[Arterial spin labeling in assessment of interstitial fibrosis in renal allografts]

Objective: To explore the feasibility and application value of arterial spin labeling (ASL) in evaluating the degree of renal fibrosis after kidney transplantation. Methods: This is a cross-sectional study. Renal transplant recipients who received treatment at the First Affiliated Hospital of Soochow University from December 2021 to December 2022 were enrolled. All participants underwent ASL scan, and the values of renal cortical renal blood flow (RBF) were measured through post-processing software. The participants were divided into different groups according to the Banff interstitial fibrosis score (ci score) of the transplanted kidneys, and then relevant indicators were compared. One-way analysis of variance was conducted to compare the differences in renal cortical RBF among the groups. Spearman correlation analysis was employed to investigate the association between renal cortical RBF and ci score of the transplanted kidney. Receiver operating characteristic curve was used to analyze the diagnostic effectiveness of renal cortical RBF and laboratory indicators for distinguishing varying degrees of fibrosis in transplanted kidneys. The Delong test was utilized to compare the area under the curve (AUC). Results: A total of 60 patients (42 males and 18 females) were included in the study, with a mean age of (44.6±10.8) years. All patients were divided into 4 groups: ci0 group (ci score=0, 11 cases), ci1 group (ci score=1, 21 cases), ci2 group (ci score=2, 20 cases), and ci3 group (ci score=3, 8 cases). With an increase in the degree of fibrosis in the transplanted kidney, there was a corresponding decrease in the renal cortical RBF value. The differences in renal cortical RBF values among the 4 groups were statistically significant[ci0 group: (214.9±28.5) ml·(100 g)-1·min-1; ci1 group: (181.7±29.3) ml·(100 g)-1·min-1; ci2 group: (158.8±39.2) ml·(100 g)-1·min-1; ci3 group: (123.1±27.2) ml·(100 g)-1·min-1; F=14.02, P<0.001]. The renal cortical RBF was moderately negatively correlated with the ci score (r=-0.644, P<0.001). The AUC for discriminating between ci0 and ci1-3 of renal cortical RBF and 24-hour urine protein was 0.881 (95%CI: 0.772-0.950) and 0.680 (95%CI: 0.547-0.795), respectively. The AUC for renal cortical RBF was significantly higher than that for 24-hour urine protein (P=0.047). The renal cortical RBF can distinguish between ci0-1 and ci2-3, as well as ci0-2 and ci3, with the corresponding AUC value of 0.796 (95%CI: 0.673-0.889) and 0.900 (95%CI: 0.795-0.963), respectively. Conclusion: ASL can quantitatively assess renal blood perfusion in transplanted kidneys and demonstrates high operational efficacy in distinguishing varying degrees of fibrosis in the transplanted kidneys.

[The application value of Gd-EOB-DTPA enhanced MRI based radiomics in the differential diagnosis of iso-or hyperintensity HCC and focal nodular hyperplasia in hepatobiliary phase]

Objective: To investigate the application value of Gd-EOB-DTPA enhanced MRI based radiomics model in the differential diagnosis of iso-or hyperintensity HCC and focal nodular hyperplasia (FNH) in hepatobiliary phase. Methods: A total of 88 patients with HCC or FNH confirmed by surgical or puncture pathology who underwent preoperative Gd-EOB-DTPA enhanced MRI (all lesions showed iso-or hyperintensity in hepatobiliary phase) between January 2015 and February 2023 in The First Affiliated Hospital of Soochow University and Nantong No.3 People's Hospital were retrospectively evaluated, which including 58 males and 30 females, aged [M(Q1, Q3)]56 (40, 67) years, including 61 patients with HCC and 27 patients with FNH. The included cases were divided into training (43 cases of HCC, 19 cases of FNH) and validation cohort (18 cases of HCC, 8 cases of FNH) in the ratio of 7∶3 using the random seeding method. A total of 1 781 radiomics features were extracted from Gd-EOB-DTPA enhanced MRI in the arterial, portal and hepatobiliary phases, respectively. The independent three phase models, combined three phases model and combined clinical-radiomics model was established using Auto-Encoder (AE) and Native Bayes (NB) classifier, respectively. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of these models. DeLong test was used to compare the areas under curve (AUC). Results: In the validation cohort, the combined clinical-radiomics model had the highest AUC (AUC=0.938, 95%CI: 0.828-1.000). The AUC, accuracy, sensitivity, specificity of the clinical-radiomics combined model using AE classifier in the validation cohort were 0.896 (95%CI: 0.760-1.000), 88.5%, 88.9%, 87.5%. The AUC of the clinical-radiomics combined model using NB classifier in the validation cohort were 0.938 (95%CI: 0.828-1.000), 92.3%, 88.9%, 100.0%. Conclusion: Gd-EOB-DTPA enhanced MRI combined clinical-radiomics model has certain value in preoperative differentiation of iso-or hyperintensity in the hepatobiliary phase HCC and FNH, with a high accuracy, sensitivity and specificity.

[Clinical and genetics characteristics of adult-onset cerebrotendinous xanthomatosis: analysis of a Chinese pedigree]

Objective: Clinical manifestations, imaging findings, pathologic features, and genetic mutations of Chinese adult patients with cerebrotendinous xanthomatosis (CTX) were analyzed in order to achieve a greater understanding of CTX that can improve early detection, diagnosis, and treatment. Methods: Clinical data including medical history, neurologic and auxiliary examinations, imaging findings, and genetic profile were collected for an adult patient with CTX admitted to the Sixth Medical Center of Chinese People's Liberation Army General Hospital in August 2020. Additionally, a systematic review of genetically diagnosed Chinese adult CTX cases reported in major databases in China and other countries was performed and age of onset, first symptoms, common signs and symptoms, pathologic findings, imaging changes, and gene mutations were analyzed. Results: The proband was a 39-year-old female with extensive, early-onset nervous system manifestations including cognitive dysfunction and ataxia. Systemic lesions included juvenile cataract and a tendon mass. Cranial magnetic resonance imaging revealed cerebral atrophy, symmetric white matter changes predominantly in the pyramidal tract, and lesions in the cerebellar dentate nucleus. A novel homozygous mutation in the sterol-27-hydroxylase (CYP27A1) gene (c.1477-2A>C) was identified. There were no family members with similar clinical presentation although some were carriers of the c.1477-2A>C mutation. The patient showed a good response to deoxycholic acid treatment. Totally there were 56 cases of adult CTX patients in China, mostly in East China (31/56, 55.4%), at a male-to-female ratio of 1.8 to 1. Multiple organs and tissues including nervous system, tendon, lens, lung, and skeletal muscle were affected in these cases. The most common neurologic manifestations were cognitive dysfunction (44/52, 84.6%) and ataxia (44/51, 86.3%). The cases were characterized by early onset, chronic progressive damage of multiple systems, long disease course, and delayed diagnosis, making the disease difficult to manage clinically and resulting in poor prognosis. The 2 most common genetic mutations in Chinese adult CTX patients were c.1263+1G>A and c.379C>T. Exon 2 of the CYP27A1 gene was identified as a mutation hot spot. Conclusions: Chinese adult patients with CTX have complex clinical characteristics, a long diagnostic cycle, and various CYP27A1 gene mutations. Early diagnosis and intervention can improve the prognosis of these patients.

[A comparison of current guidelines for the management of intrahepatic cholangiocarcinoma worldwide]

Intrahepatic cholangiocarcinoma (ICC) is the second most common human liver malignancy and its incidence rate has been gradually increasing worldwide over the past decades. Surgical resection (R0 resection) is the preferred potentially curative treatment for ICC patients. However, due to its conceal clinical features and high invasiveness, most patients have lost the opportunity for surgical resection at the time of diagnosis. In recent years, with the rapid development of targeted therapy and immunotherapy, which is represented by immune checkpoint inhibitors, clinicians are expected to provide more effective treatment options for patients with mid-stage or advanced ICC. At present, there are still controversial opinions on different guidelines regarding preoperative biliary drainage, the extent of hepatectomy, the definition of R0 resection, the width of the resection margin, lymph node dissection, postoperative recurrence, adjuvant therapy, etc. In this review, 12 guidelines or expert consensus published worldwide from 2012 to 2022 (including 4 Chinese guidelines, 4 European guidelines, 2 American guidelines and 2 Japanese guidelines) were retrieved. Focusing on sorting and comparing the current views on clinical management of ICC in different guidelines, this review aims to provide reference information for ICC clinical management and decision-making.

Decoding drug resistant mechanism of V32I, I50V and I84V mutations of HIV-1 protease on amprenavir binding by using molecular dynamics simulations and MM-GBSA calculations

Mutations V32I, I50V and I84V in the HIV-1 protease (PR) induce drug resistance towards drug amprenavir (APV). Multiple short molecular dynamics (MSMD) simulations and molecular mechanics generalized Born surface area (MM-GBSA) method were utilized to investigate drug-resistant mechanism of V32I, I50V and I84V towards APV. Dynamic information arising from MSMD simulations suggest that V32I, I50V and I84V highly affect structural flexibility, motion modes and conformational behaviours of two flaps in the PR. Binding free energies calculated by MM-GBSA method suggest that the decrease in binding enthalpy and the increase in binding entropy induced by mutations V32I, I50V and I84V are responsible for drug resistance of the mutated PRs on APV. The energetic contributions of separate residues on binding of APV to the PR show that V32I, I50V and I84V highly disturb the interactions of two flaps with APV and mostly drive the decrease in binding ability of APV to the PR. Thus, the conformational changes of two flaps in the PR caused by V32I, I50V and I84V play key roles in drug resistance of three mutated PR towards APV. This study can provide useful dynamics information for the design of potent inhibitors relieving drug resistance.

[Morvan syndrome with positive anti LGI1/CASPR2 antibodies in serum/cerebrospinal fluid:a case report and literature review]

To report a typical case of Morvan syndrome with positive anti-leucine rich glioma-inactivated 1(LGI1) and contactin-associated protein 2 (CASPR2) antibodies in serum and cerebrospinal fluid. A 39-years-old female initially presented weakness of extremeties. The main symptoms included paroxysmal limb pain, wheezing, itching, muscle twitching, epilepsy, hypomnesia, dysphoria, apathy, intractable insomnia, salivation and sweating. Tests of electrolytes found hypokalemia (2.7-3.1 mmol/L) and hyponatremia (130-136 mmol/L). Arterial blood gas analysis showed hypoxemia (oxygen saturation 50%-70%). Total thyroxine (TT4) was elevated to 207 nmol/L with positive thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (TG-Ab). LGI1and CASPR2 antibodies (CBA method) were positive in both serum and cerebrospinal fluid, and the remaining antibodies related to autoimmune encephalitis and paraneoplastic syndrome were negative. Head MRI was almost normal, while mild abnormalities were found in electroencephalogram. Electromyography showed slightly increased voltage of left quadriceps motor unit potential. After treated with corticosteroids, IVIG and mycophenolate mofetil, the patient completely improved. Cognitive function scores recovered from MoCA/MMSE (16/24) to MoCA/MMSE (26/29). Positivity of LGI1/CASPR2 antibodies both in serum/cerebrospinal fluid are rarely seen in patients with Morvan syndrome. Steroids and immunosuppressants are suggested for treatment as early as possible.

[The prediction value of enhanced magnetic resonance imaging nomogram model for dual phenotype hepatocellular carcinoma]

Objective: To explore the value of enhanced magnetic resonance imaging nomogram model in the prediction of dual-phenotype hepatocellular carcinoma(DPHCC). Methods: Data of 116 patients of hepatocellular carcinoma (HCC) confirmed by postoperative pathology, who underwent preoperative enhanced MRI between January 2016 and March 2021 in the First Affiliated Hospital of Soochow University were retrospectively evaluated, of these, there are 87 males and 28 females, aged 30-79 (59±10) years, including 31 patients with DPHCC and 85 patients with non-DPHCC. The patients were randomly divided into training set(51 cases of non-DPHCC,19 cases of DPHCC)and validation set(34 cases of non-DPHCC, 12 cases of DPHCC) in a ratio of 6∶4, according to random number table,clinical and imaging characteristics of the two groups were compared. The statistically significant parameters were included in multivariate logistic regression to identify the independent predictors and for the establishment of the nomogram model. The receiver operating characteristic curves were used to evaluate the prediction ability of the models, the corrected curve was used to validate the model. Results: In the training group, the proportions of rim arterial phase hyperenhancement in the DPHCC was significantly higher than that of the non-DPHCC [47.4%(9/19)vs 7.8%(4/51),P<0.001]. Rim arterial phase hyper-enhancement and enhanced capsule were significant predictors for DPHCC[OR=10.17(1.70-60.80),0.17(0.03-0.93),all P<0.05]. In the training group, the area under curve (AUC), sensitivity and specificity of the nomogram were 0.888 (95%CI: 0.806-0.969), 78.9% and 86.3%. In the validation group, the above three indicators were 0.811(95%CI: 0.655-0.968), 75.0% and 82.4%. Conclusion: Enhanced MRI nomogram model has certain value in prediction of DPHCC, with high sensitivity and specificity.

[Relationship between body mass index and sexual development in Chinese children]

Objective: To investigate the relationship between body mass index (BMI) and sexual development in Chinese children. Methods: A nationwide multicenter and population-based large cross-sectional study was conducted in 13 provinces, autonomous regions and municipalities of China from January 2017 to December 2018. Data on sex, age, height, weight were collected, BMI was calculated and sexual characteristics were analyzed. The subjects were divided into four groups based on age, including ages 3-<6 years, 6-<10 years, 10-<15 years and 15-<18 years. Multiple Logistic regression models were used for evaluating the associations of BMI with sexual development in children. Dichotomous Logistic regression was used to compare the differences in the distribution of early and non-early puberty among normal weight, overweight and obese groups. Curves were drawn to analyze the relationship between the percentage of early puberty and BMI distribution in girls and boys at different Tanner stages. Results: A total of 208 179 healthy children (96 471 girls and 111 708 boys) were enrolled in this study. The OR values of B2, B3 and B4+ in overweight girls were 1.72 (95%CI: 1.56-1.89), 3.19 (95%CI: 2.86-3.57), 7.14 (95%CI: 6.33-8.05) and in obese girls were 2.05 (95%CI: 1.88-2.24), 4.98 (95%CI: 4.49-5.53), 11.21 (95%CI: 9.98-12.59), respectively; while the OR values of G2, G3, G4+ in overweight boys were 1.27 (95%CI: 1.17-1.38), 1.52 (95%CI: 1.36-1.70), 1.88 (95%CI: 1.66-2.14) and in obese boys were 1.27 (95%CI: 1.17-1.37), 1.59 (95%CI: 1.43-1.78), and 1.93 (95%CI: 1.70-2.18) (compared with normal weight Tanner 1 group,all P<0.01). Analysis in different age groups found that OR values of obese girls at B2 stage and boys at G2 stage were 2.02 (95%CI: 1.06-3.86) and 2.32 (95%CI:1.05-5.12) in preschool children aged 3-<6 years, respectively (both P<0.05). And in the age group of 6-10 years, overweight girls had a 5.45-fold risk and obese girls had a 12.54-fold risk of B3 stage compared to girls with normal BMI. Compared with normal weight children, the risk of early puberty was 2.67 times higher in overweight girls, 3.63 times higher in obese girls, and 1.22 times higher in overweight boys, 1.35 times higher in obese boys (all P<0.01). Among the children at each Tanner stages, the percentage of early puberty increased with the increase of BMI, from 5.7% (80/1 397), 16.1% (48/299), 13.8% (27/195) to 25.7% (198/769), 65.1% (209/321), 65.4% (157/240) in girls aged 8-<9, 10-<11 and 11-<12 years, and 6.6% (34/513), 18.7% (51/273), 21.6% (57/264) to 13.3% (96/722), 46.4% (140/302), 47.5% (105/221) in boys aged 9-<10, 12-<13 and 13-<14 years, respectively. Conclusions: BMI is positively correlated with sexual development in both Chinese boys and girls, and the correlation is stronger in girls. Obesity is a risk factor for precocious puberty in preschool children aged 3-<6 years, and 6-<10 years of age is a high risk period for early development in obese girls.

[Changing prevalence of overweight and obesity among Chinese children aged 6-15 from 2009-2019]

Objective: To analyze the trends of overweight and obesity prevalence in Chinese children, aged from 6 to 15 years old among 4 provinces and cities from 2009 to 2019. Methods: Reviewed the national multi-center epidemiological survey data of children from the National Key Technology R&D Program of China during the Eleventh Five-Year Plan (2009 to 2010) and the National Key Research and Development Program of China during the Thirteenth Five-Year Plan (2017 to 2019). The participants' data were selected from four provinces,municipalities and autonomous region,including Beijing, Tianjin (Northern region), Zhejiang (Eastern region), and Guangxi (Southern region). Totally 14 597 pairs of 6-15 year-old children were surveyed. According to the body mass index (BMI) and standard deviation score (SDS) of children among different genders, ages, and regions, t test or chi-square test was used to evaluate the changes in overweight and obesity over a 10-year span. Results: Totally 7 721 pairs of boys and 6 876 pairs of girls were collectted in this study, whose mean age was (10.7±2.5) years. In the past 10 years, the overall BMISDS were 0.39±1.24 and 0.36±1.31 and the overall obesity rate were 11.8% (n=1 773) anel 12.5% (n=1 813) of children in the 4 administrative regions did not have statistically significant differences (all P>0.05). However, the overall overweight rate rose from 17.1% (n=2 496) to 19.1% (n=2 781) (χ²=18.657, P<0.01), and the average annual growth rate was 0.20%. The BMISDS in the Eastern region increased from 0.10±1.07 to 0.19±1.22 (t=-4.095, P<0.01), and the overweight rate and obesity rate increased by 3.8% (n=202) and 3.1% (n=169) respectively (both P<0.01); the BMISDS in the Northern region and the obesity rate did not have statistically significant differences(all P>0.05), but the overweight rate rose from 20.5% (n=1 233) to 22.8% (n=1 365) significantly (χ²=7.431, P<0.01); BMISDS in the Southern region was significantly decreased from 0.30±1.19 to 0.09±1.25 (t=1.426, P<0.01), and the rate of obesity decreased from 9.8% (n=315) to7.9% (n=256) (χ²=6.46, P<0.05), the overweight rate was not stafistically significant (P=0.10), respectively. The obesity rate of boys had risen from 16.4% (n=1 265) to 18.2% (1 407) (χ²=8.997, P<0.01) in the past 10 years, and the overweight rate had risen from 18.0% (n=1 393) to 20.5% (n=1 579) (χ²=14.26, P<0.01). The overweight+obesity rate rose from 34.4% (n=2 658) to 38.7% (n=2 986) (χ²=29.859, P<0.01), and the weight problem in the age group of 8 to 11 years was particularly severe (all P<0.01). The obesity rate of girls dropped from 6.8% (n=468) to 5.9% (n=406) (χ²=4.546, P<0.05), the overweight rate rose from 16.0% (n=1 103) to 17.5% (n=1 202) (χ²=5.006, P<0.05), and the overall overweight+obesity rate rose from 22.8% (n=1 571) to 23.4% (n=1 608) (χ²=0.53, P>0.05). Conclusions: The growth rate of obesity among children in China had slowed down from 2009 to 2019, but the overweight rate was still on the rise. The overall base of overweight and obesity population continued to expand. The weight problem of peri-adolescent boys was particularly prominent. The current status of obesity epidemics in different regions, ages, and genders are significantly different and had their own characteristics. It is necessary to establish a personalized prevention and control strategy.

Decoding molecular mechanism underlying binding of drugs to HIV-1 protease with molecular dynamics simulations and MM-GBSA calculations

HIV-1 protease (PR) is thought to be efficient targets of anti-AIDS drug design. Molecular dynamics (MD) simulations and multiple post-processing analysis technologies were applied to decipher molecular mechanism underlying binding of three drugs Lopinavir (LPV), Nelfinavir (NFV) and Atazanavir (ATV) to the PR. Binding free energies calculated by molecular mechanics generalized Born surface area (MM-GBSA) suggest that compensation between binding enthalpy and entropy plays a vital role in binding of drugs to PR. Dynamics analyses show that binding of LPV, NFV and ATV highly affects structural flexibility, motion modes and dynamics behaviour of the PR, especially for two flaps. Computational alanine scanning and interaction network analysis verify that although three drugs have structural difference, they share similar binding modes to the PR and common interaction clusters with the PR. The current findings also confirm that residues located interaction clusters, such as Asp25/Asp25', Gly27/Gly27', Ala28/Ala28', Asp29, Ile47/Ile47', Gly49/Gly49', Ile50/Ile50', Val82/Val82' and Ile84/Ile84, can be used as efficient targets of clinically available inhibitors towards the PR.

Insights into effect of the Asp25/Asp25' protonation states on binding of inhibitors Amprenavir and MKP97 to HIV-1 protease using molecular dynamics simulations and MM-GBSA calculations

The protonation states of two aspartic acids in the catalytic strands of HIV-1 protease (PR) remarkably affect bindings of inhibitors to PR. It is requisite for the design of potent inhibitors towards PR to investigate the influences of Asp25/Asp25' protonated states on dynamics behaviour of PR and binding mechanism of inhibitors to PR. In this work, molecular dynamics (MD) simulations, MM-GBSA method and principal component (PC) analysis were coupled to explore the effect of Asp25/Asp25' protonation states on conformational changes of PR and bindings of Amprenavir and MKP97 to PR. The results show that the Asp25/Asp25' protonation states exert different impacts on structural fluctuations, flexibility and motion modes of PR. Dynamics analysis verifies that Asp25/Asp25' protonated states highly affect conformational dynamics of two flaps in PR. The binding free energy calculations results suggest that the Asp25/Asp25' protonated states obviously strengthen bindings of inhibitors to PR compared to the non-protonation state. Calculations of residue-based free energy decomposition indicate that the Asp25/Asp25' protonation not only disturbs the interaction network of inhibitors with PR but also stabilizes bindings of inhibitors to PR by cancelling the electrostatic repulsive interaction. Therefore, special attentions should be paid to the Asp25/Asp25' protonation in the design of potent inhibitors towards PR.

[Value of the application of enhanced CT radiomics and machine learning in preoperative prediction of microvascular invasion in hepatocellular carcinoma]

Objective: To explore the value of machine learning models in preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) based on dual-phase contrast-enhanced CT radiomics features. Methods: The data of 148 patients [106 males and 42 females, with an average age of (58±11) years] with HCC confirmed by pathology in the First Affiliated Hospital of Soochow University from January 2015 to May 2020 were retrospectively analyzed, including 88 cases of positive MVI and 60 cases of negative MVI. According to the ratio of 7∶3, the patients were randomly divided into the training and validation sets, respectively. The three-dimensional (3D) radiomics features of HCC in arterial phase (AP) and portal venous phase (PP) were extracted by MaZda software, and the optimal feature subset was obtained by combining three feature selection methods (FPM method) and Lasso regression. Then, six machine learning methods were used to build the prediction models. Receiver operating characteristic (ROC) curves were drawn to evaluate the prediction ability of the aforementioned models, and the area under the curve (AUC), accuracy, sensitivity and specificity were calculated. Results: Radiomics features of HCC in AP and PP were extracted by MaZda software, with 239 in each phase. There were 7 optimal features in AP and 14 optimal features in PP selected by FPM method and Lasso regression, respectively. The AUCs of decision tree, extreme gradient boosting, random forest, support vector machine (SVM), generalized linear model, and neural network based on the 7 optimal features in AP in the validation set were 0.736, 0.910, 0.913, 0.915, 0.897, 0.648, respectively. The SVM had the highest AUC in the validation set, with the accuracy, sensitivity and specificity of 95.35%, 95.83% and 94.74%, respectively. Likewise, the AUCs of machine learning models in prediction of MVI in HCC based on the 14 optimal features in PP in the validation set were 0.873, 0.876, 0.913, 0.859, 0.877, 0.834, respectively, and there were no significant differences (all P>0.05). The random forest had the highest AUC in the validation set, with the accuracy, sensitivity and specificity of 90.70%, 87.50% and 94.74%, respectively. Conclusion: Machine learning models based on dual-phase enhanced CT radiomics features can be used in preoperative prediction of MVI in HCC, particularly the SVM and random forest models have high prediction efficiency.

[Systemic anti-inflammation is the key for the treat-to-target in severe immune-related skin disorders]

Immune-related skin disorders (inflammatory skin diseases and autoimmune diseases) are important diseases in dermatology. Systemic inflammation is the fundamental cause that makes these diseases difficult to control and easy to relapse. The treatment pattern of rheumatic immune diseases could be used as a reference to reach the treat-to-target (T2T) of severe immune/inflammatory skin disorders, thus to reduce systemic inflammatory damage, to effectively control symptoms in the long term, to improve the quality of life, and to help patients back to normal study/work/life status.

[Analysis of the diagnotic results and complications of pneumoconiosis patients with different insurance types]

Objective: By comparing the diagnotic results and complications of pneumoconiosis patients with work-related injury insurance and non-work-related injury insurance, to provide reference for improving the medical insurance of pneumoconiosis patients. Methods: In May 2019, the diagnotic results and complications of 3204 patients with pneumoconiosis who were hospitalized in the second department of Hunan Prevention and Treatment Institute for Occupational Diseases from January 2017 to March 2019 were retrospectively analyzed. Results: Among the 3204 patients, 896 cases (28.0%) were in stage I, 790 cases (24.6%) were in stage II, and 1518 cases (47.4%) were in stage III. 1490 cases (46.5%) of pneumoconiosis patients have complications, mainly chronic obstructive pulmonary disease (COPD) (42.3%, 1354/3204) and lung infection (23.6%, 755/3204) . 584 cases (18.2%) were covered by work-related injury insurance, and the diagnosis of pneumoconiosis patients was mainly in the stage I (61.0%, 356/584) . 2620 cases (81.8%) were covered by non-work-related injury insurance, and the diagnosis of pneumoconiosis patients was mainly in the stage III (56.0%, 1466/2620) . The complication rate of non-work-related injury insurance patients (50.1%, 1312/2620) was higher than that of work-related injury insurance patients (30.5%, 178/584) (χ(2)=73.72, P<0.01) . Conclusion: The inpatients with pneumoconiosis in Hunan Province are still mainly covered by non-work-related injury insurance, and the diagnotic period and complication rate are significantly higher than those of work-related injury insurance patients. Therefore, pneumoconiosis patients should be provided with medical security, early diagnosis and early intervention, to prevent and delay the occurrence of complications.

[Consideration and prevention of the aerosol transmission of 2019 novel coronavirus]

This article was published ahead of print on the official website of Chinese Journal of Ophthalmology on March 14, 2020. Novel coronavirus pneumonia broke out and spread to the whole nation since December 2019. The fight against the virus is now at a critical stage. Previous epidemiological investigations and animal experiments suggested aerosol could perform as a virus transmitter. Based on the clinical observation, the possibility of aerosol transmission of 2019 novel coronavirus has aroused much attention. This article focuses on the feature of aerosol transmission and the pathogens involved in. We analyze the possibility of aerosol transmission of the novel coronavirus. Relevant strategies for preventing novel coronavirus pneumonia are established for the medical personnel and general public during their work or daily life. (Chin J Ophthalmol, 2020, 56:653-656).

[The predictive value of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced MRI imaging features combined with quantitative parameters for the pathologic grading of hepatocellular carcinoma]

Objective: To investigate the predictive value of gadolinium-ethoxybenzyl- diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI imaging features combined with quantitative parameters for the pathologic grading of hepatocellular carcinoma (HCC). Methods: Eighty patients (65 males, 15 females; range 30-74 years,average age (59±11) years old) with HCC who underwent curative resection or biopsy from June 2016 to June 2019 in the First Affiliated Hospital of Soochow University after Gd-EOB-DTPA-enhanced MRI were evaluated retrospectively.According to the pathological results of the postoperative pathology, eighty patients were divided into poorly differentiated group (26 cases, 22 males, 4 females) and moderately-well differentiated group (54 cases, 43 males, 11 females). In Gd-EOB-DTPA-enhanced MRI, qualitative parameters were assessed. Quantitative parameters including tumor size, tumor-to-liver signal intensity ratio(SIR) of arterial phase (AP), portal vein phase (PP), equilibrium phase (EP) and hepatobiliary phase (HBP), contrast enhancement ration AP (CER-AP)were measured and calculated. Clinical data and qualitative parameters between poorly differentiated group and moderately-well differentiated group were analyzed by using χ(2) test.Quantitative parameters were analyzed by using independent sample t test. Statistically significant qualitative parameters, quantitative parameters, qualitative combined with quantitative parameters and AFP combined with qualitative and quantitative parameters were included in binary logistic regression model. The receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of the four prediction model for the pathologic grading of HCC. Results: There was a statistical difference between poorly differentiated group and moderately-well differentiated group in AFP, arterial peritumoral enhancement, arterial rim enhancement, peritumoral hypointensity on HBP and tumor signal (all P<0.05). In two groups, tumor size, SIR-AP and SIR-PP were (7.0±3.7) vs (3.9±2.4)cm,1.11±0.29 vs 1.31±0.32 and 0.89±0.21 vs 1.03±0.27 (all P<0.05). AUC of qualitative parameters, quantitative parameters, qualitative combined with quantitative parameters and AFP combined with qualitative and quantitative parameters were 0.805, 0.804, 0.855, 0.892.There was a statistical difference between qualitative parameters and qualitative combined with quantitative parameters in sensitivity(80.8% vs 92.3%, P<0.05). Conclusion: Gd-EOB-DTPA-enhanced MRI imaging features combined with quantitative parameters can be used to predict the pathologic grading of HCC preoperatively, which has a great applicative value.

Probing molecular mechanism of inhibitor bindings to bromodomain-containing protein 4 based on molecular dynamics simulations and principal component analysis

It is well known that bromodomain-containing protein 4 (BRD4) has been thought as a promising target utilized for treating various human diseases, such as inflammatory disorders, malignant tumours, acute myelogenous leukaemia (AML), bone diseases, etc. For this study, molecular dynamics (MD) simulations, binding free energy calculations, and principal component analysis (PCA) were integrated together to uncover binding modes of inhibitors 8P9, 8PU, and 8PX to BRD4(1). The results obtained from binding free energy calculations show that van der Waals interactions act as the main regulator in bindings of inhibitors to BRD4(1). The information stemming from PCA reveals that inhibitor associations extremely affect conformational changes, internal dynamics, and movement patterns of BRD4(1). Residue-based free energy decomposition method was wielded to unveil contributions of independent residues to inhibitor bindings and the data signify that hydrogen bonding interactions and hydrophobic interactions are decisive factors affecting bindings of inhibitors to BRD4(1). Meanwhile, eight residues Trp81, Pro82, Val87, Leu92, Leu94, Cys136, Asn140, and Ile146 are recognized as the common hot interaction spots of three inhibitors with BRD4(1). The results from this work are expected to provide a meaningfully theoretical guidance for design and development of effective inhibitors inhibiting of the activity of BRD4.

[Impact of gender on hepatic pathology and antibody - mediated immunity caused by Schistosoma japonicum infection in C57BL/6 mice]

OBJECTIVE

To investigate the effect of gender on hepatic pathology and antibody-mediated immunity in Schistosoma japonicum-infected C57BL/6 mice.

METHODS

Female and male C57BL/6 mice were infected with S. japonicum, and the hepatic pathological changes were observed using HE and picrosirius red staining in mice 8 weeks post-infection. The serum specific IgG antibody levels against the soluble adult worm antigen (SWA) and soluble egg antigen (SEA) were measured in mice using enzyme-linked immunosorbent assay (ELISA), and the percentages of follicular helper T (Tfh) cells and regulatory T (Treg) cells were detected in mouse spleen and lymph nodes using flow cytometry.

RESULTS

HE staining showed no significant difference in the mean area of a single hepatic egg granuloma between female and male mice 8 weeks post-infection with S. japonicum [(28.050 ± 3.576) × 10⁴ μm² vs. (26.740 ± 4.093) × 10⁴ μm²; t = 0.241, P = 0.821], and picrosirius red staining revealed no statistical differences between female and male mice in terms of the mean proportion of picrosirius red stained hepatic tissues [(7.667 ± 1.856)% vs. (7.667 ± 1.764)%; t = 0, P = 1] or the mean optical density [(0.023 ± 0.003) vs. (0.027 ± 0.007); t = 0.447, P = 0.678]. ELISA detected no significant differences in the serum IgG antibody levels against SWA [(2.098 ± 0.037) vs. (1.970 ± 0.071); t = 1.595, P = 0.162] or SEA [(3.738 ± 0.039) vs. (3.708 ± 0.043); t = 0.512, P = 0.623] between female and male mice 8 weeks post-infection with S. japonicum. Flow cytometry detected significantly greater percentages of Tfh cells in the spleen [female mice, (8.645 ± 1.356)% vs. (1.730 ± 0.181)%, t = 5.055, P = 0.002; male mice, (8.470 ± 1.161)% vs. (1.583 ± 0.218)%, t = 5.829, P = 0.001] and lymph nodes [female mice, (3.218 ± 0.153)% vs. (1.095 ± 0.116)%, t = 11.040, P < 0.001; male mice, (3.673 ± 0.347)% vs. (0.935 ± 0.075)%, t = 8.994, P = 0.001) of both female and male mice 8 weeks post-infection with S. japonicum than in uninfected mice; however, no significant differences were seen between female and male mice 8 weeks post-infection with S. japonicum in terms of the percentages of Tfh cells in the spleen [(8.645 ± 1.356)% vs. (8.470 ± 1.161)%; t = 0.098, P = 0.925] or lymph nodes [(3.218 ± 0.153)% vs. (3.673 ± 0.347)%; t = 1.332, P = 0.241]. There was no significant difference in the proportion of Treg cells in the spleen of male mice between infected and uninfected mice [(10.060 ± 0.361)% vs. (10.130 ± 0.142)%; t = 0.174, P = 0.867], while a higher proportion of Treg cells was seen in the spleen of female mice 8 weeks post-infection with S. japonicum than in uninfected mice [(10.530 ± 0.242)% vs. (9.450 ± 0.263)%; t = 3.021, P = 0.023]. There was no significant difference in the proportion of Treg cells in the spleen between female and male mice infected with S. japonicum [(10.530 ± 0.242)% vs. (10.060 ± 0.361)%; t =1.077, P = 0.323]. In addition, the proportions of Treg cells were significantly greater in the lymph node of S. japonicum -infected female [(17.150 ± 0.805)% vs. (13.100 ± 0.265)%; t = 4.781, P = 0.003] and male mice [(18.550 ± 0.732)% vs. (12.630 ± 0.566)%; t = 6.402, P = 0.001] than in uninfected mice; however, no significant difference was seen between female and male mice 8 weeks post-infection [(17.150 ± 0.805)% vs. (18.550 ± 0.732)%; t = 1.287, P = 0.246].

CONCLUSIONS

There are no gender-specific hepatic pathological changes or antibody-mediated immunity in C57BL/6 mice post-infection with S. japonicum.

[Study on immunological functions of heat shock protein 40 kDa of Schistosoma japonicum]

OBJECTIVE

To investigate the immunological functions of heat shock protein 40 kDa of Schistosoma japonicum (SjHSP40).

METHODS

The homology of the SjHSP40 protein sequence was analyzed and the B and T cell epitopes of SjHSP40 were predicted using bioinformatics tools. The full-length SjHSP40 gene was amplified using a PCR assay, and cloned into the prokaryotic expression vector pGEX-6P-1, which was transformed into Escherichia coli BL-21. The protein expression was induced with isopropyl β-D-thiogalactoside (IPDG), and then, the recombinant protein was purified with glutathione-sepharose 4B resin to yield the fusion protein GST-SjHSP40, which was checked with SDS-PAGE and Western blotting. Following immunization with GST-SjHSP40, the serum levels of anti-SjHSP40 IgG antibody and IgG1 and IgG2a subtypes were detected in BALB/c mice using ELISA. In addition, the effect of SjHSP40 on CD4⁺ T-cell subset differentiation was examined using flow cytometry.

RESULTS

SjHSP40 contained 7 potential B cell epitopes and multiple T cell epitopes (CTL epitopes and Th epitopes). The prokaryotic expression plasmid pGEX-6p-1-SjSHP40 was successfully constructed, and the fusion protein GST-SjHSP40 was obtained following IPDG induction and protein purification. Significantly higher serum levels of anti-SjHSP40 IgG, IgG1 and IgG2a antibodies were detected in mice immunized with GST-SjHSP40 than in other groups; however, SjHSP40 showed no remarkable effects on CD4⁺ T-cell subset differentiation.

CONCLUSIONS

SjHSP40 may induce specific humoral immune responses in mice; however, it does not affect the balance of Th immune responses. It is suggested that SjHSP40 may be a potential vaccine candidate.

[Clinical effects of surgical treatment of high myopic strabismus fixus by modified Yokoyama's surgery combined with medial rectus muscle recession]

Objective: To analyze clinical effects of modified Yokoyama's surgery combined with medial rectus muscle recession for treatment of high myopic strabismus fixus. Methods: Retrospective analysis of records of 9 patients (14 eyes) with high myopic strabismus fixus treated from February 2013 to December 2016 in the Department of Ophthalmology, Xiangya Hospital, Central South University. All patients underwent modified Yokoyama's surgery. The temporal 1/2 of the superior rectus (SR) and the superior 1/2 of the lateral rectus (LR) were united 12 to 14 mm, combined with medial rectus muscle recession. The angle of deviation of primary position, the mobility of the affected eye, and the change of CT imaging were observed and analyzed before and 6 months after surgery. Statistical analysis was performed by Mann-Whitney U test. Results: The patients were 5 females and 4 males with an average age of (60±10) years. The duration of high myopia was (33.33±6.61) years. The refractive power was (-23.32±5.95) D, and the axial length was (33.04±2.63) mm. The recession mount of medial rectus was (7.2±2.1) mm (4.0-10.0 mm) intraoperatively. At 6 months, the median esotropia improved from 130 (80-140) prism diopter (PD) to 0 (0-10) PD, and the hypotropia from 20 (15-25) PD to 0 (0-5) PD. The median abduction limitation decreased from -3 (-4--1) to -1 (-2-0), and the median limitation of elevation decreased from -2 (-4--1) to 0 (-1-0). The angle of esotropia and hypotropia significantly improved (Z=-2.67, -2.70; P=0.008, 0.007), and the restriction of abduction and elevation decreased (Z=-3.35, -3.24; both P=0.001). Only 3 patients' CT images were enrolled in a comparative study. Preoperative orbital CT scans showed inferior LR displacement and medial SR displacement with the posterior portion of the eyeball to the superotemporal quadrant of the orbit. After surgery, the mean reduction ratio of dislocation degree of the 3 patients was 28.97%, the dislocation of LR and SR was reduced, and the posterior global part was correctly positioned within the orbit. Conclusions: The modified Yokoyama's surgery combined with medial rectus muscle recession can effectively correct high myopic strabismus fixus, recover the eyeball anatomical position, and evidently improve eye mobility. The clinical effects are satisfactory. (Chin J Ophthalmol, 2019, 55: 670-676).

CiteSpace-based Document Information Visualization of Literature Published by Journal of Forensic Medicine from 1985 to 2018

Abstract

Objective To analyze a knowledge web of the literature published by Journal of Forensic Medicine from its founding in 1985 to 2018, describe the evolving process of forensic science research and explore the research hotspots and frontiers at present. Methods The literature that was published by Journal of Forensic Medicine from 1985 to 2018 was collected and analyzed in terms of elements, such as emerging research hotspots, high frequency keywords, authors, dispatching units, location of institution and funding, by CiteSpace5.3 information visualization analysis software. Results All disciplines of forensic medicine were continually developing and maturing, and the publication volume of the literature on forensic pathology had the highest weight; in research hotspots, the two categories, research and identification each had their own emphasis; as the main source of contributions to the journal, research institutes accounted for 38.99% of the total number of publications; Shanghai ranked first among all regions with 1 046 articles published. The number of funded articles was generally on the rise, with the number of funded articles published largest in 2015. Conclusion As an authoritative academic journal in the field of forensic science in China, Journal of Forensic Medicine carries the development of forensic science and witnesses the institutional reform of universities and colleges, and offers a wide range of communication and cooperation in terms of technicality and application. Many scholars and scientific research institutions have gained progress continually in various research directions in the form of teamwork; and emerging research hotspots will continue to play a huge role in future practical applications.

[Regulation of hypoxia inducible factor-1α on permeability of vascular endothelial cells and the mechanism]

Objective: To investigate the regulation of hypoxia-inducible factor-1α (HIF-1α) on permeability of rat vascular endothelial cells and the mechanism. Methods: Twelve male Sprague-Dawley rats aged 35 to 38 days were collected and vascular endothelial cells were separated and cultured. The morphology of cells was observed after 4 days of culture, and the following experiments were performed on the 2nd or 3rd passage of cells. (1) Rat vascular endothelial cells were collected and divided into blank control group, negative control group, HIF-1α interference sequence 1 group, HIF-1α interference sequence 2 group, and HIF-1α interference sequence 3 group according to the random number table (the same grouping method below), with 3 wells in each group. Cells in negative control group, HIF-1α interference sequence 1 group, HIF-1α interference sequence 2 group, and HIF-1α interference sequence 3 group were transfected with GV248 empty plasmid, recombinant plasmid respectively containing HIF-1α interference sequence 1, interference sequence 2, and interference sequence 3 with liposome 2000. Cells in blank control group were only transfected with liposome 2000. After transfection of 24 h, expression levels of HIF-1α mRNA and protein of cells in each group were respectively detected by reverse transcription real-time fluorescent quantitative polymerase chain reaction and Western blotting (the same detecting methods below) . The sequence with the highest interference efficiency was selected. (2) Another batch of rat vascular endothelial cells were collected and divided into blank control group, negative control group, and HIF-1α low expression group, with 3 wells in each group. Cells in blank control group were only transfected with liposome 2000, and cells in negative control group and HIF-1α low expression group were respectively transfected with GV248 empty plasmid and low expression HIF-1α recombinant plasmid selected in experiment (1) with liposome 2000. After 14 days of culture, the mRNA and protein expressions of HIF-1α in each group were detected. (3) Another batch of rat vascular endothelial cells were collected and divided into blank control group, negative control group, and HIF-1α high expression group, with 3 wells in each group. Cells in blank control group were transfected with liposome 2000, and cells in negative control group and HIF-1α high expression group were respectively transfected with GV230 empty plasmid and HIF-1α high expression recombinant plasmid with liposome 2000. After 14 days of culture, the mRNA and protein expressions of HIF-1α of cells in each group were detected. (4) After transfection of 24 h, cells of three groups in experiment (1) and three groups in experiment (2) were collected, and mRNA and protein expressions of myosin light chain kinase (MLCK), phosphorylated myosin light chain (p-MLC), and zonula occludens 1 (ZO-1) of cells were detected. Data were processed with one-way analysis of variance and t test. Results: After 4 days of culture, the cells were spindle-shaped, and rat vascular endothelial cells were successfully cultured. (1) The interference efficiencies of HIF-1α of cells in HIF-1α interference sequence 1 group, HIF-1α interference sequence 2 group, and HIF-1α interference sequence 3 group were 47.66%, 45.79%, and 62.62%, respectively, and the interference sequence 3 group had the highest interference efficiency. After transfection of 24 h, the mRNA and protein expression levels of HIF-1α of cells in interference sequence 3 group were significantly lower than those in blank control group (t=18.404, 9.140, P<0.01) and negative control group (t=15.099, 7.096, P<0.01). (2) After cultured for 14 days, the mRNA and protein expression levels of HIF-1α of cells in HIF-1α low expression group were significantly lower than those in blank control group (t=21.140, 5.440, P<0.01) and negative control group (t= 14.310, 5.210, P<0.01). (3) After cultured for 14 days, the mRNA and protein expression levels of HIF-1α of cells in HIF-1α high expression group were significantly higher than those in blank control group (t=19.160, 7.710, P<0.01) and negative control group (t= 19.890, 7.500, P<0.01). (4) After transfection of 24 h, the mRNA expression levels of MLCK and p-MLC of cells in HIF-1α low expression group were significantly lower than those in blank control group (t=2.709, 4.011, P<0.05 or P<0.01) and negative control group (t=2.373, 3.744, P<0.05 or P<0.01). The mRNA expression level of ZO-1 of cells in HIF-1α low expression group was significantly higher than that in blank control group and negative control group (t=4.285, 5.050, P<0.01). The mRNA expression levels of MLCK and p-MLC of cells in HIF-1α high expression group were significantly higher than those in blank control group (t=9.118, 11.313, P<0.01) and negative control group (t=9.073, 11.280, P<0.01). The mRNA expression level of ZO-1 of cells in HIF-1α high expression group was significantly lower than that in blank control group and negative control group (t=2.889, 2.640, P<0.05). (5) After transfection of 24 h, the protein expression levels of MLCK and p-MLC of cells in HIF-1α low expression group were significantly lower than those in blank control group (t=2.652, 3.983, P<0.05 or P<0.01) and negative control group (t=2.792, 4.065, P<0.05 or P<0.01). The protein expression of ZO-1 of cells in HIF-1α low expression group was significantly higher than that in blank control group and negative control group (t=3.881, 3.570, P<0.01). The protein expression levels of MLCK and p-MLC of cells in HIF-1α high expression group were 1.18±0.24 and 0.68±0.22, which were significantly higher than 0.41±0.21 and 0.35±0.14 in blank control group (t=5.011, 3.982, P<0.05 or P<0.01) and 0.43±0.20 and 0.36±0.12 in negative control group (t= 4.880, 3.862, P<0.05 or P<0.01). The protein expression level of ZO-1 of cells in HIF-1α high expression group was 0.08±0.06, which was significantly lower than 0.20±0.09 in blank control group and 0.19±0.09 in negative control group (t=4.178, 3.830, P<0.05 or P<0.01). Conclusions: HIF-1α up-regulates expressions of MLCK and p-MLC and down-regulates expression of ZO-1, thereby increasing the permeability of rat vascular endothelial cells.

[Value of spectral CT-based quantitative analysis in differential diagnosis of liver cancer and liver abscess]

Objective: To investigate the value of spectral CT-based quantitative analysis in the differential diagnosis of liver cancer and liver abscess. Methods: A total of 70 patients with space-occupying lesions in the liver(45 with liver cancer and 25 with liver abscess)underwent spectral CT scans to obtain spectral images in the arterial phase and portal venous phase. The solid constituents of lesions and the iodine and water concentrations in necrotic or cystic parts of lesions, normal hepatic tissue, and abdominal aorta in the arterial phase and portal venous phase were measured, and the normalized iodine concentration(NIC)and lesion-to-normal hepatic tissue ratio(LNR)of iodine concentration were calculated. The two samples t-test and the receiver operating characteristic(ROC)curve analysis were performed for the quantitative indices above. Results: The patients with liver cancer had higher NIC and LNR in solid constituents in the arterial phase than those with liver abscess(NIC: 0.15±0.06 mg/ml vs 0.14±0.02 mg/ml, P > 0.05; LNR: 2.78±0.65 vs 1.45±0.88, P < 0.001). The patients with liver abscess had significantly higher NIC and LNR in solid constituents in the portal venous phase than those with liver cancer(NIC: 0.65±0.08 mg/ml vs 0.52±0.08 mg/ml, P≤0.001; LNR: 1.22±0.23 vs 0.95±0.15, P≤0.001). There were no significant differences in NIC in the arterial phase or NIC and LNR in the portal venous phase in necrotic or cystic parts of lesions between the patients with liver cancer and liver abscess(P > 0.05). The optimal quantitative value for the differential diagnosis of liver cancer and liver abscess was LNR in arterial phase, and the cut-off value of 1.53 had a sensitivity of 100% and a specificity of 92%. Conclusion: Quantitative iodine concentration analysis in spectral CT imaging has a certain value in the differential diagnosis of liver cancer and liver abscess and can improve the accuracy of diagnosis.

[A clinical report of five cases of central nervous system miliary tuberculomas first diagnosed by neurologists]

To explore the clinical characteristics and imaging features of miliary tuberculomas in central nervous system(CNS). A total of 5 cases diagnosed with tuberculosis in CNS first diagnosed by neurologists in Navy General Hospital of PLA were enrolled in the study. All clinical and imaging data were collected and analyzed retrospectively. The main initial symptoms were fever and headache (4/5). Multiple diffused miliary lesions were shown by brain MRI, with maximum diameter ranged from 1-4 mm and ring-shape or nodular enhancement after gadolinium injection. As mycobacterium tuberculosis could seldomly be found in serum and cerebrospinal fluid, contrast MRI remains the effective method for detecting miliary tuberculomas in CNS.

Intensified nitrate and phosphorus removal in an electrolysis -integrated horizontal subsurface-flow constructed wetland

A novel electrolysis-integrated horizontal subsurface-flow constructed wetland system (E-HFCWs) was developed for intensified removal of nitrogen and phosphorus contaminated water. The dynamics of nitrogen and phosphorus removal and that of main water qualities of inflow and outflow were also evaluated. The hydraulic retention time (HRT) greatly enhanced nitrate removal when the electrolysis current intensity was stabilized at 0.07 mA/cm². When the HRT ranged from 2 h to 12 h, the removal rate of nitrate increased from 20% to 84%. Phosphorus (P) removal was also greatly enhanced-exceeding 90% when the HRT was longer than 4 h in the electrolysis-integrated HFCWs. This improved P removal is due to the in-situ formation of ferric ions by anodizing of sacrificial iron anodes, causing chemical precipitation, physical adsorption and flocculation of phosphorus. Thus, electrolysis plays an important role in nitrate and phosphorus removal. The diversity and communities of bacteria in the biofilm of substrate was established by the analysis of 16S rDNA gene sequences, and the biofilm was abundant with Comamonadaceae and Xanthomonadaceae bacteria in E-HFCWs. Test results illustrated that the electrolysis integrated with horizontal subsurface-flow constructed wetland is a feasible and effective technology for intensified nitrogen and phosphorus removal.

High performance of nitrogen and phosphorus removal in an electrolysis-integrated biofilter

A novel electrolysis-integrated biofilter system was developed in this study to evaluate the intensified removal of nitrogen and phosphorus from contaminated water. Two laboratory-scale biofilter systems were established, one with electrolysis (E-BF) and one without electrolysis (BF) as control. The dynamics of intensified nitrogen and phosphorus removal and the changes of inflow and outflow water qualities were also evaluated. The total nitrogen (TN) removal rate was 94.4% in our newly developed E-BF, but only 74.7% in the control BF. Ammonium removal rate was up to 95% in biofilters with or without electrolysis integration with an influent ammonium concentration of 40 mg/L, and the accumulation of nitrate and nitrite was much lower in the effluent of E-BF than that of BF. Thus electrolysis plays an important role in TN removal especially the nitrate and nitrite removal. Phosphorus removal was significantly enhanced, exceeding 90% in E-BF by chemical precipitation, physical adsorption, and flocculation of phosphorus because of the in situ formation of ferric ions by the anodizing of sacrificial iron anodes. Results from this study indicate that the electrolysis integrated biofilter is a promising solution for intensified nitrogen and phosphorus removal.

Analysis of ITS1 sequences and genetic relationships between populations of ridgetail white prawn, Exopalaemon carinicauda, in the East China Sea

Internal transcribed spacer 1 (ITS1) sequences from wild-type Exopalaemon carinicauda (N = 124) from the East China Sea were amplified and sequenced. Sequences were polymorphic and ranged from 388 to 583 bp in length. The average content of GC in sequences was significantly higher than that of AT. Altogether, 604 mutant sites with 123 haplotypes were detected; 46.7% were polymorphic sites. The genetic diversity index of population Y was highest, and the lowest was population X. Eight microsatellite sequences were detected; the most-repeated sequences were (GA)n, (AG)n, (GT)n, (TG)n, (TC)n, and (CT)n. Analysis of molecular variance revealed that genetic differentiation among the four populations were very weak, or modest. A molecular evolutionary tree was constructed using the neighbor-joining method and MEGA 6.0, and the phyletic evolutionary relationships among several Palaemonidae species examined. The phylogenetic tree showed that individuals of the same species, as well as the species of the same genus, clustered together, consistent with morphological classifications.

Protective effects of tumor necrosis factor-α blockade by adalimumab on articular cartilage and subchondral bone in a rat model of osteoarthritis

We aimed to investigate the effects of an anti-tumor necrosis factor-α antibody (ATNF) on cartilage and subchondral bone in a rat model of osteoarthritis. Twenty-four rats were randomly divided into three groups: sham-operated group (n=8); anterior cruciate ligament transection (ACLT)+normal saline (NS) group (n=8); and ACLT+ATNF group (n=8). The rats in the ACLT+ATNF group received subcutaneous injections of ATNF (20 μg/kg) for 12 weeks, while those in the ACLT+NS group received NS at the same dose for 12 weeks. All rats were euthanized at 12 weeks after surgery and specimens from the affected knees were harvested. Hematoxylin and eosin staining, Masson's trichrome staining, and Mankin score assessment were carried out to evaluate the cartilage status and cartilage matrix degradation. Matrix metalloproteinase (MMP)-13 immunohistochemistry was performed to assess the cartilage molecular metabolism. Bone histomorphometry was used to observe the subchondral trabecular microstructure. Compared with the rats in the ACLT+NS group, histological and Mankin score analyses showed that ATNF treatment reduced the severity of the cartilage lesions and led to a lower Mankin score. Immunohistochemical and histomorphometric analyses revealed that ATNF treatment reduced the ACLT-induced destruction of the subchondral trabecular microstructure, and decreased MMP-13 expression. ATNF treatment may delay degradation of the extracellular matrix via a decrease in MMP-13 expression. ATNF treatment probably protects articular cartilage by improving the structure of the subchondral bone and reducing the degradation of the cartilage matrix.

Associations of lifestyle-related factors, hsa-miR-149 and hsa-miR-605 gene polymorphisms with gastrointestinal cancer risk

To explore the associations of SNPs within hsa-miR-605 (rs2043556) and hsa-miR-149 (rs2292832) and lifestyle-related factors with gastrointestinal cancer, a case-control study including 762 cases and 757 controls was conducted. Marginally significant associations were found both for hsa-miR-149 rs2292832 with gastric cancer risk (TC + CC vs. TT, OR = 0.68, 95% CI: 0.44-1.04) and for hsa-miR-605 rs2043556 with colorectal cancer risk (AG + GG vs. AA, OR = 0.70, 95% CI: 0.48-1.02) in males. Tea drinking showed a protective effect on gastric cancer risk (OR = 0.28, 95% CI: 0.13-0.60), while smoke inhalation increased the risk of gastric cancer (OR = 1.94, 95% CI: 1.08-3.47). Irritability was found to be a risk factor for both colorectal cancer (OR = 1.61, 95% CI: 1.02-2.53) and gastric cancer (OR = 1.96, 95% CI: 1.17-3.29). Among those that engaged in smoke inhalation, miR-149 CT/CC and miR-605 AG/GG genotype carriers had increased susceptibilities to colorectal cancer (OR = 1.90, 95% CI: 1.11-3.25) and gastric cancer (OR = 1.87, 95% CI: 1.03-3.42), respectively. Among the tea drinkers, there exists a marginally protective effect of miR-605 AG/GG genotypes on colorectal cancer incidence (OR = 0.71, 95% CI: 0.47-1.06) and a significantly protective effect of miR-149 CT/CC on gastric cancer incidence (OR = 0.47, 95% CI: 0.29-0.77). The SNPs of rs2292832 and rs2043556 might be able to modify the susceptibility to male gastric and colorectal cancers, respectively. Tea drinking is a protective factor, while smoke inhalation is a risk factor for gastric cancer, and they might have the potential to modify the associations between miR-149 and miR-605 polymorphisms with gastrointestinal cancer risk. In addition, irritability was shown to be a risk factor for both gastric and colorectal cancers.

Association study between polymorphisms in selenoprotein genes and susceptibility to Kashin-Beck disease

OBJECTIVES

Kashin-Beck disease (KBD) is a disabling osteoarthropathy involving growth cartilage endemic to selenium (Se)-deficient regions in China. Associations between genetic variation in selenoprotein genes and susceptibility to many diseases have recently been investigated but few studies have been performed on KBD. We found four genetic polymorphisms in selenoprotein genes and assessed their association with increased susceptibility to KBD.

METHODS

Four polymorphisms including GPX1 (rs1050450), TrxR2 (rs5748469), SEPP1 (rs7579) and DIO2 (rs225014) were analyzed for 161 KBD patients and 312 controls using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or tetra-primer amplification refractory mutation system PCR (Tetra-primer ARMS PCR). Glutathione peroxidase (GPX) activity in whole blood was measured using a GPX assay kit. The mRNA expression of GPX1, nuclear factor-kappaB (NF-kappaB) p65 and p53 in both whole blood and articular cartilage tissue were detected using Real-Time PCR.

RESULTS

The genotypic and allelic frequency of GPX1 Pro198Leu was significantly different between KBD patients and controls (P=0.013, P=0.037). A significant increased KBD risk was observed in individuals with Pro/Leu or Leu/Leu (odds ratio=1.781; 95% confidence interval: 1.127-2.814) compared with Pro/Pro. No association was observed between the other three single nucleotide polymorphisms (SNPs) and KBD risk. In addition, GPX enzyme activity in whole blood was lower in the KBD group (P<0.01), and the GPX activity in whole blood decreased significantly in a subgroup of individuals representing Pro/Leu and Leu/Leu compared to Pro/Pro (P<0.01). In whole blood and articular cartilage tissue samples of KBD patients, GPX1 and NF-kappaB p65 mRNA levels were lower (P<0.01) while p53 levels were higher (P<0.001).

CONCLUSION

GPX1 Pro198Leu is a potential genetic risk factor in the development of KBD and the GPX1 Leu allele is significantly associated with higher KBD risk among the Chinese Han population and with lower GPX enzyme activity. The expression of apoptosis related molecules in KBD patients significantly differs from controls.

Development of a Compound-Specific Carbon Isotope Analysis Method for Atmospheric Formaldehyde via NaHSO3 and Cysteamine Derivatization

A novel method has been developed for the compound-specific carbon isotope analysis of atmospheric formaldehyde using gas chromatography/combustion/isotope ratio mass spectrometry (GC/C/IRMS). The method allows the determination of the delta13C value for atmospheric formaldehyde at nanogram levels with higher precision and lower detection limit. In the present work, atmospheric formaldehyde was collected using NaHSO3-coated Sep-Pak silica gel cartridges, washed out by water, then derivatized by cysteamine of known delta13C value, and the delta13C value of its derivative (thiazolidine) determined by GC/C/IRMS. Finally, the delta13C value of atmospheric formaldehyde could be calculated by a simple mass balance equation between formaldehyde, cysteamine, and thiazolidine. Using three formaldehydes with different delta13C values, calibration experiments were carried out over large ranges of formaldehyde concentrations. The carbon isotope analysis method achieved excellent reproducibility and high accuracy. There was no carbon isotopic fractionation throughout the derivatization processes. The differences in the carbon isotopic compositions of thiazolidine between the measured and predicted values were always <0.5 per thousand, within the specifications of the GC/C/IRMS system. The present method was also compared with the previous 2,4-dinitrophenylhydrazine derivatization method, and this method could be performed with lower analytical error and detection limit. Using this method, four 6-h ambient atmospheric formaldehyde samples were consecutively collected from 8 to 9 March 2005. The results showed that the delta13C values of atmospheric formaldehyde were different during the daytime and nighttime. This method proved suitable for the routine operation and may provide additional insight on sources and sinks of atmospheric formaldehyde.

Expression analysis and chromosome location of a novel gene (H11) associated with the growth of human melanoma cells

We have previously described the isolation of a new human gene, H11, that codes for a 25 kDa phosphoprotein with autokinase activity the expression of which is required for cell growth. The data described in this report extend these findings. Using FISH and M-FISH we show that H11 which maps at chromosome site 12q24.1-12q24.31 is not involved in chromosomal translocations. The tissue distribution of H11 mRNA is restricted, with expression being most abundant in skeletal muscle, heart, prostate and placenta. The H11 protein is cytoplasmic and it is associated with the plasma membrane. Cell surface localization in particulate aggregate formations suggests that it may be complexed to proteins involved in the transfer of extracellular growth signals.

Recovery of NV knockout infectious hematopoietic necrosis virus expressing foreign genes

Infectious hematopoietic necrosis virus (IHNV) is a Novirhabdovirus and is the causative agent of a devastating acute, lethal disease in wild and farmed rainbow trout. The virus is enzootic throughout western North America and has spread to Asia and Europe. A full-length cDNA of the IHNV antigenome (pIHNV-Pst) was assembled from subgenomic overlapping cDNA fragments and cloned in a transcription plasmid between the T7 RNA polymerase promoter and the autocatalytic hepatitis delta virus ribozyme. Recombinant IHNV (rIHNV) was recovered from fish cells at 14 degrees C, following infection with a recombinant vaccinia virus expressing the T7 RNA polymerase (vTF7-3) and cotransfection of pIHNV-Pst together with plasmids encoding the nucleoprotein N (pT7-N), the phosphoprotein P (pT7-P), the RNA polymerase L (pT7-L), and the nonvirion protein NV (pT7-NV). When pT7-N and pT7-NV were omitted, rIHNV was also recovered, although less efficiently. Incidental mutations introduced in pIHNV-Pst were all present in the rIHNV genome; however, a targeted mutation located in the L gene was eliminated from the recombinant genome by homologous recombination with the added pT7-L expression plasmid. To investigate the role of NV protein in virus replication, the pIHNV-Pst construct was engineered such that the entire NV open reading frame was deleted and replaced by the genes encoding green fluorescent protein or chloramphenicol acetyltransferase. The successful recovery of recombinant virus expressing foreign genes instead of the NV gene demonstrated that the NV protein was not absolutely required for viral replication in cell cultures, although its presence greatly improves virus growth. The ability to generate rIHNV from cDNA provides the basis to manipulate the genome in order to engineer new live viral vaccine strains.

A novel human gene similar to the protein kinase (PK) coding domain of the large subunit of herpes simplex virus type 2 ribonucleotide reductase (ICP10) codes for a serine-threonine PK and is expressed in melanoma cells

The large subunit of herpes simplex virus type 2 ribonucleotide reductase (ICP10) is a multifunctional protein that contains a serine-threonine protein kinase (PK) activity (Nelson, J. W., Zhu, J. , Smith, C. C., Kulka, M., and Aurelian, L. (1996) J. Biol. Chem. 271, 17021-17027). Phylogenetic analyses indicated that ICP10 PK belongs to a distinct subfamily of growth factor receptor serine-threonine PKs that are characterized by their ability to function with a limited number of conserved catalytic motifs (Hunter, J. C. R., Smith, C. C., and Aurelian, L. (1995) Int. J. Onc. 7, 515-522). Here, we report the isolation and characterization of a novel gene, designated H11, that contains an open reading frame of 588 nucleotides, which encodes a protein similar to ICP10 PK. The H11 protein has Mn(2+)-dependent serine-threonine-specific PK activity as determined with a GST-H11 fusion protein and by immununocomplex PK/immunoblotting assays of 293 cells transfected with a H11 eukaryotic expression vector. PK activity is ablated by mutation of Lys(113) within the presumtive catalytic motif II (invariant Lys). 293 cells stably transfected with H11 acquire anchorage-independent growth. Endogenous H11 RNA and the H11 phosphoprotein are expressed in melanoma cell lines and primary melanoma tissues at levels higher than in normal melanocytes and in benign nevi. Melanoma cell proliferation is inhibited by treatment with antisense oligonucleotides that inhibit H11 translation, suggesting that H11 expression is associated with cell growth.

Partial mapping and sequencing of a fish iridovirus genome reveals genes homologous to the frog virus 3 p31, p40 and human eIF2alpha

Iridovirus-like pathogens have been recognized as a cause of serious systemic diseases among feral, cultured and ornamental fish in the recent years. Mortalities of fish due to systemic iridovirus infection reaching 30-100% were observed in Europe, Australia, Japan and Thailand. Up to now, the molecular biology of these important pathogens has been poorly documented. To get better insights on the genomic organization of these piscine iridoviruses, we have constructed a cosmid viral DNA library from the epizootic hematopoietic necrosis virus (EHNV). Two recombinant cosmids (Cos7 and Cos12) have been selected for systematic sequencing. Cos7 and 12 are localized side by side along the genome and cover the 2/3 part of the total EHNV genome which has been estimated to be approximately 101.47 kb in length. Thirty five kilobase pairs (kbps) from Cos7 and 10 kbps from Cos12 have been determined. Sequence analysis revealed open reading frames (ORF) sharing homologies with sequences from the Frog virus 3 such as the p31 and p40 proteins. Among the others identified ORFs, some of them presented homologies with known protein sequences, such as the human eIF2alpha protein, and some did not show any significant homologies with sequences available in the databases. But, none were related to Lymphocystis virus, a member of the Iridoviridae family, for which the full genome nucleotide sequence has been determined.

OFQ reverses the kappa-opioid receptor-mediated depression of calcium current in rat dorsal root ganglion neurons

Since the characterization of orphanin FQ (OFQ), the endogenous ligand of ORL1 receptor, much work has focused on its physiological functions. OFQ was reported to antagonize the effect of opioid-induced antinociception, although its mechanism remains obscure. In the present study, whole-cell patch clamp recording technique was used to observe if OFQ can reverse the inhibition of calcium current produced by the kappa-opioid agonist U50,488H (U50) in acutely dissociated rat DRG neurons. The concentrations of OFQ and U50 were 50 nM and 10 microM, respectively. Among 49 cells recorded, the calcium channel currents of 37 (75.5%) cells were inhibited by U50, of which 30 (81.1%) cells could be reversed by OFQ. It was interesting to note the similarity between OFQ and the well characterized anti-opioid peptide CCK-8 in that it reversed kappa-opioid receptor agonist induced suppression on calcium channel current, while by itself showed a calcium channel suppressive effect. Thus OFQ may be regarded as another anti-opioid peptide.

Immunogenicity of live attenuated SA14-14-2 Japanese encephalitis vaccine--a comparison of 1- and 3-month immunization schedules

Live attenuated SA14-14-2 Japanese encephalitis (JE) vaccine has been safe and effective in >100 million immunized children, but its current administration schedule of two doses given a year apart does not lend itself to inclusion in established Expanded Program of Immunization (EPI) schedules of childhood immunization. Immune responses to immunization at shorter intervals were compared in middle-school-aged children immunized with two doses separated by 1 month (n = 116) or 2.5 months (n = 115). Two vaccine lots were compared. Seroconversion to the vaccine was observed in 100% of vaccinees immunized in the 1-month schedule and in 94% (lot 2) and 100% (lot 1) of vaccinees immunized in the 2.5-month schedule. Geometric mean titers were almost 2-fold higher with the longer schedule. The routine administration of JE SA14-14-2 vaccine to infants in an EPI schedule should be possible using either interval.

Demonstration of a fibre afferents with overlapping receptive fields in humans

According to previous data peripheral nerves may lack a detailed microanatomical organization. Nevertheless, stimuli within restricted skin areas might excite more than one afferent of the same modality. Since, as recently demonstrated, peripheral myelinated afferents are at least partially organized by both modality and somatotopy it might be possible to demonstrate such a phenomenon electrophysiologically provided that adequate procedures are used. To address this issue we recorded activity in single myelinated afferents supplying the hand with concentric needle electrodes. A combination of electrical and/or natural stimuli applied to the area where rapidly adapting (RA) or slowly adapting type I (SAI) fibres ended demonstrated that fibres of the same functional class may exhibit overlapping receptive fields in the skin.

Cholecystokinin octapeptide reverses the inhibitory effect induced by electroacupuncture on C-fiber evoked discharges

Extracellular single unit recordings were made from spinal dorsal horn wide dynamic range neurons in spinal transected, urethane-anesthetized rats. The unit discharges elicited by noxious electrical stimulation of the hind paw were suppressed by electroacupuncture (15 Hz, 0.3 ms, 3 mA, 30 min) placed at the hind leg points (S-36 and SP-6). Local spinal superfusion with naloxone (20 micrograms/15 microliters) or CCK-8 (10 ng/15 microliters) attenuated, whereas CCK-B receptor antagonist L365,260 (2.5 micrograms/15 microliters) enhanced the electroacupuncture effect. These findings provide further evidence for the notion that CCK-8, in the spinal cord, functions as an antiopioid substrate that antagonizes opioid- or electroacupuncture-induced analgesia.

Cholecystokinin octapeptide reverses the kappa-opioid-receptor-mediated depression of calcium current in rat dorsal root ganglion neurons

Although the cholecystokinin octapeptide (CCK-8) is reported to antagonize the kappa-opioid-receptor-mediated analgesic effect in spinal cord, its mechanism and sites of action remain obscure. In the present study, the whole-cell patch-clamp recording technique was employed to examine the effect of kappa-opioid agonist U50488H on voltage-gated calcium channels and the interaction between the CCK-8 and U50488H in acutely isolated rat dorsal root ganglion neurons. The results indicate that the calcium currents elicited in dorsal root ganglion neurons can be depressed by U50488H, an effect readily reversed by the kappa-opioid receptor antagonist Nor-BNI or by the antiopioid peptide CCK-8. The effect of the CCK-8 can be abolished by the CCK-B receptor antagonist, L365,260. While CCK-8 showed a potent opioid-reversal effect, it by itself exerted a slight inhibitory effect on calcium current. This novel observation in the dorsal root ganglion neurons indicates that CCK-8 can antagonize the kappa-opioid-receptor-mediated depressant effect on voltage-gated calcium current, and this antagonizing effect appears to be mediated via CCK-B receptor.

[Current status of the application of patch-clamp technique and its combinations with other techniques]

The Patch-clamp technique, as an advanced electrophysiological technique, has been widely used for research in the life science research field. A recent trend is to combine this technique with other techniques, such as the Fura-2 microfluorimetry for measuring the concentration of Ca2+, electrochemical detection with carbon-fiber electrode (i.e. amperometric detection or amperometry), and single-cell reverse transcription of RNA followed by the polymerase chain reaction (RT-PCR). This article is to summarize the current status of the use of patch-clamp technique and its combinations with other techniques in solving problems related with transmembrane signal transduction in neurobiology.

Cholecystokinin octapeptide reverses mu-opioid-receptor-mediated inhibition of calcium current in rat dorsal root ganglion neurons

Cholecystokinin octapeptide (CCK-8) is reported to antagonize the analgesic effect produced by mu- and kappa- but not delta-opioid agonist in spinal cord. However, the mechanisms of interaction remain obscure. In the present study, whole-cell patch-clamp recording was performed on acutely isolated rat dorsal root ganglion (DRG) neurons to evaluate the effects of the highly specific mu-opioid agonist ohmefentanyl and the delta-opioid agonist DPDPE on voltage-gated calcium channels and the possible interaction between CCK-8 receptor and mu- or delta-opioid receptor. The results indicated that ohmefentanyl, but not DPDPE, can suppress the voltage-gated calcium currents elicited in DRG neurons, an effect readily reversed by naloxone or by the antiopioid peptide CCK-8. The effect of CCK-8 can in turn be abolished by the CCK-B receptor antagonist L365,260. CCK-8 used by itself has no enhancing effect, but rather a depressant effect, on calcium currents. However, used simultaneously with ohmefentanyl, CCK-8 shows a clear-cut reversal of depression of the mu-opioid. We conclude that the depressant effect produced by mu-opioid on voltage-gated calcium current in DRG neurons can be antagonized by CCK-8 through CCK-B receptor located in the same neuron. The delta-opioid DPDPE has no direct effect on the voltage-gated calcium current in DRG neurons.

Changes in the content of immunoreactive dynorphin in dorsal and ventral spinal cord of the rat in three different conditions

Previous study in our group demonstrated that dynorphin exerted a significant analgesic effect in spinal cord, and electroacupuncture (EA) of high frequency (100 Hz) produced analgesia which was mediated by dynorphin released in spinal cord. However, no data are up to nowadays available for demonstrating either from anterior horn or from dorsal horn the dynorphin comes. Using radioimmunoassay, we found in the present study that ir-dynorphin content in dorsal horn was 10 times more than in anterior horn, which were 11.24 +/- 0.91 pmol/10 mg protein and 1.08 +/- 0.20 pmol/10 mg protein, respectively. Stimulation of 100 Hz EA for 30 min produced a significant increase of ir-dynorphin content in dorsal horn, in contrast, no change of ir-dynorphin content was found in anterior horn. For the meanwhile, a significant elevation of ir-dynorphin was induced by 100 Hz EA in cerebrospinal fluid. It is concluded according to these data that EA, as a stimulation in physiological condition, elevates the content of ir-dynorphin only in dorsal horn, and induces release of dynorphin in loci. The released dynorphin acts on dorsal horn to mediate the analgesia of EA.

Comparative study of the analgesic and paralytic effects induced by intrathecal dynorphin a in rats

Intrathecal injection of dynorphin A produced dual effects on sensory and motor functions in the spinal cord of the rat. At a dose of 5 nmol, dynorphin A produced an increase in tail flick latency (TFL) as well as a reversible motor paralysis as assessed by change in the angle of inclined plane. At a dose of 10 or 20 nmol, dynorphin produced a motor paralysis lasting for up to 24 hours. The effect of dynorphin A on the sensory function of the spinal cord was shown by an increase in the vocalization threshold induced by electrical stimulation of the tail, at dose range of 1.25-10 nmol, with a quick onset (5 min) and relatively short duration (within 60 min). Unlike tail flick reaction which involves spinal motor function, tail stimulation-induced vocalization threshold is a relatively pure index for spinal nociceptive activities. The differential effect of dynorphin on sensory and motor function was supported by the evidence that (1) dynorphin-induced analgesic effect (increase in vocalization threshold) was naloxone reversible, whereas dynorphin-induced motor paralysis was naloxone resistant. (2) Nor-BNI, a specific antagonist for kappa opioid receptor, blocked the sensory effect of dynorphin, but had no influence on motor effect of dynorphin. It is thus concluded that dynorphin has both analgesic and paralytic effects in spinal cord. The analgesia shown by an increase of vocalization threshold is an opioid effect, most probably mediated by kappa opioid receptor; the paralytic effect, however, is a non-opioid effect. The increase of TFL induced by dynorphin involves both sensory (analgesia) and motor (paralysis) effects.

[p21ras expression, DNA ploidy and prognosis in colorectal cancer]

83 colorectal cancer patients who underwent radical surgery were studied. Serial sections were carried out for detection of p21ras expression level by means of immunohistochemical assay combined with image analysis technique, measurement of DNA ploidy by flow cytometry and re-confirmation of diagnosis. We found that the high level of p21ras expression indicated a group of tumors with more aggressive behavior and worse prognosis. The five-year survival rate was only 26.83% in patients with p21D > or = 0.24 tumor, compared with 78.57% in those with p21D < 0.24 tumor. Five-year survivors tended to display diploid and had lower p21D. Detection of p21ras expression level (p21D) and DNA index in tumors may be helpful in predicting the outcome of colorectal cancer patients.

[Evaluation of multiple prognostic factors in colorectal cancer]

A multivariate stepwise discriminant analysis was performed to evaluate the prognostic value of DI, PI, AgNOR, p21D, CEAD and several clinicopathological features (age, sex, tumor location, histological grading, typing and staging) in 83 patients with colorectal cancer who underwent radical surgery. A fisher's discriminant function was established by using 6 selected items (staging, grading, DI, PI, AgNOR and p21D). It's efficiency, sensitivity and specificity were 91.28%, 87.18%, and 95.45% respectively. Correlative studies on DI, PI, AgNOR and p21D indicated that they are independent factors influencing prognosis. Therefore, in addition to Dukes's classification and histopathological grading of the tumor, these molecular biological factors can be considered as a new clue to evaluation of patients prognosis.