[Analysis of vaginal microecology in 23 181 cases of the gynecological female outpatients]

Objective: To analyze the vaginal microecological status of vaginitis population and non-vaginitis population of gynecological female outpatients. Methods: A total of 30 265 women who visited the gynecological outpatient clinic of Beijing Obstetrics and Gynecology Hospital from December 2018 to December 2020 completed vaginal microecological examination. After removing the follow-up patients, 23 181 women were divided into group with symptoms and signs of vaginitis (6 697 cases) and group without symptoms and signs of vaginitis (16 484 cases), according to whether the women with symptoms and signs of vaginitis or not. And the vaginal microecological status of the two groups was compared and analyzed. Results: (1) The total detection rate of vaginitis in the initial women was 34.87% (8 083/23 181), of which 46.10% (3 087/6 697) in group with symptoms and signs of vaginitis and 30.31% (4 996/16 484) in group without symptoms and signs of vaginitis, nearly 1/3 of the gynecological outpatients without signs and symptoms of vaginitis had vaginitis. (2) Among the types of simple vaginitis, vulvovaginal candidiasis (VVC) was the most frequent in group with symptoms and signs of vaginitis (16.01%, 1 072/6 697), followed by aerobic vaginitis (AV; 12.83%, 859/6 697), with significant differences compared with group without symptoms and signs of vaginitis (all P<0.001). There were no statistical differences between the two groups of bacterial vaginosis (BV) and trichomonal vaginitis (TV), indicating that BV and TV were more likely to be neglected (all P>0.05). (3) The proportion of various combinations of vaginitis among 2 632 cases of mixed vaginitis were, in descending order: BV+AV, VVC+AV, BV+AV+VVC, AV+TV, AV+TV+BV, BV+VVC. (4) Microecological analysis of 15 098 cases diagnosed with non-vaginitis had normal flora (including those with normal flora and those with normal flora but decreased function) in 14 013 cases (92.81%, 14 013/15 098), abnormal flora in 429 cases (2.84%, 429/15 098) and the BV intermediate in 656 cases (4.34%, 656/15 098); this indicated that the vast majority of the microecological tests were normal in the vaginal microbiota of those without vaginitis. Conclusions: Microecological examination could diagnose multiple pathogenic infections at once, and is especially important as a guide for the definitive diagnosis of mixed vaginitis and vaginitis with atypical clinical symptoms. Vaginal infections such as BV and TV that are easily overlooked should be concerned.

[Mineralization Characteristics of Soil Organic Carbon and Its Relationship with Organic Carbon Components in Artificial Robinia pseudoacacia Forest in Loess Hilly Region]

In order to explore the characteristics of organic carbon mineralization and the variation law of organic carbon components of an artificial forest in a loess hilly area, an artificial Robinia pseudoacacia forest restored for 13 years and the adjacent slope farmland were selected as the research objects, and indoor culture experiments under three different temperature treatments (15, 25, and 35℃) were carried out. The results indicated that the mineralization rate of soil organic carbon decreased sharply at first and then stabilized. The cumulative release of organic carbon increased rapidly in the initial stage of culture and gradually slowed in the later stage. Soil organic carbon mineralization in sloping farmland was more sensitive to temperature change, and its temperature sensitivity coefficient Q₁₀ was 1.52, whereas that in R. pseudoacacia forest land was only 1.38. According to the fitting of the single reservoir first-order dynamic equation, the soil mineralization potential C_p of R. pseudoacacia forest land and slope farmland was between 2.02-4.32 g·kg^-1 and 1.25-3.17 g·kg^-1, respectively, that is, the mineralization potential of the R. pseudoacacia forest was higher. During the cultivation period, the content of various active organic carbon components decreased with time, and that in the R. pseudoacacia forest land was greater than that in the slope land. The cumulative carbon release of soil was significantly positively correlated with the contents of MBC and DOC (P<0.05), and Q₁₀ (15-25℃) was negatively correlated with the contents of SOC, EOC, and SWC (P<0.05). These results could provide some reference for the study of soil carbon sequestration in loess hilly regions under climate change.

Changes in Soil Organic C Fractions and C Pool Stability Are Mediated by C-Degrading Enzymes in Litter Decomposition of Robinia pseudoacacia Plantations

Litter decomposition is the main source of soil organic carbon (SOC) pool, regarding as an important part of terrestrial ecosystem C dynamics. The turnover of SOC is mainly regulated by extracellular enzymes secreted by microorganisms. However, the response mechanism of soil C-degrading enzymes and SOC in litter decomposition remains unclear. To clarify how SOC fraction dynamics respond to C-degrading enzymes in litter decomposition, we used field experiments to collect leaf litter and SOC fractions from the underlying layer in Robinia pseudoacacia plantations on the Loess Plateau. Our results showed that SOC, easily oxidizable organic C, dissolved organic C, and microbial biomass C increased significantly during the decomposition process. Litter decomposition significantly decreased soil hydrolase activity, but slightly increased oxidase activity. Correlation analysis results showed that SOC fractions were significantly positively correlated with the litter mass, lignin, soil moisture, and oxidase activity, but significantly negatively correlated with cellulose content and soil pH. Partial least squares path models revealed that soil C-degrading enzymes can directly or indirectly affect the changes of soil C fractions. The most direct factors affecting the SOC fractions of topsoil during litter decomposition were litter lignin and cellulose degradation, soil pH, and C-degrading enzymes. Furthermore, regression analysis showed that the decrease of SOC stability in litter decomposition was closely related to the decrease of soil hydrolase to oxidase ratio. These results highlighted that litter degradation-induced changes in C-degrading enzyme activity significantly affected SOC fractions. Furthermore, the distribution of soil hydrolases and oxidases affected the stability of SOC during litter decomposition. These findings provided a theoretical framework for a more comprehensive understanding of C turnover and stabilization mechanisms between plant and soil.

[Effects of Straw Returning and Fertilizer Application on Soil Nutrients and Winter Wheat Yield]

In order to explore the effects of straw returning combined with fertilizer on soil nutrients and winter wheat yield in the Guanzhong area, an experimental split plot design was utilized. The main plot consisted of no straw returning (S₀) and straw returning (S). The sub-regions consisted of no fertilizer (WF), nitrogen fertilizer (NF), and nitrogen and phosphate fertilizer (NPF). Ecological stoichiometry was used to study the relationship between soil carbon, nitrogen, phosphorus content, and yield under straw returning combined with nitrogen and phosphorus fertilizer conditions. The results showed that straw and fertilization interactions had significant effects on soil organic carbon, total nitrogen, and total phosphorus contents in the surface layer (0-20 cm) (P<0.05). Compared with that in the S₀WF treatment, the SNPF treatment significantly increased soil organic carbon and total nitrogen contents in the surface layer (0-20 cm) (P<0.05). The interaction between straw and year had significant effects on soil total nitrogen content in the surface layer (0-20 cm) (P<0.05). With the increase in straw returning time, the total nitrogen content of soil 0-20 cm under the SWF treatment was significantly higher than that under the S₀WF treatment (P<0.05). Straw and fertilization and their interaction had no significant effects on organic carbon and total nitrogen contents in the 20-40 cm soil layer (P>0.05). Straw and straw interaction with fertilization significantly affected total P content in 20-40 cm soil (P<0.05). Compared with that in the SWF treatment, the SNPF treatment significantly increased the total phosphorus content in the 20-40 cm soil layer (P<0.05). Straw returning combined with chemical fertilizer also had a significant effect on soil stoichiometry. Compared with that in the S₀WF treatment, the S₀NPF treatment decreased soil C:N in the surface layer (0-20 cm) and increased soil C:P and N:P in the surface layer (0-20 cm). Compared with that in the SWF treatment, the SNF treatment reduced soil C:N in the surface layer (0-20 cm). Straw returning combined with chemical fertilizer also had a significant effect on winter wheat yield. In 2020 and 2021, the SNPF treatment increased production by 24.23% and 28.9%, respectively, compared with that of the S₀WF treatment. Correlation analysis showed that yield was significantly positively correlated with C:N (P<0.05) and C:P (P<0.01). At the same time, total nitrogen and N:P were positively correlated with treatment years (P<0.001). In conclusion, straw returning and that combined with nitrogen and phosphate fertilizer (SNPF) can improve soil nutrient characteristics, change soil stoichiometric characteristics, and increase yield in the Guanzhong area. Therefore, the results of this study indicate that straw returning combined with nitrogen and phosphate fertilizer (SNPF) is an effective way to optimize regional farmland nutrient management and improve grain production capacity.

[Effects of Straw Returning and Biochar Application on Summer Maize Yield and Soil N2O Emission in Guanzhong Plain]

Here, we investigated the effects of straw returning combined with biochar application on summer maize yield and soil nitrous oxide (N₂O) emissions, based on a field location trial in the Guanzhong Plain from 2019 to 2020. The soil N₂O emission rates were monitored using the static chamber-chromatography method. A comprehensive analysis of summer maize yields, soil N₂O emissions, and soil labile nitrogen components was conducted to clarify the effects of straw returning combined with biochar application on improving soil fertility, increasing summer maize yield, and reducing greenhouse gas emissions. The three treatments were no straw returning (S₀), straw returning (S), and straw returning combined with biochar application (SB). The results showed that the peak of N₂O emissions from each treatment occurred 10 d after the straw return, and the rate of soil N₂O emissions remained at a low level after 30 d of straw return. The rate of soil N₂O emissions showed highly significant positive correlations (P<0.05) with ammonium nitrogen (NH₄⁺-N), inorganic nitrogen (SIN), microbial nitrogen (MBN), and dissolved organic nitrogen (DON) contents. S significantly increased summer maize yield, cumulative N₂O emissions, yield-scaled N₂O intensity, and total nitrogen (TN) content by 7.4%-13%, 65.8%-132.2%, 54.6%-103%, and 27.8%-33%, respectively, compared to those in S₀. Although the trend for SB to increase summer maize yield (2.5%-3.3%) compared to that in S was not significant (P>0.05), SB significantly reduced cumulative N₂O emissions and yield-scaled N₂O intensity by 24.0%-27.3% and 26.4%-29.2%, respectively, compared to that in S. SB significantly reduced the rate of soil N₂O emissions by 45.1%-69.6% at the peak of N₂O emissions compared to that in S. Biochar application mitigated soil N₂O emissions induced by straw return and had a peak-shaving effect. SB significantly increased soil total N by 9.1%-12.2% compared to that in S. Combining summer maize yield, soil N₂O emissions, and TN content, SB not only improved soil fertility and summer maize yield but also reduced yield-scaled N₂O intensity, making it a suitable management practice that can be replicated to balance crop yield and environmental friendliness.

[Changes in Soil Microbial Carbon-Degrading Enzymes and Their Relationships with Carbon Pool Components During the Restoration Process of Robinia pseudoacacia]

To reveal the change in the characteristics of soil microbial C-degrading enzyme activities and the response to the components of C during the restoration process of Robinia pseudoacacia forests in the Loess Plateau, the components of the soil C pool, C-degrading enzyme activities, and microbial metabolic entropy of R. pseudoacacia in different restoration stages were studied, and the response relationship between C-degrading enzymes and soil C components was explored. The results showed that the microbial respiration (MR) first increased and then decreased with the restored years. We found that the microbial metabolic entropy (qCO₂) decreased significantly with the restored years, but the microbial entropy (qMB) increased. Soil C-degrading enzymes increased significantly in the early-stage restoration of R. pseudoacacia; however, oxidizing enzymes (PO and PER) and cellobiohydrolase (CBH) decreased in the late stage of restoration. The soil organic C and recalcitrant organic C increased significantly with the restored years; however, there was no significant difference for the labile organic C. Correlation analysis and the partial least squares-path model (PLS-PM) showed that soil C-degrading enzymes and C components were significantly correlated with microbial respiration and entropy (qCO₂ and qMB), respectively. The hydrolytic enzyme (BG+CBH) was significantly positively correlated with SOC, microbial biomass C, qMB, and recalcitrant and labile organic C. The oxidizing enzyme (PO+PER) was significantly positively correlated with the soil clay and qCO₂. In addition, the recalcitrant organic C was the key driver of soil microbial metabolism affected by vegetation restoration. Overall, the ecosystem of R. pseudoacacia plantations would gradually stabilize with the increase in restored years and significantly increase the sequestration effect of soil C. These results will be helpful to understand the transformation rule and regulation mechanism of the soil C pool in vulnerable habitats and provide scientific basis for the restoration and management of vegetation in the Loess Plateau.

[Effects of Nitrogen Fertilizer and Straw Returning Methods on N2O Emissions in Wheat-Maize Rotational Soils]

In order to explore the impacts of nitrogen fertilizer and straw returning methods on N₂O emissions, a two-factor split-zone design was adopted for experimentation under the winter wheat-summer maize rotation model in the Guanzhong area of Shanxi, China. The main areas of interest were conventional nitrogen (G) and reduced nitrogen (70% G); the sub-areas were straw no return (N), straw return (S), and straw return + biochar (SB); we analyzed their impacts on N₂O emissions and crop yield, and the relationships with related impact factors. The results showed that the N₂O emissions peaks appeared in the wheat season and maize season treatments within 5-16 days after fertilization, and also appeared after rainfall. The N₂O flux was significantly and positively correlated with soil temperature and NH₄⁺-N content. Regardless of the wheat season, maize season, or annual total N₂O emissions, the 70% GSB treatment was the lowest and the GS treatment was the highest. At the same level of nitrogen application, S treatment increased N₂O emissions, SB treatment could reduce N₂O emissions, both S and SB treatments could significantly increase crop yields, and SB production increased more; 70%G-level annual N₂O emissions, when compared with the G level, had been reduced by 40% to 48%, while the yield has not decreased significantly. Through comprehensive consideration, a reduction of nitrogen by 30% was achieved through the combination of straw + biochar on the basis of conventional nitrogen application, while ensuring high crop yields and the best N₂O emissions reduction.

P4506New indices of arterial stiffness correlates with disease severity and mid-term prognosis in acute decompensated heart failure

Background

Arterial stiffness has been implicated in pathophysiology of heart failure (HF) since it is involved in the ventricular-vascular coupling. Recently, new indices obtained by a cuff oscillometric technique, the arterial velocity-pulse index (AVI) for the stiffness of central arteries and the arterial pressure-volume index (API) for the stiffness of peripheral arteries have been developed and validated. However, the AVI and API measurement has not been attempted in HF population.

Purpose

This study aimed to investigate the relationship between the AVI, API and clinical outcomes in HF patients.

Methods

A prospective cohort of patients with acute decompensated HF were enrolled within 6 months, who were admitted to a tertiary referral hospital in China. Measurement of the AVI and API (AVE-1500, Shisei Datum, Tokyo, Japan) was performed on the day of admission and discharge. Patients were followed up to 6 months for the composite endpoint of all-cause death and HF rehospitalization.

Results

A Total of 127 patients were recruited for analysis (60±15 years, 70% male). 80% of the patients were in New York Heart Association (NYHA) Class III or above at admission, who presented a mean left ventricular ejection fraction (LVEF) of 34±9%. During hospitalization, all patients received guideline directed medical therapy if not contraindicated. The AVI (27.3±5.2 vs. 28.6±6.7, p=0.002) and API (24.9±4.9 vs. 26.0±6.5, p=0.05) were lower at discharge than at admission. By dividing the patients into tertiles according to the amino-terminal pro-brain natriuretic peptide (NT-proBNP), LVEF, transmitral E velocity over mitral annular e' velocity (E/e' ratio) and systolic blood pressure (SBP) at admission, it was observed that the AVI increased with a higher level of NT-proBNP (p for trend <0.001), a larger E/e' (p<0.001) and a lower LVEF (p=0.001), while the API increased as the SBP became higher (p=0.005).The improvement in AVI at discharge was correlated with that in LVEF (R=-0.3024, p<0.05) and NT-proBNP (R=0.3118, p<0.05), while the change in API was positively correlated with that in SBP (R=0.3897, p<0.001). In 6 months after discharge, there were 52 predefined events including 15 deaths and 44 HF rehospitalization. Apart from the level of NT-proBNP, the AVI at discharge of ≥26 showed a trend of being associated with the composite outcome (2.747, 1.411–5.349, p<0.001 for univariate analysis; 1.8648, 0.8928–3.8949, p=0.0973 for multivariate analysis).

Conclusions

New noninvasive arterial stiffness indices as the AVI and API reflected severity of illness and mid-term prognosis in admitted HF patients. Further studies are warranted for understanding its mechanisms and developing clinical applications.

[Relationship Between the Vegetation Community and Soil Nutrient and Enzyme Activity During the Restoration of Abandoned Land in the Loess Hilly Region]

The trends of and relationships among the plant community, soil nutrients, and four soil enzymes were investigated after being abandoned for 10, 15, 20, 30, and 45 years to reveal the soil properties during the restoration in the Loess Hilly Region. The results indicate the following ranking of dominant plant community species:Artemisia scoparia→Lespedeza dahurica+Artemisia sacrorum→Artemisia giraldii+irons Artemisia annua→Bothriochloa flaccidum+Artemisia selengensis. The ranking reflects an increase along the chronosequence of abandoned land. Moreover, the ratio of the total species of Compositae, Poaceae, and Leguminosae decreases from 66.67% to 50% and then increases up to 75%. The SOC, TN, TP, AN, AP, and four enzyme activity types (ALP, CAT, UE, and SC) increase but respond differently to restoration, while the stoichiometric ratio fluctuates. In contrast to the number of plant families, genus, species, and plant diversity, Compositae, Poaceae, and Leguminosae have major effects on the soil nutrient and enzyme activity, which explains the total variation of 72.8%, 69.1%, and 66.0%, respectively. The effects of these three families on the soil enzymes are greater than that on soil nutrients. Poaceae and Leguminosae have a positive effect on the nutrient and enzyme activity, while the family Compositae has a negative effect. Overall, the changes of dominant species of grassland communities during restoration significantly affect the soil enzyme and thereby are responsible for the soil nutrient dynamics.

Development and cross-species transferability of unigene-derived microsatellite markers in an edible oil woody plant, Camellia oleifera (Theaceae)

Camellia oleifera is an important edible oil woody plant in China. Lack of useful molecular markers hinders current genetic research on this tree species. Transcriptome sequencing of developing C. oleifera seeds generated 69,798 unigenes. A total of 6949 putative microsatellites were discovered among 6042 SSR-containing unigenes. Then, 150 simple sequence repeats (SSRs) were evaluated in 20 varieties of C. oleifera. Of these, 52 SSRs revealed polymorphism, with the number of alleles per locus ranging from 2 to 15 and expected heterozygosity values from 0.269 to 0.888. The polymorphic information content varied from 0.32 to 0.897. Cross-species transferability rates in Camellia chekangoleosa and Camellia japonica were 90.4 and 78.8%, respectively. The 52 polymorphic unigene-derived SSR markers serve to enrich existing microsatellite marker resources for C. oleifera and offer potential for applications in genetic diversity evaluation, molecular fingerprinting, and genetic mapping in C. oleifera, C. chekangoleosa, and C. japonica.

Knockdown of RhoGDIα induces apoptosis and increases lung cancer cell chemosensitivity to paclitaxel

This study aimed to investigate the effects of RhoGDIα knockdown on apoptosis and the chemosensitivity of lung cancer cells to paclitaxel. The signaling proteins involved were also assessed. RhoGDIα expression was assessed by RT-PCR, Western blotting and immunohistochemistry. Apoptosis was determined by flow cytometric assessment, and cell viability was measured with the MTT assay. Phosphorylation levels of signaling proteins, ERK, JNK, Akt, Bad and IκBα were tested by Western blotting and immunohistochemistry. Positivity for RhoGDIα in lung cancer tissues was significantly higher than in paracancerous tissues. Downregulation of RhoGDIα was associated with significantly increased apoptosis and repressed cell viability. This effect could be due to the consequent upregulation of p-JNK, as well as decreased levels of p-ERK, p-Bad and p-IκBα. Knockdown of RhoGDIα strengthened the effect on apoptosis and inhibition of cell viability induced by paclitaxel treatment. This chemosensitization effect could be a result of the intensification of pro-apoptotic JNK activation, and repression of anti-apoptotic p-ERK, p-Bad and p-IκBα expression stimulated by paclitaxel. In summary, our study indicated that RhoGDIα could be a promising therapeutic target, and the combination of RhoGDIα siRNA and paclitaxel might be a valuable potential therapy for lung cancer treatment.

Monitoring of peptide-specific and gamma interferon-productive T cells in patients with active and convalescent tuberculosis using an enzyme-linked immunosorbent spot assay

To establish a high-efficiency gamma interferon-specific enzyme-linked immunosorbent spot assay (IFN-γ ELISPOT assay) for detection of tuberculosis (TB), peptides (E6, E7, and C14) and peptide mixtures (E6 plus E7 and E6 plus E7 plus C14) were used to monitor peripheral blood (PBL) samples from patients with pulmonary TB (PTB), as well as control samples. The positive detection rates of the five IFN-γ ELISPOT assays were 78.38%, 74.86%, 55.83%, 90.43%, and 91.51%, respectively, and there were similar detection rates between the two combined peptide mixture IFN-γ ELISPOT assays and the tuberculin skin test (TST) (90.62% versus 95.59%). No significant difference was found between the detection rates of the two combined peptide mixture IFN-γ ELISPOT assays and the T-SPOT.TB assay for 86 patients with PTB (P > 0.05), but the median number of spot-forming cells/10(6) cells (SFP value) for positive results was higher by the former than by the latter assay (P < 0.05). In contrast, the 29.93% positive detection rate and median SFP value of 482 by the two combined peptide mixture IFN-γ ELISPOT assays were significantly higher than the corresponding values of 14.29% and 152 by T-SPOT.TB assay for the same 147 community donors (P < 0.05). For nine PTB patients tracked, the SFP value of 7 for the two peptide mixture IFN-γ ELISPOT assays began to decrease from the second month after regular treatment. A relatively low, almost normal, SFP level was reached and maintained after the third or fourth month. Two in-house IFN-γ ELISPOT assays and the T-SPOT.TB assay could reduce the false-positive and false-negative detection rates of TST and sputum acid-fast staining. Therefore, these two combined peptide mixture IFN-γ ELISPOT assays have a potential advantage, beyond their greater specificity and sensitivity, for use in screening and detection of active TB infection (TBI) and latent TB infection (LTBI) in China.

Natural occurrence of fumonisins b1 and b2 in corn from three main production provinces in China

A total of 255 corn samples collected in 2010 from three main corn production provinces of China (Liaoning, Shandong, and Henan) were analyzed for contamination with fumonisins (FB(1) and FB(2)). The incidence of contamination was significantly higher in samples from Liaoning than in samples from the other two provinces. Approximately 80.0% of the samples from Liaoning were contaminated with fumonisins, with a mean total fumonisin concentration of 3,990 ng/g. In contrast, the mean total fumonisin concentrations were 845 and 665 ng/g in samples from Shandong and Henan, respectively. The probable daily intake of fumonisins (0.3 μg/kg of body weight) is within the provisional maximum tolerable daily intake of 2.0 μg/kg of body weight set by the Joint Food and Agriculture Organization and World Health Organization Expert Committee on Food Additives.

[Addition internal standard method in chromatographic quantitative analysis]

Internal standard method is a conventional chromatographic quantitative method which requires one or several internal standards added. The internal standard component must not be contained in the sample and need a good separation between the internal standard and sample components. In many cases selecting an internal standard is not convenient or even restricted by the seperation of components. In this paper, we try to combine the internal standard method and the addition method to form a new chromatographic quantitation method named addition internal standard method. The principles of addition internal standard method are suitable to not only chromatographic quantitation but also polarography etc. The related theory and foundation of the method are defined. The operation steps and the conditions suitable to the method are discussed. The advantages and disadvantages of this method are explained in detail.

The role of glutamate in the locus coeruleus during opioid withdrawal and effects of H-7, a protein kinase inhibitor, on the action of glutamate in rats

To investigate the role of glutamate in the locus coeruleus (LC) during opioid withdrawal, rats were continuously infused with morphine (a mu-opioid receptor agonist, 26 nmol/microl/h) or butorphanol (a mu/delta/kappa-mixed opioid receptor agonist, 26 nmol/microl/h) intracerebroventricularly (i.c.v.) via osmotic minipumps for 3 days. A direct LC injection of glutamate (1 or 10 nmol/5 microl) or naloxone (an opioid receptor antagonist, 24 nmol/5 microl) induced withdrawal signs in morphine- or butorphanol-dependent animals. However, these agents failed to precipitate any withdrawal signs in saline-treated control animals. On the other hand, the expression of withdrawal signs precipitated by the administration of glutamate or naloxone in opioid-dependent animals was completely blocked by concomitant infusion with 1 or 10 nmol/microl/h of an inhibitor of adenosine 3',5'-cyclic monophosphate (cAMP)-dependent protein kinase and protein kinase C, H-7 [1-(5-isoquinolinesulfonyl)-2-methylpiperazine]. In animals that had been infused with opioids in the same manner, i.c.v. injection of naloxone (48 nmol/5 microl) precipitated withdrawal signs and increased extracellular fluid levels of glutamate in the LC of morphine- or butorphanol-dependent rats measured by in vivo microdialysis method. However, concomitant infusion with H-7 inhibited the increases of glutamate levels in the LC. These results strongly suggest that an expeditious release of glutamate in the LC region plays an important role in the expression of physical dependence on opioids. Furthermore, the action on glutamate release might be increased by the enhancement of cAMP-dependent protein kinase and/or protein kinase C activity.

Alpha 2-adrenoceptors and I1-imidazoline binding sites: relationship with catecholamines in women of reproductive age

A comparison is presented between plasma catecholamine concentrations and platelet [125I]-p-iodoclonidine binding sites in 16 healthy women. Blood samples were obtained at six regularly spaced intervals over two consecutive menstrual cycles from healthy women with regular menstrual periods. Although no cycle-related changes were observed per se, there were significant correlations between the platelet binding sites and plasma norepinephrine and epinephrine concentrations. The densities of platelet alpha 2-adrenoceptors were negatively correlated in an exponential fashion (r2 = 0.694, P = 0.009) with plasma epinephrine concentrations, implying agonist-induced downregulation. On the other hand, platelet I1-imidazoline binding sites were positively correlated with plasma concentrations of norepinephrine in a linear fashion (r2 = 0.326, P = 0.021). This is the first indication that I1 binding sites might be upregulated by a physiological factor. Furthermore, the data suggest that elevations in plasma norepinephrine might explain reports of upregulated I1 binding sites in depressed patients.

Plasma MHPG response to yohimbine treatment in women with hypoactive sexual desire

The use of yohimbine to treat impotence has suggested that decreased male sexual desire may relate to decreased activity of central noradrenergic neurons. Previous trials of yohimbine to treat female sexual problems are not available. Yohimbine is an alpha 2-adrenergic antagonist that stimulates norepinephrine (NE) release. In the present study, plasma concentrations of 3-methoxy-4-hydroxyphenylglycol (MHPG), the major central nervous system metabolite of NE, were measured in 9 women diagnosed with hypoactive sexual desire. Daily logs of mood and sexual activity, and trimonthly MHPG blood drawings, were obtained over an initial baseline menstrual cycle followed by two subsequent treatment cycles (yohimbine or placebo), in randomized order. Blood samples were obtained at 9:00 a.m. during (a) the early follicular phase of each cycle (24 hr after the onset of each cycle), (b) the ovulatory phase (i.e., within 1 day of an oral temperature rise), and (c) the midluteal phase (i.e., 20-25 days into each cycle). Comparisons were made with a group of 7 healthy female controls. Women with hypoactive sexual desire had slightly lower plasma MHPG values than controls at baseline, although there was only a trend toward significance during the early follicular phase (p = .09). Yohimbine (5.4 mg orally, 3 times daily, beginning at menses) caused a sustained rise in plasma MHPG of similar magnitude to that reported in men. However, in terms of improved sexual desire, yohimbine had no obvious therapeutic effect. Thus, plasma MHPG and the alpha 2-adrenergic response to yohimbine appeared within normal ranges in women with hypoactive sexual desire, with no therapeutic response to yohimbine.

Glutamate in opioid dependence

The present review will concentrate on a discussion of recent investigations which implicate a critical linkage of three facets of the central nervous system mediation of opioid dependence, as evidenced by expression of acutely-precipitated withdrawal events. These are the kappa-opioid receptor subtype, the glutamatergic neuronal system and a specific brain locus, the locus coeruleus. The impetus for this line of investigation derives from a recognition that opioid analgesics, such as butorphanol (Stadol), exhibit a markedly different profile of activity at opioid receptors than does morphine yet have abuse liability and cause dependence readily. Emphasis will be placed on demonstration of a rodent model in which butorphanol administration induces dependence through a unique (in comparison with morphine) activation of the kappa-opioid receptor. The use of in vivo microdialysis techniques clearly identifies, in this model, that acutely-precipitated withdrawal from dependence on butorphanol results in focal increases in extracellular levels of glutamate within the locus coeruleus, and that the withdrawal syndrome can be mimicked by intracerebroventricular administration of exogenous glutamate, acting through the N-methyl-D-aspartate glutamate receptor subtype. The data confirm the participation of glutamate as a general phenomenon in opioid dependence, identify the locus coeruleus as a primary site for glutamatergic mediation of dependence, and suggest novel aspects to the neuropharmacology of opioid dependence with respect to the role of the kappa-opioid receptor.

Mu- and delta-opioid receptor antagonists precipitate similar withdrawal phenomena in butorphanol and morphine dependence

The relative involvement of mu- and delta-opioid receptors in the mediation of butorphanol-, as compared to morphine-, dependence was examined with the use of highly selective antagonists at mu- and delta-opioid receptors. Extracellular fluid levels of glutamate (Glu) and aspartate (Asp) were measured within the pontine locus coeruleus following precipitation of withdrawal from dependence on either butorphanol or morphine in conscious Sprague-Dawley rats. Dependence was induced by intracerebroventricular (i.c.v.) infusion of butorphanol (26 nmol/mu l/h), morphine (26 nmol/mu l/h) or saline vehicle (1 mu l/h) for 3 days by means of an osmotic minipump. Microdialysis probes (2 mm tip) were inserted into the locus coeruleus 24 h before precipitation of withdrawal by i.c.v. injection of either the mu-opioid receptor antagonist, D-Pen-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr-NH2 (CTOP; 48 nmol/5 mu l or 48 nmol/5 mu l), or the delta-opioid receptor antagonist, naltrindole (17-cyclopropy;methyl-6,7-dehydro-4,5-epoxy-3, 14-dihydroxy-6,7,2'3'-indolmorphinan hydrochloride; 48 nmol/5 mu l or 100 nmol/5 mu l). Baseline levels of Glu ranged from 9.59 + or - 1.27 to 12.84 + or - 3.01 mu M in the various treatment groups. Levels of Asp were similar. Precipitation of withdrawal by CTOP elicited significant increases of Glu and Asp in both morphine- and butorphanol-dependent rats. Maximal increases in Glu of 425% and 258% above baseline levels were elicited in the first 15 min microdialysis sample following i.c.v. injection of CTOP in morphine- and butorphanol-dependent rats, respectively. Behavioral signs of withdrawal were greater in morphine than butorphanol-dependent groups. The i.c.v. treatment with naltrindole elicited increases in Glu and Asp that were similar, although less marked, than those precipitated by CTOP treatment. Administration of naltrindole produced equivalent signs of withdrawal in both morphine- and butorphanol-dependent rats. Withdrawal from dependence on both morphine and butorphanol is characterized by elevations in coerulear levels of excitatory amino acids. Responses elicited following the use of selective mu- and delta-opioid receptor antagonists to precipitate withdrawal suggest that the role played by these receptors in mediation of the signs and symptoms of withdrawal do not differ greatly between butorphanol- and morphine-dependent rats.

Increased locus coeruleus glutamate levels are associated with naloxone-precipitated withdrawal from butorphanol in the rat

Extracellular fluid levels of glutamate were measured in the locus coeruleus during butorphanol (a mixed agonist at mu-, delta-, and kappa-opioid receptors) withdrawal by using microdialysis in conscious butorphanol-dependent Sprague-Dawley rats. Guide cannulae were implanted chronically and rats were given intracerebroventricular (i.c.v.) infusions of butorphanol (26 nmol/1 microliter/hr) or saline (1 microliter/hr) for 3 days. Microdialysis probes (2 mm tip) were inserted into the locus coeruleus 24 hr before precipitation of withdrawal by i.c.v. injection of naloxone (48 nmol/5 microliters). A separate series of rats was rendered dependent by peripheral injection of butorphanol (20 mg/kg, s.c., b.i.d.) for 5 days and naloxone (5 mg/kg, i.p.) was given to precipitate withdrawal. Single injections of butorphanol (26 nmol/5 microliters, i.c.v.) had no effect on the extracellular fluid levels of glutamate, compared to rats injected with vehicle. Behavioral evidence of withdrawal was detected following naloxone challenge in butorphanol-dependent rats (both i.c.v. and s.c. models), but not in non-dependent, vehicle-treated rats. Significant increases (P < 0.05) in levels of glutamate were noted after naloxone-precipitated withdrawal only in the butorphanol group. The glutamate levels in the locus coeruleus increased from 8.37 +/- 2.01 before, to 21.93 +/- 4.58 microM in the first 15 min sample following i.c.v. injections of 48 nmol/5 microliters naloxone and from 10.84 +/- 1.74 before, to 26.01 +/- 6.19 microM in the 15-30 min sample following i.p. injections of 5 mg/kg naloxone in the butorphanol-dependent rats, respectively. These results provide direct evidence to support the role of excitatory amino acids within the locus coeruleus in butorphanol withdrawal.

Crosstolerance between butorphanol and morphine in rats

To investigate the antinociceptive effects of morphine and U-50,488 after continuous administration with butorphanol, rats were intracerebroventricularly (ICV) infused with butorphanol (26 nmol/microliters/h) through osmotic minipumps for 3 days. Six hours after termination of infusion, the rats were challenged with different doses of morphine or U-50,488. Antinociceptive effects, as assessed by tail-flick and acetic acid writing tests, were measured 15 min after challenge. Development of crosstolerance to morphine was evident in butorphanol-infused animals. The study also revealed that crosstolerance to butorphanol developed in continuously ICV morphine-infused animals. Continuous ICV infusion with butorphanol produced a marked rightward shift of the antinociceptive dose-response curve resulting from U-50,488 challenge. These results showed that there is an antinociceptive crosstolerance between butorphanol and morphine, and crosstolerance to U-50,488 developed in continuously butorphanol-infused animals. The present data suggested that chronic ICV treatment with high doses of butorphanol can lead to desensitization of the antinociceptive systems mediated through the central kappa as well as mu receptors in rats.

Tolerance development to butorphanol: comparison with morphine

In order to evaluate and to compare the time course, dose response, and the degree of tolerance development to butorphanol and morphine, rats were continuously intracerebroventricularly (ICV) infused with saline vehicle (1 microliter/h), butorphanol (6.5, 13, 26, and 52 nmol/microliters/h), or morphine (1.6, 6.5, and 26 nmol/microliters/h) through osmotic minipumps for 1 to 3 days. The tail-flick responses were determined pre-, during, and postinfusion. Tolerance to morphine developed faster than that to butorphanol. The antinociceptive response to the ICV challenge dose (6 h after the termination of drug infusion) of butorphanol or morphine was decreased significantly and there was a negative correlation between the dose of the drug infused and the observed antinociceptive response. In terms of butorphanol and morphine tolerance, a parallel rightward shift in the dose-response curve was produced with the degree of shift proportional to the log of the infusion dose. In tail-flick tests, the shifts of the dose-response curves for butorphanol and morphine in tolerant animals were 11.8- and 46.3-fold, respectively. However, in the acetic acid writhing test, the shifts of the dose-response curves for butorphanol and morphine in tolerant animals were 11.3- and 11.7-fold, respectively. These results suggest that there is a greater degree of tolerance to morphine than there is to butorphanol, but the degree of butorphanol tolerance is still substantial. In addition, two pain assays (tail flick vs. writhing) yielded different estimations of tolerance in a comparison of morphine and butorphanol.

[Hereditary persistence of alpha-fetoprotein]

A proband with persistently elevated AFP levels ranging between 21-129 ng/ml with median of 90 ng/ml has been found and observed for 1 year. Family studies have revealed that his father had had persistent AFP elevation for 4 years, ranging from 46 to 198.2 ng/ml, with median level of 93 ng/ml. His brother also has elevated AFP level. However, his mother, paternal uncle and paternal aunt have normal AFP level. Clinical examinations and laboratory tests have shown that AFP elevations are not associated with primary hepatocellular carcinoma, hepatitis, or other malignancies. We believe that such AFP persistency is of hereditary nature. To our knowledge, this is the first family of hereditary AFP persistence reported in China and the fourth one reported in the world literature.

[Rational surgical approaches to the treatment of small primary liver cancer, and the prevention of postoperative recurrence]

From Sep. 1985 to Dec. 1990, surgical treatment was performed in 27 patients with small primary liver cancer (SPLC, < or = 5cm in diameter). Of them, segmentectomy was done in 23 cases and radical local resection in 4 cases with recurrence rate of 66.77% (18/27). Non recurrent lesions were located in the incisal margin. In this group re-resection rate was 55.6% (10/18). (1) Early detection and treatment of recurrent lesions remain a mainstay of prolonging survival. (2) Serum Alpha-fetoprotein (AFP), ultrasonography and X-ray chest film were basic follow-up methods for subclinical recurrence of SPLC. For re-operation cases, digital subtract angiography (DSA) are useful in identifying subclinical lesions. (3) For recurrent liver cancer local hepatectomy was a reasonable approach. (4) For SPLC, radical segmentectomy or radical local resection with a safe margin of 1 to 2cm was the authors' choice.

Evaluation of combined assays of serum ferritin, alpha-1-antitrypsin and alpha-fetoprotein in liver cancer

Serum ferritin (SF), alpha-1-antitrypsin (AAT) and alpha-fetoprotein (AFP) were examined preoperatively in 66 patients with intrahepatic space-occupied lesions revealed by B-real time ultrasonography. Elevated SF levels (> 300 micrograms/L in males and > 180 micrograms/L in females), AAT levels (4.2 g/L), and AFP levels (> 20 micrograms/L) were shown in 84%, 71% and 66% respectively of 55 patients with liver cancer. Combined analysis indicates that if all the three tests are negative, liver cancer can be essentially excluded; and positive AFP can rule out hepatic hemangioma. So combined assays of SF, AAT and AFP are valuable in the diagnosis and differential diagnosis of liver cancer.

Primary ovarian pregnancy. Report of fifteen cases

From June 1973 through November 1988, fifteen cases of ovarian pregnancy were admitted to the Shanghai First People's Hospital. All these cases met the four criteria for the diagnosis as listed by Spiegelberg. The incidence of ovarian pregnancy as compared to those of normal and ectopic pregnancy are 1:3 179 and 1:28.1, respectively, which are higher than foreign data reported. Ovarian pregnancy is quite similar to tubal pregnancy in clinical manifestations. Etiological analysis does not reveal any close relationship with inflammation of the female genital tract. However, application of IUD increases the risk of ovarian pregnancy. The principle of management is wedge resection of the diseased ovary.

[Short-term curative effects of daoyin-tuna qigong therapy in 103 cases of chronic atrophic gastritis]

Daoyin-Tuna Qigong therapy was applied to 103 cases with chronic atrophic gastritis (CAG). The average duration of disease was 7.8 years. Daoyin-Tuna Qigong exercises were done 4 times a day, 1 hour each time. 79 days made a course and no drug was given. 31 cases were checked with gastroscopy and biopsy, 30 cases with electrogastrogram and 34 cases with immunity detection before and after treatment course.

RESULTS

In clinical symptoms, the therapy appeared markedly effective in 72 cases (69.9%). The effective cases were 28 (27.2%). The total effective rate was 97.1%. The body weight of 95 cases (92.2%) increased by 2.4 +/- 1.3 kg on the average at the end of the treatment course, and the capacity for eating was increased by 110 +/- 70 g a day in 99 cases (96.1%). In gastroscopy and pathology examination, the rates of marked effectiveness were 35.5% and 48.4%, the effective 29.0% and 38.7%, the total effective 64.5% and 87.1% respectively. Electrogastrogram check: the frequency and amplitude of the electrogastrogram increased markedly (P less than 0.05) in comparison with the pre-therapy. Immunology examination: E-rosette was 51.3 +/- 8.4% before treatment and 55.3 +/- 7.7% after treatment (P less than 0.05). It is suggested that Daoyin-Tuna Qigong therapy would be a better and new treatment for CAG.