Analysis of risk factors for complications following transurethral resection of the prostate

OBJECTIVE

This study investigates the risk factors for complications following transurethral resection of the prostate and provides a reference for reducing postoperative complications.

PATIENTS AND METHODS

A retrospective analysis was conducted on 322 patients with benign prostatic hyperplasia who underwent transurethral resection of the prostate from April 2015 to January 2022. Among them, 214 patients had complete clinical and follow-up data. Clinical and follow-up data were collected, and both univariate and multivariate logistic regression analyses were performed to identify factors influencing the occurrence of postoperation transurethral resection of the prostate complications.

RESULTS

The incidence of complications after transurethral resection of the prostate was 19.16% (41/214). Among them, the incidence of Grade I-II complications was 14.96% (32/214), and Grade III-IV complications were 4.2% (9/214). The preoperative Quality of Life score (p<0.001) was identified as an independent risk factor for the occurrence of Grade I-II complications after transurethral resection of the prostate. The International Prostate Symptom Score (p=0.006) was identified as an independent risk factor for the occurrence of Grade III-IV complications after transurethral resection of the prostate.

CONCLUSIONS

The preoperative Quality of Life score is an independent risk factor for the occurrence of Grade I-II complications after transurethral resection of the prostate. The International Prostate Symptom Score is an independent risk factor for the occurrence of Grade III-IV complications after transurethral resection of the prostate.

Analysis of risk factors for stone remnants and recurrence after lateral decubitus percutaneous nephrolithotomy

OBJECTIVE

This study aims to explore the risk factors for stone remnants and recurrence after lateral decubitus percutaneous nephrolithotomy (PCNL), providing insights to enhance the stone-free rate and reduce the stone recurrence rate.

PATIENTS AND METHODS

A retrospective analysis was conducted on 356 patients with renal or upper ureteral stones who underwent lateral decubitus PCNL from January 2015 to August 2022. Among them, 271 patients had complete clinical and follow-up data. General clinical information, perioperative data, and follow-up data were collected. Univariate and multivariate logistic regression analyses were performed to identify risk factors for stone remnants and recurrence after lateral decubitus PCNL.

RESULTS

The stone-free rate after lateral decubitus PCNL was 88.6% (195/271), and the stone recurrence rate within three years was 28.1% (76/271). Stone size (p<0.001) and stone co-infection (p=0.047) were identified as independent risk factors for stone remnants after lateral decubitus PCNL. Multiple stones (p=0.003) were an independent risk factor for stone recurrence after lateral decubitus PCNL.

CONCLUSIONS

Stone size and stone co-infection are independent risk factors for stone remnants after lateral decubitus PCNL. Multiple stones are an independent risk factor for stone recurrence after lateral decubitus PCNL.

["Double Grooves-Double Rings" technique of transurethral Thulium laser enucleation of the prostate: learning curve of single surgeon]

Objective: To evaluate the learning curve of the "Double Grooves-Double Rings" (DGDR) technique of transurethral Thulium laser enucleation of the prostate (ThuLEP) for benign prostatic hyperplasia (BPH) by a single surgeon. From June 2021 to July 2022, 84 patients mean age (69.0±8.0) years,preoperative prostate volume (90.9±40.3)ml with BPH underwent ThuLEP in the Department of Urology, Peking University First Hospital.Performed by a single surgeon who had no experience of transurethral resection of prostate (TURP) and any laser surgeries. The case scatter plots with the best fitting line were drawn to analyze the learning curve. According to the date of the surgeries, the patients were equally divided into three learning stages (28 patients for each group). The T-PSA,prostate volume,operative time,enucleation time, enucleation efficiency,catheter indwelling time, hemoglobin drop and perioperative complications (including re-TURP, blood transfusion, stress incontinence≥3 months and urethral stricture) were compared among the groups. The learning curve was divided into three stages, and the cutting point was shown on the 14^th case. Except the prostate volume [stage1 (75.7±30.7) ml, stage2 (93.40±39.6)ml, stage3 (103.5±46.2) ml, P<0.05], there was no significant difference of the baseline data between three groups (P>0.05). Compared with those of stage 1(100.6±24.7) min,(0.55±0.22) g/min, a statistically significant improvement was observed in both of the operative time and the enucleation efficiency among stage 2[(84.5±36.6) min, (0.87±0.33) g/min and stage 3 (71.2±26.3) min, (1.27±0.45) g/min, P<0.05]. The learning curve of the DGDR technique for ThuLEP can be divided into three stages. A ThuLEP beginner can preliminarily master this technique after completing 14 cases.

ASIC1a involves the acid-mediated activation of pancreatic stellate cells associated with autophagy induction

The acidic tumor microenvironment (TME) of pancreatic cancer affects the physiological function of pancreatic stellate cells (PSCs), which in turn promotes cancer progression. Acid-sensing ion channel 1a (ASIC1a) is responsible for acidosis-related physiopathological processes. In this study, we investigated the effect of acid exposure on the activation and autophagy of PSCs, and the role of ASIC1a in these events. The results showed that acidic medium upregulated the expression of ASIC1a, induced PSCs activation and autophagy, which can be suppressed by inhibiting ASIC1a using PcTx1 or ASIC1a knockdown, suggesting that ASIC1a involves these two processes. In addition, the acid-induced activation of PSCs was impaired after the application of autophagy inhibitor alone or in combination with ASIC1a siRNA, meaning a connection between autophagy and activation. Collectively, our study provides evidence for the involvement of ASIC1a in the acid-caused PSCs activation, which may be associated with autophagy induction.

Distinguishable spatial-spectral feature learning neural network framework for motor imagery-based brain-computer interface

Objective.Spatial and spectral features extracted from electroencephalogram (EEG) are critical for the classification of motor imagery (MI) tasks. As prevalently used methods, the common spatial pattern (CSP) and filter bank CSP (FBCSP) can effectively extract spatial-spectral features from MI-related EEG. To further improve the separability of the CSP features, we proposed a distinguishable spatial-spectral feature learning neural network (DSSFLNN) framework for MI-based brain-computer interfaces (BCIs) in this study.Approach.The first step of the DSSFLNN framework was to extract FBCSP features from raw EEG signals. Then two squeeze-and-excitation modules were used to re-calibrate CSP features along the band-wise axis and the class-wise axis, respectively. Next, we used a parallel convolutional neural network module to learn distinguishable spatial-spectral features. Finally, the distinguishable spatial-spectral features were fed to a fully connected layer for classification. To verify the effectiveness of the proposed framework, we compared it with the state-of-the-art methods on BCI competition IV datasets 2a and 2b.Main results.The results showed that the DSSFLNN framework can achieve a mean Cohen's kappa value of 0.7 on two datasets, which outperformed the state-of-the-art methods. Moreover, two additional experiments were conducted and they proved that the combination of band-wise feature learning and class-wise feature learning can achieve significantly better performance than only using either one of them.Significance.The proposed DSSFLNN can effectively improve the decoding performance of MI-based BCIs.

[Research on performance of motor-imagery-based brain-computer interface in different complexity of Chinese character patterns]

The traditional paradigm of motor-imagery-based brain-computer interface (BCI) is abstract, which cannot effectively guide users to modulate brain activity, thus limiting the activation degree of the sensorimotor cortex. It was found that the motor imagery task of Chinese characters writing was better accepted by users and helped guide them to modulate their sensorimotor rhythms. However, different Chinese characters have different writing complexity (number of strokes), and the effect of motor imagery tasks of Chinese characters with different writing complexity on the performance of motor-imagery-based BCI is still unclear. In this paper, a total of 12 healthy subjects were recruited for studying the effects of motor imagery tasks of Chinese characters with two different writing complexity (5 and 10 strokes) on the performance of motor-imagery-based BCI. The experimental results showed that, compared with Chinese characters with 5 strokes, motor imagery task of Chinese characters writing with 10 strokes obtained stronger sensorimotor rhythm and better recognition performance ( P < 0.05). This study indicated that, appropriately increasing the complexity of the motor imagery task of Chinese characters writing can obtain stronger motor imagery potential and improve the recognition accuracy of motor-imagery-based BCI, which provides a reference for the design of the motor-imagery-based BCI paradigm in the future.

Learning Common Time-Frequency-Spatial Patterns for Motor Imagery Classification

The common spatial patterns (CSP) algorithm is the most popular spatial filtering method applied to extract electroencephalogram (EEG) features for motor imagery (MI) based brain-computer interface (BCI) systems. The effectiveness of the CSP algorithm depends on optimal selection of the frequency band and time window from the EEG. Many algorithms have been designed to optimize frequency band selection for CSP, while few algorithms seek to optimize the time window. This study proposes a novel framework, termed common time-frequency-spatial patterns (CTFSP), to extract sparse CSP features from multi-band filtered EEG data in multiple time windows. Specifically, the whole MI period is first segmented into multiple subseries using a sliding time window approach. Then, sparse CSP features are extracted from multiple frequency bands in each time window. Finally, multiple support vector machine (SVM) classifiers with the Radial Basis Function (RBF) kernel are trained to identify the MI tasks and the voting result of these classifiers determines the final output of the BCI. This study applies the proposed CTFSP algorithm to three public EEG datasets (BCI competition III dataset IVa, BCI competition III dataset IIIa, and BCI competition IV dataset 1) to validate its effectiveness, compared against several other state-of-the-art methods. The experimental results demonstrate that the proposed algorithm is a promising candidate for improving the performance of MI-BCI systems.

Cluster decomposing and multi-objective optimization based-ensemble learning framework for motor imagery-based brain-computer interfaces

OBJECTIVE

Motor imagery (MI) is a mental representation of motor behavior and a widely used pattern in electroencephalogram (EEG) based brain-computer interface (BCI) systems. EEG is known for its non-stationary, non-linear features and sensitivity to artifacts from various sources. This study aimed to design a powerful classifier with a strong generalization capability for MI based BCIs.

APPROACH

In this study, we proposed a cluster decomposing based ensemble learning framework (CDECL) for EEG classification of MI based BCIs. The EEG data was decomposed into sub-data sets with different distributions by clustering decomposition. Then a set of heterogeneous classifiers was trained on each sub-data set for generating a diversified classifier search space. To obtain the optimal classifier combination, the ensemble learning was formulated as a multi-objective optimization problem and a stochastic fractal based binary multi-objective fruit fly optimization algorithm was proposed for solving the ensemble learning problem.

MAIN RESULTS

The proposed method was validated on two public EEG datasets (BCI Competition IV datasets IIb and BCI Competition IV dataset IIa) and compared with several other competing classification methods. Experimental results showed that the proposed CDECL based methods can effectively construct a diversity ensemble classifier and exhibits superior classification performance in comparison with several competing methods.

SIGNIFICANCE

The proposed method is promising for improving the performance of MI-based BCIs.

Pancreatic sarcomatoid carcinoma: CT, MRI, and 18F-FDG PET/CT features

AIM

To investigate computed tomography (CT), magnetic resonance imaging (MRI), and combined 2-[¹⁸F]-fluoro-2-deoxy-d-glucose (¹⁸F-FDG) positron-emission tomography (PET)/CT features of pancreatic sarcomatoid carcinoma (PSC).

MATERIALS AND METHODS

The hospital database was searched retrospectively for the patients with PSC confirmed at histopathology after surgery. Ten patients who underwent unenhanced and enhanced CT (n=4), unenhanced and enhanced MRI (n=2), ¹⁸F-FDG PET/CT (n=2), and both enhanced CT and ¹⁸F-FDG PET/CT (n=2) were enrolled. Two patients underwent additional delayed PET/CT. The maximum standardised uptake value (SUVmax) was measured on PET/CT images.

RESULTS

Eleven lesions were detected in 10 patients. Solid and cystic components (n=6), intratumoural haemorrhage (n=1), nodular calcification (n=2), main pancreatic duct dilatation resulted from lesion obstruction (n=5) or compression (n=3), cholangiectasis (n=5), vascular and peripheral organ invasion (n=5 and 6, respectively), hepatic and lymphatic metastases (n=4 and 2, respectively) were detected. All five lesions in four patients who underwent PET/CT showed intense FDG uptake on PET/CT with SUVmax (16, range 10.9-21.1). Increase of FDG uptake (SUVmax = 18.9, 20.1, and 27.3, respectively) was revealed on the delayed scan of three lesions in two patients.

CONCLUSIONS

PSCs were more commonly ill-defined solid cystic masses, which caused pancreatic duct obstruction/compression without pancreatic parenchymal atrophy, and these masses on PET/CT showed high FDG uptake on both initial and delayed PET/CT.

Comparison of the ERP-Based BCI Performance Among Chromatic (RGB) Semitransparent Face Patterns

Objective

Previous studies have shown that combing with color properties may be used as part of the display presented to BCI users in order to improve performance. Build on this, we explored the effects of combinations of face stimuli with three primary colors (RGB) on BCI performance which is assessed by classification accuracy and information transfer rate (ITR). Furthermore, we analyzed the waveforms of three patterns.

Methods

We compared three patterns in which semitransparent face is overlaid three primary colors as stimuli: red semitransparent face (RSF), green semitransparent face (GSF), and blue semitransparent face (BSF). Bayesian linear discriminant analysis (BLDA) was used to construct the individual classifier model. In addition, a Repeated-measures ANOVA (RM-ANOVA) and Bonferroni correction were chosen for statistical analysis.

Results

The results indicated that the RSF pattern achieved the highest online averaged accuracy with 93.89%, followed by the GSF pattern with 87.78%, while the lowest performance was caused by the BSF pattern with an accuracy of 81.39%. Furthermore, significant differences in classification accuracy and ITR were found between RSF and GSF (p < 0.05) and between RSF and BSF patterns (p < 0.05).

Conclusion

The semitransparent faces colored red (RSF) pattern yielded the best performance of the three patterns. The proposed patterns based on ERP-BCI system have a clinically significant impact by increasing communication speed and accuracy of the P300-speller for patients with severe motor impairment.

Novel hybrid brain-computer interface system based on motor imagery and P300

Motor imagery (MI) is a mental representation of motor behavior and has been widely used in electroencephalogram based brain-computer interfaces (BCIs). Several studies have demonstrated the efficacy of MI-based BCI-feedback training in post-stroke rehabilitation. However, in the earliest stage of the training, calibration data typically contain insufficient discriminability, resulting in unreliable feedback, which may decrease subjects' motivation and even hinder their training. To improve the performance in the early stages of MI training, a novel hybrid BCI paradigm based on MI and P300 is proposed in this study. In this paradigm, subjects are instructed to imagine writing the Chinese character following the flash order of the desired Chinese character displayed on the screen. The event-related desynchronization/synchronization (ERD/ERS) phenomenon is produced with writing based on one's imagination. Simultaneously, the P300 potential is evoked by the flash of each stroke. Moreover, a fusion method of P300 and MI classification is proposed, in which unreliable P300 classifications are corrected by reliable MI classifications. Twelve healthy naïve MI subjects participated in this study. Results demonstrated that the proposed hybrid BCI paradigm yielded significantly better performance than the single-modality BCI paradigm. The recognition accuracy of the fusion method is significantly higher than that of P300 (p < 0.05) and MI (p < 0.01). Moreover, the training data size can be reduced through fusion of these two modalities.

Correlation-based channel selection and regularized feature optimization for MI-based BCI

Multi-channel EEG data are usually necessary for spatial pattern identification in motor imagery (MI)-based brain computer interfaces (BCIs). To some extent, signals from some channels containing redundant information and noise may degrade BCI performance. We assume that the channels related to MI should contain common information when participants are executing the MI tasks. Based on this hypothesis, a correlation-based channel selection (CCS) method is proposed to select the channels that contained more correlated information in this study. The aim is to improve the classification performance of MI-based BCIs. Furthermore, a novel regularized common spatial pattern (RCSP) method is used to extract effective features. Finally, a support vector machine (SVM) classifier with the Radial Basis Function (RBF) kernel is trained to accurately identify the MI tasks. An experimental study is implemented on three public EEG datasets (BCI competition IV dataset 1, BCI competition III dataset IVa and BCI competition III dataset IIIa) to validate the effectiveness of the proposed methods. The results show that the CCS algorithm obtained superior classification accuracy (78% versus 56.4% for dataset1, 86.6% versus 76.5% for dataset 2 and 91.3% versus 85.1% for dataset 3) compared to the algorithm using all channels (AC), when CSP is used to extract the features. Furthermore, RCSP could further improve the classification accuracy (81.6% for dataset1, 87.4% for dataset2 and 91.9% for dataset 3), when CCS is used to select the channels.

Chronic sun exposure is associated with distinct histone acetylation changes in human skin

BACKGROUND

Photoageing is attributed to continuous sunlight or artificial ultraviolet exposure and manifests as clinical and histological changes in skin. Epigenetic changes have been found to be involved in the pathogenesis of photoageing. However, the underlying mechanisms are unclear.

OBJECTIVES

To analyse histone modification patterns in sun-exposed and nonexposed skin, and to identify the abnormally histone-modified genes related to photoageing.

METHODS

Skin biopsies were collected from both the outer forearm (sun-exposed area) and the buttock (sun-protected area) in 20 healthy middle-aged female volunteers. Global histone H3/H4 acetylation and H3K4/H3K9 methylation statuses were assessed by enzyme-linked immunosorbent assay. Expression levels of histone acetyltransferases and histone deacetylases were measured by reverse-transcriptase quantitative polymerase chain reaction (qPCR) and Western blot. Chromatin immunoprecipitation combined with DNA microarray (ChIP-chip) assay with anti-acetyl-histone H3 antibody in a sun-exposed pool (combining six sun-exposed skin samples) and a nonexposed pool (combining six nonexposed skin samples) was conducted to explore the abnormally acetylated histone H3 genes related to photoageing; ChIP-qPCR was then used to verify the results of ChIP-chip.

RESULTS

We observed higher global histone H3 acetylation levels increased EP300 and decreased HDAC1 and SIRT1 expression in sun-exposed skin compared with matched nonexposed skin. Furthermore, the ChIP-chip assay showed that 227 genes displayed significant hyperacetylation of histone H3, and 81 genes displayed significant hypoacetylation of histone H3 between the two groups. Histone H3 acetylation levels on the promoters of PDCD5, ITIH5, MMP1 and AHR were positively correlated with the mRNA expression of the corresponding gene.

CONCLUSIONS

Chronic sun exposure-induced histone H3 hyperacetylation may play a critical role in the pathogenesis of skin photoageing.

[Correlation analysis of serum secreted frizzled-related protein 5 levels with airway inflammation and insulin resistance in chronic obstructive pulmonary disease patients]

Objective: To investigate the relationship between serum secreted frizzled-related protein 5(sfrp5) levels, insulin resistance, and airway inflammation in patients with chronic obstructive pulmonary disease(COPD). Method: A total of 178 COPD patients visiting our respiratory outpatient clinic from February 2015 to January 2017 were enrolled, and 99 healthy control subjects from the same time period were selected. Serum sfrp5 levels were compared between the 2 groups. Serum sfrp5 and inflammatory cytokines in induced sputum were observed in the 4 subgroups: insulin resistant COPD group [homeostasis model assessment of insulin resistance (HOMA-IR)≥2.29], non-insulin resistant COPD group, non-COPD insulin resistant group, and healthy control group. Results: Serum sfrp5 levels were found to be significantly higher in the COPD group as compared to the healthy control group (t=-14.29, P<0.001). Serum sfrp5 levels in the insulin resistant COPD group [(8±3)ng/ml] were significantly lower than that of the non-insulin resistant COPD group [(10±5)ng/ml], non-COPD insulin resistant group [(13±3)ng/ml], and normal control group [(14±4)ng/ml, F=35.85, P<0.01]. The insulin resistant COPD group had higher levels of In(Homa-IR), as well as tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in induced sputum as compared to the non-insulin resistant COPD group, non-COPD insulin resistant group, and healthy control group (F values were 64.968, 41.40, 64.15, respectively, P value <0.01 for all items). The non-insulin resistant COPD group had higher levels of In(HOMA-IR) as well as TNF-α and IL-6 in induced sputum as compared to the non-COPD insulin resistant group and healthy control group. FEV(1)/FVC and FEV(1)% predicted were significantly lower in the insulin resistant COPD group as compared to those of non-insulin resistant COPD group and non-COPD insulin resistant group, and healthy control group (F values were 2.481 and 8.37, respectively, P value<0.05 for all items). FEV(1)/FVC and FEV(1)% predicted were significantly lower in the non-insulin resistant COPD group as compared to those of the healthy control group and non-COPD insulin-resistant group. Serum sfrp5 levels were positively correlated to FEV(1)/FVC and FEV(1) predicted (r values were 0.466 and 0.412, respectively; P values were <0.001 and 0.007, respectively) and inversely correlated to In(HOMA-IR) and TNF-α and IL-6 in induced sputum (r values were -0.304, -0.459, -0.517, respectively; P values were <0.001, 0.002, <0.001, respectively). BMI, ln(HOMA-IR), and IL-6 in induced sputum were independent related factors (r(2) values were 0.286, 0.176, 14.69, respectively; P values were <0.01 for all items) Conclusion: Sfrp5 may be concurrently associated with COPD and insulin resistance; insulin resistance may be associated with airway inflammation and airflow limitation. Sfrp5 may be involved in the development of COPD and may be the key link by which insulin resistance exerts its effects on airway inflammation.

Electrolytic partitioning of uranium and plutonium based on a new type of electrolytic mixer-settler

The design of a new type of electroreduction mixer-settler for the partitioning of uranium and plutonium during the Purex process, which is featured with E-shaped cathodes and U-shaped anodes in settling chamber, is described and the operational results achieved using this equipment are presented. The results show that this new type of mixer-settler has excellent separation performances. The flow rate of organic feed solution is 3 mL/min and the flow ratio of feed solution (1BF) to aqueous back extraction stream (1BX) and to organic wash stream (1BS) is 4/1/1. For an organic feed of 84 g/L uranium and 1.40 ⁓ 2.64 g/L plutonium, both the separation factor of plutonium from uranium and that of uranium from plutonium are apparently higher than 104

Osteoblastogenesis regulation signals in bone remodeling

Bone remodeling is essential for adult bone homeostasis. The failure of this process often leads to the development of osteoporosis, a present major global health concern. The most important factor that affects normal bone remodeling is the tightly controlled and orchestrated regulation of osteoblasts and osteoclasts. The present review summarized the recent discoveries related to osteoblast regulation from several signals, including transforming growth factor-β, bone morphogenetic proteins, Wnt signal, Notch, Eph-Ephrin interaction, parathyroid hormone/parathyroid hormone-related peptide, and the leptin-serotonin-sympathetic nervous systemic pathway. The awareness of these mechanisms will facilitate further research that explores bone remodeling and osteoporosis. Future investigations on the endogenous regulation of osteoblastogenesis will increase the current knowledge required for the development of potential drug targets in the treatment of osteoporosis.

FDG-PET study of the bilateral subthalamic nucleus stimulation effects on the regional cerebral metabolism in advanced Parkinson disease

The aim of the study was to evaluate the changes in regional cerebral metabolic rate of glucose (rCMRGlu) induced by bilateral subthalamic nucleurs (STN) stimulation in advanced Parkinson's disease (PD). 18F-Fluorodeoxyglucose (FDG) PET data obtained before and one month after stimulation were analyzed with statistical parametric mapping (SPM). As a result of clinically effective bilateral STN stimulation, rCMRGlu increased in lateral globus pallidus (GP), upper brain stem, dorsolateral prefrontal cortex (DLPFC) and posterior parietal-occipital cortex, and decreased in the orbital frontal cortex and parahippocampus gyrus (p < 0.001). We conclude that the alleviation of clinical symptoms in advanced PD by bilateral STN stimulation may be the result of activation of both ascending and descending pathways from STN and of restoration of the impaired higher-order cortex functions.

High spatial resolution in vivo 2D (1)H magnetic resonance spectroscopic imaging of human muscles with a band-selective technique

This report demonstrates a 2D (1)H magnetic resonance spectroscopic imaging (MRSI) technique that can address some technical difficulties often encountered in MRS studies of human muscles. A preliminary application of this whole-slice technique in human skeletal muscles demonstrates clearly noticeable differences in (1)H metabolite spectra between different human muscles. This observation illustrates the importance of multi-voxel and high spatial resolution in a heterogeneous environment. This technique is robust, can be easily implemented on a commercial MR scanner, and should prove useful for investigators in both basic and clinical (1)H MRS studies.

Potential heating effect in the gravid uterus during MR HASTE imaging

Our purpose was to evaluate if temperature changes occur in maternal or fetal tissues during HASTE imaging.

METHODS

Pregnant pigs were scanned with the HASTE technique, and temperatures were measured with phase maps and temperature probes inserted into the amniotic fluid and fetal brain.

RESULTS

Fiberoptic probes showed that no heating occurred in fetal tissues or amniotic fluid during HASTE imaging.

CONCLUSION

Our current HASTE protocols do not deposit a significant amount of heat in the gravid uterus. J. Magn. Reson. Imaging 2001;13:856-861.

[The risk of sustained amenorrhea in patients with systemic lupus erythematosus receiving intermittent pulse cyclophosphamide therapy]

OBJECTIVE

To determine the risk of sustained amenorrhea in premenopausal women with systemic lupus erythematosus (SLE) receiving intermittent pulse cyclophosphamide (CTX) therapy.

METHODS

Prospectively comparing the amenorrhea rate of 51 cases receiving intermittent pulse cyclophosphamide therapy versus that of 22 cases receiving intermittent pulse methylprednisolone (MP) therapy.

RESULTS

The amenorrhea rate was higher in the CTX group (19.6%) than in the MP group (P = 0.025). In the CTX group, the amenorrhea rate of patients aged over 30 was higher than that of patients aged 30 or below 30 (P = 0.0018).

CONCLUSION

Pulse CTX therapy in fertile women with SLE is associated with increased rate of sustained amenorrhea, and the older the patient is, the higher risk for sustained amenorrhea the patient runs.

[Study on bolus cyclosphamide treatment for 64 cases of lupus nephritis]

OBJECTIVE

To report on the dosing, efficacy and side-effects of bolus cyclosphamide treatment for lupus nephritis (LN).

METHODS

64 consecutive cases of LN with 10 or more erythrocytes per high-power field, proteinuria (> 1 g of protein per day) and serum creatinine increased (> 133 mumol/L) were treated by bolus therapy with cyclophosphamide (CTX) given monthly for 6 months and then quarterly for 18 months.

RESULTS

49 patients had renal remission (defined as < 10 erythrocytes per high-power field, absence of cellular casts, excretion of < 1 g of protein per day and normal serum creatinine). The mean of doses was 1.1 g for each time (0.6-1.6 g), the mean of times of bolus CTX needed was 3.6 (1-8 times). The adverse events were amenorrhea (in 41% female patients), herpes zoster (in 13% patients) and hemorrhagic cystitis (in 1 patient).

CONCLUSION

The results indicate that monthly bolus CTX therapy is effective and safe for patients with LN. Its adverse effect is relatively not a serious problem.

Water modeled signal removal and data quantification in localized MR spectroscopy using a time-scale postacquistion method

We have previously shown the continuous wavelet transform (CWT), a signal-processing tool, which is based upon an iterative algorithm using a lorentzian signal model, to be useful as a postacquisition water suppression technique. To further exploit this tool we show its usefulness in accurately quantifying the signal metabolites after water removal. However, due to the static field inhomogeneities, eddy currents, and "radiation damping," the water signal and the metabolites may no longer have a lorentzian lineshape. Therefore, another signal model must be used. As the CWT is a flexible method, we have developed a new algorithm using a gaussian model and found that it fits the signal components, especially the water resonance, better than the lorentzian model in most cases. A new framework, which uses the two models, is proposed. The framework iteratively extracts each resonance, starting by the water peak, from the raw signal and adjusts its envelope to both the lorentzian and the gaussian models. The model giving the best fit is selected. As a consequence, the small signals originating from metabolites when selecting, removing, and quantifying the dominant water resonance from the raw time domain signal are preserved and an accurate estimation of their concentrations is obtained. This is demonstrated by analyzing (1H) magnetic resonance spectroscopy unsuppressed water data collected from a phantom with known concentrations at two different field strengths and data collected from normal volunteers using two different localization methods.

[The correlation between anticardiolipin antibodies and disease activity in patients with systemic lupus erythematosus]

This study was conducted to determine the prevalence and clinical association of anticardiolipin antibodies (ACA) in serum of patients with systemic lupus erythematosus (SLE). ACA (IgG, IgA, IgM) was measured by enzyme-linked immunosorbent assay (ELISA) in the serum sample of 87 patients of SLE. The prevalence rates of ACAIgG, ACAIgA and ACAIgM were 62.1%, 52.9% and 35.6% respectively. The titers of ACAIgG and ACAIgM were positively correlated with the disease activity (r = 0.2763, P = 0.044; r = 0.3294, P = 0.018); ACAIgG, ACAIgA and ACAIgM were negatively correlated with complement C3 (r = -0.4737, P = 0.000; r = -0.2990, P = 0.017; r = -0.2758, P = 0.029); and ACAIgG was negatively correlated with complement C4 (r = -0.4079, P = 0.005). The titers of ACAIgA in patients with thrombosis was higher than that in patients without thrombosis. The patients with central nervous system involvement (CNS-SLE) had significantly higher ACAIgG and ACAIgM titers, compared with those without CNS-SLE. The results indicate there is a correlation between ACA titers and disease activity. In patients with thrombosis, the titer of ACAIgA is higher, and in patients with CNS-SLE, the titers of ACAIgG and ACAIgM are higher.

[Studies on chemical constituents of the roots of Gypsophila oldhamiana Miq]

OBJECTIVE

To separate compounds from the root of Gypsophila oldhamiana.

METHOD

Chemical and chromatographic methods were used to separate the compounds. IR, MS, NMR were used to determine the structures of compounds.

RESULT

Compound pentacosanoic acid, lacceroic acid, beta-sitosterol, alpha-spinasterol, daucosterol and sucrose were identified.

CONCLUSION

All the above compounds were obtained from this genus for the first time.

Trial of antiepilepsirine (AES) in children with epilepsy

Antieplepsirine (AES) is a new antiepileptic drug (AED) which was originally extracted from a Chinese folk remedy, and is now chemically characterized and synthesized. Its chemical structure is different from those of other available AEDs. Animal experiments involving AES demonstrated significant antiepileptic activity. Only a few clinical studies of AES with open trial have been resorted, none of which were on children. A 6.5 month, add-on, double-blind, placebo-controlled, randomized, cross-over study on AES (10 mg/kg per day) was conducted on epileptic children (aged 1-14 years) refractory to treatment with standard AEDs. The seizure frequency was recorded, and the blood levels of AES and other co-medicated AEDs (phenobarbital, phenytoin, carbamazepine and valproate) were determined. Although not planned, patients or parents were allowed to refuse to cross-over to the alternate therapy. The results were compared to the children who crossed-over as well as for the entire group during the first 3 months of randomized treatment. A total of 58 children entered, but only 34/58 children completed the cross-over study. The 24 children whose parents refused to let them be crossed-over continued the original study treatment (AES or placebo) for the entire 6 months. There was no statistically significant difference in seizure control when the entire group of 58 patients was compared to a parallel study group for the first 3 months of therapy (P = 0.178). There was a significant difference (P<0.01) in seizure control between AES and placebo treatment for the 34 patients who completed the entire cross-over study. No significant changes were seen in the blood level of other AEDs, and no serious acute side effects were observed. The results of the present study indicate the efficacy of AES for epileptic children with refractory seizures.

[Chemical constituents of Phyllanthus urinaria L. and its antiviral activity against hepatitis B virus]

Studies on the chemical constituents of Phyllanthus urinaria and its antiviral activity against hepatitis B virus were completed. Eleven compounds have been isolated. Two of them are new compounds methyl ester dehydrochebulic acid and methyl brevifolin carboxylate. Antiviral experiments on HBsAg in vitro and liver damage caused by CCl4 have shown that. Phyllanthus urinaria possesses antiviral activities against HBV.

Characterization of hydroxyapatite film with mixed interface by Ar+ ion beam enhanced deposition

Ar+ ion beam enhanced deposition (IBED) was used to produce a hydroxyapatite (HA) film on polished titanium substrates. In this study, the HA ceramic target was sputtered by an argon-ion beam with an energy of 1.5 KeV, and the sputtered film was intermittently bombarded by energetic argon-ions at 60 KeV. An effective Ca-Ti mixed layer produced by the energetic argon-ion bombardment was confirmed by using Auger electron spectroscopy. The characteristics of the deposited films were evaluated by Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction (XRD) and scanning electron microscopy (SEM) analyses. XRD analysis revealed that the as-deposited film was amorphous, and a hydroxyapatite-type structure was obtained from the post-heat treatment of the deposited films. SEM observations showed that no distinct difference in surface morphology was found between the as-deposited and heat-treated samples for Ar+ IBED films, suggesting a strongly bonded HA film on the titanium substrate. In comparison with the HA target, some chemistry alterations were brought about in the deposited films, such as the incorporation of CO3, the loss of the OH groups and some distortion of the phosphate lattice.

In vivo bone marrow lipid characterization with line scan Carr-Purcell-Meiboom-Gill proton spectroscopic imaging

Line scan Carr-Purcell-Meiboom-Gill spectroscopic imaging sequences have been used to extract lipid chemical composition indices in healthy adult bone marrow in the knee at 1.5 T. Since several spectroscopic echo readouts follow each excitation, the information acquired reflects a balance between spectral T2 decay processes and spectral resolution. To examine this balance in detail, data sets with two different echo spacings and spectral resolutions have been acquired to compare the information available from each in studies of bone marrow. Oils for which high field (7 T) proton spectra were recorded were used to evaluate the accuracy of lipid chemical composition indices extracted from the line scan Carr-Purcell-Meiboom-Gill spectroscopic imaging methods at 1.5 T. The extension of the method to fast spectroscopic imaging of bone marrow with multiple echoes is demonstrated.

Cytochrome P-450scc-mediated oxidation of (20S)-22-thiacholesterol: characterization of mechanism-based inhibition

(20S)-22-thiacholesterol (1) is found to be a potent competitive inhibitor of pregnenolone biosynthesis from cholesterol by purified reconstituted bovine adrenal cytochrome P-450scc. The apparent dissociation constant Kd, determined from difference spectra, is 0.6 microM, close to the value from kinetic studies for the apparent inhibition constant, Ki, of 0.8 microM. Studies of the time course of pregnenolone production indicate that under turnover conditions the competitive inhibitor (1) is converted to a tighter binding inhibitor, shown to be (20S,22R)-22-thiacholesterol S-oxide (4), with high diastereoselectivity and in a time-dependent manner. Both the diastereomeric sulfoxides, (20S,22S)-22-thiacholesterol S-oxide (3) and (20S,22R)-22-thiacholesterol S-oxide (4), exhibit properties consistent with their being competitive versus cholesterol, but the (22R)-sulfoxide (4) binds approximately 10 times more tightly than the (22S) diastereomer (3). The apparent Kd values of sulfoxides 4 and 3 are 0.1 and 1.14 microM, respectively. EPR and absorption spectroscopic studies of enzyme-inhibitor complexes suggest direct coordination of the oxygen atom of the (22R)-sulfoxide (4) with the catalytic heme center. This implies that the inhibitor operates by directly blocking further reaction at the active site heme group, with a substantial lifetime of the enzyme-inhibitor complex.

[Chemical components of the leaves of Pistacia Chinensis Bge]

Six compounds have been isolated from the leaves of Pistacia chinensis, a species of Anacardiaceae family. Their structures were identified on the basis of UV, IR, NMR, and MS as gallic acid, m-digallic acid, quercetin, 6-0-galloyl arbutin-quercitrin and quercetin-3-0(6''-galloyl)-beta-D-glucosides.

[Chemical constituents of the leaves of Crataegus pinnatifida Bge. var. major N. E. Br]

Compounds were isolated from the aqueous extract of the leaves of Crataegus pinnatifida var. major and seven of them were identified as 2-(4-hydroxybenzyl)malic acid, quercetin, hyperin, vitexin, rhamnosylvitexin, diethylamine hydrochloride and sorbitol respectively by UV, IR, NMR, MS, some chemical techniques by comparison with the standard spectra of known compounds.

Structural characterization of the isoenzymatic forms of human myeloperoxidase: evaluation of the iron-containing prosthetic group

Myeloperoxidase (MPO) from human neutrophils has been purified and found to exist in three isoenzymatic forms, resolved by ion exchange chromatography. In addition to differences in subunit size and cellular compartmentalization of the isoenzymes, differences have been reported in their activity and susceptibility to inhibition. The structural basis of these isoenzymes is unclear; we attempted to further define their functional characteristics and structural identity. First, we measured respective enzymatic activity using a panel of substrates; MPO I was found to have lower activity with some substrates (pyrogallol, guaiacol, potassium iodide [KI]), but similar activity to the other isoenzymes with 4-aminoantipyrine. These studies confirm that MPO I is enzymatically distinct from MPO II and MPO III. Next, we examined the structural basis of these differences by evaluating the iron-containing prosthetic group in each form using electron paramagnetic resonance (EPR) and determination of the pyridine hemochrome. No significant difference between the isoenzymes was noted in these parameters, suggesting that the prosthetic group is the same in each protein. The cause for any difference in enzymatic activity must lie then in variations extrinsic to the heme, and based on previous studies of the gene and protein analysis, the posttranslational modification of MPO must account for these isoenzymatic species.

Research note: sleep problems of normal Chinese adolescents

Eight hundred and forty-six Chinese adolescents were surveyed concerning sleep behaviours including insomnia, nightmares, somniloquism, somnambulism, bruxism, and enuresis. Bruxism was reported most frequently (22%) followed by somniloquism (17%) and insomnia (14.9%). Subjects were compared by sex, age, and rearing by parents or parent surrogates. Cross cultural comparisons and the possible significance of findings are discussed.

Patterns of psychiatric consultation in a Chinese general hospital

The authors conducted a study of psychiatric consultation in a Chinese general hospital. Seventy-five inpatients (0.74% of the patients in the hospital) were referred by different services over a 1-year period. Internal medicine referred the most patients, and organic brain syndromes were the most common diagnoses. Depression was not a frequent diagnosis, but neurasthenia was a fairly common one. None of the referred patients had a diagnosis of alcoholism, drug abuse, or personality disorder. The authors compare these data with those of Western studies and discuss the possible factors influencing psychiatric consultation in China.