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Ba Y, Sun L, Zuo J, Yu SY, Yang S, Ding LM, Feng ZC, Li ZY, Zhou GY, Yu FF. Association of oxidative stress and Kashin-Beck disease integrated Meta and Bioinformatics analysis. Osteoarthritis Cartilage 2022; 30:1606-1615. [PMID: 36096467 DOI: 10.1016/j.joca.2022.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 08/16/2022] [Accepted: 08/30/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To explore the association between oxidative stress (OS) and Kashin-Beck disease (KBD). METHODS Terms associated with "KBD" and "OS" were searched in the six different databases up to October 2021. Stata 14.0 was used to pool the means and standard deviations using random-effect or fixed-effect model. The differentially expressed genes in the articular chondrocytes of KBD were identified, the OS related genes were identified by blasting with the GeneCards. The KEGG pathway and gene ontology enrichment analysis was conducted using STRING. RESULTS The pooled SMD and 95% CI showed hair selenium (-4.59; -6.99, -2.19), blood selenium (-1.65; -2.86, -0.44) and glutathione peroxidases (-4.15; -6.97, -1.33) levels were decreased in KBD, whereas the malondialdehyde (1.12; 0.60, 1.64), nitric oxide (2.29; 1.31, 3.27), nitric oxide synthase (1.07; 0.81, 1.33) and inducible nitric oxide synthase (1.69; 0.62, 2.77) were increased compared with external controls. Meanwhile, hair selenium (-2.71; -5.32, -0.10) and glutathione peroxidases (-1.00; -1.78, -0.22) in KBD were decreased, whereas the malondialdehyde (1.42; 1.04, 1.80), nitric oxide (3.08; 1.93, 4.22) and inducible nitric oxide synthase (0.81; 0.00, 1.61) were elevated compared with internal controls. Enrichment analysis revealed apoptosis was significantly correlated with KBD. The significant biological processes revealed OS induced the release of cytochrome c from mitochondria. The cellular component of OS located in the mitochondrial outer membrane. CONCLUSIONS The OS levels in KBD were significantly increased because of selenium deficiency, OS mainly occurred in mitochondrial outer membrane, released of cytochrome c from mitochondria, and induced apoptotic signaling pathway.
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Affiliation(s)
- Y Ba
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan, 450001, PR China.
| | - L Sun
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan, 450001, PR China.
| | - J Zuo
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan, 450001, PR China.
| | - S-Y Yu
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan, 450001, PR China.
| | - S Yang
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan, 450001, PR China.
| | - L-M Ding
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan, 450001, PR China.
| | - Z-C Feng
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan, 450001, PR China.
| | - Z-Y Li
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan, 450001, PR China.
| | - G-Y Zhou
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan, 450001, PR China.
| | - F-F Yu
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan, 450001, PR China.
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Jing XP, Wang WJ, Degen AA, Guo YM, Kang JP, Liu PP, Ding LM, Shang ZH, Zhou JW, Long RJ. Small intestinal morphology and sugar transporters expression when consuming diets of different energy levels: comparison between Tibetan and small-tailed Han sheep. Animal 2022; 16:100463. [PMID: 35193064 DOI: 10.1016/j.animal.2022.100463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/28/2022] Open
Abstract
Some non-structural carbohydrates, especially starch, escape ruminal fermentation, are converted into glucose, and are absorbed from the small intestine. This glucose provides an important source of energy, and its usage is more efficient than glucose from carbohydrates which are fermented as short chain fatty acids in the rumen and, subsequently, undergo hepatic gluconeogenesis. Tibetan sheep graze on the harsh Qinghai-Tibetan Plateau (QTP) all year round and their carbohydrate and energy intakes fluctuate greatly with seasonal forage availability. Consequently, a high capacity to absorb glucose from the small intestine would be particularly beneficial for Tibetan sheep to allow them to cope with the inconsistent dietary intakes. This study examined how the small intestinal morphology and sugar transporters' expression of Tibetan and Small-tailed Han (Han) sheep respond to fluctuating energy intakes under the harsh conditions of the QTP. Han sheep graze on the QTP only in summer and are generally raised in feedlots. Twenty-four Tibetan sheep and 24 Han sheep, all wethers, were assigned randomly to four groups (n = 6 per breed/group), with each group offered a diet differing in digestible energy content: 8.21, 9.33, 10.45 and 11.57 MJ/kg DM. After 49 d, all sheep were slaughtered, tissues of the small intestine were collected, and measurements were made of the morphology and glucose transporters and the related regulation gene expressions. At intakes of low energy levels, Tibetan sheep had a greater villus surface area in the duodenum, jejunum and ileum and higher mRNA expression of sodium-dependent glucose transporter 1 in the duodenum and ileum (P < 0.05) than Han sheep. In the glucose transporter 2 (GLUT2) mediated glucose absorption pathway, Tibetan sheep had higher GLUT2 and taste receptor family 1 member 2 and 3 mRNA expressions than Han sheep in the duodenum, jejunum and ileum (P < 0.05). We concluded that the differences between breeds indicated a greater glucose absorption capacity in the small intestine of Tibetan than Han sheep, which would confer an advantage to Tibetan over Han sheep to an inconsistent energy intake on the harsh QTP. These findings suggested that ruminants raised under harsh environmental conditions with highly fluctuating dietary intakes, as is often the case in grazing ruminants worldwide, are able to absorb glucose from the small intestine to a greater extent than ruminants raised under more moderate conditions.
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Affiliation(s)
- X P Jing
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China; State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China; Laboratory for Animal Nutrition and Animal Product Quality, Department of Animal Sciences and Aquatic Ecology, Faculty of Bioscience Engineering, Ghent University, Ghent 9000, Belgium
| | - W J Wang
- State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - A A Degen
- Desert Animal Adaptations and Husbandry, Wyler Department of Dryland Agriculture, Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Beer Sheva 8410500, Israel
| | - Y M Guo
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China
| | - J P Kang
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China
| | - P P Liu
- State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - L M Ding
- State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - Z H Shang
- State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - J W Zhou
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China.
| | - R J Long
- State Key Laboratory of Grassland and Agro-Ecosystems, International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
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Ding LM, Song XL, Wang XG, Peng Y, Chen YR, Jin L, Lan JP. [Analysing pathogenic bacterial spectrum and drug resistance of bloodstream infection in patients with allogeneic hematopoietic stem cell transplantation]. Zhonghua Xue Ye Xue Za Zhi 2021; 42:807-813. [PMID: 34788919 PMCID: PMC8607017 DOI: 10.3760/cma.j.issn.0253-2727.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Indexed: 11/24/2022]
Abstract
Objective: To elucidate the clinical characteristics of bloodstream infection in patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in our hospital and improves the survival of transplant patients with bloodstream infection. Methods: Two hundred and ten patients with allo-HSCT from the Department of Hematology were retrospectively analyzed between October 2014 and September 2019. Pathogen distribution, drug resistance, risk factors, and outcomes were investigated in 49 allo-HSCT patients with bloodstream infections. Results: Forty-nine of 210 patients with allo-HSCT had bloodstream infection, and 59 pathogenic microorganisms were identified, mainly Gram-negative bacteria (67.8%) , of which E. coli had the highest incidence (23.7%) , CRO accounted for 42.5%, and Grampositive bacteria accounted for 23.7% (without vancomycin or linezolid-resistant strain) . Additionally, fungi accounted for 8.5%. Univariate analysis suggested that the risk factors of bloodstream infection were gender, pretransplant disease status, and conditioning regimen. In contrast, multivariate analysis showed that bloodstream infection was mainly related to conditioning regimens. Further grouping results showed that 77.6% of patients with neutropenia had bloodstream infections, and 22.4% of patients with non-neutropenia had bloodstream infections; 81.0% of patients with active infections before transplantation had bloodstream infections, while bloodstream infection occurred in 16.9% of patients without active infection. Survival analysis showed that long-term survival of patients with bloodstream infection is shorter than that of patients without bloodstream infection and long-term survival of patients with CRO infection is shorter than that of patients without CRO infection. The survival of patients with neutropenia longer than 14 d is shorter than that of patients with neutropenia shorter than 14 d. Furthermore, there is no correlation between whether there is an active infection before transplantation and whether they are in a neutropenic state at the time of infection and survival. Conclusion: Our results suggest that effective prevention of bloodstream infections from drug-resistant bacteria, particularly CRO, shortening the duration of neutropenia, eradication of potential infections before transplantation, and patient-adaptive conditioning could reduce transplant-related mortality and improve prognosis.
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Affiliation(s)
- L M Ding
- Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu 233030, China
| | - X L Song
- Department of Hematology and Hematopoietic Stem Cell Transplant Center, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - X G Wang
- Department of Hematology and Hematopoietic Stem Cell Transplant Center, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Y Peng
- Department of Hematology and Hematopoietic Stem Cell Transplant Center, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - Y R Chen
- Department of Hematology and Hematopoietic Stem Cell Transplant Center, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Hangzhou 310014, China
| | - L Jin
- Department of Hematology and Hematopoietic Stem Cell Transplant Center, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China
| | - J P Lan
- Department of Hematology and Hematopoietic Stem Cell Transplant Center, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, China Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Hangzhou 310014, China
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Jing XP, Wang WJ, Degen AA, Guo YM, Kang JP, Liu PP, Ding LM, Shang ZH, Zhou JW, Long RJ. Energy substrate metabolism in skeletal muscle and liver when consuming diets of different energy levels: comparison between Tibetan and Small-tailed Han sheep. Animal 2021; 15:100162. [PMID: 33485829 DOI: 10.1016/j.animal.2020.100162] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 12/21/2022] Open
Abstract
The energy intake of Tibetan sheep on the harsh Qinghai-Tibetan Plateau (QTP) varies greatly with seasonal forage fluctuations and is often below maintenance requirements, especially during the long, cold winter. The liver plays a crucial role in gluconeogenesis and skeletal muscle is the primary tissue of energy expenditure in mammals. Both play important roles in energy substrate metabolism and regulating energy metabolism homeostasis of the body. This study aimed to gain insight into how skeletal muscle and liver of Tibetan sheep regulate energy substrate metabolism to cope with low energy intake under the harsh environment of the QTP. Tibetan sheep (n = 24; 48.5 ± 1.89 kg BW) were compared with Small-tailed Han sheep (n = 24; 49.2 ± 2.21 kg BW), which were allocated randomly into one of four groups that differed in dietary digestible energy densities: 8.21, 9.33, 10.45 and 11.57 MJ /kg DM. The sheep were slaughtered after a 49-d feeding period, skeletal muscle and liver tissues were collected and measurements were made of the activities of the key enzymes of energy substrate metabolism and the expressions of genes related to energy homeostasis regulation. Compared with Small-tailed Han sheep, Tibetan sheep exhibited higher capacities of propionate to glucose conversion and fatty acid oxidation and ketogenesis in the liver, higher glucose utilization efficiency in both skeletal muscle and liver, but lower activities of fatty acid oxidation and protein mobilization in skeletal muscle, especially when in negative energy balance. However, the Small-tailed Han sheep exhibited higher capacities to convert amino acids and lactate to glucose and higher levels of glycolysis and lipogenesis in the liver than Tibetan sheep. These differences in gluconeogenesis and energy substrate metabolism conferred the Tibetan sheep an advantage over Small-tailed Han sheep to cope with low energy intake and regulate whole-body energy homeostasis under the harsh environment of the QTP.
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Affiliation(s)
- X P Jing
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China; International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China; Laboratory for Animal Nutrition and Animal Product Quality, Department of Animal Sciences and Aquatic Ecology, Faculty of Bioscience Engineering, Ghent University, Ghent 9000, Belgium
| | - W J Wang
- International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - A A Degen
- Desert Animal Adaptations and Husbandry, Wyler Department of Dryland Agriculture, Blaustein Institutes for Desert Research, Ben-Gurion University of Negev, Beer Sheva 8410500, Israel
| | - Y M Guo
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China
| | - J P Kang
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China
| | - P P Liu
- International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - L M Ding
- International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - Z H Shang
- International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
| | - J W Zhou
- State Key Laboratory of Grassland Agro-ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730020, China.
| | - R J Long
- International Centre for Tibetan Plateau Ecosystem Management, School of Life Sciences, Lanzhou University, Lanzhou 730000, China
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Wang XJ, Ding LM, Wei HY, Jiang CX, Yan Q, Hu CS, Jia GX, Zhou YQ, Henkin Z, Degen AA. Astragalus membranaceus root supplementation improves average daily gain, rumen fermentation, serum immunity and antioxidant indices of Tibetan sheep. Animal 2020; 15:100061. [PMID: 33516026 DOI: 10.1016/j.animal.2020.100061] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 11/28/2022] Open
Abstract
The use of antibiotics as supplements in animal feed is restricted due to possible health hazards associated with them. Consequently, there is increasing interest in exploiting natural products to improve health and production of livestock with no detrimental side effects. In this study, we examined the effect of Astragalus membranaceus root (AMT) supplementation on DM intake, growth performance, rumen fermentation and immunity of Tibetan sheep. Twenty-four male Tibetan sheep (31 ± 1.4 kg; 9 months old) were assigned randomly to one of four dietary treatments with different levels of AMT: 0, 20, 50 and 80 g/kg DM (A0, A2, A5 and A8, respectively) in addition to their basal diets. A0 acted as a control group, and measurements were recorded over a 56-d feeding period. Sheep fed with AMT had a higher average daily gain and a lower feed:gain ratio than controls (P < 0.001). Rumen concentrations of NH3-N (P < 0.001), total volatile fatty acids (P = 0.028), acetate (P = 0.017) and propionate (P = 0.031) in A5 and A8 were higher than those in A0. The addition of AMT in the feed significantly increased serum antioxidant and immunity factors of the sheep and increased the concentrations of serum interleukin, immunoglobulin and tumour necrosis factor-α (P = 0.010). We concluded that AMT can be used as a feed additive to improve growth performance and rumen fermentation and enhance the immunity of Tibetan sheep. Some responses exhibited a dose-dependent response, whereas other did not exhibit a pattern, with an increase in AMT. The addition of 50 and 80 g/kg AMT of total DM intake showed the most promising results.
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Affiliation(s)
- X J Wang
- State Key Laboratory of Grassland Agro-ecosystem, Engineering Research Center of Arid Agriculture and Ecological Remediation of Ministry of Education, School of Life Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
| | - L M Ding
- State Key Laboratory of Grassland Agro-ecosystem, Engineering Research Center of Arid Agriculture and Ecological Remediation of Ministry of Education, School of Life Sciences, Lanzhou University, Lanzhou, Gansu 730000, China; Qinghai Provincial Key Laboratory of Adaptive Management on Alpine Grassland, Qinghai University, Xining, Qinghai 810016, China.
| | - H Y Wei
- State Key Laboratory of Grassland Agro-ecosystem, Engineering Research Center of Arid Agriculture and Ecological Remediation of Ministry of Education, School of Life Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
| | - C X Jiang
- State Key Laboratory of Grassland Agro-ecosystem, Engineering Research Center of Arid Agriculture and Ecological Remediation of Ministry of Education, School of Life Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Q Yan
- State Key Laboratory of Grassland Agro-ecosystem, Engineering Research Center of Arid Agriculture and Ecological Remediation of Ministry of Education, School of Life Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
| | - C S Hu
- State Key Laboratory of Grassland Agro-ecosystem, Engineering Research Center of Arid Agriculture and Ecological Remediation of Ministry of Education, School of Life Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
| | - G X Jia
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Northwest Institute of Plateau Biology, Chinese Academy of Science, Xining 810001, China
| | - Y Q Zhou
- Haibei Comprehensive Experimental Station of National Beef Cattle & Yak Industrial Technology System, Haibei 810299, China
| | - Z Henkin
- Beef Cattle Section, Department of Natural Resources, Agricultural Research Organization, Newe-Ya'ar Research Center, POB 1021, Ramat Yishay, 30095, Israel
| | - A A Degen
- Desert Animal Adaptations and Husbandry, Wyler Department of Dryland Agriculture, Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel
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Ding LM, Hu HX, Wang YJ, Ji D, Ni LY, Sun ZH, Ding HY. [Tall cell variant of papillary breast carcinoma: report of a case]. Zhonghua Bing Li Xue Za Zhi 2019; 48:815-817. [PMID: 31594051 DOI: 10.3760/cma.j.issn.0529-5807.2019.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- L M Ding
- Department of Pathology, Yi'an District People's Hospital, Tongling City, Anhui Province, Tongling 244100, China
| | - H X Hu
- Department of General Surgery, Yi'an District People's Hospital, Tongling City, Anhui Province, Tongling 244100, China
| | - Y J Wang
- Clinicopathological Center, the Fourth Affiliated Hospital of Anhui Medical University, Hefei 230011, China
| | - D Ji
- Department of Pathology, Yi'an District People's Hospital, Tongling City, Anhui Province, Tongling 244100, China
| | - L Y Ni
- Department of Pathology, Yi'an District People's Hospital, Tongling City, Anhui Province, Tongling 244100, China
| | - Z H Sun
- Department of Pathology, Yi'an District People's Hospital, Tongling City, Anhui Province, Tongling 244100, China
| | - H Y Ding
- Department of Pathology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
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Zhou JW, Zhong CL, Liu H, Degen AA, Titgemeyer EC, Ding LM, Shang ZH, Guo XS, Qiu Q, Li ZP, Yang G, Long RJ. Comparison of nitrogen utilization and urea kinetics between yaks ( Bos grunniens) and indigenous cattle ( Bos taurus). J Anim Sci 2018; 95:4600-4612. [PMID: 29108052 DOI: 10.2527/jas2017.1428] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Under traditional management on the Qinghai-Tibetan Plateau, yaks () graze only on natural pasture without supplements and are forced to cope with sparse forage of low N content, especially in winter. In contrast, indigenous Tibetan yellow cattle () require supplements during the cold season. We hypothesized that, in response to harsh conditions, yaks cope with low N intakes better than cattle. To test this hypothesis, a study of whole-body N retention and urea kinetics was conducted in 2 concurrent 4 × 4 Latin squares, with 1 square using yaks and 1 square using cattle. Four isocaloric forage-concentrate diets differing in N concentrations (10.3, 19.5, 28.5, and 37.6 g N/kg DM) were formulated, and by design, DMI were similar between species and across diets. Urea kinetics were determined with continuous intravenous infusion of NN urea for 104 h, and total urine and feces were concomitantly collected. Urea production, urea recycling to the gut, and ruminal microbial protein synthesis all linearly increased ( < 0.001) with increasing dietary N in both yaks and cattle. Urinary N excretion was less ( = 0.04) and N retention was greater ( = 0.01) in yaks than in cattle. Urea production was greater in yaks than in cattle at the 3 lowest N diets but greater in cattle than in yaks at the highest N diet (species × diet, < 0.02). Urea N recycled to the gut ( < 0.001), recycled urea N captured by ruminal bacteria ( < 0.001), and ruminal microbial protein production ( = 0.05) were greater in yaks than in cattle. No more than 12% of urea recycling was through saliva, with no difference between species ( = 0.61). Glomerular filtration rate was lower ( = 0.05) in yaks than in cattle. The higher urea recycling and greater capture of recycled urea by ruminal microbes in yaks than in cattle suggest that yaks use mechanisms to utilize dietary N more efficiently than cattle, which may partially explain the better survival of yaks than cattle when fed low-N diets.
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Shi YK, Wang L, Han BH, Li W, Yu P, Liu YP, Ding CM, Song X, Ma ZY, Ren XL, Feng JF, Zhang HL, Chen GY, Han XH, Wu N, Yao C, Song Y, Zhang SC, Song W, Liu XQ, Zhao SJ, Lin YC, Ye XQ, Li K, Shu YQ, Ding LM, Tan FL, Sun Y. First-line icotinib versus cisplatin/pemetrexed plus pemetrexed maintenance therapy for patients with advanced EGFR mutation-positive lung adenocarcinoma (CONVINCE): a phase 3, open-label, randomized study. Ann Oncol 2017; 28:2443-2450. [PMID: 28945850 DOI: 10.1093/annonc/mdx359] [Citation(s) in RCA: 181] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Icotinib has been previously shown to be non-inferior to gefitinib in non-selected advanced non-small-cell lung cancer patients when given as second- or further-line treatment. In this open-label, randomized, phase 3 CONVINCE trial, we assessed the efficacy and safety of first-line icotinib versus cisplatin/pemetrexed plus pemetrexed maintenance in lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) mutation. PATIENTS AND METHODS Eligible participants were adults with stage IIIB/IV lung adenocarcinoma and exon 19/21 EGFR mutations. Participants were randomly allocated (1 : 1) to receive oral icotinib or 3-week cycle of cisplatin plus pemetrexed for up to four cycles; non-progressive patients after four cycles were maintained with pemetrexed until disease progression or intolerable toxicity. The primary end point was progression-free survival (PFS) assessed by independent response evaluation committee. Other end points included overall survival (OS) and safety. RESULTS Between January 2013 and August 2014, 296 patients were randomized, and 285 patients were treated (148 to icotinib, 137 to chemotherapy). Independent response evaluation committee-assessed PFS was significantly longer in the icotinib group (11.2 versus 7.9 months; hazard ratio, 0.61, 95% confidence interval 0.43-0.87; P = 0.006). No significant difference for OS was observed between treatments in the overall population or in EGFR-mutated subgroups (exon 19 Del/21 L858R). The most common grade 3 or 4 adverse events (AEs) in the icotinib group were rash (14.8%) and diarrhea (7.4%), compared with nausea (45.9%), vomiting (29.2%), and neutropenia (10.9%) in the chemotherapy group. AEs (79.1% versus 94.2%; P < 0.001) and treatment-related AEs (54.1% versus 90.5%; P < 0.001) were significantly fewer in the icotinib group than in the chemotherapy group. CONCLUSIONS First-line icotinib significantly improves PFS of advanced lung adenocarcinoma patients with EGFR mutation with a tolerable and manageable safety profile. Icotinib should be considered as a first-line treatment for this patient population.
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Affiliation(s)
- Y K Shi
- Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing.
| | - L Wang
- Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - B H Han
- Department of Pulmonology, Shanghai Chest Hospital, Shanghai
| | - W Li
- Department of Oncology, The First Hospital Affiliated to Jilin University, Changchun
| | - P Yu
- Department of Lung Cancer Medical Oncology, Sichuan Cancer Hospital, Chengdu
| | - Y P Liu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang
| | - C M Ding
- Department of Respiratory Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang
| | - X Song
- Department of Respiratory Medicine, Shanxi Provincial Tumor Hospital, Taiyuan
| | - Z Y Ma
- Department of Oncology, Henan Cancer Hospital, Zhengzhou
| | - X L Ren
- Department of Respiratory Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an
| | - J F Feng
- Department of Oncology, Jiangsu Cancer Hospital, Nanjing
| | - H L Zhang
- Department of Oncology, Tangdu Hospital, The Fourth Military Medical University, Xi'an
| | - G Y Chen
- Department of Medical Oncology, The Affiliated Tumor Hospital of Harbin Medical University, Harbin
| | - X H Han
- Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - N Wu
- Department of Imaging Diagnosis, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - C Yao
- Department of Biostatistics, Peking University Clinical Research Institute, Beijing
| | - Y Song
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing
| | - S C Zhang
- Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing
| | - W Song
- Department of Radiology, Peking Union Medical College Hospital, Beijing
| | - X Q Liu
- Department of Pulmonary Oncology, The 307th Hospital of Chinese People's Liberation Army, Beijing
| | - S J Zhao
- Department of Imaging Diagnosis, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Y C Lin
- Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou
| | - X Q Ye
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang
| | - K Li
- Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin
| | - Y Q Shu
- Department of Oncology, Jiangsu Provincial Hospital, Nanjing
| | - L M Ding
- Betta Pharmaceuticals Co., Ltd, Hangzhou, China
| | - F L Tan
- Betta Pharmaceuticals Co., Ltd, Hangzhou, China
| | - Y Sun
- Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
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9
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Ke WC, Ding WR, Xu DM, Ding LM, Zhang P, Li FD, Guo XS. Effects of addition of malic or citric acids on fermentation quality and chemical characteristics of alfalfa silage. J Dairy Sci 2017; 100:8958-8966. [PMID: 28918135 DOI: 10.3168/jds.2017-12875] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 07/30/2017] [Indexed: 11/19/2022]
Abstract
We studied the effects on alfalfa preservation and chemical composition of the addition of different levels of malic acid and citric acid at ensiling as well as the utilization efficiency of these 2 organic acids after fermentation. Alfalfa was harvested at early bloom stage. After wilting to a dry matter content of approximately 40%, the alfalfa was chopped into 1- to 2-cm pieces for ensiling. Four levels (0, 0.1, 0.5, and 1% of fresh weight) of malic acid or citric acid were applied to chopped alfalfa at ensiling with 4 replicates for each treatment, and the treated alfalfa forages were ensiled for 60 d in vacuum-sealed polyethylene bags (dimensions: 200 mm × 300 mm) packed with 200 to 230 g of fresh alfalfa per mini silo and an initial density of 0.534 g/cm3. The application of malic or citric acids at ensiling for 60 d led to lower silage pH than was observed in the control silage (0% of malic or citric acids). Application of the 2 organic acids led to higher lactic acid concentration in alfalfa silage than in the control silage except with the application rate of 1% of fresh weight. Silages treated with both organic acids had lower nonprotein nitrogen concentrations than the control silages, and the nonprotein nitrogen concentrations in ensiled forages decreased with the increase in malic or citric acid application rates. The application of the 2 organic acid additives led to lower saturated fatty acid proportions and higher polyunsaturated fatty acid proportions in ensiled alfalfa than in the control silage. The amount of malic and citric acids degraded during ensiling of alfalfa was 1.45 and 0.63 g, respectively. At the application rate of 0.5% of fresh weight, residues of malic acid and citric acid in alfalfa silage were 11.1 and 13.6 g/kg of dry matter. These results indicate that including malic or citric acids at the ensiling of alfalfa effectively improved silage fermentation quality, limited proteolysis, improved fatty acid composition of the ensiled forage, and could provide animals with additional feed additives proven to promote animal performance. However, when the application rate of both organic acids reached 1%, the concentration of lactic acid in silages decreased notably. Additionally, 0.5 and 1% application rates also increased the yeast count in ensiled alfalfa.
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Affiliation(s)
- W C Ke
- State Key Laboratory of Grassland Agro-Ecosystems, School of Life Sciences, Lanzhou University, Lanzhou 730000, PR China; Probiotics and Biological Feed Research Centre, Lanzhou University, Lanzhou 730000, PR China
| | - W R Ding
- State Key Laboratory of Grassland Agro-Ecosystems, School of Life Sciences, Lanzhou University, Lanzhou 730000, PR China; Probiotics and Biological Feed Research Centre, Lanzhou University, Lanzhou 730000, PR China
| | - D M Xu
- State Key Laboratory of Grassland Agro-Ecosystems, School of Life Sciences, Lanzhou University, Lanzhou 730000, PR China; Probiotics and Biological Feed Research Centre, Lanzhou University, Lanzhou 730000, PR China
| | - L M Ding
- State Key Laboratory of Grassland Agro-Ecosystems, School of Life Sciences, Lanzhou University, Lanzhou 730000, PR China
| | - P Zhang
- State Key Laboratory of Grassland Agro-Ecosystems, School of Life Sciences, Lanzhou University, Lanzhou 730000, PR China
| | - F D Li
- State Key Laboratory of Grassland Agro-Ecosystems, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou 730000, PR China
| | - X S Guo
- State Key Laboratory of Grassland Agro-Ecosystems, School of Life Sciences, Lanzhou University, Lanzhou 730000, PR China; Probiotics and Biological Feed Research Centre, Lanzhou University, Lanzhou 730000, PR China.
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10
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Ding LM, Lascano GJ, Heinrichs AJ. Effect of precision feeding high- and low-quality forage with different rumen protein degradability levels on nutrient utilization by dairy heifers. J Anim Sci 2016; 93:3066-75. [PMID: 26115292 DOI: 10.2527/jas.2014-8260] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
One approach to improving efficiency of protein and nitrogen use for optimal productivity in dairy heifers is to provide adequate levels of protein with differing rumen degradabilities. The objective of this experiment was to determine effects of manipulating RDP in diets of dairy heifers precision fed low- and high-quality forage. Eight rumen-cannulated Holstein heifers (448 ± 19 kg BW) were randomly used and assigned to an 85% forage diet with 2 forage qualities, low quality (LQ, 48% NDF) and high quality (HQ, 38% NDF), and to 4 RDP levels (62%, 68%, 74%, and 81% of CP as RDP) within forage quality administered according to a split-plot two 4 × 4 Latin square design (20-d periods). Similar N intake was provided (1.70 g N/kg BW0.75), and alterations of RDP levels were made by exchanging canola meal with heat-treated soy protein with slow-release urea. Heifers offered the HQ diet had greater apparent total tract DM and OM digestibilities than those fed the LQ diet. Apparent N digestibility tended to be higher for the HQ diet but was not affected by the levels of RDP in diets. No difference was observed for rumen VFA concentration between forage treatments, but acetate to propionate ratio was higher for LQ-fed heifers. No difference in rumen carbohydrate fermentation was detected with increasing levels of RDP. Feeding HQ forage improved DM, OM, and N apparent digestibility. Increasing RDP in LQ and HQ had no effects on apparent digestibility of any measured parameter or N dynamics in dairy heifers.
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Zhou JW, Mi JD, Titgemeyer EC, Guo XS, Ding LM, Wang HC, Qiu Q, Li ZP, Long RJ. A comparison of nitrogen utilization and urea metabolism between Tibetan and fine-wool sheep. J Anim Sci 2016; 93:3006-17. [PMID: 26115287 DOI: 10.2527/jas.2014-8865] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To study metabolic adaptation to harsh foraging conditions, an experiment was conducted to characterize and quantify N utilization efficiency and urea metabolism in Tibetan and fine-wool sheep fed 4 levels of dietary N (11.0, 16.7, 23.1, and 29.2 g N/kg DM) in 2 concurrent 4 × 4 Latin square designs. Urea kinetics were determined using continuous intrajugular infusions of 15N15N-urea. Urinary excretions of total N and urea N increased linearly (P < 0.001) with dietary N and were not different between breeds (P ≥ 0.37). Fecal N excretion increased with dietary N for Tibetan sheep but not for fine-wool sheep (linear dietary N × breed; P < 0.05). Nitrogen retention (both amount per day and percentage of N intake) increased with increasing dietary N concentration (P < 0.001), and the rates of increase were greater in fine-wool than in Tibetan sheep (linear dietary N × breed and cubic dietary N × breed; P < 0.05). In Tibetan sheep, N retention as a percentage of intake was greatest for diets containing 16.7 g N/kg DM, whereas it was maximal for fine-wool sheep when the diet contained 23.1 g N/kg DM. Urea N entry rate, urea N recycled to the gastrointestinal tract (GIT), and urea N returned to the ornithine cycle all increased with dietary N (P < 0.05), and all were greater in Tibetan than fine-wool sheep for the 11.0 g N/kg DM diet but were greater in fine-wool than Tibetan sheep for the diet with 29.2 g N/kg DM (linear dietary N × breed; P < 0.05). Urea N excreted in feces, both amount and fraction of GIT entry rate, was less in Tibetan than fine-wool sheep for the 11.0 and 16.7 g N/kg DM diets but similar for diets with 23.1 or 29.2 g N/kg DM (linear dietary N × breed; P < 0.01). For the lowest-protein diet, the fraction of urea N production recycled to the GIT was greater in the Tibetan than fine-wool sheep (88% vs. 82%), but for the diet with 29.2 g N/kg DM it was greater for fine-wool than Tibetan sheep (46% vs. 39%; linear dietary N × breed; P < 0.05). Plasma urea N increased more rapidly in response to increasing dietary N concentration for fine-wool sheep than for Tibetan sheep (linear dietary N × breed; P < 0.05). Urea tubular load and the amount and percentage of urea reabsorbed by the kidney were greater in Tibetan than fine-wool sheep (P < 0.05). These results suggest that Tibetan sheep have mechanisms that allow them to utilize N more efficiently than the fine-wool sheep when dietary N is inadequate.
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Mi JD, Zhou JW, Ding LM, Wang L, Long RJ. Short communication: Changes in the composition of yak colostrum during the first week of lactation. J Dairy Sci 2015; 99:818-24. [PMID: 26547651 DOI: 10.3168/jds.2015-9824] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 09/13/2015] [Indexed: 12/15/2022]
Abstract
Although the great interest has been paid to colostrum utilization for calves, no systematic studies evaluating the compositional changes of yak colostrum during the first week after parturition have been reported. The aim of this study was to elucidate such postpartum nutritional changes. Colostrum samples from 12 multiparous (2-7 lactations) yaks, grazed on alpine pasture, were collected at exactly 1, 24, 48, 72, 96, 120, 144, and 168 h postpartum. Gross composition (fat, total solids, protein, and ash) were measured, as well as fat and water-soluble vitamins, fatty acid and mineral composition, and IgG. The colostrum, collected 1h postpartum, had the highest concentrations of crude protein, total solids, ash, vitamin A and E, β-carotene, and most minerals (Na, Mg, Zn, Cu, and Fe). These components decreased rapidly within 24h. Similarly, at 24h postpartum, IgG content decreased to 7.5% of the value (87.78 mg/mL) at 1h postpartum. In contrast, the concentration of vitamin C increased from 1 to 24h and then decreased consistently thereafter to the lowest value at 168 h. Phosphorus and Ca contents showed an increasing trend from 24 to 168 h after calving. Lactose content increased from 2.88% at 1h to 4.96% at 48 h postpartum and was steady to 168 h. Total n-3 fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and n-3-to-n-6 fatty acid ratio were proportionally similar as a percentage of total fatty acid methyl esters during the first 168 h of milk production. However, the proportion of total n-6 fatty acid content to total fatty acid methyl esters decreased from 3.07% at 1h to 2.60% at 24h. In summary, experimental results indicate colostrum should be provided to yak calves as soon as possible after birth to provide nutrients and enhance passive immunity.
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Affiliation(s)
- J D Mi
- School of Life Sciences, Institute of Arid Agroecology, State Key Laboratory of Grassland Agro-Ecosystem, International Centre for Tibetan Ecosystem Management, Lanzhou University, Lanzhou 730000, PR China
| | - J W Zhou
- College of Pastoral Agriculture Science and Technology, State Key Laboratory of Grassland Agro-Ecosystem, International Centre for Tibetan Ecosystem Management, Lanzhou University, Lanzhou 730000, PR China
| | - L M Ding
- School of Life Sciences, Institute of Arid Agroecology, State Key Laboratory of Grassland Agro-Ecosystem, International Centre for Tibetan Ecosystem Management, Lanzhou University, Lanzhou 730000, PR China
| | - L Wang
- College of Pastoral Agriculture Science and Technology, State Key Laboratory of Grassland Agro-Ecosystem, International Centre for Tibetan Ecosystem Management, Lanzhou University, Lanzhou 730000, PR China
| | - R J Long
- School of Life Sciences, Institute of Arid Agroecology, State Key Laboratory of Grassland Agro-Ecosystem, International Centre for Tibetan Ecosystem Management, Lanzhou University, Lanzhou 730000, PR China.
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Zainal M, Ismail SM, Ropilah AR, Elias H, Arumugam G, Alias D, Fathilah J, Lim TO, Ding LM, Goh PP. Prevalence of blindness and low vision in Malaysian population: results from the National Eye Survey 1996. Br J Ophthalmol 2002; 86:951-6. [PMID: 12185113 PMCID: PMC1771293 DOI: 10.1136/bjo.86.9.951] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2002] [Indexed: 11/03/2022]
Abstract
BACKGROUND A national eye survey was conducted in 1996 to determine the prevalence of blindness and low vision and their major causes among the Malaysian population of all ages. METHODS A stratified two stage cluster sampling design was used to randomly select primary and secondary sampling units. Interviews, visual acuity tests, and eye examinations on all individuals in the sampled households were performed. Estimates were weighted by factors adjusting for selection probability, non-response, and sampling coverage. RESULTS The overall response rate was 69% (that is, living quarters response rate was 72.8% and household response rate was 95.1%). The age adjusted prevalence of bilateral blindness and low vision was 0.29% (95% CI 0.19 to 0.39%), and 2.44% (95% CI 2.18 to 2.69%) respectively. Females had a higher age adjusted prevalence of low vision compared to males. There was no significant difference in the prevalence of bilateral low vision and blindness among the four ethnic groups, and urban and rural residents. Cataract was the leading cause of blindness (39%) followed by retinal diseases (24%). Uncorrected refractive errors (48%) and cataract (36%) were the major causes of low vision. CONCLUSION Malaysia has blindness and visual impairment rates that are comparable with other countries in the South East Asia region. However, cataract and uncorrected refractive errors, though readily treatable, are still the leading causes of blindness, suggesting the need for an evaluation on accessibility and availability of eye care services and barriers to eye care utilisation in the country.
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Affiliation(s)
- M Zainal
- Department of Ophthalmology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Abstract
BACKGROUND Quality assurance of medical practice requires assessment of doctors' performance, whether informally via a system such as peer review or more formally via one such as credentialing. Current methods of assessment are, however, subjective or implicit. More objective methods of assessment based on statistical process control technique such as cumulative sum (CUSUM) procedure may be helpful. OBJECTIVE To determine the usefulness and acceptability of CUSUM charting for assessing doctors' performance. METHOD We applied CUSUM charting to assess doctors' performance of endoscopic retrograde pancreatography, renal and breast biopsies, thyroidectomy, and instrumental deliver. A CUSUM chart is a graphical representation of the trend in the outcome of a series of consecutive procedures. At acceptable levels of performance, the CUSUM curve is flat, while at unacceptable levels of performance, the curve slopes upward and eventually crosses a decision interval. When this occurs, the CUSUM chart indicates unsatisfactory performance. Thus, it provides an early warning of an adverse trend. RESULTS All participating doctors found the technique useful to objectively measure their proficiency. CUSUM charts showed the progress of trainees in acquiring new skills. As they become more skillful with training, their CUSUM curves flatten. Among consultants, level CUSUM curves demonstrated ongoing maintenance of competence. All participants found the technique acceptable as a self-assessment tool. They were, however, less certain of its acceptability as a basis for credentialing. CONCLUSION We recommend the use of CUSUM charting as a tool for personal audit at an individual level. It may also be used to show proof of technical competence for the purpose of credentialing.
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Affiliation(s)
- T O Lim
- Clinical Research Centre, Kuala Lumpur Hospital, Ministry of Health, Malaysia.
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15
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Lim TO, Ding LM, Zaki M, Merican I, Kew ST, Maimunah AH, Rozita HH, Rugayah B. Clustering of hypertension, abnormal glucose tolerance, hypercholesterolaemia and obesity in Malaysian adult population. Med J Malaysia 2000; 55:196-208. [PMID: 19839148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We determine the prevalence and determinants of clustering of hypertension, abnormal glucose tolerance, hypercholesterolaemia and overweight in Malaysia. A national probability sample of 17,392 individuals aged 30 years or older had usable data. 61% of adults had at least one risk factor, 27% had 2 or more risk factors. The observed frequency of 4 factors cluster was 6 times greater than that expected by chance. Indian and Malay women were at particular high risk of risk factors clustering. Individuals with a risk factor had 1.5 to 3 times higher prevalence of other risk factors. Ordinal regression analyses show that higher income, urban residence and physical inactivity were independently associated with risk factors clustering, lending support to the hypotheses that risk factors clustering is related to lifestyle changes brought about by modernisation and urbanisation. In conclusion, risk factor clustering is highly prevalent among Malaysian adults. Treatment and prevention programme must emphasise the multiple risk factor approach.
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Affiliation(s)
- T O Lim
- Clinical Research Centre, Hospital Kuala Lumpur, Kuala Lumpur
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16
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Parashar UD, Sunn LM, Ong F, Mounts AW, Arif MT, Ksiazek TG, Kamaluddin MA, Mustafa AN, Kaur H, Ding LM, Othman G, Radzi HM, Kitsutani PT, Stockton PC, Arokiasamy J, Gary HE, Anderson LJ. Case-control study of risk factors for human infection with a new zoonotic paramyxovirus, Nipah virus, during a 1998-1999 outbreak of severe encephalitis in Malaysia. J Infect Dis 2000; 181:1755-9. [PMID: 10823779 DOI: 10.1086/315457] [Citation(s) in RCA: 172] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/1999] [Revised: 01/07/2000] [Indexed: 11/04/2022] Open
Abstract
An outbreak of encephalitis affecting 265 patients (105 fatally) occurred during 1998-1999 in Malaysia and was linked to a new paramyxovirus, Nipah, that infected pigs, humans, dogs, and cats. Most patients were pig farmers. Clinically undetected Nipah infection was noted in 10 (6%) of 166 community-farm controls (persons from farms without reported encephalitis patients) and 20 (11%) of 178 case-farm controls (persons from farms with encephalitis patients). Case patients (persons with Nipah infection) were more likely than community-farm controls to report increased numbers of sick/dying pigs on the farm (59% vs. 24%, P=.001) and were more likely than case-farm controls to perform activities requiring direct contact with pigs (86% vs. 50%, P=.005). Only 8% of case patients reported no contact with pigs. The outbreak stopped after pigs in the affected areas were slaughtered and buried. Direct, close contact with pigs was the primary source of human Nipah infection, but other sources, such as infected dogs and cats, cannot be excluded.
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Affiliation(s)
- U D Parashar
- Respiratory and Enteric Viruses Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Lim TO, Ding LM, Zaki M, Suleiman AB, Kew ST, Ismail M, Maimunah AH, Rugayah B, Rozita H. Distribution of blood total cholesterol in a national sample of Malaysian adults. Med J Malaysia 2000; 55:78-89. [PMID: 11072494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
We describe the distribution of capillary blood total cholesterol (BC) by age, sex and ethnicity in Malaysian adults. A national sample of 20,041 individuals aged 30 or older had usable data. They were selected by stratified 2-stage cluster sampling. BC was measured using reflectance photometer. Percentile tables and curves by age, sex and ethnicity are presented. The BC distribution was right skewed and showed the expected increase with age. There were ethnic differences. Malay had the highest BC concentration, followed by Indian, Chinese and other indigenous ethnic group. However, for all ethnic groups, BC concentrations were low in comparison those prevailing in Western populations.
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Affiliation(s)
- T O Lim
- Clinical Research Centre, Jalan Pahang, Kuala Lumpur, Institute Kesihatan Umum, Kuala Lumpur
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Lim TO, Ding LM, Goh BL, Zaki M, Suleiman AB, Maimunah AH, Rozita H, Rashid A. Distribution of blood pressure in a national sample of Malaysian adults. Med J Malaysia 2000; 55:90-107. [PMID: 11072495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
We describe the distribution of blood pressure (BP) by age, sex and ethnicity in Malaysian adults. A national sample of 21,391 individuals aged 30 or older had usable data. They were selected by stratified 2-stage cluster sampling. BP was measured using an automated oscillometric device, Visomat. Percentile tables and curves by age, sex and ethnicity are presented. The systolic and diastolic BP distribution was right skewed and showed the expected increase with age. This was markedly so in Malay and other indigenous women; as a result they had most severe hypertension.
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Affiliation(s)
- T O Lim
- Clinical Research Centre, Hospital Kuala Lumpur
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Lim TO, Ding LM, Zaki M, Suleiman AB, Fatimah S, Siti S, Tahir A, Maimunah AH. Distribution of body weight, height and body mass index in a national sample of Malaysian adults. Med J Malaysia 2000; 55:108-28. [PMID: 11072496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
We describe the distribution of body weight, height and body mass index (BMI) by age, sex and ethnicity in Malaysian adults. A national sample of 28,737 individuals aged 20 or older had usable data. They were selected by stratified 2-stage cluster sampling. Percentile tables and curves by age, sex and ethnicity are presented. The body weight and BMI distributions were right skewed, while that of height was symmetrical. BMI distribution showed the expected increase with age, while that of height decrease with age. Differences in BMI between the 2 sexes and among the 4 ethnic groups were observed. Indian had the highest BMI, followed by Malay, Chinese and other indigenous ethnic group.
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Affiliation(s)
- T O Lim
- Institut Kesihatan Umum, Kuala Lumpur
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20
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Lim TO, Ding LM, Zaki M, Suleiman AB, Kew ST, Maimunah AH, Rugayah B. Distribution of blood glucose in a national sample of Malaysian adults. Med J Malaysia 2000; 55:65-77. [PMID: 11072493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
We describe the distribution of capillary blood glucose (BG) by age, sex and ethnicity in Malaysian adults. A national sample of 20,041 individuals aged 30 or older had usable data. They were selected by stratified 2-stage cluster sampling. BG was measured using reflectance photometer. Percentile tables and curves by age, sex and ethnicity are presented. The BG distribution was right skewed and showed the expected increase with age. Except in Indian, women had higher BG than men. There were also marked ethnic differences. Indian had the highest BG concentration, followed by Chinese, Malay and other indigenous ethnic group.
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Affiliation(s)
- T O Lim
- Clinical Research Centre, Department of Nephrology, Hospital Kuala Lumpur Jalan Pahang, Kuala Lumpur
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Munshi NC, Govindarajan R, Drake R, Ding LM, Iyer R, Saylors R, Kornbluth J, Marcus S, Chiang Y, Ennist D, Kwak L, Reynolds C, Tricot G, Barlogie B. Thymidine kinase (TK) gene-transduced human lymphocytes can be highly purified, remain fully functional, and are killed efficiently with ganciclovir. Blood 1997; 89:1334-40. [PMID: 9028956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A graft-versus-leukemia (GVL) effect has been considered a major factor responsible for cures in patients with hematologic malignancies undergoing allogeneic bone marrow transplantation; however, associated graft-versus-host disease (GVHD) results in significant morbidity and mortality. T-cell depletion reduces the incidence and severity of GVHD but eliminates, at least partially, the GVL effect. Reinfusion of donor T lymphocytes at relapse posttransplantation can induce a potent antitumor response, but GVHD still occurs in the majority of patients. Prior transduction of T lymphocytes with the suicide gene, the viral thymidine kinase (TK), permits specific cell kill on administration of ganciclovir (GCV). Therefore, infusion of TK-transduced T lymphocytes may induce GVL effect and allow for their subsequent selective elimination in case GVHD develops. To evaluate the efficacy and feasibility of this promising approach, anti-CD3-stimulated primary human lymphocytes cultured in interleukin-2 were TK-transduced by a retroviral vector carrying both TK and neomycin-resistance genes. After selection in G418, more than 90% of the cells contained the TK gene as shown by a semiquantitative polymerase chain reaction. In addition, 1 to 5 days of GCV exposure, at clinically achievable concentrations of 20 to 50 micromol/L, induced > or = 90% killing of G418-selected cells without affecting nontransduced cells. Correlation of the extent of T-cell kill and the proportion of TK-gene-transduced cells is consistent with the absence of a bystander effect. Transduced cells were CD3+ and either CD8+ or CD4+ and retained functional properties of untransduced cells. In vivo administration of GCV prevented tumor development after subcutaneous injection of TK-transduced murine myeloma cells (MOPC-11), whereas such an effect was not observed on injection of untransduced cells into the opposite flank. Our studies provide critical information that (1) adequate numbers of TK-transduced lymphocytes can be selected efficiently with > or = 90% purity, (2) selected cells remain functional, (3) 24 hours of exposure to GCV at clinically achievable concentration effects > or = 90% killing of selected cells, and (4) GCV is effective in vivo in killing TK-transduced cells. Based on these data, a clinical study has been initiated in patients with multiple myeloma with persistent or relapsing disease after T-cell-depleted allogeneic transplants.
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Affiliation(s)
- N C Munshi
- University of Arkansas for Medical Sciences, Little Rock 72205, USA
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Zhang MT, Liu KZ, Jin JH, Ding LM, Zhou SC, Yu QY, Zhang XZ. Five-year follow-up of immune response to hepatitis B vaccine in juveniles. Chin Med J (Engl) 1993; 106:97-9. [PMID: 8504700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The persistence of anti-HBs was investigated in 95 juveniles who received plasma-derived HBV vaccine (vaccine group) and 63 counterparts who got anti-HBs from natural HBV infection (infection group) for a period of five years. The positive rates of anti-HBs from the first to fifth year in the vaccine group are 97.89%, 98.95%, 81.05%, 78.95% and 72.63% respectively with one recipient remaining anti-HBs negative after being immunized with three dosages of 10 micrograms plasma-derived HBV vaccine in 0, 1st, 2nd month and the mean S/N values (GMV) are 30.94, 22.18, 13.61, 12.02 and 9.18 respectively. There are 26 recipients whose anti-HBs turned from positive to negative at the end of the study with a negative rate of 27.37%. The S/N GMVs in the infection group are 36.37, 27.33, 24.08 at the first, third and fifth year of the study, respectively. Both the S/N GMV and negative rate are lower than that of the vaccine group (P < 0.01). No one was found to have positive HBsAg or elevated ALT in both groups. Questions such as immune dosage, immune program and booster immunization in juvenile population are discussed.
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Affiliation(s)
- M T Zhang
- Institute of Infectious Diseases, Zhejiang Medical University, Hangzhou
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Song SY, Ding LM. [The hematopoietic effects of rubidate and its toxicity]. Zhong Xi Yi Jie He Za Zhi 1985; 5:625-6, 581. [PMID: 2938805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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