Gu-Ben-Hua-Shi (AESS) formula ameliorates atopic dermatitis via regulating NLRP3 signaling pathways

Background

Gu-ben-hua-shi (AESS) formula is a clinical experienced prescription from Guangdong Hospital of Traditional Chinese Medicine (TCM), which is used to treat atopic dermatitis (AD). Our previous work has shown that AESS has therapeutic effect on AD by regulating yes-associated protein (YAP). AESS formula has multi-component and multi-target characteristic, and need to be analyzed by systematic chemical profiling and network pharmacology technology, as well as verification of key signaling pathways. Therefore, this study aimed at investigating the efficacy and effect of AESS formula in the treatment of AD and its effect on NLRP3 signaling pathway.

Methods

The components of AESS formula were analyzed and identified by ultra high performance liquid chromatography/tandem mass spectrometry (UHPLC- MS/MS), and the potential mechanism of AESS formula in the treatment of AD was predicted by network pharmacology approach, with detected main components, and the potential components targeted NOD-like receptor thermal protein domain associated protein (NLRP3) signaling pathway [Direct binding with NLRP3, apoptosis-associated speck-like protein (ASC) and Caspase-1] were assessed using molecular docking. AD-like symptoms were constructed by DNCB induced BALB/c mice. The effect of AESS formula on dorsal skin structure in AD-like mice was observed using H&E staining. Furthermore, the western blotting experiment explored the expression of the NLRP3 pathway protein.

Results

By UHPLC-MS/MS analysis, 91 compounds were detected in AESS formula, and 76 of them were identified, while by network pharmacological analysis, 1500 component targets were obtained, and 257 of them were obtained by intersection with eczema targets. Then one of the key pathways, nucleotide-binding oligomerization domain (NOD)-like signaling pathway was obtained by KEGG enrichment analysis. Molecular docking results showed 24 main components could effectively combine with ASC and Caspase-1 (≤-7 kcal/mol). The animal experiment results further showed that AESS formula alleviates symptoms in AD-like mice. ELISA kit results showed that the expression of IL-1β and IL-18 in serum was inhibited after AESS treatment. Additionally, western blotting analysis showed that the expressions of ASC, Caspase-1 and NLRP3 protein expression in the skin tissue of mice were down-regulated after AESS treatment. The experimental results show that AESS formula inhibited the expression of NLRP3 signaling pathway for the treatment of AD.

Conclusions

AESS formula can improve AD symptoms in mice by inhibiting the activation of NLRP3 inflammasome and the expression of the related downstream inflammatory cytokines.

[The relation between residual β-cell function and autoimmune status in long-term type 1 diabetes patients]

Objective: We aimed to investigate the autoimmune status of long-term type 1 diabetes mellitus (T1DM) patients with residual β-cell function. Methods: The residual β-cell function of long-term (disease duration≥10 years) autoimmune T1DM patients from the T1DM Integrated Management Clinic of the Second Xiangya Hospital was assessed by serum C-peptide levels. Patients with fasting or 2-hour postprandial C-peptide levels over the lower sensitivity limit of detection (16.7 pmol/L) were grouped as C-peptide-positive, and others were grouped as C-peptide-negative. We screened and enrolled all the C-peptide-positive patients (n=19). C-peptide-negative patients with matched sex, age, duration, BMI (n=19) and healthy controls (n=19) were recruited at the same time. The frequencies of CD4+T cell (Th1/Th2/Th17/Treg) and B cell (MZB/FoB/B10) subsets, the expression of PD-1/PD-L1 on T and B lymphocytes, and the levels of T1DM related cytokines including IFN-γ, TNF-α, IL-1β, IL-1RA, IL-4, IL-6, IL-10, IL-12p40, IL-12p70, IL-23 and IP-10 were tested. We compared these parameters in patients with different levels of β-cell function. Results: In healthy controls, C-peptide-negative and C-peptide-positive patients, the frequencies M (Q₁, Q₃) of Th1 cells were 9.93% (7.45%, 15.20%), 14.90% (11.70%, 18.00%) and 10.20% (6.93%, 15.80%) (P=0.015), and the frequencies M (Q₁, Q₃) of Treg cells were 3.52% (2.92%, 5.68%),2.88% (1.64%, 3.22%) and 3.12% (2.81%, 4.81%) (P=0.005), and the frequencies M(Q₁,Q₃) of PD-1+B cells were 4.69% (2.64%, 6.37%), 2.11% (1.45%, 3.63%) and 4.20% (2.53%, 6.01%) (P=0.003), respectively. The levels of IL-6 M(Q₁,Q₃)were 26.43(18.06, 33.35) ng/L, 42.97 (25.52, 66.30) ng/L, and 22.07 (14.85, 34.45) ng/L (P=0.006), and the levels of IP-10 M(Q₁,Q₃) were 107.39 (76.19, 126.07) ng/L, 188.82 (131.27, 348.18) ng/L and 128.26 (114.31, 136.50) ng/L (P<0.001) in healthy controls, C-peptide-negative and C-peptide-positive patients, respectively. Compared with C-peptide-positive patients, the frequency of Th1 cells and the levels of IL-6 and IP-10 cytokines were higher, while the frequencies of Treg cells and PD-1+B cells were lower in C-peptide-negative patients (all P<0.05). Conclusions: Long-term T1DM patients with residual β-cell function had lower frequency of Th1 cells, lower levels of IL-6, IP-10 cytokines, and higher frequencies of Treg and PD-1+B cells, which indicated a pronounced autoimmune tolerance.

[Analysis of the effect of microwave ablation in the treatment of small liver cancer]

Objective: To explore the clinical effect of microwave ablation in the treatment of early small liver cancer (≤3 cm). Methods: 103 cases with small liver cancer (tumor number < 3 and maximum tumor diameter < 3 cm) who underwent microwave ablation from November 2016 to November 2018 were retrospectively collected. The rate of residual lesions, recurrence rate one-year after the operation, and surgical complications were observed and grouped according to tumor size (< 2 cm and≥2 cm group) and tumor numbers (solitary and 2 ~ 3 lesion groups). The therapeutic effects of each group were compared and analyzed. Results: The tumor residual rate and one-year recurrence rate of small liver cancer after microwave ablation were 11.7% and 35.0%, respectively. The post-ablation syndrome incidence rate was 52.4%, with no serious adverse events. Compared with tumors < 2 cm, patients with≥2 cm had a higher postoperative residual rate (χ(2) = 7.651, P = 0.006), and the one-year recurrence rate of more solitary nodular tumors was lower (χ(2) = 10.125, P = 0.001). Conclusion: Microwave ablation is a safe and effective treatment for early small liver cancer, and it is more effective for small solitary nodules (< 2 cm).

Capture Deformation Twinning in Mg during Shock Compression with Ultrafast Synchrotron X-Ray Diffraction

Deformation twinning plays a vital role in accommodating plastic deformation of hexagonal-close-packed (hcp) metals, but its mechanisms are still unsettled under high strain rate shock compression. Here we investigate deformation twinning in shock-compressed Mg as a typical hcp metal with in situ, ultrafast synchrotron x-ray diffraction. Extension twinning occurs upon shock compression along ⟨112[over ¯]0⟩ and ⟨101[over ¯]0⟩, but only upon release for loading along ⟨0001⟩. Such deformation mechanisms are a result of the polarity of deformation twinning, which depends on directionality and relative magnitude of resolved shear stress and may be common for Mg and its alloys in a wide range of strain rates.

[Quantitative study on the development of fetal ventricles and cisterna magna in second and third trimesters with MRI]

Objective: To analyze the changes of growth and development of normal fetal ventricles and cisterna magna with gestational age(GA) and the correlation with fetal gender in the second and third trimester,and establish the MR prenatal diagnosis reference standards. Methods: A total of 633 fetuses (mean GA (27.0±4.1) weeks (18.9-40.6 weeks))without central nervous system abnormalities were retrospectively collected from the Obstetrics and Gynecology Hospital of Fudan University from June 2012 to August 2017. The lateral ventricle trigonometric width (LVTW), third ventricle width (TVW), fourth ventricle width (FVW), anterior-posterior diameter of the fourth ventricle(APDFV), cavum septum pellucidum width (CSPW) and cisterna magna width (CMW) were obtained in the standard measure planes on MR image.The correlation between the biometrics and GA and the correlation between the biometrics and fetal gender were analyzed respectively, and the normal reference values of the biometrics were calculated. Spearman correlation analysis, Pearson correlation analysis,linear regression analysis, independent samples t-test and paired samples t-test were used for statistic analysis. Results: (1)Fetal LLVTW,RLVTW,TVW,CSPW and CMW in second and third trimesters were correlated with GA at medium and low levels(the correlation coefficient r were 0.311, 0.277, 0.207, 0.226, 0.295, respectively, all P<0.01). FVW and APDFV were statistically correlated with GA, and the linear regression equations were as follows: y=0.022×GA-0.043 (adjusted R(2)=0.642); y=0.018×GA-0.159 (adjusted R(2)=0.690). (2)Fetal LLVTW,RLVTW,FVW,APDFV and CSPW were not correlated with fetal gender in second and third trimesters(r=-0.078,-0.057,-0.087,-0.004 and 0.024, P=0.124,0.258,0.085,0.931 and 0.618, all P>0.05). TVW and CMW were statistically correlated with fetal gender(r=-0.310, -0.180, P=0.000, 0.006, all P<0.05). (3) The mean values of LLVTW and RLVTW were (0.71±0.13) cm and (0.68±0.13) cm, respectively, and significant difference was found between them(t=3.180, P=0.002). The mean value of CSPW was (0.59±0.15) cm. And the mean values of male and female fetuses for TVW and CMW were (0.17±0.05) cm, (0.16±0.06) cm and (0.68±0.15) cm, (0.58±0.15) cm, respectively. The corresponding prenatal MRI diagnostic criteria were as follows: LLVTW 1.1 cm, RLVTW 1.0 cm, CSPW 1.0 cm, TVW 0.3 cm, CMW (male 1.1 cm, female 1.0 cm). Conclusions: The normal fetal ventricles and cisterna magna are increased with the GA in the second and third trimesters. TVW and CMW are related to fetal gender. The establishment of normal reference values of fetal ventricles and cisterna magna based on GA and fetal gender are conducive to enhance the accuracy of MRI prenatal diagnosis.

Metformin alters DNA methylation genome-wide via the H19/SAHH axis

The molecular mechanisms underlying the antineoplastic properties of metformin, a first-line drug for type 2 diabetes, remain elusive. Here we report that metformin induces genome-wide alterations in DNA methylation by modulating the activity of S-adenosylhomocysteine hydrolase (SAHH). Exposing cancer cells to metformin leads to hypermethylation of tumor-promoting pathway genes and concomitant inhibition of cell proliferation. Metformin acts by upregulating microRNA let-7 through AMPK activation, leading to degradation of H19 long noncoding RNA, which normally binds to and inactivates SAHH. H19 knockdown activates SAHH, enabling DNA methyltransferase 3B to methylate a subset of genes. This metformin-induced H19 repression and alteration of gene methylation are recapitulated in endometrial cancer tissue samples obtained from patients treated with antidiabetic doses of metformin. Our findings unveil a novel mechanism of action for the drug metformin with implications for the molecular basis of epigenetic dysregulation in cancer. This novel mechanism of action also may be occurring in normal cells.

Methylation differences and expression profiles of the caprine DIO3 gene

DIO3 gene encoding type 3 iodothyronine deiodinase is an imprinted gene, located in the DLK1-DIO3 (delta-like 1 homolog-type 3 iodothyronine deiodinase) imprinted domain, and is potentially involved in degrading excessive amounts of thyroid hormone to protect embryogenesis. However, the underlying regulatory mechanism of the imprinted DIO3 gene expression during fetal and neonatal development in goats has not been elucidated. In this study, we explored the DNA methylation patterns of the caprine DIO3 intragenic CpG island and quantified gene expression level in six tissues from Chinese Nanjiang Yellow 3-day old kids. The expression of the DIO3 gene was determined using quantitative reverse transcription-polymerase chain reactions (qRT-PCRs), while the identification of methylation patterns was determined using bisulfite-sequencing PCRs. Modest, and non-significant (P > 0.05), methylation patterns were noted for the DIO3 CpG island methylation in the brain, heart, liver, kidney, lung, and longissimus dorsi tissues (ranging from 26.48 to 34.92%). The expression level of the DIO3 mRNA was significantly higher (P < 0.05) in the liver tissue than in the other five tissues. Pearson's correlation analysis revealed that there was no significant relationship between methylation and gene expression (P > 0.05), which indicated that the expression of the caprine DIO3 gene was likely modified by other regulatory elements. This study identified DNA methylation and expression patterns of the DIO3 gene in goats and provided insights into further regulatory mechanisms of expression and imprinting in the DLK1-DIO3 domain.

Swimming exercise ameliorates neurocognitive impairment induced by neonatal exposure to isoflurane and enhances hippocampal histone acetylation in mice

Isoflurane-induced neurocognitive impairment in the developing rodent brain is well documented, and regular physical exercise has been demonstrated to be a viable intervention for some types of neurocognitive impairment. This study was designed to investigate the potential protective effect of swimming exercise on both neurocognitive impairment caused by repeated neonatal exposure to isoflurane and the underlying molecular mechanism. Mice received 0.75% isoflurane exposures for 4h on postnatal days 7, 8, and 9. From the third month after anesthesia, the mice were subjected to regular swimming exercise for 4weeks, followed by a contextual fear condition (CFC) trial. We found that repeated neonatal exposure to isoflurane reduced freezing behavior during CFC testing and deregulated hippocampal histone H4K12 acetylation. Conversely, mice subjected to regular swimming exercise showed enhanced hippocampal H3K9, H4K5, and H4K12 acetylation levels, increased numbers of c-Fos-positive cells 1h after CFC training, and less isoflurane-induced memory impairment. We also observed increases in histone acetylation and of cAMP-response element-binding protein (CREB)-binding protein (CBP) during the swimming exercise program. The results suggest that neonatal isoflurane exposure-induced memory impairment was associated with dysregulation of H4K12 acetylation, which may lead to less hippocampal activation following learning tasks. Swimming exercise was associated with enhanced hippocampal histone acetylation and CBP expression. Exercise most likely ameliorated isoflurane-induced memory impairment by enhancing hippocampal histone acetylation and activating more neuron cells during memory formation.

Dynamic comparison of genetic diversity in a Small Tail Han sheep population using meta-analysis

The aim of this research was to identify the dynamic diversity of Small Tail Han sheep in its main producing areas between different years, and provide a basis for a breeding and genetic resources conservation strategy. For this purpose, 15 microsatellites were genotyped for Small Tail Han Sheep sampled in 2014 from Heze, China, and a comparative analysis of these data with those from a previous study was undertaken using meta-analysis. The results reveal that inbreeding has caused a reduction in diversity of Small Tail Han Sheep from 2008 to 2014. Overall, our results are helpful in understanding the dynamic change in diversity, as well as providing information for a conservation strategy for this population.

Molecular characterization and expression patterns of insulin-like growth factor-binding protein genes in postnatal Nanjiang brown goats

Insulin-like growth factor-binding proteins (IGFBPs) play a key role in modulating insulin-like growth factors (IGFs), and are considered candidate genes for growth traits in livestock. In this study, we identified the complete coding sequences of IGFBP-1 to -6 in the Nanjiang brown goat, and assessed gene tissue expression patterns by quantitative polymerase chain reaction. Expression of mRNA for the six gene targets was detectable in liver, heart, and longissimus dorsi (LD) muscle. Expression levels of IGFBP-1, -2 and -5 mRNA were higher in liver than in heart and LD muscle (P < 0.01), while IGFBP-6 expression was highest in LD muscle, and IGFBP-3 and -4 were predominantly expressed in LD muscle and liver. Higher IGFBP-2, -3, -4, and -6 mRNA levels were observed in LD, compared to triceps brachii muscle (P < 0.01). Additionally, the target genes had different temporal expression profiles during postnatal development. Histological assessment of muscle sections revealed a constant increase in muscle fiber diameter with aging. These results suggest that IGFBPs may be important for liver and skeletal muscle development, and may contribute to the biological function of these tissues in goats.

Brief Note Low diversity of the major histocompatibility complex class II DRA gene in domestic goats (Capra hircus) in Southern China

DRA encodes the alpha chain of the DR heterodimer, is closely linked to DRB and is considered almost monomorphic in major histocompatibility complex region. In this study, we identified the exon 2 of DRA to evaluate the immunogenetic diversity of Chinese south indigenous goat. Two single nucleotide polymorphisms in an untranslated region and one synonymous substitution in coding region were identified. These data suggest that high immunodiversity in native Chinese population.

Prediction of the key binding site of odorant-binding protein of Holotrichia oblita Faldermann (Coleoptera: Scarabaeida)

The scarab beetle Holotrichia oblita Faldermann (Coleoptera: Scarabaeidae) is a predominant underground pest in the northern parts of China, and its larvae (grubs) cause great economic losses because of its wide range of host plants and covert habitats. Environmentally friendly strategies for controlling adults would have novel and broad potential applications. One potential pest management measure is the regulation of olfactory chemoreception to control target insect pests. In the process of olfactory recognition, odorant-binding proteins (OBPs) are believed to carry hydrophobic odorants from the environment to the surface of olfactory receptor neurons. To obtain a better understanding of the relationship between OBP structures and their ligands, homology modelling and molecular docking have been conducted on the interaction between HoblOBP1 and hexyl benzoate in the present study. Based on the results, site-directed mutagenesis and binding experiments were combined to describe the binding sites of HoblOBP1 and to explore its ligand-binding mechanism. After homology modelling of HoblOBP1, it was found that the three-dimensional structure of HoblOBP1 consists of six α-helices and three disulphide bridges that connect the helices, and the hydrophobic pockets are both composed of five helices. Based on the docking study, we found that van der Waals interactions and hydrophobic interactions are both important in the bonding between HoblOBP1 and hexyl benzoate. Intramolecular residues formed the hydrogen bonds in the C terminus of the protein and the bonds are crucial for the ligand-binding specificity. Finally, MET48, ILE80 and TYR111 are binding sites predicted for HoblOBP1. Using site-directed mutagenesis and fluorescence assays, it was found that ligands could not be recognized by mutant of Tyr111. A possible explanation is that the compound could not be recognized by the mutant, and remains in the binding cavity because of the loss of the intramolecular hydrogen bonding that acts as a holder. So we believe that Tyr111 of HoblOBP1 is a key binding site. We also believe that Ile80A is a very important binding site, especially to some ligands.

Repression of contexual fear memory induced by isoflurane is accompanied by reduction in histone acetylation and rescued by sodium butyrate

BACKGROUND

Isoflurane produces amnesia in mice during contextual fear conditioning (CFC) trials. Histone acetylation is a form of chromatin modification involved in the transcriptional regulation underlying memory formation. We investigated whether isoflurane-induced repression of contextual fear memory is related to altered histone acetylation in the hippocampus, and whether it can be rescued by the histone deacetylases inhibitor sodium butyrate (SB).

METHODS

Adult C57BL/6 mice were chronically given intraperitoneal injections of SB or vehicle for 28 days. Immediately before CFC training, the mice were exposed to isoflurane or air for 30 min and CFC testing was performed the next day. Hippocampal histone acetylation was analysed 1 h after CFC training. c-Fos, an immediate early gene (IEG) suggested to participate in learning and memory formation, was also investigated at the same timepoint.

RESULTS

Mice exposed to isoflurane showed a reduction in freezing time during the CFC test. These mice also exhibited reduced hippocampal H3K14, H4K5, and H4K12 acetylation 1 h after CFC training, and also decreased c-Fos expression. All of these changes were attenuated in isoflurane-exposed mice that were chronically treated with SB.

CONCLUSIONS

Isoflurane suppresses histone acetylation and down-regulates c-Fos gene expression in CA1 of the hippocampus after CFC training. These changes are associated with isoflurane-induced amnesia. The HDAC inhibitor SB prevented repressed contextual fear memory, presumably by promoting histone acetylation and histone acetylation-mediated gene expression in response to CFC training.

Bilateral latissimus dorsi flaps for the reconstruction of extensive scalp defects

BACKGROUND

The reconstruction of large scalp defects is occasionally required. Several methods of scalp reconstruction have previously been described. This paper presents the authors' experience with two patients in whom traditional methods were not sufficient and in whom bilateral latissimus dorsi free flaps were required.

OBJECTIVES

To evaluate the effectiveness of a new technique in reconstructing extensive scalp defects.

METHODS

Two case histories are presented. These include the rationale for the choice of reconstruction used as well as a discussion on the technical features of the surgery.

RESULTS

Reconstruction was effective in both cases. However, one patient died in the early postoperative period from a pulmonary embolus.

CONCLUSIONS

Bilateral latissimus flaps can be safely and effectively used in closing massive scalp defects in selected cases.

Novel alternative splicing by exon skipping in KIT associated with whole-body roan in an intercrossed population of Landrace and Korean Native pigs

The KIT locus has been suggested to be a strong candidate region linked with whole-body roan in the F(2) population produced by intercrosses between Landrace and Korean Native pigs. In this manuscript, we report the finding of a novel alternative splicing event in the porcine KIT gene that results in the skipping of exon 5 in the I(Rn) allele. KIT mRNAs that lack exon 5 were identified in the large intestine and skin, suggesting that the mechanism responsible for the skipping of exon 5 may be tissue specific. A U(26) repeat in intron 5 showed complete linkage (LOD = 11.8) with the roan phenotype and absolute association with the black phenotype of the Korean Native pig (KNP) population samples, inferring that the repeat pattern may alter the complementary base-pairing-mediated looping-out of introns 4 and 5, which may mediate the exon 5-skipping event. Although the sample size in our study was relatively small, we speculate that the R3 allele containing the U(26) repeat is a causative element for the roan phenotype via alternative control of the exon skipping in our roan pedigree.

Tracing genetic differentiation of Chinese Mongolian sheep using microsatellites

The genetic consequences of population differentiation and isolation have been the subject of conservation biology. In this study, we analysed the genetic diversity and structure of Mongolian sheep in China. These animals belong to a traditional local breed with high production, extensive adaption, early maturity and roughage resistance. For this purpose, 26 microsatellites were genotyped for five Mongolian sheep populations. The Bayesian clustering indicated five clusters as the most probable genetic structure of the populations investigated. In addition, a clear genetic structure was revealed in three populations distributed at large geographical scales, while the other cluster encompassed UQ and HLBR sheep that displayed no clear differentiation, probably due to their close and small geographical distributions. Overall, our results are helpful in understanding the interplay of population dynamics in these close genetic lineages of Mongolian sheep.

Sore throat or hoarse voice with bronchial blockers or double-lumen tubes for lung isolation: a randomised, prospective trial

Double-lumen endotracheal tubes and bronchial blockers allow lung isolation for one-lung ventilation. Few studies, however, directly compare these devices. Further, a new endobronchial blocker (Coopdech) is available in some countries. Our primary hypothesis was that bronchial blockers would be associated with less sore throat or hoarse voice than double-lumen tubes. Secondary outcomes were successful one-lung ventilation and surgical access. In this prospective trial, 120 Chinese patients undergoing elective surgery were randomly assigned to one of four groups of 30 patients: Coopdech blocker, Arndt blocker Univent tube or double-lumen tube. Postoperative sore throat and hoarse voice were assessed in the recovery room and 24 hours after surgery. The incidence and severity of sore throat or hoarse voice was less in the blocker groups than double-lumen tube group: Coopdech 13%, Arndt 20%, Univent 30% and double-lumen tube 60%, P < 0.001. The blocker groups did not significantly differ P = 0.28. Compared to the double-lumen tubes the bronchial blockers took about two minutes less to position but five minutes longer for lung deflation. Surgical exposure was uniformly good across the four groups. We conclude that clinical use of the Coopdech endobronchial blocker is similar to the Arndt and Univent blockers and that all three are associated with less sore throat or hoarse voice than double-lumen tubes.

Sore Throat or Hoarse Voice with Bronchial Blockers or Double-Lumen Tubes for Lung Isolation: A Randomised, Prospective Trial

Double-lumen endotracheal tubes and bronchial blockers allow lung isolation for one-lung ventilation. Few studies, however, directly compare these devices. Further, a new endobronchial blocker (Coopdech) is available in some countries. Our primary hypothesis was that bronchial blockers would be associated with less sore throat or hoarse voice than double-lumen tubes. Secondary outcomes were successful one-lung ventilation and surgical access. In this prospective trial, 120 Chinese patients undergoing elective surgery were randomly assigned to one of four groups of 30 patients: Coopdech blocker, Arndt blocker, Univent tube or double-lumen tube. Postoperative sore throat and hoarse voice were assessed in the recovery room and 24 hours after surgery. The incidence and severity of sore throat or hoarse voice was less in the blocker groups than double-lumen tube group: Coopdech 13%, Arndt 20%, Univent 30% and double-lumen tube 60%, P <0.001. The blocker groups did not significantly differ, P=0.28. Compared to the double-lumen tubes the bronchial blockers took about two minutes less to position but five minutes longer for lung deflation. Surgical exposure was uniformly good across the four groups. We conclude that clinical use of the Coopdech endobronchial blocker is similar to the Arndt and Univent blockers and that all three are associated with less sore throat or hoarse voice than double-lumen tubes.

Tracheal resection for critical tracheal occlusion due to intraluminal tumour

Anaesthesia for tracheal resection requires careful planning by an experienced team. We report a case of urgent tracheal resection for a vascular tumor in a 41-year-old man who was a heavy smoker The tumour occupied most of his trachea. A CT reconstruction of the tumor assisted in planning. Perioperative tracheal laser therapy and cardiopulmonary bypass were not used due to concerns about excessive bleeding. Intraoperative airway management involved an upper endotracheal tube placed by the anaesthetist and a second, lower, endotracheal tube placed by the surgeon. The existing evidence for anaesthesia management of tracheal resection is currently limited to case reports. This case illustrates how preoperative imaging and careful planning can lead to a successful outcome, despite the potentially life-threatening nature of the pathology and the surgery.

Comparative evaluation of the cerebral state index and the bispectral index during target-controlled infusion of propofol

BACKGROUND

Cerebral state index (CSI) has recently been introduced as an intra-operative monitor of anaesthetic depth. We compared the performance of the CSI to the bispectral index (BIS) in measuring depth of anaesthesia during target-controlled infusion (TCI) of propofol.

METHODS

Twenty Chinese patients undergoing general anaesthesia were recruited. CSI and BIS, and predicted effect-site concentration of propofol were recorded. The level of sedation was tested by Modified Observer's Assessment of Alertness/Sedation Scale (MOAAS) every 20 s during stepwise increase (TCI, 0.5 microg ml(-1)) of propofol. The loss of verbal contact (LVC) and loss of response (LOR) were defined by MOAAS values of 2-3 and less than 2, respectively. Baseline variability and the prediction probability (P(K)) were calculated for the BIS and CSI. The values of BIS(05) and CSI(05), BIS(50) and CSI(50), BIS(95) and CSI(95) were calculated at each end-point (LVC and LOR).

RESULTS

Baseline variability of CSI was more than that of BIS. Both CSI and BIS showed a high prediction probability for the steps awake vs LVC, awake vs LOR, and LVC vs LOR, and good correlations with MOAAS values.

CONCLUSION

Despite larger baseline variation, CSI performed as well as BIS in terms of P(K) values and correlations with step changes in sedation.

[Methodological studies on the evaluation of family burden due to injuries]

OBJECTIVE

To evaluate the method for describing the burden and dimensions of injury on family.

METHODS

Eighty-four families of patients with injury from the selected families were studied. Status on family function, including before and after the suffering disease, were measured with Family APGAR index. Present family function was re-measured one week after the initial study. The burden of injury on these families was measured with Family Burden Score.

RESULTS

There were significant differences (P < 0.01) between scores of APGAR before and after the onset of injury. Forty-one point six seven percent of the families were with dysfunctions prior to the injuries, while 89.29% of families having dysfunctions for the time being. There were universal burden on the families of patients with injury in multi-dimensions, including economic status, routine life, entertainment, relationship between members, physiological and psychological health of the members, and social relationship of and within the families.

CONCLUSION

Injury may bring impacts to the patient's family in multi-dimensions and induce dysfunction to patient's family. Both patients and their families should be involved when providing health care to and evaluating burden of injury on them.

Outcome of 2,284 cases with acute traumatic brain injury

OBJECTIVE

To analyze the prognosis of 2284 cases with acute traumatic brain injury and discuss possible methods to improve the outcome of head injuries.

METHODS

The relationship between trauma cause, trauma severity and management and patient's outcome was retrospectively analyzed.

RESULTS

Good recovery was achieved in 60.20%, moderate disability was 13.22%, severe disability 15.24%, vegetative status 0.31% and mortality 11.03%. The mortality was 1.07% in cases with GCS 15-13, 2.47% in cases with GCS 12-9, 13.29% in cases with GCS 8-6, and 57.4% in cases with GCS 5-3.

CONCLUSIONS

To prevent hypoxia, remove intracranial hematoma as soon as possible, use standard large traumatic craniotomy and apply mild hypothermia may be useful means for improving the outcome of severely head injured patients.

Mechanisms of induction of renal allograft tolerance in CD45RB-treated mice

BACKGROUND

Rejection is the most significant problem in the field of transplantation. The current goal of transplant immunology is to develop better immunotherapeutic protocols that are aimed at specifically suppressing alloreactivity and preserving an otherwise intact immune system. We have previously shown that mice will accept renal allografts indefinitely with normal renal function after two injections of a monoclonal antibody to the CD45RB protein. Furthermore, this antibody will reverse acute rejection when therapy is delayed until day 4 and will still induce tolerance. The mechanisms of this therapeutic benefit are not known.

METHODS

BALB/C mice were used as recipients of major multiple histocompatibility complex-mismatched kidneys using C57BL/6 as donors. Immunoperoxidase microscopy and Northern blots for cytokine gene expression were used to study the renal allografts. Fluorescence-activated cell sorter (FACS) analyses of peripheral blood lymphocytes were performed. Phosphotyrosine peptide phosphatase assays were performed on splenic lymphocyte membranes.

RESULTS

A CD45RB monoclonal antibody (MB23G2) induced tolerance and partially depletes peripheral blood lymphocytes. A therapeutically ineffective CD45RB monoclonal antibody (MB4B4) merely coated the circulating lymphocytes. Furthermore, MB23G2 stimulated more tyrosine phosphatase activity than MB4B4 in mouse T-cell membranes.

CONCLUSIONS

The clearance of peripheral blood lymphocyte populations and stimulation of protein tyrosine phosphatase activity may be important in the mechanism of tolerance induction by CD45RB therapy, which may be clinically relevant in the therapy of organ rejection in humans.

[Survey on traditional medicinal resources of Uncaria distributed in China]

OBJECTIVE

To make clear the botanical origin of medicinal Uncaria distributed in China and the situation of its use in folk medicines.

METHODS

Collecting data and making on-the-spot investigation.

RESULTS

There are thirteen medicinal plants which belong to Uncaria genus, and ten of them are commercially available. A clear idea was obtained of their geographical distribution, distribution features and practical experiences in folk application.

CONCLUSION

This investigation is helpful in further researching and exploring the resources of Uncaria for medical use, as well as provides a scientific basis for production, management and safe use of crude drugs.

[A survey on botanical origins of drug tiannanxing produced in Sichuan]

According to the investigation and identification of botanical origins of 7 species and 1 variety of the traditional Chinese drug Tiannanxing produced in Sichuan, it has been found out that the main species available on the market are Arisaema erubescens and A. heterophyllum, while A. asperatum, A. wilsonii and A. fargesil come second. A key for their identification is presented in this paper.

[Folk medicine of the Qiang nationality]

Based on a two-year investigation of folk medicine of the Qiang Nationality, systematic studies have been made on its formation and development, specific methods of physical therapy and experiences and features of clinical application.

Transcriptional regulation of the yeast DnaJ homologue SIS1

The Saccharomyces cerevisiae SIS1 gene encodes an essential heat shock protein with similarity to the Escherichia coli DnaJ protein. In sis 1-85 and sis1-86 mutants, the sis1 RNA is induced to high levels at room temperature and without heat shock. The presence of wild type SIS1 in the sis1-85 mutant represses the overexpression of SIS1-85 protein. Furthermore, overexpression of wild type SIS1 reduces the beta-galactosidase activity expressed from a SIS1:lacZ fusion. These results suggest that SIS1 negatively regulates its own expression. The autoregulation of SIS1 transcription is mediated through a 39-base pair cis-element containing the SIS1 heat shock element plus additional flanking sequences on one side. Although SIS1 transcription is constitutive, it is transiently induced upon heat shock. In addition, SIS1 transcription is regulated by SSA (a class of HSP70 proteins) function. The elevated transcription of SIS1 in ssa1 ssa2 mutants is mediated solely through the SIS1 heat shock element. Therefore, the SIS1 autoregulatory element is different from the SSA-responsive element, suggesting that the mechanism involved in autoregulation of SIS1 is distinct from regulation of SIS1 by SSA proteins.

Nonlinear behaviour of human motoneurons

When ramp-and-hold currents are injected into a motoneuron of an anesthetized cat, the motoneuron responds with a high initial firing rate (dynamic phase), which then adapts to a lower steady-state firing rate. The firing rates during the dynamic and the steady-state phases are linearly related to the rate of change and the magnitude of the injected current, respectively. In human subjects, where inputs to the motoneurons are not accessible, force parameters are used to describe motoneuron behaviour. Population responses of human motoneurons, measured in terms of gross electromyographic (EMG) activity, increase linearly with the magnitude and the rate of change of force. No study has attempted to examine the question of linearity of single motor units during the dynamic as well as the steady-state phases. The following study recorded single motor unit and EMG activities simultaneously from the flexor carpi radialis muscle in human subjects completing ramp-and-hold force trajectories. Although the results confirmed the linear relationship between EMG activities and the rate and magnitude of the force, a nonlinear activity pattern was observed between the single motor unit firing and the force parameters, suggesting that recruitment must be responsible for the linear behaviour of EMG activity. Comparisons of different background activity levels on the firing patterns of a given motor unit, as well as comparisons of two simultaneously recorded units, further supported nonlinear response patterns of single motor units.

The yeast SIS1 protein, a DnaJ homolog, is required for the initiation of translation

The S. cerevisiae SIS1 gene is essential and encodes a heat shock protein with similarity to the bacterial DnaJ protein. At the nonpermissive temperature, temperature-sensitive sis1 strains rapidly accumulate 80S ribosomes and have decreased amounts of polysomes. Certain alterations in 60S ribosomal subunits can suppress the temperature-sensitive phenotype of sis1 strains and prevent the accumulation of 80S ribosomes and the loss of polysomes normally seen under conditions of reduced SIS1 function. Analysis of sucrose gradients for SIS1 protein shows that a large fraction of SIS1 is associated with 40S ribosomal subunits and the smaller polysomes. These and other results indicate that SIS1 is required for the normal initiation of translation. Because DnaJ has been shown to mediate the dissociation of several protein complexes, the requirement of SIS1 in the initiation of translation might be for mediating the dissociation of a specific protein complex of the translation machinery.

SIT4 protein phosphatase is required for the normal accumulation of SWI4, CLN1, CLN2, and HCS26 RNAs during late G1

In Saccharomyces cerevisiae, the RNA levels of the G1 cyclins CLN1, CLN2, and HCS26 increase dramatically during the late G1 phase of the cell cycle. The SIT4 gene, which encodes a serine/threonine protein phosphatase, is required for the normal accumulation of CLN1, CLN2, and HCS26 RNAs during late G1. This requirement for SIT4 in normal G1 cyclin RNA accumulation is at least partly via SWI4. Strains containing mutations in SIT4 are sensitive to the loss of either CLN2 or CLN3 function. At the nonpermissive temperature, temperature-sensitive sit4 strains are blocked for both bud emergence and DNA synthesis. Heterologous expression of CLN2 in the absence of SIT4 function results in DNA synthesis, but most of the cells are still blocked for bud emergence. Therefore, SIT4 is required for at least two late G1 or G1/S functions: the normal accumulation of G1 cyclin RNAs (which is required for DNA synthesis) and some additional function that is required for bud emergence or cell cycle progression through late G1 or G1/S.