Synergistic antitumor effect of TRAIL and adriamycin on the human breast cancer cell line MCF-7

The aim of the present study was to determine the effect of the combination of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and adriamycin (ADM) on the human breast cancer cell line MCF-7 and to identify potential mechanisms of apoptosis. Cell viability was analyzed by the MTT assay and the synergistic effect was assessed by the Webb coefficient. Apoptosis was quantified using the annexin V-FITC and propidium iodide staining flow cytometry. The mRNA expression of TRAIL receptors was measured by RT-PCR. Changes in the quantities of Bax and caspase-9 proteins were determined by Western blot. MCF-7 cells were relatively resistant to TRAIL (IC50 >10 microg/mL), while MCF-7 cells were sensitive to ADM (IC50 <10 microg/mL). A subtoxic concentration of ADM (0.5 microg/mL) combined with 0.1, 1, or 10 microg/mL TRAIL had a synergistic cytotoxic effect on MCF-7 cells, which was more marked with the combination of TRAIL (0.1 microg/mL) and ADM (0.5 microg/mL). In addition, the combined treatment with TRAIL and ADM significantly increased cell apoptosis from 9.8% (TRAIL) or 17% (ADM) to 38.7%, resulting in a synergistic apoptotic effect, which is proposed to be mediated by up-regulation of DR4 and DR5 mRNA expression and increased expression of Bax and caspase-9 proteins. These results suggest that the combination of TRAIL and ADM might be a promising therapy for breast cancer.

Recombinant human growth hormone improves survival and protects against acute lung injury in murine Staphylococcus aureus sepsis

OBJECTIVE

To investigate whether recombinant human growth hormone (rhGH) reduces mortality and protects against Staphylococcus aureus sepsis-induced acute lung injury.

METHODS

The bacteria-positive rate of blood smears and bacteria colony counts in bacteria plate culture, TNFalpha and IL-10 plasma levels, lung injury score, expression of intercellular adhesion molecule-1 (ICAM-1) as well as activation of nuclear factor-kappa B (NF-kappaB) in the lungs were determined 6, 12 and 24 h after 140 KM mice were injected with physiologic saline (i.p. group C, n = 20); S. aureus E311122 (1.75 x 10(12) cfu/L, 40 ml/kg, i.p. group S, n = 60); or S. aureus (as group S) with a subsequent treatment of rhGH (1.0 U kg(-1) day(-1)), i.m. group T, n = 60). The cumulative survival rate of an additional 15 mice from each group was followed for 7 days post S. aureus injection.

RESULTS

rhGH treatment significantly increased IL-10 plasma levels and the 7-day cumulative survival rate, whereas the bacteria-positive rate of blood smears, bacteria colony counts in bacteria plate cultures, lung injury score, ICAM-1 and NF-kappaB expression in the lungs were significantly reduced. In addition, rhGH treatment significantly suppressed the S. aureus sepsis-induced elevation of TNFalpha plasma levels.

CONCLUSIONS

These results indicate an ability of rhGH to prevent S. aureus sepsis-induced acute lung injury in mice, which may be attributed to attenuation of increased plasma TNFalpha levels, and elevated IL-10 plasma levels as well as reduced ICAM-1 expression and inhibited NF-kappaB activity in the lungs.

A clinical study of 115 patients with extranodal natural killer/T-cell lymphoma, nasal type

AIMS

To investigate the clinicopathological features, treatment outcomes, and prognostic factors in patients with extranodal natural killer (NK)/T-cell lymphoma, nasal type.

MATERIALS AND METHODS

We retrospectively reviewed the medical records of 115 patients diagnosed with extranodal NK/T-cell lymphoma, nasal type who were admitted to our hospital between January 1991 and June 2006.

RESULTS

In total, 107 patients were available for follow-up. After the completion of treatment, 48 patients (44.9%) achieved a complete remission. By the end of the follow-up period, 60 patients (56.1%) had died from local recurrence or metastases. The mean survival duration was 70.0 months, the median survival duration was 42 months, and the 5-year survival rate was 39.4%. The mean survival durations of the three treatment groups of chemoradiotherapy, radiotherapy and palliative treatment were 91.6, 60.1 and 17.6 months, respectively. The median survival durations were 72.0, 42.0 and 10 months, respectively. Patients treated with > 50 Gy had better local control and survival than the < 50 Gy group. However, there was no significant difference between patients having fewer than four cycles of chemotherapy and patients having more than four cycles. Multifactor Cox regression model analysis showed that B symptoms, gender, International Prognostic Index (IPI) score, disease stage and therapy were all independent prognostic factors.

CONCLUSIONS

The prognosis of extranodal NK/T-cell lymphoma, nasal type is poor and significantly influenced by B symptoms, gender, IPI score, clinical staging and the method of treatment. Chemoradiotherapy should be the first choice for treatment.

Successful granulocyte-colony stimulating factor treatment of Crohn's disease is associated with the appearance of circulating interleukin-10-producing T cells and increased lamina propria plasmacytoid dendritic cells

Granulocyte-colony stimulating factor (G-CSF) has proved to be a successful therapy for some patients with Crohn's disease. Given the known ability of G-CSF to exert anti-T helper 1 effects and to induce interleukin (IL)-10-secreting regulatory T cells, we studied whether clinical benefit from G-CSF therapy in active Crohn's disease was associated with decreased inflammatory cytokine production and/or increased regulatory responses. Crohn's patients were treated with G-CSF (5 microg/kg/day subcutaneously) for 4 weeks and changes in cell phenotype, cytokine production and dendritic cell subsets were measured in the peripheral blood and colonic mucosal biopsies using flow cytometry, enzyme-linked immunosorbent assay and immunocytochemistry. Crohn's patients who achieved a clinical response or remission based on the decrease in the Crohn's disease activity index differed from non-responding patients in several important ways: at the end of treatment, responding patients had significantly more CD4(+) memory T cells producing IL-10 in the peripheral blood; they also had a greatly enhanced CD123(+) plasmacytoid dendritic cell infiltration of the lamina propria. Interferon-gamma production capacity was not changed significantly except in non-responders, where it increased. These data show that clinical benefit from G-CSF treatment in Crohn's disease is accompanied by significant induction of IL-10 secreting T cells as well as increases in plasmacytoid dendritic cells in the lamina propria of the inflamed gut mucosa.

Correction of congenital severe ptosis by suspension of a frontal muscle flap overlapped with an inferiorly based orbital septum flap

BACKGROUND

This report introduces a new method for correction of congenital severe upper eyelid ptosis.

METHODS

The poor levator-function upper eyelid ptosis of 22 patients was corrected using suspension of the frontal muscle flap overlapped with an inferiorly based orbital septum flap as a motor unit, which substituted for the function of the levator muscle. The frontal muscle flap and orbital septum flap were formed in the frontal part and upper eyelid, respectively. Two flaps were overlapped and sutured to suspend the upper eyelid and to correct the congenital severe upper eyelid ptosis. This technique avoids the need for the linking structure necessary with the standard frontalis sling approach and improves the direction of pull to mimic that of a normal levator more closely than that of frontalis muscle advancement.

RESULTS

The follow-up period ranged from 6 to 20 months (mean, 12 months). A total of 4 patients had bilateral surgery, whereas 18 patients underwent unilateral surgery (26 eyelids). In 22 cases (26 eyes), congenital severe upper eyelid ptosis was treated using suspension of the frontal muscle flap overlapped with an inferiorly based orbital septum flap. After the operation, 17 cases (19 eyes) were followed up and analyzed retrospectively. The average follow-up period was about 12 months (range, 6-20 months). The 17 corrected eyes had a symmetric redundant fold of preseptal skin according to the marginal reflex distance-1 (MRD-1) measurement used to judge efficacy. Two eyes in this series required reoperation for undercorrection. Complications such as ectropion and corneal exposure were avoided.

CONCLUSION

Use of a frontalis muscle lap overlapped with an inferior based orbital septum flap to manage severe congenital upper eyelid ptosis is a useful procedure that results in substantial cosmetic and functional improvement with few complications.

Effects of recombinant human growth hormone on acute lung injury in endotoxemic rats

OBJECTIVE

To investigate the effects of recombinant human growth hormone (rhGH) on rat acute lung injury (ALI).

METHODS

ALI was mimicked by intraperitoneal (i. p.) injection of E. coli. Female Sprague-Dawley rats were randomized into three groups: control group, injected with physiologic saline (i. p.); ALI group, received a bolus injection of E. coli (1 x 10(10) cfu/l, 15 ml/kg, i. p.) followed by intramuscular physiologic saline injection; and ALI + GH group, received a bolus administration of E. coli, and then treated with intramuscular rhGH injection (2.25 U/kg/d). ALI group and ALI + GH group were subdivided into day 1 and day 3 subgroups, respectively. Left lungs were lavaged and bronchial alveolar lavage fluid (BALF) was harvested. Lung injury score, lung wet-to-dry weight (W/D) ratio, percentage of neutrophils (PMNs) in BALF, lung permeability index (LPI), intercellular adhesion molecule-1(ICAM-1) expression and activation of nuclear factor-kappa B (NF-kappaB) in the lungs were determined.

RESULTS

(1) On day 1 and day 3, the lung injury score, lung W/D ratio, LPI and protein content in BALF were significantly higher in the ALI group than in the control and ALI + GH groups. rhGH attenuated lung injuries significantly. (2) Compared with the control group, the percentage of PMNs in BALF was elevated significantly in the ALI and ALI + GH groups, especially in ALI group. (3) Nuclear positive rate of NF-kappaB and ICAM-1 expression at the levels of protein and mRNA in the lung in the ALI group on day 1 and day 3 were higher than in the control group. rhGH diminished activation of NF-kappaB and expression of ICAM-1 in the lung markedly.

CONCLUSIONS

Treatment with rhGH can significantly attenuate lung injury in the endotoxemic rats, which may be attributed to the reduction of the expression of ICAM-1, the influence on the adhesion and activation of PMNs, the inhibition of the activation of NF-kappaB and the regulation of the transcription of certain proinflammatory cytokines.

Beneficial effect of recombinant human growth hormone on the intestinal mucosa barrier of septic rats

The objective of the present study was to investigate the effects of recombinant human growth hormone (rhGH) on the intestinal mucosa barrier of septic rats and explore its possible mechanism. Female Sprague-Dawley rats were randomized into three groups: control, Escherichia coli-induced sepsis (S) and treatment (T) groups. Groups S and T were subdivided into subgroups 1d and 3d, respectively. Expression of liver insulin-like growth factor-1 (IGF-1) mRNA, Bcl-2 and Bax protein levels and the intestinal Bax/Bcl-2 ratio, and plasma GH and IGF-1 levels were determined. Histological examination of the intestine was performed and bacterial translocation was determined. rhGH significantly attenuated intestinal mucosal injuries and bacterial translocation in septic rats, markedly decreased Bax protein levels, inhibited the decrease of Bcl-2 protein expression and maintained the Bax/Bcl-2 ratio in the intestine. rhGH given after sepsis significantly improved levels of plasma GH (T1d: 1.28 +/- 0.24; T3d: 2.14 +/- 0.48 microg/L vs S1d: 0.74 +/- 0.12; S3d: 0.60 +/- 0.18 microg/L; P < 0.05) and IGF-1 (T1d: 168.94 +/- 65.67; T3d: 201.56 +/- 64.98 microg/L vs S1d: 116.72 +/- 13.96; S3d: 107.50 +/- 23.53 microg/L; P < 0.05) and expression of liver IGF-1 mRNA (T1d: 0.98 +/- 0.20; T3d: 1.76 +/- 0.17 vs S1d: 0.38 +/- 0.09; S3d: 0.46 +/- 0.10; P < 0.05). These findings indicate that treatment with rhGH had beneficial effects on the maintenance of the integrity of the intestinal mucosa barrier in septic rats.

Clinical significance and assessment of cytokines in various stages of ulcerative colitis

In order to study the clinical significance and change of interleukin (IL)-1 beta and IL-10 concentration in intestinal mucosal tissues in various stage of ulcerative colitis (UC), IL-1 beta and IL10 levels were measured by enzyme linked immunosorbent assays (ELISA). Our results showed that IL-beta level caused by spontaneous secretion in the intestinal mucous tissues in active stage of ulcerative colitis was significantly higher than that in normal controls and in remission stage of ulcerative colitis (P < 0.01, P < 0.001). IL-10 level in various stage of UC was relatively lower in controls, but there was no significantly difference between the two groups. Our study suggested that higher IL-1 beta level in active might play an important role in pathogenesis of UC, and IL-10, as an anti-inflammatory cytokine, was low in active UC, suggesting that it may be a important factor contributing to the development of higher IL-1 beta level.

Efficacy of hirudin in reducing cardiovascular events in patients with acute coronary syndrome undergoing early percutaneous coronary intervention

AIMS

Although hirudin is superior to unfractionated heparin for prevention of death, myocardial infarction, or refractory ischaemia in patients with non-ST-elevation acute coronary syndrome, it is not clear whether hirudin is also of benefit in acute coronary syndrome patients undergoing early percutaneous coronary intervention.

METHODS AND RESULTS

In the OASIS 2 trial, 10 141 patients with non-ST-elevation acute coronary syndrome were randomized to 72 h of intravenous hirudin or unfractionated heparin. Percutaneous coronary intervention was performed at the discretion of the investigator. One hundred and seventeen patients underwent percutaneous coronary intervention within the first 72 h ("early percutaneous coronary intervention"). In patients undergoing early percutaneous coronary intervention, hirudin compared with unfractionated heparin was associated with a significantly lower incidence of death or myocardial infarction at 96 h (6.4% vs 21.4%, OR 0.30; 95% CI: 0.10-0.88) and 35 days (6.4% vs 22.9%, OR 0.25; 95% CI: 0.07-0.86). In the unfractionated heparin group, death or myocardial infarction was significantly higher at 35 days in patients undergoing early percutaneous coronary intervention compared with those managed conservatively (22.9% vs 7.3%, OR 3.14, P<0.001) but this early percutaneous coronary intervention-related hazard was not observed in hirudin-treated patients (6.4% vs 6.8%, OR 0.94 P=1.0). A time-dependent covariate for percutaneous coronary intervention was not significant in a Cox regression model, suggesting a similar treatment benefit with hirudin before and after percutaneous coronary intervention. After adjustment for percutaneous coronary intervention propensity, the benefits of hirudin remained significant. There were three major bleeds in patients undergoing early percutaneous coronary intervention, all in patients randomized to hirudin.

CONCLUSION

In patients with non-ST-elevation acute coronary syndrome undergoing early percutaneous coronary intervention, a direct thrombin inhibitor such as hirudin may be more effective than heparin in reducing the incidence of ischaemic complications.

[A case report of idiopathic polypoidal choroidal vasculopathy]

PURPOSE

To report a case of idiopathic polypoidal choroidal vasculopathy (IPCV) and its angiographic characteristics.

METHODS

General ophthalmic check up, analyses of fundus picture, funds fluorescein angiography (FFA), indocyanine green angiography (ICGA) as well as literature review.

RESULTS

The lack of typical choroidal neovascularization (CNV) on FFA and characteristic polypoidal choroidal vasculopathy on ICGA as well as its unsymmetrical manifestation and discrepancy with age-related macular degeneratio (AMD) on the fundus picture are typical signs for the diagnosis of IPCV.

CONCLUSION

The angiographic features on FFA and ICGA are specific for the diagnosis of IPCV. Differentiating IPCV and AMD has clinical significance in prognosing the visual acuity, progress and management of the diseases.

[Correlations of Ki-67 expression and histopathologic characteristics in uveal melanomas]

PURPOSE

To investigate the relations between the cellular proliferation and histopathologic variables in paraffin embedded uveal melanomas with the using of the monoclonal antibody Ki-67 as a proliferation marker.

METHODS

Fifty-seven enucleated eyes were included for histopathological study and Ki-67 immunostaining. All these eye globes were enucleated between 1988 and 1997 without prior treatment.

RESULTS

The score of Ki-67 index ranged from zero to 4.89%, mean (0.75 +/- 1.02) %. The mean score of Ki-67 was significantly higher in large tumors (P = 0.007) or in tumors that contained epithelioid cells (P = 0.037) when compared to medium size tumors or to spindle cell type tumors. There was a significant difference of the distribution of epithelioid cell and spindle cell when compared histologic cell type with tumor size (chi 2 = 4.528, P < 0.05). Higher proportions of large tumors were found in epithelioid cell group. No significant correlation was found between the Ki-67 index and tumor location, scleral extension and age.

CONCLUSION

The Ki-67 index is significantly correlated with the histologic cell type and tumor size.

Analysis of mono- and oligosaccharides by multiwavelength surface plasmon resonance (SPR) spectroscopy

Surface plasmon resonance (SPR) spectra of different saccharides were collected using a home-made multiwavelength SPR apparatus. Pentoses, hexoses, disaccharides and a trisaccharide were distinguished from one another according to their SPR spectra collected at the same concentration. The spectra were also used for the quantitation of sugars by exploring the linear relationship between resonance wavelength and solute concentration. The dynamic linear ranges for the determination of glucose, sucrose and raffinose are 0.01-0.2, 0.005-0.1 and 0.0025-0.1 mol/L, respectively. The SPR spectrum of a mixture of two components was investigated. While the experiments have not been carried out, the implications from this work are that the technique would be applicable to mixtures containing more than two components.

Clinical analysis of Leber's hereditary optic neuropathy harboring mtDNA mutation at nt11778

PURPOSE

To improve our diagnostic technique through the analysis of clinical features of Leber's hereditary optic neuropathy (LHON) harboring mtDNA point mutation at nt11778.

METHODS

Detection of nt11778 mutation was performed on 38 patients clinically diagnosed as LHON in our ophthalmic center from year 1998 to 2000. Circumstances of onset and family history were obtained and ophthalmoscopy, fundus fluorescein angiography, visual field and visual evoked potential were performed on all 38 patients.

RESULT

30 In 38 patients (78.95%) harbor nt11778 mutation, including 28 male (93.33%) and 2 female (6.67%). The ratio of affected male to female is 14:1. Patients harboring nt11778 mutation display typical clinical manifestations.

CONCLUSION

Identification of one of the three LHON specifically associated mtDNA mutations is essential to confirm the diagnosis.

Change of visual acuity and related factors in idiopathic optic neuritis

PURPOSE

To study the change of visual acuity and related factors in idiopathic optic neuritis.

METHODS

Retrospectively studying 136 cases (210 eyes) of idiopathic optic neuritis hospitalized in our department during last 5 years. The data was analyzed with the methods of multivariate stepwise regression analysis by SPSS statistic package.

RESULTS

The final visual acuity was very strongly related positively to the initial visual acuity at the time point of starting treatment and negatively to the time span beginning the treatment to the time showing improvement, age of patient and the duration from onset of the disorder to the time point of treatment beginning.

CONCLUSIONS

Promptly right treatment can significantly change the natural course and the final vision of optic neuritis. Severe visual loss, old age, longer time without right therapy and slow improvement after the treatment may indicate an unfavorable final visual recovery. The different dosages of steroid applied in this study was not significant in view of the final visual acuity.

Prognostic significance of thrombocytopenia during hirudin and heparin therapy in acute coronary syndrome without ST elevation: Organization to Assess Strategies for Ischemic Syndromes (OASIS-2)study

BACKGROUND

The development of thrombocytopenia in acute coronary syndromes (ACS) appears to be associated with adverse clinical outcomes. Unfractionated heparin is a recognized cause of thrombocytopenia, but the incidence, predictors, and prognostic significance of thrombocytopenia during hirudin therapy in ACS have not been reported.

METHODS AND RESULTS

Patients with ACS without ST elevation were randomized in a double-blind manner to receive a 72-hour intravenous infusion of unfractionated heparin or hirudin. Platelet counts were measured at baseline and within 24 hours of completion of study drug. The overall incidence of thrombocytopenia (<100x10(9)/L) was 1% and was similar in unfractionated heparin- and hirudin-treated patients (P:=0.42). Thrombocytopenia during study drug infusion was an independent predictor of 7-day outcomes, including death (OR, 6.7; 95% CI, 1.9 to 25); the composite of death, myocardial infarction, and recurrent ischemia (OR, 2.0; 95% CI, 1.0 to 1.5); revascularization (OR, 4.0; 95% CI, 2.2 to 7.1); and major bleeding (OR, 8.3; 95% CI, 3.4 to 17.7). Among patients who developed thrombocytopenia, hirudin (OR, 5.4; 95% CI, 2.6 to 11.3) but not unfractionated heparin (OR, 2.0; 95% CI, 0.3 to 14.4) therapy was associated with a significantly increased risk of major bleeding.

CONCLUSIONS

Early-onset thrombocytopenia in patients with ACS without ST elevation is strongly associated with adverse clinical outcomes, including death, ischemic events, and bleeding. The excess of major bleeding in hirudin-treated patients who develop thrombocytopenia suggests that thrombocytopenia may contribute to the increased risk of bleeding observed with hirudin.

Osteogenic potential of cultured bone marrow stromal cells transfected with transforming growth factor beta 1 gene in vitro

To study the osteogenic potential of cultured bone marrow stromal cells (BMSCs) transfected with transforming growth factor beta 1 (TGF-beta 1) gene in vitro, cultured BMSCs were transfected with the complexes of pcDNA3-TGF-beta 1 and Lipofectamine Reagent in vitro. The cell proliferation was detected by MTT method and the morphological features of transfected BMSCs was observed. ALP stains and PNP method were used to measure ALP activity. In addition, the collagen type I propeptides and mineralized matrixes were examined by immunohistochemical staining and tetracycline fluorescence labeling respectively. The morphological and biological characters of the transfected BMSCs were similar to those of osteoblasts and the cell proliferation was promoted. The cell layer displayed strong positive reaction for ALP stains and immunohistochemical staining. ALP activity and collagen type I expression increased remarkably after transfection. Mineralized matrixes formed earlier and more in transfected BMSCs as compared with control group. It is concluded that transfecting with TGF-beta 1 gene could promote the osteogenic potential of cultured BMSCs.

Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction

OBJECTIVES

We sought to evaluate the prognostic impact of right ventricular (RV) myocardial involvement in patients with inferior myocardial infarction (MI).

BACKGROUND

There is uncertainty regarding the risk of major complications in patients with inferior MI complicated by RV myocardial involvement. Whether these complications are related to RV myocardial involvement itself or simply to the extent of infarction involving the left ventricle (LV) is also unknown.

METHODS

We examined the incidence of death and mechanical and electrical complications in patients with (n = 491) and without (n = 638) RV myocardial involvement and in patients with anterior MI (n = 971) in an analysis from the Collaborative Organization for RheothRx Evaluation (CORE) trial. Left ventricular infarct size was assessed by technetium-99m-sestamibi single-photon emission computed tomography and peak creatine kinase, and LV function was assessed by radionuclide angiography. We also performed a meta-analysis in which we pooled the results of our study with previous smaller studies addressing the same question.

RESULTS

Six-month mortality was 7.8% in inferior MI compared with 13.2% in anterior MI. Among patients with inferior MI, serious arrhythmias were significantly more common in patients with RV myocardial involvement who also had a trend toward higher mortality, pump failure and mechanical complications. However, this was not associated with a difference in LV infarct size or function. A meta-analysis of six studies (n = 1,198) confirmed that RV myocardial involvement was associated with an increased risk of death (odds ratio [OR] 3.2, 95% confidence interval [CI] 2.4 to 4.1), shock (OR 3.2, 95% CI 2.4 to 3.5), ventricular tachycardia or fibrillation (OR 2.7, 95% CI 2.1 to 3.5) and atrioventricular block (OR 3.4, 95% CI 2.7 to 4.2).

CONCLUSIONS

Patients with inferior MI who also have RV myocardial involvement are at increased risk of death, shock and arrhythmias. This increased risk is related to the presence of RV myocardial involvement itself rather than the extent of LV myocardial damage.

[Surgical treatment of recurrent dislocation of the patella in children]

OBJECTIVE

To study an operative method for repair of recurrent dislocation of the patella in children.

METHODS

36 children with recurrent patellar dislocation were treated surgically at an average age of 9.1 years. They were followed on average for 4 years and 4 months. Nine of the 36 children underwent bilateral repair, with 45 knees were treated. The combined soft tissue operations included lateral retinacular releasing, medial retinacular tightening of the knee, vastus medialis muscle transfer to the patella, medial and distal transfer of the half patellar tendon.

RESULTS

28 patients had stable knee joint and a full range of motion, and improved sports activity after operation. Seven children achieved satisfactory function of the knee joint but there was no significant difference between pre-and postoperative sports exercise ability. One child suffered from a redislocation of the patella. Wound infection was not seen and the range of knee joint motion was not restricted in all patients.

CONCLUSIONS

The combined procedures for repair of recurrent dislocation of the patella in children risk free for growth disturbances secondary to iatrogenic injury to the proximal tibial physis. It is safe and effective for recurrent dislocation of the patella in skeletally immature children.

Differences in risk factors, atherosclerosis and cardiovascular disease between ethnic groups in Canada: the study of health assessment and risk in ethnic groups (SHARE)

Cardiovascular disease rates vary greatly between ethnic groups in Canada. To establish whether this variation can be explained by differences in disease risk factors and subclinical atherosclerosis, we undertook a population-based study of three ethnic groups in Canada: South Asians, Chinese and Europeans. A total of 985 participants were recruited from three cities (Hamilton, Toronto and Edmonton) by stratified random sampling. Clinical cardiovascular disease was defined by history or electrocardiographic findings. Carotid atherosclerosis was measured with B-mode ultrasonography. Conventional (smoking, hypertension, diabetes, raised cholesterol) and novel risk factors (markers of a prothrombotic state) were measured. Within each ethnic group and overall, the degree of carotid atherosclerosis was associated with a higher prevalence of cardiovascular disease. South Asians had the highest prevalence of this condition compared with Europeans and Chinese (11%, 5% and 2%, respectively; p=0.0004). Despite this finding, Europeans had more atherosclerosis (mean of the maximum intimal medial thickness 0.75 [0.16] mm) than South Asians (0.72 [0.15] mm) and Chinese (0.69 [0.16] mm). South Asians had an increased prevalence of glucose intolerance, higher total and low-density lipoprotein cholesterol, higher triglycerides and lower high-density lipoprotein cholesterol, and much greater abnormalities in novel risk factors including higher concentrations of fibrinogen, homocysteine, lipoprotein(a), and plasminogen activator inhibitor-1. Although there are differences in conventional and novel risk factors between ethnic groups, this variation and the degree of atherosclerosis only partly explains the higher rates of cardiovascular disease among South Asians compared with Europeans and Chinese. The increased risk of cardiovascular events could be due to factors affecting plaque rupture, the interaction between prothrombotic factors and atherosclerosis, or as yet undiscovered risk factors.

[Determination of malignant disease-associated DNA-binding protein 2 in patients with liver cancer]

The aim of this study was to assess the value of malignant disease-associated DNA-binding protein 2(MAD2) in the diagnosis of liver cancer. The concentration of plasma MAD2 was determined in 27 patients with primary liver cancer, 14 patients with metastatic liver cancer and 12 healthy subjects by ELISA assay. The primary tumors of all the patients with metastatic liver cancer were located in the gastrointestinal tract, which had been radically resected and had no signs of local recurrence. The concentrations of plasma MAD2 in the patients with primary liver cancer, with metastatic liver cancer, and the healthy subjects were 30.56 +/- 11.38 micrograms/ml, 9.27 +/- 5.58 micrograms/ml and 8.43 +/- 5.62 micrograms/ml, respectively. The concentration of MAD2 in patients with primary liver cancer was significantly higher than that in the patients with metastatic liver cancer and healthy subjects (P < 0.001). There was no significant difference between the healthy subjects and the patients with metastatic liver cancer(P > 0.05). These results suggest that MAD2 may be an useful marker for the diagnosis of primary liver cancer.

Endotoxin downregulates hepatic expression of P-glycoprotein and MRP2 in 2-acetylaminofluorene-treated rats

In liver, the ATP-dependent transporters P-glycoprotein (PGP) and multidrug resistance protein-2 (MRP2) are involved in the secretion of numerous drugs and toxins in bile. Although constitutive levels of PGP and MRP-2 are decreased in rat liver after exposure to endotoxin, it is possible that induced forms of these transporters may be alternately affected. In vitro, the hepatocarcinogen, 2-acetylaminofluorene (AAF) induces expression of PGP and MRP2. Thus, we examined the influence of endotoxin on the expression of PGP and MRP2 in AAF-treated rats. Expression of PGP and MRP2 was analyzed on Westerns and by RT-PCR in livers obtained from endotoxin and control groups. In vivo, AAF treatment significantly induced PGP/mdr1 expression and imposed a significant reduction in the expression of spgp. MRP2 protein and mRNA levels were not altered by AAF administration. Endotoxin administration to both AAF-treated and non-AAF-treated rats elicited significant reductions in the protein and mRNA expression of MRP2 and PGP (P < 0.05). Our data indicate that endotoxin suppresses the overexpression of PGP and constitutive expression of MRP2 in AAF-treated rats. Furthermore, in vivo administration of AAF, which maximally induces PGP does not induce MRP2.

Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE)

BACKGROUND

Cardiovascular disease rates vary greatly between ethnic groups in Canada. To establish whether this variation can be explained by differences in disease risk factors and subclinical atherosclerosis, we undertook a population-based study of three ethnic groups in Canada: South Asians, Chinese, and Europeans.

METHODS

985 participants were recruited from three cities (Hamilton, Toronto, and Edmonton) by stratified random sampling. Clinical cardiovascular disease was defined by history or electrocardiographic findings. Carotid atherosclerosis was measured with B-mode ultrasonography. Conventional (smoking, hypertension, diabetes, raised cholesterol) and novel risk factors (markers of a prothrombotic state) were measured.

FINDINGS

Within each ethnic group and overall, the degree of carotid atherosclerosis was associated with a higher prevalence of cardiovascular disease. South Asians had the highest prevalence of this condition compared with Europeans and Chinese (11%, 5%, and 2%, respectively, p=0.0004). Despite this finding, Europeans had more atherosclerosis (mean of the maximum intimal medial thickness 0.75 [0.16] mm) than South Asians (0.72 [0.15] mm), and Chinese (0.69 [0.16] mm). South Asians had an increased prevalence of glucose intolerance, higher total and LDL cholesterol, higher triglycerides, and lower HDL cholesterol, and much greater abnormalities in novel risk factors including higher concentrations of fibrinogen, homocysteine, lipoprotein (a), and plasminogen activator inhibitor-1.

INTERPRETATION

Although there are differences in conventional and novel risk factors between ethnic groups, this variation and the degree of atherosclerosis only partly explains the higher rates of cardiovascular disease among South Asians compared with Europeans and Chinese. The increased risk of cardiovascular events could be due to factors affecting plaque rupture, the interaction between prothrombotic factors and atherosclerosis, or as yet undiscovered risk factors.

[A study on the relationship between the expression of Bax gene products and prognosis in patients with human non-small cell lung cancer]

BACKGROUND

To explore the relationship between the expression of Bax gene and oncogenesis , development and prognosis of lung cancer.

METHODS

The expression level of Bax gene products was detected in 124 human non-small cell lung cancer by immunohistochemistry labelled-streptavidin-biotin methods.

RESULTS

The expressional level of Bax products in lung cancer tissues (53. 76 %) was significantly lower than that in the normal tissues adjacent to lung cancer (75. 51 %) and normal lung tissues (74. 97 %) ( P < 0. 01) . The expressional level of Bax products was closely related with P-TNM stage , the size of primary tumor and lymph node metastasis ( P < 0. 01 or P < 0. 05) ; but not to histological classification , cell differentiation and site of the cancer , and age , sex of the patients and smoking or not ( P > 0. 05) . The five-year survival rate in patients with high Bax expression was significantly higher than that in patients with low Bax expression ( P < 0. 01) .

CONCLUSIONS

Abnormal expression of Bax gene may play an important role in the oncogenesis , development and prognosis of lung cancer. Bax gene may be involved in the oncogenesis , development and metastasis of lung cancer.

[A multicenter randomized phase II trial of domestic product of rhG-CSF(Rui Xue Xin) in preventing leukopenia caused by chemotherapy in patients with lung cancer]

BACKGROUND

To evaluate the effect and toxicity of the domestic product of rhG-CSF (Rui Xue Xin) in preventing leukopenia caused by chemotherapy in patients with lung cancer.

METHODS

67 patients in multicenter were randomly devided into AB group and BA group. The first cycle was a trial cycle (chemotherapy plus injection of Rui Xue Xin) , and the second cycle was a control cycle (chemotherapy alone) in AB group. On the contrast , the first cycle was a control cycle , and the second cycle was a trial cycle in BA group. The changes of white blood cell (WBC) and absolute neutrophil counts (ANC) , and the side effect of Rui Xue Xin were observed and compared between the trial cycle and control cycle.

RESULTS

Of the 67 patients , 6 cases were out of the trial because of patient compliance , and the another one case due to fever , and the other 61 cases could be used to analyze and to evaluate the effects and toxicity of Rui Xue Xin. The duration of leukopenia and neutropenia in cycle A was significantly shorter than that in cycle B ( P < 0. 01) . The nadirs of WBC and ANC following chemotherapy were remarkably higher in cycle A than those in cycle B ( P < 0. 01) . The incidence of chemotherapy delay due to WBC < 4. 0 *109 /L on the 21st day after chemotherapy in cycle A was also significantly lower than that in cycle B ( P < 0. 01) . The total rate of side effects of Rui Xue Xin was 26. 2 % , including pain and scleroma on the injection sites , weakness , fever. But , all of them were mild and didn't need to give any treatment.

CONCLUSIONS

The results demonstrate that Rui Xue Xin is able to reduce the degree of leukopenia and neutropenia , and to shorten the duration of leukopenia and neutropenia caused by chemotherapy in patients with lung cancer. The toxicity is also slight.

Study on gastric empty disorder after the gastric ulcer healing and therapeutic effect of cisapride

Gastric emptying time of liquid meal was detected by using ultrasonography in 28 gastric ulcer patients with continual or recurrent dyspepsia symptoms after the ulcer healing. Sixteen out of 28 patients (57.1%) with a delay of gastric emptying time (T1/2) were randomly divided into two groups: 8 cases were treated with cisapride 5 mg three times a day and 8 cases with cisapride 10 mg three times a day respectively. The results showed that cisapride could relieve the symptoms with the effective rate being 68.8% in the two groups. T1/2 in the patients after treatment with cisapride was significantly shorter than before treatment (P < 0.001). It was concluded that there is a delay of T1/2 in some patients with gastric ulcer healing. Cisapride could promote gastric empty of liquid meal and relieve the symptoms efficiently. The effect of lower dose of cisapride is similar to that of higher dose.

[Comparison between carboplatin and cisplatin plus etoposide and carboplatin plus etoposide in the treatment of small cell lung cancer.]

BACKGROUND

To evaluate the effect and toxicity of combination chemotherapy with carboplatin and cisplatin plus etoposide (CPE regimen) and carboplatin plus etoposide (CE regimen) in the treatment of small cell lung cancer (SCLC) .

METHODS

Thirty-two patients with SCLC were treated with CPE and CE regimens , and each regimen had 16 cases respectively. There were 10 retreated cases in CPE group and 7 retreated cases in CE group.

RESULTS

The total response rate (CR + PR) was 81. 3 %(13/ 16) in CPE group , and 87. 5 %(14/ 16) in CE group ( P > 0. 05) respectively. The response rate of the retreated cases in CPE group was 60 %(6/ 10) , and 42. 9 %(3/ 7) in CE group ( P < 0. 05) . The bone marrow suppression rate was 71. 9 % in CPE group and 93. 8 % in CE group ( P < 0. 05) . There were no significant differences between other toxicity in both groups ( P > 0. 05) .

CONCLUSIONS

The therapeutic effect of CPE regimen in SCLC is similar to that of CE regimen , but the bone marrow suppression rate of CPE regimen is less severe than that of CE regimen. The therapeutic effect of CPE regimen is better than that of CE regimen for the retreated cases.

Fine chemical manipulations of microscopic liquid samples. 1. Droplet loading with chemicals

Physically and chemically stable microscopic aqueous droplets of nano-, pico-, and femtoliter volumes were made and kept under heptane. Such droplets can contain chemicals of interest in pico-, femto-, and attomole amounts or less. Their fine chemical manipulation was achieved by a diffusional microburet (DMB), which consists of a pulled glass capillary whose microscopic tip is filled with a tiny diffusion membrane of agar or polyacrylamide gel. Once this tip is moved into a target droplet by a fine micromanipulator under a microscope, diffusional reagent delivery from the DMB body begins, driven by the concentration gradient within the tip. This system was tested in this work by delivering an inert fluorescent dye, Lucifer Yellow CH, into buffer droplets while fluorescence intensity in each droplet was recorded. An exponential decay of delivery rate was observed corresponding to an exponential saturation process for the accumulation of the delivered chemical inside the target droplet.

[Analyses of central serous chorioretinopathy from indocyanine green angiography]

PURPOSE

To compare and analyse the characters of Indocyanine Green Angiography (ICGA) and Fundus Fluorescein Angiography (FFA) in Central Serous Chorioretinopathy (CSCR) and explore its pathological significance.

METHOD

35 cases of CSCR were examed with Heidelberg Retina Angiography. Simultaneous images of ICGA and FFA were analysed.

RESULTS

Among the 35 cases, 29(83%) revealed more lesions in ICGA than in FFA. The lesions appeared in FFA were all associated with ICGA changes.

CONCLUSION

The increasing of choroid hyperpermeability is an early change, which causes the overlying RPE dysfunction and structural damage. Some points related to the laser and medical treatment to CSCR were also discussed.

Single cell model for simultaneous drug delivery and efflux

Multidrug resistance (MDR) of some cancer cells is a major challenge for chemotherapy of systemic cancers to overcome. To experimentally uncover the cellular mechanisms leading to MDR, it is necessary to quantitatively assess both drug influx into, and efflux from, the cells exposed to drug treatment. By using a novel molecular microdelivery system to enforce continuous and adjustable drug influx into single cells by controlled diffusion through a gel plug in a micropipet tip, drug resistance studies can now be performed on the single cell level. Our dynamic model of this scheme incorporates drug delivery, diffusive mixing, and accumulation inside the cytoplasm, and efflux by both passive and active membrane transport. Model simulations using available experimental information on these processes can assist in the design of MDR related experiments on single cancer cells which are expected to lead to a quantitative evaluation of mechanisms. Simulations indicate that drug resistance of a cancer cell can be quantified better by its dynamic response than by steady-state analysis.

Role of Helicobacter pylori infection in pathogenesis of gastric adenocarcinoma

To study the effect of Helicobacter Pylori (Hp) on the process of gastric carcinogenesis, 35 cases of chronic gastritis, 20 cases of gastric adenocarcinoma were studied by use of transmission electron microscopy, immunohistochemical and molecular biological technique. The results showed that 24 of 35 cases of chronic gastritis were positive for Hp, 11/20 cases of gastric adenocarcinoma were Hp positive. PCNA positive cell labeling index (LI) in Hp-associated chronic gastritis (LI = 20.6 +/- 4.7) was higher than that in Hp negative chronic gastritis (LI = 11.3 +/- 5.2) (P < 0.05). HSP70 expression of gastric adenocarcinoma tissues in Hp-infected patients were lower than that of non-Hp-infected gastric cancer. p53 gene mutation was found in gastric adenocarcinoma with positive Hp. It was suggested that Hp may enhance gastric cell proliferation, decrease the expression of HSP70 which induces p53 mutation.

Continuous in situ electrochemical monitoring of doxorubicin efflux from sensitive and drug-resistant cancer cells

One of the least well understood problems in cancer chemotherapy is the cross-resistance of certain tumor cells to a series of chemically unrelated drugs. Multidrug resistance (MDR) can be attributed to several different biophysical processes, among them increased drug efflux. This has been found to correlate with overexpression of the cell surface 170-kDa P-glycoprotein that actively excludes cytotoxic drugs against their concentration gradient. To better understand MDR, experimental methods are needed to study drug efflux from cancer cells. Continuous measurement of efflux of nonfluorescent drugs on the same cell culture in situ, or assessing efflux from a few cells or even a single cell, is beyond the capabilities of existing technologies. In this work, a carbon fiber (CF) microelectrode is used to monitor efflux of doxorubicin from a monolayer of two cell lines: an auxotrophic mutant of Chinese hamster ovary cells, AUXB1, and its MDR subline, CHRC5. Because doxorubicin is both fluorescent and electroactive, the results could be validated against existing data obtained optically and with other techniques on the same cell lines, with good agreement found. The electrochemical detection, however, is capable of in situ monitoring with high temporal resolution and is suitable for single-cell studies.

The role of ras gene mutation in gastric cancer and precancerous lesions

Abnormality of ras gene family was studied in a total of 206 cases of gastric cancer and precancerous lesions by PCR-RFLP, PCR-SSCP and DNA sequencing. The results showed that mutation rate of H-ras 12 codon in metaplasia, atypical hyperplasia, early-stage cancer and advanced cancer was 16.7%, 31.2%, 50.0%, and 32.2%, respectively. In the groups of superficial gastritis and normal controls, no mutation were detected in codon 12 of ras. Mutations of H-ras 61 codon and N-ras 12 codon in various groups were the same as those in normal control. K-ras 12 codon mutation was detected in only 2 cases of gastric cancer by using PCR-SSCP, but it was not detected by DNA sequencing, which may be polymorphism. All H-ras 12 codon mutations were G-->T mutation. There were significant difference between the groups of metaplasia, dysplasia, gastric carcinoma and normal control group (P < 0.05, P < 0.01, P < 0.01, respectively). It was concluded that H-ras 12 codon mutation was an early event and may play an important role in gastric carcinogenesis. Although K-ras, N-ras mutation rates are high in colon cancer and leukemia, it seems to bear no relationship with gastric cancer.

[Experimental study on immunity and burn wound healing]

The immune system is involved in the complicated process of wound healing. In this study, we at first set up an optimal immuno-suppression model with low-doze radiation with 60Co and found that both the ratio of Th/Ts in peripheral blood and the rate of T cells adhesion to tumour cells dropped persistently, and there were no significant injuries to skin tissue DNA and cells cycle in 20 days after 2Gy radiation with 60Co. Then we investigated the influence of immuno-suppression on burn wound healing. The results showed that both ability of collagen repair and rates of wound healing after burn injury were inhibited in immuno-suppression rats. This indicated that it was necessary to improve immunity condition to enhance wound healing after severe burn injury.

Maximal aerobic capacity and its relationship with physical growth in Chinese children

Maximal aerobic capacity and its relationship to physical growth in 463 Chinese children and adolescents aged 10-19 is reported. Results show that VO2max, VO2max/height and VO2max/HRmax positively relate to measures of physical growth such as height, weight and lean body mass (LBM). Correlation of VO2max/weight with physical growth variables is high and positive in boys and low and negative in girls. The sample is divided to two groups on each variable: well-developed and relatively poorly-developed according to height, weight and LBM. SDS values of VO2max, VO2max/height and VO2max/HRmax are higher in the first group than in the second group. In contrast, SDS values of VO2max/weight and VO2max/LBM are greater in second group. The similarity of results between SDS values with correlation analysis suggest that weight and LBM are probably the decisive factors that influence VO2max.

[Experimental studies of jiantang oral solution on reducing glycemia]

Mice or rats were pretreated P. O. with 8.0 gg.kg-1, 15.0 g.kg-1 and 30.03 g.kg-1 of Jiangtang Oral Solution once daily for 10 days respectively. The results showed that Jiangtang Oral Solution did not affect the glycemia and lipid in normal mice and rats, but significantly lowered the blood sugar in hyperglycemic mice and rats induced by alloxan, adrenalin, and streptozotocin. Meanwhile, Jiangtang Oral Solution significantly lowered blood lipid in mice and rats induced by yolk and high cholesterol foods. This study provides a reliable pharmacologic base for the clincal use of Jiangtang Oral Solution.

Abnormal change of p53 gene in gastric and precancerous lesions and APC gene deletion in gastric carcinoma and near tissues

p53 gene mutation (exon4, 5, 6, 7, 8 and intron6) in gastric cancer and precancerous lesions and p53 gene (exon4 and ontron6), APC gene deletion in gastric carcinomas were studied by PCR/SSCP and PCR/RFLP. Results showed mutation rate of p53 in metaplasia, dysplasia and gastric carcinoma was 37.5% (3/8), 42.17% (8/19), 53.33 (16/30) respectively. There was significant difference among groups of metaplasia, dysplasia, cancer and normal controls. No exon8 mutation was found in metaplasia and dysplasia, but 4 cases were found to have exon8 mutation in cancer group. It is suggested that exon8 mutation occurs at the late stage of gastric cancer, but exon 5, 6, 7 mutation occur in the course of precancerous lesion to cancer. Loss of heterozygosity (LOH) of exon4, intron6, APC was 47, 37% (9/19), 8.73% (2/23), 16.67% (3/18) respectively. LOH of exon4 had something to do with poor differentiation, lymph node metastasis, depth of invasion. LOH of exon4 may be of prognostic marker of gastric cancer. We are led to conclude that p53 gene mutation is an early event and perhaps work together with ras oncogene in gastric carcinogenesis.

Complexometric determination of metal ions by microscopic diffusional titration

Acid/base titrations of pico- and femtoliter microsamples have been performed previously using a diffusional microburet (DMB) for reagent delivery in a simple droplet-heptane system (Gratzl, M.; Yi, C. Anal. Chem. 1993, 65, 2085-2088). The lowest delivery rate achieved with a DMB was about 6 fmol/s, which would correspond to about a 1 microL/year volumetric flow rate with a hypothetical equivalent mechanical delivery scheme (Yi, C.; Gratzl, M. Anal. Chem. 1994, 66, 1976-1982). In this work, the feasibility of complexometric titrations in microscopic samples is explored. Stability of pH in the microdroplets required for different determinations and the effects of DMB shank geometry on titration characteristics are also studied. Diffusional microtitrations of Fe(III), Zn(II), and Cu(II) have been performed with EDTA. Xylenol orange and Eriochrome Black T provide clear color changes at the end point of the respective titrations, despite the microscopic size of the samples (between 16 and 1570 pL, corresponding to diameters between 30 and 144 microns). Random errors of the determinations relative to full scale were 6.6% for Fe(III), 5.8% for Cu(II), and 7.9% for Zn(II). The pH required for EDTA titrations of the individual metal ions stays stable in the acidic range. This makes the microscopic titration of a number of metal ions, such as Fe(III), Fe(II), Cu(II), and Pb(II), feasible in a simple droplet-heptane system without any modification. With a higher density of strongly alkaline buffer droplets (about 100 droplets/mm2) sprayed on the bottom of the Petri dish, or by flushing N2 above the heptane, the microscopic samples can also be kept alkaline despite ambient CO2 present. In this way, Zn(II) can also be titrated in microdroplets, requiring a pH around 10. This work renders it possible to perform a variety of complexometric titrations and other chemical manipulations in microdroplets even if they need to be kept alkaline. Similar titrations in single biological cells to assess intracellular buffer capacities of different metal ions, such as Ca(II) and Mg(II), are underway.

[Sternocleidomastoid muscle lengthening for the cure of muscular torticollis]

A Z-plasty was designed to lengthen the sternocleidomastoid muscle for the treatment of muscular torticollis. Since September 1990, forty-nine patients (36 males, 13 females) have been treated. Their age ranged from 2 to 22 years old. Follow-up of there months to three years showed 95.9% of them were good results. The paper not only described the operative procedure, indications, choice of anaesthesia. postoperative functional exercise and the application of neck splint, but also emphasized the aesthetic effect to the operation.