[The association of lipid profile and bleeding in patients with minor stroke or transient ischemic attack on antiplatelet therapy: subgroup analysis of CHANCE]

Objective: Abnormalities of lipid profile were considered as risk factors of hemorrhage after ischemic stroke. We aimed to determine the relationship between lipid levels and bleeding in minor stroke or transient ischemic attack (TIA) patients receiving antiplatelet therapy. Methods: Serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglyceride were tested in a subgroup of 3 044 consecutive patients from Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. Patients were randomized to clopidogrel plus aspirin group or single aspirin group. The primary endpoint was any bleeding within 90 days. The secondary endpoint was severe bleeding according to the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) definition. Cox proportional hazards models were used to assess the associations of lipid levels and outcomes. Results: A total of 59 (1.9%) bleeding events occurred at 90 days. High-density lipoprotein cholesterol (adjusted HR=2.16; 95%CI 1.17-4.00, P=0.014) and age (adjusted HR=1.04; 95%CI 1.01-1.06, P=0.006) were significantly associated with any bleeding. High-density lipoprotein cholesterol was also associated with severe bleeding (adjusted HR=3.05; 95%CI 1.39-6.68, per 1 mmol/L increase). No correlations between outcomes and levels of total cholesterol, low-density lipoprotein cholesterol and triglyceride were found. There was no interaction of any lipid component level with randomized antiplatelet therapy. Conclusions: Elevated high-density lipoprotein cholesterol is independently associated with any bleeding and severe bleeding in the patients with acute minor stroke or high-risk TIA on antiplatelet therapy.

[The study of cyclosporin A modified intraocular lens preventing posterior capsular opacification in rabbit eyes]

OBJECTIVE

To investigate the safety and efficacy of cyclosporine A sustained release from modified intraocular lens for preventing posterior capsular opacification (PCO) in rabbit eyes.

METHODS

Forty-five New Zealand albino rabbits undergoing phacoemulsification in their right eyes were randomly and equally divided into three groups. Group A had implanted original IOL, group B had implanted PLGA-IOL(IOL coated with polylactide-glycoli acid), and group C had implanted CsA-PLGA-IOL (CsA loaded PLGA-IOL). All the 45 eyes were examined by a slit-lamp microscope. The intraocular pressures were recorded. Anterior chamber flare and aqueous humor cells were graded at different time point after surgery. The concentrations of CsA in the aqueous humor and blood were determined by high performance liquid chromatography. Anterior segment tissue was histologically examined. Wet posterior capsules were weighed. PCO was graded 6 months later.

RESULTS

The mean concentrations of CsA in group C at 2 h,1 d,3 d,7 d,14 d,30 d,60 d after operation were (11.47±2.42) mg/L, (10.30±2.15) mg/L, (6.71±1.45) mg/L, (4.81±1.16) mg/L, (6.11±0.84) mg/L, (2.53±0.77) mg/L, (0.86±0.28) mg/L. The concentrations of CsA in blood were undetectable. During the early days after operation, the reactions of the anterior chamber in group A and B were more severe than group C. The initial appearance of PCO in group C was much later than in the other two groups, and the grade of PCO in group C was much lower than the other two groups. The mean weights of wet posterior capsules in group A(312.86±52.91) mg and B(310.64±62.42) mg were much heavier than that of group C(56.93 ± 24.24) mg. Histological observation showed that there was remarkably less accumulation of lens materials on the posterior capsules in group C than in the other two groups. No toxic actions were found in intraocular tissues in group C.

CONCLUSION

Our study suggested that Cyclosporin A modified intraocular lens could effectively and safely prevent the formation and development of posterior capsular opacification in rabbit eyes for a relatively long term.

Bactericidal and biocompatible properties of TiN/Ag multilayered films by ion beam assisted deposition

Nanoscale TiN/Ag multilayered films of thickness 500 nm were synthesized on AISI317 stainless steel by ion beam assisted deposition (IBAD) with the modulation period of 4, 5, 6, 7.5, and 12 nm. The bactericidal and biocompatible properties of TiN/Ag multilayered films were investigated through Gram negative E. coli bacteria and L929 cells (mice fibroblast) as well as human umbilical vein endothelial cells (HUVEC). The results show that the TiN/Ag multilayered films with the modulation period of 7.5 nm possess the strongest bactericidal property. The cytotoxicity grade of TiN/Ag multilayered coating with the modulation periods of 7.5 nm, 12 nm is in 0-1 scope, which indicates this film has no cytotoxicity to L929. HUVEC on TiN/Ag multilayered film grows well and shows good cellularity. Auger electronic spectroscopy reveals the relationship between the structure of TiN/Ag multilayered film and the biomedical properties.

F+ ion implantation induced cell attachment on intraocular lens

Cell attachment on the polymethylmethacrylate (PMMA) intraocular lens (IOL) was studied by ion implantation. F+ ion implantation was performed at an energy of 80 keV with fluences ranging from 5 x 10(12) to 5 x 10(15) ions/cm2 at room temperature. The cell attachment tests gave interesting results in that the number of the platelets, the neutral granulocytes, and the macrophages adhering on the surface of the IOLs was reduced significantly after F+ ion implantation. The optimal fluence was about 3 x 10(14) to 4 x 10(14) ions/cm2. The hydrophobicity imparted to the surface was also monitored. At the same time, no appreciable change in the tensile strength and the optical transmittance of the implanted samples was observed. X-ray photoelectron spectroscopy (XPS) and fourier transfer infrared (FTIR) analysis showed that F+ ion implantation caused the cleavage of some pendants, the oxidation of the surface, and the formation of some new F-containing groups. These results were responsible for the cell attachment changes.

A survey of social nutrition status of the elderly in the urban area of Chengdu, Sichuan Province

The social nutrition status was investigated among 246 subjects aged 60-90 living at three urban communities in Chengdu of Sichuan Province. The questionnaire was designed to evaluate socio-demographic background, the subjects' nutrition knowledge, and the support systems for geriatric nutrition. Fasting venous blood was collected for the analysis of biochemical parameters. Blood pressure, bone mineral contents (BMC), body weight (BW) and body height (BH) were measured at the same time. Only 49.7% of the subjects correctly answered four basic questions on nutrition. Food patterns for the elderly were simple and modest. Several nutrition-related disorders for the elderly were including high systolic blood pressure (44.6%), hypertriglyceridemia (25.9%), high diastolic blood pressure (25.1%), obesity (24.5%), high PBG (20.6%), emaciation (19.9%), high FBG (17.9%) and osteoporosis (16.8%). These data indicate that the support systems for the geriatric nutrition will have to be improved.

Elevated rates of severe neural tube defects in a high-prevalence area in northern China

In the northern provinces of China, the birth prevalence rate of neural tube defects (NTDs) is among the highest in the world-at about 6 per 1,000 births in rural areas. A unique population-based birth defects surveillance system in which photographs are taken of infants with selected external birth defects was implemented in two provinces in northern China and two provinces in southern China where NTD rates approximate those in the United States. In the period from March 1992 through December 1993, 660 infants with NTDs were identified by the surveillance project from a birth cohort of 251,567. We compared data from the two surveillance areas in China with data from a low-prevalence area in the United States to determine if the pattern of NTD types differs. Based on birth prevalence rates of NTDs from the Metropolitan Atlanta Congenital Defects Program, the observed to expected ratios for two types of NTDs are markedly increased at 80.8 for craniorachischisis and 25.0 for iniencephaly. Rates of these two NTDs in the southern provinces are increased to a lesser degree with observed to expected ratios of 7.1 for craniorachischisis and 2.7 for iniencephaly. The pattern of NTDs in northern China shows an increase in types that are rare in low-prevalence areas such as metropolitan Atlanta. Increased awareness of varying patterns of NTDs in different populations may have important implications for identifying etiologic and pathogenetic mechanisms of NTDs.