A phase II study of retifanlimab, a humanized anti-PD-1 monoclonal antibody, in patients with solid tumors (POD1UM-203)

BACKGROUND

POD1UM-203, an open-label, multicenter, phase II study, evaluated retifanlimab, a humanized monoclonal antibody targeting programmed cell death protein-1 (PD-1) in patients with selected solid tumors where immune checkpoint inhibitor therapies have previously shown efficacy.

PATIENTS AND METHODS

Eligible patients (≥18 years) had measurable disease and included unresectable or metastatic melanoma, treatment-naive metastatic non-small-cell lung cancer (NSCLC) with high programmed death-ligand 1 (PD-L1) expression (tumor proportion score ≥50%), cisplatin-ineligible locally advanced/metastatic urothelial carcinoma (UC) with PD-L1 expression (combined positive score ≥10%), or treatment-naive locally advanced/metastatic clear-cell renal cell carcinoma (RCC). Retifanlimab 500 mg was administered intravenously every 4 weeks as a 30-min infusion. The primary endpoint was investigator-assessed overall response rate.

RESULTS

Overall, 121 patients (35 melanoma, 23 NSCLC, 29 UC, 34 RCC) were enrolled and treated. The overall response rate [95% confidence interval (CI)] was 40.0% (23.9-57.9) in the melanoma cohort, 34.8% (16.4-57.3) in the NSCLC cohort, 37.9% (20.7-57.7) in the UC cohort, and 23.5% (10.7-41.2) in the RCC cohort. Median duration of response was 11.5 months (95% CI 2.2-not reached) in the UC cohort, and was not reached in the other cohorts. Retifanlimab safety was consistent with previous experience for PD-(L)1 inhibitors.

CONCLUSIONS

Retifanlimab demonstrated durable antitumor activity in patients with melanoma, NSCLC, UC, or RCC. The efficacy and safety of retifanlimab were as expected for a PD-(L)1 inhibitor. These data support further study of retifanlimab in solid tumors.

Dihydromyricetin reverses capecitabine-induced peripheral myelin dysfunction through modulation of oxidative stress

Previous clinical reports have shown that capecitabine, an oral prodrug of 5-fluorouracil (5-Fu), can induce peripheral neuropathy, resulting in numbness, paresthesia and hypoesthesia. However, the mechanism through which capecitabine causes peripheral nerve injury remains unclear. Here, we demonstrate that systemic administration of capecitabine leads to myelin abnormalities in the peripheral nerves of mice, which are possibly attributed to the death of Schwann cells, the myelinating cells in the peripheral nervous system. Furthermore, our results show that 5-Fu induces significant oxidative stress in Schwann cells by inhibiting the expression of the anti-oxidative protein DJ-1, leading to a decrease in Schwann cell markers. We found that the anti-oxidant dihydromyricetin (DMY) reverses 5-Fu-induced Schwann cell death and oxidative stress and alleviates capecitabine-induced myelin abnormalities. Taken together, our data indicate that capecitabine induces peripheral myelin dysfunction by regulating DJ-1-mediated oxidative stress in Schwann cells and reveal DMY as a potential therapeutic strategy for capecitabine-induced peripheral neuropathy.

Women and partners' experience of major postpartum haemorrhage: a qualitative study

OBJECTIVE

To examine women and their partners' experience of major postpartum haemorrhage (PPH).

DESIGN

A qualitative interview study.

SETTING

Two Labour and Delivery Units in Denmark.

POPULATION

Women who experienced major PPH (≥1 litre within 2 hours after vaginal birth).

METHODS

Semi-structured interviews were conducted with 15 women and nine partners (nine joint interviews, six individual interviews). Interviews were analysed using thematic analysis.

MAIN OUTCOME MEASURES

A qualitative description of women and their partners' experiences.

RESULTS

Three major themes were identified. (1) 'From birth to emergency' included factors that increased concern in women and their partners, such as 'incomprehensible' medical terminology, a tense atmosphere, and alarm call. Transfer to the operating theatre was experienced as the most devastating part of major PPH. (2) 'Feeling safe during an emergency' described factors that supported the women and their partners' management of the situation such as brief explanations from a few healthcare professionals and reassurance that the healthcare professionals were in control of the situation. The pain was experienced as severe, but acceptable. (3) 'Family unity challenged' described how family bonding was supported by positioning the partner at the head of the bed and by keeping the baby on the woman's chest.

CONCLUSIONS

Several factors such as small gestures from healthcare professionals and appropriate organisation of the PPH can make a difference to the woman and her partner's experience of major PPH. Particularly, efforts that support family bonding are greatly valued by women and their partners.

Percutaneous vertebroplasty versus non-operative treatment for osteoporotic vertebral compression fractures: a meta-analysis of randomized controlled trials

PURPOSE

Osteoporotic vertebral compression fractures (OVCFs) are common in the elderly population and are often treated using percutaneous vertebroplasty (PVP). However, the effectiveness of PVP reported by various randomized controlled trials (RCTs) is inconclusive. This study aimed to analyze, from published literature, the efficacy and safety of PVP for OVCFs.

METHODS

A search was conducted in Medline, EMBASE, and Cochrane Libraries since their respective inception on January 1, 2019, for RCTs of OVCFs treated with PVP compared with non-operative treatment. The primary outcomes were pain relief at 1 to 2 weeks, 1 to 3 months, and 6 to 12 months. The secondary outcome was the rate of occurrence of new vertebral fractures. Meta-analysis was performed using a random effect model.

RESULTS

A total of 13 RCTs comprising 1624 patients were included. For the blinded studies, statistical differences were found between PVP and the sham injection group for the 3 primary outcomes in the subgroup of the Vertebroplasty for Acute Painful Osteoporotic fractURes (VAPOUR) trial. Although pain scores were similar between the PVP group and the sham injection group for the VAPOUR trial at each period, the effect size of PVP increased over time. For the open-label studies, PVP significantly reduced pain at all time points. The risk of new vertebral fractures was similar between the PVP groups and control groups.

CONCLUSIONS

Application of PVP was effective and safe only in patients with acute OVCFs having persistent and severe pain. No benefits were recorded, among patients with older fractures or those bearing non-severe symptoms.

Combination therapy with parathyroid hormone analogs and antiresorptive agents for osteoporosis: a systematic review and meta-analysis of randomized controlled trials

Combination therapy with parathyroid hormone (PTH) analogs and antiresorptive agents may be more effective than monotherapy for the treatment of osteoporosis. This study aimed to estimate the effectiveness and safety of this combination therapy for osteoporosis. MEDLINE, EMBASE, and Cochrane Library were searched from inception to May 1, 2018, including randomized controlled trials (RCTs) with a duration of at least 6 months on adults with osteoporosis treated with combination therapy versus monotherapy. Outcomes included fractures, bone mineral density (BMD) changes, and adverse events. A meta-analysis was performed using a random-effect model, to estimate risk ratios (RRs) for fractures, and mean differences (MDs) for BMD changes. A total of 19 RCTs and 2177 patients were included. Compared with monotherapy, combination therapy had an advantage of 36% (RR, 0.64; 95% confidence interval (CI), 0.42-0.98) regarding fracture risk reduction. It also appears to improve lumbar spine BMD by 4.06% (95%CI = 2.60-5.53) and total hip BMD by 1.89% (95%CI = 1.25-2.53). No RCT reported an increased risk of serious adverse events. Among patients with osteoporosis, combination therapy was superior to monotherapy regarding improvement of the lumbar spine and total hip BMD, without risk of serious adverse events. Combination therapy also had an advantage over monotherapy on fracture risk reduction. However, owing to the limited sample size, additional larger studies are required to confirm this benefit.

Schisandrin B attenuates lipopolysaccharide-induced activation of hepatic stellate cells through Nrf-2-activating anti-oxidative activity

Activated hepatic stellate cells (HSCs) are known to have a potential role in increasing the deposition of ECM and elevating proliferation in liver fibrosis, which can be driven by lipopolysaccharide (LPS). Schisandrin B (SB) is a dibenzocyclooctadiene derivative of Schisandra chinensis with anti-oxidative stress activity, but its effective target is unknown. Here, we have evaluated whether SB is protective against the LPS-induced activation of HSCs and have explored the underlying anti-oxidative stress mechanisms of SB. HSCs were treated with SB 1 h prior to LPS, and then incubated for indicated time. Nrf-2 in HSCs was inhibited genetically. The simultaneous effects on Nrf-2 activity, oxidative stress, cell proliferation, and ECM deposition were examined. SB decreased LPS-induced cell proliferation, fibrosis, and oxidative stress in HSCs. We further demonstrated that the protective effects of SB in LPS-induced HSCs activation involve the modulation of Nrf-2. SB, specifically targeting Nrf-2, attenuates the oxidative stress in HSCs. SB also reduces LPS-induced fibrosis and cell viability in HSCs. In addition, Nrf-2 may serve as a therapeutic target for infections or periods of chronic oxidative stress and may help with future drug discovery.

Chromosomal microarray as primary diagnostic genomic tool for pregnancies at increased risk within a population-based combined first-trimester screening program

OBJECTIVE

To evaluate the performance of high-resolution chromosomal microarray (CMA) as the standard diagnostic approach for genomic imbalances in pregnancies with increased risk based on combined first-trimester screening (cFTS).

METHODS

This was a retrospective study of genomic findings in a cohort of 575 consecutive pregnancies undergoing invasive testing because of a cFTS risk ≥ 1:300 on a publicly funded population-based screening program in the Central and Northern Regions of Denmark, between September 2015 and September 2016. Women with fetal nuchal translucency thickness ≥ 3.5 mm or opting for non-invasive prenatal testing (NIPT) were excluded. Comparative genomic hybridization was performed using a 180-K oligonucleotide array on DNA extracted directly from chorionic villus/amniocentesis samples. Genomic outcomes were reported in relation to cFTS findings.

RESULTS

Of the 575 pregnancies that underwent invasive testing, CMA detected 22 (3.8% (95% CI, 2.5-5.7%)) cases of trisomies 21, 18 and 13, 14 (2.4% (95% CI, 1.4-4.0%)) cases of other types of aneuploidy and 15 (2.6% (95% CI, 1.5-4.3%)) cases with a pathogenic or probably pathogenic copy number variant (CNV). Of the 15 CNVs, three were > 10 Mb and would probably have been detected by chromosomal analysis, but the other 12 would most probably not have been detected using conventional cytogenetic techniques; therefore, the overall detection rate of CMA (8.9% (95% CI, 6.8-11.5%)) was significantly higher than that estimated for conventional cytogenetic analysis (6.8% (95% CI, 5.0-9.1%)) (P = 0.0049). Reducing the cFTS risk threshold for invasive diagnostic testing to 1 in 100 or 1 in 50 would have led, respectively, to 60% or 100% of the pathogenic CNVs being missed.

CONCLUSIONS

CMA is a valuable diagnostic technique that can identify an increased number of genomic aberrations in pregnancies at increased risk on cFTS. Limiting diagnostic testing to pregnancies with a risk above 1 in 100 or 1 in 50, as proposed in contingent NIPT/invasive testing models, would lead to a significant proportion of pathogenic CNVs being missed at first-trimester screening. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Genetic variants of microRNA processing genes and risk of non-syndromic orofacial clefts

OBJECTIVE

MicroRNA (miRNA) processing genes play important roles in the craniofacial development. The aim of this study was to explore the associations between single nucleotide polymorphisms (SNPs) of miRNA processing genes with the risk of non-syndromic orofacial clefts (NSOC).

METHODS

We genotyped 12 potentially functional SNPs from seven miRNA processing genes (GEMIN3, DROSHA, DGCR8, GEMIN4, PIWIL1, XPO5, and DICER) in a case-control study of 602 NSOC cases and 605 controls.

RESULTS

Two SNPs were associated with the susceptibility of CL/P: rs10719 in DROSHA led to an increased risk of cleft lip with or without palate (CL/P) (GA/AA: p = .024, OR = 1.33, 95% CI = [1.04, 1.70]; GG + GA/AA: p = .037, OR = 1.29, 95% CI = [1.02, 1.63]), while rs493760 in DROSHA (CC/TT: p = .049, OR = 0.58, 95% CI = [0.34, 0.99]) could reduce the risk of CL/P. In addition, rs10719 (A)-rs493760 (C) haplotype contributed to a decreased risk of CL/P (OR = 0.77, 95% CI = [0.63, 0.94]), whereas the rs10719 (G)-rs493760 (C) haplotype contributed to the increased risk of cleft palate only (CPO) (OR = 2.70, 95% CI = [1.15, 6.35]). However, there was no difference observed in these SNPs after the Bonferroni correction.

CONCLUSION

Taken together, our results provided the potential evidence that rs10719 and rs493760 might contribute to the risk of CL/P and suggested potential genetic basis and mechanisms of CL/P. The lack of association between these SNPs and CPO might be due to the limited sample size of CPO subgroup.

Blood versus crystalloid cardioplegia for pediatric cardiac surgery: a meta-analysis

OBJECTIVE

Blood and crystalloid cardioplegia are the main myocardial protective solutions used in pediatric cardiac surgery. However, the effectiveness of these two solutions on myocardial metabolism, reperfusion injury and clinical outcomes in pediatric patients is still under debate. The purpose of this meta-analysis was to compare the efficacy of these two cardioplegia solutions in pediatric cardiac surgery.

METHODS

Keyword searches were performed on PUBMED, EMBASE and The Cochrane Library for randomized, controlled, clinical studies which were primarily comparing blood and crystalloid cardioplegia in pediatric cardiac surgery and provided data of postoperative cardiac troponin I (cTnI), lactate, mechanical ventilation time, length of intensive care unit (ICU) stay and inotropic support. Databases were searched from 1966 to June 2013 and were restricted to peer-reviewed English language publications of human subjects. We summarized the combined results of the data as mean difference (MD, when outcome measurements were made on the same scale) or standard mean difference (SMD, when the studies assess the same outcome with different scales), with 95% confidence intervals.

RESULTS

Five studies were identified, with a total of 323 patients. Lactate level after cardiopulmonary bypass (CPB) was significantly lower after blood cardioplegia compared with crystalloid cardioplegia (SMD 1.09, 95%CI 0.12 to 2.06, p=0.03); cTnI release postoperatively at 4-6 h (MD 0.92 ng/ml, 95%CI -0.13 to 1.97, p=0.09), 12 h (MD 0.2 ng/ml, 95% CI -0.43 to 0.84, p=0.53) and 24 h (MD 0.98 ng/ml, 95%CI -0.26 to 2.22, p=0.12) was not significantly different between the groups; ventilation duration (MD 5.15 hours, 95%CI -7.51 to 17.81, p=0.42) and length of ICU stay (SMD -0.3, 95%CI -0.80 to 0.21, p=0.25) were not significantly different between the groups either.

CONCLUSION

Myocardial metabolism was better in the blood cardioplegia group compared with the crystalloid cardioplegia group. However, there was no evidence of improvement in myocardial damage or clinical outcome for either cardioplegia solution.

Expression profiling based graph-clustering approach to determine renal carcinoma related pathway in response to kidney cancer

BACKGROUND

Renal cell carcinoma (RCC) is the most common cancer of the kidney. Despite advances in treatment, 5-year survival rate for metastatic RCC is estimated to be less than 10%. Thus, new therapeutic options for RCC are urgently needed.

AIM

In this study, our objective here was to identify a set of discriminating genes in RCC and normal kidney tissue, and predict their underlying molecular pathway in response to RCC using graph-clustering approach and gene ontology (GO) term analysis.

MATERIALS AND METHODS

The GSE6344 expression profile was used in this study and the tissues used were either de-identified or were archival tissues. Through Statistical analysis, Network analyses, graph clustering and Pathway enrichment analysis to predict underlying molecular pathway.

RESULTS

The results indicated the genes in cluster 1 and cluster 6 were involved in metabolism pathways, such as PPAR (peroxisome proliferator activated receptor) signaling pathway and Glycolysis pathway, etc. The genes in cluster 2, 3, 5, and 7 were associated with RCC progression through adhesion pathways, such as Focal adhesion, Cell adhesion molecules, and Gap junction. Besides, cluster 4 participated in MAPK (mitogen activated protein kinases) signaling pathway.

CONCLUSIONS

These results suggested these pathways play an important role in RCC progression. Further study may pay more attention to confirm the unidentified genes, explore their prognosis for RCC, and novel chemotherapeutic targets.

Does 6% hydroxyethyl starch 130/0.4 impact differently on blood glucose than 4% gelatin in patients receiving open heart surgery?

Objectives: To investigate whether starch-based colloid may impact differently on blood glucose than a gelatin-based colloid in adult patients receiving open heart surgery.

Methods: 70 adult patients scheduled for elective first-time cardiac surgery were enrolled and randomized into two groups. The circuits were primed with either 6% HES 130/0.4 or 4% gelatin. The peak glucose level, incidence of hyperglycemia, glucose variation and glucose level at different time points during operation were compared between the two groups. A p-value ≤ 0.05 was accepted as significant.

Results: The peak glucose (150±30mg/dl vs 142±27, p=0.236) and glucose variation demonstrated by standard deviation (26±12mg/dl vs 23±11mg/dl, p=0.202) were comparable between the two groups. Repeated measurement ANOVA revealed that the main effect for artificial colloid was not significant (p=0.349).

Conclusions: With the data available, we could not prove that starch-based colloid (HES130) had a different impact on intra-operative blood glucose than a gelatin-based colloid in adult patients receiving open heart surgery.

Container fumigation as a quarantine treatment for Anoplophora glabripennis (Coleoptera: Cerambycidae) in regulated wood packing material

Anoplophora glabripennis Motschulsky, an Asian cerambicid beetle, was first found in the United States in 1996 and was likely introduced into the United States through infested wood packing materials and dunnage. Methyl bromide (MeBr) fumigation is an internationally accepted treatment for such wood-boring beetles, but the use of MeBr is scheduled for reduction or elimination as alternatives become available. The use of MeBr can be reduced by more efficient and technically sound fumigation techniques, including good circulation and proper loading. Concentration x time products (CxT) reported for A. glabripennis in solid wood timbers were used to test estimated doses in container fumigations conducted in Tianjin and Shanghai, China, during years 2002-2003. We found that CxT products observed were generally adequate and would support reduced doses of MeBr at temperatures intermediate (10.0 and 15.6 degrees C) to the Animal and Plant Health Inspection Service schedule of 80 g and 48 g/m3 at > or =4.4 and > or = 21.1degrees C, respectively. The use of fans is recommended, and loading of the containers should never reach 100% to allow for better circulation and desorption. Proper use of fans will allow for better aeration and increase safety to inspectors and consignees of containerized fumigated commodities.

Validation of the Spanish version of the SCOFF questionnaire for the screening of eating disorders in primary care

OBJECTIVE

To assess the performance of the Spanish version of a new screening tool (the SCOFF) for the detection of eating disorders (EDs) in primary care.

DESIGN

validation study. The psychiatric interview Schedules for Clinical Assessment in Neuropsychiatry (SCAN) was used as the "gold standard." Blinding was applied to administration of the SCOFF and the clinical interview.

SETTING

six primary health care centers in Zaragoza and Huesca, Spain.

PARTICIPANTS

203 female patients, between the ages of 15 and 53 years, with a probable diagnosis of ED.

MAIN OUTCOME MEASURE

validity as assessed by sensitivity, specificity, positive predictive value and negative predictive value. In addition, test-retest reliability and the receiver operating characteristics (ROC) curve were calculated.

RESULTS

The best threshold point in the Spanish version was 2+ positive answers, the same as that recommended in the original British study. This cutoff point provided 97.7% sensitivity and 94.4% specificity for the detection of EDs in primary care. For each specific ED, sensitivity and specificity with this threshold point were, respectively, the following: bulimia, 97.8% and 94.4%; anorexia, 93.1% and 94.4%; and ED not otherwise specified (EDNOS), 100% and 94.4%.

CONCLUSIONS

The Spanish version of the SCOFF questionnaire shows excellent psychometric properties for the early detection of EDs in primary settings.

HBx protein of hepatitis B virus (HBV) can form complex with mitochondrial HSP60 and HSP70

HBx, a transcriptional transactivating protein of hepatitis B virus (HBV), is required for viral infection and has been implicated in virus-mediated liver oncogenesis. However, the molecular mechanism for its influence on cell remains largely unknown. It was proved that HBx need the help of host cell proteins to exert its function by binding to them. During purifying of GSTX (fusion protein of GST and HBx) expressed in E. coli, we found that it can bind specifically with GrpE (HSP60) and DnaK (HSP70) of E. coli while GST cannot. Using GST pull-down, two-dimensional gel electrophoresis and mass spectrum, we found that GSTX can also bind to human mitochondrial HSP60 and HSP70, which are homologues of GrpE and DnaK. These interactions between HBx and mitochondrial HSP60 and HSP70 are supported by the result of co-immunoprecipitation experiment. It means that HBx can form complex with E. coli and human HSP60 and HSP70. The implication of HBx, HSP60 and HSP70 complex in molecular mechanism of virus infection is discussed.

Direct protective effect of interleukin-10 on articular chondrocytes in vitro

OBJECTIVE

To assess whether interleukin-10 (IL-10) is chondroprotective in vitro.

METHODS

Chondrocytes were isolated from femoral cartilage of rats (7-10 days) by digestion with collagenase II. The first passage cells were grown in 24- well plates with DMEM, supplemented with 10% fetal bovine serum, for 2-4 days. The cells were then cultured in 0.1% fetal bovine serum DMEM medium, and given respectively interleukin-1 (IL-1) 100 mu/ml, IL-1 100 mu/ml + recombinant murine interleukin-10 (rmIL-10) 20 ng/ml, rmIL-10 20 ng/ml, and cultured for 48 hours. Scanning electron morphology and immunohistochemical study of nitric oxide synthase 2 and matric metalloproteinase 3 mRNA in situ hybridization were performed. Cell proliferation and morphology were observed under inverted microscope from the beginning of cell culture for three weeks.

RESULTS

IL-1 stimulated granule production in the cytoplasma of chondrocytes, and the cells died in the second and third weeks of culture. IL-10 antagonized IL-1, protected the cells from death and maintained chondrocyte proliferation. Scanning electron morphology showed that IL-1 stimulated the formation of numerous microvilli on the cell surface, while thin and less numerous microvilli were found in cultures with IL-10. Immunohistochemical study and in situ hybridization showed that IL-10 inhibited NOS2 and MMP3 expression.

CONCLUSION

IL-10 not only inhibits the synthesis of inflammatory cytokines, but also directly protects chondrocytes by antagonizing IL-1.

Elbow load during pushup at various forearm rotations

OBJECTIVE

Elbow joint loading was evaluated during pushup exercises at various forearm rotations.

DESIGN

Subjects were asked to perform pushup in various forearm rotations: neutral, 90 degrees internal rotation, and 90 degrees external rotation.

BACKGROUND

Training with pushup exercise is good for the muscles and joints of the upper extremities. However, excessive shear forces on the elbow might lead to injuries to either normal trainees or to handicapped people, especially for those who rely on elbow prosthesis.

METHODS

The kinematics and kinetics of the elbow joint were investigated under various forearm rotations.

RESULTS

The loading biomechanics of the elbow joint differed with various forearm rotations. It was noted that greater posterior and varus forces of the elbow are encountered with internal rotation of the hand position and, consequently, full forearm pronation.

CONCLUSIONS

Pushup with hands in internally rotated position should be prevented so as to avoid excessive shear forces or moments.

RELEVANCE

Knowledge of elbow kinematics and kinetics may be helpful in preventing injuries by reducing the elbow shear force with changes of forearm rotation.

[The mechanical chemical attachment of artificial cartilage (PVA-hydrogel) to metal substrate (or underlying bone)]

The biocompatibility and tribological characteristics of PVA-hydrogel are excellent, but it is very difficult to make the artificial cartilage material (PVA-hydrogel) attach to the underlying bone. In this study, PVA-hydrogel is attached to the metal fibre mesh by means of micro-mechanical interlock methods at first, then the surface of metal fibre mesh is bonded to the underlying bone by the bone cement(PMMA). In this way, the artificial cartilage can be firmly attached to the underlying bone(or metal substrate). Microstructure analysis and mechanical tests show that the attachment between artificial cartilage and the metal substrate is firm.

Cyanide self-addition, controlled adsorption, and other processes at layered double hydroxides

Layered double hydroxides (LDH) are anion-exchanging materials of the type M(III)-M(II)x(OH)(2x + 2)Y that occur abundantly in nature, and can concentrate, protect, and activate simple organic anionic species of possible relevance to the earliest organisms. We now wish to report progress in the following areas: 1) Internal vs. external uptake of anions. Ferrocyanide does not displace carbonate from synthetic hydrotalcite (Mg:Al LDH carbonate) but is nevertheless taken up on the outside of the particles. In other cases, anion uptake is controlled by specific hydrogen bonding requirements rather than by charge density alone, a feature that can be used to control whether uptake will be both internal and external, or external only. These two findings taken together have important implications for specific catalysis by LDH, since specific hydrogen bonding will affect the individual and relative conformations of substrate anions, and anions occupying space in the interlayer will be under tighter constraints than those adsorbed externally. 2) Specific reactions catalyzed by LDH. We have found that the LDH Mg2Al(OH)6Cl catalyzes the self-addition of cyanide, to give in a one-pot reaction at low concentrations an increased yield of diaminomaleonitrile and in addition, at higher (> or = 0.05 M) concentrations, a purple-pink material that adheres to the LDH. We are investigating whether this reaction also occurs with hydrotalcite itself, what is the minimum effective concentration of cyanide, and what can be learned about the products and how they compare with those reported at high HCN concentrations in the absence of catalyst.

Plasma CPU-86017 concentrations regarding suppression of ouabain-induced cardiac arrhythmias and decrease of heart rate in guinea pigs

AIM

To determine the effective plasma levels of CPU-86017 which could suppress the cardiac arrhythmias induced by i.v. ouabain in guinea pigs.

METHODS

The cardiac arrhythmias and the heart rate were monitored by ECG traces. Blood samples were collected to determine plasma levels using HPLC assay. TXB2 and 6-keto-PGF1 alpha were measured in plasma.

RESULTS

The plasma concentrations of CPU-86017 which were effective to suppress ventricular fibrillation (VF) and heart rate were 0.13-0.23 mg/L and 0.13-0.31 mg/L, respectively. A reduction of TXB2 levels and an elevation of 6-keto-PGF1 alpha levels were observed after CPU-86017 i.v. administration.

CONCLUSION

The arrhythmia-suppressing and heart rate-slowing effect of CPU-86017 followed a linear relationship with its concentrations in plasma.

[Circadian rhythm changes of the levels of endogenous insulin in growing rat's blood after functional mandibular protrution]

OBJECTIVE

In order to determine whether the metabolism of the body can be influenced by local functional orthopedic treatments and the relationship between the proliferation and translation of condyle and the metabolism of the body, the author investigates the circadian rhythm of the levels of endogenous insulin (Ins) in growing rats' blood and the changes after functional mandibular protrusion in daytime (8:00-20:00) or nighttime (20:00-8:00).

METHODS

72 4-week-old SD rats were divided equally and randomly into experimental and control groups, and the rats in experimental groups were put on the functional appliances in daytime (8:00-20:00) or nighttime (20:00-8:00). After 7 days, all rats were sacrificed at 0:00, 4:00, 8:00, 12:00, 16:00, 20:00 in a day. Radioimmunoassay methods wore used to detect the levels of endogenous insulin in growing rats' blood in every four hours of a day.

RESULTS

1. The growing rats' blood displayed a significant circadian rhythm in the levels of endogenous insulin, the acrophase was about 13:02. 2. The circadian rhythm still existed after used functional appliance. No significant changes (both mesors and amplitudes) had been observed in the experimental groups comparing with the control groups. 3. The circadian rhythm of insulin in blood concerned with that of endogenous insulin in condyle.

CONCLUSION

1. The metabolism of the body can not be influenced by local functional orthopedic treatments. 2. The proliferation and translation of condyle concern with the metabolism of the body.

Layered double hydroxide stability. 2. Formation of Cr(III)-containing layered double hydroxides directly from solution

Solutions containing divalent metal [M(II) = Mg2+, Zn2+, Co2+, Ni2+, Mn2+] chlorides and CrCl3 6H2O were titrated with NaOH to yield, for M(II) = Zn, Co, and Ni, hydrotalcite-like layered double hydroxides (LDHs), [[M(II)]1-z[Cr(III)]z(OH)2][Cl]z yH2O, in a single step, without intermediate formation of chromium hydroxide. Analysis of the resultant titration curves yields solubility constants for these compounds. These are in the order Zn < Ni approximately Co, with a clear preference for formation of the phase with z = 1/3. With Mg2+ as chloride, titration gives a mixture of Cr(OH)3 and Mg(OH)2, but the metal sulfates give Mg2Cr(OH)6 1/2(SO4) by a two-step process. Titrimetric and spectroscopic evidence suggests short-range cation order in the one-step LDH systems.

Immunoassays to study prevalence of antibody against GB virus C in blood donors

Immunoassays were developed to determine the seroprevalence of antibody against human GB virus C (GBV-C). The antigenic target in each assay was a 44.6-kDa glycosylated protein representing the first 315 amino acids encoded by the GBV-C E2 gene. Sera or plasma were assayed for E2 antibody using an anti-human EIA format in which antigen-coated polystyrene beads were reacted with sample, and bound antibody was detected by addition of enzyme labelled goat anti-human IgG. The presence of anti-E2 antibody was confirmed using a sandwich EIA format in which samples were reacted with antigen coated polystyrene beads, followed by addition of solution phase biotinylated antigen. Detection of antibody captured biotinylated E2 was accomplished by addition of enzyme-conjugated anti-biotin antibody. Antibody against the E2 antigen was detected in 7.4 and 7.8% of 500 sera and 500 plasma, respectively, from US volunteers donating to a Wisconsin blood center, and in approximately 10.7% of hepatitis and retrovirus marker-negative volunteer blood donors from a Missouri blood center. The rate in 1018 sera from US commercial donors at multiple US blood centers was 36.7%. These results indicated a relatively high prevalence of GBV-C exposure in US volunteer donors, and particularly in commercial donors. The clinical implication of the high exposure rate is unclear. These immunoassays are being combined with nucleic acid detection to assess prevalence of GBV-C world wide and to determine if GBV-C plays a role as an etiologic agent.

Inhibitory effects of hypercholesterolemia and ox-LDL on angiogenesis-like endothelial growth in rabbit aortic explants. Essential role of basic fibroblast growth factor

Hypercholesterolemic (HC) rabbits exhibit suppressed compensatory vascular growth after restriction of arterial supply. However, neovascularization is commonly found in atheromas containing inflammatory cells. We used an in vitro model to determine the effects of hypercholesterolemia on angiogenesis in the absence or presence of inflammatory cells. HC rabbit aortic explants (1 mm2) with or without (n = 90 each) lesion-forming inflammatory cells were cultured in a collagen matrix with serum-free medium. Explant-derived endothelial cell growth was organized into capillary-like microtubes (CLM) that could be videomicroscopically quantified. CLM growth from lesion-free HC explants was significantly reduced to 13 +/- 4% of the value in explants (n = 90) from normocholesterolemic (NC, n = 15) rabbits (P < .001). In contrast, in lesion-containing HC explants, the matrix was invaded by foam cells, and CLM growth was not inhibited. Immunoassayable basic fibroblast growth factor (bFGF, in pg/mL) in the culture medium was significantly lower in lesion-free HC (< 5) than NC explants (11 +/- 2, P < .01) or HC explants with lesions (14 +/- 3). In addition, CLM growth was reduced in NC explants incubated with oxidized LDL (ox-LDL, 50-100 micrograms/mL). Exogenous bFGF (10 ng/mL) reversed the inhibitory effects of hypercholesterolemia and ox-LDL, whereas bFGF-neutralizing antibody (10 micrograms/mL) abolished CLM growth in all groups. In cultured rabbit aortic endothelial cells, ox-LDL reduced DNA synthesis, but this inhibition was reversed by bFGF. We conclude that hypercholesterolemia and ox-LDL inhibit angiogenesis like endothelial growth because of a suppressed availability of endogenous bFGF. Retained responsiveness to exogenous bFGF suggests that inducing bFGF expression at targeted sites may improve collateral growth in hyperlipidemic arterial disease.

Lipid peroxidation of mitochondrial membrane induced by D1: an organic solvent extractable component isolated from a crude extract of burn eschar

D1, an organic solvent extractable component of an extract from burn eschar was characterized and the mechanism of its inhibitory effect on mitochondrial respiratory functions was investigated. Using silicic acid column chromatography, it was found that D1 consisted of two parts: a toxic simple lipid and a non-toxic complex lipid. Six subunits were obtained by further silicic acid column chromatography, among them, the no. 4 and no. 6 were toxic. Infrared spectrometric studies showed that no. 4 consisted of esters, while no. 6 were peroxides. D1 also contained large amounts of malonaldehyde (MDA) and lipid hydroperoxides (ROOH). Vitamin E was found to prevent the inhibitory action of D1 on mitochondrial function and to reduce the amount of MDA produced. However, if vitamin E was introduced after the addition of D1 the inhibition could not be prevented, although there was still a reduction in MDA production; therefore, MDA per se was probably not the cause of the inhibition. D1 induced ROOH formation in mitochondrial membranes. Cumene hydroperoxide, an organic hydroperoxide, was capable of inhibiting the mitochondrial function. This inhibitor action was blocked by vitamin E. It is speculated that ROOH in D1 is probably the element that inhibits mitochondrial function. That D1 caused lipid peroxidation of membrane lipid was also proved by analysing the fatty acid composition of mitochondrial membranes before and after treatment with D1. It was found that the amount of polyunsaturated fatty acids decreased and that of saturated fatty acids increased after incubation with D1, a direct proof that lipid peroxidation has occurred. Lipid peroxidation of the membrane lipid was the result of the action of oxygen free radicals. This process was best shown by a chemiluminescence study. In this experiment, D1 induced chemiluminescence which was dose-dependently related to the amount of D1 used. This was probably the most direct proof that D1 caused lipid peroxidation of membrane lipid resulting in damage of the mitochondria.

[Cervical intervertebral disc calcification in children: report of 10 patients]

Eleven cervical intervertebral space calcifications were studied in ten children (5 boys, 5 girls), with mean age of 9.4 years. The aetiology, symptoms, roentgenographic clinic features were analyzied. All ten patients showed evidence of calcification of the cervical intervertebral disc. One had calcification in two disc spaces of the cervical spine and associated with subluxation of C1,2. Two patients had calcification protruded into the spinal canal without symptoms of spinal cord compression. One had symptom of nerve root irritation. Eight of ten patients had symptoms which disappeared in two weeks after treatment. Eight patients had been followed over one year. The calcification disappeared from 2 to 8 months. The diagnostic criteria for the syndrome of this study are: (1) pediatric age group only; (2) local or referred pain; (3) limited cervical spine motiion; (4) evidence of inflammation; (5) visible calcification of the cervercal intervertebral disc on roentgenogram; (6) self-limited course; (7) good result after conservative treatment and good prognosis.

[Effect of environmental temperature, cryopreservation and aging on Plasmodium vivax sporozoites developing into exoerythrocytic stages]

After Anopheles stephensi mosquitoes with salivary infection of Plasmodium vivax were put in environments with temperatures of 30 +/- 1 degrees C, 26 +/- 1 degrees C or 13 +/- 1 degrees C for 5 d, their glands were aseptically dissected and sporozoites were collected and inoculated into HepG2-A16 cell monolayers. Seven days post-inoculation the cultured materials were harvested and the exoerythrocytic schizonts and hypnozoites were observed under the microscope by using immunoperoxidase staining technique. The results showed that the sporozoite developing rate of 30 +/- 1 degrees C group and 13 +/- 1 degrees C group was significantly lower than that of 26 +/- 1 degrees C group (0.33%, 0.35% and 0.75% respectively). The proportion of hypnozoites in the total number of EE forms was the highest in the low temperature group (62.5%) compared with 26 +/- 1 degrees C and 30 +/- 1 degrees C group (40.1% and 42.7% respectively). Suggesting that the low environmental temperature first affected the viability of tachysporozoites or the phenotype of sporozoites and thus resulted in heightened hypnozoite rate. This is parallel to the epidemiological data that in the regions of high latitute vivax malaria with long incubation period was more frequently observed. When the sporozoites within the body of mosquito were cryopreserved at -70 degrees C or in liquid nitrogen for 24 h or 5 d respectively, the proportion of hypnozoite increased 87.4% and 82.4%, respectively. However, cryopreservation did not inactivate all of the tachysporozoites, indicating that the resistance to ultralow temperature in bradysporozoite was much greater than that in tachysporozoites. Aging of sporozoites decreased their developing rate and the exoerythrocytic (EE) schizonts were found to grow sluggishly and asynchronously, indicating that the size of EE schizont and the age of sporozoites are in negative correlation. Meantime, proportion of the hyponozoite decreased significantly.

[Observation on hypnozoite of different isolates of Plasmodium vivax in cultured materials]

The hypnozoites of different isolates of P. vivax from Shenzhen and Shixin, Guangdong Province, Changsha, Hunan Province and Yincheng, Hubei Province of China in cultured materials were observed employing immunoperoxidase staining method. The percentages of hypnozoites among exoerythrocytic stages were 40.1, 43.5, 50.6 and 57.1%, respectively, indicating that the percentage of hypnozoites and the latitude are in positive correlation. The equation is y = -6.68 + 2.05x. When the difference in latitude of Plasmodium vivax isolate source was more than 5 degrees, a significant difference in the percentage of hypnozoites in various geographic isolates was found. However, the average diameters of hypnozoites and schizonts among various geographic isolates showed no significant difference. The results showed that in the regions north to the Yangtze River, the proportion of hypnozoite in the liver stage of P. vivax was larger than those in the southern China, being consistent with the clinical manifestations.

[What has the reform of primary care meant in the community approach to arterial hypertension?]

OBJECTIVE

To evaluate an arterial Hypertension programme (AHP), with analysis of its feasibility and the problems inherent in the methodology used.

DESIGN

A retrospective evaluation of the results of an AHP programme. A population projection of the results by means of an extrapolated calculation.

SETTING

An urban Health Centre.

PATIENTS

A random sample of 282 patients selected from the total of 564 individuals diagnosed with AHT over the 6 years of the programme's operation.

MEASUREMENTS AND MAIN RESULTS

The 564 patients in the records made up 16.5% of the Health Area's adult population. The iceberg phenomenon (the percentage of undiagnosed hypertension sufferers) has evolved from 59% in 1988 to the present 17%. 7.4% of the sample received no treatment. Average AHT figures for the patients in treatment were 143 +/- 15 mm Hg systolic pressure and 85 +/- 9 mm Hg diastolic. 75% had adequate control of their tension figures (< 160/95). The population projection of these findings indicated that 57% of Hypertension sufferers calculated to be living in the Health area were diagnosed and monitored.

CONCLUSIONS

The results show that the AHT situation among the population has substantially improved. The methodology used is easy to manage and can be of service in the evaluation of the impact of AHT programmes on the population.

[Pharmacokinetics of liensinine in rabbits]

A method for the determination of plasma concentration of liensinine with HPLC and pharmacokinetic study of liensinine in rabbits were reported. Assay linearity was shown over the range of 0.125-2.5 micrograms/ml serum with regression coefficient of 0.9997. The mean recoveries of liensinine in plasma (within-day and between-days) were all more than 99% of the dose and the coefficients of variation were less than 5%. After a single intravenous injection of liensinine 6mg/kg to rabbit. The pharmacokinetic characteristics were found to fit a two-compartment open model. Important parameters were: t1/2 alpha = 8.303 min t1/2 beta = 129.960min AUC = 132.67 micrograms.min/ml CL = 0.045 L/min Vc = 2.768 L/kg.

[Pharmacokinetics of sinomenine by HPLC]

Pharmacokinetics of sinomenine in rabbit was studied by reverse-phase HPLC method. After i.v. injection of 20 mg/kg of sinomenine to rabbits, the pharmacokinetic characteristics were found to fit a two-compartment open model.