Acromegaly presented with acne vulgaris: a retrospective study with 123 cases

BACKGROUND

Acne vulgaris is a prevalent skin condition. We have found that some acromegaly patients have acne. However, no study has examined the relationship between acromegaly and acne.

OBJECTIVE

To explore prevalence and correlation of adult acne in patients with acromegaly.

METHODS

For this cross-sectional study, we collected questionnaires, clinical information, and laboratory test results of acromegaly patients from January 2022 to December 2022 at Huashan Hospital. Of the 133 questionnaires returned, 123 had valid responses.

RESULTS

Of the 123 patients with acromegaly enrolled in this study, 54.5% had adult acne. No statistically significant difference was found in prevalence between male and female patients. 61.2% of adult acne patients reported late-onset acne. Late-onset acne patients first developed acne years before acromegaly diagnosis (mean of 5.6 years for male and 4.5 years for female patients). Some acne patients have received traditional anti-acne treatment. Moreover, 31% of the patients reported no improvement, and only 3.5% of patients claimed complete resolution of acne after treatment. Before acromegaly treatment, the prevalence of adult acne was 51.2%, with mild acne accounting for 73.0%, moderate acne accounting for 23.8%, and severe acne accounting for 3.2%. After acromegaly treatment, the prevalence of adult acne was significantly decreased to 37.4% (P = 0.007). An overall decrease in acne severity was noted, with 93.5%, 6.5%, and 0% having mild, moderate, and severe acne, respectively. A total of 83.6% of the patients had self-assessed acne remission, and 33.3% of the patients reported complete acne resolution. However, 9.0% of patients reported that their condition had worsened after acromegaly treatment. After treatment, GH, IGF-1, IGF-1 index, insulin levels, and HOMA-IR decreased significantly in all patients with acromegaly (P < 0.05). Acne remission correlated positively with IGF-1 levels, but not with GH levels. The relationship between acromegaly and acne remains to be elucidated.

CONCLUSIONS

Our findings provide preliminary evidence of the high prevalence of adult acne in acromegaly patients, and a high rate of late-onset acne as well. Traditional anti-acne treatments are less effective. Acne could be considerably relieved by treating acromegaly. Acne remission positively correlated with IGF-1 decline as well, which revealed the correlation between acne and IGF-1.

[Chinese multidisciplinary expert consensus on the management of adverse drug reactions associated with savolitinib]

MET gene is a proto-oncogene, which encodes MET protein with tyrosine kinase activity. After binding to its ligand, hepatocyte growth factor, MET protein can induce MET dimerization and activate downstream signaling pathways, which plays a crucial role in tumor formation and metastasis. Savolitinib, as a specific tyrosine kinase inhibitor (TKI) targeting MET, selectively inhibits the phosphorylation of MET kinase with a significant inhibitory effect on tumors with MET abnormalities. Based on its significant efficacy shown in the registration studies, savolitinib was approved for marketing in China on June 22, 2021 for the treatment of advanced non-small cell lung cancer with MET 14 exon skipping mutations. In addition, many studies have shown that MET TKIs are equally effective in patients with advanced solid tumors with MET gene amplification or MET protein overexpression, and relevant registration clinical studies are ongoing. The most common adverse reactions during treatment with savolitinib include nausea, vomiting, peripheral edema, pyrexia, and hepatotoxicity. Based on two rounds of extensive nationwide investigations to guide clinicians, the consensus is compiled to use savolitinib rationally, prevent and treat various adverse reactions scientifically, and improve the clinical benefits and quality of life of patients. This consensus was prepared under the guidance of multidisciplinary experts, especially including the whole-process participation and valuable suggestions of experts in Traditional Chinese Medicine, thus reflecting the clinical treatment concept of integrated Chinese and western medicines.

[Effect of sctence information regulator 3 on temporomandibular joint osteoarthritis]

Temporomandibular joint osteoarthritis (TMJOA) is a common subclass of temporomandibular disorders, with complicated causes and limited treatment. In addition to inflammatory reaction, structural changes of temporomandibular joint (TMJ) as condylar osteophyte formation, sclerosis, erosion, and subchondral bone cysts will happen at the same time. At present, it is found that epigenetic regulation can affect the growth and development of TMJ and regulate the immune inflammatory reaction, so we can speculate that epigenetic modification is involved in the occurrence and development of TMJOA. This paper reviews the researches of silence information regulator 3 (SIRT3), which is a key factor in epigenetics, in the field of osteoarthritis and rheumatoid arthritis.In order to discuss the effect of SIRT3 on the growth and development of TMJ by mediating acetylation modification, such as bone, cartilage, synovium and blood vessels, as well as alleviating osteoarthritis and synovitis. By doing this, the understanding of TMJOA can be enriched, with the goal of finding a new possibility for the clinical treatment of TMJOA.

[Study on the incidence of adult herpes zoster in Yichang city and its association with early-life famine exposure]

Based on Yichang health big data platform, 850 608 patients from September 2018 to September 2019 were included in this study. According to the date of birth, the participants were divided into early childhood famine exposure group, fetal famine exposure group and non-famine exposure group. The incidence of adult herpes zoster (HZ) in Yichang city was analyzed, and the correlation between early life famine exposure and adult HZ was analyzed. In 2019, the crude incidence rate of adult HZ in Yichang was 6.83‰. The crude incidence rate of adult HZ in females (7.26‰) was higher than that in males (6.40‰). Compared with the non-famine exposure group, fetal famine exposure was associated with the incidence of adult HZ (OR=1.21; 95%CI: 1.01-1.45, P=0.041). After stratification by sex, fetal famine exposure was only found to be associated with the onset of adult HZ in females (OR=1.28, 95%CI:1.02-1.61, P=0.034).

Association between sleep structure and amnesic mild cognitive impairment in patients with insomnia disorder: a case-control study

STUDY OBJECTIVES

To examine the association between sleep structure and amnesic mild cognitive impairment (aMCI) in patients with insomnia disorder.

METHODS

A total of 256 patients with insomnia disorder were diagnosed by neurologists, 45 of whom were diagnosed with aMCI according to the Petersen criteria, and 45 participants with intact cognition were chosen as controls matched for age and education. A case-control study was conducted to compare sleep structure between aMCI and control patients with insomnia disorder. We evaluated self-reported sleep problems by the Insomnia Severity Index and objective sleep features by polysomnography. Logistic regression models were used to estimate the associations between sleep parameters and aMCI in patients with insomnia disorder.

RESULTS

There was no significant difference in Insomnia Severity Index scores between the aMCI and control groups. In the logistic regression after adjustment for covariates, people with a longer sleep duration (adjusted odds ratio [aOR] = 0.56, 95% confidence interval [CI]: 0.36-0.89), greater sleep efficiency (aOR = 0.50, 95% CI: 0.32-0.77), and a higher percentage of total sleep time in stage 3 of non-rapid eye movement sleep (N3%) (aOR = 0.02, 95% CI: 0.01-0.15) have a lower relative probability of having aMCI. By contrast, higher N1% (aOR = 2.28, 95% CI: 1.36-3.82) and wake after sleep onset (aOR = 1.31, 95% CI: 1.11-1.55) may be risk factors for aMCI in patients with insomnia.

CONCLUSIONS

In patients with insomnia disorder, sleep duration, sleep fragmentation, sleep efficiency, N1% and N3% were independently associated with the presence of aMCI. In the clinical setting, if patients with insomnia show much more serious abnormalities in these sleep indices, clinicians should pay attention to their cognitive function. In-depth research would also be worthwhile to elaborate the causality between sleep and cognitive decline.

[Prevalence and risk factors of Blastocystis hominis infections among AIDS patients in Nanchang City]

OBJECTIVE

To investigate the prevalence and risk factors of Blastocystis hominis infections among AIDS patients in Nanchang City.

METHODS

A cross-sectional questionnaire survey was conducted among AIDS patients in Nanchang City during the period between May and September, 2016. B. hominis infection was detected in patients'stool samples using a PCR assay, and the CD4⁺ T cell count was measured in subjects'blood samples. In addition, the risk factors of B. hominis infection in AIDS patients were identified using univariate and multivariate logistic regression analyses.

RESULTS

A survey was conducted in Nanchang City from May to September 2016. A total of 505 AIDS patients were investigated, and the prevalence of B. hominis infection was 4.16%. Univariate analysis revealed that B. hominis infection correlated with the occupation (χ² = 8.595, P = 0.049), education level (χ² = 14.494, P = 0.001), type of daily drinking water (χ² = 10.750, P = 0.020), root of HIV infections (χ² = 8.755, P = 0.026) and receiving anti-HIV therapy (χ² = 23.083, P = 0.001) among AIDS patients, and multivariate logistic regression analysis identified daily direct drinking of tap water as a risk factor of B. hominis infections [odds ratio (OR) = 7.988, 95% confidential interval (CI): (1.160, 55.004)] and anti-HIV therapy as a protective factor of B. hominis infection [OR = 0.183, 95% CI: (0.049, 0.685)].

CONCLUSIONS

The prevalence of B. hominis is 4.16% among AIDS patients in Nanchang City. Daily direct drinking of tap water is a risk factor, and anti-HIV therapy is a protective factor of B. hominis infection among AIDS patients living in Nanchang City.

[Prevalence and risk factors of Blastocystis infections among primary school students in Jiangjin District, Chongqing City]

OBJECTIVE

To investigate the prevalence and risk factors of Blastocystis infections among primary school students in Jiangjin District, Chongqing City.

METHODS

A cross-sectional questionnaire survey was conducted among students sampled from a primary school in Jiangjin District, Chongqing City on April, 2018, and their stool samples were collected for microscopic examinations, in vitro culture and PCR assays to analyze the prevalence of Blastocystis infections and subtype of the parasite. In addition, the risk factors of Blastocystis infections among primary school students were identified using univariate analysis and multivariate logistic regression analysis.

RESULTS

A total of 466 primary students were surveyed, and the subjects had a mean age of (9.81±1.66) years and included 236 males (50.64%) and 230 females (49.36%). The prevalence of Blastocystis infections was 15.24% (71/466) among the study students, and there was no significance difference in the prevalence between male and fe- male students (16.52% vs. 13.91%; χ2 = 0.616, P = 0.433). In addition, there was a significant difference in the prevalence of Blastocystis infections among grade 1 (6.35%, 4/63), grade 2 (5.17%, 3/58), grade 3 (21.74%, 15/69), grade 4 (25.30%, 21/83), grade 5 (10.19%, 11/108) and grade 6 students (20.00%, 17/85) (χ2 = 15.410, P = 0.009). There were four Blastocystis subtypes characterized (ST1, ST3, ST6 and ST7), in which ST6 was the most common subtype (45.07%, 32/71), followed by ST3 (25.35%, 18/71). Multivariate logistic regression analysis revealed that minority ethnicity [odds ratio (OR) = 4.259, 95% confidential inter- val (CI) : (1.161, 15.621)] and low maternal education level (primary school and below) [OR = 9.038, 95% CI: (1.125, 72.642)] were identified as risk factors of Blastocystis infection among primary school students in Jiangjin District, Chongqing City.

CONCLUSIONS

There is a high prevalence of Blastocystis infections detected among primary school students in Jiangjin District, Chongqing City, and ST6 and ST3 are predominant subtypes. Minority ethnicity and low maternal education level (primary school and below) are risk factors for Blastocystis infections in primary school students.

[Advances in supercooling liver preservation]

Liver transplantation is currently the only effective treatment for end-stage liver disease. The preservation of donor liver before transplantation is important. But both traditional static cold storage and machine perfusion are limited by the preservation time, so that the allotment space of donor liver is limited, which inevitably leads to the abandonment of part of donor liver.At present, to find a preservation technology that not only guarantees the quality of donor liver but also has a longer effective preservation time is the direction of joint efforts of all clinicians. Supercooling liver preservation(SLP) to find a preservation technology that not only guarantees the quality of donor liver but also has a longer effective preservation time is the direction of joint efforts of all clinicians. SLP, a new method based on using cryoprotectants to keep donor liver under -6 ℃ and recovering the graft with subnormothermic machine perfusion that enables long-term transplantation survival following 4 days of liver preservation, made a revolutionary breakthrough in the field of liver preservation, carved out a new field for the research of liver preservation. This article reviews the latest experimental research progress of SLP in the field of liver transplantation.

[Prevalence and risk factors of Blastocystis hominis infection in inpatients in Jiangjin District, Chongqing City]

OBJECTIVE

To understand the prevalence and risk factors of Blastocystis hominis infection in inpatients in Jiangjin District, Chongqing City.

METHODS

A cross-sectional study was conducted in a community hospital in Jiangjin District, Chongqing City, and the inpatients were surveyed by questionnaires. After obtaining the informed consent from the inpatients or legal guardians, the stool and blood samples were collected and examined by microscopy and PCR from April 17 to May 1, 2018. The univariate analysis and logistic regression analysis were used to analyze the risk factors of the B. hominis infection.

RESULTS

A total of 198 hospitalized patients were investigated, and the infection rate of B. hominis was 10.61% (21/198), and the infection rate of the females (12.10%) was higher than that of the males (8.11%), but the difference was not statistically significant. The highest rate of infection was 19.23% in the age group of 10 to 20 years, followed by 17.74% in the age group of 60 years and above, and the lowest rate was 2.38% in the age group of 20 to 40 years. The difference in infection rates of B. hominis among the different age groups was statistically significant (P < 0.05). The infection rate of B. hominis in the people who used dry pail latrines was 33.30%, which was higher than that of the people who used water flush toilets (9.10%) (P < 0.05). The genotypes of B. hominis were ST1, ST3, ST6 and ST7, and ST6 and ST3 being the most predominant genotypes which accounted for 47.62% (10/21) and 38.10% (8/21) respectively, and among the infected males, the genotypes were only ST3 and ST6. The multiple logistic regression analysis showed that among the factors affecting B. hominis infection, only keeping pets was a risk factor [OR = 3.798, 95% CI (1.245, 11.581), P < 0.05].

CONCLUSIONS

A high prevalence of B. hominis infection is found in the inpatients in Jiangjin District, Chongqing City, the predominant genotypes are ST6 and ST3, and keeping pets may be one of the main risk factors.

[Epidemiological characteristics and risk factors of Blastocystis hominis infection among patients with HIV/AIDS in Fuyang City Anhui Province]

OBJECTIVE

To investigate the prevalence and risk factors of Blastocystis hominis infections among patients with HIV/AIDS in Fuyang City, Anhui Province.

METHODS

A cross-sectional study was conducted in Fuyang City, Anhui Province in 2016. The demographic and socioeconomic status, and the lifestyle and production style were collected using a questionnaire survey. B. hominis DNA was detected in subjects'stool samples using a PCR assay, and the CD4+ T lymphocyte count and HIV viral load were measured in the subjects' blood samples. The risk factors of B. hominis infections among patients with HIV/AIDS were identified using univariate and multivariate logistic regression analyses.

RESULTS

A total of 398 HIV/AIDS patients were enrolled in this study, with a mean age of 49.3 years, a mean body weight of 55.9 kg and a mean height of 164.4 cm. The prevalence of B. hominis infection was 6.78% in the study subjects, and no gender- (χ² = 1.589, P = 0.207), education level- (χ² =0.508, P = 0.776), marital status- (χ² = 0.419, P = 0.811) or occupation-specific prevalence (χ² = 2.744, P = 0.615) was detected. Among the patients with HIV/AIDS, there were no significant differences in the age (t = 0.370, P = 0.712), height (t = 1.587, P =0.113), body weight (t = 0.516, P = 0.606), CD4⁺ T lymphocyte count (t = 1.187, P = 0.230) or HIV viral load (t = 0.193, P =0.496) between B. hominis-infected and uninfected individuals. Dinking non-tap water [OR = 6.554, 95% CI: (1.876 to 22.903)] and keeping dogs [OR = 5.895, 95% CI: (2.017 to 17.225)] were identified as risk factors for B. hominis infection in patients with HIV/AIDS.

CONCLUSIONS

The prevalence of B. hominis infection is high in HIV/AIDS patients, and drinking non-tap water and keeping dogs are risk factors for B. hominis infection among HIV/AIDS patients.

[Current status of pesticides against ticks]

Ticks can spread a variety of diseases and cause serious damage to animal husbandry. However, the existing insecticide and vaccine control methods have some disadvantages. In this paper, we review the research status of tick pesticides, including the chemical pesticides and non-chemical pesticides (Chinese herbal medicine, nanometer material, virus, fungus and bacterium pesticides), and analyze the disadvantages of the existing researches on pesticides against ticks, in order to provide a theoretical reference for establishing high-efficient and safety tick control methods.

[Decabromodiphenyl ethane: a review of its pollution levels and toxicity]

Decabromodiphenyl ethane (DBDPE) is a kind of new brominated flame retardants, which is widely used as a replace of decabromodiphenyl ether in electronic appliances, textiles and other goods. This review summarizes environmental levels and body burden of human beings of DBDPE in recent years. The data shows that the concentration of DBDPE in the environment and human tissues shows an upward trend. According to limited experiments about its toxicity, DBDPE shows similar toxicity to decabromodiphenyl ether. DBDPE can interfere thyroid hormones balance, and cause damage to liver, reproductive development, kidney, et al, which implies that DBDPE might be another new persistent organic pollutant. Further researches are needed.

Nanoscale Generation of White Light for Ultrabroadband Nanospectroscopy

Achieving efficient localization of white light at the nanoscale is a major challenge due to the diffraction limit, and nanoscale emitters generating light with a broadband spectrum require complicated engineering. Here we suggest a simple, yet highly efficient, nanoscale white-light source based on a hybrid Si/Au nanoparticle with ultrabroadband (1.3-3.4 eV) spectral characteristics. We incorporate this novel source into a scanning-probe microscope and observe broadband spectrum of photoluminescence that allows fast mapping of local optical response of advanced nanophotonic structures with submicron resolution, thus realizing ultrabroadband near-field nanospectroscopy.

[The relationship between the recurrence of benign paroxysmal positional vertigo and the level of bone mineral as well as estrogen in postmenopausal women]

Objective: To investigate the relationship between the recurrence of benign paroxysmal positional vertigo(BPPV) and the levels of bone mineral density(BMD) and estrogen in postmenopausal women. Methods: A total of 38 postmenopausal women with recurrent BPPV were recruited as study group, in the First Affiliated Hospital of Soochow University from December 2013 to June 2017. Meanwhile, 49 normal menopausal women were included as control. All patients were natural menopausal for over one year.The patients were diagnosed as BPPV based on results of Dix-Hallpike test and Roll-test, with at least two episodes of recurrent onset. In the subjects, BMD was measured by dual X-ray absorptiometry of lumbar vertebrae. Estrogen levels were obtained by testing serum estradiol (E2) levels in early morning fasting venous blood. In the present study, we compared the level of E2 and the value of BMD in two groups by SPSS 21.0. In the study group, patients with decreased BMD were divided into two groups: treatment and untreated group. The recurrence rate of BPPV was compared between the two groups within 12 months. Results: ①The averagel levels of E2 and BMD in the study group were (16.21±11.00)ng/L and -1.68±0.98) respectively, which were significantly lower than those in the control group (t value was 7.03 and 8.05 respectively, both P<0.05). The averagel levels of E2 and BMD incontrol group were(28.52±6.34)ng/L and -0.18±0.77 respectively. ②The number of patients with decreased BMD in the study group (30 cases) was more than that in control group (6 cases), and the difference was statistically significant (P<0.05). ③ The recurrence rate of BPPV in treatment group [17.6%(3/17)] was significantly lower than that of untreated group [61.5%(8/13)], and the difference was statistically significant (P<0.05). Conclusion: Recurrent BPPV in postmenopausal women usually accompany with low levels of estrogen and BMD. Active treatment is helpful for their recurrence of BPPV.

Evolutionary relationships between seryl-histidine dipeptide and modern serine proteases from the analysis based on mass spectrometry and bioinformatics

Seryl-histidine dipeptide (Ser-His) has been recognized as the shortest peptide with hydrolysis cleavage activity; however, its protein cleavage spectrum has not yet been fully explored. Here, four differently folded proteins were treated with Ser-His, and the digestion products were evaluated with high-resolution mass spectrometry. The cleavage efficiency and cleavage propensity of Ser-His against these protein substrates were calculated at both the primary and secondary sequence levels. The above experiments show that Ser-His cleaves a broad spectrum of substrate proteins of varying secondary structures. Moreover, Ser-His could cleave at all 20 amino acids with different efficiencies according to the protein, which means that Ser-His has the original digestion function of serine proteases. Furthermore, we collected and compared the catalytic sites and cleavage sites of 340 extant serine proteases derived from 17 representative organisms. A consensus motif Ser-[X]-His was identified as the major pattern at the catalytic sites of serine proteases from all of the organisms represented except Danio rerio, which uses Ser-Lys instead. This finding indicates that Ser-His is the core component of the serine protease catalytic site. Moreover, our analysis revealed that the cleavage sites of modern serine proteases have become more specific over the evolutionary history of this family. Based on the above analysis results, it could be found that Ser-His is likely the original serine protease and maybe the evolutionary core of modern serine proteases.

[Prevalence of obstructive sleep apnea hypopnea syndrome in professional drivers and the relationship with traffic accidents]

Objective: To study the prevalence of obstructive sleep apnea hypopnea syndrome (OSAHS) and its relationship with traffic accidents in the professional drivers. Methods: Questionnaires of OSAHS were sent to 950 professional drivers who had annual physical examination at the Central Hospital of Jiading District in Shanghai from October 2014 to September 2015. Those with moderate to severe snoring and/or Epworth Sleepiness Scale (ESS)≥9 performed the home sleep testing. All drivers were divided into OSAHS and non-OSAHS according to the survey and monitoring. The following parameters were compared such as driving ages, neck circumference, body mass index (BMI), average night sleep time, ESS, hypertension, diabetes, hypertrophy of tonsil and the incidence of traffic accidents. The risk factors of traffic accidents were analyzed by multivariate Logistic regression. Results: Totally 826 responses were eligible, including 578 (70.0%) with self-reported snoring. There was measurement failure involving 3 of 233 the home sleep testing due to sensor off, 823 subjects were included in the study. The prevalence of OSAHS was 13.5% (111/823). The mild, moderate and severe OSAHS were 47, 38 and 26 cases respectively. There were 712 drives without OSAHS. The neck circumference[(39.8±3.8) vs (39.0±3.0) cm]and BMI[(26.7±4.2) vs (24.4±3.8) kg/m²]were significantly higher in the drivers suffering from OSAHS (all P<0.05). The percentage of ESS≥ 9 (57.7% vs 12.6%), hypertension (27.9% vs 5.9%), diabetes (4.5% vs 1.1%), hypertrophy of tonsil (7.2% vs 2.3%) were higher in the drivers with OSAHS (all P<0.05). There were no significant difference in driving ages and average night sleep time between two groups (all P>0.05). The overall incidence of traffic accidents was 5.8% (48/823) in a year. The percentage was respectively 17.1% (19/111) in OSAHS and 4.1% (29/712) in non-OSAHS (P<0.001). Multiple logistic regression analysis showed that sleepiness (OR=30.578, 95%CI: 10.699-87.394; P<0.001), OSAHS (OR=14.062, 95%CI: 4.791-41.269; P<0.001) and vehicle years (OR=2.345, 95%CI: 1.183-4.646; P<0.05)were the risk factors, while the average night sleep time (OR=0.037, 95%CI: 0.014-0.098; P<0.001) was the protective factor. Conclusion: Professional drivers have higher prevalence of OSAHS, which contributes to the increased risk of traffic accidents.

Chaperones and intimate physical examinations: what do male and female patients want?

INTRODUCTION

Many studies of patients' perception of a medical chaperone have focused on female patients; that of male patients are less well studied. Moreover, previous studies were largely based on patient populations in English-speaking countries. Therefore, this study was conducted to investigate the perception and attitude of male and female Chinese patients to the presence of a chaperone during an intimate physical examination.

METHODS

A cross-sectional guided questionnaire survey was conducted on a convenient sample of 150 patients at a public teaching hospital in Hong Kong.

RESULTS

Over 90% of the participants considered the presence of a chaperone appropriate during intimate physical examination, and 84% felt that doctors, irrespective of gender, should always request the presence of a chaperone. The most commonly cited reasons included the availability of an objective account should any legal issue arise, protection against sexual harassment, and to provide psychological support. This contrasted with the experience of those who had previously undergone an intimate physical examination of whom only 72.6% of women and 35.7% of men had reportedly been chaperoned. Among female participants, 75.0% preferred to be chaperoned during an intimate physical examination by a male doctor, and 28.6% would still prefer to be chaperoned when being examined by a female doctor. Among male participants, over 50% indicated no specific preference but a substantial minority reported a preference for chaperoned examination (21.2% for male doctor and 25.8% for female doctor).

CONCLUSIONS

Patients in Hong Kong have a high degree of acceptance and expectations about the role of a medical chaperone. Both female and male patients prefer such practice regardless of physician gender. Doctors are strongly encouraged to discuss the issue openly with their patients before they conduct any intimate physical examination.

[The role of video nystagmography in the diagnosis and treatment of multiple benign paroxysmal positional vertigo]

Objective:To explore the role of video nystagmography in the diagnosis and treatment of multiple benign paroxysmal positional vertigo. Method: Eleven patients of 313 patients with benign paroxysmal positional vertigo had been diagnosed as multiple benign paroxysmal positional vertigo.They were post and horizontal semicircular canal ipsilaterally, bilateral post semicircular canal, superior and horizontal semicircular canal ipsilaterally, and bilateral superior semicircular canal benign paroxysmal positional vertigo.Result:The patients were performed Dix-Hallpike test and Roll test under VNG, combined with track record by video nystagmography to confirm the affected sites. Six cases were post and horizontal semicircular canal benign paroxysmal positional vertigo ipsilaterally. Three cases were bilateral posterior semicircular canal benign paroxysmal positional vertigo, one case of superior semicircular canal and horizontal semicircular canal benign paroxysmal positional vertigo ipsilaterally, and one case of bilateral superior semicircular canal benign paroxysmal positional vertigo. The symptom of patients got relief after repositioning sequentially. We repositioned the affected canal with strong nystagmus and vertigo at the first time. Conclusion:Multiple benign paroxysmal positional vertigo was rare and easily misdiagnosed because of complex nystagmus. We can confirm the affected canal and intensity by video nystagmography and get good prognosis after repositioning sequentially.

Vascular endothelial growth factor +405G/C and -2578C/A polymorphisms and breast cancer risk: a meta-analysis

This study aimed to analyze the association between the 405G/C and -2578C/A polymorphisms of the vascular endothelial growth factor (VEGF) gene and breast cancer risk by meta-analysis. A systematic computerized search of PubMed, Google Scholar, and Web of Science databases was performed to identify relevant publications. After rigorous searching and screening, 9 eligible case-control studies were included in this meta-analysis. The associations between the VEGF gene 405G/C and -2578C/A polymorphisms and breast cancer risk were estimated by pooled ORs and 95%CIs using fixed- or random-effect models. Meta-analysis results showed no significant association between the 405G/C polymorphism and breast cancer risk (CC vs GG: OR = 1.04, 95%CI = 0.92-1.17; CC vs GC: OR = 1.04, 95%CI = 0.93-1.17; dominant model: OR = 0.95, 95%CI = 0.85-1.06; recessive model: OR = 0.92, 95%CI = 0.70-1.20). The results also did not show significant association for the -2578C/A polymorphism: (AA vs CC: OR = 1.03, 95%CI = 0.91-1.15; AA vs GA: OR = 0.99, 95%CI = 0.89-1.10; dominant model: OR = 1.00, 95%CI = 0.90-1.10; recessive model: OR = 1.03, 95%CI = 0.94-1.13). Similar results were observed in the subgroup analyses on ethnicity, sample size, and Hardy-Weinberg equilibrium. These findings suggested a lack of association between the VEGF gene 405G/C and -2578C/A polymorphisms and breast cancer susceptibility.

Atom-economic generation of gold carbenes: gold-catalyzed formal [3+2] cycloaddition between ynamides and isoxazoles

The generation of gold carbenes via the gold-catalyzed intermolecular reaction of nucleophiles containing relatively labile N-O or N-N bonds with alkynes has received considerable attention during recent years. However, this protocol is not atom-economic as the reaction produces a stoichiometric amount of pyridine or quinoline waste, the cleaved part of the N-O or N-N bonds. In this article, we disclose an unprecedented gold-catalyzed formal [3+2] cycloaddition between ynamides and isoxazoles, allowing rapid and practical access to a wide range of synthetically-useful 2-aminopyrroles. Most importantly, mechanistic studies and theoretical calculations revealed that this reaction presumably proceeds via an α-imino gold carbene pathway, thus providing a strategically novel, atom-economic route to the generation of gold carbenes. Other significant features of this approach include the use of readily-available starting materials, high flexibility, simple procedure, mild reaction conditions, and in particular, no need to exclude moisture or air ("open flask").

Efficient and practical synthesis of enantioenriched 2,3-dihydropyrroles through gold-catalyzed anti-Markovnikov hydroamination of chiral homopropargyl sulfonamides

A direct gold-catalyzed anti-Markovnikov hydroamination of chiral homopropargyl sulfonamides has been developed. A range of enantioenriched 2,3-dihydropyrroles are readily accessed by utilizing this approach.

Practical, modular, and general synthesis of 3-coumaranones through gold-catalyzed intermolecular alkyne oxidation strategy

A gold-catalyzed intermolecular alkyne oxidation for the preparation of 3-coumaranones has been developed. Using 8-isopropylquinoline N-oxides as oxidants, the reactions of o-ethynylanisoles afford versatile 3-coumaranones in moderate to good isolated yields. The synthetic utility of this chemistry is also indicated by the synthesis of the natural product sulfuretin.

Investigating conversion of endplate chondrocytes induced by intermittent cyclic mechanical unconfined compression in three-dimensional cultures

Mechanical stimulation is known to regulate the calcification of endplate chondrocytes. The Ank protein has a strong influence on anti-calcification by transports intracellular inorganic pyrophosphate (PPi) to the extracellular matrix. It is known that TGF-β1 is able to induce Ank gene expression and protect chondrocyte calcification. Intermittent cyclic mechanical tension (ICMT) could induce calcification of endplate chondrocytes by decrease the expression of Ank gene. In this study, we investigated the relation of intermittent cyclic mechanical unconfined compression (ICMC) and Ank gene expression. We found that ICMC decreased the Ank gene expression in the endplate chondrocytes, and there was an decreased in the TGF-β1 expression after ICMC stimulation. The Ank gene expression significantly increased when treated by transforming growth factor alpha 1 (TGF-β1) in a dose-dependent manner and decreased when treated by SB431542 (ALK inhibitor) in a dose-dependent manner. Our results implicate that ICMC-induced downregulation of Ank gene expression may be regulated by TGF-β1 in end-plate chondrocytes.

Flexible and practical synthesis of 3-oxyindoles through gold-catalyzed intermolecular oxidation of o-ethynylanilines

A novel gold-catalyzed intermolecular oxidation of o-ethynylanilines has been developed, which provides a reliable access to synthetically useful 3-oxyindoles. Importantly, this gold-catalyzed oxidative process outcompetes the typical indole formation.

Gold-catalyzed intermolecular oxidation of o-alkynylbiaryls: an easy and practical access to functionalized fluorenes

A novel gold-catalyzed intermolecular oxidation of o-alkynylbiaryls has been developed. A variety of functionalized fluorenes are readily accessed by utilizing this non-diazo approach, thus providing a viable alternative to synthetically useful fluorenes.

Generation of gold carbenes in water: efficient intermolecular trapping of the α-oxo gold carbenoids by indoles and anilines

The efficient intermolecular reaction of gold carbene intermediates, generated via gold-catalyzed alkyne oxidation, with indoles and anilines has been realized in aqueous media.

Gold-catalyzed intermolecular oxidation of chiral homopropargyl sulfonamides: a reliable access to enantioenriched pyrrolidin-3-ones

A gold-catalyzed intermolecular oxidation of chiral homopropargyl sulfonamides has been developed, which provides a reliable access to synthetically useful chiral pyrrolidin-3-ones with excellent ee by combining the chiral tert-butylsulfinimine chemistry and gold catalysis.

Force-induced optical nonlinearity and Kerr-like coefficient in opto-mechanical ring resonators

This paper demonstrates the optical nonlinearity in opto-mechanical ring resonators that consist of a bus waveguide and two ring resonators, which is induced by the optical gradient force and characterized by the Kerr-like coefficient. Each ring resonator has a free-hanging arc that is perpendicularly deformable by an optical gradient force and subsequently this deformation changes the effective refractive index (ERI) of the ring resonator. The change of the ERI induces optical nonlinearity into the system, which is described by an equivalent Kerr coefficient (Kerr-like coefficient). Based on the experimental results, the Kerr-like coefficient of the ring resonator system falls in the range from 7.64 × 10(-12) to 2.01 × 10(-10) m(2)W(-1), which is at least 6-order higher than the silicon's Kerr coefficient. The dramatically improved optical nonlinearity in the opto-mechanical ring resonators promises potential applications in low power optical signal processing, modulation and bio-sensing.

Sources of ambient volatile organic compounds and their contributions to photochemical ozone formation at a site in the Pearl River Delta, southern China

The Positive Matrix Factorization (PMF) receptor model and the Observation Based Model (OBM) were combined to analyze volatile organic compound (VOC) data collected at a suburban site (WQS) in the PRD region. The purposes are to estimate the VOC source apportionment and investigate the contributions of these sources and species of these sources to the O(3) formation in PRD. Ten VOC sources were identified. We further applied the PMF-extracted concentrations of these 10 sources into the OBM and found "solvent usage 1", "diesel vehicular emissions" and "biomass/biofuel burning" contributed most to the O(3) formation at WQS. Among these three sources, higher Relative Incremental Reactivity (RIR)-weighted values of ethene, toluene and m/p-xylene indicated that they were mainly responsible for local O(3) formation in the region. Sensitivity analysis revealed that the sources of "diesel vehicular emissions", "biomass/biofuel burning" and "solvent usage 1" had low uncertainties whereas "gasoline evaporation" showed the highest uncertainty.

Pure angular momentum generator using a ring resonator

This paper reports a pure angular momentum generator using a ring resonator surrounded by a group of nano-rods. The evanescent waves of the circulating light in the ring are scattered by the nano-rods and generate a rotating electromagnetic field, which has only angular momentum but no linear momentum along the axis of rotation. The angular order is determined by the difference between the order of Whispering Gallery mode and the number of the rods, the rotating frequency is equal to the light frequency divided by the angular order. The maximum amplitude of the rotating electromagnetic fields can be 10 times higher than the amplitude of the input field when there are 36 rods (R(rod) = 120 nm, nr = 1.6). The pure angular momentum generator provides a new platform for trapping and rotation of small particles.

Effect of traffic rule breaking behavior on pedestrian counterflow in a channel with a partition line

In this paper a partition line is used in the counterflow system to present the default (conventional) traffic rule: pedestrians prefer to walk on a certain side on the road during movement, e.g., the right-hand side in China or the left-hand side in Japan. Based on the counterflow model of Takimoto (model A), we introduced two modified models, i.e., model B and C, to study the effects of a partition line in the consideration of people who do not obey the default traffic rule. Model B represents that factor in time scale, while model C in space scale. In model B, there are pedestrians who cross the partition line but choose not to obey the default traffic rule with a probability p(nor), while in model C, if a pedestrian crosses the partition line and goes away from it further than a certain nonobeying-rule threshold distance d(t), he will not obey the traffic rule. It is found that the behavior of traffic rule breaking influences much the counterflow when it is at the choking flow state rather than at the free moving or stopped state. Furthermore, it is shown that the default traffic rule is not always positive to the counterflow in all situations. It depends on the game result of these two opposite sides: to use the channel width as much as possible and to avoid the interference from the other group as far as possible.

Cellular automaton simulation of pedestrian counter flow considering the surrounding environment

This paper presents a cellular automaton model without step back to simulate the pedestrian counter flow in a channel. The consideration of the surrounding environment when people make judgments on moving directions is added to a random walker model also without step back. Two types of walkers: the right walkers going to the right and the left walkers going to the left are taken into account. The characteristics of counterflow are clarified. Influences of the different interaction radius values and system sizes on movement are studied. Phase transition from free moving to jamming is observed with the increase of entrance density. It is found that the critical entrance density pc at the transition point does not depend on the system size when the interaction radius value is large. Simulation results are represented as a comparison with the random walker model.

[HOE642 (Cariporide) reduces the intracellular calcium overload of isolated immature rabbit ventricular myocytes induced by anoxia/reoxygenation]

AIM

To observe the effects of HOE642 (Cariporide) on intracellular free calcium in isolated immature rabbit ventricular myocytes induced by anoxia/reoxygenation, and to search the protective mechanism of the Na+/H+ exchange inhibitor on immature rabbit hearts.

METHODS

The ventricular cardiomyocytes isolated from six New Zealand immature rabbit hearts were divided into three groups of each heart, which were attained by mean of collagenase (type II, 0.28 mg/ml) perfusion. All cells were incubated with calcium fluorescence indicator Fluo-3/AM, and then the intracellular free calcium was measured under the laser scanning confocal microscopy. As well as the creatine phosphokinase (CK) and lactic dehydrogenase (LDH) were measured. The baseline was measured after isolation without anoxia/reoxygenation. The control group received anoxic conditions for 60 minutes and reoxygenation for 30 minutes, then measured. The experiment group received the same conditions as control group with addition of HOE642 (1 micromol/L).

RESULTS

After anoxia/reoxygenation, the intracellular free calcium of isolated immature rabbit ventricular myocytes and CK, LDH in control group increased significantly than baseline (P < 0.01), there were no significant difference of immature myocardial [Ca+]i and CK, LDH between experiment group and baseline (P > 0.05), and the experiment group myocardial [Ca2+]i and CK, LDH reduced significantly than control (P < 0.01).

CONCLUSION

HOE642 (Cariporide) may reduce intracellular calcium overload and the enzymes level (CK, LDH) in isolated immature rabbit ventricular myocytes induced by anoxia/reoxygenation, so the protective mechanism of HOE642 on immature rabbit heart may be by inhibition of the intracellular free calcium overload.

[The effect of ischemic preconditioning on adenosine phosphate content after spinal cord ischemia in rabbits]

AIM

To study the effect of ischemic preconditioning (IP) on adenosine phosphate content after spinal cord ischemia in rabbits.

METHODS

We established a lumbar spinal cord ischemia model by inflating the balloon of a 4F Swan-Ganz catheter positioned in the abdominal aorta of the rabbits. All rabbits were divided into sham-operated group, ischemic group and IP group. Adenosine phosphate content in spinal cord of all rabbits was determined at 4 hours, 2 days and 5 days after spinal cord ischemia by using reverse phase HPLC.

RESULTS

ATP content in lumbar spinal cord of rabbits in ischemic group was markedly reduced (P < 0.01 vs sham-operated group). But in IP group, it was obviously elevated at each time point compared with ischemic group (P < 0.01).

CONCLUSION

IP can significantly elevated ATP content in postischemic lumbar spinal cord in rabbits. This may be one of the mechanisms that IP can protect spinal cord from ischemic injury.

Effect of dl-praeruptorin A on calcium current in ventricular cells of guinea pig

With patch clamp technic (whole cell recording), the effect of dl-praeruptorin A (Pra), an ingredient of Peucedanum praeruptorum Dunn on calcium current (ICa) in the single ventricular cells of guinea pig was studied. Results showed that under Cs/Cs condition, when the holding potential was -40 mV and in the presence of Pra (1, 10, 100 mumol.L-1), ICa was decreased dose-dependently from 2.02 +/- 0.24, 2.00 +/- 0.12, 2.12 +/- 0.33 nA (control) to 1.60 +/- 0.24, 1.32 +/- 0.08, 1.16 +/- 0.43 nA, respectively, and their inhibitory rates were 21%, 33.5%, 45%, respectively. The current-voltage relation curve showed that the reversal potential of ICa was +60 mV; the potential producing peak value of ICa was about 0 mV. The results indicated that Pra had a Ca2+ channel blocking effect.

Electron microscopic observations of tegumental damage in adult Schistosoma japonicum after in vivo treatment with levo-praziquantel

The in vivo effects of a single dose of levo-praziquantel, 75 mg/kg in PEG 400, on the tegumental surface of adult S. japonicum were compared with the effects of a single dose (150 mg/kg) of the mixed isomer preparation, using scanning and transmission electron microscope. Worms were recovered from mice at 10 min, 30 min, 1 hr, 4 hr, 12 hr, 24 hr and 48 hr after treatment. After 10 min exposure to either compound, the tegumental folds and sensory organelles were swollen and the tegument vacuolated. After 12-24 hr, the surface was eroded and exfoliated with exposure of intrategumental and/or subtegumental tissues and attachment of leukocytes to the denuded areas. Vehicle controls were normal throughout the time period examined. These studies demonstrate that the levo isomer of praziquantel causes acute structural damage to the tegument similar to that seen with the mixed isomer preparation.

Myocardial protection of cold crystalloid and warm blood cardioplegia. A comparative study

Twenty patients undergoing open-heart valvular operations were divided randomly into two groups. Intermittent perfusion of cold crystalloid (St. Thomas Hospital solution) with hypothermic cardiopulmonary bypass (CPB) in the hypothermic group and continuous administration of warm blood cardioplegia with normothermic CPB in the normothermic group were used respectively. The results of warm blood cardioplegia were superior to those of cold crystalloid. 70% of patients treated with the warm technique had spontaneous return of normal sinus rhythm shortly after removal of the aortic cross-clamp, compared with only 10% of the hypothermic group (P < 0.05). The extracorporeal support time from releasing of aortic clamp to the weaning of CPB was significantly shorter in the normothermic group (33.50 +/- 3.78 min vs. 25.00 +/- 4.64 min, P < 0.05). The postoperative ventilation support time was also much shorter than that of the hypothermic group (19.84 +/- 1.11 h vs. 38.98 +/- 16.55 h, P < 0.05). More atrial beating occurred in the normothermic group (80% vs. 20%, P < 0.05) during aortic clamping, and it is showed that continuous warm blood cardioplegia might not efficiently prevent the atrium from damage.

Whole-cell patch clamp measurements and berberine inhibition of hyperpolarization-activated inward current in rabbit sinoatrial node cells

Single rabbit sinoatrial node (SAN) cells were isolated by means of an enzymatic dispersion procedure and used for the whole-cell patch clamp experiment. At a holding potential of -40 mV, a time- and voltage-dependent inward current, I(f), was activated at different hyperpolarization potentials from -60 mV to -110 mV. The current-voltage relation curve showed that I(f) was activated at potential more negative than -40 mV. Five min after treatment by CsCl 2 mmol.L-1-containing Tyrode solution, I(f) was almost completely blocked. At a hyperpolarization potential of -110 mV, I(f) was reduced from 1.7 +/- 0.2 nA of the control to 1.2 +/- 0.4 nA after superfusing with Tyrode solution containing berberine (Ber) 1 mumol.L-1 for 5 min. And it was difficult to wash out this action. Ber also had inhibitory effects on other currents to a certain extent. The results indicate that I(f) is a Cs(+)-sensitive current and that the negative chronotropic effect of Ber may be due to the inhibition of I(f) that functions as an important pacemaking modulator for the spontaneous depolarization of SAN tissue.

[A pathological analysis of 51 cases of renal osteodystrophy]

Renal osteodystrophy is a metabolic bone disease of chronic renal failure. The long-standing alterations in mineral metabolism generated by renal failure have a profound effect on the skeleton and induce severe systemic metabolic bone disease. Iliac crest biopsy was performed in 51 patients of chronic renal failure and examined with microscopy. The histological bone changes are characterized by ostitis fibrosa, increased resorption of bone and number of osteoclasts, increased osteoid volume (osteoblastic osteoid and acellular osteoid), active remodelling of bone and aluminum deposition in bone. According to the histological appearance, advanced renal bone disease can be subdivided into three major histological groups: secondly hyperparathyroid bone disease (high turnover uremic osteodystrophy), osteomalacia (low turnover uremic osteodystrophy) and mixed uremic osteodystrophy consisting of mild to moderate hyperparathyroid bone disease and defective mineralization. Aluminum-related bone changes can be seen in varying degrees in all these groups. Even though these groups do not fully represent separate entities and transformation from one form to another can occur, it is essential to distinguish them since therapy can be tailored according to the predominant histologic findings.

Streptozotocin induced cardiomyopathy in diabetic rats

Microscopic quantitative cardiomyopathy was previously reported in spontaneous diabetic biobreeding (BB) rats, but the nature of the lesions remains obscure. To further study the specificity of cardiomyopathy in streptozotocin-diabetic rats and discuss the existence of diabetic heart disease, we compared 40 streptozotocin-diabetic rats (D group) with 40 normal control rats (C group) at various durations in plasma glucose, fructosamine, plasma lipid, left ventricular enzyme contents and alterations of myocardial cells and coronary artery tree under electron and light microscope respectively. In 4 weeks, D rats showed myocardial mitochondrial swelling and degeneration, whereas at 8 weeks, myocardial enzyme contents markedly decreased, and myocardial lesions were more conspicuous with disruption of myocardial cells, formation of myocardial contraction bands, dilatation of intercalated discs, deposition of glycogen granules, etc. At 11 weeks, microscopic changes were essentially similar, whereas the decrease of enzyme contents became more conspicuous. During the 11 weeks, persistent and marked hyperglycemia and elevation of fructosamine were observed, however, no abnormalities were found along the coronary artery tree in the D rats. The results indicated that cardiomyopathy is diabetes specific, and exists independently as one of the three important components of diabetic heart disease.

[Aluminum in renal osteodystrophy]

To evaluate the relationship between aluminum and renal osteodystrophy, iliac bone biopsies and bone aluminum staining were studied in 51 patients with end-stage renal failure. In 27 of 51 cases were measured PTH, 1.25 (OH)2D3 levels and bone aluminum contents. We found that the incidence of renal osteodystrophy was 100%. The positive rate of bone aluminum staining was 12%. The rate was highest in low-turnover osteomalacia. Serum aluminum and bone aluminum contents were significantly higher than controls in three types of renal osteodystrophy on hemodialysis. Bone aluminum correlated with the duration of hemodialysis (r = 0.704), also with the serum calcium (r = 0.341). The duration of hemodialysis and bone aluminum contents were markedly longer and higher in positive group of bone aluminum staining than that of negative group (P < 0.001, respectively). Our data suggested that: (1) aluminum accumulation in bone was related to duration of hemodialysis, (2) aluminum may play important roles in the intervention of bone mineralization.

Survey of 160 centenarians in Shanghai

One hundred and sixty centenarians were discovered and followed up for 7 years (1982-88) in Shanghai. The proportion of centenarians in the population was non-significantly greater in the urban than in the rural area and centenarians were in general increasing in both areas over the years. The factors promoting longevity were good medical care and benevolent attention from family members. Autopsy was performed in eight centenarians revealing the main causes of death as pneumonia and cancer.

[Re-open heart surgery in congenital heart disease. An analysis of 23 cases]

The authors reported 23 cases of re-open heart surgery in 1473 patients with congenital heart disease treated surgically in the last ten years. The incidence was 1.6%. In 13 cases of the 23 re-open heart procedure was performed before closing the chest during the operation because of missed diagnosis in 5, incomplete correction of the anomaly in 5, and injure to important organ in 3. All of the 13 patients were recovered and discharged. Of the 23 cases re-open heart surgery was performed during the early postoperative period in 8 cases, including 4 cases of misdiagnosis, and 4 incomplete correction. 1 patient with VSD had still residual ventricular septal shunt post reintervention and died of circulatory failure. Re-open heart surgery was performed during the late postoperative period in 2 of the 23 cases. There was 1 missed diagnosis, and another incomplete correction. 1 patient died of massive bleeding during the reoperation. The anthers pointed out that accurate diagnosis and error-free operation is of most importance in avoiding re-open heart surgery. Through exploration to the heart after resuscitation during the operation and positive re-opening of the heart when necessary were emphasized. Indication of early and late postoperative re-open heart surgery and methods to prevent its complication were listed.

[Surgical treatment of mitral prolapse with chordae plasty]

Surgical treatment of 8 cases of anterior mitral leaflet prolapse was reported. Of the 8 cases, chordae elongation was occurred in 2, chordae rupture in 6, and congenital in 6, rheumatic in 2. Chordae reimplanting was performed in 5 cases, chordae shortening in 2, chordae prosthesis with surgical suture in 1, and combined annuloplasty in 7 of the 8 cases. The result of mitral plasty was better in congenital mitral prolapse. Indications of this technique and postoperative management were listed.