The miR-1906 mimic attenuates bone loss in osteoporosis by down-regulating the TLR4/MyD88/NF-κB pathway

In this study, the ability of microRNA-1906 (miR-1906) to attenuate bone loss in osteoporosis was evaluated by measuring the effects of a miR-1906 mimic and inhibitor on the cellular toxicity and cell viability of MC3T3-E1 cells. Bone marrow-derived macrophage (BMM) cells were isolated from female mice, and tartrate-resistant acid phosphatase signalling was performed in miR-1906 mimic-treated, receptor-activated nuclear factor kappa-B (NF-κB) ligand (RANKL)-induced osteoclasts. In-vivo, osteoporosis was induced by ovariectomy (OVX). Rats were treated with 500 nmol/kg of the miR-1906 mimic via intrathecal administration for 10 consecutive days following surgery. The effect of the miR-1906 mimic on bone mineral density (BMD) in OVX rats was observed in the whole body, lumbar vertebrae and femur. Levels of biochemical parameters and cytokines in the serum of miR-1906 mimic-treated OVX rats were analysed. The mRNA expression of toll-like receptor 4 (TLR4), myeloid differentiation primary response 88 (MyD88), p-38 and NF-κB in tibias of osteoporotic rats (induced by ovariectomy) was observed using quantitative reverse-transcription polymerase chain reaction. Treatment with the miR-1906 mimic reduced cellular toxicity and enhanced the cell viability of MC3T3-E1 cells. Furthermore, osteoclastogenesis in miR-1906 mimic-treated, RANKL-induced osteoclast cells was reduced, whereas the BMD in the miR-1906 mimic-treated group was higher than in the OVX group of rats. Treatment with the miR-1906 mimic also increased levels of biochemical parameters and cytokines in the serum of ovariectomised rats. Finally, mRNA expression levels of TLR4, MyD88, p-38 and NF-κB were lower in the tibias of miR-1906 mimic-treated rats than in those of OVX rats. In conclusion, the miR-1906 mimic reduces bone loss in rats with ovariectomy-induced osteoporosis by regulating the TLR4/MyD88/NF-κB pathway.

Biomarker and Clinical Trial Design Support for Disease-Modifying Therapies: Report of a Survey of the EU/US: Alzheimer's Disease Task Force

BACKGROUND

Disease-modifying therapies are urgently needed for the treatment of Alzheimer's disease (AD). The European Union/United States (EU/US) Task Force represents a broad range of stakeholders including biopharma industry personnel, academicians, and regulatory authorities.

OBJECTIVES

The EU/US Task Force represents a community of knowledgeable individuals who can inform views of evidence supporting disease modification and the development of disease-modifying therapies (DMTs). We queried their attitudes toward clinical trial design and biomarkers in support of DMTs.

DESIGN/SETTING/PARTICIANTS

A survey of members of the EU/US Alzheimer's Disease Task Force was conducted. Ninety-three members (87%) responded. The details were analyzed to understand what clinical trial design and biomarker data support disease modification.

MEASUREMENTS/RESULTS/CONCLUSIONS

Task Force members favored the parallel group design compared to delayed start or staggered withdrawal clinical trial designs to support disease modification. Amyloid biomarkers were regarded as providing mild support for disease modification while tau biomarkers were regarded as providing moderate support. Combinations of biomarkers, particularly combinations of tau and neurodegeneration, were regarded as providing moderate to marked support for disease modification and combinations of all three classes of biomarkers were regarded by a majority as providing marked support for disease modification. Task Force members considered that evidence derived from clinical trials and biomarkers supports clinical meaningfulness of an intervention, and when combined with a single clinical trial outcome, nearly all regarded the clinical trial design or biomarker evidence as supportive of disease modification. A minority considered biomarker evidence by itself as indicative of disease modification in prevention trials. Levels of evidence (A,B,C) were constructed based on these observations.

CONCLUSION

The survey indicates the view of knowledgeable stakeholders regarding evidence derived from clinical trial design and biomarkers in support of disease modification. Results of this survey can assist in designing clinical trials of DMTs.

Prevalence of pollen-induced allergic rhinitis with high pollen exposure in grasslands of northern China

BACKGROUND

The aim of this study was to investigate the prevalence of epidemiologic and physician-diagnosed pollen-induced AR (PiAR) in the grasslands of northern China and to study the impact of the intensity and time of pollen exposure on PiAR prevalence.

METHODS

A multistage, clustered and proportionately stratified random sampling with a field interviewer-administered survey study was performed together with skin prick tests (SPT) and measurements of the daily pollen count.

RESULTS

A total of 6043 subjects completed the study, with a proportion of 32.4% epidemiologic AR and 18.5% PiAR. The prevalence was higher in males than females (19.6% vs 17.4%, P = .024), but no difference between the two major residential and ethnic groups (Han and Mongolian) was observed. Subjects from urban areas showed higher prevalence of PiAR than rural areas (23.1% vs 14.0%, P < .001). Most PiAR patients were sensitized to two or more pollens (79.4%) with artemisia, chenopodium, and humulus scandens being the most common pollen types, which were similarly found as the top three sensitizing pollen allergens by SPT. There were significant regional differences in the prevalence of epidemiologic AR (from 18.6% to 52.9%) and PiAR (from 10.5% to 31.4%) among the six areas investigated. PiAR symptoms were positively associated with pollen counts, temperature, and precipitation (P < .05), but negatively with wind speed and pressure P < .05).

CONCLUSION

Pollen-induced AR (PiAR) prevalence in the investigated region is extremely high due to high seasonal pollen exposure, which was influenced by local environmental and climate conditions.

Changes of serum vascular endothelial growth factor of patients with rectal cancer before and after neoadjuvant chemotherapy and tumor progress

In the rapid development of armamentarium, neoadjuvant chemotherapy has become an important part of a multi-instrument comprehensive treatment of malignant tumor, which presents promising application prospects. This paper researches changes of Vascular Endothelial Growth Factor (VEGF) and Vascular Endothelial Growth Factor-2 (VEGF-2) in serum of patients with rectal cancer before and after neoadjuvant chemotherapy and discusses how tumor progression rules relate to curative effect and prognosis. Enzyme linked immunosorbent serologic assay (ELISA) was applied for the detection of VEGF expression and VEGF-2 expression of 45 patients with rectal cancer (treatment group) before and after neoadjuvant chemotherapy, which was compared to the expressions of 45 healthy people (control group). After 8 weeks of continuous neoadjuvant chemotherapy, the results did not present obvious differences of VEGF and VEGF-2 expression in patients with different curative effects between pre-chemotherapy and post-chemotherapy. However, VEGF and VEGF-2 expression of patients with CR+PR and NC significantly decreased. This proved the excellent curative effect of neoadjuvant chemotherapy, with which the expressions of VEGF and VEGF-2 of rectal cancer patients decreased. The above experiment provides new ideas for the application of neoadjuvant chemotherapy in treating rectal cancer.

A comparison of exact tests for trend with binary endpoints using Bartholomew's statistic

Tests for trend are important in a number of scientific fields when trends associated with binary variables are of interest. Implementing the standard Cochran-Armitage trend test requires an arbitrary choice of scores assigned to represent the grouping variable. Bartholomew proposed a test for qualitatively ordered samples using asymptotic critical values, but type I error control can be problematic in finite samples. To our knowledge, use of the exact probability distribution has not been explored, and we study its use in the present paper. Specifically we consider an approach based on conditioning on both sets of marginal totals and three unconditional approaches where only the marginal totals corresponding to the group sample sizes are treated as fixed. While slightly conservative, all four tests are guaranteed to have actual type I error rates below the nominal level. The unconditional tests are found to exhibit far less conservatism than the conditional test and thereby gain a power advantage.

Prevalence of cardiovascular disease and risk factors in the Chinese population with impaired glucose regulation: the 2007-2008 China national diabetes and metabolic disorders study

Cardiovascular disease (CVD) is one of the most common chronic diseases in China. This aim of this study is to determine the prevalence of CVDs and risk factors in Chinese impaired glucose regulation subjects.We used a multistage, stratified sampling method to select subjects from the general Chinese population aged 20 years and older. Subjects underwent an oral glucose tolerance test to identify normal glucose tolerance (NGT) and impaired glucose regulation including isolated impaired fasting glucose (i-IFG), impaired glucose tolerance (i-IGT), and combined IFG/IGT and diabetic mellitus (DM). A logistic regression analysis was performed to examine the association between glucose abnormalities and CVD events.We identified that 34 293 subjects had NGT, 1 469 i-IFG, 4 571 i-IGT, 957 IFG/IGT and 4 949 DM. The age-sex standardized prevalence rate of cardiovascular disease was 1.06% (95% CI 0.87-1.28), 1.79% (95% CI 1.37-2.33) and 3.83% (95% CI 2.79-5.24) in NGT, impaired glucose regulation and DM, respectively. Among impaired glucose subjects, prevalence of defined CVD risk factors (smoking, overweight, obesity, hypertension and dyslipidemia) was 29.52% (95% CI: 27.8-31.21), 36.25% (95% CI: 34.29-38.26), 10.05% (95% CI: 8.86-11.37), 36.43% (95% CI: 34.53-38.36) and 69.96% (95% CI: 67.87-71.98), respectively. Compared to 1 risk factor, the odds ratios (ORs) of CVDs with 2, 3 or 4 risk factors were 1.94 (95% CI: 0.74-5.09), 2.76 (95% CI: 1.06-7.21) and 5.84 (95% CI: 1.68-20.26), respectively. Additionally, compared to i-IFGs, ORs of CVDs with i-IGT and IFG/IGT were 2.88 (95%CI 1.36-6.01) and 2.12 (95% CI 0.83-5.44), respectively.The prevalence of cardiovascular risk factors was high in the Chinese impaired glucose regulation population. The postprandial hyperglycemia is more associated with CVD than isolated fasting hyperglycemia.

Where do golf driver swings go wrong? Factors influencing driver swing consistency

One of the challenging skills in golfing is the driver swing. There have been a large number of studies characterizing golf swings, yielding insightful instructions on how to swing well. As a result, achieving a sub-18 handicap is no longer the top problem for golfers. Instead, players are now most troubled by a lack of consistency during swing execution. The goal of this study was to determine how to consistently execute good golf swings. Using 3D motion capture and full-body biomechanical modeling, 22 experienced golfers were analysed. For characterizing both successful and failed swings, 19 selected parameters (13 angles, 4 time parameters, and 2 distances) were used. The results showed that 14 parameters are highly sensitive and/or prone to motor control variations. These parameters sensitized five distinct areas of swing to variation: (a) ball positioning, (b) transverse club angle, (c) transition, (d) wrist control, and (e) posture migration between takeaway and impact. Suggestions were provided for how to address these five distinct problem areas. We hope our findings on how to achieve consistency in golf swings will benefit all levels of golf pedagogy and help maintain/develop interests to involve more golf/physical activity for a healthy lifestyle.

Diagnostic value of serum anti-C1q antibodies in patients with lupus nephritis: a meta-analysis

The autoantibodies against C1q (anti-C1q) have been reported in patients with systemic lupus erythematosus (SLE). In the past decade, though there were increasing studies suggesting it is relatively specific in lupus nephritis (LN), its overall diagnostic value in LN has not been evaluated. The meta-analysis was conducted to quantitatively evaluate the diagnostic accuracy of autoantibodies against C1q in patients with LN, and to provide more precise evidence of a correlation between anti-C1q antibodies and activity of LN. We searched Medline, Embase and Cochrane databases and contacted authors if necessary. A total of 25 studies including 2,502 patients with SLE and 1,317 with LN met our inclusion criteria for this meta-analysis. Among all 25 studies, 22 studies were available for comparison between SLE with and without LN, and 9 studies compared anti-C1q between patients with active and inactive LN. Summary receiver operating characteristic (SROC) curve was used to summarize comprehensive test performance. The QUADAS tool was used to assess the quality of the studies. For the diagnosis of LN, the pooled sensitivity and specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) of anti-C1q were 0.58 (0.56-0.61, 95% confidence interval [95% CI]), 0.75 (0.72-0.77, 95% CI), 2.60 (2.06-3.28, 95% CI), 0.51 (0.41-0.63, 95% CI), and 6.08 (3.91-9.47, 95% CI) respectively. The area under the SROC curve (AUC) was 0.7941. For comparison between active and inactive LN, the weighted sensitivity, specificity, PLR, NLR and DOR were 0.74 (0.68-0.79, 95% CI), 0.77 (0.71-0.82, 95% CI), 2.91 (1.83-4.65, 95% CI), 0.33 (0.19-0.56, 95% CI), and 10.56 (4.56-24.46, 95% CI) respectively. The AUC was 0.8378. In conclusion, this meta-analysis indicates that anti-C1q antibodies have relatively fair sensitivity and specificity in the diagnosis of LN, suggesting that the presence of anti-C1q antibodies may be a valuable adjunct for predicting LN and assessing renal activity.

Association between polymorphism of tumour necrosis factor alpha-308 gene promoter and asthma: a meta-analysis

BACKGROUND

Asthma is a complex polygenic disease in which gene-environment interactions are important. The gene encoding tumour necrosis factor alpha (TNFalpha) is one of several candidate loci for asthma pathogenesis and is highly polymorphic. A number of studies have investigated the polymorphism of TNFalpha-308 gene promoter (substitution G-->A, designated as TNF1 and TNF2) in relation to asthma susceptibility in different populations. However, the results of individual studies have been inconsistent.

METHODS

To address the inconsistent findings in studies of the association of the polymorphism of TNFalpha-308 gene promoter with susceptibility to asthma, a systematic review was undertaken of the published data and a meta-analysis was performed. The MEDLINE database was searched for case-control studies published in English language journals from 1966 to October 2005. Data were extracted using standardised forms and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.

RESULTS

Fifteen eligible studies, comprising 2409 patients with asthma and 3266 controls, were included in the meta-analysis. Using the random effects model, the pooled result showed that the TNF2 allele is associated with overall susceptibility to asthma (OR 1.37, 95% CI 1.02 to 1.84, p=0.04). The ORs for asthma susceptibility in TNF2 homozygote individuals were significantly increased at 2.01 (95% CI 1.26 to 3.20, p=0.009) and 1.51 (95% CI 1.02 to 2.22, p=0.041) compared with TNF1 homozygotes and TNF2/1 heterozygotes, respectively. In addition, the pooled OR for asthma risk in TNF2/1 heterozygotes was also significantly higher than that in TNF1/1 homozygotes (OR 1.47, 95% CI 1.01 to 2.13, p=0.045).

CONCLUSIONS

The TNF2 allele confers a significant risk for developing asthma. A large scale case-control study is needed to clarify the functional effect of the polymorphism of the TNFalpha gene in the pathogenesis of asthma.

Come FLY with us: toward understanding fragile X syndrome

The past few years have seen an increased number of articles using Drosophila as a model system to study fragile X syndrome. Phenotypic analyses have demonstrated an array of neuronal and behavioral defects similar to the phenotypes reported in mouse models as well as human patients. The availability of both cellular and molecular tools along with the power of genetics makes the tiny fruit fly a premiere model in elucidating the molecular basis of fragile X syndrome. Here, we summarize the advances made in recent years in the characterization of fragile X Drosophila models and the identification of new molecular partners in neural development.

Automatic verification of step-and-shoot IMRT field segments using portal imaging

In step-and-shoot IMRT, many individual beam segments are delivered. These segments are generated by the IMRT treatment planning system and subsequently transmitted electronically through computer hardware and software modules before they are finally delivered. Hence, an independent system that monitors the actual field shape during treatment delivery is an added level of quality assurance in this complicated process. In this paper we describe the development and testing of such a system. The system verifies the field shape by comparing the radiation field detected by the built-in portal imaging system on the linac to the actual field shape planned on the treatment planning system. The comparison is based on a software algorithm that detects the leaf edge positions of the radiation field on the portal image and compares that to the calculated positions. The process is fully automated and requires minimal intervention of the radiation therapists. The system has been tested with actual clinical plan sequences and was able to alert the operator of incorrect settings in real time.

Development of sensitive esterase assays based on alpha-cyano-containing esters

A novel approach is reported for the development of fluorogenic esterase reporters using alpha-cyano-containing esters as substrates. After ester hydrolysis, the released alcohol, a cyanohydrin, rapidly eliminates HCN to yield the corresponding aldehyde resulting in strong fluorescence. The pi conjugation of the resulting aldehyde also greatly enhances UV absorption and red shifts fluorescence emission relative to a corresponding alcohol or phenol. Two substrates, R/S-acetic acid cyano-(6-methoxynaphthalen-2-yl)-methyl ester (compound I) and trans/cis-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropanecarboxylic acid R/S-cyano-(6-methoxynaphthalen-2-yl)-methyl ester (compound II), were synthesized and evaluated as substrates. Such alpha-cyano substrates possess very low background fluorescence and are more stable under enzyme assay conditions than phenolic substrates due to the aliphatic cyano group. The higher molar absorbtivity and quantum yield of the aldehyde, along with its larger Stokes' shift combined with the increased stability and lower background signal of the cyanohydrin substrate, increases the utility and sensitivity of the resulting assays over current methods. Moreover, compound II showed high selectivity to pyrethroid-cleaving esterases and may provide a direct tool to monitor pyrethroid resistance in insects.

A-6G variant of the angiotensinogen gene and essential hypertension in Han, Tibetan, and Yi populations

To investigate the relationship between the A-6G variant in the promoter of the angiotensinogen gene and essential hypertension in Han, Tibetan, and Yi populations. All patients with essential hypertension were selected by WHO criteria. And the polymorphism of the A-6G variant was determined by PCR/RFLP. The data were analyzed by t test and chi2 test. There was no significant difference in the genotype or allele frequencies between normotensives and hypertensives in the Han, Tibetan, and Yi populations, respectively. However, when the subjects were divided into male and female subgroups, the genotype distributions among hypertensives and normotensives of the Tibetan female group were as follows: AA, 37% vs. 48%; AG, 52% vs. 48%; GG, 11% vs. 4%, respectively and the frequency of the G allele was significantly higher in hypertensives than in normotensives in the Tibetan female group (0.37 vs. 0.28, chi2=4.25, p<0.05). In addition, we observed that there was a significant difference between the Han and Tibetan normotensive groups in the distributions of the allele and genotype frequencies of the A-6G variant. The frequency of the G allele was 0.29 and 0.17 in the Tibetan normotensive and Han groups, respectively (p<0.001). The G allele of the A-6G variant was associated with hypertension in the Tibetan females, but not in the Yi or Han females. And we confirmed that there was a significant difference in the prevalence of the allele frequencies of the A-6G variant between the Han and Tibetan normotensive groups.

Molecular determinants for the distinct pH sensitivity of Kir1.1 and Kir4.1 channels

Kir1.1 (ROMK1) is inhibited by hypercapnia and intracellular acidosis with midpoint pH for channel inhibition (pK(a)) of approximately 6.7. Another close relative, Kir4.1 (BIR10), is also pH sensitive with much lower pH sensitivity (pK(a) approximately 6. 0), although it shares a high sequence homology with Kir1.1. To find the molecular determinants for the distinct pH sensitivity, we studied the structure-functional relationship using site-directed mutagenesis. An NH(2)-terminal residue (Lys-53) was found to be responsible for the low pH sensitivity in Kir4.1. Mutation of this lysine to valine (K53V), a residue seen at the same position in Kir1. 1, markedly increased channel sensitivity to CO(2)/pH. Reverse mutation on Kir1.1 (V66K) decreased the CO(2)/pH sensitivities. Interestingly, mutation of these residues to glutamate greatly enhanced the pH sensitivity in both channels. Other contributors to the distinct pH sensitivity were histidine residues in the COOH terminus, whose numbers are fewer in Kir4.1 than Kir1.1. Mutation of two of these histidine residues in Kir1.1 (H342Q/H354N) reduced CO(2)/pH sensitivities, whereas the creation of two histidines (S328H/G340H) in Kir4.1 increased the CO(2)/pH sensitivities. Combined mutations of the lysine and histidine residues in Kir4.1 (K53V/S328H/G340H) gave rise to a channel that had CO(2)/pH sensitivities almost identical to those of the wild-type Kir1.1. Thus the residues demonstrated in our current studies are likely the molecular basis for the distinct pH sensitivity between Kir1.1 and Kir4.1.

Enzyme-linked immunosorbent assay for the pyrethroid permethrin

Permethrin is a predominant pyrethroid widely used in agriculture and public health. A competitive enzyme-linked immunosorbent assay (ELISA) for the detection of permethrin was developed. Two haptens, the trans- and cis-isomers of 3-(4-aminophenoxy)benzyl-3-(2, 2-dichloroethenyl)-2,2-dimethylcyclopropanecarboxylate, were synthesized and conjugated with thyroglobulin as immunogens. Four antisera were generated and screened against six different coating antigens. The resulting ELISA has an I(50) value of 2.50 microg/L and relatively low cross-reactivities with other major pyrethroids, such as esfenvalerate, cypermethrin, deltamethrin, and cyfluthrin. Methanol was found to be the best solvent for this ELISA, with optimal sensitivity observed at a concentration of 40% (v/v). The assay parameters are unchanged at pH values between 5.0 and 8.0, whereas higher ionic strengths (>0.2 M PBS) strongly suppress the absorbances. River water samples fortified with permethrin were analyzed according to this method and validated by GC-MS. Good recoveries and correlation with spike levels were observed, suggesting this immunoassay is valuable for environmental monitoring and toxicological studies at parts per trillion levels of permethrin.

[Expression of MRP gene in non-small cell lung cancer and its significance]

BACKGROUND

To investigate the effects of multi-drug resistance associated protein gene (MRP gene) overexpression on the prognosis of patients with non-small cell lung cancer (NSCLC) .

METHODS

Paraffin-embedded cancer tissues from 47 cases of NSCLC who had undergone radical resection were determined for expression of MRP gene mRNA by in situ hybridization combined with immunohistochemistry and all the patients had been followed up.

RESULTS

All of 47 lung cancer specimen were found to have overexpression of MRP gene mRNA and the overexpression was closely related to survival time and recurrence or metastasis after surgery , but not to the clinical pathological factors.

CONCLUSIONS

MRP gene is related with the prognosis of lung cancer patients and may be regarded as indicator to predict the prognosis and to choose suitable chemotherapy for non-small cell lung cancer patients.

Isotope-labeled immunoassays without radiation waste

The practice of immunoassay has experienced a widespread transition from radioisotopic labeling to nonisotopic labeling over the last two decades. Radioisotope labels have drawbacks that hamper their applications: (i) perceived radiation hazards of reagents, (ii) regulatory requirements and disposal problems of working with radioactive materials, and (iii) short shelf-life of the labeled reagents. The advantage of isotopic labeling is the incorporation into analytes without altering structure or reactivity, as is often the case with ELISA or fluorescent detection systems. We developed a format for isotope label immunoassay with the long-life isotope (14)C as the label and accelerator mass spectrometer (AMS) as the detection system. AMS quantifies attomole levels of several isotopes, including (14)C. With this exquisite sensitivity, the sensitivity of an immunoassay is limited by the K(d) of the antibody and not the detection system. The detection limit of the assays for atrazine and 2,3,7,8-tetrachlorodibenzo-p-dioxin was 2.0 x 10(-10) M and 2.0 x 10(-11) M, respectively, approximately an order of magnitude below the standard enzyme immunoassay. Notably, <1 dpm (0.45 pCi) of (14)C-labeled compound was used in each assay, which is well below the limit of disposal (50 nCi per g) as nonradioactive waste. Thus, endogenous reporter ligands quantified by AMS provide the advantages of an RIA without the associated problems of radioactive waste.

[Expression and prognostic significance of multidrug resistance associated protein (MRP) gene in non-small cell lung cancer by in situ hybridization]

OBJECTIVE

To study the effect of MRP gene overexpression on prognosis of patients with non-small cell lung cancer (NSCLC).

METHODS

Paraffin-embedded tissues from 47 cases of NSCLC who had undergone radical tumor resection were examined for expression of MRP gene mRNA by in situ hybridization using labelled digoxigenin probes combined with immunohistochemistry. All the patients were retrospectively followed-up.

RESULTS

All of the 47 lung cancer specimens were found to have overexpression of MRP mRNA. It was significantly correlated with patients' survival period, response to chemotherapy, recurrence and mestastases after surgery, but was not correlated with histology, tumor size, node status, TNM stage, degree of differentiation, age and sex.

CONCLUSION

Overexpression of MRP gene is a marker of prognostic significance in patients with NSCLC.

Transcranial Doppler characteristics in persistent vegetative status, locked-in syndrome and brain death

AIM

Comparison of the transcranial Doppler (TCD) characteristics of cerebral circulation in persistent vegetative status (PVS), locked-in syndrome and brain death patients.

METHODS

Using TCD ultrasound to detect the flow velocity and waveform patterns of middle cerebral artery (MCA) and basilar artery (BA) in patients with PVS, locked-in syndrome and brain death.

RESULTS

The mean velocities of middle cerebral artery (Vmca) and basilar artery (Vba) were 30.0 cm/s and 24.3 cm/s in PVS patients respectively, which decreased 45.0% and 14.4% in comparing with normal value. For patients with locked-in syndrome, Vmca and Vba were 49.7 cm/s and 9.8 cm/s, which decreased 5.0% and 61.7% than the normal value respectively. These results showed that the decrease of anterior circulation was predominant in PVS, and the decrease of posterior circulation was predominant in locked-in syndrome. A unique diastolic reverse flow, short peak systolic wave or undetectable flow signal in middle cerebral artery were predominant in brain death patients, which was completely different from that of either PVS or locked-in syndrome.

CONCLUSION

TCD was a valuable tool in distinguishing PVS, locked-in syndrome and brain death patients according to the differences in velocities and patterns of anterior and posterior cerebral arteries.

[A study on relationship between hypertension and polymorphism of ACE gene in male Yi people in Liangshan Yi autonomous prefecture, Sichuan]

OBJECTIVE

To explore relationship between polymorphism of ACE gene and hypertension.

METHODS

A cross-sectional study was conducted and PCR technique was used to analyze gene polymorphism.

RESULTS

Genotypes DD, ID and II of ACE gene accounted for 13.0% and 9.7%, 50.9% and 48.4%, and 36.1% and 41.9%, respectively, in the normotensives and hypertensives. Frequencies of I and D alleles for ACE gene were 61.6% and 66.1%, and 38.4% and 33.9%, respectively, in the normotensives and hypertensives. There was no significant difference in distribution of II, ID and DD genotypes and I/D allele frequencies of ACE gene between the hypertensives and normotensives in male Yi people.

CONCLUSION

Association between polymorphism of ACE gene and hypertension was uncertain.

An enzyme-linked immunosorbent assay for the detection of esfenvalerate metabolites in human urine

The pyrethroids are one of the most heavily used insecticide classes in the world. Sensitive and rapid analytical techniques are needed for assessments of human exposure to these compounds. Highly sensitive and selective ELISAs for glycine conjugates of esfenvalerate key metabolites phenoxybenzoic acid (PBA) and s-fenvalerate acid (sFA) were developed. Rabbits were immunized with either N-(3-phenoxybenzoyl)-4-amino-L-phenylalanine-fetuin or N-[(S)-4-chloro-2-(methylethyl)benzeneacetyl]-4-amino-L-phenyla lan ine -fetuin, and all sera were screened against numerous coating antigens. The antibodies with the least interference and best sensitivity were optimized and characterized. The I(50)s for sFA-glycine and PBA-glycine in buffer were found to be 0.40 +/- 0.12 microg/L (1.47 +/- 0.44 nmol/L) and 0.42 +/- 0.18 microg/L (1.56 +/- 0.67 nmol/L), respectively. Both assays exhibited high selectivity. Little or no cross reactivity to the parent compound and other metabolites was measured. The matrix effects of urine were investigated. Solid-phase extraction (SPE) strategies were used in an attempt to decrease the matrix effects and increase the sensitivity of the overall method. The limit of quantitation (LOQ) for both sFA-glycine and PBA-glycine in urine with SPE is 1.0 microg/L (3.70 nmol/L). These assays could be used as markers of exposure for monitoring biological samples.

[A case-control study on Guillain-Barre syndrome in children of North China]

OBJECTIVE

This study aimed at exploring the risk factors for Guillain-Barre syndrome (GBS).

METHODS

A case-control study design was used with 51 cases of GBS, diagnosed based on their symptoms, signs and electrophysiological examinations and exclusion of poliomyelitis and other acute flaccid paralysis, and 51 controls matched on age, sex and resident village. Serum IgG antibodies specific for Campylobacter jejuni were determined for all the subjects by enzyme-linked immunosorbent assay (ELISA) with a preparation of surface antigen of C. jejuni C(1) strain isolated from the patients and prevalent in north China. Each case and control were interviewed with his/her parents or guardians by a trained interviewer using an ad hoc questionnaire, including his/her demographic information, socioeconomic status, onset of the illness, and potential risk factors in their environment and personal hygiene. Data were analyzed with SAS software release 6.04 in a microcomputer.

RESULTS

GBS was associated with a few factors, such as residential areas (45 of the 51 cases living in the rural areas, accounting for 88.2% of the total), polio and hepatitis B vaccine immunization before onset of the illness (with ORs of 7.27 and 3.14, respectively), no hand washing after defecation and before meals (with an OR of 6.15) and getting cold and going to the river or lake site before onset of the illness (with ORs of 13.75 and 12.20, respectively). Infection with Campylobacter jejuni associated strongly with the illness (with an OR of 9.5, P < 0.001). Thirty-five of the 51 cases had precursor symptoms before onset of the illness (68.6%).

CONCLUSION

It suggests that occurrence of GBS may correlate to infection with Campylobacter jejuni and poor personal hygiene in children.

Development of an immunoassay for the pyrethroid insecticide esfenvalerate

A competitive enzyme-linked immunosorbent assay was developed for the detection of the pyrethroid insecticide esfenvalerate. Two haptens containing amine or propanoic acid groups on the terminal aromatic ring of the fenvalerate molecule were synthesized and coupled to carrier proteins as immunogens. Five antisera were produced and screened against eight different coating antigens. The assay that had the least interference and was the most sensitive for esfenvalerate was optimized and characterized. The I(50) for esfenvalerate was 30 +/- 6.2 microg/L, and the lower detection limit (LDL) was 3.0 +/- 1.8 microg/L. The assay was very selective. Other pyrethroid analogues and esfenvalerate metabolites tested did not cross-react significantly in this assay. To increase the sensitivity of the overall method, a C(18) sorbent-based solid-phase extraction (SPE) was used for water matrix. With this SPE step, the LDL of the overall method for esfenvalerate was 0.1 microg/L in water samples.

Effect of lidocaine on improving cerebral protection provided by retrograde cerebral perfusion: a neuropathologic study

OBJECTIVE

To determine whether lidocaine can improve the neuropathologic results in canine brains after retrograde cerebral perfusion (RCP).

DESIGN

Randomized, blinded, experimental study.

SETTING

University animal laboratory.

PARTICIPANTS

Mongrel dogs.

INTERVENTIONS

Fourteen mongrel dogs were placed on 120 minutes of hypothermic (20 degrees C) RCP. Following the RPC, they then resumed cardiopulmonary bypass and rewarming for 60 minutes. In the lidocaine group (n = 8), lidocaine was administered continuously; in the control group (n = 6), normal saline was administered. Cerebral perfusion fixation was performed at the end of the experiment.

MEASUREMENTS AND MAIN RESULTS

The number of ischemic cells in 200 neurons was counted in the parietal cortex, CA1 sector of the hippocampus, CA3 sector of the hippocampus, ventral posterolateral nucleus of the thalamus, and Purkinje cells of the cerebellar cortex. Those in the parietal cortex, CA1 sector of the hippocampus, and ventral posterolateral nucleus of the thalamus were significantly less in the lidocaine group than in the control group (25.8+/-17.3 v 53.7+/-12.0; p < 0.01; 17.0+/-8.5 v 54.7+/-22.1; p < 0.01; and 16.9+/-17.8 v 49.7+/-28.4; p < 0.05, respectively). The total number of ischemic cells in the five examined regions was also significantly less in the lidocaine group than in the control group (89.5+/-19.4 v 219.5+/-45.5; p < 0.01).

CONCLUSION

Continuous lidocaine significantly alleviated the ischemic neuropathologic injury after RCP and thus possibly improved cerebral protection.

Lidocaine improving the cerebral protection by retrograde cerebral perfusion

OBJECTIVE

To determine whether lidocaine can improve the cerebral protection provided by retrograde cerebral perfusion.

METHODS

Sixteen mongrel dogs were placed on cardiopulmonary bypass and cooled to 20 degrees C. Retrograde cerebral perfusion was then carried out for 120 minutes, with the external jugular venous pressure kept at 3.33 kPa. Cardiopulmonary bypass was resumed, and the animals were rewarmed to 36 degrees C. The animals were divided into two groups. In the lidocaine group (n = 8), lidocaine was administrated continuously throughout the experiment. In the control group (n = 8), normal saline was given at the same rate.

RESULTS

In both groups, cerebral tissue creatine phosphate and adenosine triphosphate concentrations and energy charge increased by the end of hypothermic cardiopulmonary bypass, decreased continuously during retrograde cerebral perfusion, and recovered gradually after resuming cardiopulmonary bypass. Nevertheless, they recovered to significantly higher levels in the lidocaine group than in the control group (creatine phosphate: 2.44 +/- 0.53 versus 1.61 +/- 0.49 mumol/g wet weight, P = 0.006; adenosine triphosphate: 0.71 +/- 0.18 versus 0.50 +/- 0.17 mumol/g wet weight, P = 0.029; energy charge: 0.59 +/- 0.10 versus 0.48 +/- 0.09, P = 0.044) by the end of the experiment. There was no significant difference between the two groups in the cerebral tissue water content (control group: 77.6% +/- 1.9%; lidocaine group: 77.6% +/- 1.3%).

CONCLUSION

Continuous lidocaine infusion accelerates the recovery of cerebral tissue high energy phosphate contents after resuming cardiopulmonary bypass, but it has no effect on the formation of cerebral edema after retrograde cerebral perfusion.

[Relationship between blood pressure and serum insulin in Yi and Han people in Liangshan, Sichuan Province]

OBJECTIVE

To explore the relationship between blood pressure and serum insulin level in different nationalities and whether there is difference in the effects of insulin on raising blood pressure.

METHODS

Study subjects were selected with cluster sampling from urban and rural areas in Xichang City, Butuo County and Zhaojue County, Liangshan Yi Autonomous Prefecture, Sichuan Province during October to December 1996, including Yi farmers, Yi migrants and local Han residents. Their systolic and diastolic blood pressure, body height and weight, and serum insulin were measured.

RESULTS

Systolic and diastolic blood pressure in Yi farmers were significantly lower than those in Yi migrants and local Han residents. There was no significant difference in systolic and diastolic blood pressure between Yi migrants and local Han residents and in serum insulin level between Yi farmers and Yi migrants, with the means of 9.078 microIU/ml and 8.892 microIU/ml, respectively. But, serum insulin level in Yi farmers and migrants was significantly higher than that in local Han residents (6.577 microIU/ml). Multivariate regression analysis showed that there was no significant relationship between serum insulin level and systolic and diastolic blood pressure in different populations, except for that there was a weaker relationship between serum insulin and systolic blood pressure in Yi migrants.

CONCLUSION

The association between serum insulin and blood pressure was uncertainty, which suggested that blood pressure was little affected by serum insulin.

Lidocaine prolongs the safe duration of circulatory arrest during deep hypothermia in dogs

PURPOSE

To test the hypothesis that lidocaine prolongs the safe period of circulatory arrest during deep hypothermia.

METHODS

Sixteen dogs were subjected to cooling, first surface cooling to 30 degrees C and then core cooling to 20 degrees C rectal temperature). The circulation was then stopped for 90 min. In the lidocaine group, 4 mg.kg-1 lidocaine was injected into the oxygenator two minutes before circulatory arrest and 2 mg.kg-1 at the beginning of reperfusion and rewarming. The control group received equivalent volumes of normal saline. Post-operatively, using a neurological deficit scoring system (maximum deficit score-100; minimum-zero indicating that no scored deficit could be detected). Neurological function was evaluated hourly for six hours and then daily for one week, the pharmacokinetic parameters were calculated using one compartment model.

RESULTS

On the seventh day, the neurological deficit score and overall performance were better in the lidocaine (0.83 +/- 2.04) than in the control group (8.33 +/- 4.08 P < 0.05). During the experiment, the base excess values were also better in the lidocaine than in the control group (at 30 min reperfusion: -4.24 +/- 1.30 vs -8.20 +/- 2.82 P < 0.01, at 60 min reperfusion was -3.34 +/- 1.87 vs -7.52 +/- 2.40 (P < 0.01). On the eighth day the extent of pathological changes were milder in the lidocaine group than that in the control group. The elimination half life of lidocaine was 40.44 +/- 7.99 during hypothermia and 2.01 +/- 4.56 during rewarming.

CONCLUSIONS

In dogs lidocaine prolongs the safe duration of circulatory arrest during hypothermia.

[Role of nitric oxide in hemodynamic and extravascular lung water in a dog endotoxin shock model]

OBJECTIVE

To verify the effects of nitric oxide pathway modification on hemodynamics and extravascular lung water during sepsis.

METHODS

Experiments were conducted in three groups of anesthetized dogs with sodium pentobarbital. In group 1 (n = 8), lipopolysaccharide was injected intravenously to produce endotoxin shock. Group 2 (n = 8) received both lipopolysaccharide and L-arginine, a precursor of nitric oxide synthesis, intravenously. Group 3 (n = 8) received both lipopolysaccharide and N-nitro-L-arginine (L-NNA), a competitive inhibitor of nitric oxide generation, intravenously. Hemodynamic data included MAP, CVP, PAP, PAWP, CI, SI, SVRI, PVRI, LVSWI and RVSWI were measured or calculated. Oxygenational data included DO2, O2ER, and VO2 were calculated. Extravascular lung water (EVLW) was measured.

RESULTS

L-arginine increased CI (2.2 +/- 0.7 to 2.7 +/- 0.7 L.min-1)/m2 and SI (15 +/- 3 to 19 +/- 5 ml/m2, P < 0.05) and decreased PVRI (320 +/- 86 to 211 +/- 87 dyne. sec/cm5-m2, P < 0.05) without significant changes in O2ER, DO2 and VO2. All of the untoward hemodynamic effects of endotoxin were exacerbated by the addition of L-NNA (CI-56 +/- 2%, SI -58 +/- 5%, P < 0.05, SVRI + 170 +/- 10%, PVRI + 129 +/-15%, P < 0.01). As DO2, was significantly decreased by L-NNA (534 +/- 104 to 300 +/- 90 ml.min-1/m2, P < 0.01), therefore, O2ER was also increased (insufficiently), and VO2 was still decreased significantly (146 +/- 58) to 115 +/- 38 ml.min-1/m2, P < 0.05. EVLW was markedly increased by L-NNA (5.4 +/- 1.0 to 6.2 +/- 0.7 g/kg, P < 0.01).

CONCLUSIONS

The inhibition of nitric oxide synthesis has serious adverse hemodynamic and oxygenational consequences in our endotoxin shock model. We speculate that nitric oxide inhibition has no foreseeable therapeutic role in early stage of septic shock.