[Longdan Xiegan Decoction and its interpretation from the perspective of meridians]

By systematically examing through Longdan Xiegan Decoction in medical books of the past dynasties, it was found that the Longdan Xiegan Decoction recorded in Lan Shi Mi Cang mainly targeted men's genital odor at frist. After Xue Ji's addition and subtraction, the scope of the prescription was gradually generalized and expanded, and confusion its name, composition and source of the prescription appeared, which was particularly prominent in Jingyue Quanshu and Yifang Jijie.Doctors used to interpret this prescription from the perspective of viscera. In order to better understand the main treatment rules of Longdan Xiegan Decoction, it is necessary to change the perspective and reinterpreted it from the perspective of meridians.Attributing the symptoms of the perineum to Liver Meridian of Foot-Jueyin,hypochondriac pain, deafness and other symptoms to the Gallbladder Meridian of Foot-Shaoyang, and adding or subtracting herbs according to the specific conditions, is not only conducive to a comprehensive and in-depth understanding of the prescription to achieve accurate clinical syndrome differentiation and medication, but also prompts modern researchers to rethink the important role of meridian theory in the formation and development of the theoretical system of traditional Chinese medicine.

Correlation between preoperative systemic immune-inflammatory indexes and the prognosis of gastric cancer patients

OBJECTIVE

The aim of this study is to explore the potential value of high preoperative systemic immune-inflammation index (SII) expression in the prognosis of patients with gastric cancer (GC) by meta-analysis.

MATERIALS AND METHODS

The major databases were searched to screen relevant clinical studies on the prognostic value of SII in gastric cancer (GC) patients, published from the establishment of the database to May 2022. RevMan 5.3 was utilized to perform a meta-analysis of relevant data. The differences in age, tumor size, differentiation degree, tumor-node-metastasis (TNM) stage, overall survival (OS), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) between the high SII expression group (H-SII) and the low SII expression group (L-SII) were compared. Heterogeneity was assessed by Cochran's Chi-square test.

RESULTS

A total of 16 studies with 5,995 GC patients were included. Compared with the L-SII group, the proportion of patients older than 60 years in the H-SII group was markedly higher (OR=0.85, 95% CI: 0.75-0.97; Z=2.45, p=0.01); the proportion of patients with tumor size larger than 5 cm increased (OR=2.18, 95% CI: 1.69-2.81; Z=6.03, p<0.00001); the proportion of patients with TNM stage ≥T3 increased (OR=2.41, 95% CI: 1.89-3.08; Z=7.06, p<0.00001); overall survival (OS) decreased (OR=-23.92, 95% CI: -37.57 to -10.26; Z=3.43, p=0.0006); the 5-year survival rate (SR) decreased markedly (OR=0.39, 95% CI: 0.24-0.64; Z=3.81, p=0.0001); the proportion of patients with high NLR expression was increased (OR=22.19, 95% CI: 10.66-46.18; Z=8.29, p<0.00001); and the proportion of patients with high PLR expression was also markedly increased (OR=15.97, 95% CI: 8.57-29.75; Z=8.73, p<0.00001).

CONCLUSIONS

A high preoperative SII was an independent risk factor for poor prognosis in GC patients.

Targeting the renin angiotensin system for respiratory diseases

Renin-angiotensin system (RAS) plays an indispensable role in regulating blood pressure through its effects on fluid and electrolyte balance. As an aside, cumulative evidence from experimental to clinical studies supports the notion that dysregulation of RAS contributes to the pro-inflammatory, pro-oxidative, and pro-fibrotic processes that occur in pulmonary diseases like asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and acute lung injury (ALI). Pharmacological intervention of the various RAS components can be a novel therapeutic strategy for the treatment of these respiratory diseases. In this chapter, we first give a recent update on the RAS, and then compile, review, and analyse recent reports on targeting RAS components as treatments for respiratory diseases. Inhibition of the pro-inflammatory renin, angiotensin-converting enzyme (ACE), angiotensin (Ang) II, and Ang II type 1 receptor (AT1R) axis, and activation of the protective ACE2, AT2R, Ang (1-7), and Mas receptor axis have demonstrated varying degrees of efficacies in experimental respiratory disease models or in human trials. The newly identified alamandine/Mas-related G-protein-coupled receptor member D pathway has shown some therapeutic promise as well. However, our understanding of the RAS ligand-and-receptor interactions is still inconclusive, and the modes of action and signaling cascade mediating the newly identified RAS receptors remain to be better characterized. Clinical data are obviously lacking behind the promising pre-clinical findings of certain well-established molecules targeting at different pathways of the RAS in respiratory diseases. Translational human studies should be the focus for RAS drug development in lung diseases in the next decade.

[Retrospective analysis of short-term curative effect of total laparoscopic loop ileostomy reversal after radical resection of rectal cancer]

Objective: To investigate the safety, feasibility and short-term efficacy of total laparoscopic loop ileostomy reversal in patients after resection of rectal cancer. Methods: The clinical data of 20 patients who underwent total laparoscopic loop ileoscopic loop ileostomy after radical resection of rectal cancer at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, or Beijing Chaoyang District Sanhuan Cancer Hospital from October 2019 to June 2020 were collected and retrospectively analyzed. Results: All patients had successfully underwent total laparoscopic ileostomy reversal without conversion to open surgery or discontinued operation. No perioperative related death cases were found. In the whole group, the median operation time was 97 (60-145) minutes and the median intraoperative blood loss was 20 (10-100) milliliters. The median Visual Analogue Scale (VAS) score was 1.9 (1-5) one day after the operation. Nobody needed to use additional analgesic drugs. The median time to grand activities was 25 (16-42) hours, the median time to flatus was 44 (19-51) hours, and the median hospitalization after operation was 6.9 (5-9) days. No patients underwent operation related complications such as operative incision infection, abdominal and pelvic infection, intestinal obstruction, anastomotic leakage, bleeding and so on. Conclusions: Total laparoscopic loop ileostomy reversal appears to be safe, feasible and with promising efficacy for selected patients.

[Effect and safety of endobronchial placement of vaseline gauze in the treatment of patients with bronchial fistula]

Objective: To investigate the application of vaseline gauze to occlude the bronchial fistulas and its clinical effectiveness and safety in this retrospective study. Methods: This study retrospectively reviewed the clinical records of 14 patients with bronchial fistulas at Department of Respiratory and Critical Care Medicine, Shanghai Dongfang Hospital affiliated to Tongji University between June 2019 and June 2022. Seven of the 14 patients were female, and the age ranged from 16 to 74 years. We retrieved all the clinical records of all the enrolled patients during the 6 to 12 months follow-up after the operation, including the information for removal of chest drainage pipe, the failure of endobronchial blockage using vaseline gauze, as well as the complications (migration of the vaseline gauze, obstructive pneumonia, pulmonary atelectasis, et. al.) after the operation. Results: Of the 14 patients, 3 patients had fistula located in main or lobar bronchi; 10 patients had fistula located in distal airways; and 1 patient had fistula located both in main bronchi and distal airways. Ten patients were complicated with pneumonia or pleural cavity infections; Five were complicated with pneumothorax or hydropneumothorax. All of the 14 patients achieved successful airway occlusion after the placement of vaseline gauze in the responsible bronchial airways or stumps for the fistulas. Eleven of the 14 patients successfully removed the drainage tube for the residual cavity, 3 of the 14 patients successfully removed the vaseline gauze for the fistula which was healing during the follow up of 6-12 months. No one of the patients had severe complications or treatment failure. Conclusion: Bronchial placement of vaseline gauze might be a feasible and effective technique for treatment of bronchial fistulas.

[Application of portable electroencephalograph in patients with epilepsy and establishment of medical platform]

Objective: To provide a portable electroencephalograph that can facilitate long-term monitoring of epilepsy patients outside the hospital, and establish a medical platform for epilepsy data monitoring and treatment. Methods: From June 2018 to October 2019, twenty-nine patients from Huashan Hospital (superior hospital) and Jing'an District Central Hospital (subordinate hospital) of Fudan University were enrolled in the study. Among them, twenty-eight cases were diagnosed with epilepsy and 1 case was epileptic seizure. Electroencephalogram (EEG) was collected by portable electroencephalograph once a week and followed up for three months. The seizure frequency, seizure form, medication type, EEG lead number and positive rate were recorded. Patients' medical records and EEG data were uploaded to the cloud database to build a medical alliance platform. Doctors of different levels of hospitals couldobtain diagnosis and achieve resource sharing based on the platform. The data was statistically analyzed using SPSS 18.0. Results: The EEG data collected by the portable electroencephalograph hadfewer artifacts, complete sleep cycle, and could record the interictaldischarges. Twenty-nine patientsunderwent a total of 148 EEG monitoring during the three-month follow-up. Eighty-five cases of epileptic discharges were detected, and the EEG positive rate was 57.4%. The positive rate of EEG in patients with generalized seizures (84.9%) was higher than that in patients with focal seizures (42.1%) (P<0.01); the positive rate of EEG in patients with 2-3 antiepileptic drugs and patients with frequent seizures within three months were also higher (P<0.05). Doctors in the superior hospital in the platform make diagnosis and treatment suggestions according to the above data. Elevenseizure-free patients and four patients with fewer seizures and discharges were diverted to the community hospital for follow-up. Fourteen patients with poor seizure control and/or continuous epileptic discharges were diverted to the superior hospitalto adjust the medication. Doctors of subordinate hospital acquired the diagnosis and treatment suggestions through the platform, and then strengthened the daily care and follow-up. Conclusion: Combined with a portable electroencephalograph, the current study establishs a medical platform for patients with epilepsy to achieve long-term monitoring and rational use of medical resources.

Replacing soybean meal with flax seed meal: effects on nutrient digestibility, rumen microbial protein synthesis and growth performance in sheep

Flax seed meal (FSM) is rich in various nutrients, especially CP and energy, and can be used as animal protein feed. In animal husbandry production, it is a long-term goal to replace soybean meal (SBM) in animal feed with other plant protein feed. However, studies on the effects of replacing SBM with FSM in fattening sheep are limited. The aim of this experiment was to study the effects of replacing a portion of SBM with FSM on nutrient digestibility, rumen microbial protein synthesis and growth performance in sheep. Thirty-six Dorper × Small Thin-Tailed crossbred rams (BW = 40.4 ± 1.73 kg, mean ± SD) were randomly assigned into four groups. The dietary treatments (forage/concentrate, 45 : 55) were isocaloric according to the nutrient requirements of rams. Soybean meal was replaced with FSM at different levels (DM basis): (1) 18% SBM (18SBM), (2) 12% SBM and 6% FSM (6FSM), (3) 6% SBM and 12% FSM (12FSM) and (4) 18% FSM (18FSM). The rams were fed in individual pens for 60 days, with the first 10 days for adaptation to diets, and then the digestibility of nutrients was determined. There was no significant difference in DM intake, but quadratic (P < 0.001) effects on the average daily gain and feed efficiency were detected, with the highest values in the 6FSM and 12FSM groups. For DM and NDF digestibility, quadratic effects were observed with the higher values in the 6FSM and 12FSM groups, but the digestibility of CP linearly decreased with the increase in FSM in the diet (P = 0.043). There was a quadratic (P < 0.001) effect of FSM inclusion rate on the estimated microbial CP yield. However, the values of intestinally absorbable dietary protein decreased linearly (P < 0.001). For the supply of metabolisable protein, both the linear (P = 0.001) and quadratic (P = 0.044) effects were observed with the lowest value in the 18FSM group. Overall, the results indicated that SBM can be effectively replaced by FSM in the diets of fattening sheep and the optimal proportion was 12.0% under the conditions of this experiment.

Carbon emissions embodied in the global supply chain: Intermediate and final trade imbalances

By differentiating intermediate trade from final trade, this paper combines typical statistics for the world economy in 2012 to explore the transfer of embodied carbon emissions via the global supply chain and the related trade imbalance. The emission transfer embodied in interregional trade is in magnitude around 40% of global direct carbon emissions. The global intermediate trade volume of embodied carbon emissions is estimated to be 2.3 times as much as the final trade volume. While Mainland China obtains a considerable economic trade surplus, its carbon trade deficit is about twice the carbon trade surplus of the United States. Mainland China's final trade deficit is around 1.2 times as much as its intermediate trade deficit of embodied carbon emissions. EU27, the United States, ASEAN and Japan serve as the major contributors to China's intermediate and final trade deficits. For the United States, its intermediate carbon trade surplus is almost equal to its final trade surplus. The United States gains a carbon surplus with most of its trading partners in both intermediate and final trades. A future scenario analysis in terms of carbon emission projection is conducted. While the direct and embodied carbon emissions of the United States and Japan are estimated to change slightly from 2012 to 2040, India's carbon emissions are projected to experience a twofold increase during the period. In the long term, though with ups and downs, the economic globalization will be inevitably moving forward, leading to a highly sliced-up global supply chain and increasingly delicate regional specialization as well as frequent intermediate trade between regions. It is suggested that nations and regions should follow this trend and adapt themselves to the global value chain by carefully assessing their roles in intermediate and final trades in terms of both currency and embodied carbon emissions.

LncRNA SNHG8 promotes the development and chemo-resistance of pancreatic adenocarcinoma

OBJECTIVE

The aim of this study was to investigate the role of small nucleolar RNA host gene 8 (SNHG8) in the pathogenesis of pancreatic adenocarcinoma and to explore the possible underlying mechanism.

PATIENTS AND METHODS

SNHG8 expression in 40 pairs of pancreatic adenocarcinoma tissues and para-cancerous tissues, as well as 10 normal pancreas tissues was detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Survival analysis was conducted to explore the correlation between SNHG8 expression and the prognosis of pancreatic adenocarcinoma patients. After the transfection of SNHG8 siRNA into pancreatic adenocarcinoma cells, the proliferation and cell cycle were detected by cell counting kit-8 (CCK-8) assay and flow cytometry, respectively. Meanwhile, cell apoptosis was detected by flow cytometry and Western blot. The regulatory effect of SNHG8 on the chemo-sensitivity of pancreatic adenocarcinoma cells was assessed by CCK-8 assay.

RESULTS

The expression of SNHG8 in pancreatic adenocarcinoma tissues was significantly higher than that of para-cancerous tissues and normal pancreatic tissues. Pancreatic adenocarcinoma patients with higher expression of SHNG8 presented shorter overall survival than those with lower expression. Meanwhile, SNHG8 expression was correlated with tumor stage and differentiation level, whereas not correlated with age, sex, tumor location and lymph node metastasis of pancreatic adenocarcinoma patients. In vitro results showed that SNHG8 knockdown significantly decreased the proliferative ability, prolonged G0/G1 phase and increased the apoptosis of Hs766T and PANC-1 cells. Western blot results elucidated that SNHG8 knockdown remarkably downregulated the protein expression levels of cleaved caspase-3 and cleaved PARP in Hs766T and PANC-1 cells. In addition, SNHG8 significantly decreased the chemo-sensitivity of pancreatic adenocarcinoma cells.

CONCLUSIONS

SNHG8 is highly expressed in pancreatic adenocarcinoma tissues and is negatively correlated with its prognosis. Moreover, SNHG8 promotes cell proliferation and cell cycle, whereas inhibits cell apoptosis and reduces the chemo-sensitivity of pancreatic adenocarcinoma cells.

Energy use by globalized economy: Total-consumption-based perspective via multi-region input-output accounting

Within a single integrated globalized economy featuring robust fluxes of interregional trades, the world economy is like a giant bathtub containing the world inventory of energy use. Based on different norms or ethic percepts, the energy use of the world economy is reallocated to nations and regions via global supply chain using normative accounting schemes. By combining typical statistics for world economy 2012, a new perspective is presented in this study to look into the energy use of regional economies from the side of genuine final consumers. Parallel to the final-demand-based accounting method, a total-consumption-based multi-region input-output accounting method is developed following the norm of consumption being the ultimate end and purpose of all producing activities. From a total-consumption-based perspective, the energy use of the United States economy is shown in magnitude 1.8 times that of mainland China, compared to a ratio of 88% from a territorial-based perspective. The consumer-product-related trade imbalances of major economies in terms of both currency and energy use are analyzed, with major interregional net trade flows illustrated. While the United States and mainland China are respectively revealed as the leading net exporter and net importer of currency, the energy trade deficit of the latter is in magnitude around four times the energy trade surplus of the former. The trade structures by geography and sector are respectively presented for the United States and mainland China as two distinct economies. It is found that around half of the United States' exports of energy use originate from transport and service industries, while nearly 90% of mainland China's exports of energy use come from heavy industry. The findings are supportive for nations to identify their roles in the global supply chain from the perspective of genuine final consumers and adjust the trade patterns for sustained energy use.

Potential involvement of S1PR1/STAT3 signaling pathway in cardiac valve damage due to rheumatic heart disease

Rheumatic heart disease (RHD) is a public health burden in developing countries. Th17 cell-associated cytokines might play a role in the pathogenesis and development of RHD, but the specific molecular mechanism is not completely understood. We investigated the potential role of sphingosine-1-phosphate receptor 1 (S1PR1)/signal transducer and activator of transcription 3 (STAT3) signaling pathway in cardiac valve damage in a rat model of RHD. We used 20 Lewis rats divided randomly into control and RHD groups. The RHD model was constructed by injecting inactivated group A Streptococci and complete Freund's adjuvant (CFA). The rats in the control group were injected with normal saline and CFA. Th17 cell-related cytokines were measured by ELISA. Fibrosis was assessed by histological examination. RT-qPCR and western blot were used to detect the expression of S1PR1 and STAT3/phosphorylated STAT3 (p-STAT3). The S1PR1/STAT3 signaling pathway was activated in the RHD model. Compared to the control group, serum levels of IL-17 and IL-21 cytokines associated with Th17 cells were increased significantly in the RHD group; the collagen volume fraction also was substantially increased. The S1PR1/STAT3 signaling pathway might be involved in RHD induced cardiac valve damage by regulating Th17 cells.

Cup-on-cup technique to manage severe protrusio acetabular defects

Previous studies have demonstrated that revision of total hip arthroplasty consumes considerably more resources than the primary procedure. Worse, patients who need revision procedures are more likely to have radiographic evidence of acetabular and femoral bone loss than those undergone primary total hip arthroplasty. Many techniques have been introduced to manage different conditions of acetabular deficiencies. We describe a rare case of a 67-year-old man with severe acetabular bone loss, which was caused by a long-term loose acetabular component and was successfully managed by cup-on-cup technique. We also discuss the similarities and differences between cup-on-cup and cup-in-cup techniques in the management of protrusio acetabular defects, with a case-based approach.

MiR-377 suppresses cell proliferation and metastasis in gastric cancer via repressing the expression of VEGFA

OBJECTIVE

In recent years, microRNAs have been identified to participate in tumor genesis and progression of different tumors including gastric cancer. However, the role of miR-377 played in gastric cancer (GC), and its mechanisms have not been demonstrated.

PATIENTS AND METHODS

We detected miR-377 expression level in 86 GC and adjacent normal tissue samples by quantitative reverse transcription PCR (qRT-PCR) as well as in GC cell lines. The relationship between miR-377 and clinical pathological features was analyzed. Using miR-377 mimics and inhibitors, we interfered with miR-377 level and employed several functional experiments to study the miR-377 effects on cell proliferation, migration, and invasion. Western blot assay and dual-luciferase assay were used to verify the target of miR-377.

RESULTS

miR-377 expressed significantly lower in GC tissues and cell lines compared to normal tissues and GES-1 cells. Overexpression of miR-377 inhibited cell growth, migration and invasion, while downregulation miR-377 obviously promoted cell growth and metastasis. Furthermore, vascular endothelial growth factor A (VEGFA) was confirmed as a direct target of miR-377 and reversed the influence of mir-377 over-expression.

CONCLUSIONS

miR-377 expressed lower in GC and suppressed cell proliferation, migration and invasion partly via repressing the VEGFA expression, which could provide a potential target for GC diagnosis and therapy.

[Study on the dynamic variations and influencing factors of serum lipid levels during pregnancy and postpartum]

Objective: To study the variations and influencing factors of serum triglycerides and cholesterol levels during pregnancy and postpartum. Methods: A retrospective study was performed among 5 020 healthy singleton (95.10%, 4 774/5 020) and twin (4.90%, 246/5 020) women who had delivery in Women's Hospital, Zhejiang University School of Medicine from January 2011 to December 2016. Serum triglycerides and cholesterol levels during pregnancy and postpartum of all the cases were collected. Both singleton and twin pregnant women were divided into advanced age and appropriate age groups, and then data of serum sample were assigned to 3 groups according to the gestation weeks, which were second trimester pregnancy (24-28 gestation weeks) , third trimester pregnancy (32-41 gestation weeks) and postpartum (within 72 hours after delivery) . The serum triglycerides and cholesterol levels in each groups were compared. Results: (1) Serum triglycerides and cholesterol levels during the second trimester pregnancy, third trimester pregnancy and postpartum were higher than levels of non-pregnancy in both singleton and twin groups (all P<0.05) . (2) Serum triglycerides and cholesterol levels in the third trimester pregnancy group were higher than those of second trimester pregnancy group in both advanced age and appropriate aged women regardless singleton or twin pregnancy (all P<0.05) . The 95%CI of serum lipid levels in each group during second and third trimester pregnancy were as follows: in appropriate aged singleton group, the triglycerides levels were 1.07-4.13 and 1.52-7.21 mmol/L, and the cholesterol levels were 2.77-12.11 and 4.44-9.36 mmol/L. In advanced aged singleton group, the triglycerides levels were 1.28-4.61 and 1.70-7.80 mmol/L, and the cholesterol levels were 4.35-8.40 and 4.46-9.35 mmol/L; in appropriate aged twin group, the triglycerides levels were 1.39-7.16 and 1.90-9.29 mmol/L, and the cholesterol levels were 4.99-12.16 and 4.52-10.07 mmol/L; in advanced aged twin group, the triglycerides levels were 1.61-5.32 and 1.94-9.29 mmol/L, and the cholesterol levels were 5.24-8.10 and 4.53-8.86 mmol/L. (3) Serum lipids levels rapidly decreased during postpartum compared to the third trimester pregnancy. The 95%CI of blood lipid levels in each group were as follows: in appropriate aged singleton group, the triglycerides level was 0.90-5.64 mmol/L and the cholesterol level was 4.70-8.52 mmol/L; in advanced aged singleton group, the triglycerides level was 0.87-5.43 mmol/L and the cholesterol level was 4.68-9.04 mmol/L; in appropriate aged twin group, the triglycerides level was 1.20-8.21 mmol/L and the cholesterol level was 4.66-8.45 mmol/L; in advanced aged twin group, the triglycerides level was 1.32-6.61 mmol/L, and the cholesterol level was 5.01-7.94 mmol/L. (4) Serum triglycerides and cholesterol levels in twin pregnant women were significantly higher than in singleton during the second trimester and third trimester pregnancy both in advanced age and appropriate age groups (all P<0.05) . During postpartum, there was no difference in serum lipid levels between the singleton and twin pregnant women in appropriate age group (triglycerides: P=0.982; cholesterol: P=0.759, respectively) . While the serum lipid levels in twin pregnant women were significantly higher than those of singleton women in advanced age group (triglycerides: P=0.000; cholesterol: P=0.000, respectively) . Conclusions: The standard of serum lipid levels of non-pregnant adults is not suitable for assessing that in pregnant women. Regardless of singleton or twin pregnancy, serum triglyceride and cholesterol levels during pregnancy elevate with the increasing gestational week and then rapidly decrease during postpartum. Age and twins are the influencing factors of the elevated physiological lipid levels during pregnancy.

[Curative effects and influenced factors of primary chemotherapy with single-agent methotrexate on low-risk gestational trophoblastic neoplasia]

Objective: To evaluate the efficacy of primary chemotherapy with single-agent methotrexate (MTX) for low-risk gestational trophoblastic neoplasia and to analysis the influenced factors. Methods: We retrospectively reviewed 259 cases with low-risk gestational trophoblastic neoplasia whose primary chemotherapies were MTX 0.4 mg·kg(-1) (maximum 25 mg) daily for 5 days every other week. Patients' data between January 2001 and June 2015 was collected and the relationships of different factors to outcomes of chemotherapy were also evaluated. Results: 183 of the 259 patients (70.66%, 183/259) achieved complete primary remission and all patients achieved complete remission after salvage chemotherapy. Univariate analysis showed that FIGO score, serum level of HCG before treatment and interval months from previous pregnancy were significantly associated with outcome of chemotherapy (P=0.001, 0.018, 0.014 respectively). Logistic regression analysis showed that the FIGO score (OR=4.094) and antecedent pregnancy (OR=0.268) were two independent factors predictive for the outcome of chemotherapy. Conclusions: Primary chemotherapy with single-agent MTX may still be one of the options for patients with low risk GTN. The FIGO score and antecedent pregnancy are two independent risk factors of outcome of single-agent MTX chemotherapy.

Ectopic expression of Arabidopsis thaliana Na+(K+)/H+ antiporter gene, AtNHX5, enhances soybean salt tolerance

Drought and salt stresses are the two major factors influencing the yield and quality of crops worldwide. Na(+)(K(+))/H(+) antiporters (NHXs) are ubiquitous membrane proteins that play important roles in maintaining the cellular pH and Na(+)(K(+)) homeostasis. The model plant Arabidopsis potentially encodes six NHX genes, namely AtNHX1 to 6. In the present study, AtNHX5, a comparatively less well-studied NHX, was cloned and transferred into a soybean variety, Dongnong-50, via Agrobacterium-mediated cotyledonary node transformation to assess its role in improving salt tolerance of the transgenic plants. The transgenic soybean plants were tolerant to the presence of 300 mM NaCl whereas the non-transgenic plants were not. Furthermore, after NaCl treatment, the transgenic plants had a higher content of free proline but lower content of malondialdehyde compared to the non-transgenic plants. Our results revealed that that AtNHX5 possibly functioned by efficiently transporting Na(+) and K(+) ions from the roots to the leaves. Overall, the results obtained in this study suggest that soybean salt tolerance could be improved through the over expression of Arabidopsis AtNHX5.

Lack of association between the aryl hydrocarbon receptor rs2066853 polymorphism and breast cancer: A meta-analysis on Ahr polymorphism and breast cancer

Published data regarding the association between aryl hydrocarbon receptor (Ahr) rs2066853 polymorphism and the risk of breast cancer shows conflicting results. We performed a meta-analysis on 2999 patients and 3050 controls from three related case-control studies to estimate the association between Ahr rs2066853 polymorphism and the risk of breast cancer. The protocol was approved by the Institutional Animal Care and Use Committee (IACUC) at the University of Florida (America NIH Publication No. 86-231985 Revision). According to the three eligible populations, the odds ratios (ORs), 95% confidence intervals (CIs) on the risk of breast cancer for the genotypes GA vs GG, AA vs GG, and A vs G were 1.06 (0.81-1.40), 0.96 (0.81-1.13), and 1.02 (0.85-1.22), respectively. The OR (95%CI) for GA + AA vs GG was 1.05 (0.80-1.37). Furthermore, after multi-variates adjustment, the ORs (95%CIs) were 1.05 (0.80-1.38) for GA vs GG, and 0.92 (0.76-1.10) for AA vs GG. This meta-analysis suggests that Ahr (rs2066853) polymorphism would not modify the risk of breast cancer. However, further research should be conducted to provide more evidence.

Meta-analysis comparing early versus delayed laparoscopic cholecystectomy for acute cholecystitis

BACKGROUND

Previous studies comparing early laparoscopic cholecystectomy (ELC) with delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis were incomplete. A meta-analysis was undertaken to compare the cost-effectiveness, quality of life, safety and effectiveness of ELC versus DLC.

METHODS

PubMed, Embase, the Cochrane Library and Web of Science were searched for randomized clinical trials (RCTs) that compared ELC (performed within 7 days of symptom onset) with DLC (undertaken at least 1 week after symptoms had subsided) for acute cholecystitis.

RESULTS

Sixteen studies reporting on 15 RCTs comprising 1625 patients were included. Compared with DLC, ELC was associated with lower hospital costs, fewer work days lost (mean difference (MD) -11·07 (95 per cent c.i. -16·21 to -5·94) days; P < 0·001), higher patient satisfaction and quality of life, lower risk of wound infection (relative risk 0·65, 95 per cent c.i. 0·47 to 0·91; P = 0·01) and shorter hospital stay (MD -3·38 (-4·23 to -2·52) days; P < 0·001), but a longer duration of operation (MD 11·12 (4·57 to 17·67) min; P < 0·001). There were no significant differences between the two groups in mortality, bile duct injury, bile leakage, conversion to open cholecystectomy or overall complications.

CONCLUSION

For patients with acute cholecystitis, ELC appears as safe and effective as DLC. ELC might be associated with lower hospital costs, fewer work days lost, and greater patient satisfaction.

Correlation between the NPPB gene promoter c.-1298 G/T polymorphism site and pulse pressure in the Chinese Han population

The aim of this study was to investigate the correlation between the natriuretic peptide precursor B (NPPB) gene single nucleotide polymorphism (SNP) c.-1298 G/T and pulse pressure (PP) of the Chinese Han population and the association between genotype and clinical indicators of hypertension. Peripheral blood was collected from 180 unrelated patients with hypertension and 540 healthy volunteers (control group), and DNA was extracted to amplify the 5'-flanking region and 2 exons of the NPPB gene by polymerase chain reaction; the fragment was sequenced after purification. The clinical data of all subjects were recorded, the distribution of the NPPB gene c.-1298 G/T polymorphism was determined, and differences in clinical indicators between the two groups were evaluated. The mean arterial pressure PP, and creatinine levels were significantly higher in the hypertension group than in the control group (P<0.05), but no other clinical indicators differed between the groups. There were no significant differences in genotype frequency and distribution of the NPPB gene c.-1298 G/T polymorphism between the hypertension group and the control group (P>0.05); in the control group, the mean PP of individuals with the SNP c.-1298 GG genotype was greater than that of individuals with the GT+TT genotype (P<0.05). In conclusion, there was no significant correlation between the NPPB gene c.-1298 G/T polymorphism and the incidence of essential hypertension in the Han population; however, the PP of the SNP c.-1298 GG genotype was greater than that of the GT+TT genotype in the control group.

Effect of aerobic exercise on miRNA-TLR4 signaling in atherosclerosis

Toll-like receptor 4 (TLR4)-tumor necrosis factor receptor 6 (TRAF6) signaling is activated in atherosclerosis (AS), inducing inflammatory mediators. Because miR-146a, a TLR4 microRNA (miRNA), can regulate TLR4 signaling during inflammatory responses, this study investigated the effects of aerobic exercise on TLR4-targeted miRNAs in AS. Apolipoprotein E-null mice fed a high-fat diet for 12 weeks were separated into 3 groups: (i) no treatment (AS), (ii) statin treatment (AD), or (iii) aerobic exercise (AE). Plaques and foam cells were observed in the untreated control and statin groups, respectively, but not in the AE group. Reduced angiotensin II (Ang II) and endothelin 1 (ET1) levels were observed in the AE group. Both treatment groups significantly altered the expression of inflammatory cytokine expression and reduced vascular TLR4 levels. Increased miR-146a and miR-126 and reduced miR-155 levels were observed in both treatment groups (all, P<0.001). miR-146a interacted with the 3' untranslated region of the TRAF6 gene, reducing its expression. Thus, aerobic exercise and statins may induce miR-146a expression, thereby reducing vascular TRAF and TLR4 signaling and vascular inflammatory injury in AS. Further analysis of this pathway may provide insight into the protective effects of aerobic exercise on vascular disease as well as new therapeutic targets.

Interspecies difference of luteolin and apigenin after oral administration of Chrysanthemum morifolium extract and prediction of human pharmacokinetics

The aims of the present study were to study the interspecies difference in the pharmacokinetics of luteolin and apigenin occurring in Chrysanthemum morifolium extract (CME) among rats, beagle dogs, mini-pigs, and humans, and compared the human pharmacokinetic parameters with the data predicted from the above three animals. The plasma concentrations of luteolin and apigenin were determined with a RP-HPLC method. An interspecies difference of pharmacokinetics was found, especially between rats and other species, the plasma concentration of luteolin was much lower than that of apigenin in rats, although the content of luteolin in CME was higherthan that of apigenin, whereas the plasma concentration of luteolin was much higher than that of apigenin in dogs, mini-pigs and humans. Animal scale-up of some pharmacokinetic parameters of luteolin and apigenin were also performed after rats, beagle dogs, mini-pigs and humans were orally given CME at dosages of 400 mg/kg, 102 mg/kg, 90 mg/kg, and 20 mg/kg, respectively. Linear relationships were obtained between log mean retention time (MRT) and log species body weight (W) (kg), and log elimination half-life (t1/2) (h) and logW. The corresponding allometric equations were MRT=9.382W(0.1711) (R2 = 0.9999) and t1/2 = 4.811W(0.1093) (R2 = 0.9013) for luteolin, MRT = 12.53W(0.0356) (R2 = 0.9980) and t1/2 = 7.940W(0.0294) (R2 = 0.9258) for apigenin, respectively. The predicted human pharmacokinetic parameters (MRT and t1/2) by an allometric approach were 18.6 h and 7.46 h for luteolin, 14.3 h and 8.95 h for apigenin, respectively, which were close to the values obtained from humans (20 mg CME/kg) in the present study. The study has demonstrated the possibility to extrapolate the pharmacokinetic behavior of flavonoids from animals to humans.

Nanometer size effect on structural and magnetic properties of La0.2Ca0.8MnO3

Structural and magnetic properties of La0.2Ca0.8MnO3 nanoparticles with average size of 15-37 nm, prepared by the glycine-nitrate method, have been studied. Synchrotron experiments performed in the temperature range of 80-300 K have shown that a structural transition from room temperature orthorhombic Pnma to monoclinic P2(1)/m space group, associated with orbital ordering, occurs below 200 K in the studied particles. This transition observed for the largest particles of 37 nm is very close to that of bulk, as seen by similar temperature variation of lattice parameters and orthorhombic strain. The transition is highly suppressed for smaller 15 nm particles. Horizontal and vertical shifts of magnetic hysteresis loops (M(Shift) and H(EB)), displayed in a field cooled process, indicate size dependent exchange bias effect. It is also shown that M(shift) and H(EB), as well as the remanent magnetization M(r) and coercive field H(c) at low temperatures, exhibit a non-monotonic size dependence for particles around 23 nm. These effects may be attributed to the changes in uncompensated spins at the surface, anisotropy or alternatively to a transition from a multi-domain to the single domain state.

[Preparation of monoclonal antibodies against West Nile virus envelope protein domain.]

BACKGROUND

To prepare monoclonal antibodies against West Nile virus (WNV) envelope protein domain.

METHODS

BALB/c mice were immunized with recombinant antigen of West Nile virus envelope protein domain, and the spleen cells of the mice were used to prepare the monoclonal antibodies (McAb) by hybridoma technique.

RESULTS

Three hybridoma cell strains secreting McAbs against WNV envelope protein domain, designated as 4F7, 6H3 and 8E4, respectively, were obtained and were identified by indirect enzyme linked immunosorbent assay (ELISA), they belonged to IgG1, IgG1 and Ig2a, respectively. Two epitopes of envelope protein domain were determined, among them, 4F7 and 6H3 were against the same epitope and 8E4 to another one.

CONCLUSIONS

The results of indirect ELISA, Western blot and indirect immunofluorescence experiment indicated that these three McAbs were specific for West Nile virus envelope protein domain and did not cross-react with Japanese encephalitis virus and other viruses, so they can be used for specific detection of West Nile virus.

Bone marrow transplantation for beta-thalassaemia major by an HLA-mismatched parent

A six-year-old boy was diagnosed with beta-thalassaemia major during infancy. Since then, he required monthly blood transfusion and irregular iron chelation therapy. He had hepatosplenomegaly and elevated liver enzymes; the serum ferritin was up to 3800 ng/mL. An echocardiogram showed left-ventricular enlargement. His one-antigen-mismatched mother was chosen as a bone marrow donor. He was pretreated with intensive red blood cell transfusion and hydroxyurea for 6 weeks prior to conditioning. The conditioning included total body irradiation (300 cGy), busulfan (14 mg/kg), cyclophosphamide (160 mg/kg) and anti-thymocyte globulin (rabbit; 90 mg/kg). Marrow cell dose was 5.4 x 108/kg. Graft versus host disease (GVHD) prophylaxis included cyclosporine A (CSA) and methylprednisolone. Neutrophil engraftment occurred on day 23. Grade II acute GVHD occurred on day 45. The patient developed complications including septicaemia, haemorrhagic cystitis, intracranial haemorrhage and heart failure. He subsequently recovered from the complications without sequelae. The patient remained transfusion-independent at a follow-up examination after 18 months. This case suggested that a mismatched family member may be considered as a bone marrow donor for beta-thalassaemia major. In places where conventional treatment is not feasible, for example, in China, this approach may be an alternative option. A more intensive immunosuppressive regimen and a higher marrow cell dose may be important for successful engraftment. High-dose anti-thymocyte globulin may also prevent severe GVHD.

Effects of electroacupuncture on blood-brain barrier after cerebral ischemia-reperfusion in rat

The effect of electroacupuncture (EA) on the blood-brain barrier (BBB) after cerebral ischemia-reperfusion (I-R) was investigated in rats. The dye Evans Blue (EB) was used as a tracer for assessing the disruption of BBB. Fluorescence quantification of EB was performed to explore the temporal pattern of permeability of BBB after the cerebral I-R with a fluorescence spectrophotometer (HITACHI 650-60). Furthermore, the morphology of BBB opening was detected under confocal laser scanning microscopy system. It was found that the BBB opening after cerebral I-R was biphasic. A rare scattered extravasation of EB was detected 2 hours after cerebral I-R. The EB extravasation reached its first peak at 6 h then decreased at 24 h and increased again at the time-point of 48h after cerebral I-R. EA can attenuate the disruption of BBB after cerebral I-R. EA could not only limit the area of extravasation of EB, but also reduce the concentration of extravasation of EB in the rat brain after cerebral I-R. The results indicated that one of the mechanisms of curative effect of EA on the cerebral ischemia might be due to its function of protecting the integrity of BBB.

Characterization of a recombinant outer surface protein A (OspA) vaccine against Lyme disease

Lyme disease, the most prevalent tick-borne disease in the United States, results from infection with Borrelia burgdorferi sensu stricto. Early studies of Borrelia burgdorferi sensu stricto identified outer surface protein A (OspA), a lipoprotein on the surface of spirochetes that could be the target of protective antibodies to this agent. Pasteur Mérieux Connaught has developed a Lyme vaccine, ImuLyme, using recombinant OspA protein (rOspA). Methods were developed to routinely assess the identity, quantity, structure, purity, biological activity, heterogeneity, stability, and potency of rOspA. In addition, several methods were performed on a series of lots to support the routine testing methods and further our understanding of the physicochemical characteristics of rOspA. These tests were electrospray mass spectrometry, circular dichroism, two-dimensional gel electrophoresis, amino acid analysis, peptide mapping with peptide sequencing, and the application of proteomic methodology to identify trace contaminant host cell proteins. The results of these methods indicate that the rOspA lots are composed of highly purified and properly processed and folded rOspA with trace amounts of E. coli host cell proteins.

Characterization of post-translationally modified recombinant protein using liquid chromatography/mass spectrometry

Post-translational modification plays an important role in the biological functions of many proteins. Characterization of such modifications is crucial in the development of recombinant protein-based vaccines. Liquid Chromatography coupled with Mass Spectrometry (LC/MS) provides a powerful tool with high resolution and accuracy to characterize proteins and their post-translational modifications. The technique was applied to characterization of a Lyme vaccine protein rOspA (recombinant Outer surface protein A). The results demonstrate that LC/MS could be used to resolve and characterize various forms of post-translational lipidation of the protein. It was this detailed structural information that made it possible to validate a method for quantitative determination of the lipidation forms of rOspA.

[Biliary tract reconstruction after cystectomy of congenital choledochal cyst]

OBJECTIVE

To evaluate the operative methods of biliary tract reconstruction after cystectomy of congenital choledochal cyst(CCC).

METHODS

One hundred and six cases with CCC underwent cystectomy and biliary tract reconstruction in our hospital from July 1984 to December 1999 were followed up. Among them, there were three kinds of procedures in biliary tract reconstruction: with single Roux-Y hepaticojejunostomy in 48 cases, with intussusceptive valve to the line of Roux-Y hepaticojejunostomy in 37 cases, with rectangular valve to the line of Roux-Y hepaticojejunostomy in 21 cases.

RESULTS

Fifty nine cases were followed up for 4.68 years in average. There were 3 cases with ascending cholangitis after single Roux-Y hepaticojejunostomy. And the symptom disappeared in 2 cases underwent reoperation with an intussueceptive valve plasty to the line of Roux-Y hepaticojejunostomy. No patients suffered from ascending cholangitis in the precautionary valve plasty group.

CONCLUSION

It suggests that the postoperative ascending cholangitis can be prevented effectively if standard cystectomy and prophylactic intussusceptive valve added to the line of Roux-Y hepaticojejunostomy are carried out. The procedure should be performed as soon as possible providing the child is tolerable.

[Study on anticancer activity of Syngnathus in vitro]

OBJECTIVE

To study the anticancer activity of Syngnathus in vitro.

METHOD

Observing the influence of different extracts from Syngnathus on growth of different cancer cell strains by MTT method.

RESULT

It has been found out that the fat-soluble nonsaponified extract from Temminck et Schlegel and the alcoholic extract from Syngnathus acus have cytotoxic activities. The nonsaponified extract from Temminck et Schlegel can inhibit the growth of cancer cell strains KB, Hela, PAA, K562, and Bcap37, and the alcoholic extract from Syngnathus acus can inhibit the growth of cancer cell strin KB, But Bloch shows no apparent anticancer activity.

CONCLUSION

Syngnathus has promising prospects as an anticancer Chinese medicine.

[The diploid of genetically engineered yeast for expression of hybrid HBsAg gene SA-28]

By mating a yeast haploid expressing hybrid HBsAg gene SA-28, Y19/YFD158, with another hapolid Y95, the diploid Y95xY19/YFD158 was constructed. The experiments showed that the cell density of the diploid in fermentation was three time higher than that of the haploid, the stability of expression vector in the diploid was much higher than in the haploid, the xpression level of hybrid HBsAg gene of the diploid was more than three time higher than that of the haploid and the average cope number in diploid cell was a little lower than that in the haploid.

Hyperlipidemia of normal pregnancy in Karachi-Pakistan

During pregnancy, changes in the levels of total cholesterol, triglyceride, low density lipoprotein-cholesterol, and high density lipoprotein-cholesterol have been described, but in the existing literature these effects remain controversial because of inconsistencies. Moreover, the degree of change varies from study to study. Therefore, the present study completely investigated changes in lipids and lipoproteins throughout the pregnancy and in the puerperium. We also investigated whether or not any relation between plasma lipids and other pregnancy related factors exist. Concentrations of cholesterol and triglyceride of total plasma, and lipoproteins were determined in 56 pregnant women throughout the pregnancy and in the puerperium along with 56 non-pregnant women. Compared to control group, concentrations of cholesterol and triglyceride of total plasma and lipoproteins increased significantly during second trimester and reached maximum in the third trimester. Both cholesterol and triglyceride concentrations decreased significantly within 24 hours of delivery and this was reflected in all lipoproteins. In the majority of subjects, cholesterol and triglycerides remained significantly high until 4 weeks of postpartum. The magnitude of the serum cholesterol increment appeared in part to be related to that of serum triglyceride, but these increments appeared to be independent of age, weight gain, numbers of previous pregnancies and sex of the fetus. This study concludes that hyperlipidemia is a common finding during pregnancy.

The effects of 2-bromopropane on viability and testosterone production ability of rat Leydig cells in primary culture

Epidemiological surveys and animal experiments have shown that 2-bromopropane induces oligozoospermia in exposed workers and inhibits spermatogensis in laboratory animals. However, the mechanism by which 2-bromopropane exerts its effects is unknown. To this end, we examined the formation of testosterone by the Leydig cells and their survival of these cells in the presence of different concentrations of 2-bromopropane in vitro. Leydig cells were isolated following vascular perfusion, enzymatic dissociation and Percoll gradient centrifugation techniques. The cells were cultured in culture dishes. After 8 h, different cultures were exposed to 2-bromopropane at concentrations of 0.01 mmol/L, 0.10 mmol/L and 1.00 mmol/L. In order to stimulate Leydig cells to secrete testosterone, human chorionic gonadotropin (hCG) was also added. Cell viability was determined using the trypan blue dye exclusion test and cell numbers were counted by hemocytometer. Testosterone secretion was detected by radioimmunoassay. The cell viability decreased after exposure to 2-bromopropane in a dose-dependent way, but no morphological change was observed. The cell number decreased in the 2-bromopropane-treated cultures. The secretion of testosterone did not manifest defectable changes in the culture treated with 0.10 mmol/L and 0.01 mmol/L of 2-bromopropane; however, it decreased significantly (P < 0.02) in the presence of 1.00 mmol/L. Therefore, our results strongly suggest that 2-bromopropane may exert its cytotoxic effects on Leydig cells in vitro. We speculate that the decrease in the numbers of Leydig cells caused by 2-bromopropane was mediated by a feedback mechanism resulting from a lower testosterone concentration.

A rare-earth phosphor containing one-dimensional chains identified through combinatorial methods

An unusual luminescent inorganic oxide, Sr2CeO4, was identified by parallel screening techniques from within a combinatorial library of more than 25,000 members prepared by automated thin-film synthesis. A bulk sample of single-phase Sr2CeO4 was prepared, and its structure, determined from powder x-ray diffraction data, reveals one-dimensional chains of edge-sharing CeO6 octahedra, with two terminal oxygen atoms per cerium center, that are isolated from one another by Sr2+ cations. The emission maximum at 485 nanometers appears blue-white and has a quantum yield of 0.48 +/- 0.02. The excited-state lifetime, electron spin resonance, magnetic susceptibility, and structural data all suggest that luminescence originates from a ligand-to-metal Ce4+ charge transfer.

Variations in ocular pressure during menstrual cycle

The present study investigated whether a correlation between days of the menstrual cycle and variations in intraocular pressure exists or not. The number of days since the beginning of last menses was recorded along with intraocular pressure for 1,459 women. Measurements were taken by Goldmann applanation tonometer. The differences among various days of menstrual cycle were statistically insignificant. The highest mean IOP occurred between 20th and 22nd day and the second peak from 13th to 15th days of the cycle. The lowest mean IOP was found from 16th to 19th days of the cycle. This study concludes that intraocular pressure varies with the various days of the menstrual cycle, but fluctuations are statistically insignificant and cannot affect the diagnoses of glaucoma.

Analysis of lipidation of recombinant Lyme vaccine protein (rOspA) by electrospray mass spectroscopy

Lipidation at the N-terminal of recombinant outer surface protein A (rOspA) is an important determinant of its immunogenicity. Lipidation patterns of rOspA can be sensitive to processing environments and storage conditions. In order to assure product consistency and stability. it is essential to characterize and monitor lipidation patterns of rOspA through its life-cycle. Electrospray mass spectroscopy combined with maximum entropy calculation was employed to analyze the lipidation of rOspA. The results revealed that more than 90% of protein is a tri-lipidated rOspA and the remainder is di-lipidated. It was demonstrated that the method is both sensitive and quantitative and has the potential to be used for routine quality control and stability testing.

Effect of third trimester of pregnancy on diurnal variation of ocular pressure

This study was planned to evaluate the effect of pregnancy on diurnal variation of intraocular pressure (IOP) after placing control on all the IOP affecting factors. The IOP was measured with the Goldmann applanation tonometer. Both in the control and 3rd trimester subjects, the peak of mean IOP appeared in the morning when the subjects waked, and the trough of mean IOP happened at 2 am to 4 am. The diurnal intraocular pressure curves revealed that the IOP peaks were 15.4 +/- 0.9 and 12.9 +/- 0.6 mmHg in the control and third trimester pregnant subjects, respectively. Whereas the trough were 13.1 +/- 0.4 and 11.8 +/- 0.3 mmHg, respectively. The mean diurnal variation were 2.3 +/- 0.6 mmHg (P < 0.01), and 1.1 +/- 0.8 mmHg in the control and third trimester subjects, respectively. There are two main findings of present study: first, compared with non-pregnant control subjects, the IOP was significantly lower (P < 0.001) in the third trimester pregnant subjects. Second, in the third trimester of pregnancy, the lower IOP level was associated with the less degree of IOP fluctuations at various hours of the day.

Monthly measurements of intraocular pressure in normal, ocular hypertensive, and glaucoma male subjects of same age group

BACKGROUND

Recently it has been shown that environmental conditions have a significant influence on intraocular pressure (IOP). Due to differences in inherent constitution, diet and environmental conditions, there is a clear need for well collected IOP data in different countries and ethnic groups. The seasonal variation of IOP has never been described in Pakistani subjects.

METHODS

IOP was measured each month over the course of 12 months with the Goldmann applanation tonometer in normal, ocular hypertensive, and glaucoma male subjects.

RESULTS

In all groups, the average intraocular pressures in the winter months were highest, while lowest in summer months. The intraocular pressures of spring and autumn months were nearly the same. The intraocular pressure levels in these seasons were between the IOP levels in summer and winter seasons. The difference between highest and lowest IOP was 1.4 +/- 0.2, 3.1 +/- 1.4, and 2.3 +/- 1.1 mmHg, in normal, ocular hypertensive, and glaucoma subjects, respectively. The ups and downs of intraocular pressure were greater in the ocular hypertensive subjects than in the glaucoma patients.

CONCLUSIONS

This study confirms that season influences IOP, and concludes that seasonal influence is highest in ocular hypertensive than in normal and glaucoma subjects. As compared to other nations, effect of seasons on IOP seems to be somewhat less pronounced in Pakistan.

The effect of exercise training on physical fitness and plasma lipids in young Chinese men and women

BACKGROUND

The mortality from coronary heart disease (CHD) has been steadily increasing in many parts of the world. Measures to reduce the incidence of CHD were initially addressed mainly to middle aged and elderly population groups, but for effective prevention of CHD, measures addressed to younger age groups are also necessary. Moreover, differences between male and female plasma lipid changes after exercise training are not known exactly.

METHODS

The concentrations of plasma lipids, before and after regular physical exercise training for 12 weeks, were analyzed in 25 male and 25 female medical students of the same age group. Physical fitness was evaluated by the measurement of maximum oxygen uptake.

RESULTS

Results indicated that plasma tri-glyceride, HDL-cholesterol, LDL-cholesterol and VLDL-cholesterol differences between the before-and-after exercise were significant (p < 0.05) in males while the differences of plasma total cholesterol were found to be insignificant. In females there were no significant changes in the plasma lipids levels. In both males and females, the marked increase in maximal O2 uptake after exercise training indicated an improvement in physical fitness.

CONCLUSIONS

This study concludes that a short-term exercise program can improve plasma lipid and lipoprotein patterns more in males than in females. It also suggests that daily physical exercise may be an important prevention for cardiovascular diseases in later life, so it is essential to establish a life style with optimum nutrition and physical activity in both the young and in adults of all ages.

Hormonal changes associated with menstrual cycle have no definite influence on ocular pressure

BACKGROUND

Despite some findings to the contrary, it would appear that pharmacological doses of progesterone and estrogen (alone or in combination) can influence intraocular pressure (IOP). The relationship between hormonal changes associated with the menstrual cycle and intraocular pressure is not clearly understood. After elimination of those factors that can affect IOP, the present study investigated whether physiological hormonal changes associated with the menstrual cycle have a correlation with intraocular pressure.

METHODS

Intraocular pressure and the concentrations of circulating hormones, namely, the luteinizing hormone (LH), follicle-stimulating hormone (FSH), estrone (E1), estradiol (E2), progesterone, and testosterone, of twenty married women of the same age groups were recorded daily throughout a menstrual cycle. None was taking any contraceptives in any form. The intraocular pressure was measured using a Goldmann applanation tonometer.

RESULTS

The intraocular pressure values fluctuated in each of the twenty subjects at various times of the cycle; however, they were not definitely correlated with the different phases of the cycle. This study failed to find any correlation between IOP and progesterone or estradiol levels.

Resting intraocular pressure of steel factory workers is related to their physical fitness

Intraocular pressure (IOP) has never been compared between hard working and sedentary subjects. The relationship between physical fitness and IOP is not clearly known. There are only two studies and their results are contradictory. The variability in their results may be due to several factors. Therefore, the present study was planned to investigate the relationship between working style, physical fitness and IOP after taking into account those factors that can affect IOP. One hundred fifty male volunteers of a steel factory were divided equally in two groups. The subjects of group 1 were sedentary worker, whereas group 2 subjects were actively engaged in heavy works requiring exertion. Physical fitness was evaluated by the measurement of maximum oxygen uptake with a Bechman O2 analyzer. IOP was measured with the Goldmann applanation tonometer. As compared to sedentary subjects, maximum oxygen uptake was significantly higher whereas IOP was significantly lower in those who did moderate or severe exertions. The maximum oxygen uptake difference between group 1 and 2 was found to be (mean +/- SD) 5.1 +/- 1.1 ml/kg/min (p < 0.001), whereas, IOP difference was 1.9 +/- 0.7 mmHg (p < 0.001). This study concludes that hard working is associated with physical fitness and physical fitness is associated with reduced resting IOP. It would seem reasonable at present not to discourage subjects who have ocular hypertension from exercise; perhaps, on the contrary, it should be encouraged to increase their physical fitness.

Maternal-fetal transfer of metallic mercury via the placenta and milk

To clarify the situation of trans-placental movement and milk screening of metallic mercury in human, the content of mercury was detected in the maternal blood, umbilical cord blood, milk, and placental tissues. In 18 parturient women, 9 had been occupationally exposed to metallic mercury whereas the other 9 had not. Mercury was detected by means of cold vapor atomic absorption spectrophotometry. Results showed that the concentrations of mercury of the umbilical cord blood and placental tissues were higher than that of maternal blood. The ratio of organic and total mercury of milk was markedly lower than that of maternal blood in the exposed group (P < 0.01). The ratio of inorganic to total mercury of milk was significantly higher than that of maternal blood (P < 0.01). Therefore, this study concluded that the metallic mercury can be transferred to the fetus via the placenta and secreted to a newborn via milk.

Magnitude of decrease in intraocular pressure depends upon intensity of exercise

The present study was planned to investigate the relationship between the magnitude of intraocular pressure (IOP) reduction after short-duration exercise and the intensity, duration and quantity of exercise in healthy subjects. Twenty-five healthy, sedentary male of the same age group, performed exercises at the levels of 80%, 60%, and 40% maximum heart rate (HRmax) for 15 minutes, 80% HRmax for 7.5 minutes, 60% HRmax for 10 minutes, and 40% HRmax for 30 minutes. IOP was measured with the Goldmann applanation tonometer. The IOP reduction at 5 minutes after 15 minutes of exercising at 80% HRmax, 60% HRmax, and 40% HRmax were 4.7 +/- 0.9, 3.5 +/- 0.7, and 0.9 +/- 0.4 mmHg, respectively. At five minutes, after exercising 7.5 minutes at 80% HRmax, 10 minutes at 60% HRmax, and 30 minutes at 40% HRmax, IOP reduced by 4.5 +/- 0.7, 3.3 +/- 0.9, and 2.9 +/- 1.1 mmHg, respectively. This study concludes that intensity of exercise seems responsible for the magnitude of the initial IOP decrease after short-term exercise. Furthermore, it seems that other factors such as duration of exercise or quantity of exercise, blood pressures, body mass index are not related to the amount of the initial fall in IOP.

The effect of physical fitness on intraocular pressure in Chinese medical students

BACKGROUND

Virtually all the tissues and systems of the human body have been shown to be responsive to programs of exercise. Regarding the relationship between physical fitness and intraocular pressure (IOP), the existing literature is controversial with some associations inconsistent. In one study, IOP values were not dependent upon changes in physical fitness. In contrast to this, another study demonstrated that physical fitness significantly reduces intraocular pressure levels. In recent years it has been noted that intraocular pressure is a dynamic function and is subject to many influences both acutely and over the long term. The variety of results of previous studies may have come from several factors which can affect intraocular pressure. The present study was planned to investigate the effects of physical fitness on intraocular pressure in Chinese medical studies, after elimination of other affecting factors.

METHODS

Forty medical students were categorized into control and experimental groups, each consisting of 20 subjects. The experimental group took a supervised exercise program for 10 weeks. Physical fitness was evaluated by measurement of maximum oxygen uptake with a Beckman O2 analyzer. Intraocular pressure was measured with the Goldmann applanation tonometer.

RESULTS

After exercise training, the experimental group showed a marked increase in physical fitness. The difference of IOP between the control and experimental groups before exercise conditioning was 0.3 +/- 0.1 mmHg (P > 0.05). After 10 weeks, this difference increased to 1.1 +/- 0.4 mmHg (p < 0.05).

CONCLUSIONS

This study concludes that physical fitness reduces intraocular pressure. Whether exercise conditioning has a role as a nonpharmacologic approach or as an addition to medical therapy must be left to future investigations.

Intraocular pressure trends in pregnancy and in the third trimester hypertensive patients

BACKGROUND

Systemic blood pressure is positively related to intraocular pressure. During the third trimester of pregnancy decreased intraocular pressure while increased blood pressure has been reported. After taking into account all those factors that can affect intraocular pressure, the present study investigated whether or not the high blood pressure found in late pregnancy influences the known ocular hypotensive effect of late pregnancy.

SUBJECTS AND METHODS

Normotensive subjects in all trimesters of pregnancy and non-pregnant control groups along with third trimester hypertensive subjects were studied. Intraocular pressure was measured with the Goldmann applanation tonometer.

RESULTS

In the second and third trimester subjects, the mean intraocular pressure was significantly lower than in the non-pregnant control group. The differences between first and second, first and third, and second and third trimesters of pregnancy were (mean +/- s.d.) -0.5 +/- 1.2 (p < 0.05), -1.5 +/- 1.7 (p < 0.001), and -1.0 +/- 2.1 (p < 0.01) mmHg respectively. The mean difference between third trimester hypertensive and third trimester normotensive pregnant women was 0.53 +/- 1.5 mmHg (p < 0.05).

CONCLUSIONS

With advancing pregnancy, intraocular pressure decreases. The mean intraocular pressures of third trimester hypertensive pregnant women were significantly higher from that of third trimester non-hypertensives. Knowledge of the normal level of intraocular pressure in various stages of pregnancy may help glaucoma screeners.

Diurnal variation of intraocular pressure in normal and ocular hypertensive subjects of China

This study evaluated the distribution of Intraocular pressure (IOP) levels in 67 normal and 59 ocular hypertensive (OHT) subjects during the day after placing control on all those factors that can affect IOP. The IOP was measured with the Goldmann applanation tonometer. All the subjects were examined according to standard protocols. Both in the normal and OHT subjects, the peak of mean IOP appeared in the morning when the subjects woke up and the trough of mean IOP occurred between 2 a.m. to 4 a.m. The mean diurnal variation were (mean +/- sem) 2.9 +/- 0.7 and 3.5 +/- 0.7 mmHg in the normal and in OHT subjects, respectively. Ninety-four percent of the normal subjects and sixty-eight percent of the OHT subjects exhibited a similar diurnal behaviour in both eyes. The IOP variation did not correlate with the variations of blood pressure. The diurnal variation of IOP, found in Chinese, is lower than in other nations. The clinical importance of findings that the peaks of IOP occur in the early morning, raised a serious question as to the necessity of extending the diurnal IOP curves beyond the usual working time (JPMA 46:171, 1996).