Preoperative contrast-enhanced CT-based radiomics signature for predicting hypoxia-inducible factor 1α expression in retroperitoneal sarcoma

AIM

To develop and test a contrast-enhanced computed tomography (CECT)-based radiomics signature (RS) to preoperatively predict hypoxia-inducible factor 1α (HIF-1α) expression in retroperitoneal sarcoma (RPS).

MATERIALS AND METHODS

This study included 129 patients with RPS retrospectively who underwent CECT, including 64 male and 65 female patients (55 [2-84] years). Participants were divided into a training set comprising 85 patients and a test set comprising 44 patients. Clinical data and CECT findings of all patients were collected. RS construction was performed by the minimum redundancy maximum relevance method and least absolute shrinkage and selection operator algorithm. The clinical information was analysed by univariate and multivariate logistic regression analysis. The RS and risk factors were included to build a radiomics nomogram. The predictive efficacy of different models was evaluated by accuracy, area under the receiver operating characteristic curve (AUC), and decision curve analysis.

RESULTS

The RS combined signature was constructed on the basis of multi-phase CECT and had an accuracy of 0.795 and an AUC of 0.719 (95% confidence interval [CI], 0.552-0.886) in the test set, which were higher than that of the radiomics nomogram (accuracy: 0.636; AUC: 0.702 [95% CI, 0.547-0.857]) and the clinical model (accuracy: 0.682; AUC: 0.486 [95% CI, 0.324-0.647]). The decision curve analysis showed that the RS combined signature provided better clinical application than the clinical model and radiomics nomogram.

CONCLUSIONS

The multi-phase CECT-based RS constructed can be used as a powerful tool for predicting HIF-1α expression in patients with RPS.

Development and validation of risk prediction models for stroke and mortality among patients with type 2 diabetes in northern China

BACKGROUND

Stroke is one of the leading causes of disability and mortality in patients with type 2 diabetes mellitus (T2DM). Risk models have been developed for predicting stroke and stroke-associated mortality among patients with T2DM. Here, we evaluated risk factors of stroke for individualized prevention measures in patients with T2DM in northern China.

METHODS

In the community-based Tianjin Chronic Disease Cohort study, 58,042 patients were enrolled between January 2014 and December 2019. We used multiple imputation (MI) to impute missing variables and univariate and multivariate Cox's proportional hazard regression to screen risk factors of stroke. Furthermore, we established and validated first-ever prediction models for stroke (Model 1 and Model 2) and death from stroke (Model 3) and evaluated their performance.

RESULTS

In the derivation and validation groups, the area under the curves (AUCs) of Models 1-3 was better at 5 years than at 8 years. The Harrell's C-index for all models was above 0.7. All models had good calibration, discrimination, and clinical net benefit. Sensitivity analysis using the MI dataset indicated that all models had good and stable prediction performance.

CONCLUSION

In this study, we developed and validated first-ever risk prediction models for stroke and death from stroke in patients with T2DM, with good discrimination and calibration observed in all models. Based on lifestyle, demographic characteristics, and laboratory examination, these models could provide multidimensional management and individualized risk assessment. However, the models developed here may only be applicable to Han Chinese.

Photoluminescence and magnetism integrated multifunctional black phosphorus probes through controllable PO bond orbital hybridization

Biological probes with integrated photoluminescence and magnetism characteristics play a critical role in modern clinical diagnosis and surgical protocols combining fluorescence optical imaging (FOI) with magnetic resonance imaging (MRI) technology. However, traditional magnetic semiconductors can easily generate a spin splitting at the Fermi level and half-metallic electronic occupation, which will sharply reduce the radiation recombination efficiency of photogenerated carriers. To overcome this intrinsic contradiction, we propose a controllable oxidation strategy to introduce some particular PO bonds into black phosphorus nanosheets, in which the p orbital hybridization between P and O atoms not only provides some carrier recombination centers but also leads to a room-temperature spin polarization. As a result, the coexistence of photoluminescence and magnetism is realized in multifunctional black phosphorus probes with excellent biocompatibility. This work provides a new insight into integrating photoluminescence and magnetism together by intriguing atomic orbital hybridization.

[Consistency of ALK Ventana-D5F3 immunohistochemistry interpretation in lung adenocarcinoma among Chinese histopathologists]

Objective: To understand the consistency of ALK Ventana-D5F3 immunohistochemistry (IHC) interpretation in Chinese lung adenocarcinoma among histopathologists from different hospitals, and to recommend solution for the problems found during the interpretation of ALK IHC in real world, with the aim of the precise selection of patients who can benefit from ALK targeted therapy. Methods: This was a multicenter and retrospective study. A total of 109 lung adenocarcinoma cases with ALK Ventana-D5F3 IHC staining were collected from 31 lung cancer centers in RATICAL research group from January to June in 2018. All cases were scanned into digital imaging with Ventana iSCANcoreo Digital Slide Scanning System and scored by 31 histopathologists from different centers according to ALK binary (positive or negative) interpretation based on its manufacturer's protocol. The cases with high inconsistency rate were further analyzed using FISH/RT-PCR/NGS. Results: There were 49 ALK positive cases and 60 ALK negative cases, confirmed by re-evaluation by the specialist panel. Two cases (No. 2302 and No.2701) scored as positive by local hospitals were rescored as negative, and were confirmed to be negative by RT-PCR/FISH/NGS. The false interpretation rate of these two cases was 58.1% (18/31) and 48.4% (15/31), respectively. Six out of 31 (19.4%) pathologists got 100% accuracy. The minimum consistency between every two pathologists was 75.8%.At least one pathologist gave negative judgement (false negative) or positive judgement (false positive) in the 49 positive or 60 negative cases, accounted for 26.5% (13/49), 41.7% (25/60), respectively, with at least one uncertainty interpretation accounted for 31.2% (34/109). Conclusion: There are certain heterogeneities and misclassifications in the real world interpretation of ALK-D5F3 IHC test, which need to be guided by the oncoming expert consensus based on the real world data.

Study of SU-8 photoresist cross-linking process by atomic force acoustic microscopy

In this paper, a method is presented to detect the different phases of epoxy cross-linking process and the subsurface structures of SU-8 thin films by atomic force acoustic microscopy (AFAM). The AFAM imaging of SU-8 thin films was investigated under different exposure and bake conditions. Optimized conditions were obtained for the cross-linking of SU-8 thin film at the exposure does of eight laser pulses with the laser fluence 10 mJ cm^-2 per pulse and the post exposure bake (PEB) time at 90 s. The subsurface structures of undeveloped SU-8 thin films were visible in the AFAM images. This method provides an effective and low-cost way for the determination of different phases of epoxy cross-linking process in nanostructured compounds, for the non-destructive testing of subsurface defects, and for the evaluation of the quality of patterned structures.

Contrast-enhanced CT findings of intravenous leiomyomatosis

AIM

To characterise the contrast-enhanced computed tomography (CT) imaging findings of nine patients with intravenous leiomyomatosis (IVL).

MATERIALS AND METHODS

The contrast-enhanced CT imaging findings of nine patients with histopathologically proven IVL were examined. The location, morphology, extension pathway, adhesion, and degree and pattern of enhancement of the tumour were assessed.

RESULTS

Four patients had tumours located within the inferior vena cava, and five had tumours that involved the right heart. Seven patients with residual uterus myoma showed enhanced heterogeneous contrast of the uterus. Eight tumours extended into the inferior vena cava through the iliac veins and one through the bilateral iliac veins. All the IVLs demonstrated heterogeneous enhancement on contrast-enhanced CT and appeared to have lower density than the contrast-enhanced venous blood. On the coronal and sagittal images, tumours were continuous and, when the right heart was involved, the lesions displayed a characteristic "walking stick head" or "snake head" appearance. The lesion looked similar to a "sieve" on axial contrast-enhanced CT images, and a "luffa sponge" on post-processing coronal or sagittal images.

CONCLUSION

Contrast-enhanced CT imaging has unique advantages in the diagnosis of IVL, namely, luffa sponge and sieve appearance, which can be helpful for differential diagnosis. Contrast-enhanced CT can demonstrate tumour location and full-scale extension pathway, which are important for diagnosis, surgical planning, and follow-up of the tumour.

Describing the quality of life of boys with haemophilia in China: Results of a multicentre study using the CHO-KLAT

INTRODUCTION

The treatment of haemophilia varies across countries and across regions within some countries. Similar variation has been observed in health-related quality of life (HR-QoL). Relatively little is known about the HR-QoL of boys with haemophilia in China.

AIM

The aim of this study was to describe the HR-QoL of boys with haemophilia in China using the Canadian Haemophilia Outcomes-Kids Life Assessment Tool (CHO-KLAT).

METHODS

Boys (4-18 years of age) with haemophilia and their parents were enroled in a cross-sectional study. All parents/guardians of study subjects were requested to complete a CHO-KLAT questionnaire during a clinic visit, and report on several other clinical and socioeconomic factors in the past year. Boys who were > 7 years also completed the CHO-KLAT.

RESULTS

A total of 269 parents of boys with haemophilia, from 13 hospitals in 12 provinces, were enroled during 2014. The boys ranged from 4.0 to 17.9 years of age; 91% had haemophilia A, most had moderate (52%) or severe (36%) disease, and most were receiving sub-optimal on-demand therapy or low-dose prophylactic therapy. Child self-report CHO-KLAT scores were available for 171 boys ≥7 years of age and ranged from 24.2 to 85.3 with a mean of 57.6 (n = 171). Parent proxy-reported CHO-KLAT scores ranged from 25.0 to 88.7 with a mean of 55.1 (n = 269).

CONCLUSION

HR-QoL scores in boys with haemophilia in China were substantially lower than reported from Canadian and European boys with haemophilia. Longer term prospective studies are required to examine the factors impacting the HR-QoL for boys with haemophilia in China.

[Application of disparity discriminating accuracy test in evaluating the stereopsis of postoperative intermittent exotropia]

OBJECTIVE

To discuss the application of disparity discriminating accuracy test in evaluating the stereopsis of postoperative intermittent exotropia.

METHODS

Patients with intermittent exotropia who underwent surgery during July 2011 to June 2013 were followed up. The stereoacuity was examined by Titmus Stereotest, Randot Stereotest and Frisby Stereotest. Twenty adult cases whose stereoacuity reached normal were chosen as experimental group. Twenty healthy adults were selected as normal control group. Both groups were examined with disparity discriminating accuracy test. Discriminating accuracy of the two groups were analyzed with Two-Way ANOVA method. Test-retest reliability was analyzed with Intraclass Correlation Coefficient analysis.

RESULTS

The test-retest reliability of disparity discriminating accuracy test is excellent (ICC=0.99, P<0.01) . Discriminating accuracy under different disparities in experimental group were 0.56±0.09, 0.67±0.14, 0.77±0.15, 0.82±0.14, 0.85±0.11, 0.85±0.14, 0.87±0.10, 0.84±0.16, while those in control group were 0.77±0.09, 0.88±0.09, 0.93±0.08, 0.91±0.09, 0.95±0.08, 0.96±0.05, 0.97±0.06, 0.96±0.04. There were statistically significant differences between them (F=38.06, P<0.01) . The discriminating ability of group grating in both groups was affected by the size of disparity. Under situation of small disparity, a large difference was found between the experimental group (0.67±0.12)and control group(0.86±0.07) (F=4.84, P<0.05).

CONCLUSIONS

Stereoscopic function can be evaluated comprehensively with disparity discriminating accuracy test. Use this test, a certain degree of dysfunction in stereopsis can still be found in postoperative intermittent exotropic patients who reached normal stereoacuity examined with traditional stereotests. (Chin J Ophthalmol, 2016, 52: 584-588).

MRI findings in intraspinal mature teratoma

AIM

To characterise and evaluate magnetic resonance imaging (MRI) images for their clinical value in diagnosing and assessing intraspinal mature teratoma.

MATERIALS AND METHODS

MRI images obtained from eight patients with a histopathologically verified intraspinal mature teratoma were analysed retrospectively regarding tumour location, size, and margins. Additionally, the signal intensity and enhancement pattern on MRI and other associated malformations were also assessed.

RESULTS

Three cases that contained fatty tissue showed markedly heterogeneous hyperintense signalling on T1-weighted images, and mixed hyperintense and hypointense signalling on T2-weighted images and fat-suppression sequences. All three of those cases showed an irregular peripheral fatty tissue signal, and one case showed additional patches of an interspersed calcification signal. The remaining five cases without fatty tissue displayed heterogeneous hyperintense signalling on T1-weighted images and T2-weighted images, and also on fat-suppression sequences. Four of the five cases showed additional patches of interspersed nodular calcification signals. Contrast-enhanced MRI images showed only slight enhancement (n=3).

CONCLUSIONS

MRI is regarded as the reference standard diagnostic technique to reveal the location of teratomas and the degree of spinal cord involvement. In most cases, MRI provides accurate anatomical and histological information, which is necessary for patients with suspected intraspinal mature teratoma.

KRAS status and resistance to epidermal growth factor receptor tyrosine-kinase inhibitor treatment in patients with metastatic colorectal cancer: a meta-analysis

AIM

This study reviewed the association between KRAS mutation and resistance to treatment with epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitors (TKIs) in patients with metastatic colorectal cancer (mCRC).

METHOD

A search was carried out of PubMed, MEDLINE, EMBASE and the Cochrane Library databases (to November 2013) without language restrictions.

RESULTS

Ten studies were included in the final meta-analysis, consisting of 1339 patients with mCRC, of whom 427 (32%) had a KRAS mutation. The objective response rate (ORR) of mCRC patients with KRAS mutation was 8% (33/427), whereas the ORR of mCRC patients with wild-type KRAS was 34% (306/912). The overall pooled response rate (RR) for the ORR was 1.297 (95% CI 1.244-1.353, P < 0.01). Subgroup analysis comparing cetuximab monotherapy treatment with cetuximab plus chemotherapy, showed a pooled RR of 1.26 (95% CI 1.12-0.63, P < 0.01) and 1.30 (95% CI 1.25-1.36, P < 0.01), respectively. For patients receiving anti-EGFR with monoclonal antibodies (mAb) given as first-line treatment or not, the pooled RRs were 1.34 (95% CI 1.23-1.46, P < 0.01) and 1.29 (95% CI 1.23-1.35, P < 0.01). The data on progression-free survival from five studies in the meta-analysis gave a hazard ratio (HR) of 1.99 with a 95% CI of 1.69-2.29. Finally, the data for overall survival in mCRC patients were pooled from the only three studies reporting the HR (1.80; 95% CI 1.50-2.10). None of the results had any evidence of heterogeneity.

CONCLUSION

All the results favoured a stronger link between mutant KRAS and anti-EGFR mAb, but due to a mutually exclusive relationship between KRAS and other gene mutations the clinical usefulness of KRAS mutation as a selection marker for sensitivity to EGFR TKIs in mCRC is limited.

Seasonal changes in antifreeze protein gene transcription and water content of beetle Microdera punctipennis (Coleoptera, Tenebrionidae) from Gurbantonggut desert in Central Asia

Desert beetle Microdera punctipennis (Coleoptera: Tenebriondae) is a special species in Gurbantonggut Desert in Central Asia. To investigate the possible strategy it employs for cold survival, seasonal changes in supercooling point (SCP), body water content, haemolymph osmolality and antifreeze protein gene (Mpafp) expression were measured over 13 months. Our results show SCPs in M. punctipennis adults changed from -8.0°C in summer to -18.7°C in winter. During winter, adults endured modest water loss; total water decreased from 65.4 percent in summer to 55.9% in winter. Mpafp mRNAs level increased by 13.1 fold from summer to early winter, and haemolymph osmolality increased accordingly from 550 mOsm to 1486 mOsm. Correlation coefficient of Mpafp mRNAs level and SCP indicates that Mpafp mRNA explained 65.3 percent of the variation in SCPs. The correlation between Mpafp mRNA level and total water reflected an indirect influence of antifreeze protein on water content via reducing SCP.

Application of monitored natural attenuation to remediate a petroleum-hydrocarbon spill site

Contamination of groundwater by petroleum-hydrocarbons is a serious environmental problem. The Monitored Natural Attenuation (MNA) approach is a passive remediation to degrade and dissipate groundwater contaminants in situ. In this study, a full-scale natural bioremediation investigation was conducted at a gasoline spill site. Results show that concentrations of major contaminants (benzene, toluene, ethylbenzene, and xylenes) dropped to below detection limit before they reached the downgradient monitor well located 280 m from the spill location. The results also reveal that natural biodegradation was the major cause of the observed contaminant reduction. The calculated natural first-order attenuation rates for BTEX and 1,2,4-trimethylbenzene (1,2,4-TMB) ranged from 0.051 (benzene) to 0.189 1/day (1,2,4-TMB). Evidence for the occurrence of natural attenuation includes the following: (1) depletion of dissolved oxygen, nitrate, and sulfate; (2) production of dissolved ferrous iron, sulfide, and CO2; (3) decreased BTEX concentrations and BTEX as carbon to TOC ratio along the transport path; (4) increased alkalinity and microbial populations; (5) limited spreading of the BTEX plume; and (6) preferential removal of certain BTEX components along the transport path. Additionally, the biodegradation capacity (44.73 mg/L) for BTEX and 1,2,4-TMB was much higher than other detected contaminants within the plume. Hence, natural attenuation can effectively contain the plume, and biodegradation processes played an important role in contaminant removal.

A member of the Y-box protein family interacts with an upstream element in the alpha1(I) collagen gene

Transforming growth factor beta (TGF-beta) stimulates protein complex formation on a TGF-beta response element (TAE) found in the distal portion (-1624) of the collagen alpha 1(I) promoter. To identify the fibroblast proteins in this complex, an expression library constructed from human embryonic lung fibroblasts mRNA was screened using a tetramer of TAE. Y-box binding protein (YB-1), was identified as a protein in the TAE-protein complex. The protein expressed by phage clones formed a specific complex with labeled TAE but not mutated TAE (mTAE) similar to the complex formed with nuclear protein. Nuclear protein-TAE complexes isolated from native gels contained YB-1 by Western analysis. TGF-beta treatment increased the amount of YB-1 protein in nuclear extracts, decreased its amount in cytoplasm, but did not alter the steady state levels of YB-1 mRNA. A full-length YB-1 protein expressed in human lung fibroblasts was primarily located in the nucleus with punctate staining in cytoplasmic regions. The expression of YB-1 decreased in the cytoplasm after 2 h of TGF-beta treatment. Therefore, the increased binding activity seen in TGF-beta-stimulated nuclear extracts was due primarily to relocalization of YB-1 from the cytoplasm to the nuclear compartment. Co-transfection of YB-1 cDNA with a collagen promoter-reporter construct caused a dose-dependent activation of collagen promoter activity in rat fibroblasts whereas the promoter with a mutation in the TAE element was not sensitive to YB-1 co-expression. In conclusion, we have identified YB-1 as a protein that interacts with a TGF-beta response element in the distal region of the collagen alpha 1(I) gene. YB-1 protein activates the collagen promoter and translocates into the nucleus during TGF-beta addition to fibroblasts, suggesting a role for this protein in TGF-beta signaling.

Language acquisition, unemployment and depressive disorder among Southeast Asian refugees: a 10-year study

The current study examines the risk-inducing effects of unemployment and the protective effects of language facility on the mental health of Southeast Asian refugees resettling in Canada. Rates of depression and of unemployment declined dramatically during the first decade after arrival. Although language fluency also improved during this period, approximately 8% of the sample spoke no English even after 10 years in the country. Initial depression was a strong predictor of subsequent depression. For males, job experience in Canada was the strongest predictor of subsequent employment whereas, for women, depression proved an important predictor of employability. For men in particular, unemployment was a potent risk factor for depression. During the initial period of resettlement, English-speaking ability had no effect on depression or on employment. However, by the end of the first decade in Canada. English language fluency was a significant predictor of depression and employment, particularly among refugee women and among people who did not become engaged in the labor market during the earliest years of resettlement. Study results demonstrate that the mental health salience of risk and protective factors changes according to the phase of resettlement.

[A randomized, controlled clinical trial of meropenem and imipenem/cilastatin in the treatment of acute bacterial infections]

OBJECTIVE

Meropenem is a new carbapenem antibiotic developed by Sumitomo Pharmaceuticals and shown to resist degradation by renal dehydropeptidase I (DPH-I), an enzyme which exists chiefly in the kidneys and decomposes carbapenem antibiotics. It has a powerful antibacterial activity with broad antibacterial spectrum. The objective of the study is to evaluate the efficacy and safety of meropenem.

METHODS

A randomized, open-label, controlled study was conducted for treating patients with bacterial infections. A total of 112 hospitalized patients were enrolled in the study. 55 patients received meropenem 500 mg every 12 hours (or 1g every 12 hours if necessary) and 57 patients received imipenem/cilastatin 500 mg/500 mg every 12 hours (or 1g/1g every 12 hours if necessary) intravenously. The duration of treatment was 7-14 days in both groups.

RESULTS

42 of the 55 cases receiving meropenem and 41 of the 57 cases receiving imipenem/cilastatin were assessable for clinical efficacy. The overall efficacy rate was 88.1%(37/42) for the meropenem group and 85.4%(35/41) for the imipenem/cilastatin group, whereas the bacterial eradication rate was 81.1%(30/37) and 84.2%(32/38), respectively. 47(69.1%) of 68 strains isolated from patients produced beta-lactamase. Adverse drug reaction was evaluated in 44 cases of the meropenem group and 41 cases of the imipenem/cilastatin group. The adverse drug reaction rate was 13.6%(6/44) and 12.2%(5/41), respectively. The results showed that there were no statistical differences between these two groups (P > 0.05).

CONCLUSION

Meropenem and imipenem/cilastatin were effective and safe for the treatment of lower respiratory tract infections and urinary tract infections and other infections caused by beta-lactamase-producing strains.

Non-specific deadenylation and deguanylation of naked RNA catalyzed by ricin under acidic condition

Ricin A-chain catalyzes the hydrolysis of the N-glycosidic bond of a conserved adenosine residue at position 4324 in the sarcin/ricin domain of 28S RNA of rat ribosome. The GAGA tetraloop closed by C-G pairs is required for recognition of the cleavage site on 28S ribosomal RNA by ricin A-chain. In this study, ricin A-chain (reduced ricin) exhibits specific depurination on a synthetic oligoribonucleotide (named SRD RNA) mimic of the sarcin/ricin domain of rat 28S ribosomal RNA under neutral and weak acidic conditions. Furthermore, the activity of intact ricin is also similar to that of ricin A-chain. However, under more acidic conditions, both enzymes lose their site specificity. The alteration in specificity of depurination is not dependent on the GAGA tetraloop of SRD RNA. A higher concentration of KCl inhibits the non-specific N-glycosidase activity much more than the specific activity of ricin A-chain. In addition, characterization of depurination sites by RNA sequencing reveals that under acidic conditions ricin A-chain can release not only adenines, but also guanines from SRD RNA or 5S ribosomal RNA. This is the first report of the non-specific deadenylation and deguanylation activity of ricin A-chain to the naked RNA under acidic conditions.

[Expression of Fas on monocytes and the level of plasma soluble FasL in patients with chronic renal failure]

OBJECTIVE

The dysfunction of monocytes in uremic patients has been demonstrated to be associated with monocyte accelerated apoptosis. The study was conducted toelucidate the mechanisms by which monocyte apoptosis was induced.

METHODS

Seven non-dialyzed chronic uremic patients and 18 hemodialysis (HD) patients were enrolled in the study. Fifteen healthy volunteers were selected as controls. The expression of Fas and Fas ligand (FasL) was examined by immunofluorescent staining and flow cytometer analysis. The levels of soluble FasL (sFasL) in plasma were analyzed by enzyme-linked immunosorbent assay (ELISA). The percentage of apoptotic cells in monocytes cultured in vitro with recombinant human FasL (rHu-FasL) was quantitated by DNA content analysis after extraction of the degraded DNA. Monocyte survival rate was analyzed by 5-diphenyl tetrazolium bromide (MTT) staining.

RESULTS

Expression of Fas on monocytes was significantly higher in uremic and HD patients than that in healthy subjects. Higher levels of Fas expression were demonstrated on monocytes from HD as patients compared with those from non-dialyzed patients. There was no difference in monocyte Fas expression between pre- and post-dialysis session and between patients using polysulfone and cellulose dialyzer. There was no detectable FasL expression on monocytes from both uremic patients and healthy controls. Plasma sFasL could be detected in uremic and HD patients, but not in healthy controls. There was no significant difference in levels of plasma sFasL between non-dialyzed and HD patients, pre- and post-dialysis session, and patients treated with polysulfone and cellulose dialyzer. When monocytes were cultured in vitro with rHu-FasL for 2 hours, higher levels of apoptosis and lower survival rate were found in monocytes from HD patients as compared with those from healthy controls.

CONCLUSION

The up-regulated expression of functional Fas on monocytes and the presence of sFasL in plasma may contribute to the accelerated apoptosis of monocytes seen in uremic patients.

Enhanced oxidant stress in synovial vessels of patients on hemodialysis

OBJECTIVE

To test the hypothesis that the susceptibility of synovial vessels to redox uncoupling which could result in oxidative damage capable of promoting beta 2-microglobulin (beta 2 m) deposition.

METHODS

The expression of oxidative markers by microvascular endothelial cells in hemodialysis (HD) patients, non-uremic patients and normal subjects was determined using immunostaining and Northern blotting.

RESULTS

Synovial vascular endothelial cells of HD patients exhibited evidence of oxidant stress: induction of malondialdehyde (MDA) epitopes and heme oxygenase. These oxidative markers were not detectable in microvascular endothelial cells of other tissues from HD patients, as well as in the synovial vessels of non-uremic or normal controls. Higher levels of heme oxygenase mRNA in synovia were seen in patients with beta 2 m deposition compared with patients without beta 2 m deposition.

CONCLUSIONS

Oxidative damage of the synovial microvasculature in uremic patients may be one of the factors which can promote deposition of beta 2 m in osteoarticular tissue.

[Synthesis of the new reagent N-hexyl-N'-(sodium aminobenzenesulfonate) thiourea (HXPT) and its spectrophotometric study with Pd2+]

A new reagent N-Hexyl-N'-(sodium aminobenzenesulfonate) thiourea (HXPT) was synthesized. Its structure was also characterized. A new spectrophotometric method of determining Pd2+ was developed based on the new reagent. In the range of pH 5.4-5.8 Pd2+ forms a stable yellow complex with HXPT in the presence of CTMAB,and its apparent molar absorptivity is 2. 21 x 10(5) L x mol(-1) x cm(-1) at the maximum absorption wavelength 296.8 nm. Beer's law is obeyed in the range of 1-7 microg x 25 mL(-1) for Pd2+. This method has been used for the determination of trace Pd2+ in ores and catalyst with satisfactory results.

Perceived racial discrimination, depression, and coping: a study of Southeast Asian refugees in Canada

Using data obtained from personal interviews with 647 Southeast Asian refugees in Canada, this study tests hypotheses regarding both the association between perceived racial discrimination and depression, and the roles of coping and ethnic identity in conditioning the nature of the discrimination-depression relation. Refugees who reported that they had experienced racial discrimination had higher depression levels than their counterparts who reported no such experiences. Responding to discrimination through confrontation was not significantly associated with depression. Study findings support the effectiveness of forbearance in diminishing the strength of the association between discrimination and depression. The moderating effect of forbearance was conditioned by the level of ethnic identity: The beneficial effect of forbearance was significantly greater among those holding stronger ethnic identification. Cultural and situational interpretations of the findings are presented.

[The effects of nitric oxide and endothelia levels on plasma in patients with chronic heart failure]

OBJECTIVE

To study the effects of prostaglandin E1 on plasma nitric oxide (NO) and endothelin (ET) levels in patients with chronic heart failure.

METHODS

Pulmonary artery pressure (PAP), pulmonary arterial and venous plasma ET and angiotensin converting enzyme (ACE) levels were determined in patients with chronic heart failure (CHF) and the effects of prostaglandin E1 (PGE1) were evaluated.

RESULTS

(1) Pulmonary hypertension was present in patients with CHF. Plasma NO and ET levels in the pulmonary artery were higher than those in the pulmonary vein (P < 0.05), the levels in the latter was in turn higher than those in normal subjects (P < 0.05). (2) Plasma ACE levels showed a similar change, (3) The increase of plasma ET was more than the increase of NO in patients with CHF, thus, NO/ET ratio was decreased in CHF (P < 0.05). (4) PGE1 caused significant decrease in PAP but increase in cardial index. It decreased plasma NO, ET, ACE, and increased NO/ET ratio (P < 0.05). These effects became more apparent with the increase of PGE1 level.

CONCLUSION

NO and NO/ET ratio might be involved in CHF by causing pulmonary hypertension and local vascular endothelium perturbation. PGE1 could inhibit these effects and play an important role in the prevention and treatment of CHF.

A randomized controlled clinical trial on piperacillin/tazobactam versus ticarcillin/clavulanic acid for the treatment of bacterial infections

OBJECTIVE

To compare the efficacy and safety of two beta-lactam-beta-lactamase inhibitor combinations, piperacillin/tazobactam and ticarcillin/clavulanic acid in the treatment of bacterial infections.

METHODS

A randomized, open-labeled, controlled study was conducted for the treatment of 124 hospitalized patients with lower respiratory tract infection and urinary tract infections. Sixty-three patients received piperacillin (4 g)/tazobactam (500 mg) every 8 hours by intravenous infusion and 61 patients received ticarcillin (3 g)/clavulanic acid (200 mg) every 8 hours by intravenous infusion. The duration of treatment was 7-14 days in both groups.

RESULTS

Sixty-three of 79 cases who received piperacillin/tazobactam and 61 of 84 cases who received ticarcillin/clavulanic acid were assessable for clinical efficacy. The overall efficacy rates were 90.5% for the piperacillin/tazobactam group and 88.5% for the ticarcillin/clavulanic acid group, whereas the bacterial eradication rates were 90.2% and 92.0%, respectively. 78 (77.2%) of 101 strains isolated from patients produced beta-lactamases. The adverse reaction was evaluated in 65 cases of piperacillin/tazobactam group and 62 cases of ticarcillin/clavulanic acid group. The adverse drug reaction rates were 7.69% (5/65) and 8.06% (5/62), respectively.

CONCLUSIONS

Piperacillin/tazobactam and ticarcillin/clavulanic acid were effective and safe for the treatment of lower respiratory tract infections and urinary tract infections caused by beta-lactamase-producing strains. The results showed that there was no statistical difference between these two groups (P > 0.05).

[The protective effect of removing circulatory TNF by immuno-adsorption on endotoxin-induced acute lung injury]

OBJECTIVE

To study the protective effect of removing circulatory TNF by immunoadsorption on endotoxin-induced acute lung injury in rabbits.

METHOD

New Zealand white rabbits injected with lethal dose of endotoxin underwent hemoperfusion with immunoadsorbent. TNF and IL-8 levels in BALF were measured, the number of leukocytes and percentage of PMN in BALF were analyzed and the ratio of wet lung to body weight and pulmonary microvascular permeability index were also studied. In addition, the survival rate was observed.

RESULT

Treatment with immunoadsorption markedly attenuated the pulmonary microvascular permeability increased by endotoxin and improved the survival rate.

CONCLUSION

Immunoadsorption to remove circulating TNF is an effective way to protect rabbits against endotoxin-induced acute lung injury.

Phase I clinical trial of cefditoren pivoxil (ME 1207): pharmacokinetics in healthy volunteers

Pharmacokinetics of ME1207 were evaluated in 5 groups of healthy adult male volunteers given single preprandial administration of 100, 200 and 300 mg; postprandial administration of 200 mg; and administration of 200 mg every 12 h for 7 consecutive days. Blood drug concentrations were determined by HPLC and bioassay after oral single administration of 100, 200 and 300 mg before meals. Serum concentrations and major pharmacokinetic parameters (Cmax, Tmax, AUC and T1/2 Ke) determined by these two methods were comparable. Cmax and AUC determined by bioassay after postprandial administration were greater than those determined after preprandial administration. Blood concentrations determined 1.5 and 12 h after each administration, during repeated administration of 200 mg every 12 hours for 7 days, were always about 2.5 and 0 mg/l, respectively, indicating that the drug is not accumulated in the body. Within 24 hours after administration of 100, 200 and 300 mg, 19.93 +/- 5.20, 20.24 +/- 3.72 and 21.29 +/- 5.47%, respectively, of the dose were excreted into urine in an unchanged form.

[Effects of specific removal of circulating tumor necrosis factor-alpha by immunoadsorption on nitric oxide in endotoxin shock]

OBJECTIVES

To evaluate the effects of specific removal of circulating TNF-alpha by immunoadsorption on nitric oxide (NO) in endotoxin shock.

METHODS

Immunoadsorbent against TNF-alpha was produced by the attachment of anti-TNF-alpha monoclonal antibody (McAb) to agarose beads. Blank columns were made of agarose beads without the attachment of anti-TNF-alpha McAb. New Zealand white rabbits were injected intravenously with Lipopolysaccharide (LPS, Escherichia coli O111: B4, 8.0 x 10(9) cfu/kg. B.W), and then were randomly divided into three groups: (1) control group(n = 25); without other treatment. (2) pseudoperfusion group(n = 25): rabbits underwent hemoperfusion through the blank columns. (3) perfusion group (n = 15): rabbits underwent hemoperfusion through the immunoadsorbent columns. Hemoperfusion was started at 1 h after the injection of LPS, and was sustained for two hours with blood flow rate of 5 ml/min.

RESULTS

Mean arterial pressure in the perfusion group was significantly increased at 30 min after hemoperfusion (P < 0.05). It maintained a level higher than that before hemoperfusion (P < 0.05), and was higher (P < 0.05) than that in the control and pseudoperfusion groups at 3 h (end of the monitoring period). The plasma TNF-alpha level in the perfusion group was significantly lower than that in the other two groups at 2, 3 and 6 hour after LPS injection (P < 0.05). Although the concentration of plasma nitrite (NO2-, one of the stable end products of NO) in the perfusion group was significantly lower (P < 0.05) than that in the other two groups from 3 h after LPS infusion, it was significantly higher (P < 0.05) than the baseline value from 30 min to 12 h. The activities of NO synthase (NOS) in the heart and lung were significantly lower (P < 0.05) in the perfusion group than in the other two groups at 24 h. The serum levels of alanine transaminase, aspartate transaminase, urea nitrogen, creatinine, lactate dehydrogenase, alpha-hydrobulyric dehydrogenase and alkaline phosphatase in the perfusion group were significantly lower (P < 0.05) than those in the other two groups at 24 h. Moreover, the survival rate of rabbits in the perfusion group was higher (P < 0.05) than that of the other two groups at 24 h.

CONCLUSION

Specific removal of circulating TNF-alpha by immunoadsorption actually acts as the selective inhibition of the inducible NOS(iNOS) and may be a new and effective therapy for endotoxin shock.

Phase I clinical trial of cefditoren pivoxil (ME1207). Tolerance in healthy volunteers

A tolerance study to ME1207 was conducted in healthy volunteers using five single doses administered before a meal (50, 100, 200, 300 and 500 mg), a single 200 mg dose administered after a meal, and 200 mg administered every 12 h for 7 days. No subjective symptoms or changes in haematological and biochemical examinations and urinalysis were observed after single administration of 50 to 500 mg Four subjects complained of minimal upper abdominal discomfort when 200 mg was administered every 12 h for 7 days, but this symptom disappeared without remedial action in all cases. Therefore ME1207 was thought to be safe when orally administered at the above-mentioned doses by the above-mentioned administration methods.

Effects of removing circulatory tumor necrosis factor by immunoadsorption on experimental endotoxin shock animals

OBJECTIVE

To evaluate the effects of removing circulatory tumor necrosis factor (TNF) by immunoadsorption on endotoxin shock animals.

METHODS

Sixty New Zealand white rabbits were injected intravenously with lethal dose of endotoxin (10 Billion cfu/kg E. Coli endotoxin) and randomly divided into 3 groups: perfusion group, hemoperfusion started at 1 hour after injecting endotoxin through immunoadsorbent columns against TNF; pseudoperfusion group, hemoperfusion through blank columns; and control group, injected with endotoxin only. The arterial pressure, microcirculation of the mesentery, plasma levels of TNF, IL-1, IL-6, IL-8, nitrite, endothelin-1 (ET-1), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine were measured and analyzed and finally the survival rate was observed.

RESULTS

Plasma levels of TNF were sharply reduced after immunoadsorption. Moreover, release of IL-1, IL-6, IL-8, NO and ET-1 were also attenuated. Hemodynamic abnormalities could be improved and survival rate ameliorated significantly.

CONCLUSION

Specific immunoadsorption of circulating TNF might be a new and effective therapy for endotoxin shock.

[The effects of removing circulated TNF by immunoadsorption on renal changes in rabbits with endotoxin shock]

OBJECTIVES

To remove circulating tumor necrosis factor (TNF) by specific immunoadsorption column containing anti-TNF monoclonal antibody (McAb) and observe the effects of the therapy on renal changes in experimental endotoxin shock.

METHODS

New Zealand white rabbits were injected with lethal dose of E. coli endotoxin (LPS, 8 x 10(9) cfu/kg) to produce endotoxin shock, then were divided into two groups: control (n = 7) and perfusion group (n = 10). Perfusion was started at 1 hour after administration of endotoxin. Mean arterial pressure (MAP) was monitored continuously. Blood samples were collected for assay of TNF, urea nitrogen (BUN) and creation (Cr). Six hours after infusion of LPS, rabbits were sacrificed, then the kidney was taken for pathologic observation.

RESULTS

MAP was increased 30 minutes after perfusion in perfusion group, then kept at a level higher than that in the control group in the monitoring period (P < 0.01). The plasma TNF activation was reduced significantly in the perfusion group (44 +/- 10) compared with the control group (1448 +/- 226, P < 0.05) one hour after perfusion. The levels of BUN and Cr were decreased in the perfusion group compared with the control group. The degree of glomerular congestion and infiltration of leukocytes in glomeruli was significantly lower in the perfusion group than in the control group. The degree of tubular necrosis was decreased significantly in the perfusion group compared to that in the control group (P < 0.05). The mitochondrial ultrastructural changes were more severe in the control group than in the perfusion group.

CONCLUSIONS

Specific immunoadsorptive column containing anti-TNFMcAb could remove effectively circulating TNF in experimental endotoxin shock. Reducing levels of TNF in the early phase of endotoxin shock may ameliorate the state of hypotension.

Characterization of human cyclooxygenase 2 gene promoter localization of a TGF-beta response element

We characterized 2.3 kb of 5'-flanking region of the human cyclooxygenase 2 gene and analyzed its promoter activity. We localized three positive and two negative cis-acting regulatory regions and a TGF-beta response region. Basal promoter activity was located between -77 and +99 bp. Maximal promoter activity was observed from -1838 to +99 bp. A TGF-beta response region was found between -454 and -288 bp. This region included an NF-I site. Electrophoretic mobility shift assays showed that TGF-beta caused a marked change in the pattern and intensity of this NF-I like protein complex.

Superior real-time holographic storage properties in doped potassium sodium strontium barium niobate crystal

We demonstrate superior holographic storage performance in a cobalt doped potassium sodium strontium barium niobate (Co:KNSBN) crystal that possesses a fast response time of 1.4 ms, a large photorefractive sensitivity of 13 x 10(-3) cm(3) J(-1) under a total writing intensity of 1 W/cm(2) , and high spatial resolution of 45 line pairs/mm. Reconstructed images with high fidelity have been obtained in real-time holographic storage. The dynamic properties of the index grating, the dependence of response time on writing intensity, and the dark decay of diffraction signal with increased writing intensity indicate that two species and shallow traps exist in Co:KNSBN crystal.

[Effects of epidermal growth factor (EGF) on proliferation of human peritoneal mesothelial cells]

In order to study the effects of epidermal growth factor (EGF) on proliferation of human peritoneal mesothelial cells (HMC) and repair repair of damaged human peritoneum, the mesothelial cells from human omentum were seperated and cultured in vitro. The authors assessed the expression of EGF-R on the surface of HMC with ABC immune histochemical method and tested the proliferation extent of HMC treated with EGF at different time and dosage levels with 3H-thymidine incorporation method. The results showed that EGF-R existed on the surface of HMC and EGF could stimulate the proliferation of HMC. The proliferation of HMC growing in the media containing 20 micrograms/L EGF was more significant than that growing in RPMI-1640 alone. The greatest proliferation index (PI = 8.16) of HMC appeared in the media containing 50 micrograms/L EGF. The proliferation of HMC stimulated by EGF was time- and dose-dependent. These studies indicate that the proliferation of HMC stimulated by EGF may play a very important role in the structral and functional recovery of the injured peritoneum.

[Chemical constituents of Stellera chamaejasme L]

Twelve compounds were isolated from the roots of Stellera chamaejasma. Five of them were elucidated by spectroscopic and chemical methods as 3', 14-dimethyl-4', 11-dimethoxy-5, 7-dihydroxybenzoflavanone (10), daphnetin (1), umbelliferone (2), daucosterol (5) and beta-sitosterol (3). Compound 10 is new. Compounds 1, 2, 5, 10 were isolated for the first time from S. chamaejasme.

[Tuberculosis in chronic renal failure patients with or without renal replacement therapy]

Tuberculosis developed in 40 out of 978 chronic renal failure (CRF) patients with or without renal replacement therapy during a five-year period. The incidence was 4.1% and was 10 times higher than that in the general population. The onset of symptoms was within 1 year after dialysis or kidney transplantation in 68% of the patients. 82.5% of them had predominantly extrapulmonary tuberculosis and most of these were lymph node infection. The diagnosis of tuberculosis in these patients was difficult; tuberculin sensitivity was present only in 6.4% of the patients and examination of sputum and other fluid for mycobacteria was usually unrewarding. Detecting serum anti-PPD-IgG level might be a valuable supplementary diagnostic method, because 85% of patients with active tuberculosis showed positive results. Measuring serous exudate and urine anti-PPD-IgG level by ELISA or M. Tuberculosis DNA by PCR might be helpful in the diagnosis of tuberculous serositis and urinary tract mycobacterial infection.

[Effects of high concentration glucose on cell growth and matrix biosynthesis in human peritoneal mesothelial cells]

During CAPD, the peritoneal mesothelial monolayer is directly bathed in dialysate containing 1.50%-4.25% glucose. In this study, we separated and cultured mesothelial cells from human omentulum (HMC) to test the effects of glucose on cell growth and matrix biosynthesis. [3H] thymidine incorporation was significantly inhibited in cells grown in > or = 1.00% glucose, compared with cells grown in 0.10% glucose and RPMI-1640 alone. HMC incubated in RPMI-1640 medium released trace fibronectin (FN) as measured by specific enzyme immunoassay, and FN level in supernatants was significantly increased when HMC grew in the media containing glucose more than 0.50%. Glucose induced inhibition of cell proliferation and increase of FN were time-and dose-dependent. Mannitol also achieved the same results, but its inhibitive effect on HMC proliferation is far less than that of isoosmolar glucose. These studies provide evidence for a multitude of direct effects of high concentration ambient glucose level on HMC growth and matrix biosynthesis, and raise the possibility that long-term exposure of HMC to high concentration glucose may induce disturbance in cell repair and metabolism, thus contributing to the formation of sclcerosing peritonitis in CAPD.

[Early diagnosis of tuberculosis after kidney transplantation by determining serum anti-PPD-IgG]

Tuberculosis is a common complication after kidney transplantation and is not easy to diagnose in the early stage. Determination of serum anti-PPD-IgG level in our laboratory indicated that it was positive in patients with active tuberculosis. The mean time (20.5 days) required to diagnose with this method was obviously shorter than that (66.8 days) required with bacteriology, pathology or imaging. There was no obvious rise in the serum level of anti-PPD-IgG in fever caused by other infections and rejection and the serum anti-PPD-IgG level in patients with tuberculosis controlled returned to normal. It is shown that determination of serum specific antibody is a better index for early diagnosis of tuberculosis complicating kidney transplantation.