of inclusion (Heinz) bodies attached to the RBC membrane increased after surgery. The interdermal delayed supersensitivity reaction became negative in seven of 26 cases of Hb H disease; the IgG also decreased after surgery. The number of PAS positive foam cells in the spleen correlated to Hb level after surgery. Infection is a common complication.