[Analysis of differences in health awareness among urban and rural elderly population under the background of aging]

Objective: To explore the status quo, differences and influencing factors of health concern among the elderly in urban and rural areas. Methods: The data of China Health and Retirement Tracking Survey (CHARLS) in 2018 were used to describe the health concerns of the elderly in urban and rural areas by selecting relevant indicators. The differences of health concerns of the elderly in urban and rural areas were compared from two aspects of social demographic characteristics and health status. Multivariate logistic regression model was used to analyze the factors affecting the health concern of the elderly in urban and rural areas. Results: A total of 7 758 urban and rural elderly were included, including 1 913 urban elderly and 5 845 rural elderly. Half (3 899, 50.3%) of the elderly are at the average level of health concern, and there is a difference between urban and rural elderly (χ2=186.61,P<0.05). The rural and urban elderly with different characteristics had different health concerns. The rural elderly with more than two diseases had higher health concerns (χ2=13.71, P=0.001), and different living types of urban elderly people have different health concerns (χ2=28.96, P<0.001). Regression analysis showed that the health concern of the elderly in urban and rural areas was affected by many factors, gender (OR=1.51, P<0.001), health status (OR=2.18, P<0.001), cognitive function impairment (OR=2.93, P<0.001), depression (OR=0.49, P<0.001) is the main factor affecting the difference of health attention of the elderly in urban and rural areas. Whether to receive pension was the influential factor of health concern of the rural elderly (OR=0.63, P<0.05); Disability was an influential factor in the health concern of the urban elderly (OR=2.11, P<0.05). Conclusion: There is much room to improve the health attention of the elderly in urban and rural areas. It is suggested to increase the economic security of the elderly in rural areas and pay special attention to the disabled elderly in urban areas, so as to further improve the health status of the elderly groups.

[Research on the formulation and revision of standard limits for antimony,boron and vanadium in the "Standards for Drinking Water Quality (GB5749-2022)" in China]

China is rich in antimony, boron, and vanadium mineral resources, which have been detected in environmental water bodies and drinking water. During the revision process of the "Standards for Drinking Water Quality (GB5749-2006)", research and evaluation are focused on three indicators: antimony, boron and vanadium. Vanadium is added and the limit value of boron is adjusted. This study reviews and discusses the technical contents related to the revision of the antimony, boron and vanadium, including the environmental presence levels, exposure status, health effects, and the revision of the standard limits of these three indicators. Suggestions are also made for the implementation of this standard.

[Methodological study on the establishment of limit values in the Standards of Drinking Water Quality]

The establishment of limit values for standards of drinking water quality is an important and complex process. This study systematically introduced the methodology of the establishment of standard limit values for drinking water quality and elaborated on the workflow of setting limit values of water quality indicators, principles and methods of selecting water quality indicators, derivation of safety reference values, and establishment of limit values. It also aimed to provide reference and support for the future revision of relevant standards.

[Artificial intelligence-based literature data warehouse for vaccine safety]

Objective: To establish a sustainable updated literature data warehouse for global vaccine safety assessment, and provide data support for evidence-based vaccine safety assessment. Methods: Semi-automated construction and updating of a literature data warehouse were achieved through the continuous integration of standard operating steps of evidence-based reviews with artificial intelligence technologies. Following the standard procedure of a systematic literature review, the literatures about vaccine safety assessment published before November 29, 2020 were retrieved from 9 databases including OVID, Scopus, Web of Science, Cochrane Library, and ClinicalTrails.org in English and Wanfang, CNKI, VIP, and SinoMed in Chinese. Literatures were screened for two rounds in a semi-automatic manner (by artificial intelligence literature processing system and manual work) according to the inclusion/exclusion criteria. Furthermore, the literatures were classified according to the types of vaccines and adverse events. The updating strategy was established, and the literature data warehouse was updated regularly. Experts were organized to select specific vaccine safety topics and carry out special demonstration studies. Results: More than 0.41 million articles were retrieved. According to the inclusion/exclusion criteria, 23 304 articles were included after two rounds of screening. At present, we have selected and completed three prior topics as demonstration studies, including the systematic review of "DPT (diphtheria, pertussis and tetanus) vaccine and encephalopathy/encephalitis", and the classified management of literatures about allergic purpura and brachial plexus neuritis. Conclusions: The sustainable updated literature data warehouse of vaccine safety can provide high-quality research data for vaccine safety research, including evidence support for immunization related policy-making and adjustment and vaccine safety-related methodological research or clinical tool development; and further demonstration studies can provide references for building a new methodological framework system for timely and efficient completion of the evidence-based assessment of vaccine safety.

[Potential suitable habitats of Haemaphysalis longicornis in China under different climatic patterns]

OBJECTIVE

To evaluate the impact of environmental and climatic factors on the distribution of suitable habitats of Haemaphysalis longicornis, and to predict the potential distribution of H. longicornis under different climate patterns in China.

METHODS

Data pertaining to the distribution of H. longicornis were retrieved from public literatures. The effects of 19 climatic factors (annual mean temperature, annual mean temperature difference between day and night, isothermality, standard deviation of seasonal variation of temperature, maximum temperature of the warmest month, minimum temperature of the coldest month, temperature annual range, mean temperature of the wettest season, mean temperature of the driest season, mean temperature of the warmest season, mean temperature of the coldest season, annual mean precipitation, precipitation of the wettest month, precipitation of the driest month, coefficient of variance of precipitation, precipitation of the wettest season, precipitation of the driest season, precipitation of the warmest season and precipitation of the coldest season) and 4 environmental factors (elevation, slope, slope aspect and vegetation coverage) on the potential distribution of H. longicornis were assessed using the maximum entropy (MaxEnt) model based on the H. longicornis distribution data and climatic and environmental data, and the potential distribution of H. longicornis was predicted under the RCP 2.6 and 8.5 emissions scenarios.

RESULTS

Among the environmental and climatic factors affecting the geographical distribution of H. longicornis in China, the factors contributing more than 10% to the distribution of H. longicornis mainly included the precipitation of the driest month (26.0%), annual mean temperature (11.2%), annual mean precipitation (10.0%) and elevation (24.2%). Under the current climate pattern, the high-, medium- and low-suitable habitats of H. longicornis are 1 231 900, 1 696 200 km² and 1 854 400 km² in China, respectively. The distribution of H. longicornis increased by 336 100 km² and 367 300 km² in 2050 and 2070 under the RCP 2.6 emissions scenario, and increased by 381 000 km² and 358 000 km² in 2050 and 2070 under the RCP 8.5 emissions scenario in China, respectively.

CONCLUSIONS

Climatic and environmental factors, such as precipitation, temperature and elevation, greatly affect the distribution of H. longicornis in China, and the suitable habitats of H. longicornis may expand in China under different climate patterns in future.

[Effects of climate changes on the distribution of Rhipicephalus microplus in China]

OBJECTIVE

To identify the environmental factors affecting the geographical distribution of Rhipicephalus microplus in China, and to examine the impact of climate changes on the distribution of R. microplus in China.

METHODS

The national and international publications pertaining to the geographical distribution of R. microplus in China were retrieved, and the geographical location was extracted. The suitable habitats of R. microplus and the dominant environmental factors affecting the distribution of suitable habitats of R. microplus were predicted in China based on the geographical data and environmental variables using the ArcGIS 10.7 software and the maximum entropy model.

RESULTS

Among the main climatic factors affecting the geographical distribution of R. microplus in China, the factors contributing more than 10% to the suitable habitats of R. microplus mainly include the annual mean precipitation (38.2%), the average temperature of the coldest quarter (28.4%) and the precipitation of the driest month (14.2%). The current suitable habitats of R. microplus were mainly found in southern China, and the high-, medium- and low-suitable areas accounted for 8.6%, 13.1% and 10.5% of the total land area of China, respectively. The suitable habitats of R. microplus were predicted to increase by 399 800 km² in China using the maximum entropy model under the RCP 4.5 emissions scenario in 2070, and the emerging suitable habitats were mainly distributed in Gansu Province, Ningxia Hui Autonomous Region, Qinghai Province, Hebei Province, Shaanxi Province, Liaoning Province, Inner Mongolia Autonomous Region, Shandong Province, Sichuan Province and Tibeten Autonomous Region. In addition, the suitable habitats of R. microplus were predicted to show an overall expansion towards northward from present to 2070.

CONCLUSIONS

Climate changes affect the distribution of suitable habitats of R. microplus in China, and annual mean precipitation may be a key factor affecting the distribution of suitable habitats of R. microplus.

[Current situation, problems and suggestions of environmental health standardization]

In this paper, the history and current situation of environmental health standardization in China are reviewed, and the experience and shortcomings in the process of environmental health standardization in China are analyzed, suggestions for the next step of environmental health standards are also put forward.

[Suggestions on environmental and health work from Health Environment Promotion Campaigns]

The Health Environment Promotion Campaigns (HEPCs) focus on the major environmental health issues and relevant factors of concern among the general public, and promote the achievement of the national health goal. Based on the summary and analysis of the background, key indicators, specific actions in different domains of the HEPCs, this paper proposes suggestions for scientifically implementing HEPCs from five aspects, namely, formulating implementation plans, establishing pilot areas, building comprehensive service platforms, improving the health literacy of residents and strengthening the development of protection technologies and standards.

HOXA11-AS regulates diabetic arteriosclerosis-related inflammation via PI3K/AKT pathway

OBJECTIVE

This study aims to explore whether homeobox A11 antisense RNA (HOXA11-AS) could regulate inflammation induced by diabetic arteriosclerosis (DAA) via PI3K/AKT pathway.

PATIENTS AND METHODS

Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was used to detect expressions of HOXA11-AS and proinflammatory genes in carotid endarterectomy samples of symptomatic and asymptomatic atherosclerosis (AS) patients, diabetes mellitus (DM), and non-DM patients. The above-mentioned genes in DM animal model and non-DM animal model were also detected. We detected the expression of HOXA11-AS in vascular smooth muscle cells (VSMCs) treated with platelet-derived growth factor (PDGF) or PDGF inhibitor imatinib, respectively. Subsequently, we applied cell transfection technology to interfere with the expression of HOXA11-AS in VSMCs. In vascular endothelial cells (VECs) and VSMCs, we detected the effect of HOXA11-AS on the expressions of genes related to the proliferation, migration, and cell cycle. Then, VSMCs were treated with tumor necrosis factor-α (TNF-α), and the expression of HOXA11-AS was examined in VSMCs. The effect of HOXA11-AS on TNF-α-induced inflammation in VSMCs was detected as well. Finally, we analyzed the effect of HOXA11-AS on PDGF-induced activation of PI3K/AKT pathway in VSMCs and VECs.

RESULTS

HOXA11-AS expression was markedly increased in carotid endarterectomy specimens of symptomatic AS patients compared to that of asymptomatic AS patients. Expression levels of HOXA11-AS and pro-inflammatory genes were significantly elevated in carotid endarterectomy specimens of DM patients. Similarly, HOXA11-AS expression was also significantly increased in carotid arteries of DM mice compared with that of non-DM mice. PDGF could upregulate HOXA11-AS expression in VSMCs, which was reversed by PDGF inhibitor imatinib. HOXA11-AS knockdown could reduce the expressions of the proliferation-associated gene (PCNA) and the cycle-related genes (p21, p53), and also inhibited the proliferation and migration of VSMCs induced by PDGF. HOXA11-AS was upregulated by TNF-α. HOXA11-AS knockdown remarkably downregulated expressions of inflammation-related genes in VSMCs induced by TNF-α. In VECs, low expression of HOXA11-AS can inhibit the expression of TNF-α-induced pro-inflammatory genes and PDGF-induced vascular inflammation-related genes. Low expression of HOXA11-AS inhibited PDGF-induced activation of PI3K/AKT pathway in VSMCs and VECs.

CONCLUSIONS

HOXA11-AS may participate in DAA by activating the PI3K/AKT pathway to regulate inflammation in VSMCs and VECs.

Research on rat models of hypobaric hypoxia-induced pulmonary hypertension

OBJECTIVE

Rat models of hypobaric hypoxia-induced pulmonary hypertension are commonly used in studies of chronic mountain sickness, while there are few researches specially focusing on these rats model. This study aims to exploring possible pathogenesis of hypobaric hypoxia-induced pulmonary hypertension by experimenting on hypobaric hypoxia-induced PH rat models at different simulate- altitudes.

MATERIALS AND METHODS

32 healthy male SD rats were randomly divided into six groups of different degree and time period of hypobaric hypoxia. The mean pulmonary arterial pressure (m PAP), right ventricular pressure (RVSP), the right ventricle (RV), left ventricular (LV), ventricular septal (S), the right ventricular hypertrophy index (RVHI) [calculated under the formula of RV / (LV + S)], hematoxylin-eosin staining, elastic fibers staining, the ratio of the thickness of vascular wall to its outer diameter (MT%), the ratio of the cross-sectional area of the middle vascular wall to the total vascular cross-sectional area (MA%); the α-SMA, and the Ki6 expressions were detected to evaluated the pulmonary hypertension.

RESULTS

There were significant differences of the mPAP, RVSP and RVHI value between the hypobaric hypoxia groups and the control group (p < 0.05). The mPAP, RVSP, RVHI, MT%, MA%, α-SMA, and Ki6 of rats in model groups at an altitude of 3KM were higher than those of the control group, which raised gradually with the number of weeks increasing. The mPAP, RVSP, RV / (LV + S) value, MT%, MA%, α-SMA, and Ki67 of the 5KM-4W group were significantly higher than those of the control group (p < 0.05).

CONCLUSIONS

Rat models with pulmonary hypertension at different altitudes have been successfully established by automatic adjusting hypobaric hypoxia chamber. Exposure to a low oxygen environment at a simulate-altitude of 3 km for 8 weeks have caused the pathological remodeling of pulmonary vascular walls and pulmonary hypertension, and further led to a series of pathological changes, including right ventricular hypertrophy. This model is easy to be replicated with good reproducibility and provides evidence for clinical trial of drugs.

Chromatin structure of two genomic sites for targeted transgene integration in induced pluripotent stem cells and hematopoietic stem cells

Achieving transgene integration into preselected genomic sites is currently one of the central tasks in stem cell gene therapy. A strategy to mediate such targeted integration involves site specific endonucleases. Two genomic sites within the MBS85 and CCR5 genes [AAVS1 and CCR5 zinc finger nuclease (CCR5-ZFN) site, respectively] have recently been suggested as potential target regions for integration as their disruption has no functional consequence. We hypothesized that efficient transgene integration maybe affected by DNA accessibility of endonucleases and therefore studied the transcriptional and chromatin status of the AAVS1 and CCR5 sites in eight human induced pluripotent stem (iPS) cell lines and pooled CD34+ hematopoietic stem cells. Matrixchromatin immunoprecipitation (ChIP) assays demonstrated that the CCR5 site and surrounding regions possessed a predominantly closed chromatin configuration consistent with its transcriptionally inactivity in these cell types. In contrast, the AAVS1 site was located within a transcriptionally active region and exhibited an open chromatin configuration in both iPS cells and hematopoietic stem cells. To show that the AAVS1 site is readily amendable to genome modification, we expressed Rep78, an AAV2-derived protein with AAVS1-specific endonuclease activity, in iPS cells after adenoviral gene transfer. We showed that Rep78 efficiently associated with the AAVS1 site and triggered genome modifications within this site. On the other hand, binding to and modification of the CCR5-ZFN site by a zinc-finger nuclease was relatively inefficient. Our data suggest a critical influence of chromatin structure on efficacy of site-specific endonucleases used for genome editing.

High efficiency reconstitution of a human-mouse chimeric Fab of CAb-1 antibody specific to human colon cancer

Monoclonal antibody (mAb) has been widely applied in the treatment of human diseases, especially in malignant tumours. However, most antibodies produced in mouse by hybridoma technology might induce severe human anti-mouse reactions. We had reported a murine mAb CAb-1 of therapeutic interest for its specifically binding to a cell surface glycoprotein of human colon cancer. Here, we attempted to generate a reconstituted human-mouse chimeric Fab (cFab) of CAb-1 in vitro to reduce its antigenicity and increase its capacity of penetration. First, the genes of heavy and light chain variable region (VH, VL) of CAb-1 were cloned. Then, the chimeric light chain (cL) and Fd (cFd) were constructed and expressed in Escherichia coli. Finally, the reconstituted cFab was obtained by gradient dialysis of the mixture of cFd and cL. SDS-PAGE and western blot analysis showed the reconstituted cFab with a recovery rate of 70.2% when the initial total concentration of cL and cFd proteins to be 100 microg/ml. The reconstituted cFab maintained the affinity and specificity to colon cancer cells compared with its parental antibody as determined by immunostaining analysis, FACS and ELISA. Our results established a foundation for further application of the cFab in diagnosis and treatment of colon cancer.

Epitope mapping of series of monoclonal antibodies against the hepatocellular carcinoma-associated antigen HAb18G/CD147

The hepatocellular carcinoma-associated antigen HAb18G/CD147, a member of CD147 family, could promote tumour invasion and metastasis via inducing the secretion of matrix metalloproteinases (MMP). Anti-CD147 monoclonal antibodies (MoAb) have exhibited obvious inhibitory effect on MMP induction. However, none of the epitopes of these MoAb has been reported. We previously prepared five MoAb against HAb18G/CD147, named HAb18, 3B3, 1B3, 5A5 and 4D2. To map the epitopes of these MoAb, a series of truncated fragments of extracellular region of HAb18G/CD147 was expressed in Escherichia coli and the MoAb-binding affinity to these fragments was examined with an enzyme-linked immunosorbent assay and Western blot. The residues (39)LTCSLNDSATEV(50), (36)KILLTCS(42) and (22)AAGTVFTTVEDL(33) were determined to be the epitopes of HAb18, 3B3 and 1B3, respectively, which were further proved by a dot-blot analysis with synthesized peptides and bioinformatics epitope prediction. The binding regions of MoAb 5A5 and 4D2 were located at residues E(120)-R(203). Then we constructed and expressed full-length HAb18G/CD147 and truncated HAb18G/CD147 without residues A(22)-V(50) in COS-7 cells. Gelatin zymography and Boyden chamber assay showed that the COS-7 cells expressing truncated HAb18G/CD147 failed to induce MMP production and enhance the cells' invasive potential, compared with the cells expressing full-length HAb18G/CD147. Taken together with the obviously inhibitory effects of HAb18 on the function of full-length HAb18G/CD147, these findings suggest that residues (22)AAGTVFTTVEDLGSKILLTCSLNDSATEV(50) may play a critical role in the functions of HAb18G/CD147 on MMP secretion and tumour invasion. These key residues can be used as potential drug target in cancer therapy.

HAb18G/CD147-mediated calcium mobilization and hepatoma metastasis require both C-terminal and N-terminal domains

HAb18G/CD147 is a heavily glycosylated protein containing two immunoglobulin superfamily domains. Our previous studies have indicated that overexpression of HAb18G/CD147 enhances metastatic potentials in human hepatoma cells by disrupting the regulation of store-operated Ca2+ entry by nitric oxide (NO)/cGMP. In the present study, we investigated the structure-function of HAb18G/CD147 by transfecting truncated HAb18G/CD147 fragments into human 7721 hepatoma cells. The inhibitory effect of HAb18G/CD147 on 8-bromo-cGMP-regulated thapsigargin-induced Ca2+ entry was reversed by the expression of either C or N terminus truncated HAb18G/CD147 in T7721deltaC and T7721deltaN cells, respectively. The potential effect of HAb18G/CD147 on metastatic potentials, both adhesion and invasion capacities, of hepatoma cells was abolished in T7721deltaC cells, but not affected in T7721deltaN cells. Release and activation of matrix metalloproteinases (MMPs), MMP-2 and MMP-9, were found to be enhanced by the expression of HAb18G/CD147, and this effect was abolished by both truncations. Thapsigargin significantly enhanced release and activation of MMPs (MMP-2 and MMP-9) in non-transfected 7721 cells, and this effect was negatively regulated by SNAP. However, no effects of thapsigargin or SNAP were observed in T7721 cells, and expression of HAb18G/CD147 enhanced secretion and activation of MMPs at a stable and high level. Taken together, these results suggest that both ectodomain and intracellular domains of HAb18G/CD147 are required to mediate the effect of HAb18G/CD147 on the secretion and activation of MMPs and metastasis-related processes in human hepatoma cells by disrupting the regulation of NO/cGMP-sensitive intracellular Ca2+ mobilization although each domain may play different roles.

An experimental model of retinal pigment epithelial and neurosensory serous detachment

PURPOSE

The authors document an animal model of retinal pigment epithelial (RPE) detachments.

METHODS

N-ethylmaleimide (NEM) and sodium iodate (sulfhydryl-alkylating agents) were injected into the vitreous of Dutch pigmented rabbits. Subretinal fluid samples were withdrawn 0.5 and 3 hours after NEM injections and analyzed for albumin content by gel electrophoresis. Selected eyes were examined histologically.

RESULTS

Injections of 9.2 micrograms NEM caused wrinkling of the retina within 15 minutes, at which time fluorescein angiography revealed multifocal RPE detachments. At this stage, histologic sections showed moderate choroidal edema and RPE detachment. Elevated retinal detachments developed over the next 15 to 25 minutes. Histologic sections showed massive choroidal edema and RPE fragmentation. The albumin concentration of subretinal fluid rose from 60% of serum level at 30 minutes after NEM to 80% after 3 hours. Sodium iodate did not cause choroidal edema or RPE detachment.

CONCLUSION

In rabbits, intravitreal NEM causes the rapid appearance of choroidal edema and RPE detachment, followed by serous retinal detachment. The initial effect probably is caused by an alteration of choroidal vascular permeability. The relationship of these effects to sulfhydryl alkylation is unclear because sodium iodate failed to produce RPE detachments. N-ethylmaleimide effects may model aspects of clinical RPE and serous retinal detachments.

Cytochalasin D reversibly weakens retinal adhesiveness

This study asks whether retinal adhesiveness is affected by cytochalasin D, a drug that is known to alter the apical morphology of the retinal pigment epithelium (RPE). Cytochalasin D was injected intravitreally in Dutch rabbits and retinal adhesiveness measured 0.5 to 72 h later by two methods: in vitro peeling of the retina from retinal pigment epithelium to observe the amount of adherent pigment, and in vivo measurement of the pressure needed to achieve retinal separation. Electroretinograms were recorded, and RPE apical morphology was examined by scanning electron microscopy. The injection of 60 microM cytochalasin D caused in vitro retinal adhesiveness to fall within 3 h to 10% of normal although the electroretinogram (a, b, and c-waves) remained normal. Smaller doses of cytochalasin D had a lesser effect. The RPE apical surface at 3 h showed large bullet-like microvilli, swollen cone sheaths, and an absence of filamentous microvilli. The severity of these changes was dose-related. At 72 h after cytochalasin D, retinal adhesiveness had largely recovered, and RPE apical morphology appeared normal again. Thus, cytochalasin D weakens retinal adhesiveness acutely but reversibly, and both the initial effect and recovery correlate with changes in RPE microvillar morphology. This suggests that actin microfilaments may be involved in mechanisms of retinal adhesion.

The interphotoreceptor matrix mediates primate retinal adhesion

OBJECTIVE

To assess the participation of cone matrix sheaths, which are domains of the cone photoreceptor-associated interphotoreceptor matrix that extend from the neural retina to the surface of the retinal pigment epithelium (RPE), in retinal adhesion.

METHODS

Monkey and human retinas were partially peeled from the RPE, and the tissues were examined by lectin histochemistry to determine the effects of physical separation on the cone matrix sheath.

RESULTS

A firm attachment of cone matrix sheaths to both the RPE and the neural retina that was strong enough to cause detachment of sheets of RPE cells from Bruch's membrane or tearing of the sheaths as a result of retinal peeling was observed. Cone matrix sheaths can stretch considerably and contract following tearing. Their integrity was compromised rapidly after the first postmortem minute.

CONCLUSION

Cone matrix sheath glycoconjugates are likely to play a major role in mediating retinal adhesion by forming a molecular bridge between the neural retina and the RPE.

The metabolic dependency of retinal adhesion in rabbit and primate

OBJECTIVE

To determine the oxygen and glucose dependency of retinal adhesion in primate and rabbit.

METHODS

Experiments were performed on Dutch rabbits and monkeys. Retinal adhesiveness was measured by peeling the retina from the retinal pigment epithelium in vitro, under different conditions of PO2 and glucose supply, and by observing the amount of adherent pigment. In vivo ischemia was produced by raising the intraocular pressure.

RESULTS

Retinal adhesion failed quickly at low oxygen tensions, but a well-oxygenated solution preserved strong retinal adhesion in vitro for 15 to 20 minutes in rabbit tissue and up to 50 minutes in primate tissue. Ischemic adhesive failure was reversible on raising the PO2. Glucose levels did not affect adhesiveness. Ischemia in vivo for more than 1 minute caused rabbit retina to lose its adhesiveness.

CONCLUSIONS

Retinal adhesion is continually and reversibly dependent on oxygenation, and probably on aerobic metabolism. Primate tissue is more resistant to metabolic adhesive failure than is rabbit tissue, but the metabolic requirements appear qualitatively similar.

The rate and source of albumin entry into saline-filled experimental retinal detachments

PURPOSE

To investigate the rate and source of albumin entry into experimental nonrhegmatogenous detachments.

METHODS

Detachments were made in Dutch rabbits by injecting Hanks' balanced salt solution into the subretinal space through a micropipette. Subretinal fluid was withdrawn 0 to 4 hours later through a similar micropipette and analyzed for osmolality and albumin content (by gel electrophoresis). Sodium iodate was injected intravenously in some rabbits to damage the retinal pigment epithelium (RPE). In some rabbits fluorescein isothiocyanate albumin (FITC-albumin) was injected intravitreally or intravenously to measure its entry into the subretinal fluid by fluorophotometry. Results from 4 to 8 eyes were averaged for each data point.

RESULTS

The albumin concentration and total amount of albumin in the subretinal fluid increased steadily over 4 hours in retinal detachments initially filled with Hanks' solution. Pretreating rabbits with sodium iodate injection resulted in a 50-fold increase in the rate of albumin entry, although the levels were still low relative to those of serum. Intravitreal FITC-albumin entered the subretinal fluid at a rate independent of sodium iodate damage, but intravenous FITC-albumin only entered the subretinal space after RPE damage. Subretinal fluid osmolality remained within the range of 291 to 294 mOsm/kg, irrespective of sodium iodate damage or differences in the rate of fluid absorption.

CONCLUSIONS

These results indicate that albumin can diffuse into the rabbit subretinal space from both vitreous and bloodstream, although entry from serum requires damage to the RPE. Subretinal fluid appears to be transported actively (control eyes) or passively (iodate-damaged eyes) out of the subretinal space, despite albumin entry and without major osmolar shifts.

Conditions necessary for the formation of serous detachment. Experimental evidence from the cat

OBJECTIVE

To evaluate experimentally the conditions necessary for the formation of serous detachments.

METHODS

Selective injury to the retinal pigment epithelium (RPE) and choriocapillaris was produced in cats using weak laser burns and intense diffuse light, with or without photosensitization with rose bengal. The fundi were analyzed by observation, fluorescein angiography, and histologic examination.

RESULTS

Injuring the RPE alone did not cause detachments. Focal injury to the RPE and choriocapillaris caused moderate detachment only when an area surrounding the focal leakage site had been subjected to light damage. Diffuse injury to the RPE and choriocapillaris caused broader detachments.

CONCLUSIONS

Three conditions are necessary for serous detachments to form: (1) a source of fluid pressure, (2) a defect in the blood-retinal barrier (entry site), and (3) an area of impaired fluid transport beyond the site of leakage (if fluid is to accumulate over a broader area).

Retinal adhesiveness in the monkey

PURPOSE

To determine factors that influence retinal adhesion in the primate and compare these with previous data from the rabbit.

METHODS

Retinal adhesiveness was studied in monkey eyes immediately after enucleation. The retina was peeled manually from the retinal pigment epithelium, and the amount of pigment that remained adherent to the retina was used as an index of adhesiveness.

RESULTS

The rate of post mortem failure of retinal adhesiveness in the monkey was less than in the rabbit under similar conditions. However, as in the rabbit, adhesiveness was sensitive to temperature, pH, and the concentrations of calcium and magnesium, and subretinal injections of neuraminidase weakened adhesion beyond the injection sites.

CONCLUSIONS

Mechanisms of retinal adhesion are similar in primates and rabbits.

Retinal adhesiveness in surgically enucleated human eyes

PURPOSE

Retinal adhesion in rabbits and monkeys has been shown to involve the interphotoreceptor matrix and depend on environmental factors, such as temperature, pH, and calcium concentration. This study was designed to see whether these same factors modulate retinal adhesiveness in humans.

METHODS

Four surgically enucleated human eyes were studied. Strips of eyecup were placed in experimental baths shortly after enucleation to evaluate environmental conditions. Retinal adhesive strength was quantified by the amount of retinal pigment epithelial pigment adherent to retina peeled from strips of eyecup. Cone and rod sheaths of the interphotoreceptor matrix were studied by microscopic examination of samples stained with the lectins peanut and wheat germ agglutinin.

RESULTS

Retinal adhesiveness fell to 0 approximately 40 minutes after enucleation. Adhesive strength was maintained by cold temperature and was weakened by low pH or low calcium in the bath. Cone and rod matrix sheaths became stretched (indicating a bond) as outer segments and retinal pigment epithelium were peeled apart.

CONCLUSION

Retinal adhesion in humans appears to involve similar mechanisms as in rabbits and monkeys.

Oxygen dependency of retinal adhesion

PURPOSE

Normal retina is firmly attached to the retinal pigment epithelium, but the force of this adhesion drops precipitously within the first 2-3 min after enucleation. The purpose was to study metabolic factors that might be relevant to this postmortem failure of adhesion.

METHODS

Dutch rabbit retina was manually peeled from the retinal pigment epithelium on strips of enucleated eyecup within a 37 degrees C bath. Retinal adhesiveness was measured by observing the amount of retinal pigment epithelium that remained adherent to the retina.

RESULTS

Autologous whole blood in place of salt solution retarded the decrease in adhesiveness. A solution of hemoglobin alone was similarly effective, whereas methemoglobin solution failed to help the persistence of retinal adhesion. Bubbling oxygen into the salt solution and circulating it to avoid oxygen depletion at the tissue boundary also proved effective at sustaining retinal adhesiveness. Eyes made ischemic in vivo for 5 min or longer, by elevating intraocular pressure, showed virtually no retinal adhesion when enucleated immediately thereafter. However, eyes made ischemic for 10 min, but allowed to regain circulation for 5 min before enucleation, showed a return of retinal adhesiveness to 80% of normal.

CONCLUSIONS

Oxidative metabolism is critical to the maintenance of retinal adhesiveness, and the effects of oxygen deprivation on adhesion are reversible within a certain time period.

Nuclear morphometry and its prognostic significance in laryngeal squamous cell carcinomas

The five parameters including nuclear area (NA), nuclear perimeter (NP), nuclear diameter (ND), axis ratio and nuclear roundness were evaluated with MIAS200 Image Analysis System (Sichuan University, Chengdu) in 45 patients with laryngeal primary squamous cell carcinoma, which were confirmed pathologically and operated on from January 1977 to October 1987. The results showed that NA, NP and ND are important prognostic indicators. The survival rate in patients with large nuclei (NA greater than 73 microns2, NP greater than 32.5 microns, ND greater than 12 microns) was significantly lower than that in those with small nuclei (NA less than 73 microns2, NP less than 32.5 microns, ND less than 12 microns) (P less than 0.0025). These findings strongly suggest that patients with laryngeal squamous cell carcinoma with large nuclei should be treated more aggressively.

Induction of serous retinal detachment in rabbit eyes by pigment epithelial and choriocapillary injury

Serous retinal detachments have been produced experimentally by occluding the choroidal circulation. We sought a more realistic model by adjusting rose bengal photosensitization to injure the retinal pigment epithelium and choriocapillaris in rabbits without causing vascular occlusion. We accomplished this by either using low doses of rose bengal or cooling the animal to reduce ocular temperature by 4 degrees C. Detachments typically appeared within 1 day after light exposure, centered over the area of light damage. Fluorescein angiography showed no capillary occlusion, but there was leakage of dye from areas of light damage. Light microscopy of light-damaged areas showed swelling or disruption of retinal pigment epithelial cells but a patent choriocapillaris. These data suggest that a combination of retinal pigment epithelial and choriocapillary damage may be necessary for serous detachment to occur.

Recovery of retinal adhesion after enzymatic perturbation of the interphotoreceptor matrix

Previous investigations established that focal subretinal injections of neuraminidase, chondroitinase, and hyaluronidase in the rabbit lead to a diffuse loss of retinal adhesiveness beyond the site of injection. This loss of adhesiveness, measured by peeling of the retina immediately after enucleation, correlates with changes in the interphotoreceptor matrix (IPM), as monitored by lectin histochemistry. In this study, rabbits were evaluated during recovery of retinal adhesiveness after subretinal injections of neuraminidase and chondroitinase. Adhesion recovered steadily 5-20 days after chondroitinase injection. After administration of neuraminidase, adhesion remained low for approximately 14 days but recovered to normal by 20 days. The recovery of adhesiveness correlated closely with reestablishment of the normal distribution of peanut agglutinin-binding glycoconjugates in the IPM, one group of molecules thought to participate in retinal adhesion. Electroretinography and light microscopy showed no abnormalities in the retina or retinal pigment epithelium after recovery. These results suggest that IPM glycoconjugates participate in maintaining retinal adhesion.

[The expression of nuclear estrogen receptor and its relation to cytoplasmic estrogen receptor in breast cancer]

Sixty specimens of breast cancer were assayed with ER-monoclonal antibody by immunocytochemical staining. Twenty-nine (48.33%) were nuclear estrogen receptor positive (ERn+). The number of ERn+ cancer cells decreased in the following sequence: mucinous carcinoma, invasive lobular carcinoma, invasive ductal carcinoma, and papillary adenocarcinoma. Two apocrine carcinomas were ERn-. ERn+ rate was higher in patients over 60 years of age (P less than 0.05). The amount of ERn+ cells was much greater in cancer cells than in the surrounding benign epithelial cells. This phenomenon may indicate that malignant cells are more hormone-dependent than benign cells. The results of immunocytochemical staining and steroid binding assay were compared. By immunocytochemical staining, twenty-four of fifty-seven cases (42.11%) were ERn+ and ERc+. Sixteen cases (28.07%) were ERn- and ERc-. This study showed that in a number of breast cancers ERs were positive in both cytoplasms and nuclei and the concordant rate was 70.18%. In the remaining cases 13 (22.81%), ERs were positive in the cytoplasm, and in 4 cases (7.02%) positive in nuclei only. Additionally, fifty-two out of 60 cases were assayed by 3H-estradiol and 3H-R5020 by means of steroid binding assay. Twenty-seven cases of them (51.92%) showed ERc+ and PRc+, and seventeen cases (32.69%) were ERc- and PRc-. Their correspondent rate was 84.61%.

DNA content and estrogen receptors in primary carcinoma of the breast

DNA content and estrogen-receptor status were studied in 54 consecutive patients with primary breast carcinoma. Estrogen-receptor determinations were performed by immunohistochemical assay on frozen sections with a monoclonal antibody against the estrogen-receptor molecule and by biochemical analysis with a dextran-coated charcoal method. Nuclear DNA content was measured by flow cytometry performed on formalin-fixed, paraffin-embedded sections. Seventy-two percent of tumours were positive for estrogen receptors by immunohistochemical assay and 67% by biochemical assay. Comparison of the qualitative results of immunohistochemical and biochemical estrogen-receptor determinations revealed a strong correlation between the two assays, with agreement in 90% of the cases (p less than 0.001). Regression analysis showed only a weak relationship between the quantitative results of the two assays. DNA analysis was performed in 51 cases, and 54% demonstrated aneuploid stemlines by flow cytometry. An association was demonstrated between aneuploidy and low levels of estrogen receptor. The association was highly significant with the immunohistochemical assay but not with the biochemical assay. The authors' results suggest that immunohistologic determinations of estrogen receptor status may better reflect the biologic features of the tumour cells. However, improved standardization in reporting the results is necessary if the test is to have widespread use.

[Influences of open thoracoscopy on human body: experience in 65 cases]

The influence of open thoracoscopy with fiber-bronchoscope on human body was studied in 65 patients with pleural disease. The items observed included blood pressure, Pulse rate, respiration rate, blood gas analysis and clinical manifestations. It was found that open thoracoscopy has little influence on human body and the patients tolerated it well. No severe complication was found and operative procedures might be avoided popularization of this technique is therefore suggested.

[The relation of deoxyribonucleic acid contents and nuclear estrogen receptors in breast cancers]

Flow cytometry was applied to the analysis of DNA contents in 59 cases of breast cancer, among which 28 cases were diploidy cancers, and 31 were aneuploid. DNA index of these cases was found to be ranging from 0.45 to 3.35, including S-phase fraction (SPF) from 2.46% to 78.87%, and proliferation index (PI) from 17.06 to 87.04. In 60 cases of breast carcinoma, nuclear estrogen receptors (ERn) were assayed by immunocytochemistry with ER-monoclonal antibody. 29 of them were ERn-, and 31 were ERn+. The DNA contents and ERn levels, both detected in each of 57 cases, were found to be correlated to some extent. In aneuploidy cancer group, there were more ERn- cases than ERn+ cases (P less than 0.05). The mean value of PI was higher in the ERn- group than in the ERn+ group, and the corresponding ERn- cases were more frequent with increase of PI value. Among those cases in which SPF was over 40%, there were more ERn- cases than ERn+ cases. The relations between ERn levels and DNA contents may represent the degree of differentiation of breast cancers and may help to predict prognosis.

Systemic mannitol increases retinal adhesiveness measured in vitro

Pigmented rabbits were given mannitol intravenously, and at various times thereafter blood osmolality was measured and eyes were enucleated to measure retinal adhesiveness to the retinal pigment epithelium. Both blood osmolality and retinal adhesion increased in proportion to the dose of mannitol. We found a measurable increase in retinal adhesion as early as 10 minutes and as late as 4 hours after mannitol injection. We suspect that mannitol dehydrates the subretinal space and thereby enhances the adhesive properties of the interphotoreceptor matrix or tightens the interdigitation between photoreceptors and pigment epithelial cells. Our data suggest that mannitol could have clinical application in the management of retinal detachments.

Retinal adhesiveness is weakened by enzymatic modification of the interphotoreceptor matrix in vivo

The role of interphotoreceptor matrix (IPM) constituents in mediating adhesion between the retina and retinal pigment epithelium (RPE) was investigated by injecting specific enzymes into rabbit eyes either intravitreally or subretinally. Retinal adhesiveness was measured by peeling the retina from the pigment epithelium 1-3 days later and observing the amount of adherent pigment. Effects of enzymes on the IPM were monitored by observation of peanut agglutinin (PNA) binding to cone matrix sheaths; retinal and RPE toxicity was excluded by electroretinography and histology. Three enzymes that degrade glycosaminoglycans or saccharides known to be constituents of the IPM (chondroitinase ABC, neuraminidase, and testicular hyaluronidase) both weakened adhesion and altered PNA binding, although the effects on the cone matrix sheaths were different for each enzyme. An enzyme specific for hyaluronic acid (Streptomyces-derived hyaluronidase), which has not been identified as a major IPM constituent, had no effect on either adhesion or PNA binding. The authors conclude that IPM-associated glycoconjugates participate in retinal adhesion, although their precise composition, interaction with IPM components, and relationship to other mechanisms of adhesion remain to be determined.

[Sequelae in 4122 cases of cesarean section]

From 1986-1987, there were altogether 28,048 deliveries in our hospital, and there were 4,122 cases of Cesarean section, a rate of 14.69%. Early postoperative complications occurred in 522 cases (12.66%). These were namely: postpartum hemorrhage 242 cases (5.87%), postoperative morbidity 151 cases (3.66%), bladder injury during operation 6 cases (0.15%), urinary fistula 1 case, transient hematuria after operation 39 cases (0.95%). 348 Cesarean section cases were followed-up 1-3 years after operation and 44 of them were found to suffer from late complications (12.64%). These included chronic overiosalpingitis 23 cases (6.6%), parametritis 9 cases (2.58%), paracystitis 6 cases (1.7%), abdominal incision scar endometriosis 3 cases (0.86%), ectopic pregnancy 3 cases (0.86%).

[Clinical and pathologic comparison of adult respiratory distress syndrome and infant respiratory distress syndrome]

The authors compared the clinical and pathological findings between adult respiratory distress syndrome (ARDS), and infant respiratory distress syndrome (IRDS). In ARDS, the most common causes were injury, infection, shock and acidosis. The clinical course was longer. The weight of the lungs increased markedly, the hyaline membrane formation in the alveoli was late in the clinical course, and the degree of edema in the interstitium of the lungs and microthrombosis within the blood vessels was more serious. The pathogenesis of ARDS was related to the activation of the complements and neutrophils by inflammation in which proteinase, oxygen radical, thromboxane, leukotriene and prostaglandin were released. Thus the endothelial cells of the blood vessels and capillary-alveoli membrane were damaged by these mediators. On the other hand, the main contributory factors of IRDS were suffocation of premature fetus by various reasons in the uterus and aspiration of meconium during delivery by the infant. The clinical course was shorter, alveolar hemorrhage and collapse were severe and hyaline membrane in alveoli was formed in early stage of the clinical course. Insufficiency of surfactant in premature fetus, damage of the surfactant system by hypoxia, aspiration of foreign materials and defect of the epithelial cells of infant were the pathogenic factors of IRDS, they resulted in increase of permeability of fluid and, as a result, led to pulmonary edema and atelectasis.

The enhancement of retinal adhesiveness by ouabain appears to involve cellular edema

Our previous work showed that ouabain increases retinal adhesion to the retinal pigment epithelium, but the mechanism of this effect has been unclear. In this study, we have found that the ouabain-induced increase in retinal adhesiveness was blocked reversibly by removing sodium from the medium or by exposure to hyperosmotic solution. Hyposmotic solution slowed down the postmortem failure of adhesion. Tissue edema could not be documented histologically, but retinal tissue water content increased by 2.9% after exposure to ouabain. These data suggest that the ouabain effect involves cellular edema, which may enhance adhesion by tightening the interdigitation between photoreceptor outer segments and retinal pigment epithelial microvilli.

Reversibility of retinal adhesion in the rabbit

We have studied retinal adhesion in the rabbit using a new technique for quantifying adhesiveness by the observation of how much pigment remains adherent to the photoreceptors after separation. Previous in vitro work has shown that retinal adhesiveness falls within 3 min after enucleation, is weakened by low pH or the removal of calcium and magnesium, and is increased by cold temperature. This report shows that the effects of low pH, low calcium/magnesium and temperature are all rapidly reversible. Thus, restoring normal pH or normal calcium/magnesium will restore adhesiveness to control levels, and adhesion may be repeatedly weakened or strengthened by the adjustment of temperature or the ionic environment. The actions of pH and calcium/magnesium are in part additive, while cold temperature can maintain adhesion even in low pH or low calcium/magnesium. These findings suggest that irreversible processes such as metabolic or enzymatic decay are not primarily responsible for the loss of retinal adhesion which occurs so rapidly after enucleation or death. They also suggest that retinal adhesion is a multifactorial process.

Selection of hormone-responsive advanced breast cancer with a cytoplasmic estrogen receptor assay. Analysis of 100 cases

One hundred women with advanced breast cancer were treated with endocrine therapy alone and the clinical response was correlated with the estrogen receptor status of the tumor as determined by a fluorescent histochemical assay designed to estimate the percentage of cancer cells with high cytoplasmic estrogen binding activity. Using clinical response rates as the standards for measurement, this histochemical method showed an 84% sensitivity, a 74% specificity, a 76% positive predictive value and an 82% negative predictive value. These results indicate that the histochemical assay may serve as a supplementary means to identify hormone-responsive mammary carcinomas and as a research tool to study the biology of this group of tumors.

Pigment adherence as a measure of retinal adhesion: dependence on temperature

Retinal adhesion deteriorates rapidly after enucleation. We have developed a new in vitro method for measuring retinal adhesiveness in the rabbit that is faster than previous models, and can monitor changes sooner after enucleation. We used the percentage of retina which retained pigment after peeling from the RPE as a quantitative measure of retinal adhesiveness. We found that the failure of adhesion after death is more rapid and severe than previously reported, but can be inhibited by cold temperature. Pigment adherence was also modified by ionic and metabolic factors that have been found to affect other indices of adhesion. These results emphasize the limitations of in vitro data relative to the physiologic forces that maintain retinal adhesion in vivo.