[A preliminary study on the establishment of a subcutaneous allergen-specific immunotherapy center]

Allergic diseases can notably affect a patient's quality of life. World Health Organization (WHO) has identified these diseases as one of the key areas for research and prevention in the 21st century. Currently, allergen-specific immunotherapy is viewed as a potential treatment approach that could modify the natural progression of allergic diseases, thus being recognized as a crucial tactic in their prevention and treatment. Nonetheless, the broad implementation of allergen-specific immunotherapy in clinical settings continues to confront challenges. One significant issue is the absence of standardized centers for subcutaneous allergen-specific immunotherapy. This article presents several perspectives and recommendations for establishing a standardized subcutaneous allergen-specific immunotherapy center.

[Attention to the prevention and control of allergic diseases in the elderly]

With the global increase in the prevalence of allergic diseases and the rising life expectancy, it is anticipated that the number of elderly patients affected by allergies will also increase. While it was previously believed that allergies primarily affected children and adolescents and diminished with age, epidemiological studies indicate a growing prevalence of allergies in the elderly. Various allergic diseases have similar prevalence rates in the elderly as in the general population, and some, like drug allergies, are even more prevalent in this age group. Allergic diseases in the elderly often present with atypical symptoms, leading to challenges in differential diagnosis and treatment. This paper discusses immunosenescence and the distinct features of allergic diseases in older individuals. The goal is to raise awareness among healthcare providers about allergies in older adults, encourage preventive measures, and improve the quality of life for elderly patients with allergies. By managing allergies better, it can also help with the management of other chronic diseases in the elderly and contribute to better overall health for everyone.

[Brief analysis on the current status of medical education and specialty of allergy in China and abroad and the strategies for the development of allergology in China]

The increase in the prevalence of allergic diseases has brought a substantial medical, social and economic burden. The development of allergology is relatively lag behind the allergy prevalence in China. Both the numbers of allergy specialty and allergist are scarce and thus the diagnosis and treatment of allergic disease does not meet the needs of allergy patients. This article summarizes the status of medical education and specialty development of allergology in China and abroad. In addition, the key strategies for promoting the development of allergy education and specialty were discussed, including undergraduate and graduate education of allergology, the orientation of allergy specialty and related specialty/subspecialty, the integration of allergology into the standardized residents training system, training and certification of allergists, and multidisciplinary diagnosis and treatment model.

[Biomarkers associated with severity classification of asthma identified by comprehensive bioinformatics analysis]

Using an integrated bioinformatics approach to find novel biomarkers that can predict asthma severity. From June 2022 to December 2022, this clinical medical study was conducted and completed in the Department of Allergy, Zhongnan Hospital of Wuhan University. The gene chip dataset GSE43696 was screened and downloaded from the high-throughput Gene Expression Omnibus (GEO) database, and the gene chip data preprocessing was completed using package "affy" in R and "rma" algorithm in turn. Use the the "edgeR" and "limma" packages to screen out the differentially expressed genes (DEGs) between normal controls, mild to moderate asthma patients and severe asthma patients, and then use the "clusterProfiler" package to perform GO enrichment analysis and KEGG pathway enrichment analysis of DEGs, finally use the STRING website to construct a protein-protein interaction (PPI) network of DEGs to further screen key genes. Using the R language "WGCNA" package, the weighted gene co-expression network analysis (WGCNA) was performed on the dataset GSE43696, and the modules significantly related to the severity of asthma were screened out, then the hub genes were obtained by intersecting the WGCNA analysis results with the DEGs screened by PPI. Datasets GSE43696 and GSE63142 were used to verify the expression of hub genes, and the diagnostic value was evaluated according to the ROC curve, then the potential function of hub genes in dataset GSE43696 was further clarified by gene set enrichment analysis (GSEA). The results showed that a total of 251 DEGs were screened, including 39 in the normal group and mild to moderate asthma group, 178 in the normal group and severe asthma group, and 34 in the mild to moderate asthma group and severe asthma group, mainly involved in biological processes such as response to toxic substance, response to oxidative stress, extracellular structure organization, extracellular matrix organization. Two modules significantly correlated with asthma severity were screened out (red module, P=7e-6, r=0.43; pink module, P=5e-8, r=-0.51), and finally six hub genes were obtained, including B3GNT6, CEACAM5, CCK, ERBB2, CSH1 and DPPA5. The comparison of gene expression levels and ROC curve analysis of datasets GSE43696 and GSE63142 further verified the six hub genes, which may associated with o-glycan biosynthesis, alpha linolenic acid metabolism, linoleic acid metabolism, pentose and glucoronate interconversions. In conclusion, through a variety of bioinformatics analysis methods, this study identified six hub genes significantly related to the severity of asthma, which potentially provided a new direction for the prediction and targeted therapy of asthma.

[Clinical and imaging characteristics of optic nerve tumors as the differencial diagnosis of optic neuritis]

Objective: To investigate the clinical and imaging features of optic nerve tumors that require differential diagnosis from optic neuritis. Methods: A retrospective case series study was conducted. Clinical data of patients diagnosed with optic nerve tumors from January 2017 to December 2021 at the Second Affiliated Hospital of Zhejiang University School of Medicine were collected. A total of 29 patients (39 eyes) with clinical and magnetic resonance imaging (MRI) findings similar to optic neuritis or optic neuropathy were included. There were 15 cases of optic nerve sheath meningioma (ONSM) (17 eyes), 4 cases of optic nerve glioma (ONG) (5 eyes), and 10 cases of infiltrative optic nerve lesions (ION) (17 eyes). All patients underwent best-corrected visual acuity (BCVA), anterior and posterior segment examinations, visual field examination, and orbital or cranial MRI examination. Patient data were observed and analyzed, treatment and follow-up information were recorded, and clinical and imaging features were summarized and compared with those of optic neuritis or optic neuropathy. Results: Among the 29 patients with optic nerve tumors, 10 were male and 19 were female, with an average age of (43.3±13.8) years and a range of 11 to 72 years. The follow-up time was 6.8 (2.0, 11.0) months, with a range of 1 to 33 months. Sixteen patients (21 eyes) with optic nerve tumors were initially misdiagnosed as having acute optic neuritis and showed poor response to steroid treatment. Of these, 9 cases (11 eyes) were ONSM, 4 cases (6 eyes) were ION, and 3 cases (4 eyes) were ONG. The diagnostic delay time was 7.1 (1.5, 12.0) months, with a range of 1 to 24 months. The main clinical symptoms of all affected eyes were acute vision loss in 23 eyes, slow vision loss in 5 eyes, transient blackouts in 4 eyes, and no obvious visual symptoms in 7 eyes. The median BCVA of all affected eyes was 0.1, ranging from light perception to 1.0. Fundus examination results showed optic disc edema in 34 eyes and normal optic disc in 5 eyes among the 39 eyes with optic nerve tumors. A total of 27 patients (33 eyes) completed visual field examinations, which revealed an enlarged physiological blind spot in 11 eyes, a concentric or tubular visual field contraction in 8 eyes, a diffuse decrease in light sensitivity in 7 eyes, an arcuate scotoma in 4 eyes, and a normal visual field in 3 eyes. All affected eyes completed orbital or cranial MRI examinations, which showed mild optic nerve thickening in 22 eyes, significant thickening in 6 eyes with distortion, and no significant thickening in 6 eyes. Contrast-enhanced T1-weighted imaging (T1WI) MRI showed optic nerve parenchymal thickening in 5 eyes, all of which were ONG, and 2 of them had optic nerve parenchymal enhancement. Optic nerve sheath thickening and enhancement without optic nerve parenchymal thickening or enhancement were observed in 28 eyes, including 17 eyes of ION and 11 eyes of ONSM. There were 6 eyes with no obvious optic nerve thickening, which were all ONSM, showing mild or significant thickening and enhancement of the optic nerve sheath without optic nerve parenchymal thickening or enhancement. Conclusions: Optic nerve tumors can present with ophthalmic clinical features similar to optic neuritis, such as optic disc edema, and demonstrate MRI findings that resemble those of optic neuritis. Therefore, differentiation between the two is crucial, based on differences in their natural course and response to steroid therapy.

[Study on the characteristics of Aspergillus fumigatus-sensitized asthma and allergic bronchopulmonary aspergillosis]

Objective: To investigate the clinical characteristics of Aspergillus fumigatus(A.f)-sensitized asthma and allergic bronchopulmonary aspergillosis (ABPA), which provides a foundation for the diagnosis and differential diagnosis of A.f-sensitized asthma and ABPA, as well as the prevention of ABPA. Methods: This was a single-center retrospective case-control study. Collected the clinical data of patients who visited the Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University from December 2018 to May 2022.A total of 122 patients were included, including 64 males (52.5%) and 58 females (47.5%).The age range was 3 to 89 years.The median age was 44 years.The average age was 41.8 years.The patients were divided into three groups (48 ABPA, 35 A.f-sensitized asthma and 39 HDM-sensitized asthma).Analyzed the differences and correlations among clinical indicators in the three groups, and evaluated the risk factors for the development of ABPA in A.f-sensitized asthma.For statistical analysis, metrological data was tested by t-test or Wilcoxon Mann-Whitney. Classification variables by chi-square test or Fisher's exact test. Pearson correlation analysis for normal distribution data.Spearman correlation analysis for skewed distribution data. Influencing factor analysis was performed using multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve was made, the area under the ROC curve (AUC) was calculated, and the sensitivity and specificity of the model were evaluated. Results: Compared with patients with A.f-sensitized asthma, the fractional exhaled nitric oxide (FeNO) [75.00(52.00, 87.00)ppb vs. 40.00(32.00, 52.00)ppb], eosinophils% (EO%) [10.60(6.75, 13.05) vs. 4.10(1.20, 7.30)], eosinophils (EO) [1.50(1.07, 2.20)×10⁹/L vs. 0.33(0.10, 0.54)×10⁹/L], A.f-specific Immunoglobulin E (sIgE) [10.24(4.09, 22.88)KU/L vs. 1.13(0.53, 3.72) KU/L], and sIgE to total IgE(tIgE) ratio (sIgE/tIgE) [0.0049(0.0027, 0.0100) vs. 0.0008(0.0004, 0.0017)] were higher in ABPA patients, the differences were statistically significant (P<0.001). In all patients, tIgE was positively correlated with EO% (r=0.206, P<0.05) and EO (r=0.302, P<0.001). sIgE/tIgE was negatively correlated with one-second rate (FEV1/FVC%) (r=-0.256, P<0.01). The percentage of predicted forced vital capacity [FVC(%)] was negatively correlated with FeNO (r=-0.184, P<0.05).In the ABPA group, the percentage of predicted peak expiratory flow [PEF(%)] was negatively correlated with FeNO (r=-0.295, P<0.05). In the HDM-sensitized asthma group, FeNO was positively correlated with EO% (r=0.49, P<0.01) and EO (r=0.548, P<0.001).The results of logistic regression analysis showed that FeNO and EO were the influencing factors for the development of ABPA in A.f-sensitized asthma. ROC curve analysis results showed that A.f-sIgE (cut-off, 4.108; AUC=0.749;95%CI, 0.632-0.867), sIgE/tIgE(cut-off, 0.0026;AUC=0.749;95%CI, 0.631-0.868), FeNO(cut-off, 55.5;AUC=0.794; 95%CI, 0.687-0.900), EO% (cut-off, 8.70;AUC=0.806;95%CI, 0.709-0.903) and EO (cut-off, 0.815;AUC=0.865;95%CI, 0.779-0.950) had differential diagnostic value in A.f-sensitized asthma and ABPA.The combination of FeNO, EO and EO% had good diagnostic efficiency in differentiating A.f-sensitized asthma from ABPA, with a sensitivity of 91.4% and a specificity of 84.4%. Conclusion: Compared with patients with A.f-sensitized asthma, patients with ABPA have more severe eosinophil inflammation. The higher the FeNO and EO, the more likely A.f-sensitized asthma will develop into ABPA.sIgE/tIgE may have differential diagnostic value in A.f-sensitized asthma and ABPA.The combination of FeNO, EO and EO% has good diagnostic efficacy in differentiating A.f-sensitized asthma from ABPA.

[Analysis of PKD1 gene mutation in a pedigree affected with autosomal dominant polycystic kidney disease]

Objective: To analyze the clinical phenotype and detect the pathogenic gene in a Chinese pedigree with autosomal dominant polycystic kidney disease(ADPKD). Methods: The proband of this study was hospitalized in Dongguan City People's Hospital on October 10, 2017, due to "left maxillary apical cyst". Clinical phenotypes were noted, imaging examinations and determination of biochemical indicators were carried out for the clinical diagnosis of the proband. Genomic DNA was extracted from peripheral venous blood. Whole-exome genotyping of the proband was performed with the next generation sequencing technology, and the candidate mutation site of the patient and his family members was verified by PCR and Sanger sequencing technology. The mutation site was further screened in 150 unrelated healthy Chinese controls. Mutation frequency within human populations and bioinformatics analysis were predicted with softwares including ExAC, dbSNP, HGMD, 1000 genomes, ClinVar, PKDB, Mutation Taster and PhyloP. Results: The proband, a 46-year-old male, was diagnosed with hypertension, positive urine occult blood and elevated blood creatinine. B-ultrasound and CT examinations showed that he had bilateral polycystic kidney with left kidney stones and polycystic liver. The gene analysis showed that the c.11017-10C>A heterozygous splice mutation in PKD1 gene was identified in the proband, his second younger brother, younger sister, daughter and niece, but absent in 150 healthy controls. Bioinformatics analysis showed it has been reported in the dbSNP, ClinVar, HGMD, PKDB and Mutation Taster databases. Some databases predicted it has a harmful function for probably leading to production of a truncated polycystin1(PC1) protein. Conclusion: c.11017-10C>A underlies the Chinese ADPKD pedigree and expands mutation spectrum of PKD1.

[Factor analysis of effective platelet-producing ability of fetal liver-derived cells]

Objective: To study the different factors affecting platelet production post transplantation of hematopoietic stem cells (HSCs) isolated from different sources in order to explore novel options for treating platelet depletion following HSCs transplantation. Methods: HSCs and their downstream derivatives including myeloid and lymphoid cells (i.e., collective of mononuclear cells (MNCs)), were isolated from E14.5 fetal liver (FL) and bone marrow (BM) of 8-week-old mice by Ficoll separation technique. These cells were subsequently transplanted into the tibia bone marrow cavity of recipient mice post lethal myeloablative treatment in order to construct the FL-MNCs and BM-MNCs transplantation mouse model. Routine blood indices were examined in these recipient mice. The chimeric rate of donor cells in recipient peripheral blood cells were determined by flow cytometry. Different groups of cells involved in platelet reconstruction were analyzed. CD41⁺megakaryocytes were sorted from fetal liver or bone marrow using magnetic beads, which were then induced to differentiate into platelets in an in vitro assay. Quantitative RT-PCR was used to detect the expression of platelet-related genes in CD41⁺megakaryocytes from the two sources. Results: Both the FL-MNCs and the BM-MNCs transplantation groups resumed normal hematopoiesis at the 4th week after transplantation, and the blood cells of the recipient mice were largely replaced by the donor cells. Compared with the mice transplanted with BM-MNCs, the platelet level of mice transplanted with FL-MNCs recovered faster and were maintained at a higher level. At week 4, the PLT level of the FL-MNCs group was (1.45±0.37)×10¹²/L, and of the BM-MNCs group was (1.22±0.24)×10¹²/L, P<0.05. The FL-MNCs contain a higher proportion of hematopoietic stem cells (Lin^-Sca-1⁺c-Kit⁺)(7.60%±1.40%) compared to the BM-MNCs (1.10%±0.46%), P<0.01; the proportion of the megakaryocyte progenitor cells (Lin^-Sca-1^-c-Kit⁺CD41⁺CD150⁺) and mature megakaryocyte cells (CD41⁺CD42b⁺), also differ significantly between the FL-MNCs (3.05%±0.22%, 1.60%±0.06%, respectively) and the BM-MNCs (0.15%±0.02%, 0.87%±0.11%, respectively) groups, both P<0.01. In vitro functional studies showed that FL-MNCs-CD41⁺megakaryocytes could produce proplatelet-like cells more quickly after induction, with proplatelet-like cells formation on day 3 and significant platelet-like particle formation on day 5, in contrast to bone marrow-derived BM-MNCs-CD41⁺megakaryocytes that failed to form proplatelet-like cell on day 5. In addition, FL-MNCs-CD41⁺cells expressed higher levels of platelet-related genes, Mpl (3.25-fold), Fog1 (3-fold), and Gata1 (1.5-fold) (P<0.05). Conclusion: Compared with the BM-MNCs group, the FL-MNCs transplantation group appears to have a more efficient platelet implantation effect in the HSCs transplantation recipient in vivo, as well as a higher platelet differentiation rate in vitro. This might be related to a higher proportion of megakaryocytes and higher expression levels of genes such as Mpl, Fog1, and Gata1 that could be important for platelet formation in FL-MNCs-CD41⁺cells. Further exploration of the specific functions of these genes and the characteristics of the different proportions of the donor cells will provide valuable clues for the future treatment of platelets reconstitution after HSCs transplantation clinically.

Effects of honeycomb extract on the growth performance, carcass traits, immunity, antioxidant function and intestinal microorganisms of yellow bantam broilers

Although many studies have already described the physiological effects of bee products, such as honey, propolis, pollen, and royal jelly, on livestock farming, the health benefits of the honeycomb are still not fully understood. The problem of drug residues and bacterial resistance caused by the abuse of antibiotics is becoming increasingly serious. For this reason, a safe, green substitute has to be sought. We conducted a comparative study of honeycomb extract (HE) and an antibiotic on growth performance, carcass traits, immunity, antioxidant function and intestinal microorganisms of yellow bantam broilers. A total of four hundred eighty 21-day-old female yellow bantam broilers were randomly divided into 5 groups of 6 replicates of 16 birds each. The 5 groups were as follows, with birds receiving a basal diet supplemented with 150 ppm (mg/kg) of chlortetracycline (CTE), a basal diet without HE (control group), and a basal diet with 0.1%, 0.15%, or 0.2% HE for 60 days. The results showed that HE addition significantly increased average daily feed intake (ADFI), average daily gain (ADG), decrease feed gain ratio (F/G) from 21 to 80 and 51 to 80 days of age compared to the control group, with all 3 HE addition groups having statistically identical values to the antibiotic group. HE implementation dramatically increased spleen index, serum immunoglobulin A (IgA), immunoglobulin M (IgM,), glutathione peroxide (GSH-Px), superoxide dismutase (SOD), total antioxidant capacity (T-AOC), and total cecum bacteria and Lactobacillus compared to the control group, numerically at the same level as, or even better than, the antibiotic group. HE and CTE both markly reduced serum malondialdehyde (MDA) concentration compared to the control group, with higher concentrations of HE reducing the effect more dramatically than antibiotics. Both HE and CTE significantly raised dressed yield compared to the control group. In summary, HE, as a potential antibiotic alternative, improved growth performance, carcass traits, immune function, serum antioxidant capacity and intestinal microorganisms in yellow bantam broilers. According to the cubic regression analyses, the recommended supplemental dose of HE was calculated to be 0.15 to 0.17% for female yellow bantam broilers between 21 and 80 d of age.

[The clinical advances of the peanut oral immunotherapy]

Food allergy is a global problem. Peanut is one of the most common food allergens that can result in anaphylaxis, even with milligram exposure. Most peanut allergies could persist lifelong. The current standard of care for peanut allergy is strict dietary avoidance and immediate treatment of allergic reaction triggered by accident exposure. Oral immunotherapy (OIT) induces an increased reactivity threshold via modulation of the immune system. In recent years, peanut OIT has been developed to protect peanut-allergic individuals against severe or life-threating allergic reaction. This review discussed the update of the mechanism, efficacy, safety and impact on quality of life of peanut OIT for peanut allergy.

[Comparison of different reconstruction procedures after distal gastrectomy in patients with gastric cancer]

Objective: To systematically compare the effect of Roux-en-Y with Billroth Ⅰ or Billroth Ⅱ in gastric cancer patients after distal gastrectomy by meta-analysis. Methods: Systematic search was conducted on the relevant electronic databases of Pubmed, Embase, Wanfang Database, CNKI and VIP from the established time to August 18, 2019. The randomized controlled trials about comparison of Roux-en-Y with Billroth Ⅰ or Billroth Ⅱ were strictly screened and analyzed by the software of Revman 5.3. Procedure and postoperative outcomes were analyzed, respectively. Results: A total of 783 relevant literatures were systematically retrieved, and 6 randomized controlled trials, including 954 patients, finally met the inclusion criteria after strict screening. The results of meta-analysis showed that operative time of Billroth Ⅰ was significantly shorter than that of Roux-en-Y (MD=-37.60, 95%CI:-50.79--24.40, P<0.001), intraoperative bleeding (MD=-21.64, 95%CI:-32.20--11.07, P<0.001) and the number of delayed gastric emptying (RR=0.52, 95%CI: 0.31-0.86, P=0.01) of Billroth Ⅰ were both significantly less than those of Roux-en-Y, while bile reflux (RR=8.17, 95%CI: 2.21-31.53, P=0.002) and residual gastritis (RR=1.75, 95%CI:1.43-2.14, P<0.000 01) of Billroth Ⅰ were both significantly higher than those of Roux-en-Y, other outcomes showed no significant difference. Compared with Roux-en-Y, operative time of Billroth Ⅱ was significantly shorter (MD=-19.73, 95%CI:-32.82--6.64, P=0.003), while bile reflux (RR=17.63, 95%CI: 4.50-69.02, P<0.001), residual gastritis (RR=1.94, 95%CI:1.15-3.26, P=0.01) and reflux esophagitis (RR=3.13, 95%CI: 1.31-7.45, P=0.01) of Billroth Ⅱ were all significantly higher, and there was no significant difference in other outcomes. Conclusion: Compared with Billroth Ⅰ and Billroth Ⅱ, the operation time of Roux-en-Y in gastric cancer patients undergoing distal gastrectomy is longer, but the incidences of bile reflux and residual gastritis are both lower, and the postoperative quality of life seems better.

Fibrogrowth factor-2 protects against acute lung injury by activating the PI3K/Akt signaling pathway

Acute lung injury (ALI)/Acute respiratory distress syndrome (ARDS) is a very dangerous disease. The purpose of this study was to investigate the effects of fibrogrowth factor-2 (FGF-2) on lipopolysaccharide (LPS)-induced lung injury and its mechanisms. C57/BL6 mice were used in the study and LPS was used to construct the ALI/ARDS model. In addition, human normal lung epithelial cell line BEAS-2B was cultured to investigate the effect of FGF-2 on the lung and its mechanism of action in vitro. FGF-2 significantly reduced wet/dry weight ratio of mice, the number of cells and inflammatory factors in BALF, and MPO activity in lung tissue. In addition, FGF-2 also reduced the level of oxidative stress in mouse lung tissue. In vitro, FGF-2 effectively reduced LPS-induced inflammatory and apoptotic levels of BEAS-2B cells and increased the activity of the PI3K/Akt signaling pathway. However, LY294002, an inhibitor of the PI3K/Akt signaling pathway, alleviated the protective effect of FGF-2 on lung tissue. Therefore, FGF-2 attenuated inflammation, oxidative stress and apoptosis in alveolar epithelial cells by activating the PI3K/Akt signaling pathway.

[Establishment and primary clinical application of metabolic evaluation database of urolithiasis]

Objective: To establish the metabolic evaluation database of urolithiasis, perform metabolic evaluation, and provide instructions for treatment and prevention of urolithiasis. Methods: This metabolic evaluation database was developed by JAVA and was established by Oracle11g database and Browser/Server framework. We extracted the clinical data of all patients who had complete information, and analyzed their risk factors of stone formation, stone-related medical history, blood and urine tests results and 24-hour urine analysis. Results: A total of 360 patients diagnosed as urolithiasis were included in this research. Male to female ratio was 1.9∶1, and the urolithiasis was first diagnosed at (35.5±13.5) years old. Family history was positive in 39.7% of patients. Metabolic syndrome occurred in 35.0% of patients. Overweight or obesity occurred in 73.2% and 50.0% of male patients, respectively. Abdominal obesity in 62.3% and 56.1% of male and female patients, respectively. Among all patients, 67.5% had high urine sodium, 53.6% had hypercalciuria, 41.1% had hypocitraturia, 29.7% had hyperuricosuria, 22.5% had hypomagnesuria, 15.8% had hyperoxaluria, 11.7% had hyperphosphoraturia, and 36.4% had low urinary volume. Conclusions: The prevalence of overweight or obesity, abdominal obesity, hypertension, diabetes, and metabolic syndrome in stone patients were significantly higher than those in general population. The number of 24-hour urinary abnormalities was positively associated with body mass index. The interventions on high urinary sodium, low urinary volume, obesity and metabolic syndrome were important to the treatment of urolithiasis. This database would facilitate the metabolic evaluation, provide evidence for the treatment and prevention of urolithiasis, and lay foundation for finding important controllable risk factors of urinary stone.

[Outcomes of patients treated with drug-coated balloons for de novo large coronary vessels]

Objective: To evaluate the efficacy and safety of drug-coated balloons (DCB) for de novo large coronary vessels. Methods: One hundred and two patients were retrospectively enrolled in this study, there were 104 lesions with the reference lumen diameter of target vessel more than 2.8 mm and patients were treated with DCB in de novo lesions during May 2015 and July 2017 in our center. Coronary artery angiography and quantitative coronary angiography were performed in 82 (80.4%) patients at follow up period ((8.1±1.7) months post procedure). The endpoints were late lumen loss (LLL) at follow up,and major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI), target lesion revascularization (TLR) and stent or target lesion thrombosis at 12 months post procedure. Results: Ninety-eight lesions were treated with DCB only, 6 (5.9%) bailout drug-eluting stent (DES) were used because of severe coronary dissection, 2 patients (2.0%) received revascularization driven by acute ischemic events during hospitalization. Cutting balloons and NSE balloons were used in 65.4% (68/104) and 26.0% (27/104) lesions. The lesion length was (12.57±3.58) mm and the DCB length was (19.87±4.55) mm. The late lumen loss was (0.01±0.52) mm during angiographic follow up. The TLR rate and overall MACE rate was 3.9% (4/102) and 3.9% (4/102) and there was no death,MI and target lesion thrombosis at 12 months follow up. Conclusion: DCB treatment for de novo large coronary vessels is effective and safe.

[Quantitative measurement of citric acid in urine using tandem liquid chromatography mass spectrometry]

Objective: To find a suitable method for the determination of citric acid in the urine of patients with stones, in order to provide a new method and basis for the prevention and treatment of stone. Methods: Liquid chromatography tandem mass spectrometry was used to analyze the citric acid in urine directly. And the accuracy, stability, repeatability and other indicators of the results were detected. Results: The results showed a good linear relationship with the concentration of citric acid in urine. y=50.31x+ 0.002 6 (R(2)=0.994 21). The results were stable, reproducible [intra-day (Coefficient of Variance) CV ≈1% and inter-day CV<10%], and the accuracy of which was comparable with that of the enzyme method (n=20, R=0.97). Conclusion: Using the method of this study to detect the content of citric acid in urine has the advantages of simple operation, good repeatability, accurate results, and low price. So it is worth to be popularized and applied in clinical practice.

[Quantitative measurement of oxalic acid in urine by liquid chromatography combined with tandem mass spectrometry]

Objective: To find a suitable method for the determination of oxalic acid in the urine of patients with stones, in order to provide a new method and basis for the prevention and treatment of stone. Methods: Liquid chromatography combined with tandem mass spectrometry was used to analyze oxalic acid in urine directly.The accuracy, stability, repeatability and other indicators of the results were tested. Results: The results showed a good linear relationship with the concentration of oxalic acid in urine. y=58.524x-15.246 (R(2)=0.979 02). The results were stable, reproducible (the intra-day and inter-day coefficient of variation was less than 10% and 15%, respectively), and the accuracy was comparable with that of the enzyme method (N=20, R=0.93). Conclusion: Using the method of this study to detect the content of oxalic acid in urine has the advantages of simple operation, good repeatability, accurate results, and low price. It is worth to be popularized and applied in clinical practice.

Apparent metabolizable and net energy values of corn and soybean meal for broiler breeding cocks

The AME and net energy (NE) values of 4 corn varieties, including 2 normal corn varieties (Zheng Dan 958 and Xian Yu 335), and one each of waxy corn and sweet corn, and 2 soybean meal samples including regular (RSBM) and dehulled soybean meal (DSBM), were determined in 2 experiments for broiler breeding cocks using the indirect calorimetry method. The 4 test diets in Experiment 1 consisted of each test corn, which replaced 40% of the corn-soybean meal basal diet, and the test diets in Experiment 2 contained 25% RSBM or DSBM, which was used to replace the corn basal diet. Thirty (Experiment 1) or 18 (Experiment 2) 50-week-old Arbor Acre (AA) broiler breeding cocks were used in a completely randomized design. After a 7 d dietary adaptation period, 6 birds as replicates from each treatment were assigned to individual respiration chambers for energy measurement via gaseous exchange and total excreta collection for 10 d. In Experiment 1, the AME, ME intake (MEI), retained energy (RE), NE, and NE:AME ratio values were higher (P < 0.001) in the test diets as compared with the corn-soybean meal basal diet. The AME and NE values in the sweet corn diet were higher (P < 0.05) than those values in the other 3 test diets. The heat production (HP), fasting heat production (FHP), and respiration quotient (RQ) were not influenced by the various experimental diets. The respective AME and NE values were 3,785, 3,775, 3,738, and 3,997 kcal/kg (DM basis), and 2,982, 3,006, 2,959, and 3,146 kcal/kg (DM basis) for Zheng Dan 958, Xian Yu 335, waxy corn, and sweet corn. Birds fed a corn basal diet in Experiment 2 had higher AME, MEI, RE, NE, and NE:AME ratio values (P < 0.001). Soybean meal substitution had no effect on HP, FHP, or RQ. The average AME and NE content was 2,492 and 1,581 kcal/kg (DM basis) for RSBM, and 2,580 and 1,654 kcal/kg (DM basis) for DSBM, respectively.

PCR-DGGE test for direct identification of intestinal bacterial flora in blood feeding ticks in China

Ticks are vectors of diseases that affect humans and animals worldwide. In current study, the intestinal bacterial flora associated with the blood feeding ticks (Haemaphysalis flava, Haemaphysalis longicornis, Rhipicephalus haemaphysaloides, Boophilus microplus and Dermacentor sinicus) were analyzed using polymerase chain reaction and denaturing gradient gel electrophoresis (PCR-DGGE) and then sequenced. The five ticks were collected from cattle, dog, hedgehog and goats in Fujian, Shandong, Henan, Jiangxi, Hunan, Shanxi and Guangxi provinces, China. Our results show that nine distinct DGGE bands were found using PCR-DGGE method. Sequences analyses indicated that they belonged to Rickettsia peacockii, Rickettsia raoultii, Rickettsia helvetica, Rickettsia slovaca, Rickettsia tarasevichiae, Coxiella sp., Erwinia sp., Klebsiella pneumoniae and Pseudomonas aeruginos. The present results indicate that zoonotic pathogens are present in ticks in many provinces of China. This useful information will aid in the epidemiology of tick-borne zoonotic diseases in China as well as in raising awareness to avoid tick bites is an important measure to prevent the infection and transmission of zoonotic pathogens.

Effects of dietary oligosaccharide supplementation on growth performance, concentrations of the major odor-causing compounds in excreta, and the cecal microflora of broilers

This study investigated the effects of dietary supplementation with 4 types of oligosaccharides on the growth performance, concentrations of the major odor-causing compounds in excreta and cecal microflora of broilers. Three hundred 21-day-old Archer Abor broilers with an average initial live weight of 702.3 g were randomly divided into 5 dietary treatments: basal diet, basal diet + 5 g/kg of mannan-oligosaccharide (MOS), basal diet + 1.2 g/kg of inulin, basal diet + 1.5 g/kg of fructo-oligosaccharide (FOS), and basal diet +1.25 g/kg of soybean oligosaccharide (SBOS), respectively. Each diet was fed to 6 replicates of 10 birds from d 21 to 42, and body weight and feed intake were recorded. Fresh excreta were sampled from each replicate on d 40, 41, and 42 and stored at -20 °C until further analysis. On d 42, the ceca of killed birds were aseptically removed, and the cecal contents were collected into sterile containers and stored at -80 °C until further analysis. Results showed that feeding inulin, FOS, and SBOS diets resulted in an improvement in daily gain (P < 0.05). Broilers fed the SBOS diet showed lower feed:gain ratio (1.84g:g) than the other groups (P > 0.05). Broilers fed the FOS diet showed the lowest volatile basic nitrogen, pH value, and indole and skatole contents in excreta, and broilers fed the SBOS diet had higher total volatile fatty acids concentrations than control (P < 0.05). The cecal microbial community was measured using the PCR-DGGE, which indicated that the cecal microflora Shannon-wiener index and richness of SBOS-fed broilers were significantly higher than that of the control (P < 0.05). The lowest evenness was recorded in the FOS group, which was significantly lower than the other groups (P < 0.05) except the SBOS group. Based on the sequences of the corresponding 16S rDNA of the DGGE bands, in combination with the contents of the major odor-causing compounds in excreta, it is suggested that uncultured Lachnospiraceae bacterium and Bacteroides sp. were associated with the production of major odor-causing compounds in excreta.

Genetic diversity analysis of Capparis spinosa L. populations by using ISSR markers

Capparis spinosa L. is an important medicinal species in the Xinjiang Province of China. Ten natural populations of C. spinosa from 3 locations in North, Central, and South Xinjiang were studied using morphological trait inter simple sequence repeat (ISSR) molecular markers to assess the genetic diversity and population structure. In this study, the 10 ISSR primers produced 313 amplified DNA fragments, with 52% of fragments being polymorphic. Unweighted pair-group method with arithmetic average (UPGMA) cluster analysis indicated that 10 C. spinosa populations were clustered into 3 geographically distinct groups. The Nei gene of C. spinosa populations in different regions had Diversity and Shannon's information index ranges of 0.1312-0.2001 and 0.1004-0.1875, respectively. The 362 markers were used to construct the dendrogram based on the UPGMA cluster analysis. The dendrogram indicated that 10 populations of C. spinosa were clustered into 3 geographically distinct groups. The results showed these genotypes have high genetic diversity, and can be used for an alternative breeding program.

Resveratrol could reverse the expression of SIRT1 and MMP-1 in vitro

Intervertebral disc degeneration is the main cause of lumbago disease, in which the extracellular matrix structure and moisture in the nucleus pulposus is lost continuously. In this study, we aimed to detect differential expression of silence mating type information regulation 2 homolog 1 (SIRT1) and matrix metalloproteinase-1 (MMP-1) in human intervertebral disc nucleus pulposus cells and to explore the effects of SIRT1 and MMP-1 on the development of the intervertebral disc degeneration. Intervertebral disc nucleus pulposus specimens from 41 patients who underwent lumbar protrusion resection at HuiZhou Municipal Central Hospital, during the period from October 2011 to December 2013, were studied in comparison with 23 control cases from patients who underwent fractured lumbar resection. In degenerated human intervertebral disc nucleus pulposus cells, the expression of SIRT1 is decreased and MMP-1 is increased compared with that of the control cells. Resveratrol could reverse these effects, thereby increasing the expression of SIRT1 (0.87 ± 0.07 vs 0.54 ± 0.04), Coll2α1 (0.90 ± 0.08 vs 0.38 ± 0.01), and aggrecan (0.69 ± 0.07 vs 0.42 ± 0.05) and decreasing the expression of MMP-1 (0.61 ± 0.03 vs 0.93 ± 0.08). These results suggest that resveratrol could possibly reverse the process of intervertebral disc degeneration and thus could be applied as a potential drug for the disease.

Repairing rabbit radial defects by combining bone marrow stroma stem cells with bone scaffold material comprising a core-cladding structure

We prepared a bone scaffold material comprising a PLGA/β-TCP core and a Type I collagen cladding, and recombined it with bone marrow stroma stem cells (BMSCs) to evaluate its potential for use in bone tissue engineering by in vivo and in vitro experiments. PLGA/β-TCP without a cladding was used for comparison. The adherence rate of the BMSCs to the scaffold was determined by cell counting. Cell proliferation rate was determined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method. The osteogenic capability was evaluated by alkaline phosphatase activity. The scaffold materials were recombined with the BMSCs and implanted into a large segmental rabbit radial defect model to evaluate defect repair. Osteogenesis was assessed in the scaffold materials by histological and double immunofluorescence labeling, etc. The adherence number, proliferation number, and alkaline phosphatase expression of the cells on the bone scaffold material with core-cladding structure were significantly higher than the corresponding values in the PLGA/β-TCP composite scaffold material (P < 0.05). An in vivo test indicated that the bone scaffold material with core-cladding structure completely degraded at the bone defect site and bone formation was completed. The rabbit large sentimental radial defect was successfully repaired. The degradation and osteogenesis rates matched well. The bone scaffold with core-cladding structure exhibited better osteogenic activity and capacity to repair a large segmental bone defect compared to the PLGA/β-TCP composite scaffold. The bone scaffold with core-cladding structure has excellent physical properties and biocompatibility. It is an ideal scaffold material for bone tissue engineering.

Effects of flavones of sea buckthorn fruits on growth performance, carcass quality, fat deposition and lipometabolism for broilers

The objective of this study was to evaluate the effects of different levels of flavones of sea buckthorn fruits (FSBF) on growth performance, carcass quality, fat deposition, and lipometabolism for broilers. 240 one-day-old Arbor Acres male broilers were randomly allotted to 4 dietary treatments (0, 0.05%, 0.10%, and 0.15% FSBF) with 6 replicates of 10 birds. Broilers were reared for 42 d. Results showed FSBF quadratically improved average daily feed intake (ADFI), average daily gain (ADG), and final body weight (BW) (P = 0.002, P = 0.019 and P = 0.018, respectively). The abdominal fat percentage in 0.05%, 0.10%, and 0.15% FSBF supplementation groups was decreased by 21.08%, 19.12%, and 19.61% with respect to the control group, respectively (P < 0.05). The intramuscular fat (IMF) content in the breast muscle of the broilers was increased by 7.21%, 23.42% and 6.30% in 0.05%, 0.10% and 0.15% FSBF groups, and that in the thigh meat was raised by 4.43%, 24.63% and 12.32%, compared with the control group, respectively (P < 0.05). FSBF had a quadratic effect on the abdominal fat percentage and IMF in the breast muscle (P < 0.05). Dietary FSBF also modified fatty acids of muscular tissues, resulting in a higher ratio of unsaturated to saturated fatty acids (P < 0.05). Supplementing FSBF in the diet greatly decreased the levels of triglyceride, cholesterol, and low-density lipoprotein cholesterol (P < 0.05). Moreover, the quadratic responses were also observed in the levels of insulin and adiponectin in serum (P = 0.020 and P = 0.037, respectively). Abdominal fat percentage was correlated negatively with insulin and positively with adiponectin (P < 0.05). IMF content in the breast and thigh muscles were correlated positively with insulin, and negatively with adiponectin (P < 0.05). A positive correlation existed between breast muscle, IMF, and leptin (P < 0.05). In conclusion, adding FSBF into the diets affected growth performance and fat deposition of broilers by regulating lipometabolism. Fat deposition and distribution of broilers were closely associated with concentrations of insulin and adiponectin. The optimal level of FSBF supplemented in diet was 0.05 to 0.10% in this study.

Rapamycin, a specific inhibitor of the target of rapamycin complex 1, disrupts intestinal barrier integrity in broiler chicks

To uncover the molecular mechanisms underlying the intestinal barrier integrity, this study determined whether the rapamycin (RAPA)-sensitive target of rapamycin complex 1 (TORC1) pathway was involved in this process. Three groups of 4-day-old male chicks were randomly subjected to one of the following treatments for 6 days: high-dose RAPA [a specific inhibitor of TORC1; an intraperitoneal injection of 1.0 mg/kg body weight (BW), once daily at 09:00 hours], low-dose RAPA (0.4 mg/kg BW) and RAPA vehicle (control). Results showed that the RAPA treatment increased mortality, while decreasing villus height (p < 0.01), claudin 1 expression, content of immunoglobulin A (IgA), extent of TORC1 phosphorylation (p < 0.05), ratio of villus height to crypt depth (p < 0.01), and population of IgA-positive B cells in intestinal mucosa, particularly for the jejunum. Some aspects of these responses were dose dependent and appeared to result from weight loss. Together, RAPA exerts the expected inhibition of small intestinal development and IgA production in birds, suggesting the important role of TORC1 in gut barrier integrity.

Dexamethasone and sodium carboxymethyl cellulose prevent postoperative intraperitoneal adhesions in rats

We aimed to evaluate the effects of the barrier agent sodium carboxymethyl cellulose (SCMC) with and without dexamethasone for the prevention of postoperative adhesion formation in a rat model of postoperative peritoneal adhesion. A total of 160 three-month old male and female Wistar rats underwent a laparotomy, and adhesions were induced by ileocecal abrasion. Rats were randomly assigned to 4 groups (n=40 each): group A, untreated; group B, treated with SCMC only; group C1, treated with SCMC + 3 mg dexamethasone, and group C2, treated with SCMC + 8 mg dexamethasone. After 12 days, adhesion formation and histopathological changes were compared. In groups A, B, C1, and C2, the mortality rates were 10, 5, 5, and 5%, respectively. In groups C1 and C2, the adhesions were filmy and easy to dissect and were milder compared with those in groups A and B. The total adhesion score in group C1 (3.38±0.49) was significantly lower than that of group B (6.01±0.57; P<0.01) or group A (8.01±0.67; P<0.05). There was no significant difference in adhesion formation between groups C1 and C2. Compared with groups A and B, groups C1 and C2 exhibited milder histopathological changes. SCMC in combination with dexamethasone can prevent adhesion formation and is a better barrier agent than SCMC alone. The safety and feasibility of SCMC in combination with dexamethasone to prevent adhesion formation after abdominal surgery warrants further clinical study.

A simple empirical model for the clarification-thickening process in wastewater treatment plants

In wastewater treatment plants (WWTPs), activated sludge is thickened in secondary settling tanks and recycled into the biological reactor to maintain enough biomass for wastewater treatment. Accurately estimating the activated sludge concentration in the lower portion of the secondary clarifiers is of great importance for evaluating and controlling the sludge recycled ratio, ensuring smooth and efficient operation of the WWTP. By dividing the overall activated sludge-thickening curve into a hindered zone and a compression zone, an empirical model describing activated sludge thickening in the compression zone was obtained by empirical regression. This empirical model was developed through experiments conducted using sludge from five WWTPs, and validated by the measured data from a sixth WWTP, which fit the model well (R² = 0.98, p < 0.001). The model requires application of only one parameter, the sludge volume index (SVI), which is readily incorporated into routine analysis. By combining this model with the conservation of mass equation, an empirical model for compression settling was also developed. Finally, the effects of denitrification and addition of a polymer were also analysed because of their effect on sludge thickening, which can be useful for WWTP operation, e.g., improving wastewater treatment or the proper use of the polymer.

Attempts to increase inosinic acid in broiler meat by using feed additives

To explore regulation of inosinic acid content in chicken meat as a result of feed additives, 576 one-day-old male Arbor Acres broilers were randomly allotted into 8 dietary treatments including control, purine nucleotide (P), betaine (B), soybean isoflavone (S), purine nucleotide + betaine (PB), purine nucleotide + soybean isoflavone (PS), betaine +soybean isoflavone (BS), and purine nucleotide + betaine + soybean isoflavone (PBS) by a 2 × 2 × 2 factorial arrangement. At d 42 of age, broilers were slaughtered, and growth performance, carcass characteristics, inosinic acid content, and activities of enzyme closely related to inosinic acid metabolism of broilers were measured. The results revealed that these feed additives did not affect ADG and ADFI of the broilers (P > 0.05). However, supplementing purine nucleotides lowered feed/gain of broilers in PS and PBS groups (P < 0.05). There was a significant interaction on feed/gain of broilers between purine nucleotides and soybean isoflavone (P < 0.05). The abdominal fat percentages in groups B, S, BS, and PBS were lower than the control group, respectively (P < 0.05). The thigh muscle percentages of groups P and B were higher than that of group PB (P < 0.05). There were certain interactions on the percentage of thigh muscle (P = 0.05) and abdominal fat (P < 0.05) between P, B, and S groups. Compared with the control group, inosinic acid content in broiler breast meat was improved by using feed additives (P < 0.05). Supplementing purine nucleotides, betaine, soybean isoflavone, and their combinations increased alkaline phosphatase activity in breast meat of broilers (P < 0.05). Purine nucleotides improved the activity of adenosine deaminase, but decreased the activity of 5'-nucleotidase. Soybean isoflavone lowered the activity of alkaline phosphatase. There were no significant interactions on activities of creatine kinase, adenosine deaminase, alkaline phosphatase, and 5'-nucleotidase between these additives (P > 0.05). The umami rating of broiler breast meat increased in conjunction with supplementing these additives. In conclusion, supplementing standard feed with the additives investigated in this study could improve inosinic acid content in chicken meat by increasing synthase activity or inhibiting degradation enzyme activity without inferior growth performance and carcass quality.

Sequence variation in the Toxoplasma gondii eIF4A gene among strains from different hosts and geographical locations

Toxoplasma gondii is an opportunistic protozoan parasite that infects a wide range of animals, including humans. The T. gondii eukaryotic translation initiation factor 4A (eIF4A) protein is expressed in the tachyzoite, but its expression is markedly downregulated in the bradyzoite, and it is therefore considered to be associated with tachyzoite virulence. The present study examined sequence variation in the eIF4A gene among nine strains of different genotypes from different hosts and geographical localities using polymerase chain reaction amplification, sequence analysis, and phylogenetic reconstruction by Bayesian inference. The complete genomic sequence of the eIF4A gene was 3156 bp in length in the strain TgCgCaI, 3153 bp in the strain MAS, 3152 bp in the strain TgPNY, and 3154 bp in the other six strains. Sequence analysis identified 29 (0-0.8%) variable nucleotide positions among all strains, with 16 of these variations located in the coding region, while the other 12 were distributed between the two introns. Phylogenetic analyses revealed that these eIF4A sequences were not effective molecular markers for intra-species phylogenetic analysis and differential identification of T. gondii strains from different hosts and geographical locations. This study demonstrated the existence of low sequence variation in the eIF4A gene, suggesting that T. gondii eIF4A may represent a suitable candidate vaccine against toxoplasmosis.

Toxoplasma gondii rhoptry protein 38 gene: sequence variation among isolates from different hosts and geographical locations

Toxoplasma gondii is an obligate intracellular parasite that is able to infect almost all mammalian species, and may lead to toxoplasmosis of the host. In the present study, we examined sequence variation in rhoptry protein 38 (ROP38) genes among T. gondii isolates collected from different hosts and geographical regions. The complete ROP38 gene from 13 T. gondii isolates was amplified and sequenced. The results of sequence alignments showed that the lengths of the entire ROP38 gene ranged from 2646 to 2650 bp, with a sequence variation of 0.2-1.1%, among the 13 T. gondii isolates. This result indicated low sequence variation in the ROP38 gene. Phylogenetic analysis of ROP38 sequences using Bayesian inference showed that the clustering of the 13 T. gondii isolates was not consistent with their respective genotypes. This result indicates that the ROP38 gene is not a suitable genetic marker for population genetic studies of different T. gondii genotypes from different hosts and geographical locations, but may represent a potential vaccine candidate against toxoplasmosis, and hence worthy of further research.

Pollen limitation and Allee effect related to population size and sex ratio in the endangered Ottelia acuminata (Hydrocharitaceae): implications for conservation and reintroduction

Small populations may suffer more severe pollen limitation and result in Allee effects. Sex ratio may also affect pollination and reproduction success in dioecious species, which is always overlooked when performing conservation and reintroduction tasks. In this study, we investigated whether and how population size and sex ratio affected pollen limitation and reproduction in the endangered Ottelia acuminata, a dioecious submerged species. We established experimental plots with increasing population size and male sex ratio. We observed insect visitation, estimated pollen limitation by hand-pollinations and counted fruit set and seed production per fruit. Fruit set and seed production decreased significantly in small populations due to pollinator scarcity and thus suffered more severe pollen limitation. Although frequently visited, female-biased larger populations also suffered severe pollen limitation due to few effective visits and insufficient pollen availability. Rising male ratio enhanced pollination service and hence reproduction. Unexpectedly, pollinator preferences did not cause reduced reproduction in male-biased populations because of high pollen availability. However, reproductive outputs showed more variability in severe male-biased populations. Our results revealed two component Allee effects in fruit set and seed production, mediated by pollen limitation in O. acuminata. Moreover, reproduction decreased significantly in larger female-biased populations, increasing the risk of an Allee effect.

Inhibition of nuclear factor-κB by an antioxidant enhances paclitaxel sensitivity in ovarian carcinoma cell line

The objective of this study was to determine whether paclitaxel and a strong antioxidant, pyrrolidinedithiocarbamate (PDTC), can affect the activation of nuclear factor-kappa B (NF-kappaB) in SKOV-3 human ovarian cancer cell line and the effect of these two agents on the growth and apoptosis of the cancer cells. The cells were treated with various concentrations of paclitaxel and/or PDTC at various time intervals. Following treatments, cell growth and apoptosis were determined by 2-(2-methoxy-4-nitrophenyl)-3-(4-nitrophenyl)-5-(2,4-disulphonyl)-2H-tetrazolium (WST-8) (WST) assay and flow cytometry, respectively. Western blot assay was used to determine the nuclear p65 protein and cytoplasmic IkappaB-alpha protein. High doses of PDTC significantly inhibited the growth of SKOV-3 cells and caused apoptosis. Paclitaxel and lower doses of PDTC combined demonstrated additive inhibition of cell growth and increased levels of apoptosis. Treatment of paclitaxel alone showed increased nuclear p65 protein and decreased cytoplasmic IkappaB-alpha protein expression, while pretreatment of PDTC reversed this function. PDTC blocks the paclitaxel-induced activation of NF-kappaB leading to increased chemosensitivity to paclitaxel and enhanced apoptosis. Combining antioxidants and paclitaxel has significant potential to overcome the risk of paclitaxel resistance.

Allergy practice worldwide: a report by the World Allergy Organization Specialty and Training Council

In 2004 the World Allergy Organization's Specialty and Training Council conducted a survey of World Allergy Organization (WAO) member societies to obtain information about the status of the specialty of allergy worldwide. Responses were received from 33 countries, representing a population of 1.39 billion people, of whom it was estimated that 22% may suffer from some form of allergic disease. Allergy was reported by 23 respondents to be a certified or accredited specialty in their country, and the number of certified allergists per head of population ranged from 1:25 million to 1:16,000. Allergists were ranked as the fifth most likely clinicians to see cases of allergic asthma, third most likely to see allergic rhinitis, and fourth most likely to see eczema or sinusitis. Nine countries only reported that children with allergic diseases would be seen by a pediatrician with appropriate training. The survey results highlight a pressing need for the development of allergy services worldwide.

[Significance and application of nuclear matrix protein 22 in detecting bladder cancer]

OBJECTIVE

To investigate the significance of nuclear matrix protein 22 (NMP22) in the detection of bladder cancer.

METHODS

The level of NMP22 was measured in the urine of 90 patients (40 patients with bladder cancer and 50 patients with non-bladder cancer) by ELISA and compared with urinic cytology (UC).

RESULTS

The level of NMP22 in bladder cancer group was significantly higher than that of control group, and it was not influenced by hematuria. The sensitivity of NMP22 was high, but the specificity was lower than that of UC.

CONCLUSION

NMP22 can be used to screen and follow up bladder cancer with high sensitivity.

[Early operation with anterior screw-plate system for cervical spine fracture and dislocation]

OBJECTIVE

To evaluate the function of the cervical spine anterior screw-plate system in the early operation of cervical spine fracture and dislocation.

METHODS

One hundred and fifteen patients with fracture and dislocation of lower cervical spine treated by cervical anterior decompression, reduction, iliac crest autograft, fixed with cervical anterior locking plate (AO, spine-tech, Orion).

RESULTS

All the cases were free from complication except one patient was complicated with infection of the surgical wound and another one with a transient dysfunction of recurrent laryngeal nerve. Symptom of patients were significantly improved in postoperation and no hardware failure.

CONCLUSIONS

Early anterior decompression operation for cervical fracture and dislocation can achieve satisfactory clinical outcomes, anterior cervical vertebral screw-plate system is safety, simplicity, rigidity and can provide good conditions for early anterior cervical spine operation.

Monitoring percent free PSA in serial specimens: improvement of test specificity, early detection, and identification of occult tumors

We have measured the serum concentration of prostate specific antigen (tPSA) and determined the percent free PSA (% fPSA) in serial specimens from 64 patients with prostate cancer, 35 patients with benign prostate hyperplasia (BPH), and 3 patients with prostitis. We found that the % fPSAs were not a constant for individual patients during the course of the disease. When we compared only the % fPSA of the first specimen of serial specimens from individual patients, who were largely untreated, 37% of BPH specimens were above 22%, whereas only 1.6% cancer samples were above that value. We also found that 67% of cancer specimens and 14% of BPH samples were below 8%, respectively. Although % fPSA distribution pattern remained similar between two types of specimens, less differentiation was found between BPH and prostate cancer in random specimens compared to the study using first specimens of an individual patient's serial samples. Percent fPSA apparently are affected by treatment. However, the most important benefit for the determination of % fPSA appears to be the sensitivity of % fPSA to identify occult tumors when the tPSAs were in the normal concentration range. Determination of % fPSA also seems to improve the specificity of tPSA, not only during screening for the differentiation between BPH and prostate cancer, but also during monitoring of treatment and recurrence.

Serum chromogranin A: early detection of hormonal resistance in prostate cancer patients

We monitored both chromogranin A (CgA) and neuron specific enolase (NSE) in serial serum specimens from 14 patients with prostate cancer (CAP patients) showing resistance to hormonal treatment. Elevated serum CgA was detected in 10 out of these 14 patients (71%) during treatment, and an early appearance of elevated serum CgA was found in 6 of 14 (43%) of these patients when serum tPSA levels were still in the normal range. If patients with radical prostatectomy were not included, the percentage of patients showing an early appearance of elevated serum CgA would have been much higher. Elevated serum CgA levels also were found in patients not subject to hormonal therapy. Serial specimens from two out of three prostate cancer patients, randomly selected, contained elevated serum CgA. Serum NSE was not detectable in any of the serial specimens we studied, suggesting that CgA, not NSE, should be used as a marker for neuroendocrine differentiation. We also compared the serum CgA in random serum specimens between patients with BPH (benign prostate hyperplasia) and with prostate cancer in the concentration range of serum tPSA between 3-15 ng/mL. Although serum CgA concentrations in BPH patients overlapped considerably with those levels in patients with prostate cancer, levels > 100 ng/mL should suggest prostate cancer. The early appearance of elevated serum CgA allows an early change of therapy to be made and can lead to the effective prevention of any further development of metastases.

Production of milligram concentrations of free prostate specific antigen (fPSA) from LNCaP cell culture: difference between fPSA from LNCaP cell and seminal plasma

We have established a procedure for the production of milligrams of free PSA (fPSA) from LNCaP cells derived from a human carcinoma of the prostate. By growing LNCaP cells in a serum-free medium in the presence of a synthetic androgen (R1881) and taking advantage of the special design of the Micro-mouse Hollow Fiber Bioreactor, relatively pure fPSA could be obtained. We found that columns containing either Sephacryl S-100 or S-200 could be used to remove the small amount of bovine serum albumin (BSA) and PSA-alpha 1-antichymotrypsin complex (PSA-ACT) from the preparation. More than 90% of the PSA from LNCaP cell cultures are fPSA. Like fPSA from seminal plasma, two fractions of fPSA differing in protease activity can be separated by DEAE-Sepharose chromatography. Based on the band pattern exhibited on the Western blot following sodium dodecyl sulfate-polyacrylamide electrophoresis separation, fPSA from LNCaP contains more inactive PSA isoforms. This was confirmed by chromatofocusing: the isoelectric point (pl) of the major PSA isoforms from the LNCaP cell culture were higher (6.8 and 6.6) than that (6.4 and 6.1) of fPSA from seminal fluid. We conclude that the LNCaP cell culture is a reliable source for obtaining large quantities of pure fPSA both for the preparation of assay calibrators and controls and for studying the difference in fPSA between benign prostate disease and prostate cancer.

Impact of assay parameters on the accuracy of free PSA test: source and stability of calibrator, calibration curve fitting, and level of total PSA in the serum

The measurement of PSA is recommended for men over 50 years of age for screening of prostate cancer. However, proper differentiation of prostate cancer from benign prostate hyperplasia (BPH) relies on an accurate measurement of free PSA (fPSA) and a correct calculation of percent fPSA. Because of the extremely low concentration of fPSA in the serum, any slight deviation from its true value may produce large errors in percent fPSA calculated. Therefore, we undertook a study examining carefully those parameters of the fPSA assay which might affect the fPSA determination. We found that the integrity of the calibrator, the computer curve-fitting program selected, the source of the calibrator, and the total PSA or fPSA + PSA complexes (tPSA) concentration of the specimen all had an impact on the accuracy of the fPSA value assayed. We found that an examination of the slope of the calibration curve was important to reveal whether the calibrator had or had not been denatured during storage. We also found that the 4-parameter cure fitting program was best suited for plotting the fPSA calibration curve. The calibrator we isolated from LNCaP cells was acceptable for our assay because it had an affinity for the assay antibody very similar to that of serum fPSA. We also determined the effect of tPSA concentration on the fPSA determinations and found that within the concentration range of 4-10 ng/mL the impact on the percent fPSA calculated was not significant. We believe that our assay produces accurate fPSA values when all these assay parameters are well controlled.

Development of an immunoassay specific for the PSA-ACT complex without the problem of high background

We have developed an assay specific for the PSA-ACT (PSA-alpha 1-antichymotrypsin) complex that effectively diminishes the problem of high assay background commonly reported by other investigators. The assay follows a two-site ELISA format. Polyclonal anti-PSA antibodies were coated on the microplate to capture the PSA complex from the serum, whereas the biotinylated anti-ACT polyclonal antibodies and HRP-conjugated streptavidin were used for detection. The high background ordinarily associated with this assay was greatly reduced when milk casein was added in addition to albumin for blocking and when the Super Block was also included in the diluents for sample dilution and dilution of enzyme conjugated detecting antibodies. The assay has a sensitivity of 0.05 ng/mL. The within-run precision ranges from 4.2-7.2% and the between-run precision falls between 5.8-8.5%. Cross reactions with ACT and free PSA (fPSA) are 0.0001% and 0.02%, respectively. The highest concentration of PSA-ACT complex in the maternal sera was < 0.4 ng/mL by this assay, much less than reported in the literature. Using this improved assay, the sum of fPSA and PSA-ACT concentrations were less than that of their corresponding total PSA (tPSA) most of the time. We believe that this improved assay should be used to replace the current tPSA assay for screening, monitoring, and managing patients with prostate cancer.

Serum chromogranin A: early detection of hormonal resistance in prostate cancer patients

We monitored both chromogranin A (CgA) and neuron specific enolase (NSE) in serial serum specimens from 14 patients with prostate cancer (CAP patients) showing resistance to hormonal treatment. Elevated serum CgA was detected in 10 out of these 14 patients (71%) during treatment, and an early appearance of elevated serum CgA was found in 6 of 14 (43%) of these patients when serum tPSA levels were still in the normal range. If patients with radical prostatectomy were not included, the percentage of patients showing an early appearance of elevated serum CgA would have been much higher. Elevated serum CgA levels also were found in patients not subject to hormonal therapy. Serial specimens from two out of three prostate cancer patients, randomly selected, contained elevated serum CgA. Serum NSE was not detectable in any of the serial specimens we studied, suggesting that CgA, not NSE, should be used as a marker for neuroendocrine differentiation. We also compared the serum CgA in random serum specimens between patients with BPH (benign prostate hyperplasia) and with prostate cancer in the concentration range of serum tPSA between 3-15 ng/mL. Although serum CgA concentrations in BPH patients overlapped considerably with those levels in patients with prostate cancer, levels > 100 ng/mL should suggest prostate cancer. The early appearance of elevated serum CgA allows an early change of therapy to be made and can lead to the effective prevention of any further development of metastases.

Monitoring percent free PSA in serial specimens: improvement of test specificity, early detection, and identification of occult tumors

We have measured the serum concentration of prostate specific antigen (tPSA) and determined the percent free PSA (% fPSA) in serial specimens from 64 patients with prostate cancer, 35 patients with benign prostate hyperplasia (BPH), and 3 patients with prostitis. We found that the % fPSAs were not a constant for individual patients during the course of the disease. When we compared only the % fPSA of the first specimen of serial specimens from individual patients, who were largely untreated, 37% of BPH specimens were above 22%, whereas only 1.6% cancer samples were above that value. We also found that 67% of cancer specimens and 14% of BPH samples were below 8%, respectively. Although % fPSA distribution pattern remained similar between two types of specimens, less differentiation was found between BPH and prostate cancer in random specimens compared to the study using first specimens of an individual patient's serial samples. Percent fPSA apparently are affected by treatment. However, the most important benefit for the determination of % fPSA appears to be the sensitivity of % fPSA to identify occult tumors when the tPSAs were in the normal concentration range. Determination of % fPSA also seems to improve the specificity of tPSA, not only during screening for the differentiation between BPH and prostate cancer, but also during monitoring of treatment and recurrence.

Advantages of replacing the total PSA assay with the assay for PSA-alpha 1-antichymotrypsin complex for the screening and management of prostate cancer

Several advantages become immediately apparent when the prostate specific antigen (PSA, or tPSA) assay is replaced by the assay specific for the serum PSA-alpha 1-antichymotrypsin (PSA-ACT) complex. For instance, random contributions to the tPSA value by various serum minor PSA isoforms can be avoided, making possible the determination of a more accurate relation of the PSA-ACT concentration to the tumor activity. Discrepancies in percent free PSA (% fPSA) values from the same specimens due to the use of different commercial kits also can be eliminated, mainly because the PSA-ACT assay does not have the problems in antibody selection and calibrator preparation usually associated with the tPSA assay. We found that at the present time different cutoffs of % fPSA for the differentiation of BPH from prostate cancer must be established for each individual tPSA assay. Cutoffs established using values from one tPSA assay should not be used for making clinical decisions when their tPSA values are determined by a different kit. Moreover, when we monitored the patients during treatment with serum tPSA, specific fPSA, and specific PSA-ACT complex assays simultaneously, it was clear that any interpretation of the patient's clinical status based on tPSA values alone could be misleading. Because there is less PSA-ACT complex in BPH specimens relative to that found in cancer serum samples, expressing fPSA as "fPSA/PSA-ACT x 100" and measuring PSA-ACT complex concentrations instead of tPSA during screening improve the measurable contrast between BPH and prostate cancer. Although individually modest, collectively these advantages can add up to considerable improvements.

[Three-dimensional computed tomography in the diagnosis of diseases of jaw bone(report of 22 cases).]

3DCT reconstruction,as a new roentnogenographic technique,has not been yet used so much in Oral Maxillofacial Surgery in our country.Scine early 1993,22 cases of 3DCT reconstruction have been performed on a Siemens Plus-s CT scanner for the diagnosis and surgical planning of jaw bone disease and injuries.It demonstrated that 3DCT reconstruction is a useful technique for the diagnosis and surgical planning of jaw bone disease.

Biomechanical assessment of below-knee residual limb tissue

In vivo indentation properties of the residual limb tissues of a group of senior subjects with below-knee (BK) amputation were measured and compared with those of nondisabled young adults. It was found that differences attributable to site variations, states of muscular activity, and the differences between the nondisabled young group and the group consisting of the seniors with amputation were all noted to be highly significant statistically. However, paired comparison between the residual limb and the sound contralateral limb of the senior group showed no significant difference. Residual limb properties measured right before the first prosthetic measurements and fittings and those measured at the first outpatient follow-up were found to be slightly different.