Observation of the Exotic 0_{2}^{+} Cluster State in ^{8}He

We report here the first observation of the 0_{2}^{+} state of ^{8}He, which has been predicted to feature the condensatelike α+^{2}n+^{2}n cluster structure. We show that this state is characterized by a spin parity of 0^{+}, a large isoscalar monopole transition strength, and the emission of a strongly correlated neutron pair, in line with theoretical predictions. Our finding is further supported by the state-of-the-art microscopic α+4n model calculations. The present results may lead to new insights into clustering in neutron-rich nuclear systems and the pair correlation and condensation in quantum many-body systems under strong interactions.

Theoretical prediction of superatom WSi12-based catalysts for CO oxidation by N2O

Catalytic conversion of N2O and CO into nonharmful gases is of great significance to reduce their adverse impact on the environment. The potential of the WSi12 superatom to serve as a new cluster catalyst for CO oxidation by N2O is examined for the first time. It is found that WSi12 prefers to adsorb the N2O molecule rather than the CO molecule, and the charge transfer from WSi12 to N2O results in the full activation of N2O into a physically absorbed N2 molecule and an activated oxygen atom that is attached to an edge of the hexagonal prism structure of WSi12. After the release of N2, the remaining oxygen atom can oxidize one CO molecule via overcoming a rate-limiting barrier of 28.19 kcal mol-1. By replacing the central W atom with Cr and Mo, the resulting MSi12 (M = Cr and Mo) superatoms exhibit catalytic performance for CO oxidation comparable to the parent WSi12. In particular, the catalytic ability of WSi12 for CO oxidation is well maintained when it is extended into tube-like WnSi6(n+1) (n = 2, 4, and 6) clusters with energy barriers of 25.63-29.50 kcal mol-1. Moreover, all these studied MSi12 (M = Cr, Mo, and W) and WnSi6(n+1) (n = 2, 4, and 6) species have high structural stability and can absorb sunlight to drive the catalytic process. This study not only opens a new door for the atomically precise design of new silicon-based nanoscale catalysts for various chemical reactions but also provides useful atomic-scale insights into the size effect of such catalysts in heterogeneous catalysis.

[The mechanism by which hsa_circRNA_103124 highly expressed in peripheral blood of patients with active Crohn's disease regulates macrophage differentiation, pyroptosis and inflammation]

Objective: To investigate the role and related mechanism of the highly expressed circular RNA molecule 103124 (hsa_circRNA_103124) in macrophage differentiation, pyroptosis and inflammation in peripheral blood mononuclear cells (PBMC) of patients with active Crohn's disease (CD). Methods: Patients with active CD (CD group) admitted to the Affiliated Suzhou Hospital of Nanjing Medical University from April to September 2018 and healthy people (control group) from the physical examination center of the hospital from July to October 2018 were retrospectively selected. The levels of hsa_circRNA_103124 and Toll-like receptor 4 (TLR4) in PBMC of the two groups were detected by real-time quantitative polymerase chain reaction (RT-qPCR). Tohoku hospital pediatrics-1 (THP1) cell line was used as a model for the study of hsa_circRNA_103124 regulating macrophage differentiation. Lentivirus infection was used to construct hsa_circRNA_103124 overexpressed or down-regulated THP1 cells to induce macrophage-like differentiation. According to the expression level of hsa_circRNA_103124, THP1 cell lines were divided into the following four groups: pLC5-ciR was overexpression control group; hsa_circRNA_103124 OE was the overexpression group; ShRNActrl was down-regulated expression control group; hsa_circRNA_103124 ShRNA was the down-regulated expression group. Flow cytometry was used to detect levels cluster of differentiation (CD) 68, CD80, interleukin (IL)-6, tumor necrosis factor α (TNF-α) and reactive oxygen species (ROS). The expression levels of IL-6, TNF-α, IL-1β, TLR4 and myeloid differentiation factor 88 (MyD88) were detected by RT-qPCR. The levels of gasdermin D (GSDMD), IL-18 and NOD-like receptor thermal protein domain associated protein 3 (NLRP3) were determined by immunofluorescence and RT-qPCR. Pearson correlation analysis was used to analyze the correlation between the abundance of hsa_circRNA_103124 and TLR4 expression level or Crohn's disease activity index (CDAI). Results: A total of 50 patients were included in the CD group, including 36 males and 14 females, aged (35±10) (19-64) years. A total of 30 subjects were included in the control group, including 22 males and 8 females, aged (38±9) (24-64) years. hsa_circRNA_103124 [(0.009±0.016) vs (0.003±0.002), P=0.042] and TLR4 [(0.005±0.003) vs (0.001±0.001), P<0.001] were all upregulated in the PBMC of patients in the CD group, compared with the control group. And hsa_circRNA_103124 was positively correlated with TLR4 (r=0.40, P=0.004). hsa_circRNA_103124 level was positively correlated with CDAI (r=0.32, P=0.024). The expression of CD68 (P=0.002) and CD80 (P<0.001) were enhanced. hsa_circRNA_103124 promoted production of ROS and the expression of IL-6, TNF-α, IL-1β, TLR4, MyD88, GSDMD, IL-18 and NLRP3 in macrophage-like M1 differentiated THP1 cells (all P<0.05). Conclusion: High expresion of hsa_circRNA_103124 in PBMC of patients with active CD may promote macrophage M1 differentiation, pyroptosis and inflammation through enhancing the expression of TLR4, MyD88, NLRP3 and GSDMD.

[Exploration of the effect of blood lipids on the lesion distribution pattern in acute ischemic stroke based on MRI study with population standard spatial analysis]

Objective: To explore the effect of blood lipids on the lesion distribution pattern in patients with acute ischemic stroke by using MRI technology based on population standard spatial analysis. Methods: The MRI data of 1 202 patients with acute ischemic stroke in General Hospital of Eastern Theater Command from January 2015 to December 2020 and Nanjing First Hospital from January 2013 to December 2021 were retrospectively collected, including 871 males and 331 females, aged 26 to 94 (64±11) years. According to the condition of blood lipids, they were divided into the dyslipidemia group (n=683) and the normal blood lipids group (n=519). After the automatic segmentation of diffusion-weighted imaging (DWI) images by artificial intelligence, the infarct sites were registered to the standard space which was used to draw the frequency heat map. The chi-square test was used to compare the difference in lesion location between the two groups. Generalized linear model regression analysis was used to observe the correlation between each blood lipid index and lesion site, and inter-group comparison and correlation analysis were used to observe the relationship between each blood lipid index and lesion volume. Results: Compared with the normal blood lipid group, the lesions in the dyslipidemia group were more extensive, mostly distributed in the occipital temporal region of the right posterior cerebral artery and the frontal region of the left middle cerebral artery. The brain regions of higher triglyceride(TG) and higher low-density lipoprotein cholesterol(LDL-C) groups were concentrated in the posterior circulation. The brain regions in the higher total cholesterol(TC) and lower high-density lipoprotein cholesterol(HDL-C) groups were concentrated in the anterior circulation(all P<0.05). In the anterior circulation infarct volume, the higher TC group was significantly higher than the normal TC group[(27.58±5.34) vs (17.73±1.18)ml, P=0.029]. In the posterior circulation infarct volume, the higher LDL-C group and the TG group were significantly higher than the normal LDL-C and TG groups[(7.55±2.51) vs (3.55±0.31) ml; (5.76±1.19) vs (3.36±0.30) ml](both P<0.05). Correlation analysis showed that TC and LDL-C were non-linearly (U-shaped) correlated with anterior circulation infarct volume (both P<0.05). Conclusions: Different blood lipids have effects on the distribution pattern and volume of ischemic stroke infarcts. Different hyperlipidemia is related to the specific distribution site and the larger extent of infarction.

[The diagnostic and evaluation value of plasma interleukin 9 in the mucosal healing in patients with inflammatory bowel disease treated with biological agents]

Objective: To investigate the diagnostic and evaluation value of plasma interleukin 9 (IL9) in the mucosal healing (MH) in patients with inflammatory bowel disease (IBD) treated with biological agents. Methods: Cohort study. IBD patients (137 cases) treated in the Affiliated Suzhou Hospital to Nanjing Medical University (Suzhou Municipal Hospital) from September 2019 to January 2022 were prospective selected. Each patient was treated with biological agents [Infliximab (IFX, 56 cases), Adalimumab (ADA, 20 cases), Ustekinumab (UST, 18 cases), Vedolizumab (VDZ, 43 cases)]. According to different therapeutic drugs, the IFX, ADA, UST, and VDZ group were divided. Clinical symptoms, inflammatory indicators and imaging examinations etc. were evaluated every 8 weeks, and the degree of MH was evaluated by endoscopy at the 54th week. The expression of plasma IL9 was detected by ELISA after initial enrollment (W 0) and 8 weeks of biological treatment (W 8). Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of IL9 for MH. Select the cut off value for the optimal ROC threshold based on the highest value of the Youden index. Spearman's rank correlation was used to analyze the correlation between IL9 and Simple Endoscopic Score for CD (SES-CD) and Mayo Endoscopic Score (MES), so as to evaluate the predictive value of IL9 for MH in IBD patients treated with biologic agents. Results: Among the 137 patients, there were 97 Crohn's disease (CD) patients, 53 males and 44 females, aged (31.6±10.3) years (18-60 years). There were 40 ulcerative colitis (UC) patients, 22 males and 18 females, aged (37.5±14.7) years (18-67 years). Among the CD patients, 42 cases (43.3%) achieved MH on endoscopy at the 54th week, and 60 patients (61.9%) achieved clinical remission. Among the UC patients, 22 cases (55.0%) achieved MH and 30 cases (75.0%) achieved clinical remission. At W 0, the relative expression of IL9 in patients in IBD patients who achieved MH after 54 weeks of biological treatment was lower than that in the non-MH patients [x¯±s, (127.42±34.43) vs (146.82±45.64) ng/L, (113.01±44.88) vs (146.12±48.66) ng/L, respectively, both P<0.05]. At W 8, the relative expression of IL9 in the MH group was lower than that in the non-MH patients (both P<0.05). The relative expression of IL9 in the MH patients after IFX treatment was lower than that in the non-MH group (P<0.05). There was no significant difference among the other groups between MH and non-MH patients (all P>0.05). IL9 at W 8 showed high value in predicting MH in IBD [CD patients: area under curve (AUC)=0.716(95%CI: 0.616-0.817, P<0.001), sensitivity and specificity were 80.77%(95%CI:67.64%-88.45%) and 48.89%(95%CI: 35.53%-64.47%), respectively; UC patients: AUC=0.821, sensitivity and specificity were 77.78% and 72.73%, respectively]. At W 8, the cut off values for CD and UC patients were IL9>80.77 ng/L and IL9>77.78 ng/L, respectively. IL9 was positively correlated with endoscopic MH score parameters [M(Q₁,Q₃),SES-CD: 3.0(8.5, 18.5); MES: 2.0(1.0, 3.0)] (r=0.55, 0.72, respectively, both P<0.001) at W8. Conclusion: The plasma IL-9 at the week 8 after biological agents treatment can be used to diagnose and evaluate the MH of patients with IBD.

[Periprosthetic gout flare after total knee arthroplasty: A misdiagnostic case report]

Periprosthetic gout flare is a rare arthritic condition after total knee arthroplasty, but the symptoms of gout may have often been mistaken as acute periprosthetic infection given their similarity. Misdiagnosis as periprosthetic infection can lead to unnecessary surgery, long-term dependence on anti-biotics, and even malfunction of the involved knee joint. Here, we report a case study of a patient with immunodeficiency condition of long-term oral glucocorticoid and diabetes mellitus, who had undergone a knee replacement 8 weeks before. The initial symptoms of fever and joint pain together with the dysfunction of her right knee with elevated inflammatory markers, such as increased serum leukocytes, erythrocyte sedimentation rate, C-reactive protein, and synovial cell counts led to a diagnosis of acute periprosthetic infection. Arthrocentesis and bacterial culture were performed preoperatively. According to the current Musculoskeletal Infection Society (MSIS) criteria for diagnosis of periprosthetic infection, the case was classified as periprosthetic infection and a prosthesis retained debridement surgery was performed. However we got negative culture results in all the pre-operative and intro-operative samples. The symptoms as well as the laboratory inflammatory markers improved shortly after the debridement surgery until the 11th day when all the similar systemic and local symptoms recurred. With a remedial crystal analysis of synovial fluid from the patient, gouty flare was found to be the cause of acute arthritis finally. Accor-dingly, after anti-gout medications were administrated, the symptoms associated with acute arthritis gra- dually subsided, and there was no recurrence during a 24-month follow-up. This article described the cli-nical manifestation, diagnosis and differential diagnosis, treatment of a case of periprosthetic gout. Although relatively rare, gout should be considered as a differential diagnosis in suspected periprosthetic infection. Current criteria for periprosthetic infection can not exclude the diagnosis of periprosthetic gout flare, it is therefore imperative that the analysis of joint aspirate for crystals be conducted to determine the correct course of treatment, or unnecessary surgical procedure may be performed in periprosthetic gout case.

On the Catalytic Performance of (ZrO)n (n=1-4) Clusters for CO Oxidation: A DFT Study

The unique characteristic of superatoms to show chemical properties like those of individual atoms opens a new avenue towards replacing noble metals as catalysts. Given the similar electronic structures of the ZrO superatom and the Pd atom, the CO oxidation mechanisms catalysed by (ZrO)_n (n=1-4) clusters were investigated in detail to evaluate their catalytic performance. Our results reveal that a single ZrO superatom exhibits superior catalytic ability in CO oxidation than both larger (ZrO)_n (n=2-4) clusters and a Pd atom, indicating the promising potential of ZrO as a "single-superatom catalyst". Moreover, the mechanism of CO oxidation catalysed by ZrO^+/- suggests that depositing a ZrO superatom onto the electron-rich substrates is a better choice for practical catalysis application. Accordingly, a graphene nanosheet (coronene) was chosen as a representative substrate for ZrO and Pd to assess their catalytic performances in CO oxidation. Acting as an "electron sponge", this carbon substrate can both donate and accept charges in different reaction steps, enabling the supported ZrO to achieve enhanced catalytic performance in this process with a low energy barrier of 19.63 kcal/mol. This paper presents a new realization on the catalytic performance of Pd-like superatom in CO oxidation, which could increase the interests in exploring noble metal-like superatoms as efficient catalysts for various reactions.

Polymeric tungsten carbide nanoclusters as potential non-noble metal catalysts for CO oxidation

The discovery of tungsten carbide (WC) as an analog of the noble metal Pt atom is of great significance toward designing novel highly-active catalysts from the viewpoint of the superatom concept. The potential of such a superatom to serve as building blocks of replacement catalysts for Pt has been evaluated in this work. The electronic properties, adsorption behaviors, and catalytic mechanisms towards the CO oxidation of (WC)_n and Pt_n (n = 1, 2, 4, and 6) were compared. Counterintuitively, these studied (WC)_n clusters exhibit quite different electronic properties and adsorption behaviours from the corresponding Pt_n species. For instance, (WC)_n preferentially adsorbs O₂, whereas Pt_n tends to first combine with CO. Even so, it is interesting to find that the catalytic performances of (WC)_n are always superior to the corresponding Pt_n, and especially, the largest (WC)₆ cluster exhibits the best catalytic ability towards CO oxidation. Therefore, assembling superatomic WC clusters into larger polymeric clusters can be regarded as a novel strategy to develop efficient superatom-assembled catalysts for CO oxidation. It is highly expected to see the realization of non-noble metal catalysts for various reactions in the near future experiments by using superatoms as building blocks.

Designing Special Nonmetallic Superalkalis Based on a Cage-like Adamanzane Complexant

In this study, to examine the possibility of using cage-like complexants to design nonmetallic superalkalis, a series of X@3⁶adz (X = H, B, C, N, O, F, and Si) complexes have been constructed and investigated by embedding nonmetallic atoms into the 3⁶adamanzane (3⁶adz) complexant. Although X atoms possess very high ionization energies, these resulting X@3⁶adz complexes possess low adiabatic ionization energies (AIEs) of 0.78–5.28 eV. In particular, the adiabatic ionization energies (AIEs) of X@3⁶adz (X = H, B, C, N, and Si) are even lower than the ionization energy (3.89 eV) of Cs atoms, and thus, can be classified as novel nonmetallic superalkalis. Moreover, due to the existence of diffuse excess electrons in B@3⁶adz, this complex not only possesses pretty low AIE of 2.16 eV but also exhibits a remarkably large first hyperpolarizability (β₀) of 1.35 × 10⁶ au, indicating that it can also be considered as a new kind of nonlinear optical molecule. As a result, this study provides an effective approach to achieve new metal-free species with an excellent reducing capability by utilizing the cage-like organic complexants as building blocks.

DFT study on the adsorption of 5-fluorouracil on B40, B39M, and M@B40 (M = Mg, Al, Si, Mn, Cu, Zn)

Based on density functional theory, the adsorption behavior of 5-fluorouracil (5-Fu) on B₄₀ and its derivatives has been explored. It was observed that 5-Fu prefers to combine with the corner boron atom of the B₄₀ cage via one of its oxygen atoms, forming a strong polar covalent B–O bond. The adsorption energy of 5-Fu on B₄₀ was calculated to be −11.15 kcal mol⁻¹, and thus, it can be duly released from B₄₀ by protonation in the slightly acidic environment of tumor tissue, which makes for reducing the toxic and side effects of this drug. Additionally, the substituent and embedding effect of Mg, Al, Si, Mn, Cu, and Zn atoms on the drug delivery performance of B₄₀ have been also considered. We hope this work could offer some implications for the potential application of boron-based nanomaterials, such as B₄₀ in drug delivery.

The adsorption of 5-fluorouracil on B₄₀ and its derivatives has been theoretically studied to provide some implications for the potential application of B₄₀ in drug delivery.

Designing an alkali-metal-like superatom Ca3B for ambient nitrogen reduction to ammonia

Converting earth-abundant nitrogen (N₂) gas into ammonia (NH₃) under mild conditions is one of the most important issues and a long-standing challenge in chemistry. Herein, a new superatom Ca₃B was theoretically designed and characterized to reveal its catalytic performance in converting N₂ into NH₃ by means of density functional theory (DFT) computations. The alkali-metal-like identity of this cluster is verified by its lower vertical ionization energy (VIE, 4.29 eV) than that of potassium (4.34 eV), while its high stability was guaranteed by the large HOMO-LUMO gap and binding energy per atom (E_b). More importantly, this well-designed superatom possesses unique geometric and electronic features, which can fully activate N₂via a "double-electron transfer" mechanism, and then convert the activated N₂ into NH₃ through a distal reaction pathway with a small energy barrier of 0.71 eV. It is optimistically hoped that this work could intrigue more endeavors to design specific superatoms as excellent catalysts for the chemical adsorption and reduction of N₂ to NH₃.

On the Role of Alkali-Metal-Like Superatom Al12 P in Reduction and Conversion of Carbon Dioxide

Developing efficient catalysts for the conversion of CO₂ into fuels and value-added chemicals is of great significance to relieve the growing energy crisis and global warming. With the assistance of DFT calculations, it was found that, different from Al₁₂ X (X=Be, Al, and C), the alkali-metal-like superatom Al₁₂ P prefers to combine with CO₂ via a bidentate double oxygen coordination, yielding a stable Al₁₂ P(η² -O₂ C) complex containing an activated radical anion of CO₂ (i.e., CO₂ ^.- ). Thereby, this compound could not only participate in the subsequent cycloaddition reaction with propylene oxide but also initiate the radical reaction with hydrogen gas to form high-value chemicals, revealing that Al₁₂ P can play an important role in catalyzing these conversion reactions. Considering that Al₁₂ P has been produced in laboratory and is capable of absorbing visible light to drive the activation and transformation of CO₂ , it is anticipated that this work could guide the discovery of additional superatom catalysts for CO₂ transformation and open up a new research field of superatom catalysis.

Mediating effect of mental resilience on depression level and sleep disturbance in elderly patients with gastroesophageal reflux disease

BACKGROUND

Gastroesophageal reflux disease (GERD) is a common disease of the digestive system. With the development of health models, mental resilience has attracted more attention from clinical doctors and nurses.

AIM

To investigate the mediating effect of mental resilience on depression and sleep disturbance in elderly patients with GERD.

METHODS

One hundred and twenty GERD patients treated at Jinhua Second Hospital from June 2018 to December 2019 were selected using convenience sampling method. The sleep quality index scale, mental resilience scale, and depression scale were used to assess the sleep quality, mental resilience, and depression of these patients, respectively. Regression analysis and the Bootstrap method were adopted for statistical analysis.

RESULTS

The sleep quality score of GERD patients was 6.57 ± 2.92. The score of mental resilience was 52.04 ± 7.58. The depression score was 18.39 ± 4.15. Pearson correlation analysis showed that mental resilience in elderly GERD patients was negatively correlated with sleep quality (r = -0.272, P < 0.01), depression was positively correlated with sleep quality index (r = 0.179, P < 0.01), and depression was negatively correlated with mental resilience (r = -0.251, P < 0.01). Multiple regression analysis was used to establish model 1 with depression level as dependent variable and different demographic characteristics as independent variables. Model 2 was established by introducing sleep quality index and model 3 by introducing mental resilience. Sleep quality index and mental resilience had positive and negative predictive effects on depression level, respectively. Multiple linear regression analysis combined with the Bootstrap method suggested that mental resilience had a mediating effect between sleep quality and depression.

CONCLUSION

Mental resilience plays a mediating role between depression and sleep disorder in elderly patients with GERD. It is of great significance to monitor sleep quality and mental resilience in elderly GERD patients and formulate reasonable intervention measures in clinical work to improve the mental health of elderly GERD patients.

Influence of sleep disorders on anxiety and depression and quality of life in elderly patients with chronic functional constipation

BACKGROUND

With the changes of dietary structure and lifestyles, the incidence of chronic constipation is gradually increasing. Sleep disorders increase gastrointestinal symptoms and are a risk factor for anxiety and depression. The purpose of this study was to explore the influence of sleep disorders on anxiety and depression and quality of life in elderly patients with chronic functional constipation, so as to provide an objective basis for the treatment of elderly patients with chronic functional constipation.

AIM

To investigate the effects of sleep disorders on anxiety and depression and quality of life in elderly patients with chronic functional constipation.

METHODS

A total of 126 elderly patients with chronic functional constipation admitted to our hospital from March 2017 to September 2019 were selected as the study subjects. They were divided into a sleep disorder group and a normal sleep group according to whether they had a sleep disorder. All patients underwent assessments using the constipation scoring system (CSS), patient assessment of constipation-symptoms (PAS-SYM) questionnaire, sleep quality assessment, self-rating anxiety scale (SAS), self-rating depression scale (SDS), and a quality of life scale.

RESULTS

In the sleep disorder group, the CSS score was 19.63 ± 3.36, the PAS-SYM score was 1.59 ± 0.52, the SAS score was 58.92 ± 6.72, and the SDS score was 57.74 ± 6.38, all of which were significantly higher than those of the normal sleep group (P < 0.05). The scores of social function, emotional score, physical role, physical health, mental health, and total health in the sleep disorder group were 71.56 ± 3.38, 75.89 ± 2.95, 76.86 ± 2.92, 80.25 ± 3.35, 78.36 ± 3.65, and 76.19 ± 2.56, respectively, all of which were significantly lower than those of the normal sleep group (P < 0.05). CSS scores, PAS-SYM scores, and total scores were positively correlated with SAS and SDS scores (P < 0.05). The scores of the six dimensions in SF-36 were negatively correlated with SAS and SDS scores (P < 0.05).

CONCLUSION

Sleep disorders, anxiety, and depression may be important factors affecting the clinical symptoms and quality of life of elderly patients with chronic functional constipation.

Positive-Parity Linear-Chain Molecular Band in ^{16}C

An inelastic excitation and cluster-decay experiment ^{2}H(^{16}C,^{4}He+^{12}Be or ^{6}He+^{10}Be)^{2}H was carried out to investigate the linear-chain clustering structure in neutron-rich ^{16}C. For the first time, decay paths from the ^{16}C resonances to various states of the final nuclei were determined, thanks to the well-resolved Q-value spectra obtained from the threefold coincident measurement. The close-threshold resonance at 16.5 MeV is assigned as the J^{π}=0^{+} band head of the predicted positive-parity linear-chain molecular band with (3/2_{π}^{-})^{2}(1/2_{σ}^{-})^{2} configuration, according to the associated angular correlation and decay analysis. Other members of this band were found at 17.3, 19.4, and 21.6 MeV based on their selective decay properties, being consistent with the theoretical predictions. Another intriguing high-lying state was observed at 27.2 MeV which decays almost exclusively to ^{6}He+^{10}Be(∼6  MeV) final channel, corresponding well to another predicted linear-chain structure with the pure σ-bond configuration.

Mediating role of self-efficacy in social support and health-promoting lifestyle between elderly patients with functional dyspepsia

BACKGROUND

Both self-efficacy and social support can affect a patient's health. At present, there are few studies on elderly patients with functional dyspepsia (FD) from the perspective of self-efficacy and social support. Therefore, this study explored the mediating role of self-efficacy between social support and health-promoting lifestyle of elderly FD patients, and provided an objective basis for clinical work to improve the health level of elderly FD patients.

AIM

To investigate the mediating effect of self-efficacy on social support and health-promoting lifestyle in elderly patients with FD.

METHODS

One hundred and sixty-two elderly patients with FD who were hospitalized at Jinhua Second Hospital of Zhejiang Province from October 2018 to October 2019 were selected for the survey using the general self-efficacy questionnaire, social support scale, and health promotion lifestyle scale.

RESULTS

The total social support score in elderly FD patients was 37.65 ± 6.58, which was at the moderate level. The total score of the general self-efficacy scale was 27.62 ± 5.48, which was moderate. The total score of the health promotion lifestyle scale was 120.85 ± 20.73, which was at the fair level. Pearson correlation analysis showed that health promotion lifestyle, social support, and self-efficacy were positively correlated (P < 0.05), and total score of social support, objective support dimension, and general self-efficacy were positively correlated (P < 0.01). Stratified regression analysis was performed with self-efficacy as the mediating variable, social support as the independent variable, and health-promoting lifestyle as the dependent variable. The estimated mediating effect was 0.175 (0.458 × 0.384), accounting for 28.87% [(0.458 × 0.384)/(0.458 × 0.384 + 0.431)]. The results showed that all of the standardized regression coefficients reached significant levels (P < 0.01), indicating that self-efficacy had an intermediary effect between social support and health promotion in elderly FD patients. Based on multivariate linear regression analysis, adopting the percentile inspection sampling methods and taking the confidence interval of 95% using the Bootstrap method to test the mediation effect of self-efficacy, the results showed that the 95% confidence interval of the mediating effect of self-efficacy was 0.115-0.223 (P < 0.05), suggesting a mediating role for self-efficacy between social support and health promoting lifestyle.

CONCLUSION

Social support, self-efficacy, and health-promoting lifestyle of elderly FD patients are at the moderate or fair level. Self-efficacy is a partial mediator between social support and health promotion. Therefore, in clinical work, medical staff should strengthen the social support in elderly FD patients and improve their self-efficacy to improve their health promotion lifestyle level and health.

Proton Shell Evolution below ^{132}Sn: First Measurement of Low-Lying β-Emitting Isomers in ^{123,125}Ag

The β-delayed γ-ray spectroscopy of neutron-rich ^{123,125}Ag isotopes is investigated at the Radioactive Isotope Beam Factory of RIKEN, and the long-predicted 1/2^{-} β-emitting isomers in ^{123,125}Ag are identified for the first time. With the new experimental results, the systematic trend of energy spacing between the lowest 9/2^{+} and 1/2^{-} levels is extended in Ag isotopes up to N=78, providing a clear signal for the reduction of the Z=40 subshell gap in Ag towards N=82. Shell-model calculations with the state-of-the-art V_{MU} plus M3Y spin-orbit interaction give a satisfactory description of the low-lying states in ^{123,125}Ag. The tensor force is found to play a crucial role in the evolution of the size of the Z=40 subshell gap. The observed inversion of the single-particle levels around ^{123}Ag can be well interpreted in terms of the monopole shift of the π1g_{9/2} orbitals mainly caused by the increasing occupation of ν1h_{11/2} orbitals.

[Expression of microRNA-155 in inflammatory bowel disease and its clinical significance]

Objective: To explore the expression of microRNA-155 in colonic mucosa and peripheral blood in patients with inflammatory bowel disease(IBD), and to examine the clinical value and significance of microRNA-155 in the diagnosis of IBD. Methods: Quatitative reverse-transcription PCR was performed to detect the expression of microRNA-155 in 20 patients with Crohn disease(CD), 21 patients with ulcerative colitis (UC), 18 patients with IBD type unclassified(IBDU), 25 healthy people(control group), 12 patients with infection colitis and 19 patients with ischemia colitis.Receiver operating characteristic (ROC) curve was performed to analyze the clincal value of microRNA-155 in diagnosis of IBD. Results: The expression of microRNA-155 in colonic mucosa in CD, UC and IBDU group was significantly higher than that in control group(P<0.05). MicroRNA-155 expression was also significantly higher in UC group in comparison to CD group (35.4±3.0 vs 18.6±5.9, P<0.01), IBDU group in comparison to CD group (23.0±3.7 vs 18.6±5.9, P<0.05) and UC group in comparison to IBDU group (35.4±3.0 vs 23.0±3.7, P<0.01). The plasma level of microRNA-155 in UC group (55.6±2.5) and IBDU group (48.1±6.2) was significantly higher than that in control group(P<0.05), while no significant difference in CD group was observed when compared with control group(P>0.05). ROC curve shows an AUC of 0.83 and 95%CI of 0.679-0.986 of microRNA-155 expression in colonic mucosa.The sensitivity and specificity of microRNA-155 expression in colonic mucosa in diagnosis of IBD was 68.4% and 78.6%, respectively. Conclusions: MicroRNA-155 showed high expression in colonic mucosa and peripheral blood in patients with IBD.MicroRNA-155 shows promise as a biomarker in diagnosis of IBD.Furthermore, the aberrant expression indicates that microRNA-155 may be involved in pathogenesis and progression of IBD.

[Relationship between hypertension and body mass index, waist circumference and waist-hip ratio in middle-aged and elderly residents]

Objective: To assess the relationship between hypertension and BMI, waist circumference and waist-hip ratio in middle-aged and elderly residents in Luzhou, Sichuan province. Methods: A total of 2 033 middle-aged and elderly local residents aged 35-69 years were enrolled from Luzhou through stratified cluster sampling from March 27 to April 20, 2015. A face-to-face questionnaire survey and physical examination were conducted by trained investigators. Results: The overall prevalence rate of hypertension was 43.48%. The overweight rate, obesity rate, centrality obesity (calculated according to waist circumference) and centrality obesity (calculated according to waist-hip ratio) were 42.5%, 14.6%, 48.4% and 74.0%, respectively. The multivariate logistic analysis showed that gender and age were related to the prevalence of hypertension. Compared with age group <40 years, the OR values were 2.066 and 4.756 respectively in age groups 45-60 and ≥60 years. After control the confounding effect of gender and age, overweight, obesity and centrality obesity (calculated according to waist circumference) were risk factors for hypertension, waist-hip ratio was not used in the regression equation. BMI and waist circumference or waist-hip ratio had combined effect on the prevalence of hypertension. Compared with the normal adults, the risk for hypertension increased as the increase of the level of overweight and obesity [OR from 1.524 (95%CI: 1.044-2.226) to 4.461 (95%CI: 3.405-6.326) and OR from 1.569 (95%CI: 1.134-2.171) to 5.468 (95%CI: 3.797-7.876)]. Conclusions: The influences of BMI, waist circumference and waist-hip ratio on the prevalence of hypertension were significant, but the influence of waist circumference on hypertension was greater than waist-hip ratio. Keeping normal bodyweight might be one of the effective hypertension prevention measures.

94 β-Decay Half-Lives of Neutron-Rich _{55}Cs to _{67}Ho: Experimental Feedback and Evaluation of the r-Process Rare-Earth Peak Formation

The β-decay half-lives of 94 neutron-rich nuclei ^{144-151}Cs, ^{146-154}Ba, ^{148-156}La, ^{150-158}Ce, ^{153-160}Pr, ^{156-162}Nd, ^{159-163}Pm, ^{160-166}Sm, ^{161-168}Eu, ^{165-170}Gd, ^{166-172}Tb, ^{169-173}Dy, ^{172-175}Ho, and two isomeric states ^{174m}Er, ^{172m}Dy were measured at the Radioactive Isotope Beam Factory, providing a new experimental basis to test theoretical models. Strikingly large drops of β-decay half-lives are observed at neutron-number N=97 for _{58}Ce, _{59}Pr, _{60}Nd, and _{62}Sm, and N=105 for _{63}Eu, _{64}Gd, _{65}Tb, and _{66}Dy. Features in the data mirror the interplay between pairing effects and microscopic structure. r-process network calculations performed for a range of mass models and astrophysical conditions show that the 57 half-lives measured for the first time play an important role in shaping the abundance pattern of rare-earth elements in the solar system.

Observation of enhanced monopole strength and clustering in (12)Be

In a recent breakup-reaction experiment using a Be12 beam at 29  MeV/nucleon, the 0+ band head of the expected He4+He8 molecular rotation was clearly identified at about 10.3 MeV, from which a large monopole matrix element of 7.0±1.0  fm2 and a large cluster-decay width were determined for the first time. These findings support the picture of strong clustering in Be12, which has been a subject of intense investigations over the past decade. The results were obtained thanks to a specially arranged detection system around zero degrees, which is essential in determining the newly emphasized monopole strengths to signal the cluster formation in a nucleus.

One-year follow-up study of post-traumatic stress disorder among adolescents following the Wen-Chuan earthquake in China

Post-traumatic stress disorder (PTSD) is the most common psychological disorder among victims of natural disasters. PTSD prevalence and risk factors among adolescents remain unidentified among victims of the Wen-Chuan earthquake. This study screened survivors to determine the prevalence of PTSD and examined risk factors for PTSD among adolescents at three Wen-Chuan secondary schools. PTSD screening was done using the PTSD Checklist-Civilian version (PCL-C). A generalized estimating equation approach was used to control for repeated measurements in the same individuals and to predict risk factors for PTSD. The study included 1,474 students in grades 7, 8, 10 and 11 from three Wen-Chuan secondary schools at 4, 6, 9, and 12 months after the earthquake. The average age of students was 15.0 (13.0, 16.0) both at the first and the second time point, and 16.0 (14.0, 17.0) at the third and the fourth time point. The screened prevalence of PTSD was 11.2%, 8.8%, 6.8% and 5.7% at 4, 6, 9, and 12 months after the earthquake, respectively. Risk factors for PTSD were: time duration, school location (the proximity of epicenter), grade, nationality, parent injury, and severe property damage. In conclusion, PTSD risk factors are in accordance with previous studies; however, the role of nationality and time duration in post-traumatic stress disorder merits further research.

Construction of single-chain interleukin-12 DNA plasmid to treat airway hyperresponsiveness in an animal model of asthma

Allergic asthma is strongly associated with the airway inflammation caused by the dysregulated production of cytokines secreted by the allergen-specific type-2 T helper (Th2) cells. Interleukin (IL)-12 is a heterodimeric cytokine, which strongly promotes the differentiation of naive CD4(+) T cells to the type-1 T helper (Th1) phenotype and suppresses the expression of Th2 cytokines. Therefore, immunotherapy with IL-12 has been suggested as a possible therapy for asthma. In previous studies, we developed a murine model of airway inflammation based on the purified, house dust-mite allergen Der p 1 (Dermatophagodies pteronyssinus) as a clinically relevant allergen. We hypothesized that the expression of IL-12 in the airway may represent an effective therapy for allergic airway diseases. In this study, we investigate whether the local transfer of the IL-12 gene to respiratory tissues modifies allergic inflammation and airway hyper-responsiveness (AHR) in our disease model. To enhance the in vivo delivery of the IL-12 gene, we expressed the murine single-chain IL-12 protein from a nonviral vector to which the two IL-12 subunits (p35 and p40) were linked by a 14- to 18-amino-acid linker. One of these single-chain IL-12s, containing an 18 amino-acid polypeptide linker, was stably expressed and had a high level of biological activity comparable to that of native IL-12 in vitro. In mice with Der p 1-induced asthma, the local administration of this IL-12 fusion gene into the lungs significantly prevented the development of AHR, abrogated airway eosinophilia, and inhibited type-2 cytokine production. These findings indicate that the local transfer of the single-chain IL-12 gene is effective in modulating pulmonary allergic responses and may be a convenient method for future applications of DNA vaccination.

Anti-tumor effect of angiogenesis inhibitor TNP-470 on the human nasopharyngeal carcinoma cell line NPC/HK1

The efficacy and targeting cells of angiogenesis inhibitor TNP-470 on human squamous cell nasopharyngeal carcinoma (NPC) were investigated. The colorimetric MTT assay was used to evaluate the IC50 values of NPC/HK1 cells and human dermal microvascular endothelial cells (HDMEC) for TNP-470. An NPC human tumor model was built by tumor-bearing nude mice using the NPC cell line of NPC/HK1. TNP-470 (30 mg/kg s.c.) was injected every other day. The results showed that the IC50 of NPC/HK1 cells for TNP-470 was 3.8 times higher than that of HDMEC. A significant difference in tumor volume between control and treatment groups was found after 7 days of treatment and increased thereafter. At the end of the treatment, tumor volume was 773.7 +/- 287.1 mm3 (n = 8) in the control group versus 454.5 +/- 132.8 mm3 (n = 8) in the treatment group (p = 0. 013); the ratio of the mean tumor volume in treated animals to that of control animals was 0.587, resulting a 41.3% decrease in tumor growth. The necrotic area was larger in the treatment group. Physical toxicity did not result from the treatment. These studies suggest that angiogenesis inhibitor TNP-470 is effective in the treatment of squamous cell NPC without obvious toxicity.

Administration of interleukin-12 prevents mite Der p 1 allergen-IgE antibody production and airway eosinophil infiltration in an animal model of airway inflammation

The aim of the present study was to examine the in vivo effect of interleukin (IL)-12 on a murine model of asthma induced by Dermatophagoides pteronyssinus-derived Der p 1 allergen. C57BL/6 mice immunized with Der p 1 allergen adsorbed to alum/pertussis toxin developed a T-helper type 2 (Th2)-dominant immune response characterized by the presence of IgE antibody, airway eosinophil infiltration and increased production of Th2 cytokine. Intraperitoneal injection of IL-12 (1 or 0.1 microg per day) for 5 days (day -1 to +3) simultaneously with each immunization, inhibited the production of IgE and IgG1 antigen-specific antibodies, whereas production of IgG2a was strongly enhanced. In addition, mice receiving both doses of IL-12 showed a strong inhibition of IL-5 but up-regulation of IFN-gamma production by spleen cells stimulated with antigen. Administration of IL-12 also prevented antigen-induced eosinophil infiltration into the bronchoalveolar area in a dose-dependent manner and the primary inflammatory mediator serotonin in bronchoalveolar lavage (BAL) fluids was also reduced significantly. Taken together, the data indicate that IL-12 has a potent immunomodulatory effect on house-dust-mite-induced allergic disorders and may be used as an efficient agent for immunotherapy.

Primary study in experimental antiangiogenic therapy of nasopharyngeal carcinoma with AGM-1470 (TNP-470)

OBJECTIVE

To evaluate the efficacy of the angiogenesis inhibitor AGM-1470 for the experimental treatment of nasopharyngeal carcinoma (NPC).

METHODS

A NPC human tumour model was built by tumour-bearing nude mice using the NPC cell line CNE-2. Twenty-one BALB/c nude mice bearing CNE-2 xenografts were randomized into a treatment group and a control group. In the treatment group, AGM-1470 was injected 30 mg/kg subcutaneously every other day; while the vehicle (three per cent ethanol solution in 0.9 per cent saline) was given to the mice in control group. Tumour volumes and animal weights were measured every third day. Autopsy was performed after 18 days of treatment. The tumour tissue as well as the murine tissues of heart, kidney, and liver in each mouse were removed for formalin fixation and routine HE staining. Pathological evaluation was performed in these tissues.

RESULTS

There was a significant difference in tumour volume between the two groups at day 9 of treatment and this increased thereafter. At day 15 of treatment, the tumour volume was 4251 +/- 559 mm3 (n = 10) in the control group versus 3122 +/- 967 mm3 (n = 11) in the AGM-1470 treated group (p = 0.004); and T:C ratio (mean tumour volume of treated/mean tumour volume of control) was 0.73, resulting in a 27 per cent decrease in tumour growth. Central necrosis and consequential shrinkage of tumours occurred in both groups at the end of experiment. Physical toxicity and histological toxicity of heart, liver, and kidney did not result from AGM-1470 therapy.

CONCLUSIONS

AGM-1470 suppresses the growth of the human NPC cell line CNE-2. Treatment by AGM-1470 has no physical nor histological toxicity. Angiogenesis inhibitors may be effective in the treatment of the local lesion of NPC.

Phenotypic and functional analysis of activated B cells of autoimmune NZB x NZW F1 mice

Polyclonal B-cell activation is the central theme in the production of autoantibodies and possible activation of autoreactive T cells in both human and murine lupus. The abnormal expansion of CD5+ B cells in murine lupus has been suggested, in particular, to be one of the most characteristic findings in these mice. Activated B cells can be separated from the B cells of resting stage by the difference in cell density. The aim of this study was to investigate the characteristics of different densities of the spleen cells separated by gradient density. Furthermore, the ability of anti-DNA antibody secretion in each percoll gradient fraction of B cells was also analysed. The results showed: a higher percentage of CD5+ B cells, which corresponded to the activated B-cell population, in percoll gradient 1 and 2 fractions; that splenic B cells of NZB/W F1 mice had proliferative response to interleukin (IL)-4 or IL-5 but not to IL-10 or interferon-gamma (IFN-gamma); and that B cells isolated by percoll gradient produced anti-DNA antibody after stimulation with lipopolysaccharide (LPS) plus IL-5 and IFN-gamma, but not IL-4 and IL-10. These data suggest that B cells at different stages of activation express differential characteristics and functions.

Reconstitution of severe combined immunodeficient mice with spleen cells from autoimmune NZBxNZW F1 mice

OBJECTIVE

The aim of this study is to establish an animal model to investigate the role of individual subsets of immune cells in the pathogenesis of systemic lupes erythematosus.

METHODS

Spleen cells isolated with from both young and old autoimmune NZB/W F1 mice were injected into the peritoneal cavity of severe combined immunodeficient (SCID) mice. Sera anti-DNA antibody levels and proteinuria of these SCID mice were followed regularly. In addition, histological changes of the kidneys were also examined.

RESULTS

The data suggest that anti-ss, dsDNA antibody can be detected in the sera of SCID mice 21 days after reconstitution with the spleen cells of either young or old NZB/W F1 mice, with titers of antibody increasing over time. In addition, proteinuria was also noted in most of these mice 3 months after reconstitution. Histopathological examination of the kidney also revealed the typical changes of glomerulonephritis. Immunofluorescence staining of kidney sections also demonstrated immune complex deposition.

CONCLUSION

Once validated, this animal model could be used in future studies to investigate the role of individual subsets of cells in the pathogenic mechanisms of SLE.

Establishment and characterization of cloned CD4- CD8- alphabeta-T cell receptor (TCR)-bearing autoreactive T cells from autoimmune NZB x NZW F1 mice

Murine models such as NZB/W F1, NZB.H-2bm12 and MRL.lpr/lpr mice have provided greater insight into the pathogenic mechanisms of lupus. To understand further the roles of T cells and cytokines in the pathogenesis of murine lupus, 11 cloned anti-DNA antibodies augmenting autoreactive T cell lines were derived from NZB/W F1 mice. All these autoreactive cells responded to syngeneic splenic cells and helped syngeneic B cells to produce anti-DNA antibodies, especially the IgG antibody. Ten out of 11 autoreactive T cell lines expressed neither CD4 nor CD8 cell surface markers on their surface. In addition, the cytokine production pattern of these autoreactive T cell lines was predominantly of type 0 (Th0) or type 2 T helper cells (Th2). To further investigate the role of accessory molecules in the activation of these autoreactive T cell lines, expression of IL-2R and heat-stable antigen (HSA) on these autoreactive T cells was analysed. Results suggest that the HSA played a critical role in the activation and function of these double-negative cloned autoreactive T cells.

In vitro and in vivo functional analysis of CD5+ and CD5- B cells of autoimmune NZB x NZW F1 mice

Polyclonal B cell activation has been thought to play the critical role in production of autoantibodies, and possible activation of autoreactive T cells in murine lupus, especially abnormal expansion of CD5+ B cells, is one of the characteristic findings in these mice. The aim of this study was to investigate further the characteristics and function of CD5+ and CD5- B cells. Both CD5+ and CD5- B cells were isolated for in vitro autoantibody production, cytokine expression and in vivo anti-DNA antibody production with reconstitution of severe combined immunodeficient (SCID) mice. The data showed: (i) both CD5+ and CD5- B cells produced a high level of anti-DNA antibody after stimulation with lipopolysaccharide (LPS) plus IL-5; (ii) both peritoneal CD5+ and CD5- B cells expressed a high level of IL-10 mRNA after stimulation with LPS, while in contrast CD5- B cells of non-autoimmune BALB/c mice did not express IL-10 mRNA after stimulation; (iii) SCID mice reconstituted with either CD5+ or CD5- B cells all produced significant levels of anti-DNA antibodies in vivo and manifested with proteinuria. These data suggest both CD5+ and CD5- B cells play important roles in polyclonal B cell activation and subsequent autoantibody production. Generalized polyclonal B cell activation, instead of expanding a certain subpopulation of B cells, contributed to the pathogenesis of autoimmunity in murine lupus.

Nasopharyngeal and nasal malignant lymphoma: a clinicopathological study of 54 cases

Forty-one cases of nasopharyngeal and 13 cases of nasal malignant lymphoma have been examined histologically and immunohistochemically. All of the cases were non-Hodgkin's lymphoma; one case was of follicular type and the remaining 53 were of diffuse type. Large cell lymphoma comprised 48% of cases and most of the immunoblastic lymphomas showing pleomorphism occurred in the nose. Twenty-seven cases were of T-cell and 21 of B-cell phenotype. The predominance of T-cell lymphoma was due to an increased incidence of these in the nose, the T:B ratio of 3.33:1 contrasting with a 1:1.05 ratio in the nasopharynx. Nasopharyngeal lymphomas seem to show an intermediate incidence between the T-cell predominance in the nose and a B-cell predominance in the oropharynx. Since the large cell type of lymphoma was predominant, the differential diagnosis from undifferentiated carcinoma is important and is facilitated by the use of immunostaining methods.

[Value of monoclonal antibodies in the diagnosis of Hodgkin's disease in paraffin sections]

A comprehensive panel of monoclonal antibodies that mark R-S/H cell, T- and B-cell, monocyte/histocyte was tested in paraffin sections of 107 cases of Hodgkin's disease (HD) including 21 cases of lymphocyte predominance (LP) and 86 cases of Non-LP HD. Thirty cases each of peripheral T-cell lymphoma and B-cell lymphoma were also tested for comparison. R-S/H cells were not stained with T-cell marker (UCHL-1) or monocyte/histocyte marker (Mac387) in all of these cases of HD. The results showed presence of certain difference in the phenotype of LP from non-LP. The H+L type of R-S/H cells of LP often reacted with B-cell markers including L26, LN2, LN1 and MB2 (93.3%-100%), LCA (83.3%) and EMA (92.3%), but rarely with LeuM1,T mü 9, or BerH2. On the contrary, most of the R-S/H cells of non-LP reacted with LeuM1 (80%), T mu 9(84%), BerH2(65%) but not with B-cell markers, LCA or EMA. Our study suggests a B-cell (probably the follicular center cell) derivation for L+H type of R-S/H cells in LP. The fact that 1 case of LP in this group transformed to a large cell B-cell lymphoma also supports this consideration. PNA is a sensitive marker of R-S/H cells but is not a specific one, since PNA stains 43.3% of the peripheral T-cell lymphoma and 20% of the B-cell lymphomas. Our findings indicate that using a panel of antibodies which mark R-S/H cells, T- and B-cells in paraffin sections will be helpful in the diagnosis and subtyping of Hodgkin's disease.

[Clinicopathological and cell immunophenotypic analysis of 54 cases of malignant nasopharyngeal/nasal lymphoma]

54 cases of nasopharyngeal/nasal non-Hodgkin's malignant lymphoma (NP/N-ML), including 41 cases of NP-ML and 13 cases of N-ML, were analyzed histologically and immunohistochemically and all of these materials were prepared in paraffin sections. They were all of diffuse type but one, of follicular type. Large cell type lymphomas were more commonly seen in this series (53.1%), and immunoblastic type with cell pleomorphism was more common in N-ML. A panel of monoclonal antibodies composed of LCA, L26, LN2, UCHL1, Leu22, Mac387 and Leu7 was used in this study. There were 27 cases exhibiting T-cell phenotype and 21 cases showing B-cell phenotype. No histiocytic type was found. The ratio of T, B cell lymphomas was different in NP-ML(T: B = 17: 18) and N-ML (T: B = 10: 3) groups, and the predominance of T-cell N-ML was obvious. Immunostaining with cytokeratin, LCA, L26, UCHL1 is of great help in differential diagnosis and immunophenotyping.

Preferential endocardial residence of B-cells in the "Quilty effect" of human heart allografts: immunohistochemical distinction from rejection

Endocardial infiltrates (EI) are a common and often problematic observation in endomyocardial biopsy specimens (EMBs) from patients receiving cyclosporine immunosuppression following cardiac transplant. Histologic and immunohistologic findings in 23 EMBs from 19 patients and 15 autopsy or explanted allografts demonstrated EIs to be rich in B lymphocytes (871/mm2) compared to T-lymphocytes (803/mm2). Macrophages also demonstrated an endocardial preference over deeper myocardium. In contrast, T-lymphocytes outnumbered B-lymphocytes in deeper myocardium (mean 44/mm2 versus 22/mm2) especially when rejection was present. In allograft specimens, the overall number of typical nodular EIs or percent length of endocardial involvement by EI did not correlate with the presence or absence of myocardial rejection at autopsy or explant but were related to implant duration (r = +0.63, p less than 0.01) and number of previous rejection episodes. The number of thin, nondiscrete endocardial infiltrates was greater in hearts with any myocardial rejection or inflammation present. No relationship was observed between EIs present in either EMB or allografts and the cumulative or mean dose or mean serum level of cyclosporine. Thus, a distinct morphologic and immunohistologic profile distinguishes EIs from acute rejection.

Mantle zone lymphoma. A clinicopathologic study of 22 cases

A clinicopathologic analysis of 22 cases of mantle zone lymphoma (MZL) was performed. In lymph node sections, MZL was characterized by the proliferation of neoplastic small lymphoid cells in wide mantles around benign germinal centers. Eighteen cases were of the intermediate lymphocytic type and four cases were of the small lymphocytic type. Immunohistologic analysis of paraffin sections revealed the following characteristic immunophenotype of MZL: L26, LN2, NUB1 and T2/48 positive, and LN5, LN1, AF6 and UCHL1 negative. The immunophenotype of MZL was identical to that of normal primary lymphoid follicles and the mantle zones of secondary follicles, except for the absence of staining with LN5 in MZL. The median age of the patients was 63 years, and the male-to-female ratio was 1.2:1. B symptoms were present in 55% of the patients, and 81% had splenomegaly. An absolute lymphocytosis was present at the time of initial diagnosis in 13% of the patients, and 67% had bone marrow involvement by lymphoma. Thirteen percent of the patients had Stage II disease, 23% had Stage III disease, and 64% had Stage IV disease. All 22 patients received some form of therapy, with 73% receiving multiagent chemotherapy. Eleven patients achieved a complete remission at some time during their course. The overall median survival of the entire group was 88 months. Clinical features which appeared to influence survival adversely included an absolute lymphocyte count above 4000/microliters, a platelet count less than 100,000/microliters, and male sex. Achievement of a complete remission at any time favorably influenced survival. Pathologic features which appeared to influence survival adversely were a mitotic rate of 10 or more per 10 high-power fields (HPF) and the presence of 40 or more large lymphoid cells per 10 HPF. These findings lead the authors to conclude that MZL is a distinctive form of low-grade non-Hodgkin's lymphoma.

Malignant lymphoma in Nebraska and Guangzhou, China: a comparative study

Two hundred thirty-four consecutive cases of malignant lymphoma (192 non-Hodgkin's lymphomas and 42 Hodgkin's disease) from Guangzhou, China, and 589 cases (498 non-Hodgkin's lymphomas and 91 Hodgkin's disease) from the University of Nebraska Lymphoma Registry were examined in a retrospective histopathologic analysis and the results compared to those of the National Cancer Institute (NCI) Working Formulation Summary. Aggressive non-Hodgkin's lymphoma was excessive in Guangzhou (82.3 per cent; P less than 0.001) and Nebraska (80.3 per cent; P less than 0.001) when compared with the NCI data (54.2 per cent). The small noncleaved cell, lymphoblastic, and diffuse mixed-cell subtypes were more frequent in China (15.6 per cent each; P less than 0.001), whereas the small lymphocytic, follicular large cell, and immunoblastic subtypes predominated in Nebraska (8 per cent, 8.4 per cent, and 21.8 per cent, respectively; P less than 0.001). The overall median age of onset for non-Hodgkin's lymphoma was 42.0 years in Guangzhou and 63.5 years in Nebraska. Hodgkin's disease represented 18 per cent of the malignant lymphomas in Guangzhou and 15 per cent in Nebraska. The mixed-cellularity type was most common in Guangzhou (52 per cent; P less than 0.001) and the nodular-sclerosing type in Nebraska (56 per cent; P less than 0.010). The low median age and excess of certain aggressive subtypes of non-Hodgkin's disease in Guangzhou suggest a possible viral etiology, whereas the excess of certain subtypes of non-Hodgkin's lymphoma in Nebraska may be related to intense agricultural activity.

Monoclonal antibodies marking T lymphocytes in paraffin-embedded tissue

The authors investigated the ability of 70 monoclonal antibodies obtained from the Third International Workshop on Human Leukocyte Antigens (Oxford, 1986) to mark T lymphocytes in B5-fixed paraffin-embedded tissue. No staining occurred with 65 of the antibodies; however, 5 antibodies marked small lymphocytes in the T-cell areas of human tonsil. Two antibodies which strongly labeled lymphocytes, UCHL1 and T2/48, were used to examine 106 cases of non-Hodgkin's lymphoma, 29 cases of Hodgkin's disease, and a variety of normal and neoplastic tissues. UCHL1 and T2/48 each marked 86% (37/43) of B5-fixed T-cell lymphomas. Only 50% of formalin-fixed T-cell lymphomas were marked with these antibodies. UCHL1 marked 1.8% (1/56) of the B-cell lymphomas, compared with T2/48, which marked 19.6% (11/56) of the B-cell lymphomas. T2/48 had the interesting attribute of marking cells of the follicular mantle-zone and intermediate lymphocytic lymphoma, suggesting that the antibody recognizes a B-cell differentiation antigen. No Reed-Sternberg cells, epithelial neoplasms, sarcomas, neurogenic tumors, or normal nonlymphoid tissue were marked by either antibody. These antibodies successfully mark T cells in paraffin tissue sections and should aid in the investigation and characterization of abnormal lymphoid proliferations, "undifferentiated" malignant neoplasms, and immunologically mediated disorders.