[Effect of multistage surgery in patients with functional single ventricle and risk factors of postoperative death]

Objective: To investigate the efficacy of multistage surgery in patients with functional single ventricle (FSV) and risk factors of postoperative death. Methods: The clinical data of all consecutive patients with FSV undergoing multistage single ventricle palliation surgery in Guangzhou women and children's medical center from January 2008 to December 2017 were retrospectively reviewed. The study included 289 patients. The age was 10.0 (6.0, 35.4) months,and there were 198 male and 91 female patients. The patients were followed up at outpatient clinic. Survival rates were calculated with Kaplan-Meier. Multivariate Cox regression analysis was made to determine the risk factors of postoperative death. Results: Seventy-nine patients required the first stage palliation surgery, 232 patients received the Glenn shunt surgery, and 162 patients completed the Fontan procedure. Overall, postoperative death occurred in 39 patients including 21 after the first stage palliation surgery (early stage 13 cases, late stage 8 cases) , 10 after the Glenn shunt surgery (early stage 5 cases, late stage 5 cases) , and 8 following the Fontan procedure (early stage 6 cases, late stage 2 cases) . Kaplan-Meier analysis showed that survival rate of the entire cohort was 90.2% (95%CI 86.7%-93.7%) , 85.9% (95%CI 81.8%-90.0%) ,and 84.6% (95%CI 79.7%-89.5%) at 1 year, 5 years and 10 years post operation. Survival rate was 74.4% (95%CI 64.8%-84.0%) , 73.0% (95%CI 63.2%-82.8%) , and 73.0% (95%CI 63.2%-82.8%) at 1 year, 5 years, and 10 years post the first stage palliation surgery, 97.8% (95%CI 95.8%-99.7%) , 95.2% (95%CI 92.3%-98.1%) , and 95.2% (95%CI 92.3%-98.1%) at 1 year, 5 years, and 10 years post Glenn shunt surgery, 95.6% (95%CI 92.5%-98.7%) and 93.7% (95%CI 88.8%-98.6%) at 1 year and 5 years post Fontan surgery. Multivariate Cox regression analysis revealed that total anomalous pulmonary venous connection (HR=5.47, 95%CI 2.71-11.04, P<0.001), atrioventricular valve regurgitation more than moderate (HR=2.52, 95%CI 1.32-4.79, P=0.005), systemic ventricular outflow tract obstruction (HR=3.47, 95%CI 1.30-9.29, P=0.013), and required the first palliation surgery (HR=3.12, 95%CI 1.59-6.15, P=0.001) were risk factors of postoperative death. Conclusions: The multistage surgery can effectively improve the survival of patientswith functional single ventricle and is associated with satisfactory long-term prognosis. Total anomalous pulmonary venous connection, atrioventricular valve regurgitation more than moderate, systemic ventricular outflow tract obstruction, and required the first palliation surgery are risk factors of postoperative death in these patients.

[A preliminary prospective study on the efficacy and safety of ultrasound-guided percutaneous lauromacrogol sclerotherapy in benign cystic or predominantly cystic thyroid nodules]

Objective: To investigate the efficacy and safety of percutaneous lauromacrogol injection (PLI) in treatment of cystic or predominantly cystic thyroid nodules. Methods: A total of 114 cystic thyroid nodules and 61 predominantly cystic thyroid nodules with pain or uncomfort or aesthetic complaints were offered PLI. Therapeutic success rates and side effects were evaluated. From October 2012 to December 2015,114 patients with cystic thyroid nodules and 61 with predominantly cystic thyroid nodules with pain or uncomfortable or aesthetic complaints at the outpatient clinic of the First Affiliated Hospital of Wenzhou Medical University were offered percutaneous lauromacrogol sclerotherapy. Cytological results were benign. This study was a prospective trial. Ultrasonography sound examination was performed in all patients before treatment. The baseline data of all the patients and the data of the patients examined at the follow-up of 1, 3, 6 and 12 months were analyzed. Therapeutic success rate (nodule volume reduction >50%) and safety were observed. The data of nodule volume reduction ratio and the function of thyroid were normal distribution and analyzed by Mann-Whitney test and t test. The data of nodule volume, symptoms score and cosmetic score were skewed distribution, which were indicated with median and analyzed by nonparamentic test. Results: The mean volume of the cystic thyroid nodules was reduced from 12.5 cm(3) before PLI to 0.2 cm(3) at 12 months after PLI (χ(2)=266.175, P<0.001), with a therapeutic success rate of 100%, and the mean volume of the predominantly cystic thyroid nodules was reduced from 10.5 cm(3) before PLI to 2.0 cm(3) at 12 months after PLI (χ(2)=203.122, P<0.001) with a therapeutic success rate of 93.4%(57/61). Pressure symptom score and cosmetic grade were significantly improved at 12 months after PLI in patients with cystic or predominantly cystic thyroid nodules. Pressure symptom score and cosmetic grade in patients with cystic thyroid nodules were Z=-6.126 and Z=-13.735, respectively; pressure symptom score and cosmetic grade in patients with predominantly cystic thyroid nodules were Z=-3.126 and Z=-7.212, respectively (all P<0.001) . There no significant difference in the thyroid functions before and after PLI in two groups of patients (all P>0.05) . The side effects of PLI were mild. Conclusion: PLI is a safe and effective alternative to treat benign cystic or predominantly cystic thyroid nodules.

[Application of fluoride releasing flowable resin in pit and fissure sealant of children with early enamel caries]

OBJECTIVE

To evaluate the clinical effect of fluoride releasing flowable resin used in treatment of early enamel caries of children compared with conventional sealant.

METHODS

Seventy-six patients, including fifty-two couples of permanent first molars and thirty couples of premolars were selected for this trial. Both sides of all the molars and premolars were diagnosed as early enamel caries based on International Caries Detection and Assessment System (ICDAS) dental caries diagnostic criteria. Using the contralateral control, the teeth were randomly divided into two groups. Molars/premolars in the experimental group were sealed with a fluoride releasing flowable resin; the contralateral molars/premolars were sealed with a conventional fissure sealant as a control group. The retention rate and progress of caries were evaluated at the end of 3, 6, 12 and 24 months.

RESULTS

There was no fissure sealant loss or caries progression in both groups 3 and 6 months after sealing the premolars by fluoride releasing flowable resin or conventional fissure sealants. At the end of 12 and 24 months, only one case of fissure sealant loss was observed in conventional fissure sealant group. There was no statistical significance between the two premolar groups. In the first molar group, fluoride releasing flowable resin showed 100%, 98.08%, 90.38% and 88.46% complete retention at the end of 3, 6, 12 and 24 months, respectively. The conventional fissure sealant retention rates were 96.15%, 92.31%, 76.92% and 73.08% at the corresponding time points. The data at the end of 24 months showed that fluoride releasing flowable resin had significantly higher retention rate than the conventional fissure sealant group (P<0.05). The incidence of caries progression at the end of 6, 12 and 24 months were 1.92%, 5.77% and 7.69%, respectively, in the fluoride releasing flowable resin group. In the conventional fissure sealant group, the incidence was 5.77%, 19.23% and 25.00%, respectively. At the end of 12 and 24 months, more significant decrease of caries progress incidence was observed in the fluoride releasing flowable resin group than in the control group, and there was statistical difference between the two groups (P<0.05).

CONCLUSION

Compared with conventional fissure sealant, using fluoride releasing flowable resin as a fissure sealant in children enamel caries of permanent molars can improve the sealant preservation rate and effectively prevent enamel caries progress.

[Research progress of hydrogen-rich saline for eye diseases]

As an antioxidant, hydrogen-rich water has been widely studied in recent years. It is mild enough neither to disturb metabolic redox reactions nor to affect signaling reactive oxygen species. Therefore, there should be no or few adverse effects of H(2). Numerous studies in biology and medicine show that hydrogen-rich water has achieved good results in nervous system, digestive system, respiratory system, heart and kidney diseases. At present, there are few studies on the treatment of eye diseases with hydrogen-rich water. This review summarizes the research progress of hydrogen-rich water for eye diseases in the domestic and foreign literatures. (Chin J Ophthalmol, 2018, 54: 631-635).

[Spatial-temporal distribution characteristics of hepatitis E in Shanghai, 2006-2016]

Objective: To understand the epidemiologic characteristics and spatial-temporal distribution of hepatitis E in Shanghai between 2006 and 2016. Methods: The reported incidence of hepatitis E and health facilities' information between 2006 and 2016 were collected from the China Information System for Disease Control and Prevention. The geographic information were from Shanghai Surveying and Mapping Institute. The map scale was 1∶750 000. Global and local autocorrelation, and spatial-temporal detection methods were applied to determine the spatial-temporal characteristics of hepatitis E. Software ArcGIS 10.1 was used to analyze global and local spatial auto correlation of hepatitis E spatial clusters. Software SaTScan 9.4.4 was used to conduct scan for exploring the areas of hepatitis E temporal spatial clusters. Results: A total of 6 048 cases of hepatitis E were reported in Shanghai during 2006-2016. The average incidence was 2.14/100 000. Spatial auto correlation analysis indicated that there was significant spatial positive correlations and spatial-temporal clustering of hepatitis E in Shanghai, and the "high-high cluster" was mainly located in the downtown of the city. Conclusion: Understanding the spatial-temporal clustering areas of hepatitis E cases in Shanghai from 2006 to 2016 is important to the reasonable allocation of public health resources and effective prevention and control of hepatitis E.

Biosorption of malachite green onto Haematococcus pluvialis observed through synchrotron Fourier-transform infrared microspectroscopy

Microalgae have emerged as promising biosorbents for the treatment of malachite green (MG) in wastewater. However, the underlying mechanism for the biosorption of MG onto microalgae is still unclear and needs further intensive study. In this work, synchrotron Fourier-transform infrared (s-FTIR) microspectroscopy in combination with biochemical assay is employed to evaluate MG removal efficiency (95·2%, 75·6% and 66·5%) by three stages of Haematococcus pluvialis. Meanwhile, the various vital changes of algal cells including lipids, proteins, polysaccharides and carotenoids is distinguished and quantified in situ. This study illustrates that s-FTIR microspectroscopy is an effective and powerful tool to scrutinize the mechanism for the interactions between the MG dye and microalgal cells, and it even provides an effective and noninvasive new approach to screen potentially proper biosorbents for the removal of dyes from wastewater.

SIGNIFICANCE AND IMPACT OF THE STUDY

Microalgae have potential application for their ability to absorb dyes from industrial wastewater. In this study, we initiated the application of synchrotron Fourier-transform infrared (s-FTIR) microspectroscopy to investigate malachite green dye removal efficiency by three stages of Haematococcus pluvialis, demonstrating that s-FTIR is a very powerful tool in exploring the mechanism of the biosorption of dyes onto microalgae.

[Improving outcomes of patients with heterotaxy and functional single ventricle: a 10-year follow-up of 70 cases in a single institution]

Objective: To review current-era palliation outcomes of patients with heterotaxy and functional single ventricle in a single institution. Methods: The clinical data of 70 consecutive patients with heterotaxy undergoing multistage single ventricle palliation in Guangzhou Women and Children's Medical Center from January 2008 to December 2017 were retrospectively reviewed, and the prognosis factors for mortality were analyzed. There were 53 male and 17 female patients.The median age was 13.3 months (range: 6 days to 150 months). Single ventricle multistage palliation included 1(st) stage palliation surgery, 2(nd) bidirectional Glenn shunt, and 3(rd) stage modified Fontan.The Kaplan-Meier method was used to estimate the probability of survival. Multivariate analysis was performed by Cox regression model. Results: Sixty-two patients had right atrial isomerism while eight had left atrial isomerism. Eighteen patients (25.7%) required the first stage palliation. Fifty-five patients received the Glenn shunt, and the Fontan procedure was completed in 27 patients. Overall, mortality occurred in 17 patients (24.3%) including 9 after the first stage palliation, 6 after the Glenn shunt, and 2 following the Fontan procedure. Survival estimates for the entire cohort following surgery were 81% (95%CI: 72% to 90%), 74%(95%CI: 64% to 85%), and 74% (95%CI: 64% to 85%) at 1 year, 5 years and 10 years, respectively. Survival estimates following the first stage palliation were 56% (95%CI: 33% to 79%) and 49% (95%CI: 26% to 73%) at 1 year and 5 years, respectively. Multivariate Cox regression analysis revealed that total anomalous pulmonary venous connection (TAPVC) (HR=6.16, 95%CI: 1.65 to 22.95, P=0.007), atrioventricular valve regurgitation more than moderate (HR=3.81, 95%CI: 1.32 to 10.94, P=0.013) and required the first palliation surgery (HR=4.58, 95%CI: 1.34 to 15.72, P=0.016) were prognosis factors for overall mortality. Conclusions: The management of heterotaxy patients with functional single ventricle remains challenging, and the outcomes are continously improving in china. TAPVC, atrioventricular valve regurgitation more than moderate and required the first palliation surgery still are prognosis factors for overall mortality in heterotaxy syndrome.

Prognostic significance of downregulated BMAL1 and upregulated Ki-67 proteins in nasopharyngeal carcinoma

This study assessed the prognostic value of BMAL1 and Ki-67 expression in patients with nasopharyngeal carcinoma. Level of BMAL1 mRNA was assessed in tissue specimens from 36 nasopharyngeal carcinomas and 20 nasopharyngeal chronic inflammations using quantitative reverse transcriptase-polymerase chain reaction. Expression of BMAL1 and Ki-67 proteins was analyzed immunohistochemically in 90 paired nasopharyngeal carcinoma and distant normal tissues. The Kaplan-Meier curves and the Log-rank test were used to calculate prognostic significance stratified by BMAL1 and Ki67 protein expression and the COX regression model was to analyze the multivariate prognosis. BMAL1 mRNA was significantly reduced in nasopharyngeal carcinoma (4.67 ± 0.27 versus 6.64 ± 0.51 in chronic inflammation tissues, p = 0.002). Level of BMAL1 mRNA was associated with tumor distant metastasis (3.37 ± 0.66 versus 5.04 ± 0.27 compared with non-metastasis, p = 0.011). Level of BMAL1 protein was also reduced in tumor tissues and BMAL1 expression was associated with better 1-, 3- and 5-year overall survival (OS) of cancer patients (92.6%, 69.2% and 62.3% versus 59.1%, 40.9% and 0% in patients with low BMAL1 expressed tumors; p = 0.000). BMAL1 expression and age were independent prognostic factors for OS (p = 0.032). Furthermore, Ki-67 expression was high in tumor versus normal tissues and associated with poor OS of cancer patients (p = 0.035). The Pearson correlation analysis showed that there was an inverse association between BMAL1 and Ki-67 protein expression (p = 0.021). This study demonstrated that lost BMAL1 and Ki-67 overexpression were associated with poor OS of nasopharyngeal carcinoma patients.

[How to understand the clinical significance of autoantibodies in primary biliary cholangitis]

Autoantibodies are important indicators for the diagnosis of primary biliary cholangitis (PBC). The autoantibodies in PBC patients are mainly antimitochondrial antibodies (AMAs) and antinuclear antibodies (ANAs). AMAs are one of the diagnostic indices of PBC. PBC-specific ANAs (nuclear dots or nuclear envelope, anti-sp100, and anti-gp210) have a high specificity in the diagnosis of AMA-negative PBC. This article reviews the clinical significance of these autoantibodies and analyzes some misconceptions about the clinical diagnosis of AMA-negative PBC and PBC-AIH overlap syndrome.

[Postoperative complications following dental rehabilitation under general anesthesia in children]

Objective: To assess the postoperative complications in systemically healthy children treated for dental caries under general anesthesia (GA) after discharge and analysis of the correlative factors. Methods: This prospective observational study included 124 children aged 2-8 years old who received extensive dental treatment under GA. General conditions and treatment information were obtained from questionnaires filled by the dentist and the anesthesiologist. Postoperative data were collected from a questionnaire filled by the parents in one week. Pain was assessed by using the dental discomfort questionnaire-8 (DDQ-8) pain assessment scale. Results: The mean anesthesia time for GA procedures was 102.6 min and the mean number of treated teeth was 13.5. Approximately 66.9% (83/124) of the children had one or more postoperative complaints on the first day after the treatments. The most common complaints reported were cough, hoarseness, and dental pain followed by throat discomfort, problems in eating, swelling, weakness, sleepiness, vomiting, fever and nausea. By the seventh day after the treatment, the main complications remained were dental pain and cough, while most of other symptoms disappeared. Preoperative DDQ-8 score and the number of extracted teeth were the factors that showed a significant association with postoperative dental pain on the first day. Conclusions: Dental pain and pharynx discomfort were most frequently noted postoperative symptoms. Postoperative dental discomfort on the first day might be predicted by dental pain before GA and tooth extraction under GA.

[Effects of breast-feeding duration, bottle-feeding duration and oral habits on the occlusal characteristics of primary dentition]

OBJECTIVE

To assess the effects of breast-feeding duration, bottle-feeding duration and oral habits on the occlusal characteristics of primary dentition in 3-6-year-old children in Beijing.

METHODS

This cross sectional study was conducted via an examination of the occlusal characteristics of 734 children combined with a questionnaire completed by their parents/guardians. The examination was performed by a single, previously calibrated examiner and the following variables were evaluated: presence or absence of deep overbite, open bite, anterior cross bite, posterior cross bite, deep overjet, terminal plane relationship of the second primary molar, primary canine relationship, crowding and spacing. Univariate analysis and multiple Logistic regressions were applied to analyze the associations.

RESULTS

It was found that a short duration of breast-feeding (never or ≤6 months) was directly associated with posterior cross bite (OR=3.13, 95%CI=1.11-8.82, P=0.031) and no maxillary space (OR=1.63, 95%CI=1.23-2.98, P=0.038). In children breast-fed for ≤6 months, the probability of developing pacifier-sucking habits was 4 times that for those breast-fed for >6 months (OR=4.21, 95%CI=1.85-9.60, P=0.000 2). The children who were bottle-fed for over 18 months had a 1.45-fold higher risk of nonmesial step occlusion and a 1.43-fold higher risk of class II canine relationship compared with those who were bottle-fed for 6-18 months. Non-nutritive sucking habits were also found to affect occlusion: a prolonged digit-sucking habit increased the probability of an anterior open bite, while a pacifier-sucking habit was associated with excessive overjet and absence of lower arch developmental space. Tongue-thrust habit was associated with anterior open bite (OR=4.21, 95%CI=1.85-9.60, P=0.000 2) and posterior cross bite (OR=7.24, 95%CI=1.30-40.13, P=0.024). Lower lip sucking habit was associated with deep overjet and had a negative association with class III canine relationship. Unilateral chewing was associated with spacing in mandibular (OR=1.57, 95%CI=1.03-2.41, P=0.037). Mouth breathing was associated with chronic rhinitis and adenoidal hypertrophy and had an association with spacing in maxillary. The chi-square test did not indicate a statistically significant association between upper lip sucking habit and any occlusal characteristics.

CONCLUSION

Breast-feeding duration was shown to be associated with the prevalence of posterior crossbite, or no maxillary space in the deciduous dentition and development of a pacifier-sucking habit. Children who had a longer duration of bottle-feeding were more likely to develop class II canine relationship. Children who had an oral habit were more likely to develop abnormal occlusal characteristics.

Zearalenone Altered the Serum Hormones, Morphologic and Apoptotic Measurements of Genital Organs in Post-weaning Gilts

The present study was aimed at investigating the adverse effects of dietary zearalenone (ZEA) (1.1 to 3.2 mg/kg diet) on serum hormones, morphologic and apoptotic measurements of genital organs in post-weaning gilts. A total of twenty gilts (Landrace×Yorkshire×Duroc) weaned at 21 d with an average body weight of 10.36±1.21 kg were used in the study. Gilts were fed a basal diet with an addition of 0, 1.1, 2.0, or 3.2 mg/kg purified ZEA for 18 d ad libitum. Results showed that 3.2 mg/kg ZEA challenged gilts decreased (p<0.05) the serum levels of luteinizing hormone, however, serum levels of prolactin in gilts fed the diet containing 2.0 mg/kg ZEA or more were increased (p<0.05) compared to those in the control. Linear effects on all tested serum hormones except progesterone were observed as dietary ZEA levels increased (p<0.05). Gilts fed ZEA-contaminated diet showed increase (p<0.05) in genital organs size, hyperplasia of submucosal smooth muscles in the corpus uteri in a dose-dependent manner. However, the decreased numbers of follicles in the cortex and apoptotic cells in the ovarian were observed in gilts treated with ZEA in a dose-dependent manner. Degeneration and structural abnormalities of genital organs tissues were also observed in the gilts fed diet containing 1.1 mg/kg ZEA or more. Results suggested that dietary ZEA at 1.1 to 3.2 mg/kg can induce endocrine disturbance and damage genital organs in post-weaning gilts.

A and MdMYB1 allele-specific markers controlling apple (Malus x domestica Borkh.) skin color and suitability for marker-assisted selection

Pre-selection for fruit skin color at the seedling stage would be highly advantageous, with marker-assisted selection offering a potential method for apple pre-selection. A and MdMYB1 alleles are allele-specific DNA markers that are potentially associated with apple skin color, and co-segregate with the Rf and Rni loci, respectively. Here, we assessed the potential application of these 2 alleles for marker-assisted breeding across 30 diverse cultivars and 2 apple seedling progenies. The red skin color phenotype was usually associated with the MdMYB1-1 allele and A(1) allele, respectively, while the 2 molecular markers provided approximately 91% predictability in the 'Fuji' x 'Cripps Pink' and 'Fuji' x 'Gala' progenies. The results obtained from the 30 cultivars and 2 progenies were consistent for the 2 molecular markers. Hence, the results supported that Rf and Rni could be located in a gene cluster, or even correspond to alleles of the same gene. Our results are consistent with the hypothesis that red/yellow dimorphism is controlled by a monogenic system, with the presence of the red anthocyanin pigmentation being dominant. In addition, our results supported that the practical utilization of the 2 function markers to efficiently and accurately select red-skinned apple cultivars in apple scion breeding programs.

Intrinsic and interfacial effect of electrode metals on the resistive switching behaviors of zinc oxide films

Exploring the role of electrode metals on the resistive switching properties of metal electrode/oxide/metal electrode sandwiched structures provides not only essential information to understand the underlying switching mechanism of the devices, but also useful guidelines for the optimization of the switching performance. A systematic study has been performed to investigate the influence of electrodes on the resistive switching characteristics of zinc oxide (ZnO) films in this contribution, in terms of both the intrinsic and interfacial effects. It has been found that the low-resistance state resistances (Ω(LRS)) of all the investigated devices are below 50 Ω, which can be attributed to the formation of highly conductive channels throughout the ZnO films. On the other hand, the high-resistance state resistances (Ω(HRS)) depend on the electronegativity and ionic size of the employed electrode metals. Devices with electrode metals of high electronegativity and large ionic size possess high Ω(HRS) values, while those with electrode metals of low electronegativity and small ionic size carry low Ω(HRS) values. A similar trend of the set voltages has also been observed, while the reset voltages are all distributed in a narrow range close to ±0.5 V. Moreover, the forming voltages of the switching devices strongly depend on the roughness of the metal/ZnO and/or ZnO/metal interface. The present work provides essential information for better understanding the switching mechanism of zinc oxide based devices, and benefits the rational selection of proper electrode metals for the device performance optimization.

The clinicopathological behaviour and surgical treatment of abdominal Castleman's disease

INTRODUCTION

Castleman's disease, a rare atypical lymphoproliferative disorder of the lymphoid tissue with unknown cause, remains a diagnostic challenge. This study was conducted to analyse the clinicopathological behaviour and reasonable surgical treatment for patients with abdominal Castleman's disease.

METHODS

The medical records of seven patients with abdominal Castleman's disease were reviewed.

RESULTS

The patients comprised two men and five women, and their median age was 42.3 (range 29-53) years. The main clinical manifestation was an abdominal mass or an enlargement of the retroperitoneal lymph node. Other clinical manifestations included anaemia, loss of body weight and hypoalbuminaemia. The mean size of the tumour was 5.5 (range 4.0-8.0) cm. Postoperatively, all the patients were diagnosed with a hyaline vascular type of the disease, and had localised manifestations of the disease. All seven patients underwent complete surgical resection, two of whom also received adjuvant irregular chemotherapy (CHOP) and steroids postoperatively. All the patients survived, with no evidence of recurrence. One patient had survived for more than two years, four patients for more than three years, and two patients for more than five years.

CONCLUSION

Abdominal Castleman's disease is difficult to diagnose preoperatively, and surgical excision remains the treatment of choice, especially for localised disease.

Laboratory and field assessments of prey-mediated effects of transgenic Bt rice on Ummeliata insecticeps (Araneida: Linyphiidae)

One major concern regarding the release of Bt rice is its potential impact through tritrophic interactions on nontarget arthropods, especially natural enemies. We studied the effects of two Bt transgenic rice varieties, TT9- 3 and KMD1, expressing Cry1Ab/Cry1Ac and Cry1Ab, respectively, on a predatory ground spider [Ummeliata insecticeps (Bösenberg et Strand)] supplied with Bt rice-fed brown planthopper [Nilaparvata lugens (Stål)] nymphs. Although immunoassays confirmed that U. insecticeps ingested Bt insecticidal protein when supplied with Bt rice-fed N. lugens, no negative effects were found on its survival and development. Furthermore, the fecundity of U. insecticeps fed prey reared on Bt rice was not significantly different from that of those fed prey reared on non-Bt rice. A 3-yr field trial indicated that Bt rice did not significantly affect the population density of U. insecticeps in comparison with non-Bt rice. In conclusion, the Bt rice lines tested in this study had no adverse effects on the survival, developmental time, or fecundity of U. insecticeps in the laboratory or on population dynamics in the field.

Intrathecal cytokine and chemokine profiling in neuropsychiatric lupus or lupus complicated with central nervous system infection

The aims of this study are to investigate the cytokine, chemokine and adhesion molecule profiles in cerebrospinal fluid from patients with neuropsychiatric systemic lupus erythematosus and systemic lupus erythematosus with central nervous system infection. Experimental sets were established which included 108 patients and 132 cerebrospinal fluid samples. The patients were grouped as neuropsychiatric systemic lupus erythematosus (n = 54), systemic lupus erythematosus with central nervous system infection (n = 16), systemic lupus erythematosus controls (n=20), and non-inflammatory neurological disease (n=18). The dynamic changes of 21 patients in the neuropsychiatric systemic lupus erythematosus group before and after induction therapy were further analyzed. IL-1β, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, TNFα, IFNγ, IP-10, MCP-1, RANTES, VCAM-1, and P-selectin were measured in cerebrospinal fluid samples by using a fluorescent bead-based assay. Cerebrospinal fluid levels of IL-8, MCP-1, P-selectin and VCAM-1 were significantly increased in neuropsychiatric systemic lupus erythematosus compared with systemic lupus erythematosus controls. IL-6, IL-17, IL-8 and VCAM-1 were higher in systemic lupus erythematosus with central nervous system infection than in systemic lupus erythematosus controls. Among systemic lupus erythematosus with central nervous system infection, the IL-6, IL-17, IL-8 and IP-10 levels were higher than those in neuropsychiatric systemic lupus erythematosus. After sufficient induction therapy, IL-8, MCP-1, P-selectin, VCAM-1 and IL-6 in patients with neuropsychiatric systemic lupus erythematosus decreased significantly. Levels of all molecules tested in non-inflammatory central nervous system disease were not different from those of systemic lupus erythematosus controls. From our data, the intrathecal cytokine/chemokine profile is different among patients with neuropsychiatric systemic lupus erythematosus, systemic lupus erythematosus complicated with central nervous system infection and systemic lupus erythematosus controls. IL-8, MCP-1, VCAM-1, P-selectin and IL-6 in cerebrospinal fluid are effective parameters to monitor neuropsychiatric systemic lupus erythematosus disease activity and response to treatment. Significantly elevated IL-17, IL-6, and to a lesser extent, IL-8, favors central nervous system infection in systemic lupus erythematosus. Lupus (2010) 19, 689—695.

Autoantibody production from a thymoma and a follicular dendritic cell sarcoma associated with paraneoplastic pemphigus

BACKGROUND

Paraneoplastic pemphigus (PNP) is an autoimmune mucocutaneous disease. We previously reported that B cells in a Castleman tumour associated with PNP produced autoantibodies. However, it is uncertain whether the production of autoantibodies from the associated tumour is a common mechanism in PNP.

OBJECTIVES

To investigate autoantibody production in a thymoma and a follicular dendritic cell sarcoma that were excised from two patients with PNP.

METHODS

Tumour cells were cultured, and their surface markers were identified. Indirect immunofluorescence, immunoblotting and enzyme-linked immunosorbent assay (ELISA) using culture media from the tumours were used to detect PNP autoantibodies.

RESULTS

B cells with markers (CD22+, surface membrane IgG+ and surface membrane IgM+) of mature B lymphocytes constituted a proportion of cultured tumour cells in both tumours. Western blot showed that the medium from both the thymoma and the follicular dendritic cell sarcoma cells recognized 190-kDa periplakin and 210-kDa envoplakin bands of human epithelial proteins as well as recombinant linker regions of periplakin, envoplakin, desmoplakin and bullous pemphigoid antigen 1. ELISA was positive for antidesmoglein 3 antibody.

CONCLUSIONS

The presence and localization in tumours of B-lymphocyte clones against proteins of the plakin family and desmoglein 3 in skin may not be confined to PNP with Castleman disease, but is possibly a common mechanism in PNP associated with various tumours.

Phylogenetic relationships among the Braconidae (Hymenoptera: Ichneumonoidea) inferred from partial 16S rDNA, 28S rDNA D2, 18S rDNA gene sequences and morphological characters

Phylogenetic relationships among the Braconidae were examined using homologous 16S rDNA, 28S rDNA D2 region, and 18S rDNA gene sequences and morphological data using both PAUP* 4.0 and MRBAYES 3.0B4 from 88 in-group taxa representing 35 subfamilies. The monophyletic nature of almost all subfamilies, of which multiple representatives are present in this study, is well-supported except for two subfamilies, Cenocoelinae and Neoneurinae that should probably be treated as tribal rank taxa in the subfamily Euphorinae. The topology of the trees generated in the present study supported the existence of three large generally accepted lineage or groupings of subfamilies: two main entirely endoparasitic lineages of this family, referred to as the "helconoid complex" and the "microgastroid complex," and the third "the cyclostome." The Aphidiinae was recovered as a member of the non-cyclostomes, probably a sister group of Euphorinae or Euphorinae-complex. The basal position of the microgastroid complex among the non-cyclostomes has been found in all our analyses. The cyclostomes were resolved as a monophyletic group in all analyses if two putatively misplaced groups (Mesostoa and Aspilodemon) were excluded from them. Certain well-supported relationships evident in this family from the previous analyses were recovered, such as a sister-group relationships of Alysiinae+Opiinae, of Braconinae+Doryctinae, and a close relationship between Macrocentrinae, Xiphozelinae, Homolobinae, and Charmontinae. The relationships of "Ichneutinae + ((Adeliinae + Cheloninae) + (Miracinae + (Cardiochilinae + Microgastrinae)))" was confirmed within the microgastroid complex. The position of Acampsohelconinae, Blacinae, and Trachypetinae is problematic.

Versatile two-phase solvent system for alkaloid separation by high-speed counter-current chromatography

In order to find a versatile high speed counter-current chromatography solvent system that can be used as a general prefractionation system for most alkaloids, the crude extracts of five Chinese traditional medicinal herbs, Cortex phellodendri, Semen strychni, green tea, Sophora flavescens ait, and Datura mete L. were resolved. All separations were performed only with a two-phase system composed of CHCl3-CH3OH-water (4:3:2). The water had different acidities controlled by adding NaH2PO4 or HCl to each sample. The fractionated components were identified by thin-layer chromatography, which confirmed this solvent system was versatile and very useful for the separation of alkaloids.

Height and weight percentile curves of Beijing children and adolescents 0-18 years, 1995

Nationwide growth survey has been performed once every 10 years in Mainland China since 1975. However, no percentile growth curves for children from birth to 18 years have ever been constructed for clinical use. The third survey was performed in 1995 and from this survey, data of the Beijing population were retrieved to construct the height for age and weight for age percentile curves. A total of 12218 healthy children were examined for height and weight, using the standardized methods. Height, but not weight, was normally distributed. Smoothing was performed separately for each sex, using JPA2 model for mean height for age > 2 years. Otherwise, smoothing was performed for the following curves by polynomial equations up to the order of the 5th degree for height and 12th degree for weight, mean height for age < 2 years, SD curve of height for age from birth to 18 years, median weight for age < 2 years, median weight for age > 2 years, differences between the 3rd, 10th, 25th, 75th, 90th, 97th centiles and the median for age from birth to 18 years. The predicted adult height was 173.43cm for boys and 160.86 cm for girls, with age of peak velocity at 13 years and 11.5 years for boys and girls respectively. Compared to those in Hong Kong, they were 2.3-2.5 cm taller signifying a geographical difference in growth even within one country. Compared to the Beijing data collected in 1975 and 1985 the secular changes in growth were more obvious in the first decade, suggesting that the Beijing population was approaching the optimal adult height.

Use of PCR/DNA probes to identify circumsporozoite genotype of Plasmodium vivax in China

The paper reports the result of identifying cirumsporozoite (CS) genotype of Plasmodium vivax by using PCR/DNA probe labeled with biotin. The sensitivity of this method to detect patient blood samples was 0.2 parasite/microl and also with high specific to P. vivax. CS genes from 52 blood samples collected from patients with P. vivax in Hainan and Yunnan Provinces were amplified by PCR and 49 were positive by gel-e electrophoresis analysis, positive rate was 94%. Then the amplified CS genes further were probed with special oligoprobes (PV210 and PV247) that hybridized with the predominant CS repeat region and the variant CS repeat region. The results showed 46 (88.5%) PV210 positive and 6 (11.5%) PV247 positive; 2 hybridized with both probes. The variant genotype was present only in samples from Yunnan Province. The above results showed that the PCR/DNA probe labeled with biotin was highly sensitive and specific to P. vivax and found a CS variant genotype of P. vivax in Yunnan Province of China.

Stereoselective metabolism of metoprolol in isolated rat liver

AIM

To study the stereoselective pharmacokinetics of the enantiomers of metoprolol (Met).

METHODS

The enantiomers of Met were metabolized in isolated rat liver with hemoglubin-free medium. The enantiomers of Met were analyzed with HPLC.

RESULTS

The linear kinetics were found in 3 doses (0.16, 0.32, and 0.64 mg) of R-(+)- and S-(-)-Met. The time-concentration curve of Met was fitted in first order-kinetics compartment model. There were differences in the pharmacokinetic parameters (K, T1/2, and Cl) between the enantiomers at the same dose (P < 0.01). The ratio of liver clearence of S-(-)-Met/R-(+)-Met was 0.14-0.17.

CONCLUSION

Pharmacokinetics of enantiomers of Met in the isolated rat liver were stereoselective, with a preferential clearance of R-(+)-Met, which elimination was not a saturable process.

Reduced p53 dosage associated with mammary tumor metastases in C3(1)/TAG transgenic mice

Transgenic mice expressing the simian virus 40 large T-antigen (TAG) under the regulatory control of the rat prostatic steroid binding protein C3(1) gene develop mammary carcinomas (in females) and prostate carcinomas (in males). The development of carcinomas occurs several months after the appearance of dysplastic lesions, suggesting that TAG is necessary but insufficient for tumor formation and that other genetic events are involved in this process. TAG is known to bind to p53 and to result in its functional inactivation, which is believed to be a critical step in TAG-induced transformation. We investigated whether the TAG-p53 interaction is rate limiting in the development of phenotypic changes in these transgenic mice by crossing C3(1)/TAG transgenics with mice carrying null mutations of the p53 gene. TAG-expressing animals with a p53+/- genotype developed much more aggressive mammary tumors, as evidenced by increased numbers and size of metastases, than did TAG-expressing animals carrying two wild-type p53 alleles. While p53 was expressed in primary tumors, p53 expression appeared to be reduced or lost in many metastases in mice carrying either the p53+/+ or p53+/- genotypes. The tumorigenic process did not appear to be due to the loss of the second wild-type p53 allele or the gain of dominant oncogenic mutations in p53, as no mutations were detected in either primary or metastatic tumors by polymerase chain reaction--single-strand conformation polymorphism analyses. These findings suggest that despite the presence of TAG, p53 levels influence the characteristics of the late stages of mammary tumor growth and accelerate metastases. Functional loss of p53 and not p53 mutations participates in TAG-induced mammary carcinoma development and progression.

Pharmacokinetics of bendazac lysine in 10 Chinese young men

AIM

To compare the pharmacokinetics of domestic and imported tablets of bendazao lysine (BL).

METHODS

A single oral dose of 500 mg BL of this 2 kinds of tablets was given to 10 Chinese volunteers of Han nationality in a randomized crossover study. Plasma levels were determined with HPLC-UV method. Data were analyzed automatically by using a CAPP program on microcomputer.

RESULTS

The plasma concentration-time curve was fitted to 2-compartment open model, and the major pharmacokinetic parameters of domestic and imported BL tablets were shown respectively as following: Cmax 66 +/- 16 and 65 +/- 8 mg.L-1; Tmax 0.98 +/- 0.22 and 0.98 +/- 0.21 h; T1/2 beta 6.2 +/- 1.8 and 6.2 +/- 1.7 h; AUC 335 +/- 47 and 337 +/- 58 mg.h.L-1. There was no significant difference between domestic and imported tablets. The bioavailability of the domestic vs that of the imported tablet was 99 +/- 12%. The unchanged BL in urine were about 5.4% and 5.6% respectively of the dosage in 24 h after a single oral dose.

CONCLUSION

The two kinds of tablets had the same biological effects.

Identification of malaria-infected dried mosquitoes by biotinylated DNA probe

Dot-blot hybridization with cloned genomic DNA labeled with photobiotin as a probe is used to detect Plasmodium falciparum sporozoites in dried mosquitoes. The assay is sensitive enough to detect 2 pg Plasmodium parasite DNA, or one infected mosquito in a pool of 40 insects using DNA extraction samples, or one infected mosquito in a pool of 25 insects without DNA extraction. A single mosquito squashed directly on a nitrocellulose filter for the determination of parasites provides a simple method for the detection of sporozoites. The mosquitoes triturated in reduction buffer were efficient for the screening of malaria infection of mosquitoes in a large number of samples. The species specificity, sensitivity, and ease of performance of this assay as well as the stability of the reagents may make it a useful epidemiological tool.

[Evaluation of fetal well-being by vibro-acoustic stimulation test]

For monitoring of fetal well-being, non-stress test (NST) and vibro-acoustic stimulation test (VAS-T) were tested simultaneously in 295 normal pregnant women with gestational age over 36 weeks. In 130 women who delivered babies within 1 week after testing, the monitoring results were compared with the newborn's condition immediately after birth. The results showed that VAS-T improved the accuracy rate diagnosed by NST and shorten the time period required for examination. The clinical significance of 5 different wave forms of VAS-T were studied. Type I and Ib were typical reactive pattern which represented a good fetal condition. Type II, III and IV suggested that the fetus were in various degree of hypoxia. Specifically, Type III reflected the cord around the neck, and type IV was a sign of severe fetal distress and nervous system defect.

Changes in anti-filarial antibody after control of filariasis in Shandong Province

The changes in anti-filarial antibody level at different periods in different population groups of various controlled areas were studied by indirect fluorescent antibody test (IFT) using frozen sections of Brugia malayi adult worms as antigen. The positive rates by IFAT in formerly hyper-, moderate- and low-endemic areas decreased to the level as those in non-endemic areas 15, 10 and 10 years respectively after the control of filariasis. In the children born after the control of filariasis, the IFAT positive rate was less than 1%. An analysis of IFAT positive cases showed that the positive rate was lowest in children under 10 years old and highest in those aged 20-40 and decreased progressively with the increasing of age. In addition, the IFAT positive rates of microfilaremia cases, the residents in currently endemic area and control group from non-endemic area were 91.4%, 33.9% and 4.5% respectively. These data demonstrated the present distribution pattern of anti-filarial antibody.

[Influence of vacuum mixing on mechanical properties of homemade bone cement]

Porosity, density and rotating bar bending fatigue life of homemade bone cement are analyzed with scanning electron microscopy for two different mixing techniques: manually vacuum mixing and manually non-vacuum mixing. By vacuum mixing the rotating bar bending fatigue life is increased from 0.98 x 10(4) +/- 0.31 x 10(4) to 1.33 x 10(4) +/- 0.17 x 10(4) (P < 0.05), density increased from 1.0638 +/- 0.0005g/cm3 to 1.1024 +/- 0.0068g/cm3 (P < 0.05), porosity reduced from 10.35% +/- 2.33% to 5.83% +/- 1.74% (P < 0.05), and incidence rate of big air inclusion reduced from 5.93% to 0.9%. We believe, vacuum mixing technique of bone cement should be recommended as a routine procedure to prevent aseptic loosening of prosthesis after total joint arthroplasty.

[A study on motility of sphincter of Oddi in postcholecystectomy syndrome]

Endoscopic manometry of sphincter of Oddi (SO) and serum levels of gastrin, glucagon, and somatostatin were measured in patients with postcholecystectomy syndrome (n = 12), asymptomatic cholecystectomy patients (n = 6), and controlled subjects (n = 14). Pentagastrin-stimulated gastric acid secretion test was also performed in part of patients who had symptoms or no symptoms after the removal of gallbladder. The results showed that the patients of symptomatic group had hypertonic dyskinesia of SO as shown by deep and wide waves superimposed on high basal pressure plateau of SO. The symptomatic group also had a higher serum level of gastrin and a greater BAO than those of other two groups. No difference of serum levels of glucagon and somatostatin was found among these three groups. The hypertonic dyskinesia of SO and hypergastrinemia are possibly important factors in the pathogenesis of postcholecystectomy syndrome.

The displacement of copper by iron at the specific binding sites of ovotransferrin

We have examined the kinetics and mechanism by which iron can displace copper at the specific metal-binding sites of ovotransferrin. Fe2+ was added to Cu2+-ovotransferrin-CO3(2-) in the presence of NaHCO3 and ambient O2. The reaction has been followed by standard and stopped-flow spectrophotometry, EPR spectroscopy and analysis of chromogen-reactive Fe2+. The reaction is best described as triphasic. An initial jump in absorbance takes place in the first 2 s. In the next minute there is a further increase in absorbance and shift in the spectral maximum from 440 to 446 nm. The third phase is complex. The bulk of the spectrophotometric change, a decrease in absorbance with a shift to a maximum of 453 nm, lasts approx. 3 min. Minor spectral and EPR changes, however, take place over the next several hours. Chromogenic analysis of Fe2+ indicates that approx. 1 min is required to oxidize the Fe2+. EPR spectra reveal the formation of an Fe3+-ovotransferrin complex within the first 20 s; however, this lacks the characteristic doublet of specific Fe3+-ovotransferrin-CO3(2-). The simultaneous presence of specific Cu2+-ovotransferrin-CO3(2-) and Fe3+-ovotransferrin-CO3(2-) signals suggests a period in which the protein specifically binds both metal ions perhaps resulting from a differential reactivity of the two metal-binding sites. The addition of Cu(NO3)2 to Fe3+-ovotransferrin-CO3(2-) resulted in a complex with specific Fe3+ and non-specific Cu2+. The EPR spectrum of this complex and the final product of our displacement reaction were virtually identical. Distinct parallels in reaction of Cu2+-ovotransferrin-CO3(2-) with Fe(NH4)2(SO4)2, Fe(NO3)3 and Fe3+-nitrilotriacetic acid were observed. A reaction sequence involving the binding and oxidation of non-specific Fe2+ followed by Cu2+ displacement by Fe3+ at the specific sites and binding of non-specific Cu2+ is suggested.

[Rhabdomyosarcoma in E. N. T--report of 4 cases]

This paper reports 4 cases of rhabdomyosarcoma arising from the middle ear, maxillary sinuses, soft palate and larynx. In 3 patients, tumor resection was performed and the other was only biopsied. 3 patients died 6 months, 40 days and 19 months after diagnosis. One had recurrence 4 months after operation and was then treated with hematoporphyrin derivative (HPD)-laser photoradiation. The result was satisfactory and the patient has been living well for 2 years. Histopathology, treatment and prognosis of this tumor are discussed.