Subsurface hydrological connectivity controls nitrate export flux in a hilly catchment

Subsurface runoff represents the main pathway of nitrate transport in hilly catchments. The magnitude of nitrate export from a source area is closely related to subsurface hydrological connectivity, which refers to the linkage of separate regions of a catchment via subsurface runoff. However, understanding of how subsurface hydrological connectivity regulates catchment nitrate export remains insufficient. This study conducted high-frequency monitoring of shallow groundwater in a hilly catchment over 17 months. Subsurface hydrological connectivity of the catchment over 38 rainfall events was analyzed by combining topography-based upscaling of shallow groundwater and graph theory. Moreover, cross-correlation analysis was used to evaluate the time-series similarity between subsurface hydrological connectivity and nitrate flux during rainfall events. The results showed that the maximum subsurface hydrological connectivity during 32 out of 38 rainfall events was below 0.5. Although subsurface flow paths (i.e., the pathways of lateral subsurface runoff) exhibited clear dynamic extension and contraction during rainfall events, most areas in the catchment did not establish subsurface hydrological connectivity with the stream. The primary pattern of nitrate export was flushing (44.7%), followed by dilution (34.2%), and chemostatic behavior (21.1%). A threshold relationship between subsurface hydrological connectivity and nitrate flux was identified, with nitrate flux rapidly increasing after the subsurface connectivity strength exceeded 0.121. Moreover, the median value of cross-correlation coefficients reached 0.67, which indicated subsurface hydrological connectivity exerts a strong control on nitrate flux. However, this control effect is not constant and it increases with rainfall amount and intensity as a power function. The results of this study provide comprehensive insights into the subsurface hydrological control of catchment nitrate export.

Single-cell RNA sequencing reveals a hierarchical transcriptional regulatory network of terpenoid biosynthesis in cotton secretory glandular cells

Plants can synthesize a wide range of terpenoids in response to various environmental cues. However, the specific regulatory mechanisms governing terpenoid biosynthesis at the cellular level remain largely elusive. In this study, we employed single-cell RNA sequencing to comprehensively characterize the transcriptome profile of cotton leaves and established a hierarchical transcriptional network regulating cell-specific terpenoid production. We observed substantial expression levels of genes associated with the biosynthesis of both volatile terpenes (such as β-caryophyllene and β-myrcene) and non-volatile gossypol-type terpenoids in secretory glandular cells. Moreover, two novel transcription factors, namely GoHSFA4a and GoNAC42, are identified to function downstream of the Gossypium PIGMENT GLAND FORMATION genes. Both transcription factors could directly regulate the expression of terpenoid biosynthetic genes in secretory glandular cells in response to developmental and environmental stimuli. For convenient retrieval of the single-cell RNA sequencing data generated in this study, we developed a user-friendly web server . Our findings not only offer valuable insights into the precise regulation of terpenoid biosynthesis genes in cotton leaves but also provide potential targets for cotton breeding endeavors.

A dirigent protein complex directs lignin polymerization and assembly of the root diffusion barrier

Functionally similar to the tight junctions present in animal guts, plant roots have evolved a lignified Casparian strip as an extracellular diffusion barrier in the endodermis to seal the root apoplast and maintain nutrient homeostasis. How this diffusion barrier is structured has been partially defined, but its lignin polymerization and assembly steps remain elusive. Here, we characterize a family of dirigent proteins (DPs) essential for both the localized polymerization of lignin required for Casparian strip biogenesis in the cell wall and for attachment of the strip to the plasma membrane to seal the apoplast. We reveal a Casparian strip lignification mechanism that requires cooperation between DPs and the Schengen pathway. Furthermore, we demonstrate that DPs directly mediate lignin polymerization as part of this mechanism.

Identification and Dosimetric Analysis of Axillary Substructures Associated with Breast Cancer Related Lymphedema

PURPOSE/OBJECTIVE(S)

It has been hypothesized that substructures in the axillary region may be involved in the development of upper limb lymphedema in breast cancer patients. We aimed to compare dosimetric parameters of different substructures to identify risk regions and dose indicators related to the development of lymphedema.

MATERIALS/METHODS

A total of 486 patients with breast cancer treated with axillary node dissection (ALND) and regional node irradiation (RNI) between 2017 and 2020 were analyzed. Ten axillary substructures were retrospectively contoured, and dose-volume histogram (DVH) parameters (maximum dose [Dmax], Dmean, Dmin, V5 Gy, V10 Gy, V15 Gy, V20 Gy, V25 Gy, V30 Gy, V35 Gy, V40 Gy, V45 Gy and V50 Gy) were evaluated. EQD2 using α/β = 3 was applied for hypofractionation.

RESULTS

The cumulative incidence of lymphedema was 32.5% during the median follow-up of 25 month (IQR 15-35). Higher BMI (≥21.77 kg/m2, hazard ratio [HR]1.6, 95% CI 1.1-2.3, p = 0.019) and higher number of dissected lymph nodes (≥13, HR 1.8, 95% CI 1.1-3.0, p = 0.026) were baseline risk factors associated with breast cancer related lymphedema (BCRL). A cohort of 196 patients was obtained by 1:1 propensity score matching based on the above two factors (154 treated with 50 Gy/25 fractions [Fx] and 42 with 40.05 Gy/15Fx). The optimal metric was axillary-lateral thoracic vessel juncture (ALTJ) Dmean ≥36.84 Gy (HR 3.7, 95% CI 1.6-8.6, p = 0.002). Other significant risk factors are Medial of Axillary Nodes level I(ALN-I-M) Dmin <9.19 Gy (HR 2.3, 95% CI 1.4-3.7, p = 0.001) and Posterior of Axillary Nodes level II(ALN-II-P) Dmax <52.75 Gy (HR 2.0, 95% CI 1.2-3.5, p = 0.015). A nomogram incorporated the above three parameters was created to predict the risk of lymphedema with reasonable accuracy confirmed by both self-training (area under curve [AUC], 0.76; 95% CI, 0.67-0.84) and internal validation (AUC 0.66; 95% CI, 0.50-0.80).

CONCLUSION

A mean dose of 36.84 Gy of ALTJ may be a suggested dose limit for patients indicated RNI after ALND, especially when patients with higher BMI and higher dissected nodes. Ideally, avoidance of ALTJ may be realized without compromising dose coverage to high-risk nodal region. Confirmation of this finding in future prospective studies is needed.

Dosimetry Comparison of Incidental Irradiation to the Low Axilla in Whole Breast Irradiation Using IMRT and IMPT Therapy

PURPOSE/OBJECTIVE(S)

It has been hypothesized that incidental dose to low axilla contributes to regional control in patients receiving whole breast irradiation (WBI), especially in patients with limited metastatic sentinel nodes who were spared from subsequent axillary dissection. We aimed to compare axillary dose between intensity-modulated radiotherapy (IMRT) and intensity-modulated proton radiotherapy (IMPT).

MATERIALS/METHODS

Dosimetric comparisons between IMRT and IMPT were conducted in 15 patients treated with WBI without planned regional node irradiation (RNI). The prescribed dose was 40.05 Gy (RBE)/15 Fx. Axillary lymph nodes levels I, II (ALN I, ALN II) and rotter's lymph nodes (RN) were contoured and evaluated.

RESULTS

The dose to the axilla was generally low for IMPT, with mean dose to ALN I, ALN II, and RN of 896.31, 194.64, and 2111.58 cGy (RBE), respectively. The mean V90% and V50% of ALN I was higher for IMRT (11.5 cm3, 22.9% of structure volume, p < 0.0001; 36.1 cm3, 66.6%, p < 0.0001) compared to IMPT (1.1 cm3, 2.0%; 8.1cm3, 15.9%). Similar finding was found in other low axilla. Mean dose to total ALN caudal to axillary vein was 936.6 cGy (RBE) in IMPT compared to 2407.3 cGy in IMRT (p < 0.0001). Within all substructures of axilla, mean dose to RN was the highest, but it remains lower in IMPT than in IMRT [2111.58 cGy (RBE) versus 3510.88 cGy, p < 0.0001].

CONCLUSION

WBI treated with IMPT leads to a significant reduction of axilla dose compared to IMRT. In clinical scenarios like Z0011 or likewise requiring incidental irradiation to the low axilla without additional RNI, contouring should be modified based on individual risk.

[Review and perspective of clinical research involving chest tightness variant asthma in China]

Chest tightness variant asthma (CTVA) was first reported and named by Chinese scholars in 2013. It is a new clinical type of asthma characterized by chest tightness as the only or primary symptom, without typical asthma manifestations such as recurrent wheezing and shortness of breath, and without wheezing sounds heard during lung auscultation. The overall epidemiological data on CTVA is currently unavailable. Its pathogenesis is similar to that of typical asthma, involving eosinophilic airway inflammation. Due to the lack of typical clinical manifestations, insufficient knowledge of this disease in some clinicians and some other reasons, CTVA is susceptible to misdiagnosis or missed diagnosis. Currently, the diagnostic criteria for CTVA are: chest tightness as the only or primary symptom, without typical asthma symptoms and signs such as wheezing and shortness of breath, and with any one of the objective indicators of variable airflow limitation. Effective anti-asthma treatment is required, and other diseases that cause chest tightness, such as cardiovascular, digestive, nervous, muscular, and mental diseases should be excluded. CTVA treatment follows that of typical asthma, but the specific treatment duration is uncertain and may require long-term management. Traditional Chinese medicine has shown some therapeutic effects on CTVA. Most CTVA patients have a good prognosis after active anti-asthma treatment. This paper analyzes and summarizes the research of CTVA in China from 2013 and provides new perspectives for further exploration of CTVA.

[Response of Organic Carbon Loss to Soil Erosion and Its Drivers: A Meta-analysis]

Soil erosion is the main driving force of soil organic carbon (SOC) loss and plays an important role in the global carbon cycle. It is helpful to understand the mechanism of SOC loss under soil erosion by evaluating the main driving factors of SOC loss under soil erosion and their influence degree. Therefore, based on 24 cases published in domestic and foreign journals from 2007 to 2021, this study investigated the effects of soil erosion on SOC loss in China under different climatic factors (climate types, rainfall, and rainfall intensity) and soil factors (soil types, bulk density, and aggregate size) by using Meta-analysis. The results showed that:① compared with that under no erosion disturbance, the SOC content under erosion decreased significantly (overall decreased 16.0%), showing obvious negative response characteristics. ② Under the erosion background, the negative response degree of SOC to different factors was as follows:rainfall intensity (65.0%)>mean annual rainfall (24.3%)>soil types (21.4%)>bulk density (20.2%)>aggregate size (16.5%)>climate types (9.1%). ③ Principal component analysis showed that climate was the dominant factor affecting SOC loss, and rainfall intensity was again shown to be the key factor. In this study, the characteristics and influencing factors of SOC loss under soil erosion in China were analyzed, which provided theoretical reference for the systematic understanding of the role of soil erosion in the carbon cycle.

Dirigent gene editing of gossypol enantiomers for toxicity-depleted cotton seeds

Axial chirality of biaryls can generate varied bioactivities. Gossypol is a binaphthyl compound made by cotton plants. Of its two axially chiral isomers, (-)-gossypol is the bioactive form in mammals and has antispermatogenic activity, and its accumulation in cotton seeds poses health concerns. Here we identified two extracellular dirigent proteins (DIRs) from Gossypium hirsutum, GhDIR5 and GhDIR6, which impart the hemigossypol oxidative coupling into (-)- and (+)-gossypol, respectively. To reduce cotton seed toxicity, we disrupted GhDIR5 by genome editing, which eliminated (-)-gossypol but had no effects on other phytoalexins, including (+)-gossypol, that provide pest resistance. Reciprocal mutagenesis identified three residues responsible for enantioselectivity. The (-)-gossypol-forming DIRs emerged later than their enantiocomplementary counterparts, from tandem gene duplications that occurred shortly after the cotton genus diverged. Our study offers insight into how plants control enantiomeric ratios and how to selectively modify the chemical spectra of cotton plants and thereby improve crop quality.

[Research advances in transmission dynamic models on hand, foot, and mouth disease]

Hand, foot, and mouth disease (HFMD) is a common childhood infectious disease caused by various enteroviruses. China has the most significant number of reported cases and deaths of HFMD over the globe. Understanding the epidemic laws of HFMD can provide a scientific basis for designing prevention and control measures. The dynamic transmission models focus on the transmission mechanism of infectious diseases. They can simulate the actual situation to study the epidemic rules of diseases by adding, deleting, and subdividing compartments. More researchers have paid attention to dynamic models because of their high flexibility. To carry out the dynamic model of the HFMD research more effectively, a comprehensive understanding of related research progress in this field is deeply needed. In this paper, based on various researchers' different research purposes of dynamic models, the research progress was classified and summarized, providing meaningful guidance for model construction methods and future research directions and references for dynamic modeling of other models of infectious diseases. It was found that most studies used the SIR dynamic model or its extended model (such as the SEIR model), and few studies contained a complex factor compartment. Some important epidemiological parameters (such as R₀) were obtained by studying the HFMD cases in a specific region, simulating different intervention scenarios to evaluate the effect of measures, or revealing the future trend by model prediction. However, there is no dynamic model simultaneously considering age structure, population moving, seasonality and periodicity, and vaccination.

[Analysis of experience in diagnosis and treatment of fetal goiter in patients with Graves' disease complicated with pregnancy]

This article reported the clinical diagnosis and treatment experience of two cases of fetal goiter in Graves' disease (GD) complicated with pregnancy. Two GD patients took antithyroid drugs regularly during pregnancy and their thyroid functions were well controlled, but the levels of thyrotropin receptor antibody (TRAb) of the two cases were still above the upper limit in the second and third trimester. Two fetuses had fetal goiter in the middle and late stages of pregnancy. After continuously controlling maternal thyroid function and closely monitoring fetal ultrasound, there was no aggravation of the fetal goiter, and the delivery went smoothly. One case had neonatal hyperthyroidism. It is suggested that although the thyroid function was well controlled during pregnancy in patients with GD, the high level of serum TRAb still needs to be alert to the occurrence of fetal goiter, and fetal ultrasound is the most direct non-invasive monitoring method.

[Comparison of diagnostic value between renal cyst index and Bosniak classification in cystic renal masses]

A total of 106 patients who were diagnosed with Bosniak catergory ⅡF or Ⅲ cystic renal masses (CRM) and underwent surgery in Zhongshan-Xuhui Hospital and Xuhui District Central Hospital between January 2018 and December 2019 were retrospectively analyzed. The diagnostic accuracy of renal cyst index (RCI) and Bosniak classification system was compared by analyzing the relevant parameters including the sensitivity and specificity. There were 62 males and 44 females, with a median age of 56 years old. Among the 106 CRM, 72 were benign and 34 were malignant. The sensitivity and specificity of RCI was 94.12% and 81.94%, respectively, while the sensitivity and specificity of Bosniak classification system was 73.53% and 80.56%, respectively. Chi-square test revealed that the sensitivity of RCI was significantly higher than that of Bosniak classification system (P=0.023). The current study indicates that RCI is a simple and feasible method which can provide quantitative evaluation for predicting characteristics of CRM.

[A cross-sectional investigation on the current status and influencing factors of kinesiophobia in adult burn patients]

Objective: To investigate the current status and influencing factors of kinesiophobia in adult burn patients. Methods: A single center cross-sectional research method was conducted. A total of 170 adult burn patients, meeting the inclusion criteria, were admitted to the Department of Plastic Surgery and Burns of the West China Hospital of Sichuan University from October 2018 to December 2019. On admission, the self-made general information questionnaire was used to investigate the gender, age, education level, marital status, payment method of medical expenses, injury factors, and total burn area of patients. One month after admission or before discharge, the presence and degree of kinesiophobia of patients were evaluated by the Tampa Scale for Kinesiophobia (TSK), their pain degrees (results averaged) at the time of burn, debridement and dressing change, after burn operation, and at rest were evaluated by the Visual Analogue Scale, their social support levels were evaluated by the Social Support Revalued Scale, and their degrees of anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale. According to the TSK score, the patients with score >37 points were included into kinesiophobia group, and the patients with score ≤37 points were included into non-kinesiophobia group. The general information of patients in the two groups, as well as the pain score, social support level score, anxiety score, and depression score mentioned above, were recorded. Data of patients between the two groups were statistically analyzed with unifactor analysis including chi-square test, independent sample t test, and Mann-Whitney U test. The factors with statistically significant differences in unifactor analysis were used as variables for multivariate logistic regression analysis to screen out the independent influencing factors of kinesiophobia in adult burn patients. Results: Questionnaires and scales of 170 patients were collected, and the recovery rate was 100%. The data of two patients complicated with cranial fracture aggravation were removed, and 168 valid data were obtained, with the effective rate of 98.82%. Among the 168 patients, 88 were male (52.38%) and 80 were female (47.62%), aged from 18 to 71 (41±6) years. Most of the patients had secondary school education or below, were married, and with no out-of-pocket medical expenses. The main factors of injury were flame and hydrothermal fluid, and the total burn area was 2%-75% ((28±5)%) total body surface area. The TSK score was (41±5) points, the pain score was 4.0 (2.6, 7.0) points, the social support level score was (40±5) points, the anxiety score was 8.5 (7.0, 13.0) points, and the depression score was 9.5 (6.5, 12.0) points. A total of 98 patients had kinesiophobia, and the incidence of kinesiophobia was 58.33%. There were no statistically significant differences in gender, age, educational level, marital status, or injury factors of patients between kinesiophobia group and non-kinesiophobia group (P>0.05). The percentage of out-of-pocket expenses, total burn area, pain score, anxiety score, and depression score of patients in kinesiophobia group were significantly higher than those in non-kinesiophobia group (χ²=6.402, t=2.39, Z=-8.05, -6.68, -7.89, P<0.05 or P<0.01), and the social support level score of patients in kinesiophobia group was significantly lower than that in non-kinesiophobia group (t=5.22, P<0.01). The multivariate logistic regression analysis showed that total burn area, pain score, social support level score, anxiety score, and depression score were the independent influencing factors for the development of kinesiophobia in adult burn patients (odds ratio=0.79, 1.45, 0.78, 1.15, 1.17, 95% confidence interval=0.80-0.92, 1.24-1.74, 0.65-0.91, 1.06-1.29, 1.03-1.24, P<0.01). Conclusions: The incidence of kinesiophobia in adult burn patients is high, and the degree of kinesiophobia is mainly affected by total burn area, pain, social support level, anxiety and depression degrees, and so on. Thus these factors should be taken into consideration when designing interventions to reduce the incidence and degree of kinesiophobia.

1,10/1,11-Cyclization catalyzed by diverged plant sesquiterpene synthases is dependent on a single residue

The exquisite chemodiversity of terpenoids is the product of the large diverse terpene synthase (TPS) superfamily. Here, by using structural and phylogenetic analyses and site-directed mutagenesis, we identified a residue (Cys440 in Nicotiana tabacum 5-epi-aristolochene synthase) proximal to an ion-binding motif common to all TPSs and named the preNSE/DTE residue, which determines the product specificity of sesquiterpene synthases from different plant species. In sesquiterpene synthases catalyzing 1,10-cyclization (1,10-cyclases) of farnesyl diphosphate, mutation of the residue in both specific and promiscuous 1,10-cyclases from different lineages leads to the accumulation of monocyclic germacrene A-11-ol, which is "short-circuited" from complex cyclization cascades, suggesting a key role of this residue in generating the first common intermediate of 1,10-cyclization. Altering this residue in a specific 1,11-cyclase results in alternative 1,10-cyclization products. Moreover, the preNSE/DTE residue can be harnessed to engineer highly specific sesquiterpene synthases for an improved proportion of high-value terpenoids, such as patchoulol, a main constituent of several traditional Chinese medicines that could treat SARS-CoV-2.

Recent Advances and Future Perspectives in Cotton Research

Cotton is not only the world's most important natural fiber crop, but it is also an ideal system in which to study genome evolution, polyploidization, and cell elongation. With the assembly of five different cotton genomes, a cotton-specific whole-genome duplication with an allopolyploidization process that combined the A- and D-genomes became evident. All existing A-genomes seemed to originate from the A₀-genome as a common ancestor, and several transposable element bursts contributed to A-genome size expansion and speciation. The ethylene production pathway is shown to regulate fiber elongation. A tip-biased diffuse growth mode and several regulatory mechanisms, including plant hormones, transcription factors, and epigenetic modifications, are involved in fiber development. Finally, we describe the involvement of the gossypol biosynthetic pathway in the manipulation of herbivorous insects, the role of GoPGF in gland formation, and host-induced gene silencing for pest and disease control. These new genes, modules, and pathways will accelerate the genetic improvement of cotton.

[Effects of stepwise acute pain management on acute pain and post-traumatic stress disorder in children with burns: a prospective randomized controlled study]

Objective: To explore the effects of stepwise acute pain management on acute pain and post-traumatic stress disorder (PTSD) in children with burns. Methods: From November 2018 to December 2019, 196 children with burns who were admitted to West China Hospital of Sichuan University and met the inclusion criteria were enrolled in the prospective randomized controlled study. The children were divided into traditional pain management group (97 children, 51 males and 46 females, aged 1 to 6 years) and stepwise pain management group (96 children, 55 males and 41 females, aged 1 to 6 years) according to the random number table. Children in traditional pain management group were treated with traditional acute pain care, while the children in stepwise pain management group were treated with stepped acute pain management (moderate pain was treated with oral administration of acetaminophen sustained-release dry suspension at the dose of 10 to 15 mg/kg once every 4 to 6 hours, and severe pain was treated with morphine intravenous injection at the dose of 0.1 to 0.2 mg/kg once every 4 hours) on the basis of traditional acute pain care after admission. The COMFORT behavior scale was applied to compare the resting pain levels of children in the two groups within post injury day (PID) 3 (1, 9, and 17 o'clock each day). The adverse reactions of children in the stepwise pain management group during the treatment period were recorded. The occurrence of PTSD within one month after injury was evaluated in both groups by the revised PTSD scale. Data were statistically analyzed with independent sample t test, Bonferroni correction, analysis of variance for repeated measurement, chi-square test, Wilcoxon rank sum test, and Fisher's exact probability test. Results: The pain scores of children in stepwise pain management group were significantly lower than traditional pain management group at 1, 9, and 17 o'clock on PID 1, 1, 9, and 17 o'clock on PID 2, and 1, 9, and 17 o'clock on PID 3 (t=2.71, 3.44, 4.05, 4.18, 4.08, 4.19, 4.25, 3.69, 3.71, P<0.05 or P<0.01). The pain scores of children in both groups showed a decreasing trend over time. Of the 96 children in stepwise pain management group, 84 children were treated with oral administration of acetaminophen sustained-release dry suspension, and 12 children were treated with morphine intravenous injection. No adverse reaction occurred during the treatment period. The incidence of PTSD of children in stepwise pain management group within 1 month after injury was 3.12% (3/96), which was significantly lower than 14.43% (14/97) in traditional pain management group, P<0.05. Conclusions: The stepped acute pain management can relieve the acute pain and reduce the incidence of PTSD in children with burns.

Side Products of Recombinant Amorpha-4,11-diene Synthase and Their Effect on Microbial Artemisinin Production

Amorpha-4,11-diene synthase (ADS) is the first committed enzyme in the biosynthesis of artemisinin. Artemisinin production by biobased fermentation is considered a reliable alternative pathway. Heterologously expressed ADS has been established to generate several minor products, including structural analogues of amorpha-4,11-diene, but their fate in fermentation is still unknown. Here, using chiral analysis, we found that ADS produces one of the analogues, amorpha-4-en-11-ol, as a pair of epimers. Labeling experiments revealed that ADS mutants yielded amorphene-type sesquiterpenes, indicating the co-occurrence of initial 1,6 and 1,10 cyclization of farnesyl diphosphate in a single enzyme. Interestingly, the immediate downstream oxidase CYP71AV1 had very low affinity to the side products of the recombinant ADS, including amorpha-4-en-7-ol, which is structurally similar to amorpha-4,11-diene. Our data uncover the complex catalytic mechanism of recombinant ADS and reveal a potential negative effect of the side products of recombinant ADS on the production of the artemisinin precursor in microbes.

Genome-wide characterization of the GRF family and their roles in response to salt stress in Gossypium

BACKGROUND

Cotton (Gossypium spp.) is the most important world-wide fiber crop but salt stress limits cotton production in coastal and other areas. Growth regulation factors (GRFs) play regulatory roles in response to salt stress, but their roles have not been studied in cotton under salt stress.

RESULTS

We identified 19 GRF genes in G. raimondii, 18 in G. arboreum, 34 in G. hirsutum and 45 in G. barbadense, respectively. These GRF genes were phylogenetically analyzed leading to the recognition of seven GRF clades. GRF genes from diploid cottons (G. raimondii and G. arboreum) were largely retained in allopolyploid cotton, with subsequent gene expansion in G. barbadense relative to G. hirsutum. Most G. hirsutum GRF (GhGRF) genes are preferentially expressed in young and growing tissues. To explore their possible role in salt stress, we used qRT-PCR to study expression responses to NaCl treatment, showing that five GhGRF genes were down-regulated in leaves. RNA-seq experiments showed that seven GhGRF genes exhibited decreased expression in leaves under NaCl treatment, three of which (GhGRF3, GhGRF4, and GhGRF16) were identified by both RNA-seq and qRT-PCR. We also identified six and three GRF genes that exhibit decreased expression under salt stress in G. arboreum and G. barbadense, respectively. Consistent with its lack of leaf withering or yellowing under the salt treatment conditions, G. arboreum had better salt tolerance than G. hirsutum and G. barbadense. Our results suggest that GRF genes are involved in salt stress responses in Gossypium.

CONCLUSION

In summary, we identified candidate GRF genes that were involved in salt stress responses in cotton.

RES transformation for biosynthesis and detoxification

The reactive electrophilic species (RES), typically the molecules bearing α,β-unsaturated carbonyl group, are widespread in living organisms and notoriously known for their damaging effects. Many of the mycotoxins released from phytopathogenic fungi are RES and their contamination to cereals threatens food safety worldwide. However, due to their high reactivity, RES are also used by host organisms to synthesize specific metabolites. The evolutionary conserved glyoxalase (GLX) system scavenges the cytotoxic α-oxoaldehydes that bear RES groups, which cause host disorders and diseases. In cotton, a specialized enzyme derived from glyoxalase I (GLXI) through gene duplications and named as specialized GLXI (SPG), acts as a distinct type of aromatase in the gossypol pathway to transform the RES intermediates into the phenolic products. In this review, we briefly introduce the research progress in understanding the RES, especially the RES-type mycotoxins, the GLX system and SPG, and discuss their application potential in detoxification and synthetic biology.

Colorectal cancer with indeterminate pulmonary nodules

Colorectal cancer (CRC) is one of the most common malignancies with a dismal prognosis. Indeterminate pulmonary nodules (IPNs) are lung nodules with uncertain nature, generally defined as a noncalcified nodule smaller than 10 mm in diameter or solid nodule no greater than 20 mm at maximum diameter without malignant character. With the widespread use of preoperative staging computed tomography (CT) of the chest and follow-up CT, IPNs are frequently detected in patients with CRC, which makes diagnosis more controversial. Generally, progression to pulmonary metastasis from IPNs is rare. Thus, no further interventions were needed for IPNs in CRC patients. A second reviewing of scans with IPNs by both clinicians and experienced thoracic radiologists may help to obtain a more accurate diagnosis.

[Three-dimensional changes in condylar position in skeletal class Ⅲ patients with mandibular deviation after bilateral sagittal split ramus osteotomy]

Objective: To investigage the three-dimensional changes in condylar position after bilateral sagittal split ramus osteotomy (BSSRO) in skeletal class Ⅲpatients with mandibular deviation using cone-beam CT (CBCT). Methods: Twenty-five skeletal class Ⅲ patients with mandibular deviation were included. The patients (12 males and 13 females, aged 19-25 years, average age 22.4 years) were treated in the Department of Orthodontics, Affiliated Stomatological Hospital, Nanchang University from October 2013 to March 2017. The patients were divided into T1, T2 and T3 groups (T1 group: CBCT taken within 1 week before operation; T2 group: CBCT taken within 1 week after operation; T3 group: CBCT taken 6-8 months after surgery). Three sets of image data of condyles on both sides (deviation side and contralateral side) were obtained. After the DICOM data collection, the software of Mimics 17.0 was used to perform three-dimensional reconstruction and condylar position measurements: the distance from the condylar top (CoT) to the standard horizontal plane (SHP), the middle sagittal plane (MSP) and the sella coronal plane (SCP) (CoT-SHP, CoT-MSP, CoT-SCP); the distance from the condylar center (CoC) to SHP, MSP and SCP (CoC-SHP, CoC-MSP, CoC-SCP); the angle from the condyle cella plane (CCP) to SHP, MSP and SCP (CCP-SHP, CCP-MSP, CCP-SCP); the angle from the condyle sagittal plane (CSP) to SHP, MSP and SCP (CSP-SHP, CSP-MSP, CSP-SCP) and the distance of the anterior, superior, posterior, medial, central and lateral joint space. One-way ANOVA and LSD-t test were used to compare the changes in condylar position at different periods (T1, T2, and T3). Results: Within 1 week before operation on the deviation side, CoT-SHP [(2.5±1.3) mm], CSP-MSP (41.2°±8.4°) and the posterior joint space [(2.0±0.6) mm] were obviously increased (P<0.05), and CoT-SCP [(9.1±3.3) mm], CCP-MSP (78.2°±5.2°) were decreased significantly (P<0.05); on the contralateral side, CoT-MSP [(50.4±3.1) mm], CCP-MSP (80.6°±6.0°), the anterior joint space [(2.2±0.6) mm] and the medial joint space [(2.6±0.6) mm] were obviously increased (P<0.05), and CCP-SCP (11.4°±8.8°) were decreased significantly (P<0.05). Six to eight months after surgery, CoT-SHP [(2.2±1.0) mm] and the posterior joint space [(1.9±0.5) mm] on deviation side and CoT-SCP [(8.4±2.8) mm] on the contralateral side were increased significantly (P<0.05). No significant difference was found in other measurements (P>0.05). Conclusions: The condylar position in skeletal class Ⅲ patients with mandibular deviation was asymmetrical. Within 1 week after the operation of BSSRO, the condyle on the deviation side was moved forward, downward and inward. Meanwhile, the condyle on the contralateral side was moved backward and outward. Six to eight months after surgery, the condylar position on both sides was gradually restored to the pre-operative condylar position.

A gossypol biosynthetic intermediate disturbs plant defence response

Plant secondary metabolites and their biosynthesis have attracted great interest, but investigations of the activities of hidden intermediates remain rare. Gossypol and related sesquiterpenes are the major phytoalexins in cotton. Among the six biosynthetic intermediates recently identified, 8-hydroxy-7-keto-δ-cadinene (C234) crippled the plant disease resistance when accumulated upon gene silencing. C234 harbours an α,β-unsaturated carbonyl thus is a reactive electrophile species. Here, we show that C234 application also dampened the Arabidopsis resistance against the bacterial pathogen Pseudomonas syringae pv. maculicola ( Psm). We treated Arabidopsis with C234, Psm and ( Psm+C234), and analysed the leaf transcriptomes. While C234 alone exerted a mild effect, it greatly stimulated an over-response to the pathogen. Of the 7335 genes affected in the ( Psm+C234)-treated leaves, 3476 were unresponsive without the chemical, in which such functional categories as 'nucleotides transport', 'vesicle transport', 'MAP kinases', 'G-proteins', 'protein assembly and cofactor ligation' and 'light reaction' were enriched, suggesting that C234 disturbed certain physiological processes and the protein complex assembly, leading to distorted defence response and decreased disease resistance. As C234 is efficiently metabolized by CYP71BE79, plants of cotton lineage have evolved a highly active enzyme to prevent the phytotoxic intermediate accumulation during gossypol pathway evolution. This article is part of the theme issue 'Biotic signalling sheds light on smart pest management'.

Characterization of gossypol biosynthetic pathway

Gossypol and related sesquiterpene aldehydes in cotton function as defense compounds but are antinutritional in cottonseed products. By transcriptome comparison and coexpression analyses, we identified 146 candidates linked to gossypol biosynthesis. Analysis of metabolites accumulated in plants subjected to virus-induced gene silencing (VIGS) led to the identification of four enzymes and their supposed substrates. In vitro enzymatic assay and reconstitution in tobacco leaves elucidated a series of oxidative reactions of the gossypol biosynthesis pathway. The four functionally characterized enzymes, together with (+)-δ-cadinene synthase and the P450 involved in 7-hydroxy-(+)-δ-cadinene formation, convert farnesyl diphosphate (FPP) to hemigossypol, with two gaps left that each involves aromatization. Of six intermediates identified from the VIGS-treated leaves, 8-hydroxy-7-keto-δ-cadinene exerted a deleterious effect in dampening plant disease resistance if accumulated. Notably, CYP71BE79, the enzyme responsible for converting this phytotoxic intermediate, exhibited the highest catalytic activity among the five enzymes of the pathway assayed. In addition, despite their dispersed distribution in the cotton genome, all of the enzyme genes identified show a tight correlation of expression. Our data suggest that the enzymatic steps in the gossypol pathway are highly coordinated to ensure efficient substrate conversion.

Phase noise reduction by optical phase-locked loop for a coherent bichromatic laser based on the injection-locking technique

We present a coherent bichromatic laser system with low phase noise. An optical injection process is used to generate coherent laser beams with a frequency difference of 9.192 631 77 GHz using an electro-optical modulator. An optical phase-locked loop is then applied to reduce the phase noise. The phase noise of the beat note is -41, -81, -98, -83, and -95 dBrad²/Hz at the offset frequencies of 1 Hz, 100 Hz, 1 kHz, 10 kHz, and 1 MHz, respectively. Compared to a system that uses optical injection alone, the phase noise is reduced by up to 20-30 dB in the low-frequency range, and the intermodulation effect on the continuous atomic clock is reduced by an order of magnitude. This configuration can adjust the intensities and polarizations of the laser beams independently and reduce the phase noise caused by environmental disturbances and optical injection, which may be useful for application to atomic coherence experiments.

[Effects of microRNA-379-5p on proliferation, migration and invasion of hepatocellular carcinoma cell line]

OBJECTIVE

To investigate the effects of microRNA-379-5p (miR-379-5p) on proliferation, migration and invasion of hepatocellular carcinoma (HCC) cells.

METHODS

Human HCC cell line HepG2 was infected with lentivirus carrying miR-379-5p (miR-379-5p group) or lentivirus carrying negative control sequences (negative control group). The untreated HepG2 cells represented blank control group. Cell proliferation was determined by 3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazoliumbromide (MTT) assays. Cell migration and invasion were assessed by Transwell assays. The mRNA and protein expressions of matrix metalloproteinase-2 (MMP-2) and MMP-9 were analyzed by real-time quantitative polymerase chain reaction and Western blot, respectively.

RESULTS

Compared with negative control group and blank control group, cell migration and invasion was significantly inhibited in miR-379-5p group (P<0.05). However, there was no significant difference in cell proliferation among the three groups (P>0.05). Furthermore, the mRNA and protein levels of MMP-2 and MMP-9 in miR-379-5p group were significantly lower than that in negative control group and blank control group (P<0.05).

CONCLUSION

miR-379-5p can suppress migration and invasion of HCC cell lines, which may be achieved by inhibiting MMP-2 and MMP-9 expressions.

[Therapeutic evaluation of the correction of the severe bi-maxillary protrusion cases by Tweed-Merrifield technique]

OBJECTIVE

To evaluate the influence of Tweed-Merrifield technique in correction of severe bimaxillary protrusion adult patients on the measurement of the dental and skeletal changes after orthodontic treatment by Johnston analysis and the regular cephalomatric analysis.

METHODS

Twelve adolescent patients with severe bimaxillary protrusion were included in this self-control retrospective study. Lateral cephalometric radiographs were taken before and after treatments. All the radiographs were traced and analyzed by the method of Johnston analysis. Other measurements were evaluated using a series of 13 linear and angular measurements including SNA, SNB, ANB, U1-SN, U1-NA, U1/NA, L1-NB, U1/NB, L1/MP, U1-L1, (U1+L1)/2-AB, MP/SN and MP/FH from regular cephalomatric analysis. These measurements were also applied to compare the differences between pre- and post-treatments, which clarify the dental and skeletal changes by Johnston analysis. The effect of orthodontic correction was determined using the non-parameters test.

RESULTS

The maxillary moved backforward by 1.3 mm according to the stable skull base, while the mandible moved forward by 2.12 mm. The relative position between the maxillary and mandible (ABCH) changed 3.42 mm. The upper and lower incisors retracted significantly. The upper and lower molars moved slightly forward and the relative positions of upper and lower molars and anterior teeth after treatment were 3.44 mm and 4.23 mm respectively. After treatment, the parameters of ANB, U1-NA, U1/NA, U1-SN, L1-NB, L1/NB and L1-M were reduced by -(1.98±1.55)°(P=0.012), - (5.08±4.6) mm (P=0.002), -(11.79±1.21)°(P=0.004), -(13.55±6.32)°(P=0.047), -(3.17±3.07) mm (P=0.010), -(6.84±2.55)°(P=0.038) and -(4.13±2.24)°(P=0.048) on average, whose changes had the statistically significant effects.

CONCLUSION

Tweed-Merrifield technique (directional force technique) can stabilize anchorage molar, retract anterior teeth and significantly improve the hard and soft tissue profile for patients with bimaxillary protrusion, and make a good vertical control which means this technique is applicable to the patients who need strong anchorage. Even for the severe bimaxillary protrusion adult patients, the Tweed-Merrifield technique can control the anchoragewell and make the profiles improved greatly.

First Report of Sclerotinia sclerotiorum Causing Sclerotinia Blight on Peanut (Arachis hypogaea) in Northeastern China

Peanut, Arachis hypogaea L., is an important source of vegetable oil and protein in China with a planting area of 5 million ha and annual production of 16.2 million metric tons. In September of 2012, typical symptoms of Sclerotinia blight were first observed on peanut in Shuangcheng, Heilongjiang Province, China. Approximately 50% of the plants in a field were infected. Symptoms began as a chlorotic wilt on the foliage and developed into necrosis of basal stems and developed very quickly in the field. In advanced stages of the disease, stems and branches became bleached and eventually died. White, fluffy mycelium and black irregular sclerotia (3.5 to 5.4 mm diameter) were observed on the infected stems. Infected branches and pegs were shredded, and most pods dropped on the soil during harvest. To isolate the causal agent of the disease, sclerotia were collected from the field. Twenty sclerotia were surface disinfected in 1% NaOCl for 3 min, rinsed three times with sterile water, placed on potato sucrose agar (PSA) with 100 μg/ml streptomycin, and then incubated at 22°C in the dark for 10 days. Fungal DNA was extracted from mycelia with a TIANGEN DNAsecure Plant Kit (Beijing) and amplified by PCR with the universal fungal primer ITS1 and ITS4. PCR products of five replicates were sequenced and subjected to an NCBI BLAST search. The BLAST search revealed that our sequences (GenBank Accession No. KC935388) had 100% identity with reported sequences of Sclerotinia sclerotiorum. The isolates were identified as S. sclerotiorum (Lib.) de Bary based on mycelia, sclerotia, and rDNA sequence analysis. To conduct pathogenicity tests, nine potted peanut plants (1 month old) were each inoculated with a 5-mm-diameter disk of colonized PSA by placing the inoculum on the base of the stem. Plants were inoculated with a plug of non-colonized PSA as controls. All inoculated plants were covered with a plastic bag for 5 days to maintain high humidity and incubated at 22 to 24°C in the growth chamber with a 12-h photoperiod. After 2 days, the inoculated plants showed water-soaked brown symptoms on the stem base and whole plants wilted after 5 days under high moisture conditions. The symptoms were identical to those observed on peanut plants in Shuangcheng, Heilongjiang Province, whereas the control plants remained symptom-free. Re-isolation of the fungus from the inoculated plants confirmed that the causal agent was S. sclerotiorum. S. sclerotiorum has been reported on peanut in the United States and Argentina (1,2,3). To our knowledge, this is the first report of S. sclerotiorum as a pathogen causing Sclerotinia blight on peanut in northeastern China. References: (1) A. Marinelli et al. Int. J. Pest Manage. 44:251, 1998. (2) J. E. Woodward et al. Plant Dis. 90:111, 2006. (3) J. E. Woodward et al. Plant Dis. 92:1468, 2008.

Heterostructures of germanium nanowires and germanium-silicon oxide nanotubes and growth mechanisms

We report on a method to fabricate one-dimensional heterostructures of germanium nanowires (GeNWs) and germanium-silicon oxide nanotubes (GeSiO(x)NTs). The synthesis of the wire-tube heterostructures is carried out using a simple furnace set-up with germanium tetraiodide and germanium powders as growth precursors, gold-dotted silicon wafers as substrates and by controlling the temperature ramp rate/sequence of the growth precursors. Two types of wire-tube heterostructures resulting from distinct growth mechanisms are obtained. The type-1 heterostructure consists of a GeNW, grown via a gold-catalyzed vapour-liquid-solid process, at the lower end and a GeSiO(x)NT at the upper end. In contrast, the type-2 heterostructure is made up of a solid wire at the upper end and a hollow tube at the lower end. The solid wire portion of the type-2 heterostructure is formed through an oxide-assisted growth process.

Admission is not always necessary for patients with community-acquired pneumonia in risk classes IV and V diagnosed in the emergency room

OBJECTIVE

To determine the factors that allow patients with community-acquired pneumonia who are at high risk of mortality (risk classes IV and V) to be treated at home.

DESIGN

A prospective, observational study.

SETTING

Six hospitals and one free-standing emergency room in Edmonton, Alberta.

PARTICIPANTS

The present study included 2354 patients in risk classes IV and V who had a diagnosis of pneumonia made by an emergency room physician or an internist.

MEASUREMENTS

Symptoms, signs and laboratory findings, as well as outcome measures of length of stay and mortality.

RESULTS

Of the total study group, 319 of the patients (13.5%) were treated on an ambulatory basis. Factors predictive of admission were definite or possible pneumonia on chest radiograph as read by a radiologist, functional impairment, altered mental status, substance abuse, psychiatric disorder, abnormal white blood cell count, abnormal lymphocyte count, oxygen saturation less than 90% and antibiotic administration in the week before admission. If chest pain was present, admission was less likely. Only two of the 319 patients required subsequent admission (both had positive blood cultures) and only two died.

CONCLUSIONS

A substantial number of patients in risk classes IV and V can be safely treated at home. Factors that help clinicians to select this subset of patients are discussed.

Standard treatment for Helicobacter pylori infection is suboptimal in non-ulcer dyspepsia compared with duodenal ulcer in Chinese

BACKGROUND

Recent studies suggest that the Helicobacter pylori eradication rate in patients with non-ulcer dyspepsia is lower when compared to patients with peptic ulcer diseases.

AIM

The aim of this study was to study the efficacy of triple therapy for H. pylori infection in patients with duodenal ulcer vs. patients with non-ulcer dyspepsia.

METHODS

A total of 582 Chinese patients with proven H. pylori infection were recruited to receive: omeprazole 20 mg, amoxicillin 1000 mg and clarithromycin 500 mg all given twice daily for 7 days (OCA regime). Endoscopy with rapid urease test, histology and culture were performed before treatment. Post-treatment H. pylori status was determined by (13)C-urea breath test. Metronidazole, clarithromycin and amoxicillin resistance was defined as minimum inhibitory concentration (MIC) of >8 microg/mL, >1 microg/mL and >1 microg/mL, respectively.

RESULTS

A significantly higher (intention-to-treat/per-protocol) eradication rate was found in patients with duodenal ulcer than those with non-ulcer dyspepsia (91/94% vs. 84/88% respectively, P = 0.011 and P = 0.016). Clarithromycin resistance rate was higher in patients with non-ulcer dyspepsia than those with duodenal ulcer (14% vs. 6%, P = 0.015). Clarithromycin resistance (40% vs. 5%, P < 0.001, OR 12, 95% CI: 5.7-24.3) and the diagnosis of non-ulcer dyspepsia (91% vs. 84%, P = 0.011, OR 2.0, 95% CI: 1.2-3.3) significantly affected the success of H. pylori eradication.

CONCLUSION

Clarithromycin resistance accounts for the significantly lower and suboptimal H. pylori eradication rate of OCA regimen in Chinese patients with non-ulcer dyspepsia compared to those with duodenal ulcer.

Onset and disappearance of reflux symptoms in a Chinese population: a 1-year follow-up study

BACKGROUND

The natural history of gastro-oesophageal reflux disease in Asian population has not been studied before.

AIM

To study the onset and disappearances of reflux symptoms over a 1-year period in the Chinese population.

METHODS

A population-based telephone survey was performed in 2002 and repeated 1 year later. The change in prevalence rate, onset and disappearance of gastro-oesophageal reflux disease, and the change in diagnoses were assessed. Factors associated with the onset and disappearance of gastro-oesophageal reflux disease were studied.

RESULTS

A total of 712 subjects completed the first and second survey. The annual, monthly and weekly prevalence of gastro-oesophageal reflux disease were 34.1%, 10.1% and 2.7% respectively. The onset rate (per 1000 person-year) and disappearance rate of any gastro-oesophageal reflux disease and frequent gastro-oesophageal reflux disease (> or = monthly symptoms) were 209, 40; and 395, 243 respectively. Forty-four percentage of gastro-oesophageal reflux disease subjects changed their diagnoses in 2003. By multiple logistic regression analysis, high anxiety score (OR: 1.2, 95% CI: 1.1-1.2) and higher educational level (OR: 2.7, 95% CI: 1.3-6.3) were associated with the onset of gastro-oesophageal reflux disease; while the frequency of acid regurgitation (OR: 0.35, 95% CI: 0.17-0.70) and use of antisecretory therapy (OR: 0.50, 95% CI: 0.28-0.89) were associated with the disappearance of gastro-oesophageal reflux disease.

CONCLUSION

The prevalence of gastro-oesophageal reflux disease is stable over 1 year. Higher anxiety score and higher educational level were associated with the onset of gastro-oesophageal reflux disease, while lower frequency of reflux symptoms and infrequent use of antisecretory therapy were associated with the disappearance of gastro-oesophageal reflux disease in a Chinese population.

Double-blind, randomized controlled study to assess the effects of lansoprazole 30 mg and lansoprazole 15 mg on 24-h oesophageal and intragastric pH in Chinese subjects with gastro-oesophageal reflux disease

BACKGROUND

Previous studies have suggested that the acid secretory capacity of the Chinese population is lower than that of the Western population.

AIM

To compare the effect of lansoprazole 30 mg and 15 mg once daily on the 24-h oesophageal and intragastric pH profiles in Chinese patients with gastro-oesophageal reflux disease.

METHODS

Forty-four patients (male to female ratio, 27 : 17; mean age, 53 years; 55% with oesophagitis) with gastro-oesophageal reflux disease were randomized to receive lansoprazole 30 mg or 15 mg once daily for 4 weeks. Measurement of the 24-h oesophageal and intragastric pH, gastro-oesophageal reflux disease symptoms and quality of life was performed at baseline and during the last week of each dosing period.

RESULTS

Lansoprazole 30 mg maintained an intragastric pH > 4 for 10.5 h vs. 9.6 h for lansoprazole 15 mg (P = 0.44). The percentage total time at oesophageal pH < 4 was similar for lansoprazole 30 mg and 15 mg (2.0% vs. 2.3%, P = 0.30). The proportion of patients with complete cure of heartburn and acid regurgitation and the quality of life assessment were similar for lansoprazole 30 mg and 15 mg. Both dosages of lansoprazole were well tolerated and the compliance was 100% in both groups.

CONCLUSION

Lansoprazole dosages of 30 mg and 15 mg once daily provide a satisfactory decrease for oesophageal acid exposure and are equally effective for the treatment of gastro-oesophageal reflux disease in the Chinese population.

Prevalence, clinical spectrum and health care utilization of gastro-oesophageal reflux disease in a Chinese population: a population-based study

BACKGROUND

Population-based data on gastro-oesophageal reflux disease in Chinese are lacking. The prevalence, clinical spectrum and health care-seeking behaviour of subjects with gastro-oesophageal reflux disease were studied.

METHODS

Ethnic Chinese (3605) were invited to participate in a telephone survey using a validated gastro-oesophageal reflux disease questionnaire and the Hospital Anxiety and Depression Scale.

RESULTS

A total of 2209 subjects (58% female; mean age, 40.3 years) completed the interview. The annual, monthly and weekly prevalence rates of gastro-oesophageal reflux disease were 29.8%, 8.9% and 2.5%, respectively. Gastro-oesophageal reflux disease symptoms were associated with non-cardiac chest pain [odds ratio (OR), 2.3; 95% confidence interval (95% CI), 1.7-3.1], dyspepsia (OR, 1.9; 95% CI, 1.4-2.5), globus (OR, 1.8; 95% CI, 1.2-2.7), acid feeling in the stomach (OR, 5.8; 95% CI, 4.5-7.5) and the use of non-steroidal anti-inflammatory drugs (OR, 2.3; 95% CI, 1.5-3.6), but not with dysphagia, bronchitis, asthma, hoarseness and pneumonia. Patients with gastro-oesophageal reflux disease had a significantly higher anxiety and depression score and required more days off work when compared with subjects without. The frequency of heartburn (P = 0.032), female gender (P < 0.001), degree of depression (P = 0.004) and social morbidity (P < 0.001) were independent factors associated with health care-seeking behaviour.

CONCLUSION

The prevalence of gastro-oesophageal reflux disease was lower than that in Western populations, but carried a significant socio-economic burden in the studied Chinese population. The frequency of heartburn, female gender and psychosocial factors were associated with health care utilization in gastro-oesophageal reflux disease.

A validated symptoms questionnaire (Chinese GERDQ) for the diagnosis of gastro-oesophageal reflux disease in the Chinese population

BACKGROUND AND AIMS

To develop a validated gastro-oesophageal disease (GERD) symptom questionnaire for the Chinese population.

METHODS

One hundred Chinese patients with GERD and 101 healthy Chinese controls were presented with a 20-item GERD questionnaire in the Chinese language (Chinese GERDQ). Quality of life in GERD patients was assessed by SF-36. A standard dose of proton pump inhibitors for 4 weeks was prescribed to 35 patients with newly diagnosed GERD. The Chinese GERDQ was performed before, 4 weeks and 8 weeks after treatment. Concept, content, construct, discriminant validity and reliability of the questionnaire were assessed.

RESULTS

Seven items were selected by logistic regression to account for most of the differences between controls and GERD patients with a good reproducibility and internal consistency. A cut-off score of equal or greater than 12 was determined to discriminate between controls and GERD patients with a sensitivity of 82% and a specificity of 84%. The Chinese GERDQ correlated negatively with five domains of the SF-36 and discriminated between GERD patients who reported symptomatic improvement during proton pump inhibitor treatment and symptoms deterioration upon withdrawal of proton pump inhibitor treatment.

CONCLUSIONS

The Chinese GERDQ could be used in epidemiological studies to assess the frequency and severity of GERD in patient populations and in interventional studies of GERD.

Effects of COX-2 inhibitors on aortic prostacyclin production in cholesterol-fed rabbits

Prostacyclin (PGI(2)) is a potent vasodilator and inhibitor of platelet aggregation that is produced by prostacyclin synthase via the cyclooxygenase (COX) pathway of arachidonic acid metabolism. We investigated the potential role of COX-2 in the production of vasoactive prostanoids by aortic tissue in a rabbit model of dietary cholesterol-induced atherosclerosis. COX-1 was detected as the major isoform by immunoblot analysis in extracts from aortas of normal and 8 week cholesterol-fed animals with COX-2 being induced in atherosclerotic plaques from cholesterol-fed animals. Aortic tissue from cholesterol-fed animals showed decreased levels of basal 6-keto-PGF(1 alpha) and PGE(2) production as compared to the normal controls but showed no difference with respect to their ability to synthesize these prostanoids in response to exogenous arachidonic acid. The highly selective COX-2 inhibitors rofecoxib and the furanone DFP at concentrations of up to 10 micromol/l had no effect on the arachidonic acid-dependent production of 6-keto-PGF(1 alpha), in contrast to indomethacin, which caused a complete inhibition at 0.5 micromol/l. Celecoxib caused a significant inhibition of 6-keto-PGF(1 alpha) at 10 micromol/l but had little effect when the dose was lowered to 1 micromol/l. Similar effects of these inhibitors were observed with respect to the production of PGE(2) and no major difference was observed between aortic tissues from normal and cholesterol-fed animals with regard to inhibitor sensitivity. These results indicate that in a rabbit model of early stage cardiovascular disease, the basal production of 6-keto-PGF(1 alpha) and PGE(2) by aortic tissue is decreased. Furthermore, COX-2 expression is induced in atherosclerotic plaques and may play a role in altering localized synthesis of prostanoids in these lesions but does not appear to significantly impact the arachidonic acid-dependent prostacylin production of aortic tissues, which is largely mediated by COX-1.

Agrobacterium tumefaciens-mediated transformation of rice with the spider insecticidal gene conferring resistance to leaffolder and striped stem borer

Immature embryos of rice varieties "Xiushuill" and "Chunjiang 11" precultured for 4d were infected and transformed by Agrobacterium tumefaciens strain EHA101/pExT7 (containing the spider insecticidal gene). The resistant calli were transferred onto the differentiation medium and plants were regenerated. The transformation frequency reached 56% approximately 72% measured as numbers of Geneticin (G418)-resistant calli produced and 36% approximately 60% measured as numbers of transgenic plants regenerated, respectively. PCR and Southern blot analysis of transgenic plants confirmed that the T-DNA had been integrated into the rice genome. Insect bioassays using T1 transgenic plants indicated that the mortality of the leaffolder (Cnaphalocrasis medinalis) after 7d of leaf feeding reached 38% approximately 61% and the corrected mortality of the striped stem borer (Chilo suppressalis) after 7d of leaf feeding reached 16% approximately 75%. The insect bioassay results demonstrated that the transgenic plants expressing the spider insecticidal protein conferred enhanced resistance to these pests.

Pharmacological and pharmacodynamic essentials of H(2)-receptor antagonists and proton pump inhibitors for the practising physician

The suppression of gastric acid secretion with anti-secretory agents has been the mainstay of medical treatment for patients with acid-related disorders. Although the majority of Helicobacter pylori -related peptic ulcers can be healed with antibiotics, ulcer healing and symptom control can be significantly improved when antibiotics are given with anti-secretory agents, especially with a proton pump inhibitor. There is a dynamic relationship between the suppression of intragastric acidity and the healing of peptic ulcer and erosive oesophagitis and control of acid-related symptoms. The suppression of gastric acid secretion achieved with H(2)-receptor antagonists has, however, proved to be suboptimal for effectively controlling acid-related disorders, especially for healing erosive oesophagitis and for the relief of reflux symptoms. H(2)-receptor antagonists are also not effective in inhibiting meal-stimulated acid secretion, which is required for managing patients with erosive oesophagitis. Furthermore, the rapid development of tolerance to H(2)-receptor antagonists and the rebound acid hypersecretion after the withdrawal of an H(2)-receptor antagonist further limit their clinical use. Although low-dose H(2)-receptor antagonists are currently available as over-the-counter medications for self-controlling acid-related symptoms, their pharmacology and pharmacodynamics have not been well studied, especially in the self-medicating population. Proton pump inhibitors have been proved to be very effective for suppressing intragastric acidity to all known stimuli, although variations exist in the rapidity of onset of action and the potency of acid inhibition after oral administration at the approved therapeutic doses, which may have important clinical implications for the treatment of gastro-oesophageal reflux disease and perhaps for eradicating H. pylori infection when a proton pump inhibitor is given with antibiotics. Once-daily dosing in the morning is more effective than dosing in the evening for all proton pump inhibitors with respect to the suppression of intragastric acidity and daytime gastric acid secretion in particular, which may result from a better bio-availability being achieved with the morning dose. When higher doses are needed, these drugs must be given twice daily to achieve the optimal suppression of 24 hour intragastric acidity. Preliminary results have shown that esomeprazole, the optical isomer of omeprazole, given at 40 mg, is significantly more effective than omeprazole 40 mg, lansoprazole 30 mg or pantoprazole 40 mg for suppressing gastric acid secretion. However, more studies in different patient populations are needed to compare esomeprazole with the existing proton pump inhibitors with regard to their efficacy, cost-effectiveness and long-term safety for the management of acid-related disorders.

Review article: should we kill or should we save Helicobacter pylori?

Results from epidemiological studies and therapeutic clinical trials have shown that Helicobacter pylori infection causes acute and chronic active gastritis and is the initiating factor for the majority of peptic ulcer disease. Eradication of the infection with antibiotics resolves gastritis and restores normal gastric physiology, accelerates healing of peptic ulcer disease, and virtually eliminates recurrence of duodenal ulcer disease. The infection also plays an important role in the initiation and/or progression of gastric atrophy and intestinal metaplasia, which may eventually lead to the development of distal gastric cancer. Furthermore, almost all patients with gastric MALT lymphoma are infected with H. pylori and cure of the infection leads to histological regression of the tumor and maintains the regression in over 80% of patients during long-term follow-up. Preliminary uncontrolled data from Japan show that eradication of the infection significantly reduced metachronous intestinal-type gastric cancer following initial endoscopic resection of early gastric cancer and might also prevent the progression of gastric adenoma to gastric dysplasia or gastric cancer. Although this overwhelming evidence has demonstrated that H. pylori infection is bad for humans, some have questioned the wisdom of eradicating the infection in all those infected. Their arguments are largely based on hypothesis and circumstantial evidence: 1) Less than 20% of all H. pylori infected persons will develop significant clinical consequences in their lifetime. 2) H. pylori strains are highly diverse at a genetic level and are of different virulence. 3) The antiquity of H. pylori infection in humans and their co-evolution suggests that H. pylori may be a commensal to humans. Eradication of H. pylori may remove some beneficial bacterial strains and may provoke esophageal disease or gastric cancer at the cardia. However, careful review of the literature confirms that H. pylori infection is a serious pathogen albeit in a minority of those infected. It remains for carefully designed prospective studies, rather than hypothesis to make changes in the current consensus position.

[Eukaryotic expression and in vitro tumor cell apoptosis-induced effect of human TRAIL]

OBJECTIVE

To explore the tumor cell apoptosis induced by the effect in vitro of eukaryotic expression of full-length TRAIL cDNA and its extracellular region.

METHODS

The eukaryotic expression vectors for both forms of the cDNA acquired from the fetal heart cDNA library were constructed. After gene transfecting, the stable expression cell lines were obtained by G418 screening.

RESULTS

The supernatants from tansfectants could induce apoptosis of different tumor cell lines in vitro, and an enhanced effect was observed by adding TFAR19 (TF-1 cell apoptosis-related protein 19), a novel apoptosis gene product discovered in our laboratory.

CONCLUSION

Eukaryotic expression products of TRAIL can induce apoptosis of the tumor cells, and TFAR19 could enhance the effect on apoptosis of tumor cells.

Cost effectiveness in Canada of a multidrug prepackaged regimen (Hp-PAC)+ for Helicobacter pylori eradication

OBJECTIVE

To assess the cost effectiveness of a multidrug prepackaged regimen for Helicobacter pylori, the Hp-PAC (lansoprazole 30mg, clarithromycin 500 mg, amoxicillin 1 g, all twice daily), relative to alternative pharmacological strategies in the management of confirmed duodenal ulcer over a 1-year period from 2 perspectives: (i) a strict healthcare payer perspective (Ontario Ministry of Health) excluding the patient copayment; and (ii) a healthcare payer perspective including the patient copayment.

DESIGN

A decision-analytical model was developed to estimate expected per patient costs [1998 Canadian dollars ($ Can)], weeks without ulcer and symptomatic ulcer recurrences for the Hp-PAC compared with: proton pump inhibitor (PPI)-clarithromycin-amoxicillin (PPI-CA), PPI-clarithromycin-metronidazole (PPI-CM), PPI-amoxicillin-metronidazole (PPI-AM) and ranitidine-bismuthmetronidazole-tetracycline (RAN-BMT).

MAIN OUTCOME MEASURES AND RESULTS

All PPI-based regimens had higher expected costs but better outcomes relative to RAN-BMT. From a strict healthcare payer perspective, PPI-CM ($Can 209) yielded lower expected costs than PPI-CA ($Can 221) and slightly lower costs than Hp-PAC ($Can 211). However, these 3 regimens all shared identical outcomes (51.2 weeks without ulcer). When the current Ontario, Canada, $Can 2 patient copayment was added to the dispensing fee, Hp-PAC yielded lower costs ($Can 214) than PPI-CM ($Can 216).

CONCLUSION

From a strict healthcare payer perspective, Hp-PAC is weakly dominated by PPI-CM with an incremental cost effectiveness (relative to RAN-BMT) of $Can 5.77 per ulcer week averted. When the patient copayment is added to this perspective, Hp-PAC weakly dominates PPI-CM ($Can 5 per ulcer week averted). Regardless of perspective, Hp-PAC and PPI-CM differed by only $Can 2 per patient over 1 year and the expected time without ulcer was 51.2 weeks for both. More data on the clinical and statistical differences in H. pylori eradication with Hp-PAC and PPI-CM would be useful. This analysis does not in clude the possible advantage of Hp-PAC in terms of compliance and antibacterial resistance.

Synthesis and characterization of three tetranuclear clusters containing a [Mo3OS3Sn]6+ cubane-like core

Three heterometallic cubane-like clusters, [Mo3(mu 3-O)(mu 3-S)3(SnCl3)(dtp)3(py)3] (dtp = S2P(OC2H5)2-, py = C5H5N) (1), (PPN)[Mo3(mu 3-O)(mu 3-S)3(SnCl3)(dtp)3(mu-OAc)(py)] (OAc = CH3COO-, PPN = (C6H5)3PNP(C6H5)3+) (2), and (Et4N)[Mo3(mu 3-O)(mu 3-S)3(SnCl3)(dtp)2(mu-OAc)2(py)] (3) have been prepared by the reaction of [Mo3(mu 3-O)-(mu-S)3(dtp)4(H2O)] (4), [Mo3(mu 3-O)(mu-S)3(dtp)3(OAc) (py)] (5), and [Mo3(mu 3-O)(mu-S)3(dtp)2(OAc)2 (py)] (6) with SnCl2, respectively. They have been characterized by IR, UV-vis, 31P NMR, 95Mo NMR, and X-ray structure analysis. All of these heterometallic clusters have a [Mo3OS3Sn]6+ core but contain a different arrangement of peripheral ligands. As far as the neutral cluster 1 is concerned, there is no bridging OAc ligand, while only one bridging OAc ligand is observed for cluster 2 and two are for cluster 3. The Mo-Mo distances are about 0.03-0.04 A shorter than those of the starting trimolybdenum clusters. This indicates that the incorporation of SnCl3- fragment into (Mo3) clusters makes the Mo-Mo bonding enhanced. Crystal data for 1: triclinic, space group P-1, a = 10.7423(2) A, b = 14.0357(1) A, c = 16.9346(2) A, alpha = 84.054(1) degrees, beta = 87.095(1) degrees, gamma = 84.517(1) degrees, V = 2525.82(6) A3, Z = 2, R = 0.038 for 5584 reflections (I > 2.0 sigma(I)). Crystal data for 2: triclinic, space group P-1, a = 12.9529(1) A, b = 15.6324(2) A, c = 19.6355(1) A, alpha = 92.083(1) degrees, beta = 97.908(1) degrees, gamma = 110.337(1) degrees, V = 3677.41(6) A3, Z = 2, R = 0.034 for 8665 reflections (I > 2.0 sigma(I)). Crystal data for 3: monoclinic, space group P2(1)/n, a = 14.0852(5) A, b = 15.1324(5) A, c = 23.2691(7) A, beta = 97.371(1) degrees, V = 4918.7(3) A3, Z = 4, R = 0.049 for 4970 reflections (I > 2.0 sigma(I)).

Review article: Helicobacter pylori and gastric cancer--the clinicians'point of view

Although the incidence of gastric cancer has declined dramatically in Western countries, the most recent data from the International Agency for Research on Cancer show that it remains the second most common cancer worldwide and caused 628 000 deaths in 1990. The incidence and prevalence of gastric cancer are projected to increase over the next few decades in less developed countries as a result of the increased longevity of H. pylori-infected populations and improved therapies. Gastric carcinogenesis is a multistep and multifactorial process beginning with H. pylori-associated gastritis in most cases. H. pylori infection, together with other environmental factors and individual susceptibility, determine the final risk for the development of gastric cancer. The magnitude of H. pylori infection as a risk factor for gastric cancer in the published H. pylori and gastric cancer epidemiology studies may have been underestimated due to the inclusion of improperly selected controls. Eradication of the infection has been shown to prevent the occurrence of metachronous gastric cancer following endoscopic resection of early gastric cancer in a Japanese study. However, the generalization of this study to other populations is difficult because of the vast differences in the definition of gastric atrophy and early gastric cancer between Japanese and Western pathologists. Until an international consensus on the pathological diagnosis of gastric atrophy and early gastric cancer is reached, interpretation of studies performed in different countries remains difficult. Clinicians rely on the correct pathological diagnosis to guide the management of H. pylori infection-associated gastrointestinal diseases.

In vivo myocardial infarct size reduction by a caspase inhibitor administered after the onset of ischemia

The aim of this study was to determine the effect of different administration protocols on the cardioprotective efficacy of the non-selective, irreversible caspase inhibitors N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone (zVAD.fmk) and bocaspartyl-(OMe)-fluoromethylketone (BocD.fmk) in a rat in vivo ischemia and reperfusion paradigm. Hearts were made ischemic for 45 min and reperfused for 180 min. Under these conditions, it was determined that zVAD.fmk was cardioprotective when administered before or after the onset of ischemia, whereas BocD.fmk was efficacious only when administered before the onset of ischemia. This is the first report of in vivo cardioprotection by a caspase inhibitor when administered after the onset of ischemia.

Therapeutic effects of the endothelin receptor antagonist Ro 48-5695 in the TNBS/DNBS rat model of colitis

OBJECTIVE

Endothelins can act as polyfunctional cytokines. It is therefore possible that endothelins could play an active role in gut inflammation. Elevated levels of endothelin-1 have been reported in ulcerative colitis and Crohn's disease. The aim of this study was to establish the therapeutic effect of a 'new' endothelin receptor antagonist Ro 48-5695 in an animal model of inflammatory bowel disease. This study compares the effect of Ro 48-5695 on colonic damage induced by two haptens: trinitrobenzenesulphonic (TNBS) or dinitrobenzenesulphonic acid (DNBS).

METHODS

Colitis was induced by intra-rectal administration of TNBS or DNBS. After TNBS/DNBS injury, rats were treated with 10.0, 3.0, 1.0 or 0.3 mg/kg of Ro 48-5695 orally, daily for 5 days. On day 6 post-hapten treatment, colonic tissues were removed and examined in a blinded fashion for macroscopic damage (damage score) and myeloperoxidase (MPO) activity. Stool consistency and adhesions were also measured.

RESULTS

Oral administration of Ro 48-5695 almost completely prevented TNBS-induced damage at a dose of 10 mg/kg. The same dose in this model also had a therapeutic effect as measured by MPO and incidence of diarrhoea and adhesions. In DNBS-induced colonic damage, Ro 48-5695 was more potent and at 1.0 and 3.0 mg/kg decreased the damage score by 50 and 60% respectively; also the incidence of adhesions and diarrhoea was significantly reduced. However, MPO activity in this model was affected only by the highest dose of Ro 48-5695 tested (3.0 mg/kg) where it was reduced by 48%.

CONCLUSIONS

These data provide evidence for the involvement of endothelins in the pathophysiology of inflammatory bowel disease and support the possibility of exploring a new therapeutic approach.

Gastrointestinal safety profile of nabumetone: a meta-analysis

Individual comparative studies suggest that nabumetone has a gastrointestinal (GI) safety profile superior to comparator NSAIDs but lack power to show a statistical difference. The aim of this study was to evaluate systematically the difference in GI adverse events--especially the rate of perforations, ulcers, and bleeds (PUBs)-- between studies, meta-analyses of comparative trials of nabumetone and conventional NSAIDs, and postmarketing, open-label studies of nabumetone meeting predefined inclusion and exclusion criteria. A fully recursive literature search identified 13 studies consisting of 29 treatment arms and 49,501 patients that met the predefined criteria. Tests for heterogeneity found no significant difference between studies of each subgroup. Overall, the dyspeptic symptoms flatulence, constipation, and diarrhea were the most commonly reported adverse events accounting for 98.6% of the total GI adverse events. Significantly more patients treated with a comparator NSAID experienced GI adverse events than did those taking nabumetone (P = 0.007). After adjustment for patient-exposure years, PUBs were 10 to 36 times more likely to develop in patients treated with a comparator NSAID than with nabumetone. This was consistently seen in patients in nonendoscopic (n = 7,468) and endoscopic studies (n = 244). In the analysis of postmarketing or open-label studies of nabumetone, only one PUB was reported per 500 patient-exposure years over 17,502 treatment years (n = 39,389). GI adverse event-related dropouts and hospitalizations were increased by 1.3- and 3.7-fold if patients were treated with a comparator NSAID than with nabumetone. Significantly fewer treatment-related GI adverse events, especially PUBs, are seen in patients treated with nabumetone than with a comparator NSAID. Nabumetone is very safe for the GI tract.

II. Characterization and development of the regional- and cellular-specific abnormalities in the epididymis of mice with beta-hexosaminidase A deficiency

Beta-hexosaminidase (Hex) is a lysosomal enzyme that exists as two isoenzymes: Hex A (subunit structure alphabeta) and Hex B (betabeta). Its presence in the testis and epididymis suggests important roles for Hex and its substrates in male fertility and reproductive functions. Disruption of the Hexa gene encoding the alpha-subunit of Hex has led to the generation of a mildly affected mouse model of human Tay-Sachs disease, allowing us the opportunity to analyze the effects of isolated Hex A deficiency on epithelial cellular morphology of the male reproductive tract. At 5 weeks and at 3, 5, and 12 months, the testes, efferent ducts and epididymides of Hex A-deficient (Hexa -/-) and wild-type (Hexa +/+) mice were perfuse fixed and analyzed by routine light and electron microscopy as well as with immunocytochemistry employing antibodies to lysosomal enzymes. In the testis, the seminiferous epithelium of Hexa -/- mice appeared comparable to that of wild-type mice in appearance and topographical arrangement of its cell types at all ages examined. Also, no differences were noted for the efferent ducts. In contrast, there were striking abnormalities in the epididymides of the mutant mice; however, the abnormalities were mainly restricted to the initial segment and intermediate zone. Principal cells of these regions at 5 weeks showed a dramatic increase in the number of lysosomes as compared with those from wild-type animals, and this progressed with increasing age. Furthermore, unlike the few small lysosomes present in wild-type mice, those of Hexa -/- mice were at times enlarged and often filled the supranuclear and basal regions of these cells. In the light microscope, large, dense cellular aggregates were noted at the base of the epithelium in the proximal initial segment that corresponded in the electron microscope to two different cell types, both of which increased in size with age. One aggregate was considered to belong to narrow cells on the basis of the presence of numerous cup-shaped vesicles characteristic of these cells; they appeared to be dislocated from the upper half of the epithelium. In the distal initial segment and intermediate zone, narrow cells were readily identified, but rather than being slender as in the control animals, they were greatly enlarged and filled with pale lysosomes in mutant mice. The second type of cellular aggregate noted in the proximal initial segment corresponded to halo cells. They contained numerous small and large lysosomes and small, Golgi-related, dense, core granules characteristic of halo cells. On the basis of the large size of these cells, they appeared to be actively internalizing substances from the intercellular space. In contrast, principal and clear cells of the caput, corpus, and cauda regions did not appear to show a significant increase in number or size of lysosomes as compared with those of wild-type animals. All structures identified as lysosomes in the various cell types were immunoreactive for cathepsin D. The present data thus reveal that isolated Hex A deficiency results in region- and cell-specific abnormalities in the epididymis but in no apparent abnormalities in the testis or efferent ducts. Specific roles for Hex A that cannot be compensated for by other isozymes of Hex appear to exist within lysosomes of epithelial cells predominantly of the initial segment and intermediate zone. Taken together, the results also suggest that the inability to degrade endocytosed substrates normally acted upon by Hex A in lysosomes of principal and narrow cells leads to their accumulation, eventual fusion, and increased size.

I. Abnormalities in cells of the testis, efferent ducts, and epididymis in juvenile and adult mice with beta-hexosaminidase A and B deficiency

Beta-hexosaminidase (Hex) is a lysosomal enzyme that exists as two major isoenzymes: Hex A (subunit structure, alphabeta) and Hex B (betabeta). The presence of Hex in the testis and epididymis suggests important roles for the enzyme and its substrates in male fertility and reproductive functions. Disruption of the Hexb gene encoding the beta-subunit of Hex has led to the generation of a mouse model of human Sandhoff disease that survives to adulthood, enabling us to analyze the effects of Hex A and Hex B deficiency on epithelial cellular morphology of the male reproductive tract. At 1 and 3 months of age, the testes, efferent ducts, and epididymides of Hex-deficient (Hexb -/-) and wild-type (Hexb +/+) mice were perfuse fixed and analyzed by routine light and electron microscopy (LM and EM, respectively) as well as with immunocytochemistry employing antibodies to lysosomal proteins. In the testis, the morphological appearance and topographical arrangement of the cell types of the seminiferous epithelium of Hexb -/- mice were similar to those of wild-type animals at both ages. Both Sertoli and germ cells appeared to be unaffected. However, at both ages, myoid cells and macrophages showed an increased number of lysosomes in their cytoplasm as compared with the number seen in controls. The epithelial cells of the efferent ducts also showed an accumulation of lysosomes that increased with age as compared with controls. Principal cells of the entire epididymis revealed an increase in the size and number of lysosomes at 1 month of age as compared with those of controls, and by 3 months, these lysosomes often filled the supranuclear and basal regions of the cells. Narrow cells of the distal initial segment and intermediate zone, normally slender cells showing several lysosomes, became greatly enlarged and entirely filled with lysosomes in Hexb -/- mice. Clear cells of the caput, corpus, and cauda regions also showed a progressive increase in the size and number of lysosomes with age as compared with controls; the clear cells of the mutant mice were often enlarged and at times bulged into the lumen. Some basal cells of each epididymal region in Hexb -/- mice were similar to controls at 1 and 3 months, showing few lysosomes, while others showed an accumulation of lysosomes. Lysosomes of all affected epithelial cells were of varying sizes, but many large ones were present, apparently resulting from lysosomal fusion. Although pale stained, their identification as lysosomes was confirmed by EM immunocytochemistry with anti-cathepsin D and anti-Hex A antibodies. Predominantly in the proximal initial segment, large, pale cellular aggregates were noted in the LM analysis at the base of the epithelium, which by EM analysis were identified as belonging to two different cell types, narrow cells and halo cells. Taken together, these data reveal an increase in the size and number of lysosomes in all epithelial cell types lining the efferent ducts and entire epididymis as well as in myoid cells and macrophages of the testis. In the light of data showing epididymal defects restricted predominantly to the initial segment in Hexa -/- (Hex A-deficient) mice, our data on the Hexb -/- mice demonstrate a major role for Hex that can be fulfilled by either Hex A or Hex B in the epididymis.

A new model of cancer cachexia: contribution of the ubiquitin-proteasome pathway

A new model of cachexia is described in which muscle protein metabolism related to the ubiquitin-proteasome pathway was investigated. Cloning of the colon-26 tumor produced a cell line, termed R-1, which induced cytokine (noninterleukin-1beta, interleukin-6 and tumor necrosis factor-alpha)-independent cachexia. Implantation of R-1 cells in mice elicited significant (20-30%) weight loss and decreased blood glucose by 70%, and adipose tissue levels declined by 95% and muscle weights decreased by 20-25%. Food intake was unaffected. The decrease in muscle weight reflected a decline in insoluble, but not soluble, muscle protein that was associated with a significant increase in net protein degradation. The rate of ubiquitin conjugation of proteins was significantly elevated in muscles of cachectic mice. Furthermore, the proteasome inhibitor lactacystin blocked the increase in protein breakdown but had no significant effect on proteolysis. Several markers of the ubiquitin-proteasome pathway, E2(14k) mRNA and E2(14k) protein and ubiquitin-protein conjugates, were not elevated. Future investigations with this new model should gain further insights into the mechanisms of cachexia and provide a background to evaluate novel and more efficacious therapies.

Treatment after failure: the problem of "non-responders"

Although the currently most effective treatment regimens cure about 90% of infections, 10% of patients remain Helicobacter pylori positive. Several factors contribute to treatment failure. These include patient compliance, bacterial resistance to antibiotics, and treatment related issues. Treatment failure leads to the development of bacterial resistance to metronidazole and clarithromycin. Retreatment can be undertaken after considering several different strategies: to repeat the same regimen with full doses of medications and a longer treatment duration, or to choose different regimens to avoid the antibiotic previously used, or to switch to proton pump inhibitor (PPI) based quadruple therapy or ranitidine bismuth citrate (RBC) based triple therapy. In principle, full doses and longer treatment durations are advisable. As retreatment is always difficult, choosing the best available first line treatment regimen is still the best "rescue" treatment.

[A quick method to estimate the T-DNA copy number in transgenic rice using inverse PCR (IPCR)]

In order to obtain single T-DNA copy transgenic rice, we have established a quick method to estimate the T-DNA copy number in transgenic rice using inverse PCR (IPCR). IPCR was used to amplify junction fragments, i.e. plant genomic DNA sequences flanking the known T-DNA sequences, which will help to estimate the T-DNA copy number in transgenic rice. We have analyzed 20 transgenic plants of 15 transgenic lines. Most plants (12) contain one integrated T-DNA copy per genome, 3 plants contain two and 1 plant contains 3 copies. In 4 transgenic plants no T-DNA copies could be detected using this method. The IPCR results were further tested by Southern analysis and sequence analysis.