Developing and validating a prognostic model for mortality in patients with heart failure

Background

Heart Failure (HF) constitutes a major public health problem which remains highly prevalent in the UK and globally. Primary care plays a role in the long-term management of patients with heart failure but there are no clinically useful prognostic models to guide primary care professionals in determining those at increased risk of mortality, who could benefit from appropriate advanced care planning or escalation of treatment. Several predictive models exist but due to several limitations, clinical utility of these in the UK are limited.

Purpose

This study developed and validated a prognostic algorithm, the Nottingham Heart Failure Model, to predict the one-year risk of all-cause mortality in patients with HF.

Methods

This was a retrospective open cohort study using electronic primary care records from the UK Clinical Practice Research Datalink (CPRD) linked with secondary care records from Hospital Episode Statistics (HES) and death registration data from the Office for National Statistics (ONS). Adults with a diagnosis of heart failure were identified and multivariable Cox regression models were used to identify the risk factors that were independently associated with mortality. A prognostic model was developed to predict the one-year risk of mortality in patients with heart failure, and this was validated by bootstrapping 200 samples of the derivation data. The cohort was then split into even quartiles based on predicted risk scores from the model. These risk groups ranged from one to four with one indicating the quartile of scores with the lowest risk. Kaplan Meier curves were then produced for each group. The Royston D-statistic was then used to assess the discrimination of these quartiles by quantifying the observed separation between these groups.

Results

A total of 109,577 patients with diagnoses of heart failure were followed up from 1 January 2000 to 31 December. There were 16,437 deaths during the period of follow up. We identified 29 factors which were significantly associated with mortality risk and a prognostic model which incorporated these factors, was developed. The resulting prognostic model obtained a model validation score (C-statistic) of 0.79. The agreement between the observed and predicted proportion of events showed excellent apparent calibration. The D statistic of 1.65 suggests that the model provides a reasonably high amount of prognostic separation.

Conclusion(s)

Several patient characteristics including comorbidities, treatments, and biomarkers are significantly associated with heart failure mortality. This new model has the potential to accurately predict heart failure mortality within one year and will enable primary care professionals to better risk stratify their patients with heart failure.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): The Aziz Foundation

Ethnic disparities in mortality among overweight or obese adults with newly diagnosed type 2 diabetes: a population-based cohort study

PURPOSE

Ethnic variation in risk of type 2 diabetes is well established, but its impact on mortality is less well understood. This study investigated the risk of all-cause and cardiovascular mortality associated with newly diagnosed type 2 diabetes in White, Asian and Black adults who were overweight or obese.

METHODS

This population-based cohort study used primary care records from the UK Clinical Practice Research Datalink, linked with secondary care and death registry records. A total of 193,528 obese or overweight adults (BMI of 25 or greater), with ethnicity records and no pre-existing type 2 diabetes were identified between 01 January 1995 and 20 April 2018. Multivariable Cox proportional hazards regression estimated hazards ratios (HR) for incident type 2 diabetes in different ethnic groups. Adjusted hazards ratios for all-cause and cardiovascular mortality were determined in individuals with newly diagnosed type 2 diabetes.

RESULTS

During follow-up (median 9.8 years), the overall incidence rate of type 2 diabetes (per 1,000 person-years) was 20.10 (95% CI 19.90-20.30). Compared to Whites, type 2 diabetes risk was 2.2-fold higher in Asians (HR 2.19 (2.07-2.32)) and 30% higher in Blacks (HR 1.34 (1.23-1.46)). In individuals with newly diagnosed type 2 diabetes, the rates (per 1,000 person-years) of all-cause mortality and cardiovascular mortality were 24.34 (23.73-24.92) and 4.78 (4.51-5.06), respectively. Adjusted hazards ratios for mortality were significantly lower in Asians (HR 0.70 (0.55-0.90)) and Blacks (HR 0.71 (0.51-0.98)) compared to Whites, and these differences in mortality risk were not explained by differences in severity of hyperglycaemia.

CONCLUSIONS/INTERPRETATION

Type 2 diabetes risk in overweight and obese adults is greater in Asian and Black compared to White ethnic populations, but mortality is significantly higher in the latter. Greater attention to optimising screening, disease and risk management appropriate to all communities with type 2 diabetes is needed.

Anatomical dilation for the coronary sinus ostium in patients with pulmonary arterial hypertension and its impact to trigger the atrioventricular reentrant tachycardia: a case control study

Background

The incidence of atrioventricular reentrant tachycardia (AVNRT) in pulmonary arterial hypertension (PAH) patients is higher than the general population [1–3]. AVNRT had been reported with larger coronary sinus (CS) ostium in general population, while the mechanism and correlation between AVNRT and the CS ostium in PAH patients are poorly understood.

Purpose

We aim to investigate the impact of the CS ostium on AVNRT and find out its risk factors in PAH patients.

Methods

Of 102 pulmonary arterial hypertension (PAH) patients with catheter ablation of SVT, 10 patients confirmed AVNRT who underwent computed tomographic angiography (CTA) were enrolled as study group. The control group (PAH patients without SVT, n=20) were matched in a ratio of 2:1 based on gender and BMI. We measured maxium diameter of CS ostium in axial and LAO plane by CTA. All baseline characteristics and imaging materials were collected.

Results

PAH patients with AVNRT were older (45.9±14.8 vs. 32.1±7.6 years, P=0.025) and more likely to have larger CS ostium in LAO plane (18.6±3.3 vs. 14.8±4.0 mm, P=0.011) than those without AVNRT. The maximal diameter of CS ostium in LAO plane was an independent predictor for AVNRT in PAH patients (Odds ratio, 1.389; 95% confidence interval, 1.003–1.923; P=0.048). The cut-off value of CS ostium in LAO plane was 14.1mm (Area under curve = 0.79, P=0.012), and the sensitivity and specificity were 90% and 55%, respectively.

Conclusions

The larger CS ostium in LAO plane correlated with the higher prevalence of AVNRT in PAH patients with age. Patients with CS ostium larger than 14.1mm in LAO plane are more likely to develop AVNRT.

Funding Acknowledgement

Type of funding sources: None. Measurements and diagnosis value

[GCS score combined with CT score and serum S100B protein level Can evaluate severity and early prognosis of acute traumatic brain injury]

OBJECTIVE

To explore the value of Glasgow Coma Scale (GCS) score and CT score combined with serum S100B protein level for evaluation of injury severity and predicting early prognosis of acute traumatic brain injury (TBI).

OBJECTIVE

A total of 108 patients with TBI admitted within 24 h after injury in the Emergency Department of West China Hospital from May, 2019 to May, 2020 were enrolled in this study. The clinical data, laboratory test results, CT examination, GCS score, Full Outline of Unresponsiveness score, Fisher CT classification, Rotterdam CT score, and serum S100B protein level of the patients were collected upon admission. The patients were followed up for 28 days and divided based on their Glasgow Outcome Scale (GOS) scores into poor prognosis group (GOS 1-3) and good prognosis group (GOS 4-5). The indexes related to poor prognosis were analyzed for their efficacy for predicting the patinets' prognosis. According to the results of head CT, the patients were divided into CT^- positive (CT⁺) group and CT^- negative (CT^-) group, and the efficacy of serum S100B protein level for predicting CT positivity was evaluated.

OBJECTIVE

Compared with those with favorable prognosis, the patients with poor prognosis had significantly lower GCS scores (P < 0.01) and higher Rotterdam CT score and serum S100B protein levels (P < 0.01). Among the 3 index, serum S100B protein level had the highest AUC value (0.79); among the combined indexes, GCS score combined with serum S100B protein had the highest AUC value (0.80). Serum S100B protein level was significantly higher in CT⁺ group than in CT - group (P < 0.05) with a significant correlation with Rotterdam CT score (r=0.26, P < 0.01).

OBJECTIVE

Serum S100B protein level, GCS score, and Rotterdam CT score can be used as indicators for evaluating the severity of acute TBI, and they are all closely related with early prognosis of the patients. The combination of serum S100B protein, GCS score and Rotterdam CT score has better performance than any of the 3 indexes alone for predicting early prognosis of the patients. Serum S100B protein level is correlated with head imaging findings of patients with acute TBI, but its value in selection of appropriate imaging modalities awaits further investigation.

Community diversity and abundance of ammonia-oxidizing archaea and bacteria in shrimp pond sediment at different culture stages

AIMS

Ammonia oxidation is a significant process of nitrogen cycles in a lot of ecosystems sediments while there are few studies in shrimp culture pond (SCP) sediments. This paper attempted to explore the community diversity and abundance of ammonia-oxidizing archaea (AOA) and ammonia-oxidizing bacteria (AOB) in SCP sediments at different culture stages.

METHODS AND RESULTS

We collected SCP sediments and analysed the community diversity and abundance of AOA and bacteria in shrimp pond sediment at different culture stages using the ammonia monooxygenase (amoA) gene with quantitative PCR (qPCR) and 16S rRNA gene sequencing. The AOB-amoA gene abundance was showed higher than AOA-amoA gene abundance in SCP sediments on Day 50 and Day 60 after shrimp larvae introducing into the pond, and the diversity of AOA in SCP sediments was higher than that of AOB. The phylogenetic tree revealed that the most of AOA were the member of Nitrosopumilus and Nitrososphaera, and the majority of AOB sequences were clustered into Nitrosospira, Nitrosomonas clusters 6a and 7. The AOA community has close relationship with total organic carbon (TOC), pH, total phosphorus (TP), nitrate reductase, urease, acid phosphatase and β-glucosidase. The AOB community was related to TOC, C/N and nitrate reductase.

CONCLUSIONS

AOA and AOB play the different ecological roles in SCP sediments at different culture stages.

SIGNIFICANCE AND IMPACT OF THE STUDY

Our results suggested that the different community diversity and abundance of AOA and AOB in SCP sediments, which may improve our ecological cognition of shrimp culture stages in SCP ecosystems.

Educational weight loss interventions in obese and overweight adults with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials

AIM

The worldwide prevalence of type 2 diabetes mellitus is increasing, with most individuals with the disease being overweight or obese. Weight loss can reduce disease-related morbidity and mortality and weight losses of 10-15 kg have been shown to reverse type 2 diabetes. This review aimed to determine the effectiveness of community-based educational interventions for weight loss in type 2 diabetes.

METHODS

This is a systematic review and meta-analysis of randomized controlled trials (RCT) in obese or overweight adults, aged 18-75 years, with a diagnosis of type 2 diabetes. Primary outcomes were weight and/or BMI. CINAHL, MEDLINE, Embase, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to June 2019. Trials were classified into specified a priori comparisons according to intervention type. A pooled standardized mean difference (SMD) (from baseline to follow-up) and 95% confidence intervals (95% CI) between trial groups (difference-in-difference) were estimated through random-effects meta-analyses using the inverse variance method. Heterogeneity was quantified using I² and publication bias was explored visually using funnel plots.

RESULTS

Some 7383 records were screened; 228 full-text articles were assessed and 49 RCTs (n = 12 461 participants) were included in this review, with 44 being suitable for inclusion into the meta-analysis. Pooled estimates of education combined with low-calorie, low-carbohydrate meal replacements (SMD = -2.48, 95% CI -3.59, -1.49, I²  = 98%) or diets (SMD = -1.25, 95% CI -2.11, -0.39, I²  = 95%) or low-fat meal replacements (SMD = -1.15, 95%CI -2.05, -1.09, I²  = 85%) appeared most effective.

CONCLUSION

Low-calorie, low-carbohydrate meal replacements or diets combined with education appear the most promising interventions to achieve the largest weight and BMI reductions in people with type 2 diabetes.

Texture analysis of multi-phase MRI images to detect expression of Ki67 in hepatocellular carcinoma

AIM

To determine whether texture analysis of preoperative magnetic resonance imaging (MRI) images could be used to detect Ki67 expression, a widely used cell proliferation marker in hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

In total, 83 patients were included, 25 with low Ki67 (Ki67 ≤10%) HCC expression and 58 with high Ki67 (Ki67 ≥10%) HCC expression as demonstrated by retrospective surgical evaluation. All patients were examined using a 3 T MRI unit with one standard protocol. The region of interest was drawn manually by one radiologist. Texture analysis included histogram, co-occurrence matrix, run-length matrix, gradient, auto-regressive model, and wavelet transform features as calculated by MaZda (version 4.6; quantitative texture analysis software). The features reduced by the Fisher, probability of classification error, and average correlation coefficient (POE+ACC), mutual information were used to select the features that predicted Ki67 proliferation status with highest accuracy and then using the B11 program for data analysis and classification.

RESULTS

The misclassification rate of the principal component analysis (PCA) in the hepatobiliary phase (HBP), T2-weighted imaging (T2WI), arterial phase (AP), and portal vein phase (PVP) was 36/83 (43.37%), 35/82 (42.68%), 40/83 (48.19%), and 34/83 (40.96%), respectively. The misclassification of the linear discriminant analysis in HBP, T2WI, AP, and PVP phase was 13/83 (15.66%), 21/82 (25.61%), 9/83 (10.84%), and 8/83 (9.64%), respectively. The misclassification of the nonlinear discriminant analysis in HBP, T2WI, AP, and PVP phase was 7/83 (8.43%), 6/82 (7.32%), 5/83 (6.02%), and 7/83 (8.43%), respectively.

CONCLUSIONS

Texture analysis of HBP, AP, and PVP were helpful for predicting Ki67 expression and may provide a less-invasive method to investigate critical histopathology markers for HCC.

Small hepatocellular carcinoma: using MRI to predict histological grade and Ki-67 expression

AIMS

To investigate the predictive indicators of small aggressive hepatocellular carcinomas by examining the association between preoperative magnetic resonance imaging (MRI) parameters and Ki-67 expression and histological grade.

MATERIALS AND METHODS

Sixty patients with small hepatocellular carcinomas (tumour diameter: ≤3 cm, tumour numbers: ≤2) who underwent curative resection or biopsy after contrast-enhanced and diffusion-weighted MRI were evaluated retrospectively. Signal intensity (SI) of the whole lesion and erector spinae muscle was measured quantitatively. Tumour-to-muscle SI ratio was calculated. The association between these MRI parameters and histological grade and Ki-67 level was then investigated.

RESULTS

There was a significant correlation between tumour-to-muscle SI ratio and histological grade in tissues captured during the non-enhanced T1-weighted (p=0.001), arterial phase (p=0.001), and portal venous phase (p=0.036) of dynamic contrast-enhanced MRI and apparent diffusion coefficient (p=0.027). Arterial inhomogeneous enhancement was also correlated with high-Ki-67 expression (p=0.032).

CONCLUSIONS

Preoperative MRI may serve as a non-invasive tool for prediction of small, aggressive hepatocellular carcinomas, which may otherwise be treated conservatively.

Comparative analysis of the bacterial community compositions of the shrimp intestine, surrounding water and sediment

AIMS

To reveal the relationship of the bacterial communities in shrimp intestine and surrounding environments.

METHODS AND RESULTS

We examined bacterial communities in the intestine of pacific white shrimp, Litopenaeus vannamei, the surrounding water and sediment by high-throughput sequencing analysis. Sequences were clustered into operational taxonomic units (OTUs) at 97% similarity levels, which ranged from 4956 to 5976 in each sample. All OTUs were affiliated with at least 64 phyla. The 10 most abundant phyla were Proteobacteria, Cyanobacteria, Bacteroidetes, Chloroflexi, Firmicutes, Acidobacteria, Actinobacteria, Planctomycetes, Gemmatimonadetes and Verrucomicrobia. The relationship of bacterial communities in the intestine and the surroundings was also investigated. A total of 1395 OTUs shared in the three habitats, accounting for 80, 65 and 77% in the intestine, the surrounding water and sediment respectively. There were 352, 891, 833 unique OTUs in intestine, surrounding water and sediment. Welch's t-test analysis showed that the abundances of some taxa were significantly different between the shrimp intestine and surroundings. Unweighted pair-group method with arithmetic mean analysis revealed that there was a generally similar bacterial community composition in three environments.

CONCLUSIONS

These results showed that the bacterial compositions are mostly the same in shrimp intestine, water and sediment, but with different relative abundances of the bacterial communities.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study provided valuable findings on the relationship of the bacterial communities in shrimp intestine, the surrounding water and sediment, which can expand our knowledge of the broad trend on bacterial community in shrimp cultural ecosystems.

Restoration of MYC-repressed targets mediates the negative effects of GM-CSF on RUNX1-ETO leukemogenicity

GM-CSF signaling regulates hematopoiesis and immune responses. CSF2RA, the gene encoding the α subunit for GM-CSF, is significantly downregulated in t(8;21) (RUNX1-ETO or RE) leukemia patients, suggesting that it may serve as a tumor suppressor. We previously reported that GM-CSF signaling is inhibitory to RE leukemogenesis. Here we conducted gene expression profiling of primary RE hematopoietic stem/progenitor cells (HSPCs) treated with GM-CSF to elucidate the mechanisms mediating the negative effects of GM on RE leukemogenicity. We observed that GM treatment of RE HSPCs resulted in a unique gene expression profile that resembles primary human cells undergoing myelopoiesis, which was not observed in control HSPCs. Additionally we discovered that GM-CSF signaling attenuates MYC-associated gene signatures in RE HSPCs. In agreement with this, a functional screen of a subset of GM-CSF-responsive genes demonstrated that a MYC inhibitor, MXI1, reduced the leukemic potential of RE HSPCs and t(8;21) AML cells. Furthermore, MYC knockdown and treatment with the BET inhibitor JQ1 reduced the leukemic potential of t(8;21) cell lines. Altogether, we discovered a novel molecular mechanism mediating the GM-CSF-induced reduction in leukemic potential of RE cells, and our findings support MYC inhibition as an effective strategy for reducing the leukemogenicity of t(8;21) AML.

The antitumor effects of OSU-HDAC42, a novel histone deacetylase inhibitor, in HER-2-positive breast cancer

e14587

Background: Elevated HER-2/neu expression in primary breast tumors is associated with frequent relapse and poor prognosis. For this reason, HER-2/neu has been actively pursued as a target for novel therapeutic agents. Histone deacetylase inhibitors (HDACi), a new class of antitumor drugs, can downregulate HER2 through hyperacetylation of heat shock protein 90 (hsp90), an important ATP-dependent chaperone that mediates the stability and maturation of a variety of important oncogenic proteins, including HER2, Akt and ERα. In this study, we assess the effects of OSU-HDAC42, a novel orally bioavailable phenylbutyrate-based HDAC inhibitor, on hsp90 and HER2 downregulation. Methods: OSU-HDAC42 was tested for effects on the human breast cancer cell lines BT474, SKBR3, MDA-MB-231 and MCF-7. Assays of cell viability, cell cycle, apoptosis, HER2 expression, phosphorylation, and hsp90 acetylation were performed. Tumor growth was assessed in an orthotopic HER2+ mammary tumor model, using diets ± OSU-HDAC42. Results: SKBR3 (HER2+, ERα-) was the most susceptible to the antiproliferative effects of OSU-HDAC42 after 72 hours of treatment (IC50 = 0.025 μmol/L), followed by BT474 (HER2+, ERα+), MCF-7 (HER2-, ERα+) and MDA-MB-231 (HER2-, ERα-) cells with IC50 values calculated at 0.16, 0.19 and 0.2 μmol/L, respectively, which correlated with the level of inhibition of Hsp90 client protein expression (HER2, Akt). OSU-HDAC42 yields 43- or 65- fold greater cell killing than suberoylanilide hydroxamic acid (SAHA; vorinostat) or MS-275, respectively, and more potently suppresses the levels of Hsp90 client proteins (HER2, ERα and Akt) and induction of apoptosis in HER2+ breast cancer cells. In vivo administration of OSU-HDAC42 resulted in reductions of 76% and 82% in NT5 (HER2+,ER-) tumor mass and volume, respectively, concomitant with tubulin hyperacetylation, increased PARP cleavage, and decreased HER2 levels in OSU-HDAC42 treated mouse tumors. Conclusions: OSU-HDAC42 is a potent inhibitor of HER2+ breast cancer, mediated in part through hsp90 downregulation. As an orally bioavailable HDAC inhibitor with greater potency than other clinically available HDACi agents, OSU- HDAC42 warrants evaluation in clinical trials as a novel therapy for HER2+ breast cancer.

[Table: see text]

[Sudden blindness following operative care of a multiply traumatized patient: posterior ischemic optic neuropathy]

A 32-year-old man had fallen from an 8-m high scaffolding and had suffered multiple traumatic injuries, such as compression fractures of the thoracic vertebrae (TV) 5-7 without incarceration of the spinal canal plus a distal femoral fracture. During surgery on the day of the accident, spondylodesis and dorsal stabilization of TV 4-7 using an internal fixator were carried out and the distal femoral fracture was stabilized with a dynamic condylar screw (DCS). On the day following the accident, the malposition of a pedicle screw located at the height of TV 4 and the borderline malposition of a pedicle screw of TV 7 were corrected. Between the day of the accident and day 8 after, the patient developed impaired vision and in the further course amaurosis associated with fixed pupils. No organopathy could be noticed which could have explained the sudden vision loss. A study of the literature was done, using the keywords "blindness" and "spine surgery." Only very few cases describing a connection of spine surgery and postoperative vision loss could be found. This article aims to elaborate on the few connections worked out in these investigations.

Mining the structural knowledge of high-dimensional medical data using isomap

The paper describes an application of a new, non-linear dimensionality reduction method, named Isomap, for mining the structural knowledge from high-dimensional medical data. The algorithm was evaluated on two publicly available medical datasets: the pathological dataset of breast cancer (241 malignant samples) and the gene expression dataset from the lung (186 tumours). It was found by Isomap that the approximate intrinsic dimensionalities of these two datasets were as low as three. The spatial structures of both datasets were presented in low-dimensional space. Isomap, as a general tool for dimensionality reduction analysis, is helpful in revealing the nonlinear structural knowledge of high-dimensional medical data.

Protein kinase Calpha mediates the effect of antiarrhythmic peptide on gap junction conductance

We investigated the effects of the antiarrhythmic peptide AAP10 (GAG-4Hyp-PY-CONH2, 50 nM) on pairs of adult guinea pig cardiomyocytes and on pairs of HeLa-cells transfected with rat connexin43 (Cx43). Using double cell voltage clamp technique in cardiomyocytes under control conditions, gap junction conductance (Gj) steadily decreased (by -0.3 to -0.4 nS/min). In contrast, 50 nM AAP10 significantly enhanced Gj (by +0.22 to +0.29 nS/min). This effect of AAP10 could be significantly antagonized by bisindolylmaleimide I (BIM), and by the protein kinase C (PKC) subtype-specific inhibitors HBDDE (PKCgamma and -alpha) and CGP 54345 (PKCalpha). In HeLa-Cx43 cells we found similar electrophysiological effects of AAP10. For further analysis, we incubated HeLa-Cx43 cells with [32P]orthophosphate (0.05 mCi/ml) for 4 h at 37 degrees C followed by addition of 50 nM AAP10 for 15 min. We found that incorporation of 32P into Cx43 was significantly enhanced in the presence of AAP10, which was completely inhibited in presence of BIM. PKC enzyme-linked immunosorbent assay (ELISA) revealed significant activation of PKC by AAP10 in HeLa-Cx43 cells, which could be inhibited by HBDDE and CGP 54345. Finally, a binding study using [14C]-AAP10 as radioligand was performed. We found a saturable binding of [14C]-AAP10 with a KD of 0.88 nM to cardiac membrane preparations. For assessment of the antiarrhythmic activity in anesthetized rats, we infused aconitine until the occurrence of ventricular fibrillation (VF). The aconitine dose required for initiation of VF was significantly enhanced in the presence of AAP10. In conclusion; AAP10 increases Gj in both adult cardiomyocytes and transfected HeLa-Cx43 cells. AAP10 leads to enhanced phosphorylation of Cx43 via activation of PKCalpha. A membrane receptor exists for antiarrhythmic peptides.

[Determination of isorhamnetine and quercetin in flavone hippophaes tablets by HPLC method]

OBJECTIVE

A method was established for the determination of isorhamnetine and quercetin in flavone hippophaes tablets by HPLC.

METHODS

The HPLC system consisted of Diamonsil C18 column (250 mm x 4.6 mm, 5 microns), mobile phase of methanol-0.02 mol/L phosphoric acid (54:46), column temperature at 40 degrees C, with detection at 368 nm.

RESULTS

The linear range of isorhamnetine and quercetin were 6.5-32 micrograms/ml (r = 0.9996) and 2.5-12.4 micrograms/ml (r = 0.9991). The average recoveries were 99.4% and 99.8%, respectively. The within-day precision RSD were 1.22% and 1.32% (n = 6), and the day-to-day precision RSD were 1.07% and 1.35% (n = 5), respectively.

CONCLUSION

This method is simple and accurate. It is suitable for the preparation quality control.

The regulatory action of Radix Astragali on M-cholinergic receptor of the brain of senile rats

The changes in density of M-cholinergic receptors in different areas of senile rats and the regulatory action of Huang Qi ([symbol: see text] Radix Astragali, a drug for warming yang and replenishing qi) were observed by autoradiography. The results showed that the gray scale displayed in brain sections was clear and mainly distributed in the cortex, hippocampus and striate body, while that due to nonspecific combination was negligible. The gray scale in the cortex, hippocampus and striate body of the experimental group was markedly lower than that in the young control rats, decreased respectively by 24.87%, 14.12% and 12.76% (all P < 0.05); but it was obviously higher than those in the senile control rats, increased respectively by 24.15%, 14.38% and 13.47% (P < 0.05). The data indicate that Huang Qi ([symbol: see text]Radix Astragali) may up-regulate the decreased density of M-cholinergic receptors in the brain of senile rats.

Complexation of trivalent lanthanide cations by D-ribose in the solid state. The crystal structure and FT-IR study of PrCl3-alpha-D-ribopyranose-5H2O

The crystal structure of praseodymium chloride.alpha-D-ribopyranose pentahydrate, PrCl3-C5H10O5-5 H2O, M(r)=487.47, a=9.1989(8), b=8.8214(7), c=9.8233(9) A, beta=94.060(3) degrees, V=795.2(1) A(3), Z=2, mu=0.71073 A and R=0.0418 for 1923 observed reflections and 172 parameters has been determined. The sugar provides three hydroxyl groups, ax-eq-ax for coordination. The Pr(3+) ion is nine-coordinated with five Pr-O bonds from water molecules, three from hydroxyl groups and one from chloride. The OH, CO stretching vibrations and COH bending vibrations are shifted in the complex IR spectrum and the hydroxyl groups, water molecules, chloride ions form an extensive hydrogen-bond network.

PPARalpha deficiency reduces insulin resistance and atherosclerosis in apoE-null mice

PPARalpha is a ligand-dependent transcription factor expressed at high levels in the liver. Its activation by the drug gemfibrozil reduces clinical events in humans with established atherosclerosis, but the underlying mechanisms are incompletely defined. To clarify the role of PPARalpha in vascular disease, we crossed PPARalpha-null mice with apoE-null mice to determine if the genetic absence of PPARalpha affects vascular disease in a robust atherosclerosis model. On a high-fat diet, concentrations of atherogenic lipoproteins were higher in PPARalpha(-/-)apoE(-/-) than in PPARalpha(+/+)apoE(-/-) mice, due to increased VLDL production. However, en face atherosclerotic lesion areas at the aortic arch, thoracic aorta, and abdominal aorta were less in PPARalpha-null animals of both sexes after 6 and 10 weeks of high-fat feeding. Despite gaining as much or more weight than their PPARalpha(+/+)apoE(-/-) littermates, PPARalpha(-/-)apoE(-/-) mice had lower fasting levels of glucose and insulin. PPARalpha-null animals had greater suppression of endogenous glucose production in hyperinsulinemic clamp experiments, reflecting less insulin resistance in the absence of PPARalpha. PPARalpha(-/-)apoE(-/-) mice also had lower blood pressures than their PPARalpha(+/+)apoE(-/-) littermates after high-fat feeding. These results suggest that PPARalpha may participate in the pathogenesis of diet-induced insulin resistance and atherosclerosis.

[HBV markers in severe hepatitis B]

In order to elucidate the relationship between hepatitis B virus (HBV) replication and severity of hepatitis B, HBV serological markers and HBV-DNA in 56 patients with chronic hepatitis B were detected using the methods of ELISA and PCR, respectively. The results showed that the positive prevalence of HBeAg and/or HBV-DNA in chronic severe hepatitis B (5/25) was much lower than that in non-severe chronic hepatitis B (26/31) (P < 0.01). The study provides the suggestive evidence that viral replication is significantly reduced in severe hepatitis B. Also, increased replication of HBV appears to be not the cause of hepatic necrosis in severe hepatitis B.

[Effect of crystallization and branch on fine structure of orthorhombic in polyethylene]

The CH2 rocking bands are used as a probe to monitor the crystalline behavior of polyethylene segments in a series of poly (ethylene-octene) copolymers. High resolution and cryogenic FTIR spectra reveal that different composition and/or crystalline condition of the copolymers result in significant variation on the CH2 rocking bands including the change in peak position, band width and A730/A720. We conclude that side chain in the copolymer can influence the structure of the orthorhombic polyethylene crystallite although they can not enter the crystal lattice.

[Study on calcium-cholate-phosphate ternary complexes by FTIR spectroscopy]

The aim of this paper was to examine the calcium-cholate-phosphate tenary complexes by FTIR spectroscopy. The results indicated that the mole ratio of cholate to phosphate were 1:3 and 1:4 in ternary complexes respectively when the initial mole ratio of cholate to phosphate were 3:1 and 1.5:1 in reaction. The FTIR spectroscopic results demonstrated that in the ternary complexes Ca2+ was coordinated with O in both COO- and PO(4)3- groups.

Sugar interaction with metal ions. The crystal structure and Raman spectra study of SmCl3-galactitol complex

The crystal structure of 2SmCl3.galactitol.14H2O has been determined. The crystal system is triclinic, space group: P-1. The unit cell dimensions: a = 9.683(2) A, b = 10.341(2) A, c = 7.990(2) A; alpha = 108.01(3) degrees, beta = 92.71(3) degrees, gamma = 88.42(3) degrees. Each Sm atom is coordinated to nine oxygen atoms, three from the alditol and six from water molecules, with Sm-O distance from 2.417 to 2.520 A. The seventh water molecule is hydrogen-bonded by the hydroxy hydrogen on O-3 (O(3)-H(13)...O(10), 2.635 A). After forming complexes the peaks have shifted and the relative intensities have changed in the IR and Raman spectra, which are corresponding to the changes in bond distances and bond angles of the structures. The IR and Raman spectra of Pr-, Nd- and Sm-galactitol complexes are similar, which show that the three metal ions have the same coordination mode.

Complexation of trivalent lanthanide cations by galactitol in the solid state. The crystal structure and an FT-IR study of 2NdCl3.galactitol.14H2O

The crystal structure of 2NdCl3.galactitol.14H2O has been determined. The crystal system is triclinic, space group: -1, with unit-cell dimensions: a = 9.736(2), b = 10.396, c = 8.027 A; alpha = 108.05(3), beta = 92.68(3), gamma = 88.44(3) degrees, V= 771.6(3) A3, Z = 2. Each Nd atom is coordinated to nine oxygen atoms, three from the alditol and six from water molecules, with Nd-O distances from 2.461 to 2.552 A. The seventh water molecule is hydrogen-bonded by the hydroxyl hydrogen on O-1 (O-1-H-ll...O-10, 2.639 A). The FT-IR spectra of 2NdCl3.galactitol.14H2O and 2PrCl3.galactitol.14H2O are analogous, and show that Pr and Nd have the same coordination mode. The IR results are consistent with the crystal structures.

Saccharomyces Genome Database provides tools to survey gene expression and functional analysis data

Upon the completion of the SACCHAROMYCES: cerevisiae genomic sequence in 1996 [Goffeau,A. et al. (1997) NATURE:, 387, 5], several creative and ambitious projects have been initiated to explore the functions of gene products or gene expression on a genome-wide scale. To help researchers take advantage of these projects, the SACCHAROMYCES: Genome Database (SGD) has created two new tools, Function Junction and Expression Connection. Together, the tools form a central resource for querying multiple large-scale analysis projects for data about individual genes. Function Junction provides information from diverse projects that shed light on the role a gene product plays in the cell, while Expression Connection delivers information produced by the ever-increasing number of microarray projects. WWW access to SGD is available at genome-www.stanford. edu/Saccharomyces/.

The Stanford Microarray Database

The Stanford Microarray Database (SMD) stores raw and normalized data from microarray experiments, and provides web interfaces for researchers to retrieve, analyze and visualize their data. The two immediate goals for SMD are to serve as a storage site for microarray data from ongoing research at Stanford University, and to facilitate the public dissemination of that data once published, or released by the researcher. Of paramount importance is the connection of microarray data with the biological data that pertains to the DNA deposited on the microarray (genes, clones etc.). SMD makes use of many public resources to connect expression information to the relevant biology, including SGD [Ball,C.A., Dolinski,K., Dwight,S.S., Harris,M.A., Issel-Tarver,L., Kasarskis,A., Scafe,C.R., Sherlock,G., Binkley,G., Jin,H. et al. (2000) Nucleic Acids Res., 28, 77-80], YPD and WormPD [Costanzo,M.C., Hogan,J.D., Cusick,M.E., Davis,B.P., Fancher,A.M., Hodges,P.E., Kondu,P., Lengieza,C., Lew-Smith,J.E., Lingner,C. et al. (2000) Nucleic Acids Res., 28, 73-76], Unigene [Wheeler,D.L., Chappey,C., Lash,A.E., Leipe,D.D., Madden,T.L., Schuler,G.D., Tatusova,T.A. and Rapp,B.A. (2000) Nucleic Acids Res., 28, 10-14], dbEST [Boguski,M.S., Lowe,T.M. and Tolstoshev,C.M. (1993) Nature Genet., 4, 332-333] and SWISS-PROT [Bairoch,A. and Apweiler,R. (2000) Nucleic Acids Res., 28, 45-48] and can be accessed at http://genome-www.stanford.edu/microarray.

[Influence on luminescence of Tb o-aminobenzolate complexes by second ligand]

Two Tb o-aminobenzolate complexes with different second ligands (phenanthroline and triphenyl phasphine oxide) were synthesized. Their structures and fluorescent properties were investigated by fluorescence spectroscopy and FTIR spectroscopy. The results indicate that the second ligand affected on the complexes luminescence by changing its structure.

Complexation of trivalent lanthanide cations by inositols in the solid state: crystal structure and an FT-IR study of PrCl3.myo-inositol.9 H2O

The title compound, PrCl3.C6H12O6.9 H2O crystallized in the monoclinic space group P2(1)/n with cell dimensions a = 15.8293(3), b = 8.67750(10), c = 16.2292(3) A, beta = 107.0788(8) degrees, V = 2130.92(6) A3 and Z = 4. Each Pr ion is coordinated to nine oxygen atoms, two from the inositol and seven from water molecules, with Pr-O distances from 2.4729 to 2.6899 A; the other two water molecules are hydrogen-bonded. No direct contacts exist between Pr and Cl. There is an extensive network of hydrogen bonds formed by hydroxyl groups, water molecules, and chloride ions. The IR spectra of Pr-, Nd-, and Sm-inositol complexes are similar, which shows that the three metal ions have the same coordination mode. The IR results are consistent with the crystal structure.

[Effect of Al3+ on luminescence intensity of Tb in silica glasses]

The silica glasses doped with Tb3+ and Al3+ iones was synthesized through Sol-Gel process in this paper. The effect of Al3+ on luminescence properties of Tb3+ were studied. The results show that no obvious effect of Al3+ on the emission peak position of Tb3+, but the emission intensity of Tb3+ doped Al3+ by sol-gel process increased obviously for all samples. The emission intensity of 1% Al-99% SiO2 glass was 5 times larger than that of 100% SiO2 glass. We concluded that the relation between the energy levels of Tb3+ and the energy levels of Al3+ may be appropriate for the energy transfer, the function of Al3+ was to absorb efficiently energy and to transfer fully to Tb3+.

[Safety and immunogenicity of inactivated bivalent EHF vaccine in humans]

OBJECTIVE

Safety and immunogenicity of inactivated bivalent EHF vaccine in humans were evaluated in the epidemic area of Zhejiang province, China.

METHODS

Susceptible persons with negative anti-EHF were selected in Jiande county, Zhejiang province to receive 3 doses of inactivated bivalent EHF vaccine at 0, 7, 28 days. A booster injection was given one year after the primary immunization. Antibody responses were measured in human volunteers by IFA and MCPENT. Local and general reactions were recorded within 72 hours after each vaccination by physicians.

RESULTS

Two weeks after the primary vaccination, 99.04% of the subjects developed significant hantavirus antibody titre measured by IFA which had a 37.34% drop one year after the primary vaccination. Seroconversion rate increased to 100% two weeks after the booster dose. Neutralising antibody titres paralleled this trend with 100% of vaccine recipients producing neutralising antibody two weeks after the primary doses. However, it dropped to 80% one year after the primary vaccination. One hundred percent of the vaccine recipients started to respond two weeks after boosting. The geometric mean titre (GMT) of neutralising antibody against 76 - 118 and UR were 18.27 +/- 2.21 and 12.47 +/- 2.16 respectively after the primary injections, but it increased to 37.09 +/- 2.24 and 32.61 +/- 2.05 respectively after the secondary immunization. General and local reaction rates were 0.46% and 1.98%, with no severe side effects observed in the vaccinees.

CONCLUSION

The vaccine was well tolerated and could induce good humoral immune response.

[The study of the microwave reaction of stearic acid and pentyl amine]

In this study, the microwave reaction of stearic acid and pentyl amine was investigated by FTIR spectroscopy. The results indicated that after mixing the two reactants together, pentyl ammonium stearate was created and it formed acid-salt structure with the stearic acid remained. The results also demonstrated that under microwave radiation, the pentyl ammonium stearate could be not only decomposed, but also dehydrated to form stearic pentyl amide. It suggested that the microwave radiation was an ideal technique to make this chemical reaction much faster and much more thorough.

[FTIR study on the structures of bilirubin in solution]

The structures of bilirubin in solid-state, in HCCl3 and DMSO solution are investigated by FTIR spectroscopy. The results indicate that bilirubin have very different structures in solid-state and in solutions. The results also demonstrate that the structures vary in different solvents. There are six H-bonds in bilirubin molecule in solid-state, four in bilirubin molecule in HCCl3 solution and one in bilirubin molecule in DMSO solution.

[FT-Raman spectroscopic investigation on stomach cancer]

FT-Raman spectroscopy was used to investigate 40 normal and malignant tissues from stomach. Statistic analysis shows that the bands related to OH, NH, C=O stretching and H-O-H bending are stronger in malignant tissues. This phenomenon suggests that the hydrogen bonding systems among water and protein vary in malignant tissues.

[Luminescence enhancement of phthalate-Eu-Sr complex]

Using doped method low rare earth concentration and chelates matrix luminescence was successful in the chelates systems. The luminescence of phthalate-Eu-Sr complex is an example. The experimental results show that the complex luminescence would be enhanced co-doped other metal ions(shch as Mn), because other metal ions can transfer energy to rare earth ion. Addition of the second ligand will enhance the complex luminescence, too. In the FTIR spectra of co-doped complexes, the vibrations of nu a(COO-), nu as(COO-), nu CC have shifted, which show that the co-doped metal ions have influence on the molecular structure.

[A case-control study on the risk factors of epidemic hemorrhagic fever]

OBJECTIVE

To study the risk factors of epidemic hemorrhagic fever (EHF).

METHODS

A 1:1 matched case-control study was conducted to analyse EHF risk factors.

RESULTS

One hundred and eighty-five matched pairs were investigated. Five factors were associated with risks of the disease, including rodent activity in house, farm working, travel, annual average income of an individual and ground material of the house, when chi(2) test and logistic regression model were processed respectively. The coefficients of rodent activity in house, farm working, travel, annual average income of an individual and ground material of the house in multivariable Logistic regression model were 1.377, 1.687, 1.630, -1.216 and -0.888, respectively, when P value < 0.05 was observed.

CONCLUSIONS

Factors as high average income of individuals, brick or cement used as material of the ground in the house, seemed to be protective factors of EHF, which were important to the control and prevention of EHF.

[Spectroscopic study on DL-homocysteic acid and it's complexes]

The main IR bands of the DL-Homocysteic acid was preliminary assigned. The complexes of DL-Homocysteic acid with Na+, K+, Ca2+ were synthesized. Element analysis and TGA-DTA were used to conclude the compositions of these complexes. The FTIR and FT-Raman spectra were studied to distinguish the different coordination structures. The bands of carboxyl, sulfonate and amino groups are all shifted. The peaks of-CH2- also changed a lot. The results indicated that the H-bonding structures among the moleculars were rearranged. The carboxyl and sulfonate groups of DLH both coordinated with the metal ions. And the coordination structure of C=O group in the three complexes were all monodentated.

[Orientation of H-bonds revealed by cryogenic FTIR spectroscopy]

We propose a new way to reveal structural arrangement of hydrogen bond network using FTIR spectroscopy. When KBr pellet and fluorolube mull methods are used to prepare samples for IR measurements, the resultant spectra sometimes show significant differences, sometimes not. The reason is unknown. We use cryogenic FTIR spectra to prove pressure effect accounts for spectral variation in different sampling process. The sensitivity of the FTIR spectra to external pressure is related to the three-dimensional arrangement of hydrogen bonding network in the sample. When hydrogen bonds are in one plane, they can not resist external pressure applied perpendicular to that plane. Consequently, large differences appear between the spectra obtained using KBr pellet and fluorolube mull methods. On the other hand, when hydrogen bonds orientate towards various directions, the hydrogen bonding system can resist pressure from any directions. Thus, the FTIR spectra exhibit little variation using different sampling methods. We propose that the spectral variation obtained using above methods is a criterion to judge whether the hyrogen bonds orientate toward various directions in three-dimensional space or not.

[The FAR-IR study of several mono and disaccharides and metal-sugar complexes in solid state]

FIR spectra of saccharides have many peaks. Each saccharide has its characteristic spectrum. The first, the second, the third, the fourth strongest peak appear at different regions(a, b, c, d) and the sequence (the first in a, the second in b, the third in c, the fourth in d) is characteristic. Due to the sequence in relative intensity is different, we use a simple method encoding four strong peaks to distinguish between different saccharides. We divide 500-100 cm-1 into ten ranges and encode each region as follows: 1(100-140 cm-1); 2(141-180 cm-1); 3(181-220 cm-1); 4(221-260 cm-1); 5(261-300 cm-1); 6(301-340 cm-1); 7(341-380 cm-1); 8(381-420 cm-1); 9(421-460 cm-1); 0(461-500 cm-1). For example, the codes of xylose are 6,538 and the codes of d-arabinose are 7 486. Each saccharide has a number. In this way, we can easily differentiate between saccharides. When the complexes have formed, there are broad peaks of M-O. The phenomena illustrate that FIR technique is an useful mean to determine the formation of the complexes and possibly detect their structures.

Chemical and enzymatic stability as well as transport properties of a Leu-enkephalin analogue and ester prodrugs thereof

The Leu-enkephalin analogue (Tyr-D-Ala-Gly-Phe-Leu-NH(2)) was synthesized together with three esters prodrugs hereof. The prodrugs synthesized were the O-acetyl, O-propionyl and O-pivaloyl99%) and in good yields (60-75%). The chemical and enzymatic stability of the prodrugs has been investigated in detail. The prodrugs studied are quite chemically stable and the degradation of the prodrugs follows the pattern previously shown for similar esters (U-shaped pH-profile; maximal stability at pH 4-5). The prodrugs are degraded quantitatively in plasma to the parent peptide with half-lives in the range 2.9 min-2.6 h. Type B esterases were shown to be involved in the degradation as the half-lives increased in the presence of paraoxon. No significant stabilization was seen in 10% porcine gut homogenate. Half-lives in the same order were seen for the analogue and the prodrugs in pure Leucine aminopeptidase solution. The analogue was stable in Carboxypeptidase A solution whereas a faster degradation of the prodrugs was seen in this media. Furthermore the transport properties of the compounds has been studied. A P(app) value of 0.284x10(-6) cm/s for the analogue was obtained for the transport across Caco-2 cell monolayers in the BL-AP direction. The P(app) values were increased by a factor of 2, 7 and 18 for the acetyl-, propionyl- and pivaloylprodrug. The increase could be explained by higher lipofilicities of the prodrugs compared to the analogue.

Integrating functional genomic information into the Saccharomyces genome database

The Saccharomyces Genome Database (SGD) stores and organizes information about the nearly 6200 genes in the yeast genome. The information is organized around the 'locus page' and directs users to the detailed information they seek. SGD is endeavoring to integrate the existing information about yeast genes with the large volume of data generated by functional analyses that are beginning to appear in the literature and on web sites. New features will include searches of systematic analyses and Gene Summary Paragraphs that succinctly review the literature for each gene. In addition to current information, such as gene product and phenotype descriptions, the new locus page will also describe a gene product's cellular process, function and localization using a controlled vocabulary developed in collaboration with two other model organism databases. We describe these developments in SGD through the newly reorganized locus page. The SGD is accessible via the WWW at http://genome-www.stanford.edu/Saccharomyces/

[Study on the ingredients of reserpine by TLC-FT-SERS]

A new method for analysing the ingredients of reserpine by thin layer chromatography (TLC) and surface-enhanced Raman spectroscopy (SERS) is reported in this paper. The results show that the characteristic spectral bands of reserpine satuated at the thin layer with the amount of sample about 2 microg were obtained. The difference between SERS and solid spectra was found. An absorption model of reserpine and silver sol was proposed. This method can be used to analyse the chemical ingredients with high sensitivity.

[A study on immunogenicity and safety of bivalent inactivated vaccine against hemorrhagic fever with renal syndrome]

OBJECTIVE

To study side effects and effectiveness of bivalent inactivated vaccine against hemorrhagic fever with renal syndrome in population of a randomized controlled field trial.

METHODS

Serum indirect immunofluorescent antibody in 167 persons and neutralization antibody (types I and II) in 69 persons, who received three-dose vaccine, were determined two weeks after immunization, and side effects in 657 vaccinees were observed within 72 houses after immunization.

RESULTS

Serum positive conversion rate of indirect immunofluorescent antibody was 99.04% (166/167) with GMT of 24.51 +/- 2.06. Serum positive conversion rate of neutralization antibody was 100% (69/69), 91.30% (63/69) for types I and 88.41% (61/69) for type II, respectively. GMTs for type I and II neutralization antibody were 18.27 +/- 2.21 and 12.47 +/- 2.16, respectively. Side effects at local site vaccinated of the body and temperature rising could be seen in 1.48% and 0.36% of the vaccinees, respectively. No severe side effect and abnormal reaction was found in vaccinees on the field.

CONCLUSION

Immune response to bivalent inactivated vaccine against hemorrhagic fever with renal syndrome was satisfactory with slight side effect.