[A case of aconitum kusnezoffii intoxication with severe arrhythmia]

Aconitum kusnezoffii is a traditional Chinese medicine of Ranunculaceae family. Its toxicity is relatively strong, and its dosage is similar to that of poisoning. In clinical practice, poisoning events are often caused by excessive dosage or improper use. There is no specific antidote for kusnezoff root poisoning. Severe kusnezoff root poisoning can cause malignant arrhythmia and even death.A case of severe kusnezoff monkshood poisoning was reported in January 2021, which was treated with nificaran hydrochloride for injection in the emergency medicine department of the First Hospital of Handan City. The patient developed ventricular tachycardia, ventricular fibrillation and AS syndrome. In addition to conventional treatment, the patient did not have arrhythmia again after intravenous injection of 25 mg of nifekalan load and continuous pumping of 0.4 mg/kg/h for 7 hours, and did not relapse after discontinuation of nifekalan 24 hours later. It is suggested that the malignant arrhythmia caused by clinical severe kusnezoff monkshood poisoning can be controlled by nifekalan. Whether nifekalan is superior to conventional antiarrhythmic drugs still needs more accumulation and verification of clinical application data.

Measurement of the Cosmic Ray Helium Energy Spectrum from 70 GeV to 80 TeV with the DAMPE Space Mission

The measurement of the energy spectrum of cosmic ray helium nuclei from 70 GeV to 80 TeV using 4.5 years of data recorded by the Dark Matter Particle Explorer (DAMPE) is reported in this work. A hardening of the spectrum is observed at an energy of about 1.3 TeV, similar to previous observations. In addition, a spectral softening at about 34 TeV is revealed for the first time with large statistics and well controlled systematic uncertainties, with an overall significance of 4.3σ. The DAMPE spectral measurements of both cosmic protons and helium nuclei suggest a particle charge dependent softening energy, although with current uncertainties a dependence on the number of nucleons cannot be ruled out.

[One case of severely scalded patient with pneumonia and sepsis]

In February 2018, one 54-year-old male patient with severe scald complicated with pneumonia and sepsis was transferred to Qingdao Municipal Hospital from other hospital. Drugs including cephalosporin, vancomycin, and imipenem/cilastatin combined with ciprofloxacin were used successively for anti-infective treatment, with no obvious effect. Multiple bacterial culture results of sputum, blood, and wound exudate showed infection of extensively drug resistant Pseudomonas aeruginosa. On the 4th day of admission, the anti-infective treatment plan was adjusted, and plasma, red blood cell, and albumin were supplemented and nutritional support and symptomatic treatment were performed. At the same time, medication and drug-related adverse reaction were monitored. After treatment for more than 10 days, infection of the patient was effectively controlled and the condition gradually improved. The case suggests that severely burned patients are prone to have serious and fatal systemic infection, irregular use of antibiotics increases the risk of infection of extensively drug resistant bacteria, clear anti-infection idea and effective application of antibacterial drug can help to improve the success rate of infection treatment and are of important value in improving the prognosis of patients with severe burn.

[Preliminary clinical study of direct renin inhibitor aliskiren in the treatment of severe COVID-19 patients with hypertension]

Objective: To explore the feasibility of direct renin inhibitor aliskiren for the treatment of severe patients of COVID-19 with hypertension. Methods: A retrospective case analysis of effectiveness and safety of aliskiren treatment to lower blood pressure in three severe and one critically ill patients of COVID-19 with hypertension. Results: Four patients, two males and two females, with an average age of 78 years (66-87 years), were referred to hospital mainly because of respiratory symptoms. Three cases were confirmed by 2019-nCoV nucleic acid and antibody detection (severe type), and one with cardiac insufficiency was clinically determined (critically ill type). The previous diagnosis of hypertension was clear. Two patients took calcium channel antagonist (CCB), one patient took angiotensin converting enzyme inhibitor (ACEI), and one patient took angiotensin II receptor antagonist (ARB). After admission, ACEI or ARB were discontinued, one patient with heart failure patient was treated by aliskiren combined with diuretic; 3 patients were treated with aliskiren combined with CCB. Two patients were stopped to use CCB due to low blood pressure after 1 to 2 weeks of using CCB and aliskiren. On the basis of comprehensive therapy combined with antiviral and oxygenation treatment, aliskiren antihypertensive treatment was taken for three to four weeks. The blood pressure control of four patients was satisfactory and there was no complaint of discomfort. The condition improved, and all patients had reached the discharge standard and were discharged. Conclusion: Our preliminary clinical data shows that aliskiren's antihypertensive therapy is effective and safe for severe COVID-19 patients complicated with hypertension. Further clinical aliskiren therapy study is required with more COVID-19 patients..

[Standardization and application on ribotyping library of Clostridioides difficile in China]

Objective: To establish a standard operation procedure (SOP) for ribosome genotyping (ribotyping) on Clostridioides (C.) difficile, supplement and verify ribotyping typing library, so as to improve the comparability of data between different laboratories and to develop surveillance network of C. difficil in China. Methods: Molecular typing of 54 reference strains from the United States and Europe of C. difficile were performed by using the SOP referencing correspondence from abroad and from our laboratory with a BioNumerics 7.6 software to estimate the reference library of types of C. difficile. Identification of 374 clinical and animal isolates of C. difficile from 13 cities in China between 2010 and 2018, to supplement the library information. Kappa test was used to evaluate the consistency. Results: Results of capillary electrophoresis of reference strains appeared clear and stable, which guaranteed the clustering results being fast and accurate. Results from the supplementary typing showed that there were 84 types of isolates, of which 25 RT types were consistent with reference strains from abroad, while 58 RT types were different from referenced types. In the 40 referenced types, 15 RT types were not found in this study. In the consistency evaluation, the Kappa value was 0.891 and (P<0.01), showing the two Molecular typing as consistent and with close resemblance. Conclusions: The result of capillary electrophoresis by applying SOP for ribotyping on C. difficile base on QIAxcel capillary electrophoresis system, appeared clear and stable. The standardized library seemed more easily used for comparability and data sharing between the laboratories.

Different definitions of esophagus influence esophageal toxicity prediction for esophageal cancer patients administered simultaneous integrated boost versus standard-dose radiation therapy

We aim to evaluate whether different definitions of esophagus (DEs) impact on the esophageal toxicity prediction for esophageal cancer (EC) patients administered intensity-modulated radiation therapy with simultaneous integrated boost (SIB-IMRT) vs. standard-dose IMRT (SD-IMRT). The esophagus for 21 patients diagnosed with primary EC were defined in the following four ways: the whole esophagus, including the tumor (ESO_whole); ESO_whole within the treatment field (ESO_infield); ESO_infield, excluding the tumor (ESO_{infield-tumor}) and ESO_whole, excluding the tumor (ESO_whole-tumor). The difference in the dose variation, acute esophageal toxicity (AET) and late esophageal toxicity (LET) of four DEs were compared. We found that the mean esophageal dose for ESO_whole, ESO_infield, ESO_{infield-tumor} and ESO_whole-tumor were increased by 7.2 Gy, 10.9 Gy, 4.6 Gy and 2.0 Gy, respectively, in the SIB-IMRT plans. Radiobiological models indicated that a grade ≥ 2 AET was 2.9%, 3.1%, 2.2% and 1.6% higher on average with the Kwint model and 14.6%, 13.2%, 7.2% and 3.4% higher with the Wijsman model for the four DEs. A grade ≥ 3 AET increased by 4.3%, 7.2%, 4.2% and 1.2%, respectively. Additionally, the predicted LET increased by 0.15%, 0.39%, 1.2 × 10⁻²% and 1.5 × 10⁻³%. Our study demonstrates that different DEs influence the esophageal toxicity prediction for EC patients administered SIB-IMRT vs. SD-IMRT treatment.

Comparative Analysis of Local Control Prediction Using Different Biophysical Models for Non-Small Cell Lung Cancer Patients Undergoing Stereotactic Body Radiotherapy

PURPOSE

The consistency for predicting local control (LC) data using biophysical models for stereotactic body radiotherapy (SBRT) treatment of lung cancer is unclear. This study aims to compare the results calculated from different models using the treatment planning data.

MATERIALS AND METHODS

Treatment plans were designed for 17 patients diagnosed with primary non-small cell lung cancer (NSCLC) using 5 different fraction schemes. The Martel model, Ohri model, and the Tai model were used to predict the 2-year LC value. The Gucken model, Santiago model, and the Tai model were employed to estimate the 3-year LC data.

RESULTS

We found that the employed models resulted in completely different LC prediction except for the Gucken and the Santiago models which exhibited quite similar 3-year LC data. The predicted 2-year and 3-year LC values in different models were not only associated with the dose normalization but also associated with the employed fraction schemes. The greatest difference predicted by different models was up to 15.0%.

CONCLUSIONS

Our results show that different biophysical models influence the LC prediction and the difference is not only correlated to the dose normalization but also correlated to the employed fraction schemes.

Flattening Filter-Free Beams in Intensity-Modulated Radiotherapy and Volumetric Modulated Arc Therapy for Sinonasal Cancer

PURPOSE

To evaluate the dosimetric impacts of flattening filter-free (FFF) beams in intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) for sinonasal cancer.

METHODS

For fourteen cases, IMRT and VMAT planning was performed using 6-MV photon beams with both conventional flattened and FFF modes. The four types of plans were compared in terms of target dose homogeneity and conformity, organ-at-risk (OAR) sparing, number of monitor units (MUs) per fraction, treatment time and pure beam-on time.

RESULTS

FFF beams led to comparable target dose homogeneity, conformity, increased number of MUs and lower doses to the spinal cord, brainstem and normal tissue, compared with flattened beams in both IMRT and VMAT. FFF beams in IMRT resulted in improvements by up to 5.4% for sparing of the contralateral optic structures, with shortened treatment time by 9.5%. However, FFF beams provided comparable overall OAR sparing and treatment time in VMAT. With FFF mode, VMAT yielded inferior homogeneity and superior conformity compared with IMRT, with comparable overall OAR sparing and significantly shorter treatment time.

CONCLUSIONS

Using FFF beams in IMRT and VMAT is feasible for the treatment of sinonasal cancer. Our results suggest that the delivery mode of FFF beams may play an encouraging role with better sparing of contralateral optic OARs and treatment efficiency in IMRT, but yield comparable results in VMAT.

A Dosimetric Study of Using Fixed-Jaw Volumetric Modulated Arc Therapy for the Treatment of Nasopharyngeal Carcinoma with Cervical Lymph Node Metastasis

PURPOSE

To study the dosimetric difference between fixed-jaw volumetric modulated radiotherapy (FJ-VMAT) and large-field volumetric modulated radiotherapy (LF-VMAT) for nasopharyngeal carcinoma (NPC) with cervical lymph node metastasis.

METHODS

Computed tomography (CT) datasets of 10 NPC patients undergoing chemoradiotherapy were used to generate LF-VMAT and FJ-VMAT plans in the Eclipse version 10.0 treatment planning system. These two kinds of plans were then compared with respect to planning-target-volume (PTV) coverage, conformity index (CI), homogeneity index (HI), organ-at-risk sparing, monitor units (MUs) and treatment time (TT).

RESULTS

The FJ-VMAT plans provided lower D2% of PGTVnd (PTV of lymph nodes), PTV1 (high-risk PTV) and PTV2 (low-risk PTV) than did the LF-VMAT plans, whereas no significant differences were observed in PGTVnx (PTV of primary nasopharyngeal tumor). The FJ-VMAT plans provided lower doses delivered to the planning organ at risk (OAR) volumes (PRVs) of both brainstem and spinal cord, both parotid glands and normal tissue than did the LF-VMAT plans, whereas no significant differences were observed with respect to the oral cavity and larynx. The MUs of the FJ-VMAT plans (683 ± 87) were increased by 22% ± 12% compared with the LF-VMAT plans (559 ± 62). In terms of the TT, no significant difference was found between the two kinds of plans.

CONCLUSIONS

FJ-VMAT was similar or slightly superior to LF-VMAT in terms of PTV coverage and was significantly superior in terms of OAR sparing, at the expense of increased MUs.

Volumetric modulated arc therapy vs. c-IMRT for the treatment of upper thoracic esophageal cancer

OBJECTIVE

To compare plans using volumetric-modulated arc therapy (VMAT) with conventional sliding window intensity-modulated radiation therapy (c-IMRT) to treat upper thoracic esophageal cancer (EC).

METHODS

CT datasets of 11 patients with upper thoracic EC were identified. Four plans were generated for each patient: c-IMRT with 5 fields (5F) and VMAT with a single arc (1A), two arcs (2A), or three arcs (3A). The prescribed doses were 64 Gy/32 F for the primary tumor (PTV64). The dose-volume histogram data, the number of monitoring units (MUs) and the treatment time (TT) for the different plans were compared.

RESULTS

All of the plans generated similar dose distributions for PTVs and organs at risk (OARs), except that the 2A- and 3A-VMAT plans yielded a significantly higher conformity index (CI) than the c-IMRT plan. The CI of the PTV64 was improved by increasing the number of arcs in the VMAT plans. The maximum spinal cord dose and the planning risk volume of the spinal cord dose for the two techniques were similar. The 2A- and 3A-VMAT plans yielded lower mean lung doses and heart V50 values than the c-IMRT. The V20 and V30 for the lungs in all of the VMAT plans were lower than those in the c-IMRT plan, at the expense of increasing V5, V10 and V13. The VMAT plan resulted in significant reductions in MUs and TT.

CONCLUSION

The 2A-VMAT plan appeared to spare the lungs from moderate-dose irradiation most effectively of all plans, at the expense of increasing the low-dose irradiation volume, and also significantly reduced the number of required MUs and the TT. The CI of the PTVs and the OARs was improved by increasing the arc-number from 1 to 2; however, no significant improvement was observed using the 3A-VMAT, except for an increase in the TT.

Simultaneous modulated accelerated radiation therapy for esophageal cancer: A feasibility study

AIM: To establish the feasibility of simultaneous modulated accelerated radiation therapy (SMART) in esophageal cancer (EC).

METHODS: Computed tomography (CT) datasets of 10 patients with upper or middle thoracic squamous cell EC undergoing chemoradiotherapy were used to generate SMART, conventionally-fractionated three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiation therapy (cf-IMRT) plans, respectively. The gross target volume (GTV) of the esophagus, positive regional lymph nodes (LN), and suspected lymph nodes (LN±) were contoured for each patient. The clinical target volume (CTV) was delineated with 2-cm longitudinal and 0.5- to 1.0-cm radial margins with respect to the GTV and with 0.5-cm uniform margins for LN and LN(±). For the SMART plans, there were two planning target volumes (PTVs): PTV66 = (GTV + LN) + 0.5 cm and PTV54 = CTV + 0.5 cm. For the 3DCRT and cf-IMRT plans, there was only a single PTV: PTV60 = CTV + 0.5 cm. The prescribed dose for the SMART plans was 66 Gy/30 F to PTV66 and 54 Gy/30 F to PTV54. The dose prescription to the PTV60 for both the 3DCRT and cf-IMRT plans was set to 60 Gy/30 F. All the plans were generated on the Eclipse 10.0 treatment planning system. Fulfillment of the dose criteria for the PTVs received the highest priority, followed by the spinal cord, heart, and lungs. The dose-volume histograms were compared.

RESULTS: Clinically acceptable plans were achieved for all the SMART, cf-IMRT, and 3DCRT plans. Compared with the 3DCRT plans, the SMART plans increased the dose delivered to the primary tumor (66 Gy vs 60 Gy), with improved sparing of normal tissues in all patients. The D_max of the spinal cord, V₂₀ of the lungs, and D_mean and V₅₀ of the heart for the SMART and 3DCRT plans were as follows: 38.5 ± 2.0 vs 44.7 ± 0.8 (P = 0.002), 17.1 ± 4.0 vs 25.8 ± 5.0 (P = 0.000), 14.4 ± 7.5 vs 21.4 ± 11.1 (P = 0.000), and 4.9 ± 3.4 vs 12.9 ± 7.6 (P = 0.000), respectively. In contrast to the cf-IMRT plans, the SMART plans permitted a simultaneous dose escalation (6 Gy) to the primary tumor while demonstrating a significant trend of a lower irradiation dose to all organs at risk except the spinal cord, for which no significant difference was found.

CONCLUSION: SMART offers the potential for a 6 Gy simultaneous escalation in the irradiation dose delivered to the primary tumor of EC and improves the sparing of normal tissues.

Surgical management of biliary cystadenoma and cystadenocarcinoma of the liver

Biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC) are rare biliary duct neoplasms. This study investigated reasonable management strategies of cystic neoplasms in the liver. Charts of 39 BCA/BCAC patients (9 males, 30 female; median age 53.74 ± 14.50 years) who underwent surgery from January 1999 to December 2009 were reviewed retrospectively. Cyst fluid samples of 32 BCA/BCAC patients and 40 simple hepatic cyst patients were examined for the tumor markers carbohydrate associated antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). The most frequent symptoms were abdominal pain (N = 10), abdominal mass (N = 7), abdominal distension (N = 4), jaundice (N = 2), and fever (N = 3); the remaining patients showed no clinical symptoms. Liver resection (N = 17) or enucleation (N = 22) was performed in the 39 patients. Ultimately, 35 patients were diagnosed with intrahepatic BCA and four patients were diagnosed with BCAC. The median CA19-9 level was significantly higher in BCA/BCAC patients than in simple hepatic cyst patients. The median CEA levels in BCA/BCAC patients and controls were 6.83 ± 2.43 and 4.21 ± 2.91 mg/L, respectively. All symptoms were resolved after surgery, and only one BCAC patient showed recurrence. The incidence of intrahepatic cystic lesions was 1.7%. Increased CA19-9 levels in the cyst fluid is a helpful marker for distinguishing BCA/BCAC from common simple cysts. The presence of coarse calcifications is suggestive of BCAC. Complete surgical removal of these lesions yielded satisfying long-term outcomes with a very low recurrence rate.

Near room-temperature formation of a skyrmion crystal in thin-films of the helimagnet FeGe

The skyrmion, a vortex-like spin-swirling object, is anticipated to play a vital role in quantum magneto-transport processes such as the quantum Hall and topological Hall effects. The existence of the magnetic skyrmion crystal (SkX) state was recently verified experimentally for MnSi and Fe(0.5)Co(0.5)Si by means of small-angle neutron scattering and Lorentz transmission electron microscopy. However, to enable the application of such a SkX for spintronic function, materials problems such as a low crystallization temperature and low stability of SkX have to be overcome. Here we report the formation of SkX close to room temperature in thin-films of the helimagnet FeGe. In addition to the magnetic twin structure, we found a magnetic chirality inversion of the SkX across lattice twin boundaries. Furthermore, for thin crystal plates with thicknesses much smaller than the SkX lattice constant (as) the two-dimensional SkX is quite stable over a wide range of temperatures and magnetic fields, whereas for quasi-three-dimensional films with thicknesses over as the SkX is relatively unstable and observed only around the helical transition temperature. The room-temperature stable SkX state as promised by this study will pave a new path to designing quantum-effect devices based on the controllable skyrmion dynamics.

[Dosimetric comparison between intensity-modulated radiotherapy and conformal radiotherapy for upper thoracic esophageal carcinoma]

BACKGROUND AND OBJECTIVE

Treatment planning for radiotherapy of upper thoracic esophageal carcinoma is challenging due to the anatomical features. The difficulty may be resolved by intensity-modulated radiotherapy (IMRT). This study was to compare the dosimetric advantages of IMRT to that of conformal radiotherapy (CRT) for upper thoracic esophageal carcinoma, and to explore the clinical application of IMRT.

METHODS

Eleven patients with upper thoracic esophageal carcinoma were enrolled. In addition to the actually used CRT plan, a five-field IMRT plan was generated for each case. The parameters of dose volume histogram for targets and organs at risk were compared between two techniques.

RESULTS

For the planning target volume (PTV) of tumor and para-tumor tissues, the mean dose, maximal dose, doses covering 99% and 95% volume were similar in IMRT and CRT plans (P>0.05). However, IMRT plan had a higher conformity index than CRT plan (0.68+/-0.04 vs. 0.46+/-0.11, P<0.01). For the PTV of supraclavicular region, IMRT plan showed a better dose heterogeneity index than CRT plan (1.17+/-0.05 vs. 1.33+/-0.15, P=0.01). IMRT plan had lower maximal dose to the planning risk volume of the spinal cord (44.4 Gy vs. 52.5 Gy, P<0.05) and lower lung volume received dose of 10 Gy or higher [(32+/-6)% vs. (35+/-9)%, P<0.05] than CRT plan.

CONCLUSION

For the upper thoracic esophageal carcinoma, IMRT has more conformal distribution of dose and better spinal cord sparing than CRT, and can reduce the volume of lung that received dose of 10 Gy or higher.

Genetic polymorphism of the accessory gene regulator (agr) locus in Staphylococcus epidermidis and its association with pathogenicity

Staphylococcus epidermidis has become one of the most important causes of nosocomial infections in recent years. The staphylococcal accessory gene regulator (agr) is the most important locus responsible for the regulation of virulence factors, and it has been shown to be polymorphic. The aim of this study was to investigate the agr locus and its genetic polymorphisms in different Chinese S. epidermidis isolates and the relationship between genetic polymorphisms and pathogenicity. Specific PCR was used to amplify the different agr groups. Results were confirmed by restriction enzyme digestion and sequence analysis. agr mutations were detected and three agr groups of S. epidermidis were determined. Of the isolates, 12 % were pathogenic S. epidermidis and 17 % had naturally occurring agr mutations (P > 0.05). Pathogenic S. epidermidis isolates comprised 68.2 % agr group I, 19.3 % group II and 12.5 % group III, while isolates from healthy controls comprised 39 % agr group I, 51 % group II and 10 % group III (P < 0.01). The percentages of agr locus mutants and the three agr groups in different hospitals showed no significant differences (P > 0.05). The percentage of agr group I S. epidermidis isolated from catheters and blood was higher than that isolated from the other clinical specimens. This is the first study to investigate the genetic polymorphism of agr in S. epidermidis in China. The mean percentage of agr locus mutants was 14.9 % (12 % in clinical specimens; 17.7 % in controls). Genetic polymorphism of agr in S. epidermidis was linked to its pathogenicity; group I was associated with pathogenicity, while most isolates from healthy subjects were group II. The mechanism is to be investigated.

alpha-Adducin gene and essential hypertension in China

Adducin is a membrane skeletal protein that is involved in the regulation of membrane ion transport and cellular signal transduction. Essential hypertension has been linked to alpha-adducin gene locus, and association of a polymorphism of the gene has been found in some studies, but results of linkage or association studies on alpha-adducin gene are controversial among different populations. This study was designed to examine the linkage between alpha-adducin gene locus and essential hypertension and to reveal the relationship between an alpha-adducin gene polymorphism (Gly460Trp) and essential hypertension in a Chinese population. For the linkage study, one hundred and six Chinese nuclear families were recruited, including 417 hypertensive patients in all 474 individuals. Those samples were genotyped at D4S412 and D4S3038. The distances between the two microsatellite markers and the alpha-adducin gene locus are less than 3cM. Parametric, non-parametric linkage (NPL) analyses using the GENEHUNTER software were carried out. Sib transmission-dise- quilibrium test (S-TDT), as well as transmission-disequilibrium test (TDT). was also implemented with TDT/S-TDT Program 1.1. Serum levels of uric acid, creatinine, blood urea nitrogen (BUN), fasting glucose and lipids were determined as phenotypes. In an association study, 138 hypertensive and 121 normotensive subjects were genotyped at Gly460Trp of the alpha-adducin gene to examine a possible association between this polymorphism and blood pressure or other phenotypes. We fail to find the linkage between the two markers and essential hypertension by parametric, NPL analysis or TDT/S-TDT study. With the use of the simple association and the multivariate logistic regression analyses, we also fail to reveal a significant association between the Gly460Trp polymorphism in alpha-adducin gene and the blood pressure variation, or blood biochemical indices studied. The frequency of the 460Trp allele in Chinese (46-48%) is similar to that found in Japanese (54-60%) while the allele frequency is less common in Caucasian (13%-23%). These findings suggest that in our Chinese population, alpha-adducin 460Trp variant may not play an important role in the etiology of EH. And the negative results of linkage and TDT/ S-TDT further supports this conclusion.

Inhibitory role of GDP on saikosaponin (I) stimulated enzymes secretion and rising of [Ca2+]i in rat pancreatic acini

AIM

To study the role of guanosine diphosphate (GDP) on enzyme secretion and rising of [Ca2+]i in saikosaponin (I) [SA(I)] stimulated rat pancreatic acini.

METHODS

Cell membrane of isolated rat pancreatic acini were permeabilized using streptolysin O (SLO). Enzymes secretions were indicated by detecting total protein secretions. Intracellular Ca2+ ([Ca2+]i) was measured using Fluo-3 in SPEX spectrofluorimeter.

RESULTS

The inhibition of GDP on SA(I) stimulated enzymes secretion increased with increasing GDP concentration. There were two peaks in the time course of increase in [Ca2+]i evoked by SA(I) 10 micromol/L. After adding GDP 5 mmol/L, [Ca2+]i rose gradually without the two peaks. In permeabilized acini, the accumulation of enzymes stimulated by SA(I) in 30 min reduced by 57 % compared with intact acini. GDP 5 mmol/L decreased the initial rate of secretion.

CONCLUSION

Inhibition of GDP on increase in [Ca2+]i reduces SA(I) stimulated enzymes secretion in pancreatic acini.

[Isokinetic concentric dynamometry of knee flexors and extensors in young male]

Objective. To investigate the effects of different moving speeds on isokinetic dynamometry of knee flexors and extensors, and to provide normative data for comparative purposes in strength evaluations. Method. Thirty healthy male were tested at 60, 180, and 240 deg/sec angular velocities using a REV9000 testing and rehabilitation system. Result. Both PT (peak torque) and PT/BW (peak torque/body weights) showed significant differences (P< 0.01, P< 0.05) between flexors and extensors, and declined significantly with increased speed (P< 0.001). Peak torque differences between dominant and nondominant knee (Di%) was 10%. TPT (time to peak torque) tended to decrease as moving speeds increased (P< 0.001). APT (angle of peak torque) were 50%-70% for quadriceps, and 32%-45% for hamstrings; H/Q (hamstrings peak torque/quadriceps peak torque) was 50%-60%; WF (work fatigue) was 65%. Conclusion. The results provided a reference for strength evaluations in space medicine and space physiology, especially under simulated weightlessness and microgravity.

Coordinate expression of OPN and associated receptors during monocyte/macrophage differentiation of HL-60 cells

Promyelocytic leukemia HL-60 cells promoted by PMA to differentiate along the monocyte pathway adhere to tissue culture plates. To explore the regulation of adhesion molecules in cells promoted to differentiate, the expression and secretion of osteopontin (OPN) and expression of associated cell surface receptors, CD44 and integrin subunits alpha(v), beta3, beta1, were examined. Results were as follows: 1) PMA induced OPN mRNA and OPN secretion into media; 2) untreated cells expressed beta1 and CD44 mRNA, and PMA induced alpha(v), and beta3 mRNA and increased beta1 and CD44 mRNA expression; 3) PMA increased levels of alpha(v), beta3, beta1 and CD44 protein on the cell surface; and 4) retinoic acid, which promotes granulocytic differentiation of HL-60 cells, did not affect OPN, alpha(v), beta3, beta1, or CD44 mRNA or protein expression. These data suggest that induction of OPN and associated receptors may play a role during monocytic differentiation of HL-60 cells.

In vitro binding of MX2 (KRN8602) and epirubicin to human plasma protein

This study compares the human plasma protein binding characteristics of MX2 and epirubicin. The binding characteristics were determined by equilibrium dialysis at various concentrations of the drugs. The binding dissociation constant (Kd), binding capacity (Bmax) and partitioning constant (Kp) were obtained by Scatchard analysis of the free and bound drugs in the dialysis compartments. Our results have demonstrated that plasma protein binds epirubicin or MX2 in an unsaturable appearance over the concentration up to 150 mumol/l. At the same concentrations, plasma protein binds more epirubicin than MX2. The nature of the interaction may consist of two classes of specific binding, and a partitioning. The binding dissociation constants were 18 and 17.5 mumol/l for the higher binding class (Kd1) and 315.8 and 316.9 mumol/l for the lower binding class (Kd2), respectively, for epirubicin and MX2. The respective maximum binding capacities (Bmax) of plasma protein for epirubicin and MX2 were significantly different, 0.045 and 0.029 mumol/g protein for the higher binding class (Bmax1), and 0.39 and 0.29 mumol/g protein for the lower binding class (Bmax2). The partitioning constants (Kp) were 21.5 x 10(-5) and 20 x 10(-5) litres/g protein for epirubicin and MX2, respectively. The results suggest that plasma protein binds epirubicin or MX2 with a similar affinity, but has less binding sites for MX2. One contributing mechanism to the difference in activity noted between epirubicin and MX2 may be changes in free drug fractions.

[In vitro culture of neonatal mouse calvaria as a model for study of bone resorption]

We established the in vitro culture system of neonatal mouse calvaria. Bone resorption was determined by the following examinations; (1) the release of calcium from the calvaria into the medium was measured by use of atomic absorption spectrophotometer, and the treated to control ratio was calculated and used as an index of bone resorption; (2) the concentration of osteocalcin in the cultured medium was determined by radioimmunoassay; (3) histological examination. By combined use of the examinations, we were able to objectively determine the bone resorption of cultured calvaria.

Randomized study of chemoembolization as an adjuvant therapy for primary liver carcinoma after hepatectomy

From April 1990 to December 1993, 140 patients were recruited to a randomized study to evaluate transcatheter hepatic arterial chemoembolization (TACE) as an adjuvant therapy for primary liver carcinoma after hepatectomy. This study investigated the principle, techniques and results of TACE. The results showed that the intrahepatic recurrence rate was 48.9% in the patients who underwent radical resection only, but only 21.3% in the patients who also underwent TACE 3-4 weeks after hepatectomy (P < 0.01). The 1-, 2-, 3-, and 4-year survival rates were 72.3%, 52.7%, 35.1%, and 35.1% respectively for the patients who underwent radical resection only, and were 97.9%, 85.5%, 69.5%, and 56.9% for the patients who also underwent TACE 3-4 weeks after radical resection (P < 0.001). The 1-, 2-, 3-, and 4-year survival rates were 38.9%, 0%, 0%, and 0% for the patients who underwent palliative resection only, and were 68.3%, 32.3%, 21.5%, and 21.5% respectively for the patients undergoing TACE 3-4 weeks after palliative hepatectomy (P < 0.001).

[Effects of calcitonin and indomethacin on bone resorption mediated by interleukin-1]

The effects of calcitonin and indomethacin on bone resorption stimulated by interleukin-1 (IL-1) were studied in cultured neonatal mouse calvariae. The results showed that calcium release from cultured calvariae was significantly increased after adding 20 ng/ml IL-1 (P < 0.01). The increase of calcium release stimulated by IL-1 was blocked by both calcitonin at the concentration of 10, 100, 1,000 ng/ml and indomethacin (10(-6), 10(-5) mol/L). The stimulation of calcium release by IL-1 was also blocked even adding 10 mol/L indomethacin 5 hours after adding IL-1 into the culture. These data showed that both calcitonin and indomethacin can inhibit bone resorption stimulated by IL-1. Thus, it is possible that calcitonin and indomethacin may be used as a therapeutic agent to block inflammatory bone resorption mediated by IL-1.

[Evaluation of chemoembolization as an adjuvant therapy for primary liver carcinoma after surgical resection]

In order to decrease the intrahepatic recurrence rate after surgical resection of hepatoma, from October 1989 to December 1992, 219 patients were recruited to a prospective trial to evaluate transcatheter hepatic arterial chemo-embolization (TCE) as a postoperative adjuvant therapy for primary liver carcinoma. These patients who underwent radical or palliative resection were divided into 3 groups: (1) Resection of tumor; (2) TCE three to four weeks after resection; (3) Relapse after resection plus TCE. This study presented the principle, techniques and results of TCE. The intrahepatic recurrence rate was 58.6% in group I and 9.5% in group II (P < 0.001). The 1-, 2-, 3-year-survival rates were 67.2%, 52.0%, 42.8% of the patients in group I, while 95.2%, 84.7%, 67.7% in the patients in group II (P < 0.05). The 1-, 2-, 3-year-survival rates were 21.5%, 0%, 0% of the patients who underwent palliative. resection only, while 66.7%, 41.7% of the patients in group III (P < 0.001). Taken together, adjuvaut chemoembolization helps decrease the recurrence rate and increase the survival rate in patients with primary liver cancer treated with surgical resection.

Effects of parathyroid hormone and estradiol on proliferation and function of human osteoblasts from fetal long bone. An in vitro study

The effect of parathyroid hormone (PTH) (0.01 nM-10 nM) and 17 beta-estradiol (E2, 1 nmol-10 nM) alone or in combination on 3H-thymidine incorporation, alkaline phosphatase and adenylate cyclase activities were investigated in human fetal osteoblasts using serum-free monolayer primary cultures. The results showed that PTH inhibited cell proliferation while E2 promoted it. On alkaline phosphatase activity, PTH showed a complex results while E2 were slightly inhibitory. PHT-E2 combination suggested that E2 could alter the effect of PTH alone, also potentiated the anabolic and antagonize the catabolic effects of PTH on bone formation.

Ageing of glutathione reductase in the lens

The distribution of glutathione reductase activity in concentric layers from the lens has been determined as a function of age for 16 species. Primate lenses have almost ten times the level of glutathione reductase found in other species. Comparison with the activity of hexokinase revealed that this is not due to a higher overall rate of metabolism in these lenses. By contrast, the higher activity found in bird and fish lenses reflects a higher metabolic activity in these tissues. In all species, a gradient of activity was observed with the highest specific activity in the outermost cortical fibres, decreasing to virtually no activity in the inner parts of the tissue. No alterations were found in this gradient with increasing age, other than an increase in the amount of nuclear tissue essentially devoid of activity. The maximum activity in the outer cortical fibres was the same, regardless of the age of the lens. The time taken, in different species, for the specific activity to decrease by half, was estimated from the rate of protein accumulation. This time was found to vary from a few days to several years, indicating that the decrease in activity is not due to ageing but rather, it is related to the maturation of fibre cells. These observations are discussed in terms of current concepts of lens ageing and cataract formation.

Effects of calcitonin gene-related peptide on bone resorption mediated by interleukin-1

We examined the effects of calcitonin gene-related peptide CGRP on the bone resorption stimulated by IL-1 alpha after neonatal mouse calvaria were cultured in vitro and bone resorption was determined by measuring the release of calcium into the medium after alpha 48-hour incubation. CGRP (10(-9)-10(-8) M) blocked completely the IL1 alpha-mediated increase in bone resorption and inhibited the basal bone resorption. In accordance with the effects of calcitonin on osteoclasts, CGRP caused cessation of lamellipodia activity and gradual retraction of lamellipodia when added into the culture medium. Quantitative analysis showed that CGRP (10(-6) M) caused a gradual reduction of osteoclastic surface area and convex perineum. These data show that CGRP inhibits IL1 alpha mediated bone resorption because of its direct regulation of osteoclast activity.

On the interaction of alpha-crystallin with membranes

The interaction of human and bovine alpha-crystallins with bovine lens membranes was evaluated using binding curves and Scatchard plots constructed from scans of SDS-PAGE gels and/or from the association of [14C]-leu alpha-crystallin with the membranes. No differences were observed for total bovine, normal human 19 and 88 year old and cataractous alpha-crystallins. In each case, interaction takes place through two distinct processes, a) a high affinity (Kd = 1 x 10(-8) M) binding with low capacity (25 mg alpha-crystallin/g membrane protein) and b) partitioning (Kp = 0.25 l/g membrane protein). Loss of the high-affinity binding component was observed for bovine nuclear alpha-crystallin. Contrary to previous reports, it is concluded that cataract formation does not affect the ability of human alpha-crystallins to interact with bovine lens membranes. Reanalysis of previously published data supports this conclusion.

[The relationship between ambulatory blood pressure and left ventricular hypertrophy in essential hypertension]

The relationship between ambulatory blood pressure (ABP) and left ventricular hypertrophy (LVH) were investigated in 137 consecutive subjects (54 healthy normotensives and 83 uncomplicated patients with essential hypertension) who underwent 24-hour noninvasive ABP monitoring and M-mode echocardiography. In the normotensive group, left ventricular mass index (LVMI) was not correlated with average daytime (6AM-10PM) or nighttime (10PM-6AM) systolic and diastolic blood pressure (SBP and DBP) except for age (r = 0.405, P < 0.01). In the hypertensive group, however, LVMIs were significantly correlated with average daytime SBP (r = 0.315, P < 0.01), nighttime SBP (r = 0.408, P < 0.01) and DBP (r = 0.304, P < 0.01). Furthermore, significant inverse correlations were found between LVMI and percentage of nocturnal reduction of daytime SBP (r = -0.393, P < 0.01) and DBP (r = -0.308, P < 0.01). The results suggest that the average levels of ABP, particularly, the level of ABP during night and the loss of circadian variation of blood pressure, would be responsible for the development of LVH. The control of blood pressure and restoration of circadian blood pressure variation might be necessary for the reversal of LVH in hypertensive patients.

[Nuclear morphometry and DNA cytometry in the grading of malignant tumors of the salivary gland]

Nuclear morphometry and DNA cytometry were performed in 6 normal salivary glands and 37 malignant tumors of the salivary gland. Multivariate discrimination analysis was used to grade the malignant salivary gland tumors. The discrimination rate was 100% for normal salivary gland, benign tumor, high malignant carcinoma and low malignant carcinoma. It was 66.7% for borderline malignancies. These results indicate that quantitative cytological analysis is effective and reproducible in the grading of salivary gland tumors. Stepwise multivariate regression analysis showed that there was a very complicated correlation between DNA content and nuclear morphometric parameters of salivary gland tumors.

[Preliminary study on proliferative characteristics of the mixed tumor]

DNA-content was quantitatively determined in 2 monomorphic adenomas, 16 mixed tumors and 3 malignant mixed tumors by image analysis technique. While 7 cases of mixed tumor show slow proliferative activity similar to that of monomorphic adenomas, there are 6 cases of mixed tumor in which active proliferation and the appearance of polyploid and aneuploid (AN) below 10% are found. In 3 cases of mixed tumor the proportion of AN is above 10%, indicating abnormal proliferation as that of malignant mixed tumor. The results indicate that mixed tumors need to be considered as being composed of various kinds of biological behavior. Mixed tumors with long preoperation duration (> or = 6 years) are characterized by an increase in the number of proliferation diploid and AN as compared to that with short (< or = 3 years) preoperation duration (P < 0.01). Mixed tumors with the size > 2.5 cm have more AN than that with the size < or = 2.5 cm (P < 0.01). The results indicate that the risk of malignant transformation of a benign mixed tumor increases as it grows.