Generational effects and abnormalities in craniofacial chondrogenesis in zebrafish (Danio rerio) embryos upon maternal exposure to estrogen endocrine disrupting chemicals

Bisphenol A (BPA) and diethyl phthalate (DEP) are estrogenic endocrine disrupting chemicals (EEDCs). The present study reconfirmed that the angle of the ceratohyal cartilage (CH) in embryos were larger from maternal BPA and E2, but smaller from DEP compared to the control. However, it is still unknown whether both the BPA and DEP chemicals disrupted the action of E2 and thereby influence the estrogen signaling pathways. Additionally, it remains unclear whether they also disrupted certain related genes in the migratory pathways of neural crest cells (NCCs) in their offspring. The present data showed that nuclear estrogen receptors and membrane estrogen receptors have different disrupted profiles among female zebrafish exposed to BPA (F-BPA), and DEP (F-DEP), and external E2 (F-E2). However, certain related genes in the migratory pathways of NCCs in embryos from F-BPA and F-E2 such as the sox10, chm1, and tgfbr1a mRNA expressions showed a positive relationship compared with CH angles; the gene expressions of sox9a, smad3, and col2a1a and the CH angles of embryos exhibited an opposite relationship upon F-DEP treatments. Thus, we suggested that the genes involved in NCCs migration were potentially induced by the residual maternal DEP contents. Two sets of genes, chm1/tgfb3 and chm1/gper1, exhibited an identical profile in the ovary and its offspring at 2 h of post fertilization upon F-E2 and F-BPA treatments, respectively. We suggested that the maternal mRNA from female to embryos were transferred before the maternal-to-zygotic transition stage.

Modulation of narrow-field amacrine cells on light-evoked spike responses and receptive fields of retinal ganglion cells

By using multi-electrode array (MEA) recording technique in conjunction with white-noise checkerboard stimuli and reverse correlation methods, we studied modulatory actions of glycinergic narrow-field amacrine cells (NFACs) on spatiotemporal profiles of five functional groups of ganglion cells (GCs) in dark-adapted mouse retinas. We found that application of 2 µM strychnine significantly altered light-evoked spike rates of three groups of GCs. It also decreased receptive field center radii of all five groups of GC by a mean value of 11%, and shifted the GC receptive field (RF) centers of all GCs and the mean shift distances for the sustained GCs are significantly longer than the transient GCs. On the other hand, strychnine did not affect temporal profiles of the GC center responses, as it did not alter the time-to-peak or the biphasic index of the spike triggered average (STA) functions of GC RF centers. Strychnine also exerts limited actions on RF surrounds of most GCs, except that it moderately weakens the antagonistic surround of sustained OFF GCs and strengthens the antagonistic surround of the ON/OFF GCs, possibly through serial connections between NFACs and GABAergic wide-field amacrine cells (WFACs). Using the Sum of Separable Subfilter (SoSS) model and singular value decomposition method, we decomposed GCs' STAs into five space-time separable subfilters, studied the observation rates of each subfilter in the five functional groups of GCs and determined NFAC-dependent and -independent synaptic circuitries that mediate center and surround responses of various groups of mouse retina retinal ganglion cells.

[Research progress on the role of adipose-derived stem cell exosomes in skin scar formation]

The adipose-derived stem cell exosomes are subcellular structures of adipose stem cells. They are nano-sized membrane vesicles that can transport various cell components and act on target cells by paracrine, and they play an important role in the exchanges of substance and information between cells. Scar healing is the commonest way of healing after skin tissue injury. Pathological scar can not only cause movement dysfunction, but also lead to deformity, which affects the appearance of patients and brings life and mental pressure to the patients. In recent years, many researches have shown that the adipose-derived stem cell exosomes contain a variety of bioactive molecules, which play an important role in reducing scar formation and scar-free wound healing, by affecting the proliferation and migration of fibroblasts and the composition of extracellular matrix. This article reviewed the recent literature on the roles and mechanisms of adipose-derived stem cell exosomes in scar formation, and prospected the future application and development of adipose-derived stem cell exosomes in scar treatment.

Reproductive and Developmental Alterations on Zebrafish (Danio rerio) Upon Long-Term Exposure of Di-ethyl phthalate (DEP), Di-isononyl phthalate (DINP) and Di (2-ethylhexyl) phthalate (DEHP)

Di (2-ethylhexyl) phthalate (DEHP), di-ethyl phthalate (DEP) and di-isononyl phthalate (DINP) are all endocrine disrupting chemicals (EDCs) for organisms. However, little research has been done on the effects of long-term EDC exposure. The present study found that the zebrafish barely grew during the 7 months of DINP exposure. The fecundity rate (%) of female spawning was lower in the DEHP treatment by 4 months compared to other exposure groups. Zebrafish treated with 12.5-25.0 ppm of DEP for 4 months presented no spawning. Gonadal-somatic index (GSI) levels significantly decreased, and there were more oocytes in the atresia and peri-nucleus stage compared to the control group. In addition, the hatching rate of embryos were 71.02%, 56.92%, and 21.70% for females treated with DINP, DEHP and DEP, respectively. There were also abnormal craniofacial chondrogenesis development on 72 hpf embryos upon females treated with the three EDCs. In conclusion, long term exposure of DEHP, DINP, and DEP did not only affect the reproductive capacity of female zebrafish, but the 3 plasticizers also influence craniofacial cartilage development of its offspring.

[Effects of comprehensive treatment of infected wounds in patients with iatrogenic Cushing's syndrome]

Objective: To investigate the characteristics and comprehensive treatment of infected wounds in patients with iatrogenic Cushing's syndrome. Methods: A retrospective observational study was conducted. From May 2012 to December 2021, the data of 19 patients with iatrogenic Cushing's syndrome discharged from the Department of Burns and Plastic Surgery of the First Affiliated Hospital of Guangxi Medical University were collected, including 8 males and 11 females, aged 28-71 (56±11) years, with 12 cases of infected acute wounds and 7 cases of infected chronic wounds. The lesions were located in the limbs, perianal, and sacrococcygeal regions, with original infection ranging from 9 cm×5 cm to 85 cm×45 cm. After admission, the patients were performed with multidisciplinary assisted diagnosis and treatment, and the wounds were treated with debridement and vacuum sealing drainage, according to the size, severity of infection, suture tension, and bone and tendon tissue exposure of wounds, direct suture or autologous skin and/or artificial dermis and/or autologous tissue flap transplantation was selected for wound repair. The levels of cortisol and adrenocorticotropic hormone (ACTH) of patients at 8:00, 16:00, and 24:00 within 24 h after admission were counted. After admission, the number of operations, wound repair methods, and wound and skin/flap donor site healing of patients were recorded. During follow-up, the wounds were observed for recurrent infection. Results: The cortisol levels of 16 patients at 8:00, 16:00, and 24:00 within 24 h after admission were (130±54), (80±16), and (109±39) nmol/L, respectively, and ACTH levels were (7.2±2.8), (4.1±1.8), and (6.0±3.0) pg/mL, respectively; and the other 3 patients had no such statistical results. After admission, the number of surgical operation for patients was 3.4±0.9. The following methods were used for wound repair, including direct suturing in 4 cases and autologous skin and/or artificial dermis grafting in 9 cases, of which 2 cases underwent stage Ⅱ autologous skin grafting after artificial dermis grafting in stage Ⅰ, and 6 cases had pedicled retrograde island flap+autologous skin grafting. The wound healing was observed, showing that all directly sutured wounds healed well; the wounds in 6 cases of autologous skin and/or artificial dermis grafting healed well, and the wounds in 3 cases also healed well after the secondary skin grafting; the flaps in 4 cases survived well with the wounds in 2 cases with distal perforators flap arteries circumfluence obstacle of posterior leg healed after stage Ⅱ debridement and autologous skin grafting. The healing status of skin/flap donor sites was followed showing that the donor sites of medium-thickness skin grafts in the thigh of 4 cases were well healed after transplanted with autologous split-thickness grafts from scalp; the donor sites of medium-thickness skin grafts in 3 cases did not undergo split-thickness skin grafting, of which 2 cases had poor healing but healed well after secondary skin grafting 2 weeks after surgery; the donor sites of split-thickness skin grafts in the head of 2 patients healed well; and all donor sites of flaps healed well after autologous skin grafting. During follow-up of more than half a year, 3 gout patients were hospitalized again for surgical treatment due to gout stone rupture, 4 patients were hospitalized again for surgical treatment due to infection, and no recurrent infection was found in the rest of patients. Conclusions: The infected wounds in patients with iatrogenic Cushing's syndrome have poor ability to regenerate and are prone to repeated infection. Local wound treatment together with multidisciplinary comprehensive treatment should be performed to control infection and close wounds in a timely manner, so as to maximize the benefits of patients.

Duration of Induced Metallothionein is a Critical Factor in the Cadmium-Resistance Among Goldfish (Carassius auratus) and Common Carp (Cyprinus carpio)

According to the Environmental Protection Agency in Taiwan, the common carp (Cyprinus carpio) is one species of fish for acute toxic test. It has been found to be extremely sensitive to the toxicity of Cd²⁺; Furthermore, the goldfish (Carassius auratus) has a higher resistance than common carp upon Cd²⁺ exposure, but both fish are the same family. The aim of the study was to compare the physiological and histo-pathological responses between goldfish and common carp under exposure to sublethal concentrations of Cd²⁺ in order to understand the reasons behind the Cd²⁺-resistance. Results showed that metallothionein (MT) protein levels in visceral tissues were exceptionally increased and elevated at an earlier time in goldfish than in common carp. Meanwhile, the amount of Cd²⁺ accumulation in goldfish was higher than common carp after Cd²⁺ exposure. The histo-pathological results revealed that the density of gill mucus cells and the thickness of gill epithelium in common carp were raised earlier than in goldfish, but the histo-pathological findings resemble each other. According to the data, we suggested the efficient response of MT proteins may contribute to goldfish with a higher Cd²⁺ tolerance.

Maternal effect and dietary supplementation of estradiol-17β on female zebrafish (Danio rerio) affects the swimming behavior and stress-coping styles of its offspring

Extrinsic estradiol-17β (E2) is an environmental hormone. Female fish exposure to waterborne E2 might affect the development of craniofacial cartilage of its offspring. The present study investigates the effects of maternal E2 on larval craniofacial cartilage development by administering oral feed containing E2 (F-E2) to female zebrafish, and examines whether the swimming behavior and their stress coping style are influenced by maternal E2. The results showed that E2 contents responded to dosage and time in male fish after being fed with a diet containing E2. In addition, the E2 contents in female ovaries showed a significant increase after 250 mg of E2/kg treatment for 14 d. On the other hand, the fecundity rate of F-E2 group was lower around 2 folds than FC (female fed 0 mg of E2/kg) group. Craniofacial chondrogenesis on 72 hpf (hours of post fertilization) of F-E2 larvae were abnormalities, and a recovery to a normal developmental pattern was observed at the 96 hpf stage. The swimming speed was slower for F-E2 larvae compared to the FC larvae; and the F-E2 juvenile seems to be less responsive to cortisol (LRC) after cold stress. According to the results, we suggested that F-E2 larvae might have worse environmental adaptability than FC larvae.

Massive expansion of human induced pluripotent stem cells resulting in efficient biobanking and functional 3D tissue analysis of genetic cardiomyopathies

Introduction

Over the past decade, various protocols were established to ensure efficient differentiation of hiPSC into cardiomyocytes (CMs). A major limitation, however, remained the batch-to-batch variability of hiPSC-CM efficiency and cell number. Here, we suggest an approach in which concomitant GSK-3β inhibition and removal of cell-cell contact inhibition, resulted in a massive proliferative response of hiPSC-CMs1–3. This efficient method allows expansion and passaging of functional hiPSC-CMs, that routinely can be cryopreserved and subsequently used as a stable cell source for the downstream applications, such 3D in vitro models for the disease modelling of dilated cardiomyopathy (DCM). We focussed on the deletion of arginine 14 in the PLN gene (R14del), which is associated with severe heart failure in DCM patients, associated with arrhythmias, cardiac fibrosis and premature death.

Methods

Subsequent expansion of hiPSC-CM cultures is generally modest (<10 fold). Here, we describe a cost-effective strategy for massive expansion (up to 250-fold) of high-purity hiPSC-CMs relying on two aspects; 1) inhibition of cell-cell contact via low-density seeding and serial passaging in culture flask-format, 2)small molecular glycogen synthase kinase-3β inhibition with CHIR99021 (CHIR). Patient-specific hiPSC-CMs harbouring a PLNR14del mutation were generated and used for EHT formation and functional follow-up.

Results

We observed that proliferating hiPSC-CMs, especially within the first 2 passages, can routinely be cryopreserved and subsequently further expanded or utilized in downstream applications. Moreover, using this strategy, it is possible to produce ultimately >1 billion CMs within 3–5 weeks starting with one differentiation batch of day 11 hiPSC-CMs, without the need for cell sorting or selection. Expanded hiPSC-CMs retain their capacity to mature and allows fibrin-based engineered heart tissues (EHTs) formation. Previously expanded CMs from PLNR14del patient-specific hiPSC were used to generate EHT and displayed a reduced force phenotype (0.137±0.012 mN) vs healthy control (0.229±0.030 mN) and isogenic control (0.224±0.008 mN) in previously expanded CMs.

Conclusion

We provpresent a novel strategy for the massive expansion of functional hiPSC-CMs with concomitant GSK-3β inhibition and low cell density culture that ultimately generates up to a 250-fold increase in hiPSC-CM numbers. Expansion healthy control hiPSC-CMs does not limit the subsequent maturation process, and moreover cells remain fully functional such as required for downstream tissue engineering approaches. Therefore, CM expansion forms a well-controlled platform for upscaling hiPSC-CM production for functional 3-dimensionale PLN cardiac disease models, large drug screenings and multiple translational/regenerative applications.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): PLN Foundation

Effects of bisphenol A or diethyl phthalate on cartilage development and the swimming behavior of zebrafish (Danio rerio) through maternal exposure

Waterborne bisphenol A (BPA) and diethyl phthalate (DEP) are endocrine disruptive chemicals that impact the reproductive system of fish. The present study checks the effectiveness of the reproductive capacity on zebrafish after BPA and DEP exposure, and consequently investigates its effect on their development and the swimming behavior of its offspring. The exposure of BPA and DEP to zebrafish reveals that the levels of ovarian 17β-estradiol (E2) and relative mRNA expression (RRE) ratios (Treatment/Control) of hepatic vitellogenin (vtg1) could be induced and decreased. Liver RRE levels in estrogen receptors (ERs) are also affected. Among the ERs, esr2a significantly increased upon BPA exposure, and esr1 and esr2b decreased upon DEP exposure. In addition, the ceratohyal cartilage (CH) angle of larvae whose mothers were exposed to BPA (F-BPA) was significantly bigger, but the CH angle of larvae whose mothers were exposed to DEP (F-DEP) was significantly smaller than the control. The swimming performance of larvae from F-DEP was more compromised than the control, but the situation did not appear in the larvae from the F-BPA group. The success rate of larvae hatching from F-BPA and F-DEP was lower than control group. Moreover, the successful rate of female spawns was higher in the control group compared to the treatment groups exposed to BPA and DEP. We suggested that both maternal BPA and DEP disrupt E2 levels, and influence the CH development of larvae, resulting in a decrease in successful hatching. Only the swimming behavior of larvae from maternal DEP was disrupted.

Changes in vitellogenin and estrogen receptor expression and 17β-estradiol concentration in male juvenile tilapia can be used to evaluate endocrine-disrupting chemicals

The effects of endocrine disruption with respect to potential human toxicities have been extensively evaluated to date. However, the standard testing methods used have not always taken the most pertinent approach. In this study, we used juvenile male tilapia (Oreochromis niloticus) as an animal model to test for endocrine disruption by chemicals. We measured 17β-estradiol (E2) concentrations, and the mRNA relative expression ratio (RER; treatment/control) of vitellogenin (vtg2) and estrogen receptors (ERs) to assess whether the effluent concentration of selected plasticizers disrupt E2 function in fish. We found that the vtg2 RER was significantly increased after exposure to 2.52 nM E2 for 5 days, 0.438 μM of bisphenol A (BPA) for 7 days, or 2.865 μM Cd²⁺ for 7 days. These data support vtg2 transcript level as a sensitive biomarker to evaluate contamination of water by endocrine disrupting chemicals (EDCs). However, vtg2 expression did not respond to fluctuations of E2 concentrations in the tilapia juveniles exposed to selected plasticizers. However, the RER of three types of ERs appeared to change dramatically upon exposure to plasticizers. ERα significantly increased, but ERβ2 decreased with 3.6 μM DEP exposure. Both ERα and ERβ2 decreased significantly after 1.44 μM DIBP exposure. We suggest that changes of vtg2 mRNA RER, E2 levels and ERs mRNA expression should be taken into consideration at the same time to determine if chemical contaminants in the water are endocrine disrupters.

Genetic dissection of rod and cone pathways mediating light responses and receptive fields of ganglion cells in the mouse retina

Retinal ganglion cells (GCs) are important visual neurons which carry complex spatiotemporal information from the retina to higher visual centers in the brain. By taking advantage of pathway-specific knockout/mutant mice and multi-electrode array (MEA) recording techniques, we analyze contributions of rod and cone pathways to responsiveness, kinetics and receptive field profiles of GCs under scotopic and photopic conditions. Our data suggest: (1) Scotopic responses of some GCs require all three rod pathways, some require only the secondary and tertiary rod pathways, and others require only the tertiary rod pathway. (2) There are more responsive GCs in photopic conditions than responsive GCs in scotopic conditions. (3) Gap junctions slow down GCs' scotopic light responses and increase GCs' ratio of antagonistic to center inputs. (4) Cone pathways do not affect the kinetics but alter the ratio of antagonistic to center inputs of scotopic GC responses, and they speed up GCs photopic responses and alter the ratio of GCs' antagonistic to center synaptic inputs and receptive field profiles. (5) Rod bipolar cells shorten response latency of ON GCs and increase the ratio of GCs' antagonistic to center synaptic inputs. (6) Light adaptation speeds up GCs' temporal processing and tunes GC photopic responses to higher frequencies, and the tertiary rod pathway plays a significant role in adaptation-induced TTP changes in some GCs. (7) GC RF center sizes are partially mediated by AIIACs and GC-GC coupling. (8) Connexin36 gap junctions and cone pathways alter synaptic circuits underlying antagonistic surround inputs to GCs in photopic conditions.

[Clinical effect and safety of 144-week treatment with entecavir capsules in treatment-naïve HBeAg-positive patients with chronic hepatitis B]

Objective: To investigate the clinical effect and safety of entecavir capsules in the treatment of treatment-naïve HBeAg-positive patients with chronic hepatitis B (CHB). Methods: A total of 158 HBeAg-positive CHB patients were given oral entecavir capsules at a dose of 0.5 mg/time once a day for 144 weeks. Clinical outcome and safety were evaluated at baseline and at 24, 48, 72, 96, 120, and 144 weeks of treatment respectively. The Fisher's exact test was used for the analysis of categorical data. Results: After 144 weeks of treatment, 90.91% of all patients achieved virologic response (< 69 IU/ml), the normalization rate of alanine aminotransferase was 88.18%, the clearance rate of HBeAg was 33.33%, and the seroconversion rate of HBeAg was 24.07%. Of all patients, 2 dropped out due to adverse events and 5 experienced serious adverse reactions. Conclusion: Entecavir capsules can inhibit viral replication and have good safety in treatment-naïve HBeAg-positive CHB patients.

Anti-oxidative Responses on Hepatic Tissue of Zebrafish (Danio rerio) in a Short Duration of Sub-lethal Concentrations of Cadmium Exposure

The aim of the present study was to identify whether the responses of oxidative stress in zebrafish liver are similar to those in mammalians upon low doses of Cd²⁺ exposure in short durations. Fish were exposed to 1.78 μM Cd²⁺ (treatment) and 0.0 μM Cd²⁺ (control) for 0, 1, 3, and 6 h. The reactive oxygen species (ROS) and lipid peroxidation (LPO) of hepatic tissues significantly increased after 3 and 6 h of Cd²⁺ exposure, respectively. Antioxidants glutathione peroxidase (gpx1a), superoxide dismutase (sod), and catalase (cat) were up regulated after 1-3 h, and metallothionein isoforms (smtB and mt2) increased after 3-6 h of Cd²⁺ exposure. The caspase-3 and p53 mRNA expressions significantly increased threefolds after 1 h of Cd²⁺ exposure. Results confirmed that oxidative stress in the hepatic tissue was induced by Cd²⁺ within 3 h. However, anti-oxidative functions immediately up regulated, causing cell apoptosis levels to decrease after 6 h of Cd²⁺ exposure.

[The multicenter study on the registration and follow-up of low anticoagulation therapy for the heart valve operation in China]

OBJECTIVE

To investigate the optimal anticoagulation methods and monitoring strategy for Chinese patients undergoing heart valve replacement, which is potentially quite different from western populations.

METHODS

In this multicenter prospective cohort study, the anticoagulation and monitoring strategy data was acquired from 25 773 in-hospital patients in 35 medical centers and 20 519 patients in outpatient clinic in 11 medical centers from January 1st, 2011 to December 31th, 2015.

RESULTS

As for in-hospital patients, mean age of study population was (48.6±11.2) years old; main etiology of valve pathology was rheumatic (87.5%) origin among study cohort; 94.8% of study population received mechanical valve implantation; international normalized ratio (INR) monitoring (in all the study centers) and low-intensity anticoagulation strategy (31 hospitals chose target INR range of 1.5-2.5, and actual values of INR among 89.2% of 100 069 in-hospital monitoring samples were 1.5-2.5), with mean actual INR values of 1.84±0.53, and warfarin dosage of (2.82±0.93) mg/d were widely adopted among the study centers; strategies of in-hospital warfarin administration were similar in all the study centers; complication rates of low-intensity anticoagulation strategy were low in severe hemorrhage (0.02%), thrombosis (0.05%), and thromboembolism (0.05%) events, without anticoagulation-related death.As for 18 974 outpatient clinic patients, the follow-up rate was 92.47%, with a total of 30 012 patient-years (Pty). Anticoagulation-related morbidity and mortality rates were 0.67% and 0.15% Pty; major hemorrhage morbidity and mortality rates were 0.25% and 0.13% Pty; thromboembolism morbidity and mortality rates were 0.45% and 0.03% Pty.The mean dosage of warfarin daily dosage was (2.85±1.23) mg/d and INR value was 1.82±0.57.No significant regional difference in the intensity of anticoagulation therapy was noted during the study.

CONCLUSIONS

INR can be used as a normalized indicator for intensity of anticoagulation therapy in China.The optimal anticoagulation intensity with INR range from 1.5 to 2.5 is safe and effective for Chinese patients with heart valve replacement, and there is no significant regional difference in the intensity of anticoagulation therapy.

Anti-oxidative functions of mt2 and smtB mRNA expression in the gills and brain of zebrafish (Danio rerio) upon cadmium exposure

There were not any past studies about metallothionein isoforms (smtB and mt2) having anti-oxidative functions on zebrafish after Cd²⁺ exposure. On the other hand, the anti-oxidative enzymatic factors such as superoxide dismutase (sod), glutathione peroxidase (gpx1a), and catalase (cat) are used as references to investigate whether the smtB and mt2 have anti-oxidative responses on the gills and brain of zebrafish after 1-6 h of 0 and 1.78 μM Cd²⁺ exposure. The anti-oxidative system such as sod, cat, and gpx1a mRNA expressions demonstrated a cascade response upon Cd²⁺-induced oxidative stress in the present study. Interestingly, the smtB mRNA expression levels increased by 3.2- to 6.1-fold, and mt2 raised by 4.1- to 11.3-fold in gills at 1 and 3 h after exposure to Cd²⁺, respectively. On the other hand, the smtB mRNA levels increased by 10.6- to 58.6-fold, but mt2 mRNA levels increased by 2.3- to 11.1-fold in brain at 1 and 3 h after exposure to Cd²⁺, respectively. In addition, both tissues showed increased apoptosis levels at 3 h, and recovery after 6 h of Cd²⁺ exposure. From the results, we suggest that both mt2 and smtB play a role in anti-oxidation responses within 6 h after exposure to Cd²⁺. In conclusion, the smtB mRNA levels have a higher response than mt2 in the brain, but both mRNA expressions appear to have a similar pattern in the gill. We suggest that smtB plays an important role to defend oxidative stress in the brain of adult zebrafish upon acute Cd²⁺ exposure.

Tenofovir disoproxil fumarate vs adefovir dipivoxil in Chinese patients with chronic hepatitis B after 48 weeks: a randomized controlled trial

Tenofovir disoproxil fumarate (TDF) has demonstrated long-term efficacy and a high barrier to resistance in multiple chronic hepatitis B (CHB) populations outside of China. This study aimed to evaluate the efficacy and safety of TDF compared with adefovir dipivoxil (ADV) in Chinese patients with CHB during 48 weeks of treatment (ClinicalTrial.gov number, NCT01300234). A Phase 3, multicentred, randomized, double-blind, controlled trial compared the efficacy and safety of TDF with ADV in Chinese patients with CHB. The primary endpoint was the proportion of patients with HBV DNA <400 copies/mL in each treatment group at Week 48, using an unpooled Z-test for superiority. Secondary endpoints included viral suppression, serologic response, histological improvement, normalization of alanine aminotransferase (ALT) levels and the emergence of resistance mutations. A total of 509 patients, 202 hepatitis B e antigen (HBeAg)-positive and 307 HBeAg-negative, with HBV DNA ≥10(5) copies/mL received either TDF 300 mg od or ADV 10 mg od. At Week 48, TDF demonstrated superior viral suppression compared with ADV in both HBeAg-positive (76.7% vs 18.2%, P < 0.0001) and HBeAg-negative (96.8% vs 71.2%, P < 0.0001) patients. The majority of patients in both treatment arms achieved ALT normalization (>85%). No resistance to TDF was observed. The frequency of adverse events was comparable between treatment arms (TDF 3.9% vs ADV 4.8%). In this double-blind, randomized, clinical trial, TDF demonstrated superiority over ADV with respect to viral suppression in Chinese patients with CHB at 48 weeks of treatment and without the development of resistance.

Profiles of thyrotropin, thyroid hormones, follicular cells and type I deiodinase gene expression during ontogenetic development of tilapia larvae and juveniles

The aims of the present study are to determine whether triiodothyronine (T3) and/or thyroxine (T4) in tilapia larvae is gifted through the mother, and to investigate the change profiles of thyrotropin (TSH), thyroid follicular cells and type I deiodinase (D1) gene expression following larval development. T3 and T4 contents were measured using radioimmunoassay, thyrotropin was observed using immunocytochemistry, and the D1 gene was cloned and measured using real-time PCR. Results indicated that the β-TSH-immunoreactive cells (thyrotropin ICC) signals were detected at 9 dph (i.e., 9 days of post-hatching). Thyroid follicular cells were observed first at 3 dph, while the T3 contents of the whole body gradually decreased before 11 dph. T4 contents were detected until 13 dph, with higher secretion during 19-21 dph. In addition, the T3 synthesis was not inhibited by thiourea (TU) before 13 dph, but the TU response in the larvae appeared after 13 dph. Type I deiodinase (D1: GenBank accession number KC591724) was found to contain 2444 bases and encoded 248 amino acids. The D1 mRNA expression began to increase at 13 dph, with a higher expression during 15-19 dph. These results suggested that the T3 contents were maternally derived before 13 dph. Both thyroid hormonal changes and some parameters related to thyroid hormone synthesis in ontogenetic tilapia are discussed.

Effects of maternal cadmium exposure on female reproductive functions, gamete quality, and offspring development in zebrafish (Danio rerio)

Impacts of maternal Cd(2+) exposure on female zebrafish (Danio rerio) were observed in females as well as their offspring. In females, Cd disturbed fecundity and other reproductive functions. In their offspring, it retarded gamete development and growth and influenced gene expression. There was a positive relationship between Cd(2+) contents in ovaries of females and treatment doses of 0-8.9 μM of Cd(2+). The mating rate decreased by 60 % when females were exposed to 8.9-35.6 μM of Cd(2+) for 72 h compared with the control group. It was observed that growth is delayed by one somite stage in maternal-Cd(2+) embryos compared with control embryos, which grew at the sixth-somite stage. The ceratohyal angles of larvae of Cd-exposed adults (maternal Cd(2+)) at 72 h postfertilization (hpf) appeared to have a positive response after doses of maternal Cd. In addition, approximately 30 % of 96-hpf larvae that were treated with a dose of 35.6 μM of maternal Cd(2+) appeared to have pericardial edema. At the 5-hpf stage of maternal Cd(2+) exposure, embryos showed 33 and 37 target genes, respectively, that were significantly downregulated and upregulated as shown by cDNA microarray analysis. A major effect of maternal Cd(2+) exposure on zebrafish embryo genes is that 18.9% of transcription functions were upregulated. In addition, 33.3% of transcripts relative to the function of protein biosynthesis were downregulated. These results showed that maternal Cd(2+) exposure influenced the reproduction ability of females and also caused their embryos to develop with abnormal gene expression.

Two years efficiency of lamivudine and adefovir dipivoxil combined therapy in chronic hepatitis B patients

BACKGROUND

Lamivudine (LAM) and adefovir (ADV) are widely used in most Asian countries, though monotherapy is associated with the occurrence of resistance.

AIM

To evaluate the efficiency of LAM and ADV combined treatment of chronic hepatitis B patients with compensated cirrhosis.

PATIENTS AND METHODS

206 eligible Chinese patients were randomly assigned in a 1:1 ratio to receive either LAM or ADV for the first 24 weeks. According to virologic response at 24 weeks, the patients either continued to monotherapy or switched to combined therapy for 48 weeks. After 48 weeks, all patients received LAM and ADV combined therapy for 96 weeks.

RESULTS

Serum HBV DNA levels significantly decreased in patients with ADV or LAM monotherapy and continuously reduced after the combined therapy. Serum ALT normalized rate were 88.24% and 81.37% at week 48, and 95.74% and 87.36% at week 96 in ADV and LAM group respectively, comparing to 60.78% and 56.73% in ADV and LAM groups at baseline. The accumulated virological breakthrough rate at week 48 and 96 was significantly higher in LAM group.

CONCLUSIONS

Both combination strategies were resulted in the long term virological, biochemical improvement in Chinese chronic hepatitis B patients with compensated cirrhosis.

Full electric control of exchange bias

We report the creation of a multiferroic field effect device with a BiFeO(3) (BFO) (antiferromagnetic-ferroelectric) gate dielectric and a La(0.7)Sr(0.3)MnO(3) (LSMO) (ferromagnetic) conducting channel that exhibits direct, bipolar electrical control of exchange bias. We show that exchange bias is reversibly switched between two stable states with opposite exchange bias polarities upon ferroelectric poling of the BFO. No field cooling, temperature cycling, or additional applied magnetic or electric field beyond the initial BFO polarization is needed for this bipolar modulation effect. Based on these results and the current understanding of exchange bias, we propose a model to explain the control of exchange bias. In this model the coupled antiferromagnetic-ferroelectric order in BFO along with the modulation of interfacial exchange interactions due to ionic displacement of Fe(3+) in BFO relative to Mn(3+/4+) in LSMO cause bipolar modulation.

Effects of ambient cadmium with calcium on mRNA expressions of calcium uptake related transporters in zebrafish (Danio rerio) larvae

The mRNA expression levels of Ca²⁺ transporter genes including the epithelial calcium channel (ECaC), sodium/calcium exchanger 1b (NCX1b), and plasma membrane calcium ATPase 2 (PMCA2) were measured in zebrafish larvae after exposure to 0.08 μM Cd²⁺ in either water mixed with 0.2 mM Ca²⁺ (lCa) or 2 mM Ca²⁺ (hCa). The ECaC and NCX1b expression decreased at the 48 and 72 h mark, respectively; however, PMCA2 transcripts decreased at 96 h after exposure to Cd²⁺ in lCa environment. On the other hand, the ECaC transcripts were not affected; however, the PMCA2 transcripts were increased at 72 h, while the NCX1b transcripts significantly decreased at 48 and 96 h after exposure to Cd²⁺ in a hCa environment. The Ca²⁺ contents of larvae significantly decreased after Cd²⁺ exposure in a lCa environment; however, the Ca²⁺ contents were evidently higher after exposure to Cd²⁺ in a hCa environment, except for 48th h mark. In addition, ECaC morphants showed lower Ca²⁺ contents of whole-body, and there were higher levels of mortality after exposure to the same condition compared to the wild-type groups. In contrast, injection of ECaC cRNA resulted in an increase in Ca²⁺ content and the rate of Ca²⁺ influx in zebrafish embryos. Summary, the results showed that the Ca²⁺ transporters of zebrafish larvae were impacted after exposures of 0.08 μM Cd. However, in the exposure condition, the ECaC and PMCA2 transcripts could be restored to control levels after the fish were treated in an environment with hCa.

Maternal cadmium exposure induces mt2 and smtB mRNA expression in zebrafish (Danio rerio) females and their offspring

The present study aimed to identify the effects of maternal cadmium (Cd(2+)) exposure on the mRNA expression of mt2 (metallothionein-2) and smtB (similar to metallothionein-B) in female zebrafish (Danio rerio) and their offspring (F1 larvae). Zebrafish females were exposed to 0, 8.9, 17.8, and 35.6 μM Cd(2+) for 72 h, and their ovaries and F1 larvae were collected to measure their Cd(2+) contents and their smtB and mt2 mRNA expression. Cd(2+) contents and the mRNA expression of smtB and mt2 in F1 larvae all showed positive correlations with the maternal Cd(2+) treatment dose. The mt2 was 1.9- to 3.4-fold higher than smtB in F1 larvae. Furthermore, F1 larvae had noticeably enhanced Cd(2+) tolerance after maternal Cd(2+) treatment. These results demonstrate that maternal Cd(2+) was transferred to larval fish and induced mt2 and smtB mRNA expression to protect larva against the impacts of Cd(2+). In female ovaries, mt2 expression showed a noticeable increase after exposure to a metal environment, while smtB did not show exactly the same effect. The study can only conclude that smtB might have a much different role other than just protecting against the impacts of metals.

Changes of glycogen metabolism in the gills and hepatic tissue of tilapia (Oreochromis mossambicus) during short-term Cd exposure

The aim of the study was to test the hypothesis that the mechanism of glycogen metabolism has taken place in gills rather than in liver during Cd exposure. Male tilapia were exposed to 44.45 μM ambient Cd for 12h, and we found blood glucose significantly increased, however, lactate levels showed no significant changes. The glycogen phosphorylase (GP) activity increased immediately after 0.75 to 3h of Cd exposure in the gills, and after 1 to 6h in the liver, respectively. In addition, the glycogen level depleted faster in the gills than in the liver. Plasma cortisol level increased from 0.25 to 1h and recovered after 3h, while the glucagon did not significantly change during Cd exposure. Glucocorticoid receptor (GR) mRNA expression decreased after 0.75 h in the gills, while it significantly increased after 6h in the liver. Ca(2+), Na(+), Cl(-), and K(+) significantly decreased upon Cd exposure within 6h following Cd-induced toxic stress. We suggested that the cortisol is the spontaneous stimulation of glycogen metabolism in the gills, and it triggers a subsequent energy supply later in the liver. Taken together, the profile of glycogen metabolism between gills and liver during Cd-exposure stress provide good support to our hypothesis.

Reversible electric control of exchange bias in a multiferroic field-effect device

Electric-field control of magnetization has many potential applications in magnetic memory storage, sensors and spintronics. One approach to obtain this control is through multiferroic materials. Instead of using direct coupling between ferroelectric and ferromagnetic order parameters in a single-phase multiferroic material, which only shows a weak magnetoelectric effect, a unique method using indirect coupling through an intermediate antiferromagnetic order parameter can be used. In this article, we demonstrate electrical control of exchange bias using a field-effect device employing multiferroic (ferroelectric/antiferromagnetic) BiFeO(3) as the dielectric and ferromagnetic La(0.7)Sr(0.3)MnO(3) as the conducting channel; we can reversibly switch between two distinct exchange-bias states by switching the ferroelectric polarization of BiFeO(3). This is an important step towards controlling magnetization with electric fields, which may enable a new class of electrically controllable spintronic devices and provide a new basis for producing electrically controllable spin-polarized currents.

Preparation, characterization, and anti-tumor property of podophyllotoxin-loaded solid lipid nanoparticles

In an effort to develop an alternative formulation of podophyllotoxin suitable for drug release and delivery, podophyllotoxin-loaded solid lipid nanoparticles (PPT-SLNs) were constructed, characterized and examined for in vitro cytotoxicity and tumor inhibition. The SLNs were prepared by using a solvent emulsification-evaporation method, and their size was around 50 nm. TEM detection showed that the SLNs were homogeneous and spherical in shape, and differential scanning calorimetry (DSC) measurement revealed a new conformation of PPT-SLNs. An in vitro drug release study showed that PPT was released from the SLNs in a slow but time-dependent manner. Furthermore, the treatment of 293T and HeLa cells with PPT-SLNs demonstrated that PPT-SLNs were less toxic to normal cells and more effective in anti-tumor potency compared with unconjugated PPT. A colony forming efficiency assay showed an effective long-term cancer growth suppression of PPT-SLNs; in addition, they can also enhance the apoptotic and cellular uptake processes on tumor cells compared with PPT. These results collectively demonstrated that this SLN formulation has a potential application as an alternative delivery system for anti-tumor drugs.

A new method for CE-EC determination of mercaptopurine (MP) in a PMMA biochip with on-chip gold nano-electrode ensemble (GNEE) working and decouple electrodes

This paper presents a new method for CE-EC determination of Mercaptopurine (MP), one of the most important medicines for inflammatory bowel disease (IBD) and acute lymphoblastic leukemia (ALL) treatment, in a PMMA-based microfluidic chip. A simple and reliable process for preparing the template of gold nanoelectrode ensemble (GNEE) and fabricating the integrated microfluidic chip is reported in the present study. The use of GNEE electrodes for both electric current decoupling and signal sensing in the proposed CE-EC chip not only enhances the signal response but also decreases the background noise during detection. Results show that a good detection limit of 100 nM for detecting mercaptopurine is achieved with the proposed method. In addition, the measured results also shows a good linear response between the detected CE-EC signals and the concentration of MP within the range of 100 nM-10 mM (R2 = 0.989). The proposed microchip device provides a novel and fast detection method for mercaptopurine analysis.

Expression of mt2 and smt-B upon cadmium exposure and cold shock in zebrafish (Danio rerio)

Metallothionein-2 (mt2) and similar to metallothionein-B (smt-B) are included in the MT gene family. The objective of this study was to compare mt2 and smt-B messenger (m)RNA expressions after cadmium exposure and cold shock with whole-mount in situ hybridization in immature zebrafish (Danio rerio) and with a semi-quantitative RT-PCR in mature zebrafish. Three-day post-fertilization (dpf) larvae were treated with 0, 0.08, 0.26, and 0.89 microM cadmium for 24 and 48 h, and some larvae were challenged with a normal (28.5 degrees C) or low temperature (12 degrees C) for 12, 24, and 48 h. Results were obtained. (1) During embryonic and larval development, mt2 mRNA existed at 6 h post-fertilization (hpf), and the level rapidly increased to 24 hpf, then it gradually increased with further larval growth. smt-B was found at 12 hpf, and it also rapidly increased to 24 hpf, but remained constant during further larval development. (2) The mt2 mRNA signals and whole-body Cd contents displayed dose- and time-dependent responses after Cd exposure. After cold shock, mt2 mRNA signals also showed time-dependent expression. But smt-B mRNA signals were not appeared by either challenge. Besides, mature zebrafish were treated with 1.78 microM Cd and found that the highest levels of smt-B mRNA (smt-B/beta-actin) appeared in brain, and seems a reverse expression between smt-B mRNA and mt2 in brain after Cd exposure. Apparently, mt2 is possibly more relevant to Cd detoxification and cold shock adaptation in zebrafish larvae compared to smt-B, but smt-B might be related to certain physiological functions in neural (or brain) of mature zebrafish.

The effects of maternal Cd on the metallothionein expression in tilapia (Oreochromis mossambicus) embryos and larvae

The purpose of this study was to identify the factor(s) which would enhance the Cd resistance as assessed by the metallothionein (MT) expression in tilapia larvae. Larvae were collected from parents that were pretreated respectively with Cd or saline. At the end of the 12-week experiment, the hepatic MT and Cd contents in the breeding female fish were recorded. Our results indicated that a significant relationship between Cd and MT contents can be found in the offspring from the parent fish treated with Cd. However, the higher Cd resistance, Cd contents, and MT expression were limited to those larvae from parent fish bred within 4 weeks of the injection. By week 12, the Cd-treated fish still contained high levels of MT in their hepatic tissues. However, the MT and Cd contents in the larvae from these adult fish were not significantly different from those from the controls. In summary, we suggest that the higher Cd resistance of larvae from the egg stage was a result of the Cd contamination of the parent female, as evidenced by an increase in MT expression induced in tilapia embryos and larvae.

Juvenile tilapia (Oreochromis mossambicus) strive to maintain physiological functions after waterborne copper exposure

Juvenile tilapia were acutely exposed to 0.2 and 2 mg/L Cu(2+) for up to 144 h. The Na(+)-K(+)-ATPase (NKA)-specific activity in the gills of tilapia exposed to 0.2 mg/L Cu(2+) significantly decreased over 48-72 h and was restored to the control level after 96 h, but was again depressed during 120-144 h. The whole-body Cl(-) levels significantly decreased after 48 h, but recovered shortly afterwards and continued to do so until 144 h with 0.2 mg/L Cu exposure. During 48-72 h, the numbers of the wavy-convex type of mitochondria-rich (MR) cells appeared to significantly increase and the cortisol content also significantly increased. Changes in MR cell morphology might be necessary in order to enhance Cl(-) uptake, and this might be related to changes in cortisol levels. Whole-body Na(+) concentrations had significantly decreased by 72 h, but recovered during 96-144 h. Whole-body Cu(2+) concentrations also significantly increased compared to the initial concentration during 72-144 h of Cu exposure. All measured parameters (NKA activity, Na(+) concentration, and MR cell numbers) significantly decreased in fish exposed to 2 mg/L Cu, and no recovery was observed. These data demonstrate that juvenile tilapia strived to maintain physiological functions after exposure to sub-lethal concentrations of Cu.

Selection of a phage-displayed peptide recognized by monoclonal antibody directed blocking the site of hepatitis C virus E2 for human CD81

The human CD81 (hCD81) molecule has been identified as a putative receptor for hepatitis C virus (HCV). HCV envelope glycoprotein 2 (E2) most likely plays a pivotal role in binding to host cells by interacting with the hCD81 molecule. In this study, a phage-displayed peptide library was used to select small peptides with anti-hCD81 monoclonal antibody JS-81. The output/input ratio of phages increased about 91 fold after the third round of selection. Eight of the 30 phage clones selected from the phage library showed specific binding to the anti-hCD81 by enzyme linked immunosorbent assay (ELISA). Competitive inhibition test further demonstrated that HCV E2 could significantly inhibit the binding of a positive phage clone to anti-hCD81 JS-81. Exogenous small peptide ATWVCGPCT contained by the positive phage clones showed aligned with the hCD81 sequence from 153-161 by sequence analyses. These results suggest that the selected ATWVCGPCT is a novel hCD81-like small peptide, which can block the binding site of HCV E2 for hCD81. It may be of further application on development of antiviral agents targeting the stage of HCV entry.

Toxicological stress response and cadmium distribution in hybrid tilapia (Oreochromis sp.) upon cadmium exposure

Adult tilapia were exposed to 0 (control) and 4.45 microM Cd for 0 h, 5 h, 5 days, and 15 days, and the physiological responses of fish were described. The physiological responses were first expressed in gill tissue, in which mucus cells secretion increased, Cd accumulated, cortisol secretion was significantly higher, but serum ACH(50) activity (alternative complement hemolytic assay) was significantly lower than in controlled fish. After 5 days of Cd exposure, the ACH(50) activity showed a greater decrease, but lysozyme and cortisol contents showed significant increases over the control. Cd levels significantly increased in intestines, liver, and kidneys, and a significant induction of metallothionein (MT) protein in hepatic tissue was noted. Finally, the Cd accumulation rate still showed significant increases in these organs. However, the MT content was similar at 5 days and at 15 days after Cd exposure, and the cortisol contents had recovered to the pre-exposure level. In addition, Cd accumulation in muscle was higher after Cd exposure than in controls (t-test, p<0.05). Our results demonstrate (1) that tilapia readily regulate their physiological parameters in order to acclimate to a sublethal Cd environment; (2) these changes of physiological parameters may be related with a succession of cortisol levels following Cd exposure; (3) increasing rate of hepatic MT contents and Cd accumulation rate didn't appear identical after 5-15 days of Cd exposure. This was confirmed that hepatic MT was not a good indicator for Cd levels in tilapia.

Effects of Ca2+ or Na+ on metallothionein expression in tilapia larvae (Oreochromis mossambicus) exposed to cadmium or copper

The objectives of this study were to try to determine the reasons of the external Ca(2+) and Na(+) enhancement of Cd(2+) and Cu(2+) resistance in fish. Tilapia larvae at 3 days posthatch were exposed to (A) 0 (control), 40 microg/L Cd(2+), 40 microg/L Cd(2+) + 2 mM Ca(2+) (Cd/hyper-Ca), and 2 mM Ca(2+) or (B) 0 (control), 75 microg/L Cu(2+), 75 microg/L Cu(2+) + 0.52 mM Na(+) (Cu/hyper-Na), and 0.52 mM Na(+). After 48 hours, results indicated that (1) Cd/hyper-Ca and Cu/hyper-Na treatments showed decreased growth inhibition induced by the metals; (2) metal accumulation in Cd/hyper-Ca-treated larvae was lower compared with those exposed only to Cd; and (3) metallothionein (MT) expression was significantly higher in Cu/hyper-Na-treated larvae than in the group treated with Cu only. Taking all of this into account, either supplementary Ca(2+) or Na(+) in ambient water may help fish to maintain Ca(2+) or Na(+) homeostasis, which could decrease metal accumulation and its detrimental effects. Consequently, the fish increase MT expression and retard the growth inhibition caused by metals.

Standard treatment for Helicobacter pylori infection is suboptimal in non-ulcer dyspepsia compared with duodenal ulcer in Chinese

BACKGROUND

Recent studies suggest that the Helicobacter pylori eradication rate in patients with non-ulcer dyspepsia is lower when compared to patients with peptic ulcer diseases.

AIM

The aim of this study was to study the efficacy of triple therapy for H. pylori infection in patients with duodenal ulcer vs. patients with non-ulcer dyspepsia.

METHODS

A total of 582 Chinese patients with proven H. pylori infection were recruited to receive: omeprazole 20 mg, amoxicillin 1000 mg and clarithromycin 500 mg all given twice daily for 7 days (OCA regime). Endoscopy with rapid urease test, histology and culture were performed before treatment. Post-treatment H. pylori status was determined by (13)C-urea breath test. Metronidazole, clarithromycin and amoxicillin resistance was defined as minimum inhibitory concentration (MIC) of >8 microg/mL, >1 microg/mL and >1 microg/mL, respectively.

RESULTS

A significantly higher (intention-to-treat/per-protocol) eradication rate was found in patients with duodenal ulcer than those with non-ulcer dyspepsia (91/94% vs. 84/88% respectively, P = 0.011 and P = 0.016). Clarithromycin resistance rate was higher in patients with non-ulcer dyspepsia than those with duodenal ulcer (14% vs. 6%, P = 0.015). Clarithromycin resistance (40% vs. 5%, P < 0.001, OR 12, 95% CI: 5.7-24.3) and the diagnosis of non-ulcer dyspepsia (91% vs. 84%, P = 0.011, OR 2.0, 95% CI: 1.2-3.3) significantly affected the success of H. pylori eradication.

CONCLUSION

Clarithromycin resistance accounts for the significantly lower and suboptimal H. pylori eradication rate of OCA regimen in Chinese patients with non-ulcer dyspepsia compared to those with duodenal ulcer.

Family size, miscarriage-proneness, and handedness: tests of hypotheses of the developmental instability theory of handedness

The handedness theory of Yeo and Gangestad (1993) posits that moderate right-handedness is the modal manifestation of genetic handedness and that ''developmental instability'' produces deviations from modal handedness. It is also suggested (1) that sinistral parents may produce fewer offspring than do dextral parents; and (2) that sinistral mothers may be more prone to miscarriages than are dextral mothers. In line with these hypotheses, Gangestad et al. (1996) reported that a human leukocyte antigen (B8) was related to both left-handedness and to reduced offspring number in their study. They also found that left-handedness was related to the human leukocyte antigen DR3, and Yeo and Gangestad (1998) noted that this antigen has been found by Christiansen et al. (1996) to be associated with an increased risk of spontaneous abortion in women. We assessed the first hypothesis through a study of the family sizes of 2083 families with two right-handed parents and 502 families having one or more left-handed parents; we assessed the second hypothesis from miscarriage history data supplied by 300 dextral and 52 sinistral mothers. Results supported the developmental instability theory with respect to the hypothesis regarding family size, but not with respect to the hypothesis regarding miscarriage-proneness.

Naturopathic and Western herbal medicine practice in Australia-a workforce survey

BACKGROUND

Despite substantial growth in the use of complementary medicine, no comprehensive national study has been undertaken of the naturopathic and Western herbal medicine component of the healthcare workforce in Australia. This study aimed to examine the nature of these practices and this currently unregulated workforce in Australia.

METHODS

A comprehensive survey questionnaire was developed in consultation with the profession and distributed nationally to all members of the naturopathic and Western herbal medicine workforce.

RESULTS

The practices of herbal medicine and naturopathy make up a sizeable component of the Australian healthcare sector, with approximately 1.9 million consultations annually and an estimated turnover of $AUD 85 million in consultations (excluding the cost of medicines). A large proportion of patients are referred to practitioners by word of mouth. Up to one third of practitioners work in multidisciplinary clinics with other registered sectors of the healthcare community. The number of adverse events associated with herbal medicines, nutritional substances and homoeopathic medicines recorded in Australia is substantial and the types of events reported are not trivial. Data suggest that practitioners will experience one adverse event every 11 months of full-time practice, with 2.3 adverse events for every 1000 consultations (excluding mild gastrointestinal effects).

CONCLUSION

These data confirm the considerable degree of utilisation of naturopathic and Western herbal medicine practitioners by the Australian public. However, there is a need to examine whether statutory regulation of practitioners of naturopathy and Western herbal medicine is required to better protect the public.

Effects of copper sulfate on ion balance and growth in tilapia larvae (Oreochromis mossambicus)

Newly hatched tilapia larvae were exposed to sublethal concentrations of Cu2+ (0, 30, 50, and 100 microg/L) and lethal concentrations of Cu2+ (200 and 400 microg/L) for 24-96 h. The interaction of the exposure dose and time was related to the Cu2+ accumulation rate, which showed a higher accumulation rate with sublethal concentrations of Cu2+ within 24 h compared to the other treatments. Furthermore, Cu2+ contents in the whole body of larvae significantly increased following Cu2+ exposure times up to 96 h. Cu2+ in the medium produced a dose-response effect on Na+ and K+ contents in larvae after 96 h of exposure time. Changes in Ca2+ contents statistically significantly decreased and were shown to be dose-responsive for larval exposure times exceeding 72 h. Changes of Ca2+ contents were more sensitive than those of Na+ and K+ with Cu2+ treatment of early larvae. Notably Na+ and K+ contents showed significant increases of 17-23% in larvae exposed to low concentrations of Cu2+ (30-50 microg/L) for 24-72 h as compared to control larvae. Cu2+ caused no significant effect on body Cl- content or osmolality except at 100 microg/L Cu2+ for 24 h in tilapia larvae as compared to the control. However, there was a restoration phenomenon in larvae exposed to 100 microg/L Cu2+ for longer than 72 h. The water content of larvae exposed to Cu2+ for 96 h significantly decreased. The yolk absorption rate of tilapia larvae was significantly suppressed when they were exposed to Cu2+ medium containing 30, 50, 100, 200, or 400 Cu2+ microg/L from 72 h post transfer. These results obviously show that larvae are sensitive to Cu2+ during early development.

Protoporphyrin IX production and its photodynamic effects on glioma cells, neuroblastoma cells and normal cerebellar granule cells in vitro with 5-aminolevulinic acid and its hexylester

5-Aminolevulinic acid (ALA) has shown promising in photodynamic detection and therapy of brain tumor. However, the knowledge on selective accumulation of ALA-induced protoporphyrin IX (PpIX) in brain tumor tissue is still fragment. In the present study, the rat C6 glioma cells, human SK-N-SH neuroblastoma cells, and rat normal cerebellar granule cells (RCG) were used to investigate the PpIX production and photocytotoxicity in vitro. The C6 cells and SK-N-SH cells showed a similar kinetics of PpIX accumulation after exposure to ALA or ALA hexyl ester (ALA-H), with an initial increase up to 6-8 h and then saturated. In the case of RCG cells, the PpIX accumulation slowly increased until 12 h studied. However the cellular PpIX content was more than 10 times higher in the C6 and SK-N-SH cells than that in the normal RCG cells. The intracellular localization of PpIX measured by cofocal laser scanning microscopy was in same pattern in the C6 glioma cells and RCG normal cells with a diffuse cytoplasm distribution. The sensitivity of the C6 cells and SK-N-SH cells to ALA or ALA-H PDT was similar. It appears that ALA-H could achieve similar or slightly better results than ALA with respect to PpIX production and photoinactivation of cells, although a 10 times lower concentration of ALA-H was used.

Identification and expression of human CD81 gene on murine NIH/3T3 cell membrane

The human CD81 (hCD81) molecule has been identified as a putative receptor for hepatitis C virus (HCV). In this study, eukaryotic expression vector pCDM8-hCD81 containing hCD81 cDNA and pSV2neo helper plasmid was used to cotransfect with lipofectamine into murine fibroblast cell line NIH/3T3 to establish an hCD81-expressing cell line. Resistant cell clones were obtained 20 days after the selection with neomycin (600 micro/ml) and then cultured as monoclones. The expression of the transfected hCD81 gene in the cells was verified by RT-PCR and flow cytometry analyses. One of the selected cell clones showed obvious expression of hCD81 and was named NIH/3T3-hCD81. Competitive inhibition tests indicated that the binding of monoclonal anti-hCD81 (JS-81) to NIH/3T3-hCD81 cells was inhibited by recombinant HCV E2 protein, suggesting that the expressed hCD81 molecules on NIH/3T3-hCD81 cells maintain natural conformation of binding to HCV E2. The transfected NIH/3T3-hCD81 cells should be of great potential value in studies on HCV attachment and onset of infection.

Non-invasive assessment of arterial distension waveforms using gradient-based hough transform and power Doppler ultrasound imaging

The peripheral arterial vessel often appears as an elliptic shape under the constraints of the surrounding tissues. In this study, the gradient-based Hough transform was used to detect the central location of the ellipse and the lumen area of the arterial vessel non-invasively using power Doppler imaging. Sequential ultrasound images were used to construct arterial distension waveforms in both the major- and minor-axis directions for a few cardiac cycles. The common carotid arteries (CCAs) for nine healthy male volunteers (mean age 24 years), in the sitting position, were investigated in vivo. The CCAs (n = 9) had a mean diameter of 5.83mm, and the pulsatile diameter distension was 13.7+/-1.9%. The brachial artery and dorsalis pedis artery for five healthy male volunteers (mean age 26 years), in the supine position, had mean diameters of 4.03mm and 2.83mm and distensions of 16.7+/-4.6% and 15.5+/-5.4%, respectively. The movement of the arterial centre location during the cardiac cycle reflected the asymmetry of the reaction forces produced by the surrounding soft tissues. The present method can obtain the response of vessel distension to pulse pressure, as well as the constrained conditions of the arteries.

Spectrum of mutations of the AAAS gene in Allgrove syndrome: lack of mutations in six kindreds with isolated resistance to corticotropin

Familial glucocorticoid deficiency due to corticotropin (ACTH) resistance consists of two distinct genetic syndromes that are both inherited as autosomal recessive traits: isolated ACTH resistance (iACTHR), which may be caused by inactivating mutations of the ACTH receptor (the MC2R gene) or mutations in an as yet unknown gene(s), and Allgrove syndrome (AS). The latter is also known as triple-A syndrome (MIM 231550). In three large cohorts of AS kindreds, the disease has been mapped to chromosome 12; most recently, mutations in the AAAS gene on 12q13 were found in these AS families. AAAS codes for the WD-repeat containing ALADIN (for alacrima-achalasia-adrenal insufficiency-neurologic disorder) protein. We investigated families with iACTHR (n = 4) and AS (n = 6) and a Bedouin family with ACTHR and a known defect of the TSH receptor. Four AS families were of mixed extraction from Puerto Rico (PR); most of the remaining six families were Caucasian families from North America (NA). Sequencing analysis found no MC2R genetic defects in any of the kindreds. No iACTHR kindreds, but all of AS families, had AAAS mutations. The previously reported IVS14+1G-->A splice donor mutation was found in all PR families, apparently due to a founder effect; one NA kindred was heterozygous for this mutation. In the latter family, long-range PCR failed to identify a deletion or other rearrangements of the AAAS gene. No other heterozygote or transmitting parent had any phenotype that could be considered part of AS. The IVS14+1G-->A mutation results in a premature termination of the predicted protein; although it was present in all PR families (in the homozygote state in three of them), there was substantial clinical variation between them. One PR family also carried a novel splice donor mutation of the AAAS gene in exon 11, IVS11+1G-->A; the proband was a compound heterozygote. A novel point mutation, 43C-->A(Gln15Lys), in exon 1 of the AAAS gene was identified in the homozygote state in a Canadian AS kindred with a milder AS phenotype. The predicted amino acid substitution in this family is located in a sequence that may participate in the preservation of stability of ALADIN beta-strands, whereas the splicing mutation in exon 11 may interfere with the formation of WD repeats in this molecule. We conclude that 1) AAAS does not appear to be frequently mutated in families with iACTHR; 2) AAAS is mutated in AS families from PR (that had previously been mapped to 12q13) and NA; and, 3) there is significant clinical variability between patients with the same AAAS defect.

AMPA-preferring receptors mediate excitatory non-NMDA responses of primate retinal ganglion cells

Glutamate and kainate-induced currents of primate ganglion cells were studied using the whole-cell patch-clamp technique in a retinal slice preparation. Antagonists and allosteric modulators of desensitization selective for either alpha-amino-3-hydroxy-5-methyl-4-isoazoleprionic acid (AMPA)- or kainate-preferring receptors were used to determine the contributions of each type of receptor to excitatory responses. With synaptic transmission and NMDA receptors blocked, the AMPA-preferring receptor antagonist GYKI 52466 (30 microM-100 microM) reversibly blocked most of the glutamate-induced current in ganglion cells. GYKI 52466 also blocked the response in ganglion cells to focally applied kainate, suggesting that the current response to kainate arises from activation of AMPA-preferring receptors, and not kainate-preferring receptors. Both cyclothiazide (10 microM-100 microM) and the novel drug 4-[2-(phenylsulfonylamino)ethylthio]-2,6-difluoro-phenoxyacetamide (PEPA, 20 microM-100 microM), which selectively enhance responses mediated by AMPA-preferring receptors, enhanced glutamate-induced responses of ganglion cells. Since these drugs preferentially inhibit desensitization of the flip and flop splice variants, respectively, of AMPA-preferring receptors, it is likely that both splice variants are present on these ganglion cells. Concanavalin A, which selectively suppresses the desensitization of kainate-preferring receptors, had no effect on the glutamate-induced responses of ganglion cells. We conclude that the non-NMDA component of the excitatory, glutamatergic input to primate ganglion cells is mediated largely by AMPA-preferring receptors, with little, if any, kainate-preferring receptor-mediated response.

Head-column field-amplified sample stacking in capillary electrophoresis for the determination of cimetidine, famotidine, nizatidine, and ranitidine-HCl in plasma

In this study, low concentrations of histamine2-receptor (H2-)antagonists were effected across a water plug, with separation taking place in a binary buffer comprising ethylene glycol and NaH2PO4 (pH 5.0), and detection at 214 nm. Liquid-liquid extraction with ethyl acetate- isopropanol is shown to provide extracts that are sufficiently clean. The calibration curves were linear over a concentration range of 0.1-2.00 microg/mL cimetidine, 0.2-5.0 microg/mL ranitidine-HCl, 0.3-5.0 microg/mL nizatidine, and 0.1-3.0 microg/mL famotidine. Mean recoveries were > 82%, while the intra- and interday relative standard deviations (RSDs) and relative errors (REs) were all < 13%. The method is sensitive with a detection limit of 3 ng/mL cimetidine, 30 ng/mL ranitidine HCl, 50 ng/mL nizatidine and 10 ng/mL famotidine (S/N = 3, electric-driven injection 90 s). This newly developed capillary electrophoresis (CE) method was applied for the determination of analytes extracted from plasma taken from a volunteer dosing a cimetidine, ranitidine, and nizatidine tablet simultaneously. These three H2-antagonists can be detected in real samples by this method, excluding the low dosing of famotidine tablet.

Simultaneous determination of cimetidine, famotidine, nizatidine, and ranitidine in tablets by capillary zone electrophoresis

A simple capillary zone electrophoresis (CZE) method is described for the simultaneous determination of cimetidine (CIM), famotidine (FAM), nizatidine (NIZ), and ranitidine (RAN). The analysis of these drugs was performed in a 100 mM phosphate buffer, pH 3.5. Several parameters were studied, including wavelength for detection, concentration and pH of phosphate buffer, and separation voltage. The quantitative ranges were 100-1,000 microM for each analyte. The intra- and interday relative standard deviations (n = 5) were all less than 4%. The detection limits were found to be about 10 microM for CIM, 20 microM for RAN, 20 microM for NIZ, and 10 microM for FAM (S/N = 3, injection 1 s) at 214 nm. All recoveries were greater than 92%. Applications of the method to the assay of these drugs in tablets proved to be feasible.

alpha(2)-Macroglobulin from rheumatoid arthritis synovial fluid: functional analysis defines a role for oxidation in inflammation

A hallmark of inflammation is the release of oxidants, proteinases, and cytokines, all important mediators of the inflammatory cascade. alpha(2)-Macroglobulin (alpha(2)M) is a high-affinity, broad-specificity proteinase inhibitor that also binds and regulates the biological activities of a number of cytokines. We demonstrated recently that hypochlorite-oxidized alpha(2)M has decreased ability to inhibit proteinases and regulate cytokines in vitro. The role of oxidation in regulating alpha(2)M functions in vivo is largely unknown. To determine the extent and biological consequence of in vivo alpha(2)M oxidation, we measured the degree of oxidative alpha(2)M modification from rheumatoid arthritis (RA) synovial fluid and compared this with osteoarthritis (OA) as noninflammatory controls. We found that RA synovial fluid alpha(2)M is significantly more oxidized than that from OA. RA synovial fluid also contains a twofold higher median alpha(2)M level than OA, while having only half the alpha(2)M-proteinase inhibitory activity. Detailed biochemical analysis demonstrates proteolytically degraded alpha(2)M in RA greater than in OA synovial fluid. Additionally, the hypochlorite-mediated oxidation product, chlorotyrosine, is present in RA more than in OA or plasma alpha(2)M samples. Taken together, these findings confirm a role for oxidative regulation of inflammation by altering the functions of extracellular mediators such as alpha(2)M.

Differential regulation of the fibroblast growth factor (FGF) family by alpha(2)-macroglobulin: evidence for selective modulation of FGF-2-induced angiogenesis

The fibroblast growth factor (FGF) family has an important role in processes such as angiogenesis, wound healing, and development in which precise control of proteinase activity is important. The human plasma proteinase inhibitor alpha(2)-macroglobulin (alpha(2)M) regulates cellular growth by binding and modulating the activity of many cytokines and growth factors. These studies investigate the ability of native and activated alpha(2)M (alpha(2)M*) to bind to members of the FGF family. Both alpha(2)M and alpha(2)M* bind specifically and saturably to FGF-1, -2, -4, and -6, although the binding to alpha(2)M* is of significantly higher affinity. Neither alpha(2)M nor alpha(2)M* bind to FGF-5, -7, -9, or -10. FGF-2 was chosen for more extensive study in view of its important role in angiogenesis. It was demonstrated that FGF-2 binds to the previously identified TGF-beta binding site. The alpha(2)M* inhibits FGF-2-dependent fetal bovine heart endothelial cell proliferation in a dose-dependent manner. Unexpectedly, alpha(2)M* does not affect FGF-2-induced vascular tubule formation on Matrigel basement membrane matrix or collagen gels. Further studies demonstrate that FGF-2 partitions between fluid-phase alpha(2)M* and solid-phase Matrigel or collagen. These studies suggest that the ability of alpha(2)M* to modulate the activity of FGF-2 is dependent on an interplay with extracellular matrix components. (Blood. 2001;97:3450-3457)