Porphyrin-anthracene covalent organic frameworks for sustainable photosterilization

Covalent organic frameworks (COFs) have promising applications in enhanced phototherapy. However, COFs that can sustainably play a role in phototherapy without continuous irradiation are extremely scarce. Herein, we report the fabrication of porphyrin-anthracene multifunctional COFs (Por-DPA) for sustainable photosterilization and bacterial-infected wound healing. A porphyrin photosensitizer, as one of the monomers, was used to provide photothermal and photodynamic activities under irradiation. An anthracene derivative, a good chemical source of singlet oxygen (1O2), was selected as another monomer to capture 1O2 and release it continuously via cycloreversion in the dark. The prepared Por-DPA COF prevents the self-aggregation quenching of the photosensitizer and thermal damage caused by continuous exposure to external light sources. Besides, Por-DPA exhibits good photothermal conversion performance and efficient 1O2 production capacity through dual pathways of photosensitization and cycloreversion. The developed sustainable photosterilization platform not only has good bactericidal effects on Escherichia coli and Staphylococcus aureus, but also promotes wound healing without obvious side effects, and is expected to be a novel efficient bactericide.

[To compare the efficacy and incidence of severe hematological adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia]

Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.

[Methods for controlling and evaluating residual confounding in the association analysis of observational study with a multicenter database]

The observational research based on big data in healthcare has attracted increasing attention, with the control and evaluation of residual confounding being the critical issue that needs to be solved urgently. This review summarized the methods for statistical adjustment and sensitivity analysis of residual confounding in the association analysis with a multicenter database. Based on individual-level data, the residual confounding can be adjusted in each subcenter using methods such as regression discontinuity design, while the pooled estimate can be obtained as a weighted average. Based on the center-level results, the Bayesian Meta-analysis method can adjust the pooled estimates. The sensitivity analysis of residual confounding can also be carried out using center-level data to calculate the E-value, p^(q), T^(r, q) and G^r,q. The abovementioned methods should be selected reasonably according to the requirements for practical applications, advantages, and disadvantages. For example, the use of subcenter individual data for residual confounding adjustment usually needs strict study design and frequent coordination; the Bayesian Meta-analysis is based on some strong assumptions; the interpretation of the results in the sensitivity analysis, such as E-value requires professional judgment to assess the risk of residual confounding. Therefore, the methods for controlling and evaluating residual confounding in association analysis based on multicenter databases still need further development and improvement.

Exogenous interference and autofluorescence-free ratiometric aptasensor for detection of OTA based on dual-colored persistent luminescence nanoparticles

Accurate and sensitive detection of ochratoxin A (OTA) is highly necessary due to its high carcinogenicity, teratogenicity and mutagenicity. Herein, we reported an exogenous interference and autofluorescence-free ratiometric aptasensor based on dual-colored persistent luminescent nanoparticles for precise detection of OTA. Green-emitting ZnGeO:Mn bonded with OTA aptamer and BHQ1-modified complementary base was acted as detection and specific recognition probe (ZGM@BHQ1). Quaternary ammonium modified ZnGaGeO:Cr with red emission was employed as reference probe and further bonded to ZGM@BHQ1 through electrostatic interaction to construct the ratiometric aptasensor. The developed ratiometric aptasensor was free from real-time excitation, external interference and autofluorescence and gave low detection limit of 3.4 pg mL^-1, wide linearity in the range of 0.01-50 ng mL^-1 and high precision of 3.1 % (11 replicate determinations, at 1 ng mL^-1 level). The applicability of the aptasensor was successfully demonstrated by analyzing OTA in in grain samples with recoveries of 97.6 %-105.2 %.

[Metal artifact reduction and clinical verification in oral and maxillofacial region based on deep learning]

Objective: To construct a kind of neural network for eliminating the metal artifacts in CT images by training the generative adversarial networks (GAN) model, so as to provide reference for clinical practice. Methods: The CT data of patients treated in the Department of Radiology, West China Hospital of Stomatology, Sichuan University from January 2017 to June 2022 were collected. A total of 1 000 cases of artifact-free CT data and 620 cases of metal artifact CT data were obtained, including 5 types of metal restorative materials, namely, fillings, crowns, titanium plates and screws, orthodontic brackets and metal foreign bodies. Four hundred metal artifact CT data and 1 000 artifact-free CT data were utilized for simulation synthesis, and 1 000 pairs of simulated artifacts and metal images and simulated metal images (200 pairs of each type) were constructed. Under the condition that the data of the five metal artifacts were equal, the entire data set was randomly (computer random) divided into a training set (800 pairs) and a test set (200 pairs). The former was used to train the GAN model, and the latter was used to evaluate the performance of the GAN model. The test set was evaluated quantitatively and the quantitative indexes were root-mean-square error (RMSE) and structural similarity index measure (SSIM). The trained GAN model was employed to eliminate the metal artifacts from the CT data of the remaining 220 clinical cases of metal artifact CT data, and the elimination results were evaluated by two senior attending doctors using the modified LiKert scale. Results: The RMSE values for artifact elimination of fillings, crowns, titanium plates and screws, orthodontic brackets and metal foreign bodies in test set were 0.018±0.004, 0.023±0.007, 0.015±0.003, 0.019±0.004, 0.024±0.008, respectively (F=1.29, P=0.274). The SSIM values were 0.963±0.023, 0.961±0.023, 0.965±0.013, 0.958±0.022, 0.957±0.026, respectively (F=2.22, P=0.069). The intra-group correlation coefficient of 2 evaluators was 0.972. For 220 clinical cases, the overall score of the modified LiKert scale was (3.73±1.13), indicating a satisfactory performance. The scores of modified LiKert scale for fillings, crowns, titanium plates and screws, orthodontic brackets and metal foreign bodies were (3.68±1.13), (3.67±1.16), (3.97±1.03), (3.83±1.14), (3.33±1.12), respectively (F=1.44, P=0.145). Conclusions: The metal artifact reduction GAN model constructed in this study can effectively remove the interference of metal artifacts and improve the image quality.

Acrylate-functionalized porphyrin-covalent organic framework for bacterial-targeted and reaction-enhanced synergistic phototherapy/chemotherapy toward sterilization and wound healing

Porphyrinic covalent organic frameworks (COFs) have emerged as prospective materials in photodynamic and photothermal sterilization. However, it is still a great challenge to construct an efficient COF-based sterilizing agent with good photothermal and photodynamic properties and bacterial targeting ability. Herein, we report a multifunctional porphyrin-COF for bacterial-targeted and reaction-enhanced synergistic phototherapy/chemotherapy for sterilization and wound healing. The ordered crystal structure of the porphyrin-COF not only effectively avoids the self-aggregation-induced quenching of the porphyrin monomer, but also facilitates the storage and transport of singlet oxygen. The acrylate substituent in the other monomer serves as a bacterial targeting moiety and the in situ reaction site with the sulfhydryl group of the bacterial surface protein via a Michael addition reaction, thus fixing the bacteria on the surface of COF and making them lose the colonization ability. Furthermore, the bonding of COF and bacteria further amplifies the therapeutic efficiency of phototherapy. Therefore, the developed multifunctional sterilization platform not only provides a new strategy for the design of novel bactericidal materials but also broadens the biological applications of COF-based materials.

[Virtual reconstruction and clinical verification of maxillary defect based on deep learning]

Objective: To construct a virtual reconstruction method including midspan maxillary defects and provide clinical reference by training a generative adversarial network (GAN) model. Methods: The CT data of middle-aged Han patients with oral diseases who visited the Department of Radiology, West China Hospital of Stomatology, Sichuan University from June 2015 to June 2022 were collected, where the CT data of 100 healthy maxilla and 15 maxillary defects (5 simple unilateral defects, 5 unilateral defects involving zygomatic bone, 5 midspan defects) were selected. Mimics was used to create spherical phantom and simulate bone defects around the healthy maxillas, including simple unilateral defects, unilateral defects involving zygomatic bone and midspan defects. The original image was set as the correct reference for the reconstruction: artificial defects paired with the correct reference were divided into training set (n=70), validation set (n=20) and test set (n=10), where the first two were used to train the GAN model, and the test set was used to evaluate the GAN performance. Data from 15 clinical defects were imported into the trained GAN model for reconstruction, with mirroring and GAN-based virtual reconstruction for unilateral clinical defects, and only the latter method was adopted for midspan defects. The reconstruction results were divided into mirror reconstruction group (n=10), unilateral defect GAN reconstruction group (n=10) and midspan defect GAN reconstruction group (n=5). The test set, mirror reconstruction group, and unilateral defect GAN reconstruction group were quantitatively evaluated, whose quantitative indicators were Dice similarity coefficient (DSC) and 95% Hausdorff distance (HD95), and the group results were subjected to one-way ANOVA and Tukey test. The test set, mirror reconstruction group, unilateral defect GAN reconstruction group and midspan defect GAN reconstruction group were qualitatively scored, and Kruskal-Wallis test and Bonferroni correction were used for the total score of each group. Results: The total differences in the test set, mirror reconstruction group, unilateral defect GAN reconstruction group DCS (0.891±0.049, 0.721±0.047, 0.778±0.057, respectively) and HD95 [(3.58±1.51), (5.19±1.38), (4.51±1.10) mm, respectively] were statistically significant (F=28.08, P<0.001; F=3.62, P=0.041); among them, the test set DSC was significantly larger than the mirror reconstruction group (P<0.05), and the test set HD95 was significantly less than the mirror reconstruction group (P<0.05). Overall difference in qualitative total scores [8 (1), 6 (2), 6 (2), and 4 (2) points, respectively] in the test set, mirror reconstruction group, unilateral defect GAN reconstruction group, and midspan defect GAN reconstruction group were statistical significance (H=18.13, P<0.001); pairwise comparison showed that the total score of the test set was significantly higher than that of the mirror reconstruction group (P<0.05). Conclusions: The virtual reconstruction method based on GAN proposed in this study has better virtual reconstruction effect of unilateral defect than mirror technique, and can also realize virtual reconstruction of maxillary midspan defect.

[Application value of combined deep inhalation and breath-hold technique guided by four-dimensional CT in preoperative localization of solitary pulmonary nodules]

Objective: To explore the clinical value of four dimensional computed tomography (4 D CT) guided combined with deep inhalation and breath hold (DIBH) technique in the preoperative localization of solitary pulmonary nodules. Methods: The data of a total of 106 patients with solitary pulmonary nodules from March 2018 to May 2021 in the Ningbo First Hospital were collected retrospectively. Among them, there were 26 males and 80 females aged from 21 to 83 (47.4±14.2) years. According to different localization methods, 53 cases were divided into the control group, as the pulmonary nodules were located by CT guided injection of indocyanine green under calm breathing and 53 cases were divided into in the experimental group, as those patients were treated with indocyanine green injection under the guidance of 4 D CT combined with DIBH technology to locate pulmonary nodules. The three-dimensional distance deviation between pulmonary nodules and indocyanine green injection points was compared between the two groups to obtain the accuracy of pulmonary nodule localization. The preoperative positioning time of the two groups was compared by timing. Results: Among the 106 patients, there were 46 pure ground glass nodules, 32 sub solid nodules and 28 solid nodules, all of which were successfully localized before operation, with a success rate of 100%. The size of pulmonary nodules in the control group was (9.1±2.3) mm and the three-dimensional deviation[M(Q₁, Q₃)]between indocyanine green injection site and pulmonary nodules was X axis [7.0 (3.7, 12.6)] mm, Y axis [6.6 (2.9, 11.2)] mm, Z axis [3.0 (2.0, 6.0)]mm, respectively, and the preoperative positioning time was (11.4±3.8) min. The size of pulmonary nodules in the experimental group was (8.9±2.1) mm, and the deviations in 3 D direction were X axis [4.8 (3.0, 7.9)]mm, Y axis [3.8 (1.3, 7.5)]mm, Z axis [4.0 (2.0, 6.0)] mm, respectively. The preoperative positioning time was (9.3±3.0) min. There were statistically significant differences in preoperative positioning time and deviation of X and Y axis between the experimental group and the control group (P<0.05), but no statistically significant differences was found in deviation of Z axis (P>0.05). Conclusion: 4 D CT guided DIBH technology could improve the accuracy of preoperative localization of pulmonary nodules and save operation time, which is worthy of popularization.

The effect of androgen on wool follicles and keratin production in Hetian sheep

To investigate the optimal androgen concentration for culturing Hetian sheep wool follicle and to detect effects of androgen concentration on wool follicle cell proliferation and apoptosis using immunofluorescence labeling and real-time quantitative fluorescence determinations of wool keratin-associated protein gene expression levels. Wool follicles were isolated by microdissection and wool follicles and skin pieces were cultured in various concentrations of dihydrotestosterone (DHT) in culture medium. Next, daily lengthwise growth measurements of wool follicles were obtained using a microscopic micrometer. Cultured Hetian wool follicles were stained using the SACPIC method to reveal wool follicle structure, while sheep skin slices were used to observe cell proliferation by immunostaining and cell apoptosis using the TUNEL method. At the molecular biological level, keratin-associated protein (Kap) gene expression was studied using wool follicles cultured for various numbers of days in vitro. Effects of androgen concentrations on Hetian wool follicle growth and development were experimentally studied. EdU proliferation assays revealed that androgen promoted cell proliferation within wool follicle dermal papillae. TUNEL apoptosis detection demonstrated that androgen treatment could delay cell apoptosis. Quantitative reverse transcription polymerase chain reaction (qPCR) results demonstrated that gene expression level patterns of Hetian mountain sheep super-high sulfur protein. Kap1.1, KIF1.2, Kap2.12 and Kap4.2 gene expression level of the mountainous experimental group was significantly higher than plains Hetian sheep. An androgen concentration of 100 nM can promote the growth of Hetian wool follicle cells in vitro, resulting in overexpression of some genes of the Kap family.

[A comparison of clinical characteristics between patients with and without"recurrence"RNA positive with COVID-19]

Objective: To analysis the clinical characteristics of"recurrence"RNA positive patients with Coronavirus disease 2019 （COVID-19） and compared with those without"recurrence". Methods: 98 patients with COVID-19 in Wuhan Jinyintan Hospital and designated treatment hospitals in Quanzhou were included in this study from February 2020 to April 2020. There were 55 males and 43 females， aged from15 to 83 years， with a median age of 57.5 years， in which 20 cases were complicated with basic diseases. 15 of these patients had been diagnosed and hospitalized had been found as"recurrence"2019-nCoV RNA positive after discharge while the other 83 cases were all negative. The clinical classification of all patients was common type. Clinical data of the COVID-19 RNA"recurrence"patients were collected， and general situations， symptoms， laboratory examinations and CT images were also observed and analyzed. The patients were divided into 2019-nCoV"recurrent"group and 2019-nCoV"non-recurrent"group. There are 10 males and 5 females in 2019-nCoV"recurrent"group while 45 males and 38 females in"non-recurrent"group （χ²=0.800，P=0.371）. The age of 2019-nCoV"recurrent"group （57±21） was higher than that of"non-recurrent"group（53±17）. 8 of 15 the COVID-19"recurrent"group patients and 12 of 83"non-recurrent"patients have basic diseases. IgG and IgM of 2019-nCoV， IL-6， procalcitonin， ESR， CRP， BNP and other serum biochemical index levels were measured and compared between groups. Results: （1） The proportion of patients with common type of COVID-19 was 15.3% during 2-week medical observation after discharge. （2） All of the 2019-nCoV"recurrent"patients were hospitalized due to COVID-19 RNA positive， when they were quarantined after discharged from hospital. All the patients with mild symptoms which were clarified as common type， including 5 cases of fever， 6 cases of cough， 5 cases of expectoration， and 2 cases of slight shortness of breath. The time of symptoms appeared on （5.73±2.82） days after discharge. （3） The serum procalcitonin of all 2019-nCoV"recurrent"group patients were normal（all<0.05 ng/ml）. The BNP of"recurrent"group （151±171） ng/L， was higher than that of"non-recurrent"group （63±78） ng/L （t = 3.207， P = 0.000）. There was no significant difference in laboratory tests like leukocyte ［（6.17±2.4） and （6.04±2.41）×10⁹/L］， lymphocyte［（1.59±0.52） and （1.32±0.64）×10⁹/L］， CRP ［（12.54±28.20） and （21.74±25.63）mg/L］， ESR ［（31.07±28.72） and （34.10±22.16）mm/1 h］， AST ［（24.73±9.15） and （30.24±23.20）U/L］， ALT ［（22.60±12.82） and （36.47±34.12）U/L）， LDH ［（268±208） and （270±164）U/L］， D-dimer ［（0.60±0.50） and （0.84±0.98）μg/L］， ferritin ［（294±195） and （395±319）μg/L］， IL-6 ［（9.17±6.42） and （14.28±17.74）ng/L］ and BUN （5.77±2.66） and （4.74±2.81）U/L］ between"recurrent"and"non-recurrent"groups （all P>0.05）. （4） In"recurrent"group， ground glass， exudative or solid lesions could be found in most of the chest CT performed on re-admission. Meanwhile， fibrosis lesion was relatively rare. （5） There were no secondary transmissions were found to be caused by the 2019-nCoV"recurrent"group patients. Conclusions: Most of the 2019-nCoV patients had underlying diseases and active lesions were still found in CT images， so the possibility of virus replication may still exist. All"recurrent"patients had mild illness which may suggest that they were in recovery stage, and no evidence of transmission is found.

[Long-term oncological outcomes of laparoscopic versus abdominal surgery in stage Ⅰa1 （LVSI+）-Ⅰb1 cervical cancer patients with different tumor size: a big database in China]

Objective: To compare the long-term oncological outcomes between laparoscopic and abdominal surgery in stage Ⅰa1 （lymph-vascular space invasion-positive, LVSI⁺）- Ⅰb1 cervical cancer patients with different tumor sizes. Methods: Based on the Big Database of Clinical Diagnosis and Treatment of Cervical Cancer in China (1538 project database), patients with stage Ⅰa1 （LVSI⁺）-Ⅰb1 cervical cancer who treated by laparoscopic or abdominal surgery were included. The 5-year overall survival (OS) and 5-year disease-free survival (DFS) between the two surgical approaches were compared under 1∶1 propensity score matching (PSM) in different tumor diameter stratification. Results: (1) A total of 4 891 patients with stage Ⅰa1 （LVSI⁺）-Ⅰb1 cervical cancer who underwent laparoscopy or laparotomy from January 1, 2009 to December 31, 2016 were included in the 1538 project database. Among them, 1 926 cases in the laparoscopic group and 2 965 cases in the abdominal group. There were no difference in 5-year OS and 5-year DFS between the two groups before matching. Cox multivariate analysis suggested that laparoscopic surgery was associated with lower 5-year DFS (HR=1.367, 95%CI: 1.105-1.690, P=0.004). After 1∶1 PSM matching, 1 864 patients were included in each group, and there was no difference in 5-year OS between the two groups （94.1% vs 95.4%, P=0.151）. While, the inferior 5-year DFS was observed in the laparoscopic group (89.0% vs 92.3%, P=0.004). And the laparoscopic surgery was associated with lower 5-year DFS (HR=1.420, 95%CI: 1.109-1.818, P=0.006). (2) In stratification analysis of different tumor sizes, and there were no difference in 5-year OS and 5-year DFS between the laparoscopic group and abdominal group in tumor size ≤1 cm, >1-2 cm and >2-3 cm stratification (all P>0.05). Cox multivariate analysis showed that laparoscopic surgery were not related to 5-year OS and 5-year DFS (P>0.05). In the stratification of tumor size >3-4 cm, there was no difference in 5-year OS between the two groups (P>0.05). The 5-year DFS in the laparoscopic group was worse than that in the abdominal group (75.7% vs 85.8%, P=0.025). Cox multivariate analysis suggested that laparoscopic surgery was associated with lower 5-year DFS (HR=1.705, 95%CI: 1.088-2.674, P=0.020). Conclusions: For patients with stage Ⅰa1 （LVSI⁺）-Ⅰb1 cervical cancer, laparoscopic surgery is associated with lower 5-year DFS, and the adverse effect of laparoscopic surgery on oncology prognosis is mainly reflected in patients with tumor size >3-4 cm. For patients with tumor sizes ≤1 cm, >1-2 cm and >2-3 cm, there are no difference in oncological prognosis between the two surgical approaches.

[Research progress on abnormal liver function in pregnancy]

Abnormal liver function in pregnancy is a common clinical problem in the department of obstetrics and liver disease, but its severity can cause danger to the life of the mother and fetus. Therefore, the different cause of abnormal liver function in pregnancy should be assessed accurately in order to take early intervention measures. Moreover, it is necessary to comprehensively evaluate the situation of both mother and fetus to obtain the optimal treatment effect for abnormal liver function caused by different types of pregnancy-related liver diseases.

[Clinical control status and quality of life in patients with chronic rhinosinusitis and asthma after endoscopic surgery]

Objective:The aim of this study is to investigate the clinical control status and quality of life of patients with chronic sinusitis and asthma after endoscopic surgery. Method:A prospective study of 36 patients with chronic rhinosinusitis and asthma who had endoscopic surgery. All patients underwent standardized drug therapy before operation. After evaluation by the respiratory and anesthesiologists, they were admitted to the hospital for endoscopic surgery. The patients were closely monitored during the operation, and the patients were observed and recorded. Self-control was performed to compare the observational indexes of the patients for half a year and one year after surgery. Result:①The Asthma Control Scale （ACT） score showed that the proportion of complete control of asthma increased from 8.33% before surgery to 30.56% in the first half of the year and 27.78% in 1 year, which was significantly improved （P<0.05）. ②Asthma Quality of Life Questionnaire（AQLQ） showedthatthe indicators of postoperative quality except the response to the stimulus, limited activity, asthma symptoms, psychological status and concern for their own health are all have statistically significant （P<0.05）. ③In the first half of the year, there were 47.22%, in 1 year, 41.67% of the patients had improved asthma medication. There was no difference between the two groups （P>0.05）. ④The exhaled nitric oxide index was decreased in the first half of the year and in the first year after operation. ⑤There was no significant change in lung function indexes before and after operation （P>0.05）. Conclusion:In patients with chronic sinusitis and asthma, under the comprehensive treatment of endoscopic surgery, improving the quality of life of patients can also improve the control of asthma symptoms and medication, control the development of asthma, and have a positive effect on clinical efficacy.

[Oncolytic property of HSV-1 recombinant viruses carrying the human IL-12]

Objective: Constructed the recombinant HSV-1 deleted ICP47 and inserted human IL-12, and investigate the virus' replication ability and oncolytic property in vitro and vivo. Methods: The recombinant HSV-1 deleting ICP47 (MH1005) and then inserting human IL-12 (MH1006) were obtained with bacterial artificial chromosome technology.The replication ability and the efficiency of inhibiting tumor were detected in several nerve tumor cell lines infected with HSV-wt, MH1005 and MH1006 respectively.The murine tumor model was established by subcutaneous inoculation Neuro-2a cells on both sides of mice back respectively.A dosage of 2×10(6) PFU of HSV-wt, MH1001(recombinant HSV-1 deleted IR), MH1005, MH1006 and Mock were injected 3 times intratumorally on one side of mice back in every 3 days, the tumor volume and survival rate of the mice were measured. Results: The replication abilities of MH1005, MH1006 and HSV-wt in 293FT cells were insignificant (P>0.05); the replication abilities of recombinant HSV-1 in G422 and Neuro-2a were higher than that in SK-N-SH; and the nerve tumor cells could be inhibited significantly by recombinant HSV-1.After 15 days of treatment, on the mouse backside with injection treatment, the tumor volumes of group HSV-wt (6 267±484), MH1001 (5 730±1 071), MH1005 (4 537±538)and MH1006 (4 150±476)mm(3) were smaller than that of group Mock (6 957±722) mm(3) significantly (all P<0.01); on the mouse backside without injection treatment, the tumor volumes of group MH1005 (5 952±607) and MH1006 (5 473±661) mm(3) were smaller than those of HSV-wt (6 785±1 063), MH1001 (6 774±808) and Mock (6 957±190) mm(3) significantly (all P<0.05); after 35 days of treatment, the mice survival rates of group MH1005 (100%) and MH1006 (100%) were higher than those of MH1001 (67%), HSV-wt (50%) and Mock (33%) significantly (all P<0.05). Conclusion: MH1005 and MH1006 can infect nerve tumor cells and replicate at high level, the viruses not only kill tumor cells directly but also induce immunological rejection to tumor, and prolong the survival of mice bearing tumor.

[Effect of low-dose folate treatment on plasma homocystyeine and chemokine levels in patients with hyperhomocysteinemia]

OBJECTIVE

To explore the effect of low-dose folate on plasma homocysteinemia (Hcy) and chemokine levels in patients with hyperhomocysteinemia (HHcy).

METHODS

Forty HHcy patients were treated with 0.8 mg/d folate for 6 months. Plasma levels of Hcy, monocyte chemoattractant protein-1 (MCP-1), interleukin-8 (IL-8), malondialdehyde (MDA), and superoxide dismutase (SOD) were measured before and after folate treatment.

RESULTS

Plasma level of Hcy significantly decreased after folate treatment [(57.1 +/- 18.0) micromol/L vs (25.8 +/- 12.0) micromol/L, P <0.05]. However, the plasma levels of MCP-1, IL-8, SOD, and MDA were not changed after folate treatment.

CONCLUSION

Folate treatment can decrease the plasma Hcy level in HHcy patients; however, it has no obvious effects on the chemokine levels.

Double-Blind, Multicenter, Active-Controlled, Randomized Clinical Trial to Assess the Safety and Efficacy of Orally Administered Nicorandil in Patients With Stable Angina Pectoris in China

BACKGROUND

The efficacy and safety of nicorandil were evaluated in Chinese patients with stable angina pectoris (AP) in a double-blind, multicenter, active-controlled, randomized clinical trial.

METHODS AND RESULTS

After a 2-week washout period, 232 patients with stable AP were randomized to receive either nicorandil (5 mg tid; 115 patients) or isosorbide mononitrate (ISMN: 20 mg bid; 117 patients) for 2 weeks. Exercise capacity, number of weekly anginal attacks, nitroglycerin (NTG) consumption, and safety were evaluated. Nicorandil and ISMN significantly prolonged the time to 1 mm ST-segment depression in an exercise tolerance test. Both drugs improved the total exercise time and the time to onset of chest pain. There was no significant difference between the 2 groups. Nicorandil significantly decreased the number of anginal attacks and NTG consumption. ISMN decreased the number of anginal attacks significantly; however, there was no significance in NTG consumption, and the ratio of anginal attack reduction was at least 50% was significantly higher with nicorandil. Nicorandil was well tolerated and there was no safety profile difference compared with ISMN. Thus, nicorandil may have equivalent or better antianginal effect than ISMN.

CONCLUSIONS

Nicorandil is beneficial as treatment for AP.

Effect of phospholipid composition on characterization of liposomes containing 9-nitrocamptothecin

9-Nitrocamptothecin (9-NC), a newly developed camptothecin derivative, had poor solubility in any pharmaceutically acceptable solvents. One way of improving the solubility is to formulate the drug into liposomes. However, 9-NC has low affinity to lipid membranes resulting in a very low drug-to-liposome entrapment. We developed a novel liposome-based 9-NC formulation which was composed of soybean phosphatidylcholine (SPC), hydrogenated soybean phosphatidylcholine (HSPC), and cholesterol. Compared with conventional liposomes composed of only SPC and cholesterol, 9-NC/lipid molar ratio increased from 1:72 to 1:18 while incorporation efficiency was still maintained about 80%. In addition, after 9-NC was encapsulated into novel liposomes, pharmacokinetic results revealed an increase in area under the plasma concentration-time curve (AUC) and a decrease in distribution volume of 9-NC following intravenous administration to rats. Increased stability in plasma may account for the improved pharmacokinetic behavior of the novel liposomes. Effect of HSPC/SPC molar ratio on characterization of the novel liposomes was also investigated. Except for drug/lipid molar ratio and encapsulation efficiency, HSPC/SPC molar ratio had only a little effect on other properties of novel liposomes. In conclusion, the study suggests that the novel liposomes can act as promising carriers for hydrophobic substances such as 9-NC.

[Immediate cardioversion of atrial fibrillation and atrial flutter lasting less than 90 days by ibutilide versus propafenone: a multicenter study]

OBJECTIVE

To compare the efficacy and safety of ibutilide versus propafenone in immediate cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) lasted less than 90 days.

METHODS

212 consecutive patients suffering from AF or AFL all lasting less than 90 days that were diagnosed and treated in 5 medical centers were randomly assigned into two groups: ibutilide group (n = 107, including 75 AF cases and 32 AFL cases, receiving intravenous injection of ibutilide 1mg over 10 minutes) and propafenone group as control group (n = 105, including 76 AF cases and 29 AFL cases, receiving intravenous injection of propafenone 70 mg over 10 minutes). If AF/AFL still persisted 10 minutes after treatment, the above dose was repeated. The conversion rate within 1.5 hours and adverse effects within 4 hours were observed.

RESULTS

(1) The conversion rate on AFL of the ibutilide group was 78.1%, significantly higher than that of the propafenone group (48.3%, P < 0.01), while no significant difference was observed in the conversion rate on AF (54.7% vs. 39.5%, P > 0.05) and the mean conversion time (P > 0.05). However the overall conversion rate on AFL and AF of the ibutilide group was 61.7%, significantly higher than that of the propafenone group (41.9%, P < 0.05). (2) The conversion rate on AF/AFL lasting less than 48 h was 65.9% in the ibutilide group, not significantly different from that of the propafenone group (55.7%), the conversion rate on AF/AFL lasting 3 approximately 30 d in the ibutilide group was 66.7%, significantly higher than that of the propafenone group (26.3%, P < 0.05), and the conversion rate on AF/AFL lasting 31 - 88 d was 50%, significantly higher than that of the propafenone group (0, P < 0.01). (3) There was no difference in the times needed for conversion between these 2 groups. (4) The most severe adverse effect in the ibutilide group was short run of ventricular tachycardia occurring in 5 cases among which 4 cases recovered simultaneously and one case recovered after accepting a bolus dose of 100 mg lidocaine. The most severe adverse effects in propafenone group were RR interval longer than 1.5 s (4 cases) and transient hypotension. An acute coronary event was also seen in propafenone group, however, unrelated to the experimental drug.

CONCLUSION

Intravenous administration of ibutilide in cardioversion of AF and AFL is safe and effective.

Efficacy and safety of telmisartan vs. losartan in control of mild-to-moderate hypertension: a multicentre, randomised, double-blind study

This multicentre, randomised, double-blind, double-dummy, parallel-group study compared the efficacy and safety of telmisartan with those of losartan after 8 weeks' treatment. In total, 330 patients with mild-to-moderate hypertension (systolic blood pressure [SBP] <180 mmHg; diastolic blood pressure [DBP] 95-109 mmHg) were randomly assigned to receive once-daily treatment with telmisartan 40 mg (n = 164) or losartan 50 mg (n = 166). After 4 weeks' treatment, if a patient's DBP was > or = 90 mmHg, the dose was increased to telmisartan 80 mg or losartan 100 mg, respectively. The results show that mean trough seated blood pressure was reduced significantly more in the telmisartan group than that in the losartan group (SBP 12.5 mmHg vs. 9.4 mmHg, p = 0.037; DBP 10.9 mmHg vs. 9.3 mmHg, p = 0.030). The overall DBP response rate (reduction from baseline in mean seated DBP > or = 10 mmHg and/or a mean seated DBP <90 mmHg) at the end of the study in the telmisartan group was higher than that in losartan group (70.1% vs. 58.7%, p = 0.020). At both the low and high doses, the DBP response rates for telmisartan were significantly higher than those for losartan (telmisartan 40 mg vs. losartan 50 mg: 46.3% vs. 32.5%, p = 0.010; telmisartan 80 mg vs. losartan 100 mg: 79.3% vs. 65.3%, p = 0.008). Adverse events with the two treatments were comparable (telmisartan vs. losartan 23.2% vs. 22.9%, p = 0.952). Most events were mild in intensity and abated within 72 h. Thus, telmisartan 40 mg or 80 mg administered once daily can reduce SBP and DBP effectively and safely.

[Effect of benidipine on plasma level of calcitonin gene-related peptide in essential hypertension]

OBJECTIVE

To explore the effect of benidipine, a calcium channel blocker on the plasma levels of calcitonin gene-related peptide (CGRP) in patients with essential hypertension.

METHODS

58 outpatients with essential hypertension were treated with benidipine 4-8 mg/day for 8 weeks. 38 matched healthy people were taken as controls. The plasma levels of CGRP were measured in all patients before and after treatment and in controls.

RESULTS

The plasma levels of CGRP in hypertensive patients were significantly lower than those in controls (minimal value: 1.28 vs 39.95 ng/L; maximal value: 43.72 vs 155.59 ng/L; P <0.001). In hypertensive patients, treatment with benidipine for 2 weeks markedly decreased systolic pressure and diastolic pressure and its depressor effect was maintained during the study (P <0.05). At 8 week after treatment, the plasma levels of CGRP in hypertensive patients were significantly increased compared with those before treatment (minimal value: 2.84 vs 1.28 ng/L; maximal value: 123.99 vs 43.72 ng/L; P <0.001).

CONCLUSION

Benidipine, a calcium channel blocker significantly decreases blood pressure concomitantly with an increase in the plasma levels of CGRP in the patients with essential hypertension.

Studies on abnormality of metacestodes and adult worms of Taenia solium and Taenia saginata asiatica in rodents and pigs

Abnormalities are not uncommon in Taenia saginata and T. solium. After examining 328 mature proglottids from 2 adult worms from two experimentally infected hamsters, 13 (4.0%) were found to have no genital pore but with numerous testes and several vas efferents; 1 (0.3%) one genital pore with one reproductive system; 12 (3.7%) one on each side with two sets of reproductive system; 17 (5.2%) two on one side with 2 sets of reproductive system; 8 (2.4%) one on one side and two on the other side with 3 sets of reproductive system; 2 (0.6%) two on each side with 4 sets of reproductive system; 4 (1.2%) three on one side with 3 sets of reproductive system, and 4 one on one side and three on the other side with 4 sets of reproductive system. Nine evaginated abnormal cysticerci of T. s. asiatica from three experimentally infected SCID mice each had two protoscoleces and a big bladder. From two experimentally infected pigs, one abnormal cysticercus was observed to have two invaginated canals each in one end. Another one had a neck-band behind the scolex and a big bladder. This paper is not only the first report of abnormality of T. solium from hamster but also the first one of abnormal cysticerci of T. s. asiatica from pigs and mice.

Experimental studies on physiological and morphological aspects of Cysticercus cellulosae in pigs

Three Small-Ear-Miniature, 3 Landrace-Small-Ear-Miniature, and one Douc-Yorkshire-Landrace pigs were inoculated orally with 100 000 eggs of Zhengzhou strain or 10 000 eggs of Harbin strain of Taenia solium. A total of 3739 cysticerci were recovered from 3 Small-Ear-Miniature and 3 Landrace-Small-Ear-Miniature pigs, giving an infection rate of 85.7% and a cysticercus recovery rate of 1.1%. The predilection sites of Cysticercus cellulosae in descending order were leg muscles, abdominal muscles, thoracic muscles, liver, head muscles, diaphragm, tongue, heart, trachea, and omentum/testes. Except 2 calcified cysticerci in the tongue, 2 in the heart, and 176 in the liver, the remaining cysticerci were all alive. The greatest number of cysticerci per 100 g of muscles or viscera was found in the head muscles, followed by the leg, diaphragm, heart, tongue, thoracic, abdominal, omentum, testes, and trachea. All cysticerci were evaginated in pig's bile after fluid was drawn out from cysticerci, whereas evagination occurred in only 83.2% of those without fluid drawing. In 364 evaginated cysticerci, the mean length and width of scolex, proglottid, and bladder, and diameter of rostellum and sucker were 826 x 747 microm, 5,370 x 1,734 microm, 2,885 x 3,002 microm, 155 microm, and 253 microm, respectively. In the protoscolex, the mean number of segments was 33. Each cysticercus had 2 rows of rostellar hooks on the scolex, and the mean length and width of inner and outer hooks were 151 x 18 microm and 117 x 14 microm, respectively. The number of paired hooks ranged from 10 to 18.

Experimental studies on small hooks preceding large hooks in the growth and development of Taenia solium metacestodes

In the present study, we have determined the growth and development pattern of rostellar hooklets of Taenia solium cysticerci (Zhengzhou and Harbin strains) in three pigs (1 SEM and 2 L-SEM strains) 89-196 days post experimental infection. A total of 3,675 cysticerci were collected from 3 pigs, 3,007 (82%) of 3,675 cysticerci were evaginated by enzyme method. 439 (15%) evaginated cysticerci were carefully examined and measured after dehydration, staining, and mounting on microscopic slides. Among 439 cysticerci, 234 (53%) had pair rostellar hooks, 88 (20%) with unpair hooks, 60 (14%) only small (outer row) hooks, and 57 (13%) no hooks including 34 hooks were completely dropped and 23 no hooks developed. The number ranged from 10 to 17 pairs for pair hooks and 1 to 29 for unpair ones. The length and width of rostallar hooks on the scolex of cysticerci were usually larger in the pig with longer infection time. Moreover, cysticerci with pair and unpair rostellar hooks had only small hooks and no hooks were present on their scolices. However, cysticerci with only large (inner row) hooks were not found. These findings indicate that the growth and development of small hooks precedes that of the large hooks in the formation of the two-row pattern rostellar hook in Cysticercus cellulosae.

[Transdermal delivery of cyclosporin A solubilized in mixed micelles through mice skin]

AIM

To investigate the transdermal delivery effects of cyclosporine A solubilized in mixed micelles composed of phospholipid and different surfactants.

METHODS

When applied onto the excised abdominal skin of the mice occlusively, the enhancing effects of various mixed micelles on the penetration of cyclosporin A were assessed by an in vitro permeation technique. In vivo study was carried out by topical application of sodium cholate-phospholipid mixed micelles onto the mice skin and drug blood concentration was detected.

RESULTS

In vitro, mixed micelles containing different surfactants displayed distinct permeability and corresponded to the following order: sodium cholate > sodium deoxycholate > Trition X-100 > Tween-20. In vivo, peak drug concentration was detected at 5 h and after that the concentration fell down slowly.

CONCLUSION

Mixed micelles were shown to be efficient carrier for the transdermal delivery of the lipophilic polypeptide when kept in solution during the application process.

Preparation and evaluation of insulin-loaded polylactide microspheres using factorial design

The aim of this work was to study the influence of the concentration and molecular weight of poly(DL-lactide) (PLA) on the characteristics and in vivo biological activity of protein-loaded microspheres. At the same time, an attempt was made to achieve further optimization of the formulation. In the study, insulin was chosen as a model of protein drugs. Nine formulations of injectable insulin-loaded PLA microspheres were prepared using an emulsification and solvent evaporation process according to a factorial design. The trapping efficiency, drug loading, and the drop percentages of blood glucose levels at 24 hr and 72 hr in mice were used to evaluate the formulations. The results showed that PLA molecular weight and, especially, PLA concentration exerted influences on the characteristics and in vivo biological activity of insulin-loaded microspheres. The drug-trapping efficiency increased with the increase of the polymer concentration. The drug loading decreased with the increase of the polymer concentration and was not obviously affected by PLA molecular weight. The drop percentage of blood glucose level at 24 hr increased with the increase of polymer concentration and molecular weight. At 72 hr, the drop percentages of blood glucose levels were slightly increased with the increase of PLA concentration and then significantly decreased after the PLA concentration was above 150 mg/ml. An optimized formulation was prepared with PLA-10k at a concentration of 200 mg/ml. The experimental values of the response variables were close to the predicted values. The results suggest that the in vivo release behavior should be taken into consideration in the design of protein-loaded PLA microspheres.

[Transdermal delivery mechanisms of lecithin nanoparticles with cyclosporin A through mice skin]

AIM

To investigate the transdermal delivery mechanisms of the flexible nano-liposomes, conventional nano-liposomes and lecithin-cholate mixed micelles through mouse skin.

METHODS

Liposomes and micelles were applied onto the mouse skin non-occlusively in vitro and in vivo, then the drug concentrations in the skin, receiver and blood were determined.

RESULTS

In vitro permeation studies showed that flexible nano-liposomes and mixed micelles transported measurable amount of cyclosporin A through the skin. Conventional liposomes precluded drugs permeate through the skin while deposited it in the skin. In vivo studies indicated that blood concentration reached peak value at 8 h after the application of flexible nano-liposomes. Both conventional nano-liposomes and mixed micelles failed to deliver measurable amount of drug into the blood.

CONCLUSION

Liposomes fuse with the skin. Flexible nano-liposomes penetrate through the skin under the pressure of hydration force. Mixed micelles promote transfer in state of solution.

Sexual development of Taenia solium in hamsters from rodent-derived cysticerci

In order to determine whether Taenia solium can be maintained in the laboratory using rodents as definitive hosts, six nude rats, 20 immunosuppressed Mongolian gerbils and 20 immunosuppressed Syrian hamsters were each inoculated through a stomach tube with three cysticerci recovered from SCID mice. No adult worms of T. solium were found in the intestinal tract of any of these 46 rodents. In addition, five immunosuppressed Syrian hamsters were fed with the same number of cysticerci enclosed in rodent muscles from SCID mice. Two of these hamsters were found to be infected 40 days post-infection, each harbouring a sexually developed worm in the intestinal tract. Although no eggs were produced, prepatent infections may be possible if a longer time was allowed for worm development. Moreover, the maintenance of the life cycle of T. solium in the laboratory using the rodent model can be established.

Oncospheres of Taenia solium and T. saginata asiatica develop into metacestodes in normal and immunosuppressed mice

Normal and immunosuppressed mice were infected with oncospheres of Taenia saginata asiatica and T. solium. Although normal ICR mice were not susceptible to these two parasites, cysticerci were recovered from the immunosuppressed ones following venous injection. For T. s. asiatica, immunosuppressed ICR mice had an infection rate of 12.5% and six cysticerci of this parasite were recovered from three males. After injection of T. solium oncospheres, a high infection rate of 57% was obtained and 23 cysticerci were collected from 13 male immunosuppressed ICR mice. The immunosuppressed C57 mice had the highest infection rate (100%) and cysticercus recovery rate (2.4%) for T. solium. The infection rate and cysticercus recovery rate in six normal C57 mice were 40% and 3% respectively. The immunosuppressed ICR, Balb/c and C3H mice were also susceptible to T. s. asiatica.

Chemical pattern recognition of three Chinese herbal medicines from the genus Stephania lour

Chemical pattern recognition was applied to three Chinese herbal medicines from the genus Stephania Lour., viz. S. kwangsiensis Lo, S. viridiflavens Lo and M. Yang and S. mashanica Lo and B.N. Chang. Based on the chemical features obtained from HPLC, SIMCA program was carried out and the results showed that the classification accuracy was 100%. In addition, the obtained features showed three major classes by NLM. The results of both methods were consistent with those of plant taxonomical identification. It suggested that chemical pattern recognition could be a helpful method to classify and identify Chinese herbal medicines.

Expression of calcitonin gene-related peptide (CGRP) mRNA in rat lymphocytes

We recently found that calcitonin gene-related peptide (CGRP)-like immunoreactivity was present in lymphocytes of rat thymus and lymph node. In order to investigate whether these cells were capable of synthesizing CGRP, CGRP mRNA of rat dorsal root ganglia, thymocytes and mesenteric lymph node lymphocytes were determined by reverse transcription and polymerase chain reaction (RT-PCR) utilizing synthetic oligonucleotides bracketing a portion of the calcitonin/CGRP gene. A discrete band of the expected size of 90 base pairs was found in the dorsal root ganglia (positive control), and in both thymocytes and mesenteric lymph node lymphocytes. These data strongly suggest that CGRP is not only an important neuropeptide, but it is also synthesized in lymphocytes of both thymus and lymph nodes, which is identical to that in sensory neurons. CGRP from lymphocytes may act as an immunomodulator and serve as a common ligand in immune and nervous systems.

[Decrease of calcitonin gene-related peptide release from mesenteric arterial bed in diabetic rats and effect of nitric oxide]

Our previous work has shown that endotoxin triggers the release of calcitonin gene-related peptide (CGRP) from the mesenteric arterial bed, which is partially mediated by nitric oxide. In the present study, the changes of endotoxin-induced CGRP release from the isolated mesenteric arterial bed and the CGRP mRNA levels in dorsal root ganglia (DRG) of diabetic rats were studied in relation to the effect of nitric oxide. CGRP level in perfusate and the steady-state level of mRNA for CGRP in DRG were determined by RIA and semi-quantitatively by RT-PCR. The results showed that endotoxin (1-25 micrograms/ml) accumulated in perfusate caused concentration-dependent release of CGRP, which was significantly decreased in mesenteric arterial bed of diabetic rats. As compared with age-related control, the endotoxin (10 and 25 micrograms/ml) -induced CGRP release in diabetic rats was attenuated by 27% and 40%, respectively. L-NAME, an inhibitor of nitric oxide synthase, inhibited the effect of endotoxin in dose of 10 and 25 micrograms/ml by 23% and 46%, respectively against the control rats. However, there was no inhibitory effect of L-NAME on endotoxin-induced CGRP release in diabetic rats. The CGRP mRNA level in DRG showed no significant difference between the two groups. These results indicate that the response of the isolated mesenteric arterial bed to endotoxin-induced CGRP release in diabetic rats is significantly lower than that in control. The mechanism, at least in part, is due to a decrease of nitric oxide mediated release of CGRP, rather than a decrease of CGRP gene expression.

No subacute thrombosis and femoral bleeding complications under full anticoagulation in 150 consecutive patients receiving non-heparin-coated intracoronary Palmaz-Schatz stents

Intracoronary stenting has been shown to have better immediate and long-term clinical outcomes and less restenosis than standard balloon angioplasty. However, the benefit was achieved at the cost of higher rates of coronary thrombosis, bleeding complications, the need for anticoagulation, and longer hospital stay. For the latter reasons there is a tendency to replace the anticoagulants by antiplatelet agents alone after stenting. However, we prospectively monitored 150 consecutive patients (133 men, 17 women, mean age 58.5 years) from two centers since February 1993. They all had coronary artery disease and underwent percutaneous implantation of non-heparin-coated Palmaz-Schatz coronary stents under a full but lower dose of anticoagulation. The femoral approach was used in all patients except one. In the 150 patients, 200 stents were implanted in 165 target arteries with 172 lesions. Stenting was performed without the guidance of intravascular ultrasonography; high-pressure poststenting inflation was used in only 17.3% of patients with less than optimal angiographic results. Coronary angiography was performed at baseline, immediately after the procedure, and after 6 months (mean 207 +/- 53.6 days SD) of stenting. The mean (+/-SD) coronary minimum luminal diameter increased from 0.52 0.31 mm to 3.13 +/- 0.42 mm immediately after stenting was performed and was 2.12 +/- 0.91 mm at 6 months. There was a 0% subacute thrombosis rate and a 0% femoral bleeding complication rate in the whole series. Only three (2%) major events occurred: one Q-wave myocardial infarction from closure of an angioplasty site distal to the stent on a very long lesion, one cerebrovascular accident, and one noncoronary-related death. The only patient who underwent the brachial approach had hematoma; otherwise no other minor event occurred. The mean hospital stay was 4.5 days in one of the two study centers. The long-term clinical follow-up rate was 97.3%. The mean (+/- SD) clinical follow-up period was 589 +/- 363 days. Clinical symptoms improved; the percentage of patients who had angina according to the Canadian Cardiovascular Society functional class II, III, and IV was 31.3%, 44.7%, and 4%, respectively, before stenting was performed and was reduced to 4.7%, 3.7%, and 0%, respectively at 6-month follow-up after stenting was performed. The 6-month angiographic restudy rate was 90.6%, and the restenosis rate was 18.3%. In contrast to other reported series, these results support the idea that with careful puncture technique and meticulous postoperative wound care, intracoronary stenting can be successfully performed with the patient under full anticoagulation without major risks of bleeding and femoral vascular complications. Furthermore with a full but comparatively lower dose of anticoagulation, subacute thrombotic complications can be reduced to 0% even with non-heparin-coated stents without the use of intravascular ultrasound guidance and without the use of adjunctive high-pressure poststenting inflation in most patients. The restenosis rate and long-term clinical outcomes remained very favorable.

[Percutaneous intra-aortic balloon pumping in cardiogenic shock]

Eleven patients with cardiogenic shock underwent percutaneous intra-aortic balloon pumping (PIABP). Six (55%) survived and 5 (45%) died. Seven patients were referred to the hospital after acute myocardial infarction and 4 of them survived after the therapy in conjunction with thrombolysis or percutaneous transluminal coronary. In another four patients receiving postcardiotomy, half survived without complication. We believe that PIABP can make early revascularization safe by combating reperfusion injury.

Experimental studies of laser myocardial revascularization in rats

Myocardial revascularization by Nd: YAG laser used in rats with myocardial infarction was studied. The left coronary artery was ligated and the laser channels with a diameter of 300 microns were made immediately by 2.5-4.2 W lasersonics YAG unit. After 24 hours, the rats were killed. Evaluation included hemodynamics, lactate dehydrogenase of myocardium and myocardial infarct size. The results showed that laser myocardial revascularization reduced myocardial infarct size and enzyme leakage, and improved left ventricular function. The study may provide theoretical basis for the clinical applications of this new technique in the treatment of ischemic heart disease.

[Arteriography and bronchial artery embolization for massive hemoptysis in 100 cases of tuberculous]

Bronchial arteriography and embolization with sponge gelatin were performed in 100 tuberculous patients of massive hemoptysis. Three direct signs and other six indirect ones were found in arteriographies, Those signs were roentgenographic abnormalities for defining bleeding sites. 100 massive hemoptysis cases were treated with sponge gelatin embolization in bronchial artery. The results are satisfactory, the success rate were 92.9%, 87.4% and 79.0% at one week, one month and three months respectively. The advantages of arterial embolization and the reasons of failures were discussed in this paper.

[Percutaneous coronary laser angioplasty in a patient with chronic total obstruction of the right coronary artery]

Percutaneous coronary laser angioplasty was performed in one patient with total occlusion of right coronary artery without further balloon angioplasty in the ablated site. First of all, we used intracoronary urokinase in a total amount of 60,000 units that resulted in opening the total occluded right coronary artery to provide a passage of guidewire of laser catheter. Then a laser catheter was inserted through the guide catheter and its metal cap was in contact with the atherosclerotic lesion. The Nd:YAG laser was activated to vaporize the lesion (total energies of 54 J). Finally, the degree of residual stenosis was reduced from 95% to 20%. Percutaneous coronary laser angioplasty is a new method in treating coronary artery disease, yet it is still in its infant stage and further work is needed to develop this technological procedure.

Rearrangement of tubulin, actin, and myosin in cultured ventricular cardiomyocytes of the adult rat

Antitubulin, phalloidin, and antimyosin were used to study the distribution of microtubules, microfilaments, and myofibrils in cultured adult cardiomyocytes. These cells undergo a stereotypic sequence of morphological change in which myotypic features are lost and then reconstructed during a period of polymorphic growth. Microtubules, though rearranged during these events in culture, are always present in an organized network. Myosin and actin structures, on the other hand, initially degenerate. This initial degeneration is reversed when a cell attaches to the culture substratum. Upon attachment, new microtubules are laid down as a cortical network adjacent to the sarcolemma and, subsequently, as a network in the basal part of the cell. Actin and then myosin filament bundles appear next, in a pattern corresponding to the pattern of the microtubules. Finally, striated myofibrils are formed, first in the central part of the cell, and subsequently in the outgrowing processes of the cell. A mechanism is suggested by which the eventual polymorphic shape of a cell is related to the shape of its initial area of contact with the culture substratum. Finally, a model of myofibrillogenesis is proposed in which microtubules participate in the insertion of myosin among previously formed actin filament bundles to produce myofibrils.