[Regional disparities in trends of global gastric cancer incidence and mortality from 1990 to 2019]

Objective: To depict gastric cancer burden trends globally and analyze geographical and socioeconomic disparities among different countries and territories. Methods: We extracted the data from Global Burden of Disease 2019 Database. We conducted the Joinpoint regression and calculated the average annual percent change (AAPC) and corresponding 95% confidence interval (CI) for age-standardized gastric cancer incidence and mortality from 1990 to 2019. Linear regression was performed to measure the association of sociodemographic index (SDI) with each country's gastric cancer incidence and mortality AAPC. We applied the age-period-cohort analysis to assess the cohort effect on gastric cancer incidence and mortality. Results: The AAPCs for gastric cancer age-standardized incidence and mortality rates from 1990 to 2019 were -1.27% (95% CI: -1.43%, -1.11%) and -1.87% (95% CI: -2.01%, -1.72%), respectively. SDI levels were negatively associated with AAPCs, which means that countries with higher SDI had higher AAPC (P<0.001). The decrease of gastric cancer burden in countries with low or medium SDI levels was slower than that globally. The age-period-cohort analysis indicated that countries with higher SDI levels had more apparent decline in birth cohort effects from 1900 to 1999. Conclusions: Countries with different socioeconomic levels have various decreasing rates for gastric cancer incidence and deaths. Countries with higher SDI levels have higher declining rates for gastric cancer burden.

[A comparative analysis of the distribution of the high-risk population of upper gastrointestinal cancer and endoscopic screening compliance in two urban areas and two rural areas in China]

Objective: To analyze and compare the distribution of the high-risk population of upper gastrointestinal (UGI) cancer and the factors influencing the compliance rate of endoscopic screening in urban China and rural China. Methods: From 2015 to 2017, an epidemiological survey was conducted on residents aged 40-69 in two rural areas (Luoshan county of Henan province, Sheyang county of Jiangsu province) and two urban areas (Changsha city of Hunan province, Harbin city of Heilongjiang province). As a result, high-risk individuals were recommended for endoscopic screening. Chi-square χ(2) test was used to compare the high-risk rate of UGI cancer between urban and rural residents. In addition, the multivariate logistic regression model was used to analyze the factors influencing the compliance rate of endoscopic screening. Results: A total of 48, 310 residents aged 40-69 were enrolled in this study, including 22 870 (47.34%) residents from rural areas and 25 440 (52.66%) residents from urban areas. A total of 23 532 individuals were assessed with a high risk of UGI cancer, with an overall risk rate of 48.71%. A higher proportion of participants with high risk was observed in rural China (56.17%, 12 845/22 870) than in urban China (42.01%, 10 687/25 440). A total of 10 971 high-risk individuals with UGI cancer participated in endoscopic screening, with an overall compliance rate of 46.62% (10 971/23 532), 45.15% (5 799/12 845) in rural China, and 48.40% (5 172/10 687) in urban China. In rural population, the compliance rate of endoscopic screening was higher in those of females, aged 50-69 years, primary school education or above, high income, a family history of UGI cancer, history of gastric and duodenal ulcer, history of reflux esophagitis, and history of superficial gastritis, but lower in smokers (P<0.05). Among the urban population, the compliance rate of endoscopic screening was higher in those aged 40-49 years, uneducated, low income, family history of UGI cancer, history of reflux esophagitis, history of superficial gastritis, but lower in smokers (P<0.05). Conclusions: The proportion of participants with high risk of UGI cancer in rural areas is higher than that of urban areas. The compliance rates of endoscopic screening in urban and rural areas are low, and influencing factors of endoscopic screening exhibit some differences in rural China and urban China.

[Access to liver cancer screening and surveillance in populations in China: an exploratory analysis]

Objective: To systematically quantify the access to screening and surveillance service of liver cancer in populations in China, especially a series of sub-indicators of the availability. Methods: Following the specific indicators applied by the International Agency for Research on Cancer in the session of availability and use of screening practices in several cancer screening handbooks, information about the access/availability of liver cancer screening and surveillance in population in China were collected; the indicators included local policies and guidelines, procedures most commonly used or recommended, population coverage and participation rate, compliance and related factors, treatment rate, acceptability, equity and others. Systematic review approach was used, combined with searching core literatures/monograph, websites of governments and available program reports, for a systematic analysis on the access to liver cancer screening and surveillance in populations in China. Results: A total of 34 journal articles were included from the systematic review and most of which were about the participation of secondary liver screening or surveillance compliance; additional information were mainly obtained from the other sources. Overall, there were clearly recommended screening and surveillance procedures for liver cancer in the three major cancer screening programs funded by the central government of China. It was estimated that 0.09% of the population aged 35-74 years were covered by liver cancer screening in 2019 in China. The overall participation rates of secondary screening ranged from 37.5% to 62.3% in three major programs, the median compliance rate of surveillance was reported as 26.9% (Q₁,Q₃: 23.5%, 41.0%) in the 6 included studies. Two studies reported the factors affecting the participation and compliance. A large-scale multicenter analysis showed that the subject acceptability to alpha fetoprotein test combined with ultrasound screening was as high as 99.3% in high-risk population in urban area. The treatment rate of liver cancer founded by screening, surveillance or follow-up was estimated to be >90% in rural population. No studies of equity were obtained via the systematic review. Conclusions: The public health service programs in China all recommend specific procedures for liver cancer screening in general population and surveillance for high-risk individuals. However, the overall availability needs to be improved, particularly in the indicator of population coverage. Participation rates of screening and compliance rates of surveillance varied among the included programs and the studies, suggesting that the influencing factors need to be further identified. The relatively high subject acceptability suggests the potential demands for screening service. More efforts are needed to address the access to screening and surveillance of liver cancer in populations in China.

[DALYs for breast cancer in China, 2000-2050: trend analysis and prediction based on GBD 2019]

Objective: Based on the data of Global Burden of Disease 2019 data, to analyze the past, current, and future burden of disability-adjusted life years (DALYs) in China and compare with the international status. Methods: The total number of DALYs, age-standardized DALY rate, and the composition of different subgroups were extracted and described to analyze the time trend in 2000-2019 and the current situation in 2019 for Chinese female breast cancer. The burden of DALYs in 2050 was predicted by Joinpoint using average annual percent change (AAPC). Results: In 2000-2019, the ranking of DALYs caused by female breast cancer in China rose from the fourth to the second in all female cancers. The total DALYs increased by 48.4%, of which the years lived with disability increased from 4.8% to 8.8%. The age-standardized DALY rate only slightly decreased (AAPC=-0.3%; which increased during 2016-2019, AAPC=1.6%). In 2019, the age-standardized DALY rate for breast cancer in China was 278.0/100 000. The DALYs were 2.88 million (accounting for 14.2% of the global burden and 12.1% of all female cancers burden in China), 26.5% of which attributed known risk factors (overweight and obesity were the largest: 0.34 million DALYs, but some common breast cancer risk factors were not available on the platform, such as menstruation and fertility). In 2050, the prediction suggests that the total DALYs caused by female breast cancer in China will reach 3.80 million person-years-5.16 million person-years, increasing 32.1%-79.4% over 2019. From 2000 to 2019, the peak age of DALYs and DALY rate became older, and the DALYs among females aged 65 years and above increased faster than those younger than 65 years (AAPC were 4.8% and 1.3%, respectively). In 2019, females aged 45-74 (the starting age recommended by local guidelines for breast cancer screening) contributed 74.3% of the total DALYs. Conclusions: Over the past 20 years, the age-standardized DALY rate for breast cancer in female populations in China has not changed obviously. Without the continuous expansion of effective intervention and population aging, the burden of DALYs for female breast cancer in China will increase. DALYs for breast cancer attributed leading risk factors were still limited.

[Prognosis and related risk factors of acute respiratory distress syndrome in elder patients]

Objective: To study the risk factors associated with the hospital survival rate of elder patients with acute respiratory distress syndrome (ARDS) in Medical/Respiratory Intensive Care Units (MICUs/RICUs) by evaluating the prognosis, and therefore to provide insight into patient treatment strategy. Methods: Twenty MICUs/RICUs of 19 general hospitals in mainland China participated in the multicenter prospective cohort study carried out from Mar 1^st, 2016 to Feb 28^th, 2018. Patients who met the criteria of Berlin ARDS and older than 65 years were recruited. Baseline data, risk factors of ARDS, ventilator setup and prognosis data were collected from all patients. Univariant and multivariant regression analysis were conducted to analyze the factors associated with the prognosis. Results: 170 elder ARDS patients (age≥65 years) met the Berlin ARDS criteria, among whom 8.8% (15/170), 42.9% (73/170) and 48.2% (82/170) patients had mild, moderate and severe ARDS, respectively. The most common predisposing factor for elder ARDS was pneumonia, which was present in 134 patients (78.8%). 37.6% (64/170) patients were treated with noninvasive mechanical ventilation (NIV), but 43.8% (28/64) cases experienced treatment failure. 76.5% (130/170) patients were treated with invasive mechanical ventilation. All patients 80 years or older were given invasive mechanical ventilation. 51.8% (88/170) cases had complications of non-pulmonary organ failure. 61.8% (105/170) patients deceased during hospital stay. Multivariant logistic analysis showed that the independent risk factors for hospital survival rate in elder patients with ARDS were SOFA score (P=0.030, RR=0.725, 95% CI 0.543-0.969), oxygen index after 24 hours of ARDS diagnosis (P=0.030, RR=0.196, 95% CI 0.045-0.853), accumulated fluid balance within 7 days after diagnosis of ARDS (P=0.026, RR=1.000, 95% CI 1.000-1.000) and shock (P=0.034, RR=0.140, 95% CI 0.023-0.863). Conclusion: Among 20 ICUs, the high mortality rate of elder patients with ARDS was correlated with higher 24 hour SOFA score, lower 24 hour oxygen index after ARDS diagnosis, more positive fluid balance within 7 days and concomitant shock. The conservative fluid strategy within 7 days of ARDS diagnosis may benefit the elder ARDS patients.

[Disease burden of colorectal cancer in China: any changes in recent years?]

Objective: To update the disease burden of colorectal cancer (CRC) in Chinese population by integrating the latest multi-source evidences. Methods: Groups of data from GLOBOCAN, series of Chinese Cancer Registry Annual Report (annual report), Cancer Incidence in Five Continents (CI5), Global Burden of Disease Project 2017 (GBD), China Death Cause Surveillance Datasets and China Health Statistical Yearbooks (yearbook) were used to extract the information. Data on incidence, mortality, disability-adjusted life year (DALY) and percentage distribution of sub-location of CRC were used to analyze the latest disease burden in China, and age-standardized rates by world standard population were mainly used. Joinpoint Trend Analysis Software 4.7.0.0 was applied for time trend analysis. Data related to the economic burden of CRC in China were gathered by literature review. Results: (1) Current status: according to the latest annual report, the incidence and mortality rates of CRC were 17.1 per 100 000 and 7.9 per 100 000, respectively among the covered registration sites in 2015. The incidence ratios of male to female and that of urban to rural were 1.5 and 1.4, with the mortality ratios were 1.6 and 1.4, respectively. Similar to data from the annual report, the mortality rate was reported as 6.9 per 100 000 in 2017 by the surveillance data sets. Data from the GBD project showed that, the DALYs caused by CRC in China in 2017 was 4.254 million person years (doubled compared with that of 1990), accounting for 22.4% of the global burden of CRC. (2) Time trends: according to the annual reports, from 2009 to 2015, the incidence rate and mortality rate of CRC in China decreased by 10.2% and 9.5%, respectively. The same trend was also observed in urban sites, but was opposite in rural areas (increased 20.0% in incidence and 15.2% in mortality). Results from the Joinpoint analysis showed that the averaged annual percentage change (AAPC) was estimated as -1.6% (P<0.05) in the national mortality rate. Similarly, in the incidence and mortality rates of urban sites appeared as AAPC=-1.5% and -1.4% (all P<0.05), but inversely in the incidence rate from the rural sites as AAPC=3.3% (P<0.05). The yearbook data showed a 9.8% increase in urban and 20.6% increase in rural on the mortality in 2017 when compared with 2004, but the Joinpoint analysis showed no statistical significance (P<0.05). (3) Distribution of sub-location of CRC: the annual report showed that among all the new CRC cases in China in 2015, colon, rectal and anal cancer accounted for 49.6%, 49.2% and 1.2%, respectively, while the proportions were 51.3%, 47.6% and 1.1%, respectively in 2009. The proportion of colon cancer was continuously higher in the urban (>52%) than that in the rural areas (<44%). The CI5 Ⅺ data showed that ascending and sigmoid colons were more commonly seen among all the colon cancers. (4) Economic burden: the average annual growth rate of the medical expenditure per CRC patient in China ranged from 6.9% to 9.2%, and the 1-year out-of-pocket expenditure of a newly diagnosed patient accounted for about 60% of their previous-year household income. Conclusions: In China, the overall disease burden of CRC might have been decreased slightly but generally remained stable in the last several years, however, the rising burden appeared in the rural areas should not be ignored. In consistent with findings from a previous review, men and people from the urban areas are considered the target populations for CRC. The finding of higher proportion of colon cancer in urban areas suggests the impact of development of socioeconomic and medical technologies on CRC development and detection. The economic burden of CRC continued to grow.

[Population's acceptance and attitude toward a novel fecal immunochemical test for colorectal cancer screening: a multi-center survey in China]

Objective: To investigate the acceptance and attitude toward a novel fecal immunochemical test (FIT) in colorectal cancer screening among populations in China. Methods: From May 2018 to May 2019, 2 474 people aged 50-74 years were recruited from five provinces of China (Zhejiang, Anhui, Jiangsu, Hunan and Yunnan). The general demographic characteristics, acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey. Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool, reading and uploading results. Results: The subjects were (60.0±6.4) years old, and female, high school of above educated, unemployed/retired/other, married and with medical insurance status of "new rural cooperative medical care (NRCMC)" accounted for 61.7% (1 526), 29.0%(718), 34.3% (849), 92.7% (2 293) and 31.3%(775), respectively. The population's acceptance of the FIT technology was 94.8%. In the process of FIT screening, the percentage of occurred difficulties in sampling stool, reading and uploading results were 33.1% (819), 46.4% (1 147) and 62.9% (1 557), respectively. The main difficulties were the uncertainty about whether the sampling operation was standard (28.0%), the inability to accurately judge the result displayed (32.5%) and the need for help without using a smartphone (44.2%). The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of "NRCMC" were more likely to encounter difficulties in sampling, and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling. Those aged 65-74 years old, farmers or migrant workers, and those with "NRCMC" were more likely to encounter difficulties in readingresults, and those with 3 or more family members were less likely to encounter difficulties in reading result. Those with "NRCMC" were more likely to encounter difficulties in uploading results, and those with education level of high school or above, living with more than 3 family members were less likely to encounter difficulties in uploading results. Conclusion: The acceptance of the new FIT technology is relatively high among the subjects. Age, education level, occupation, number of family members living together and medical insurance status might be related to difficulties encountered in sampling stool, reading and uploading results, and it can be further strengthened in terms of the technology and characteristics of sub-populations.

[Health economic evidence for colorectal cancer screening programs in China: an update from 2009-2018]

Objective: This study was to systematically update the economic evaluation evidence of colorectal cancer screening in mainland China. Methods: Based on a systematic review published in 2015, we expanded the scope of retrieval database (PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, CBM) and extended it to December 2018. Focusing on the evidence for nearly 10 years (2009-2018), basic characteristics and main results were extracted. Costs were discounted to 2017 using the consumer price index of medical and health care being provided to the residents, and the ratio of incremental cost-effectiveness ratio (ICER) to per capita GDP in corresponding years were calculated. Results: A total of 12 articles (8 new ones) were included, of which 9 were population-based (all cross-sectional studies) and 3 were model-based. Most of the initial screening age was 40 years (7 articles), and most of the frequency was once in a lifetime (11 articles). Technologies used for primary screening included: questionnaire assessment, immunological fecal occult blood test (iFOBT) and endoscopy. The most commonly used indicator was the cost per colorectal cancer detected, and the median (range) of the 20 screening schemes was 52 307 Chinese Yuan (12 967-3 769 801, n=20). The cost per adenoma detected was 9 220 Yuan (1 859-40 535, n=10). In 3 articles, the cost per life year saved (compared with noscreening) was mentioned and the ratio of ICER to GDP was 0.673 (-0.013-2.459, n=11), which was considered by WHO as "very cost-effective" ; The range of ratios overlapped greatly among different technologies and screening frequencies, but the initial age for screening seemed more cost-effective at the age of 50 years (0.002, -0.013-0.015, n=3), than at the 40 year-olds (0.781, 0.321-2.459, n=8). Conclusions: Results from the population-based studies showed that the cost per adenoma detected was only 1/6 of the cost per colorectal cancer detected, and limited ICER evidence suggested that screening for colorectal cancer was generally cost-effective in Chinese population. Despite the inconclusiveness of the optimal screening technology, the findings suggested that the initial screening might be more cost-effective at older age. No high-level evidence such as randomized controlled trial evaluation was found.

[Changes of intestinal mucosal barrier function and effects of early enteral nutrition in patients with severe organophosphorus poisoning]

Objective: To observe the changes of intestinal barrier function in patients with acute severe organophosphorus pesticide poisoning (ASOPP) and the effect of early enteral nutrition on them. Methods: A single-center, single-sample, prospective, randomized controlled clinical trial was conducted. A total of 50 patients with ASOPP were divided into 24 h enteral nutrition group (group A) and 48 h (48-72 h) enteral nutrition group (B group) according to the order of hospitalization. The two groups received equal calorie nutritional support, and Serum D-lactic acid (D-LA) and serum human diamine oxidase (DAO) were detected immediately after admission and at 48 h, 72 h and 144 h. At the same time, the worst value of APACHE-Ⅱ score was recorded, and the correlation between DAO, D-LA and APACHE-Ⅱ score was analyzed. The serum concentration of D-LA and DAO in 15 healthy adults were detected as healthy control group. Results: There was no statistical difference in gender, age, poisoning time and organophosphorus pesticide components between group A and B (P>0.05). The distribution of D-LA concentration in group A poisoned patients at admission, 48 h, 72 h and 144 h was (66±19) μg/L, (68±21) μg/L, (66±19) μg/L, (63±17) μg/L, while in group B they were (62±15) μg/L, (58±17) μg/L, (58±16) μg/L, (67±9) μg/L. There was no statistical difference between the two groups in D-LA concentration and that of healthy people [(67±17) μg/L, P>0.05]. The distribution of DAO concentration in group A poisoned patients at admission, 48 h, 72 h and 144 h was (2.1±0.6) μg/ml, (2.1±0.5) μg/ml, (2.2±0.4) μg/ml, (2.2±0.5) μg/ml, while in group B they were (2.1±0.5) μg/ml, (2.1±0.5) μg/ml, (2.2±0.5) μg/ml, (2.1±0.4) μg/ml. DAO concentration in the early stage of the intoxication of the two groups were higher than that of healthy people (0.1±0.0 μg/ml) (P<0.05). There is no statistical difference in DAO concentration between group A and B at different time points (P>0.05). The APACHEE-Ⅱ score of 48 hours and 72 hours in group A (12.2+1.7, 5.5+2.1) was significantly lower than that in group B (14.1+2.4, 8.2+2.6) (P<0.05). D-LA, DAO concentration at different time points was not correlated with APACHE-Ⅱ score (P>0.05). D-LA (r, P) was immediate admission (-0.17, 0.24), 48 h (0.04, 0.79), 72 h (0.32, 0.06), 144 h (0.29, 0.07), and DAO (r, P) was immediate admission (-0.12, 0.43), 48 h (0.02, 0.92), 72 h (0.03, 0.85), 144 h (0.03, 0.82). Conclusions: Patients with ASOPP may have obvious injury at intestinal mucosa at early stage (144 h), but the intestinal permeability is normal. Early enteral nutrition therapy can promote the recovery of patients, but has low correlation with intestinal barrier function improvement.

[Protective effect of hydrogen on the lung of sanitation workers exposed to haze]

Objective: To study the protective effect of hydrogen inhalation on the lungs of sanitation workers exposed to haze. Methods: In this randomized, double-blind, placebo controlled clinical trial, 96 sanitation workers living in Shijiazhuang urban area were recruited during January to February, 2016. All enrolled participants were randomized to 2 groups; the treatment group inhaled H₂∶O₂ mixture (66.67%∶33.33%) 1 hour per day for 30 days, while the control group inhaled N₂∶O₂ mixture (66.67%∶33.33%) 1 hour per day for 30 days. Respiratory symptoms were evaluated and fractional exhaled nitric oxide(FeNO), biochemical indexes, lung function were measured at baseline(the 0th day) and during treatment (the 8th day, 15th day, and 30th day). Results: (1)The FeNO levels of the treatment group (16±5)×10⁹ were lower than those of the control group(21±14)×10⁹ on 8th day of treatment, with significant difference(F=6.94, P<0.05). (2)The levels of FEV₁ were significantly higher in participants from the treatment group as compared to the control group on both 8th [(96±13)% vs(94±14)%(F=3.96, P<0.05)] and 30th day [(97±14)% vs (95±12)%(F=8.5, P<0.05)] of treatment, while PEF was also increased on 15th day [(73±15)% vs(67±18)%(F=8.68, P<0.05)]. (3)The sputum levels of MMP-12 and SOD3 were consistently lower in the treatment group as compared to the control group at each time point, and the levels of IL-10 were higher in the treatment group as compared to the control group on the 15th and 30th day. MDA and IL-2 levels were lower in the treatment group than in the control group on the 30th day(P<0.05). The sputum levels of CRP and TGF-β₁ at each time point were not different between the 2 groups (P>0.05). (4)The serum levels of IL-2 and SOD3 were lower in the treatment group as compared to the control group while IL-10 was higher than in the control group at each time point, and MMP-12 was lower in the treatment group than that in the control group on the 30th day(P<0.05). The relative ratios of CRP, TGF-β₁ and MDA in serum at each time point between the 2 groups were not significantly different (P>0.05). (5)Hydrogen inhalation improved respiratory symptoms such as cough. Conclusions: Inhalation of hydrogen gas could alleviate airway inflammation and oxidative stress of sanitation workers exposed to air pollution. There was even a significant inhibitory effect on the level of systemic inflammatory response. Importantly, inhalation of hydrogen could improve respiratory symptoms such as cough.

High hepatitis E virus antibody positive rates in dogs and humans exposed to dogs in the south-west of China

Hepatitis E (HE) is a zoonotic viral disease caused by hepatitis E virus (HEV). The objective of this study was to investigate the prevalence of HEV infection among dogs and humans exposed to dogs in the south-west region of China. A total of 4,490 dog serum samples and 2,206 relative practitioner serum samples were collected from 18 pet hospitals and dog farms in Yunnan, Sichuan and Guizhou province, and the anti-HEV IgG antibodies were detected by ELISA. The results showed that the total positive rate of anti-HEV antibodies was 36.55% with the highest rate in city stray dogs, and the differences in distinct species and growth phases were significant. The positive rate of anti-HEV antibody in veterinarian and farm staff-related practitioners was significantly higher than the general population. The finding of the present survey suggested that high HEV seroprevalence in dogs and humans exposed to dogs in the south-west area of China poses a significant public health concern. It is urgent to improve integrated strategies to detect, prevent and control HEV infection in dogs and humans exposed to dogs in this area.

[Application of long term video electroencephalogram and resting-state functional magnetic resonance imaging in detection of cognition in patients with benign epilepsy of childhood with centrotemporal spikes]

Objective: To study the relationship between the changes of brain network and cognition in patients with benign epilepsy of childhood with centrotemporal spikes (BECTS) by using long term video electroencephalogram (VEEG) and resting-state functional magnetic resonance imaging (RS-fMRI) technology. Methods: Eleven patients with right-handed were recruited (from April 2015 to September 2016) from epilepsy specialist outpatients and functional department of neurosurgery of Tianjin Medical University General Hospital. They all underwent the long term VEEG monitoring (one sleep cycle was included at least). According to the spike-wave index (SWI) during slow ware sleep, they were divided into two groups: SWI<50% (5 cases) and SWI≥50% (6 cases). All the patients were assessed with cognitional test including language, execution, memory and attention. They also underwent the head MRI, RS-fMRI examinations. Then the results were comparatively analysed. Results: (1)There were no statisticaly significance in sex, age, age of onset, disease course, total number of seizures, years of education (P>0.05). The Full Intelligence Quotient (FIQ) (87±18), Verbal Intelligence Quotient (VIQ) (88±15) and Performance Intelligence Quotient (PIQ) (89±20) of SWI≥50% group were lower than SWI<50% group(118±8, 114±11, 119±5) and the differences were statistically significant(P<0.05). (2)There was a negative correlation between the FIQ (P=0.002), VIQ (P=0.006), PIQ (P=0.001) and SWI. The FIQ, VIQ and PIQ had no correlation with the sex, age, age of onset, disease course, total number of seizures, years of education (P>0.05). (3)Compared with SWI<50% group, SWI≥50% group showed increased regional homogeneity (ReHo) in the bilateral precentral gyrus, premotor area and the subcortical structure, the right temporal lobe and the bilateral insular lobe(P<0.05); while they showed decreased ReHo in the posterior cingulate gyrus, right posterior inferior temporal lobe and right occipital lobe(P<0.05). Conclusion: The change of the brain network which is caused by the paradoxical and constant discharge during slow ware sleep in patients with BECTS may affect the development of cognition.

[B7-H3 silencing inhibits human hematological malignancy xenograft tumor tumorigenesis and metastasis in nude mice]

OBJECTIVE

To investigate the effect and mechanism of targeted B7-H3 gene silencing on the tumorigenesis and metastasis of human hematological malignancy xenograft tumor in nude mice.

METHODS

Real-time fluorogentic quantitative PCR (qPCR) and flow cytometry (FCM) were used to detect the expression of B7-H3 in 13 strains of malignant hematologic cells. Then, U937, Maver and Z138 cells which expressed high level of B7-H3 were screened out. Targeted B7-H3 knockdown in U937, Maver and Z138 was performed by lentivirus transduction and the effect of B7-H3 silencing in stable cell lines was tested by qPCR and FCM. Injecting the nine groups subcutaneously into the nude mice to establish xenograft models after dividing the U937, Maver and Z138 into non-infected control group (CON), B7-H3 knockdown group (KD) and negative non-targeted control infected group (NC),respectively, for detecting the tumorigenicity and metastasis in vivo. Furthermore, the expression of Ki-67 in xenograft tumors was detected by immunohistochemistry (IHC). The expression of metalloproteinase 2 (MMP-2) was detected by western blot.

RESULTS

The stable B7-H3 silencing cell lines of U937, Maver and Z138 were successfully established. Compared with the NC group, the KD groups of U937, Maver and Z138 had an obviously slower tumor growth. The average tumor inhibition rates at the end of observation period were 61.83% (F=43.78, P<0.05), 59.12% (F=36.51, P<0.05) and 67.37% (F=40.29, P<0.05); there was no significant difference in tumor volume growth between the NC group and the CON group (P>0.05). The liver distant metastasis of all the xenograft tumor models in nude mice was the most common and the rates of distant metastasis in KD groups were significantly lower than that of the corresponding NC groups. The Ki-67 indexes of the KD groups were significantly lower than those of the relative NC groups in three cell lines (U937: 40.3%±5.2% vs. 79.1%±6.3%, q=30.31, P<0.05, Maver: 35.2%±6.4% vs. 69.6%±5.1%, q=24.82, P<0.05; Z138: 38.4%±7.1% vs. 75.7%±4.8%, q=28.07, P<0.05); there was no significant difference in the expression of Ki-67 between the NC group and the CON group (P>0.05). The expressions of MMP-2 were also significantly lower in the KD groups than in the NC groups (U937: q=14.59, P<0.05; Maver: q=9.25, P<0.05; Z138: q=11.04, P<0.05); there was no significant difference in the expression of MMP-2 between the NC group and the CON group (P>0.05).

CONCLUSION

Targeted B7-H3 gene silencing could inhibit the tumorigenesis and metastasis of human hematological malignancy xenograft tumor in nude mice. The mechanism may be related to the down-regulation of Ki-67 and MMP-2.

[Application of single nucleotide polymorphism-microarray and target gene sequencing in the study of genetic etiology of children with unexplained intellectual disability or developmental delay]

Objective: To evaluate the application of single nucleotide polymorphism (SNP)-microarray and target gene sequencing technology in the clinical molecular genetic diagnosis of unexplained intellectual disability(ID) or developmental delay (DD). Method: Patients with ID or DD were recruited in the Department of Neurology, Affiliated Children's Hospital of Capital Institute of Pediatrics between September 2015 and February 2016. The intellectual assessment of the patients was performed using 0-6-year-old pediatric examination table of neuropsychological development or Wechsler intelligence scale (>6 years). Patients with a DQ less than 49 or IQ less than 51 were included in this study. The patients were scanned by SNP-array for detection of genomic copy number variations (CNV), and the revealed genomic imbalance was confirmed by quantitative real time-PCR. Candidate gene mutation screening was carried out by target gene sequencing technology.Causal mutations or likely pathogenic variants were verified by polymerase chain reaction and direct sequencing. Result: There were 15 children with ID or DD enrolled, 9 males and 6 females. The age of these patients was 7 months-16 years and 9 months. SNP-array revealed that two of the 15 patients had genomic CNV. Both CNV were de novo micro deletions, one involved 11q24.1q25 and the other micro deletion located on 21q22.2q22.3. Both micro deletions were proved to have a clinical significance due to their association with ID, brain DD, unusual faces etc. by querying Decipher database. Thirteen patients with negative findings in SNP-array were consequently examined with target gene sequencing technology, genotype-phenotype correlation analysis and genetic analysis. Five patients were diagnosed with monogenic disorder, two were diagnosed with suspected genetic disorder and six were still negative. Conclusion: Sequential use of SNP-array and target gene sequencing technology can significantly increase the molecular genetic etiologic diagnosis rate of the patients with unexplained ID or DD. Combined use of these technologies can serve as a useful examinational method in assisting differential diagnosis of children with unexplained ID or DD.

Functional polymorphisms of the cyclooxygenase-2 gene and prognosis of hepatocellular carcinoma - a cohort study in Chinese people

Cyclooxygenase-2 (COX-2) influences carcinogenesis through regulation of angiogenesis, apoptosis, cytokine expression, and immune response suppression. It has been well established that COX-2 is overexpressed in a variety of human cancers, such as hepatocellular carcinoma (HCC). In this study, we aimed to evaluate the association between COX-2 polymorphisms and prognosis of HCC. We genotyped 200 HCC patients of Chinese Han descent for COX-2 gene polymorphisms (-765G>C and -1195G>A) using PCR-RFLP. Data were statistically analyzed using the Kaplan-Meier method and the Cox's proportional hazard regression model. We found that patients with the COX-2 -1195AG and -1195AG + AA genotypes demonstrated significantly decreased disease-free survival (DFS) as compared with those carrying the -1195GG genotype (P < 0.05). However, the COX-2 -765G>C polymorphism was not associated with DFS (P > 0.05). Moreover, by Cox regression analysis, blood alpha fetoprotein ≤400 ng/mL before the operation and the -1195G>A polymorphism were found to be of prognostic significance (P < 0.05), while the -765G>C polymorphism was not (P > 0.05). In summary, post-operation progression of HCC is more likely to occur in patients with the -1195AG genotype and the A allele. On the other hand, the -765G>C polymorphism is not an independent influence factor of HCC prognosis.

CARD9 mutation linked to Corynespora cassiicola infection in a Chinese patient

Corynespora cassiicola is a plant pathogen associated with leaf-spotting disease. The fungus has been found on diverse substrates: leaves, stems and roots of plants; nematode cysts and human skin. It rarely causes human infections. Here we report one case of subcutaneous phaeohyphomycosis caused by C. cassiicola with prominent tissue necrosis in a woman. All of her clinical features pointed towards a genetic linkage. Hence, whole-exome sequencing and Sanger sequencing were performed on this patient. One mutation of CARD9 was detected.

Controllable synthesis of porous iron–nitrogen–carbon nanofibers with enhanced oxygen reduction electrocatalysis in acidic medium

Porous Fe–N–C nanofibers were synthesized as non-precious metal electrocatalysts with a 20 times enhancement in oxygen reduction performance.

Expression of active caspase-3 in mitotic and postmitotic cells of the rat forebrain

Active caspase-3 immunoreactivity was detected in the rat forebrain proliferative regions at birth and remained high in these areas for about 2 weeks, during which period labeled cells were present centroperipherally across the olfactory bulb. By the end of the third postnatal week, only a small number of immunolabeled cells remained in these forebrain structures. Active caspase-3 immunolabeling was localized mostly to cell nuclei and co-localized partially with TuJ1 and NeuN immunoreactivity, but not with glial fibrially acidic protein, OX-42, gamma-aminobutyric acid, or terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL)-positive labeling. Active caspase-3 and 5-bromo-2'-deoxyuridine (BrdU) double-labeled nuclei were seen in the proliferative regions after 2 hours and in the periglomerular region of the bulb after 7 days following BrdU injections. Examination of the cells with electron microscopy confirmed that the active caspase-3-containing nuclei in the proliferative regions often had infoldings and appeared to be undergoing division. Some of the cells with active caspase-3-labeled nuclei in the bulb had synapses on their somata or dendrites. Labeled dendritic spines and a few axon terminals were also observed in the olfactory bulb. Taken together, it appears that a wave of active caspase-3-positive cells are dividing in the proliferative zones and then migrating to the bulb as they differentiate into neurons. Therefore, active caspase-3 may play a role in cellular processes such as neuronal differentiation, migration, and plasticity, in addition to its role in cell death.

Atypical features of rat dentate granule cells: recurrent basal dendrites and apical axons

The stereotyped morphology of dentate granule cells in rodents consists of apical dendrites arborizing in the molecular layer and an axon arising from the opposite pole of the soma. Recently, we showed that epilepsy induces the formation of basal dendrites on granule cells and that these dendrites extend into the hilus of the dentate gyrus. The present Golgi study of granule cells from adult rats shows two atypical features for granule cells in control rats. One is the occurrence of recurrent basal dendrites (RBDs) that are defined as basal dendrites arising at or near the hilar pole of the soma and then curving back to the molecular layer. The frequency of granule cells with RBDs was 3.8% in control rats. The second is apical axons of granule cells that were observed to originate from either the apical pole of the soma or an apical dendrite. The incidence of these "apical" axons was about 1%. These morphological findings in the present study suggest that rat granule cells are more heterogeneous than previously indicated. Furthermore, their frequency was not increased in epileptic rats.

[Effects of different training methods on cardiovascular autonomic regulation during bedrest]

Objective. To investigate the effects of different training methods on cardiovascular autonomic regulation under bedrest. Method. 15 healthy male volunteers aged 19-22 participated tests in head-down tilt (HDT) -6 degrees bedrest in order to observe the changes of cardiovascular system under simulated weightlessness. They were divided into control (5 men), hypoxia training (5 men) and Fangsong training (5 men) groups. 24 h dynamic ECG were recorded on the 2nd day of pre-bedrest, on the 3rd, 14th and 18th day of bedrest and on the 7th day of the post- bedrest. All spectra were estimated from entire 24 h HRV, before, during and after Fangsong and hypoxia training by autoregressive (AR) modeling method. Normalized low-frequency (LF%) was a quantitative marker of cardiac sympathetic activity, normalized high-frequency (HF%) reflected the changes in cardiac vagal activity, and LF/HF was considered to be related to sympathovagal balance or sympathetic activity. Result. In control group, LF% and HF% were all significantly reduced (P<0.05), LF/HL showed no significant changed during bedrest. In Fangsong group, HF% increased markedly (P< 0.05), while in hypoxia group, LF% increased markedly (P< 0.05). Conclusion. Fangsong training counteracted markedly the reduction in vagal activity, while hypoxia training counteracted markedly the decrease in sympathetic activity. It was possible that HRV indices could be used to evaluate the efficiency of countermeasures counteracting the adverse effects of weightlessness.

[Analysis of heart rate variability during parallel swinging]

OBJECTIVE

To study the pilots' heart rate variability (HRV) characteristic before, during and after parallel swing and the possibility of evaluating vestibule-vegetative nervous reaction under linear acceleration.

METHOD

37 healthy male pilots participated in parallel swing test. Dynamic ECG was recorded for 15 min before, during and after swing, using model MR-4500 Holter recorder. All spectra were estimated from 15 min HRV by autoregressive (AR) modeling method, the model order (8-15) was chosen using automatic program. The ratio of lower-frequency (LF) to high-frequency (HF) power of HRV spectrum (LF/HF) was computed. The relation between change of those ratios in different swing stage and swing time was analysed.

RESULT

Ratio of LF to HF during swing was markedly lower than those of before and after swing (P<0.01).

CONCLUSION

The vagal nervous activity was markedly increased during swing. There were complexity and versatility in the heart automatic nervous regulation before, during and after swing.

Effects of blocking GABA degradation on corticotropin-releasing hormone gene expression in selected brain regions

PURPOSE

The gamma-aminobutyric acid (GABA) degradation blocker gamma-vinyl-GABA (VGB) is used clinically to treat seizures in both adult and immature individuals. The mechanism by which VGB controls developmental seizures is not fully understood. Specifically, whether the anticonvulsant properties of VGB arise only from its elevation of brain GABA levels and the resulting activation of GABA receptors, or also from associated mechanisms, remains unresolved. Corticotropin-releasing hormone (CRH), a neuropeptide present in many brain regions involved in developmental seizures, is a known convulsant in the immature brain and has been implicated in some developmental seizures. In certain brain regions, it has been suggested that CRH synthesis and release may be regulated by GABA. Therefore we tested the hypothesis that VGB decreases CRH gene expression in the immature rat brain, consistent with the notion that VGB may decrease seizures also by reducing the levels of the convulsant molecule, CRH.

METHODS

VGB was administered to immature, 9-day-old rats in clinically relevant doses, whereas littermate controls received vehicle.

RESULTS

In situ hybridization histochemistry demonstrated a downregulation of CRH mRNA levels in the hypothalamic paraventricular nucleus but not in other limbic regions of VGB-treated pups compared with controls. In addition, VGB-treated pups had increased CRH peptide levels in the anterior hypothalamus, as shown by radioimmunoassay.

CONCLUSIONS

These findings are consistent with a reduction of both CRH gene expression and secretion in the hypothalamus, but do not support an indirect anticonvulsant mechanism of VGB via downregulation of CRH levels in limbic structures. However, the data support a region-specific regulation of CRH gene expression by GABA.

Synaptic and neurochemical features of calcitonin gene-related peptide containing neurons in the rat accessory optic nuclei

Within the rodent visual system, calcitonin gene-related peptide (CGRP) is selectively expressed in neurons in the accessory optic nuclei (AON), including the dorsal terminal nucleus (DTN), lateral terminal nucleus (LTN) and medial terminal nucleus (MTN). To determine whether CGRP-immunoreactive neurons are involved in visual circuitry, electron microscopic preparations were analyzed from normal rats and rats with optic nerve transections. A co-localization analysis was also made because CGRP-labeled neurons had features of GABAergic neurons. Thus, sections were prepared for light microscopy to determine whether CGRP-containing neurons also had glutamate decarboxylase (GAD) and other markers for GABAergic neurons, such as calcium binding proteins: calbindin (CB), calretinin (CR) and parvalbumin (PV). Electron microscopy of the DTN and LTN showed CGRP-labeled somata and dendrites that were postsynaptic to axon terminals forming asymmetric synapses. Many of these axon terminals degenerated following optic nerve transection indicating that retinal ganglion cells form synapses with CGRP-labeled neurons in the AON. In the DTN, LTN and MTN, CGRP-labeled axon terminals formed symmetric synapses with unlabeled somata as well as dendritic shafts and spines. Consistent with this type of synapse being GABAergic were the co-localization data showing that about 90% of the CGRP-labeled neurons co-localized GAD in the AON. Many CGRP-labeled neurons showed immunostaining for CR (40%) whereas only a few had labeling for CB (5%). No CGRP-labeled neurons had PV. These data show that CGRP-containing neurons receive direct retinal input and represent a subpopulation of GABAergic neurons which differentially co-express calcium-binding proteins.

Alteration of GABA transporter expression in the rat cerebral cortex following needle puncture and colchicine injection

In the adult cerebral cortex, GABA transporters (GATs) are expressed by both neurons and astrocytes. GAT-1 immunoreactivity is found in axon terminals of GABAergic neurons and astrocytes, while GAT-3 immunolabeling occurs only in the latter. The present study was designed to determine whether the expression of GAT-1 and GAT-3 in the adult rat cerebrum changes after needle lesion and colchicine infusion. Following a needle puncture or a saline injection, immunolabeling for GAT-1 and GAT-3 was slightly increased in an area around the needle track. Not only was the neuropil labeling for both GATs increased, but also a few neuronal somata were found to be immunoreactive for GAT-1. Colchicine injections induced a striking increase in immunolabeling for both GATs in the neuropil in an area adjacent to the needle path and surrounding it. A homologous region of the contralateral hemisphere also showed a moderate increase of immunoreactivity in the neuropil for both GATs. Furthermore, this contralateral site showed many neuronal somata immunolabeled for GAT-1. These changes were mainly detected during the first 5 days following intracortical lesions. These results indicate that (1) the upregulation of GAT-1 and GAT-3 in cortical interneurons and astrocytes is caused by both mechanical and chemical factors associated with the injections; (2) increased GAT-1 and GAT-3 expression contralateral to the site of colchicine injection is mediated by transcellular signaling across the corpus callosum; and (3) the lesion-induced GAT expression may play a protective role by helping to balance excitatory and inhibitory neuronal activities.

Developmental expression of gamma-aminobutyric acid transporters (GAT-1 and GAT-3) in the rat cerebellum: evidence for a transient presence of GAT-1 in Purkinje cells

The cerebellar cortex contains several classes of GABAergic neurons. Previous studies have shown that most GABAergic neurons in this region possess the capacity for gamma-aminobutyric acid (GABA) uptake. The present study determined the postnatal expression of two GABA transporters, GAT-1 and GAT-3, in the cerebellar cortex and deep nuclei of the rat by using immunocytochemistry. Immunoreactivity for GAT-1 and GAT-3 appears at postnatal day 7 (P7), emerges centroperipherally across the cerebellum during the following 2 weeks and reaches an adult-like pattern by P30. The mature patterns are fully established by P45, which for GAT-1 is characterized by immunolabeled profiles localized exclusively to neuropil, mostly in the molecular layer and the pinceaux deep to the Purkinje cell bodies, and for GAT-3 as immunoreactivity distributed in the neuropil of mainly the granular layer. Before the adult patterns are completed, GAT-1 immunoreactivity is present in the somata of Purkinje, Golgi, basket and stellate cells between P7 and P21, while GAT-3 immunoreactivity is distinct in astrocytic somata which are organized in regularly spaced clusters. During this period, there is also a banding pattern in the sagittal plane of GAT-1 immunoreactivity in developing Purkinje cells. The postnatal development of GAT-1 and GAT-3 in the rat cerebellar cortex shares a similar spatiotemporal pattern with other GABAergic parameters, including the GABA synthesizing enzyme, GABA content and uptake. Specifically, the transient expression of GAT-1 in the somata and dendrites of cerebellar GABAergic neurons appears to correlate with the supra-adult levels of whole-tissue GABA uptake capability during development. Further, GAT-1 expression in immature Purkinje cells may play a unique role in regulating GABA's function during development, since mature Purkinje cells do not express GAT-1 or take up GABA.

Dentate granule cells form novel basal dendrites in a rat model of temporal lobe epilepsy

Mossy fibre sprouting and re-organization in the inner molecular layer of the dentate gyrus is a characteristic of many models of temporal lobe epilepsy including that induced by perforant-path stimulation. However, neuroplastic changes on the dendrites of granule cells have been less-well studied. Basal dendrites are a transient morphological feature of rodent granule cells during development. The goal of the present study was to examine whether granule cell basal dendrites are generated in rats with epilepsy induced by perforant-path stimulation. Adult Wistar rats were stimulated for 24 h at 2 Hz and with intermittent (1/min) trains (10 s duration) of single stimuli at 20 Hz (20 V, 0.1 ms) delivered 1/min via an electrode placed in the angular bundle. The brains of these experimental rats and age- and litter-matched control animals were processed for the rapid Golgi method. All rats with perforant-path stimulation displayed basal dendrites on many Golgi-impregnated granule cells. These basal dendrites mainly originated from their somata at the hilar side and then extended into the hilus. Quantitative analysis of more than 800 granule cells in the experimental and matched control brains showed that 6-15% (mean=8.7%) of the impregnated granule cells have spiny basal dendrites on the stimulated side, as well as the contralateral side (mean=3.1%, range=2.9-3.9%) of experimental rats, whereas no basal dendrites were observed in the dentate gyrus from control animals. The formation of basal dendrites appears to be an adaptive morphological change for granule cells in addition to the previously described mossy fibre sprouting, as well as dendritic and somatic spine formation observed in the dentate gyrus of animal and human epileptic brains. The presence of these dendrites in the subgranular region of the hilus suggests that they may be postsynaptic targets of the mossy fibre collaterals.

Complementary distributions of calbindin, parvalbumin and calretinin in the cerebellar vermis of the adult cat

Immunocytochemistry was used to compare regional and cellular distribution of the calcium-binding proteins calbindin (CB), parvalbumin (PV) and calretinin (CR) in the cerebellar vermis of adult cats. CB and PV displayed similar patterns of distribution, mainly in Purkinje cells and their processes. Immunoreactive Purkinje cell axons were organised in bundles alternating with reaction-free strips, or raphes, of afferent fibres. In contrast, CR immunoreactivity was most apparent in unipolar brush neurons, and in mossy and climbing fibres. CR positive unipolar brush neurons were clustered and positive climbing fibres formed bands. Thus, CR was associated with afferent fibres and interneurons, and occurred in complementary structures to those demonstrated for CB and PV, mainly in efferent neurons and pathways.

Seizure-induced neuronal injury: vulnerability to febrile seizures in an immature rat model

Febrile seizures are the most common seizure type in young children. Whether they induce death of hippocampal and amygdala neurons and consequent limbic (temporal lobe) epilepsy has remained controversial, with conflicting data from prospective and retrospective studies. Using an appropriate-age rat model of febrile seizures, we investigated the acute and chronic effects of hyperthermic seizures on neuronal integrity and survival in the hippocampus and amygdala via molecular and neuroanatomical methods. Hyperthermic seizures-but not hyperthermia alone-resulted in numerous argyrophilic neurons in discrete regions of the limbic system; within 24 hr of seizures, a significant proportion of neurons in the central nucleus of the amygdala and in the hippocampal CA3 and CA1 pyramidal cell layer were affected. These physicochemical alterations of hippocampal and amygdala neurons persisted for at least 2 weeks but were not accompanied by significant DNA fragmentation, as determined by in situ end labeling. By 4 weeks after the seizures, no significant neuronal dropout in these regions was evident. In conclusion, in the immature rat model, hyperthermic seizures lead to profound, yet primarily transient alterations in neuronal structure.

Increased expression of GABA transporters, GAT-1 and GAT-3, in the deafferented superior colliculus of the rat

GABA transporters (GATs) play a critical role in the translemmal transport of GABA in neurons and glial cells. Two major brain GATs, GAT-1 and GAT-3, are found in astrocytes in the adult brain. Astroglia demonstrate morphological and molecular changes in response to brain injury and deafferentation. The present study was designed to determine whether the expression of GATs changes after nerve deafferentation using the rat superior colliculus (SC) as a model. The immunoreactivity for GAT-1 and GAT-3, as well as GABA and glutamic acid decarboxylase (GAD)-65 and GAD-67, was studied in the SC of control rats and rats with unilateral optic nerve transections. Immunolabeling for both GAT-1 and GAT-3 was increased in the neuropil of the denervated SC as compared to that for the SC of control rats or for the unaffected SC of experimental rats. In contrast, immunoreactivity for GABA, GAD-65 and GAD-67 was not altered. The change in the immunolabeling of GAT-1 and GAT-3 was detectable at 1 day postlesion and became more evident between 3-30 days postlesion. At the electron microscopic level, immunoreactivity for both GAT-1 and GAT-3 in the unaffected SC was localized to astrocytic processes, whereas GAT-1 immunolabeling was also present in synaptic terminals. In the deafferented SC, immunolabeling for both GATs was elevated in the somata and processes of hypertrophied astrocytes as compared to that in the unaffected SC, whereas GAT-1 labeling in neuronal profiles was largely unchanged. A substantial increase of GAT-1 and GAT-3 in astrocytes following optic nerve transection suggests that these cells play a role in modulating GABA's action in the deafferented SC.

Calcitonin gene-related peptide immunoreactivity selectively labels accessory optic nuclei and pathways of the rat visual system

The present study shows the distribution of calcitonin gene-related peptide (CGRP)-immunolabeled neuronal somata and fibers in the accessory optic system of adult rats. CGRP-immunoreactive cell bodies were small to medium-sized and mostly fusiform or oval-shaped. Both immunolabeled somata and fibers were found in the dorsal and lateral terminal nuclei as well as in the interstitial nucleus of the superior fasciculus (posterior fibers); whereas only immunoreactive fibers were found in the ventral division of the medial terminal nucleus, particularly its rostral portion. These results indicate that CGRP-containing neurons are present in all nuclear components of the accessory optic system and suggest that this neuropeptide may play a neuromodulative role in eye movements.

Uptake of 99mTc(5+)-complexes in ischemic myocardial slices and their dissociable ability

AIM

To find how some technetium-complexes to deliver the active species, TcO4(3-), to the target tissue from a dissociable polynuclear Tc5+ species in preserved states in vivo.

METHODS

Effect of dissociation ability of the polynuclear Tc5+ complexes on their accumulation in ischemic myocardium was tested. Ability of dissociation as having an appropriate conformation to become biologically functional after entering the blood circulation was tested using a simple dilution method by thin layer chromatography (TLC) analysis. Various degree of ischemic myocardium slices of rat were incubated with 1/100 diluted 99mTc(5+)-succimer, 99mTc(5+)-GH and 99mTc(5+)-PPi.

RESULTS

The TLC patterns of 99mTc(5+)-GH and 99mTc(5+)-PPi showed the presence of a fast increasing of free Tc-species as dilution degree increased. The relative radioactivity of peak of free pertechnetate (Rf = 0.85-1.0) with 1:500 dilution was: 99mTc(5+)-succimer 0%, 99mTc(5+)-GH 28.1% +/- 1.3%, and 99mTc(5+)-PPi 46.0% +/- 2.9% respectively. The uptake of the myocardium after ischemia for 3 h was 99mTc(5+)-succimer 420% +/- 110% dose/g tissue, 99mTc(5+)-GH 710% +/- 180% dose/g tissue, and 99mTc(5+)-PPi 1295% +/- 390% dose/g tissue respectively.

CONCLUSION

The dissociation and myocardial uptake showed: 99mTc(5+)-succimer < 99mTc(5+)-GH < 99mTc(5+)-PPi, the uptake by the ischemic myocardium is positively correlated to their dissociation.

NADPH-diaphorase reactivity is reduced in the molecular layer but increased in the granular layer of primate cerebellum after prolonged anaesthesia

To test if nitric oxide (NO) is involved in modulation of neuronal activity after global changes of brain function, nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) reactivity in the cerebellar cortex was compared in monkeys maintained under anaesthesia for 24-48 h with others only anaesthetised for perfusion. After prolonged anaesthesia, NADPH-d activity was reduced in the molecular layer, but increased in the granular layer, with the maintenance of a parasagittal patchy organisation of the highly reactive granule cells. Selective labelling of NADPH-d in the infraganglionic plexuses deep to a subset of Purkinje cell somata was lost in the anaesthetised animals. This differential alteration of NADPH-d reactivity suggests that NO may play a role in regulation of neuronal and synaptic activity during anaesthesia.

Immunoreactivity for GABA plasma membrane transporter, GAT-1, in the developing rat cerebral cortex: transient presence in the somata of neocortical and hippocampal neurons

The immunoreactivity for a gamma-aminobutyric acid (GABA) membrane transporter, GAT-1, was examined in the neocortex and hippocampal formation of developing rats from the day of birth (postnatal day 0, P0) to the adult stage. The immunolabeling was mainly localized to the neuropil, but was also in a select population of cell bodies during a limited time period. Layers I and VIb of neocortex exhibited relatively high reactivity at birth, but diminished their staining with development. In contrast, GAT-1 immunoreactivity in the neuropil in the cortical plate and its derivatives was light at birth, but increased rapidly during the first 2-3 postnatal weeks in an inside-out order. An adult pattern with immunoreactive puncta more densely distributed in layers II to IV than the deeper layers was completed by P30-45. The neuropil reactivity in the hippocampal formation at P0 was greater than that in the neocortex, densely localized in a supragranular band, and less densely in the hilus of the dentate gyrus and the strata radiatum and oriens of the hippocampus. This pattern was basically maintained at later stages except that the immunoreactivity in the supragranular band diminished, whereas that in the subgranular zone was enhanced. A population of cell bodies morphologically characteristic of cortical and hippocampal interneurons was substantially immunolabeled for GAT-1 by P5 and remained until P30. At the electron microscopic level, GAT-1 immunoreactivity was localized mainly to axon terminals and astrocytes between P5 and P45, but was also found in neuronal somata and their dendrites between P5 and P30. Our data show a differential postnatal development of GAT-1 immunoreactivity in the rat cerebral cortex, including a transient presence of immunoreactivity in the somata of a subpopulation of cerebral interneurons and a developmental downregulation of GAT-1 expression in the earliest generated cortical elements (layers 1 and VIb). The findings in the present study suggest that GAT-1 expression in the neocortex and hippocampus may relate to the functional maturation of the GABAergic system.

Prenatal development of calbindin D-28K and parvalbumin immunoreactivities in the human retina

Two calcium binding proteins, calbindin D-28K (CB) and parvalbumin (PV),immunoreactivities were examined by immunocytochemistry in the retinas of human fetuses aged from 13 weeks (W) of gestation to term. CB- and PV-immunoreactive products were both detectable at 13 W and appeared in all layers in a roughly inside-out order by 24 W. PV-immunostaining occurred in virtually all ganglion cells, most horizontal cells, and a few amacrine cells. CB-immunoreactivity was found in most amacrine cells and some horizontal cells, and a subset of cells in the ganglion cell layer that were more frequent in the nasal than the temporal retina at 13-15 W. Bipolar cells were distinctly immunostained for CB by 24 W. Foveal cones showed faint CB labeling by 24 W and intense staining at 32 W. The patterns of CB- and PV-immunoreactivities by birth were similar to those at 32 W with the addition of faint CB-immunolabeling occurring beyond the fovea in the photoreceptors. A stronger expression of CB was seen in the nasal side of the optic nerve head from 13-24 W, peaking at 15 W. The results indicate that CB and PV expression in ganglion cells and inner nuclear layer neurons proceeds in parallel with their somal and process differentiation, suggesting a possible role for these proteins in neuronal maturation. The early expression of PV and CB in ganglion cell axons might be related to optic nerve outgrowth, including path-finding at the optic chiasm. CB expression in cones and other cells in the fovea may indicate that it is involved in foveal formation that occurs during the perinatal period.

Prenatal development of nicotinamide adenine dinucleotide phosphate-diaphorase activity in the human hippocampal formation

Nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) histochemistry was used to study the development of the neurons metabolizing nitric oxide in the prenatal human hippocampal formation. Strongly reactive non-pyramidal neurons appeared in small numbers in the subplate at 15 weeks, and rapidly increased in this layer, as well as the cortical plate-derived layers between 17 and 24 weeks. The marginal zone also had a few NADPH-d cells at 15 weeks. The pattern of these darkly reactive cells stabilized by 28 weeks, with the somata distributed mostly at the border of the cortex and white matter in the entorhinal cortex and subiculum, or the alveus in Ammon's horn. Moderately stained non-pyramidal neurons appeared in the dentate gyrus by 17 weeks, and increased in this region and Ammon's horn up to 28 weeks. Small, lightly reactive non-pyramidal neurons were first seen by 32 weeks and increased in number by term. They were mainly distributed in layers II/III of the entorhinal cortex and stratum pyramidale of the subiculum and Ammon's horn. NADPH-d positive fibers in the marginal zone were mostly thin and developed between 20 and 28 weeks. In other cortical layers, thick processes from the darkly stained NADPH-d neurons appeared first, then fine fibers appeared more numerous, especially after 28 weeks. NADPH-d processes that arose from non-pyramidal cells were frequently apposed to blood vessels, including those in the hippocampal fissure. In addition, NADPH-d reactivity was also present in pyramidal and granule cells, but this staining was most pronounced between 15 and 24 weeks. The results show three types of distinctly stained NADPH-d interneurons in the fetal human hippocampal formation with different developmental courses and morphology. Also, hippocampal principal neurons transiently express NADPH-d at early fetal ages. Our data correlated with other findings suggest that nitric oxide may play a role in neuronal development in the hippocampal formation by modulating neuronal differentiation and maturation, and regulating blood supply.

Morphological diversity of nitric oxide synthesising neurons in mammalian cerebral cortex

Neocortical neurons that utilise nitric oxide (NO) differ in morphology in different mammalian species. In the present study we examine these differences in the neocortex of mouse, rat, guinea-pig, rabbit, cat and monkey using histochemistry for nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) and immunocytochemistry for nitric oxide synthase (NOS), gamma amino-butyric acid (GABA), calbindin (CB), parvalbumin (PV) and calretinin (CR). NO neurons are non-pyramidal and can be divided into two distinct types, both of which react for NOS and NADPH-d. Type I neurons have a relatively large soma with heavy reaction product filling even the fine processes. They occur in all species, mainly near the border between the cortex and white matter, with fewer in the cortex, mostly in the superficial layers (II-IV). Type II cells are more numerous, smaller, and lighter in reactivity. They are in all species examined here except rodents, and in all cortical layers, but mainly layers II-IV. Most intracortical and some subcortical Type I neurons express GABA. A few intracortical Type I cells contain CB. All Type II cells express GABA and most also CB. Neither Type I nor Type II cells stain for PV or CR. We conclude that there is a tendency for a reduction of Type I cells, and increase of Type II, in mammalian neocortex with phylogeny.

Induction of NADPH-diaphorase activity in the forebrain in a model of intracerebral hemorrhage and its inhibition by the traditional Chinese medicine complex Nao Yi An

Induction of NADPH-diaphorase (NDP) activity in the rat cerebral cortex was studied after autologous blood injection into the internal capsule as experimental model of intracerebral hemorrhage. The potential inhibitory effect on NDP induction by Nao Yi An (NYA), a complex derived from materials of animal and plant origin used in the treatment of intracerebral hemorrhage in traditional Chinese medicine, was also investigated. In animals without therapeutic treatment 2 and 4 days after injection of autologous blood, NDP activity was highly induced in pyramidal neurons in the neocortex, piriform, and entorhinal cortices, in astrocytes and in phagocytes in the hematoma and the area surrounding it, as well as in the subcortical white matter, and in endothelial cells in both the cortex and subcortical white matter bilaterally. Oral administration of NYA failed to inhibit NDP induction in endothelial cells but demonstrated a strong inhibitory effect on NDP activity induced in pyramidal neurons and astrocytes. NDP induction in phagocytes was also inhibited by the administration of NYA. Altogether the present results suggest that intracerebral hemorrhage in the internal capsule may induce nitric oxide synthase activity in different cell populations in the cortex and that administration of NYA can selectively inhibit such induction and, thus, potentially play a neuroprotective role.

Prenatal development of calbindin D-28K in human visual cortex

The distribution of the calcium-binding protein calbindin D-28K (CB) was investigated in human fetal primary visual cortex. CB is present in Cajal-Retzius cells of layer I, in sparse neurons of the ventricular and intermediate zones (VZ, IZ), and in tangential fibres in IZ by 15 weeks (W) of gestation. Cajal-Retzius cells lose their staining by 30W. CB appears in layers II-VI mainly from 26W, following an inside-outside sequence. Until 34W, CB labelling is in somata and neuropil located primarily in layers IVA, IVC and V. Then reactive perikarya and puncta increase in layers II-IVA and deep IVB and C, but are reduced in infragranular layers from 34W to term. From 30W positive somata form clusters in the cell-rich bands in layers IV and V and labelled neuropil in layers III and IV has a periodic pattern from 34W. Also from 34W, numerous lightly reactive pyramidal cells are present in layers II to IVA in primary, but not secondary, visual cortex. Our results show precocious expression of CB before full laminar differentiation of the cortex and that some of this expression is transient.

Early expression of recoverin in a unique population of neurons in the human retina

The calcium-binding protein recoverin has been reported as present in photoreceptors, cone bipolar cells and sparse cells in the ganglion cell layer in the adult retinae of various vertebrate species. The present study was undertaken to clarify the developmental pattern of recoverin-immunoreactive cells in the human retina with particular attention to the cells in the inner retinal layers. In the adult human retina, small populations of recoverin-containing cells are present in the ganglion cell and nerve fiber layers. However, the precursors of these cells are quite numerous on the inner and outer borders of the nerve fiber layer in the fetal retina. By 13 weeks of gestation these cells express recoverin very intensely. By 24 weeks they are mature-looking with relatively large soma sizes (mean = 118 microns 2) and appear round, oval or multipolar in shape, with varying numbers of short processes. There follows a noticeable reduction of the mean soma size, but little change in morphology and process number during the remaining gestational stages up to and after birth. The mean numerical density of the recoverin-positive cells in the fetal inner retinal layers is gradually reduced from the high level at 13 weeks until birth, when there is a great drop to the adult level. The recoverin-immunoreactive cells in the ganglion cell layer demonstrate distinctively different developmental and morphological features from the principle neurons and glial cells in the retina. They are probably the neurons derived from the marginal zone of the retinal primordium that reside in the inner and outer borders of the nerve fiber layer due to the invasion of ganglion cell axons. The expression of recoverin in the neurons may be significant in maintaining an inside-out and centroperipheral gradient of calcium concentration in the premature retina, thereby playing a role in determining the polarity of the differentiating ganglion cells and the growth of their axons in a centrifugal spatiotemporal order.

Prenatal development of NADPH-diaphorase-reactive neurons in human frontal cortex

Nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) histochemistry was used to study the morphology and development of neurons that metabolize nitric oxide (NO) in the frontal cortex of human fetuses aged from 13 weeks of gestation (13W) to term, to investigate whether the two distinct types of NO neuron described in the adult develop differently. Large, heavily stained, sparsely spiny, non-pyramidal neurons (Type I) develop by 15W mainly in the subplate (SP) of the cortical Anlage. They achieve an adult-like pattern by 32W, distributed thoughout the cortex and subcortical white matter, but with the highest concentration in the white matter. Small, lightly stained cells (Type II) develop later (32W) thoughout the cortex, but especially in layers II-IV, and increase in number to term. NADPH-d-positive dendrites and axons appear in the cortex and white matter by 15W. They include thick, radially oriented, dendritic processes from Type I neurons in SP and CP. Their arbors expand and mature between 17 and 28W. Fine horizontal axons are visible in layer I by 17W. Others develop in layers II-IV from 28W, and have reached a high degree of development by term. NADPH-d-positive axons in the cortex seem to have both intrinsic and extrinsic origins. Thus the two types of NADPH-d neurons found in adult primate, including human, cortex are reflected by different developmental forms prenatally. It is concluded that NO-metabolizing neurons in the human cortex may be involved in various aspects of development, including morphological and functional maturation, and that the late-developing Type II neurons may represent a cell line specific to primates, perhaps related to the development of their higher cortical activity and of potential importance in the pathophysiology of diseases of cognitive function.

Prenatal development of parvalbumin immunoreactivity in the human striate cortex

In human primary visual cortex, parvalbumin (PV) is expressed by Cajal-Retzius cells in layer I by 20 weeks of gestation (20W), but its immunoreactivity is mostly lost by term. PV immunoreactivity in layers II-VI mainly develops later, from 26 to 34W, following an approximately 'inside-outside' sequence in a series of bands. PR-positive perikarya appear in layer V by 20W, but only in small numbers. They increase in number and staining intensity by 26W. By 30W a band of densely labelled somata and neuropil occupies layers IVC-VI. By 34W a second, less dense, band of cell bodies and neuropil appears in IVB and IVCalpha, separated from the deep band by IVCbeta which is cell-sparse and almost fibre-free. Between 38 and 40W, a third minor band consisting mainly of fibres is seen in layer IVA. Reactive cell bodies form clusters, and the neuropil staining is mosaic-like. PV-positive neurons are of two main types: large with wide dendritic arbor, and smaller with simpler dendrites. However, a few have characteristics of pyramidal cells, and a few others resemble glial cells. The laminar pattern of PV-immunoreactive somata in human striate cortex is established by term, rather than postnatally as in most mammals, implying that PV may be involved in neuronal development in prenatal human striate cortex.

NADPH-diaphorase-positive neurons in primate cerebral cortex colocalize with GABA and calcium-binding proteins

Neurons in the monkey cerebral cortex containing nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) can be divided into two distinct types, both nonpyramidal. Type I neurons have a large soma (diameter 20-50 microm), a dense NADPH-d histochemical reaction, and are distributed throughout the cortex, but mainly in the subcortical white matter, and are mostly aspiny. Type II cells have a small soma ( Together with previous observations that almost all cortical NADPH-d cells in various subprimates are like type I cells, we suggest that type II cells may form a group of NADPH-d-rich neurons differentiated in higher mammalian cortex from a subpopulation of calbindin-containing GABAergic interneurons, and these nitric oxide-synthesizing cells may play a role in control of intracortical neuronal activity characteristic of higher cerebral functions in advanced mammals.

Spatial periodicity of NADPH-diaphorase and synaptophysin, but not SNAP-25, reactivity in the monkey cerebellar cortex

We recently described a parasagittal patchy organisation of nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) activity in the granular layer of the rat cerebellum. We now report the pattern of NADPH-d distribution in the primate cerebellum and its relationship to two synaptic proteins, synaptophysin and synaptosomal associated protein 25 kDa (SNAP-25), using histochemistry and immunocytochemistry. NADPH-d reactivity was localised in the molecular and granular layers (ML, GL) and a subset of infraganglionic plexuses (IGPs), but not in the Purkinje cell layer and the white matter. In ML, the histochemical reactivity was dense and relatively homogeneous in the neuropil, and moderate in the stellate cells. A patchy organisation of NADPH-d in GL was detected in both horizontal and parasagittal sections. In the IGPs staining for NADPH-d revealed modular positive zones alternating with negative ones. The positive and negative IGP zones were usually congruent with the high and low NADPH-d reactivity in GL, respectively. Both synaptic proteins were strongly expressed in the neuropil in ML and GL, and their patterns were relatively homogeneous. However, synaptophysin was present in a subpopulation of IGPs organised in modules which corresponded to those expressing NADPH-d. Our results indicate that the NADPH-d modular system is more complicated in the primate cerebellum than in the rat. In addition, we have provided suggestive evidence of a co-expression of NADPH-d and synaptophysin in selected IGP modules in primate cerebellum, which suggests that nitric oxide may be involved in the activity of the Purkinje cells by affecting the basket cell synaptic input.

Development of NADPH-diaphorase activity in the rat neocortex

The activity of nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d), an enzyme related to the synthesis of nitric oxide (NO), was studied histochemically in rat neocortex from the day of birth (P0) to young adulthood. At birth, NADPH-d containing neurons were already identifiable, sparsely distributed in the deep half of the pallium of the cerebrum. In addition, weakly stained bands of NADPH-d positive neuropil were detectable in layers VI and deep V and the cortical plate (CP). During the first postnatal week, NADPH-d positive neurons increased markedly, especially in CP and the superficial layers. By P7 the cells were mainly in layers VIb and II/III. Differential NADPH-d activity in the neuropil during this period appeared as higher activity gradually moving upwards until the highest intensity localised in layers II and upper III. In the caudal part of the cortex, the higher activity covered the whole of the supragranular layers. By the end of the second postnatal week, both the number and laminar distribution of NADPH-d neurons were adult-like, still mainly in layers VIb and II/III. The staining intensity in the neuropil was generally reduced but the banding pattern seen at P7 was still present. No detectable changes in the patterns of NADPH-d positive cells and neuropil in the neocortex occurred after the second postnatal week. The rostral part of the cortex matured slightly earlier than the caudal part. These results show that the development of NADPH-d activity correlates with the laminar differentiation and suggest that NADPH-d or NO may play an important role in the maturation of cortical neurons including the establishment of functional connections.

Parasagittal patches in the granular layer of the developing and adult rat cerebellum as demonstrated by NADPH-diaphorase histochemistry

The development of nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) activity in the rat cerebellum was studied histochemically. NADPH-d reactivity was observed in the internal granular layer and some Purkinje cells by the end of first postnatal week (PW1). By PW2, the staining was localized in the granular layer (GL) and the molecular layer (ML), but not in the Purkinje cell layer. The staining in GL and ML increased further, and parasagittally organized NADPH-d patches in GL were recognizable by PW3. These patches were more distinct and almost adult-like by PW4. These results provide the first evidence of a patchy organization of NADPH-d activity in GL and suggest that NADPH-d plays an important role in the maturation and function of the cerebellum.

Prenatal development of GABA-immunoreactive neurons in the human striate cortex

The prenatal development of neurons immunoreactive to gamma-aminobutyric acid (GABA) in the striate cortex (area 17) of human foetuses aged from 14 weeks to term was studied immunocytochemically. In the 14 week foetus GABA-immunoreactive cells occurred in all layers of area 17 with the highest density in the marginal zone (MZ), subplate (SP), deep intermediate zone (IZ) and ventricular zone (VZ). The cortical plate (CP), which gives rise to most of the definitive adult cortical layers, had relatively low concentrations of GABAergic cells. By 17 weeks the density in the proliferative VZ had declined. At 20 weeks some of the adult layers were recognisable; the density of GABA-positive neurons was now highest in the definitive cortex, especially the deep layers (layers VI and V), was lower in the superficial cortical plate, and was lowest in IZ, where the white matter would form. The peak of GABA-immunoreactive neuronal density continued to move superficially during development, and was in layer IVc by 30 weeks. The laminar distribution stabilised from 30 weeks with three dense bands: in layer IVc and superficial V, layer IVa, and layers II and superficial III. The tangential distribution of GABAergic neurons was determined in two older brains (32 and 39 weeks) and no unequivocal spatial periodicity was observed in this plane. The mean cross-sectional area of GABAergic neurons in area 17 increased with foetal age, and also increased from superficial to deep layers at each age. Most GABA-immunoreactive neurons in younger brains contained immunonegative or weakly positive nuclei and had few visible processes, while in the older brains most neurons contained positive nuclei and had more visible processes. The proportion of GABA-immunoreactive bipolar cells declined during development while that of multipolar cells increased. GABAergic neurons thus differentiate early in human foetal striate cortex. They are initially most numerous in the proliferative layers deep to the developing definitive cortex; from 20 weeks of gestation, their peak moves superficially into the maturing deep layers (VI and V) and a stable laminar distribution is attained by 30 weeks, with peaks in layers II/IIIm, IVa and IVc/V. There is no obvious horizontal periodic distribution before term.

Isolation and structural identification of 9hydroxy-9desmethyl-cyclosporine

A metabolite of cyclosporine has been isolated and its structure identified through use of HPLC and tandem mass spectroscopy. Fast atom bombardment mass spectrometry of an HPLC fraction co-eluting with 1 eta hydroxy-cyclosporine (M17) indicated that the mass of this metabolite was 2 Da greater than that of cyclosporine. Further isolation by HPLC yielded a pure fraction, which we analyzed with tandem mass spectrometry. Linear acyl fragment ions originating from the metabolite under collision-induced dissociation were consistent with the difference in mass being associated with amino acid 9 in the cyclosporine backbone. We propose a nomenclature system for future discussion of cyclosporine metabolites.