Efficacy and safety of hylan G-F 20 injection in treatment of knee osteoarthritis in Chinese patients: results of a prospective, multicentre, longitudinal study

OBJECTIVE

To study the efficacy and safety of single intra-articular injection of 6-mL hylan G-F 20 in Chinese patients with symptomatic knee osteoarthritis.

DESIGN

Prospective case series.

SETTING

Six government hospitals in Hong Kong.

PATIENTS

Patients with primary knee osteoarthritis were recruited from six government hospitals from 1 October 2010 to 31 May 2012. All patients received 6-mL intra-articular injection of hylan G-F 20.

MAIN OUTCOME MEASURES

Pain visual analogue scale, functional visual analogue scale, and 5-point Likert scale on change of pain and function were assessed. Adverse events were checked. Radiographs were taken pre-injection and at 3 months and 1 year.

RESULTS

A total of 110 knees of 95 patients with primary knee osteoarthritis were treated. The mean age of the patients was 62 (standard deviation, 9.8) years. All patients completed 1 year of follow-up. The mean pain visual analogue scale, functional visual analogue scale, and Likert value for pain and function showed statistically significant improvements at 6 weeks, 3 months, 6 months, and 1 year compared with the pre-injection values. No significant correlations were found between changes in visual analogue scale and age, body mass index, pre-injection radiological osteoarthritis severity, serum erythrocyte sedimentation rate, or C-reactive protein. Serial radiographs did not show any changes in the radiological severity of knee osteoarthritis. Overall, 16.4% of the patients experienced mild and self-limiting adverse events.

CONCLUSION

Hylan G-F 20 is a safe and effective therapy to relieve pain and improve function for up to 1 year in Chinese patients with knee osteoarthritis.

Regulation of protocadherin gene expression by multiple neuron-restrictive silencer elements scattered in the gene cluster

The clustered protocadherins are a subfamily of neuronal cell adhesion molecules that play an important role in development of the nervous systems in vertebrates. The clustered protocadherin genes exhibit complex expression patterns in the central nervous system. In this study, we have investigated the molecular mechanism underlying neuronal expression of protocadherin genes using the protocadherin gene cluster in fugu as a model. By in silico prediction, we identified multiple neuron-restrictive silencer elements (NRSEs) scattered in the fugu protocadherin cluster and demonstrated that these elements bind specifically to NRSF/REST in vitro and in vivo. By using a transgenic Xenopus approach, we show that these NRSEs regulate neuronal specificity of protocadherin promoters by suppressing their activity in non-neuronal tissues. We provide evidence that protocadherin genes that do not contain an NRSE in their 5' intergenic region are regulated by NRSEs in the regulatory region of their neighboring genes. We also show that protocadherin clusters in other vertebrates such as elephant shark, zebrafish, coelacanth, lizard, mouse and human, contain different sets of multiple NRSEs. Taken together, our data suggest that the neuronal specificity of protocadherin cluster genes in vertebrates is regulated by the NRSE-NRSF/REST system.

Velocity map imaging in time of flight mass spectrometry

A new variation on time of flight mass spectrometry is presented, which uses a fast framing charge coupled device camera to velocity map image multiple product masses in a single acquisition. The technique is demonstrated on two photofragmentation processes, those of CS(2) and CH(3)S(2)CH(3) (dimethyldisulfide) at a photolysis wavelength of 193 nm. In both cases, several mass fragments are imaged simultaneously, and speed distributions and anisotropy parameters are extracted that are comparable to those obtained by imaging each fragment separately in conventional velocity map imaging studies.

The metIC operon involved in methionine biosynthesis in Bacillus subtilis is controlled by transcription antitermination

There are two major pathways for methionine biosynthesis in micro-organisms. Little is known about these pathways in Bacillus subtilis. The authors assigned a function to the metI (formerly yjcI) and metC (formerly yjcJ) genes of B. subtilis by complementing Escherichia coli metB and metC mutants, analysing the phenotype of B. subtilis metI and metC mutants, and carrying out enzyme activity assays. These genes encode polypeptides belonging to the cystathionine gamma-synthase family of proteins. Interestingly, the MetI protein has both cystathionine gamma-synthase and O-acetylhomoserine thiolyase activities, whereas the MetC protein is a cystathionine beta-lyase. In B. subtilis, the transsulfuration and the thiolation pathways are functional in vivo. Due to its dual activity, the MetI protein participates in both pathways. The metI and metC genes form an operon, the expression of which is subject to sulfur-dependent regulation. When the sulfur source is sulfate or cysteine the transcription of this operon is high. Conversely, when the sulfur source is methionine its transcription is low. An S-box sequence, which is located upstream of the metI gene, is involved in the regulation of the metIC operon. Northern blot experiments demonstrated the existence of two transcripts: a small transcript corresponding to the premature transcription termination at the terminator present in the S-box and a large one corresponding to transcription of the complete metIC operon. When methionine levels were limiting, the amount of the full-length transcript increased. These results substantiate a model of regulation by transcription antitermination.

The study of Central Taiwan particles concentration variations during earthquake period

Ambient particle concentration was taken on the traffic sampling site over the Chung-Chi Road over the bridge (CCROB) in front of Hungkuang Institute of Technology (HKIT). The sampling time was from August 1999 to December 1999. During the sampling period, Taiwan's biggest earthquake in more than a century registered 7.3 on the Richter scale (Taiwan Chi-Chi Earthquake). Besides, there are more than 20,000 aftershocks following the Taiwan Chi-Chi Earthquake within 3 months. Thus, the mass concentration of particles with aerodynamic diameters smaller than 2.5 microm (PM2.5) and PM2.5-10 was also collected then compared with the total mass concentration of suspended particles (TSP) in this study. The average TSP, PM2.5-10, and PM2.5 concentrations are 106, 24.6, and 58.0 microg/m3, respectively, after the Taiwan Chi-Chi Earthquake. The average TSP concentrations before and after Taiwan Chi-Chi Earthquake were 69.6 and 127 microg/ m3, respectively. In addition, statistical analysis of the PM10 data from this study and EPA in 1999 yielded a Tstatistic of 0.147, which is smaller than t(0.975,18) = 2.101. It is indicated that there was no significant difference. So, the PM10 concentrations measured after Taiwan Chi-Chi Earthquake in this study were also greater than those data previously obtained from Taiwan EPA in the same region of this area. The relationships between TSP, PM10, PM2.5-10, and PM2.5 particle concentrations and wind speed (R2) are .77, .59, .58, .58, respectively. And the ratios of PM2.5/PM25-10, PM2.5/PM10, and PM10/TSP are 221%, 67.2%, 58.0%, respectively. The average ratios of PM2.5/PM2.5-10 and PM2.5/PM10 increase by about 120% and 17%. It indicated that the fine-particles concentration increases compared to the coarse-particles concentration after 921 Taiwan Chi-Chi Earthquake. And the proposed reasons are that local motor vehicle emissions combined the fine particles transported from the Chi-Chi epicenter. More importantly, the wind direction was mainly blown from southeastern part. These two main factors enhance the fine-particles concentration in this area.