Stable structure and fast ion diffusion: N-doped VO2 3D porous nanoflowers for applications in ultrafast rechargeable aqueous zinc-ion batteries

Aqueous rechargeable zinc-ion batteries (ARZIBs) are promising candidates for fast-charging energy-storage systems. The issues of stronger interactions between Zn²⁺ and the cathode for ultrafast ARZIBs can be partially addressed by enhancing mass transfer and ion diffusion of the cathode. Herein, via thermal oxidation for the first time, N-doped VO₂ porous nanoflowers with short ion diffusion paths and improved electrical conductivity were synthesized as ARZIBs cathode materials. The introduction of nitrogen derived from the vanadium-based-zeolite imidazolyl framework (V-ZIF) contributes to enhanced electrical conductivity and faster ion diffusion, while the thermal oxidation of the VS₂ precursor assists the final product in exhibiting a more stable three-dimensional nanoflower structure. In particular, the N-doped VO₂ cathode shows excellent cycle stability and superior rate capability with the delivered capacities of 165.02 mAh g^-1 and 85 mAh g^-1, at 10 A g^-1 and 30 A g^-1, and the capacity retention of 91.4% after 2200 cycles and 99% after 9000 cycles, respectively. Remarkably, the battery takes less than 10 s to be fully charged at 30 A g^-1. Hence, this work provides a new avenue for designing unique nanostructured vanadium oxides and developing electrode materials suitable for ultrafast charging.

21 One-Shot Tract Dilatation for Supine Percutaneous Nephrolithotomy (PCNL) in Obese Patients

Introduction

With the rising incidence of both obesity and urolithiasis, the need to perform stone surgery in high BMI patients is increasing. We analysed the safety and efficacy of the one-shot tract dilatation (OSD) technique in obese patients undergoing supine percutaneous nephrolithotomy (PCNL).

Method

Retrospective review of all supine PCNLs performed by a single surgeon between January 2014 and December 2020. Patient factors (age and BMI), stone complexity and procedural characteristics (tract size and dilatation technique) were collected. Outcomes included access success, length of stay, operating duration, and inpatient complications.

Results

Overall 104 supine PCNLs were performed in 93 patients. Forty-four had a BMI >/ =  30 kg/m2 with a median age of 53 years, median BMI 35.12 kg/m2 and median Guy’s stone score of 2. When initial puncture was successful (43 cases (98%)), tract dilatation was satisfactory on all occasions. Dilatation was performed using a balloon dilator (24Ch) in 12 cases and OSD in 31 cases (range 16Ch to 24Ch, median 22Ch). Median length of stay was lower when OSD used (1 day) versus balloon (2 days), P = 0.03. Median operating time using OSD was 98 minutes versus 120 minutes using balloon (P = 0.10). There was no significant difference in operative time or length of stay when using OSD compared with BMI < 30 kg/m2. There were two Clavien-Dindo Grade I and one Grade II complications in patients where OSD was used. No transfusions were required.

Conclusions

One shot dilatation is an effective and safe means of access in obese patients when performing a supine PCNL.

Genome-wide identification studies - A primer to explore new genes in plant species

Genome data have accumulated rapidly in recent years, doubling roughly after every 6 months due to the influx of next-generation sequencing technologies. A plethora of plant genomes are available in comprehensive public databases. This easy access to data provides an opportunity to explore genome datasets and recruit new genes in various plant species not possible a decade ago. In the past few years, many gene families have been published using these public datasets. These genome-wide studies identify and characterize gene members, gene structures, evolutionary relationships, expression patterns, protein interactions and gene ontologies, and predict putative gene functions using various computational tools. Such studies provide meaningful information and an initial framework for further functional elucidation. This review provides a concise layout of approaches used in these gene family studies and demonstrates an outline for employing various plant genome datasets in future studies.

Nitrogen-Doped Metallic MoS2 Derived from a Metal-Organic Framework for Aqueous Rechargeable Zinc-Ion Batteries

Molybdenum disulfide (MoS₂) has been extensively studied as a potential storage material for batteries. However, the electrochemical performance of MoS₂ is far from ideal, and it exhibits severe activity fading resulting from its low electronic conductivity. The present work synthesizes nitrogen (N)-doped 1T MoS₂ nanoflowers made of ultrathin nanosheets via the one-step hydrothermal sulfurization of a molybdenum-based metal-organic framework precursor. The resulting metallic phase shows improved conductivity and hydrophilicity, and characterization demonstrates that N doping effectively expands the interlayer spacing and increases the concentration of sulfur vacancies serving as defects. This material demonstrates high rate performance and good cycling stability when used as the cathode in an aqueous rechargeable zinc-ion battery (ARZIB). Its performance is superior to those of pure 1T MoS₂ and 2H MoS₂ synthesized with MoO₃ as the molybdenum source. Ex situ X-ray photoelectron spectroscopy and X-ray diffraction analyses are performed to explore the reaction mechanism during charging and discharging of the N-doped 1T MoS₂. A three-cell series ARZIB system containing this material is used to power five light-emitting diodes to confirm the possible practical applications of this technology.

A constriction channel analysis of astrocytoma stiffness and disease progression

Studies have demonstrated that cancer cells tend to have reduced stiffness (Young's modulus) compared to their healthy counterparts. The mechanical properties of primary brain cancer cells, however, have remained largely unstudied. To investigate whether the stiffness of primary brain cancer cells decreases as malignancy increases, we used a microfluidic constriction channel device to deform healthy astrocytes and astrocytoma cells of grade II, III, and IV and measured the entry time, transit time, and elongation. Calculating cell stiffness directly from the experimental measurements is not possible. To overcome this challenge, finite element simulations of the cell entry into the constriction channel were used to train a neural network to calculate the stiffness of the analyzed cells based on their experimentally measured diameter, entry time, and elongation in the channel. Our study provides the first calculation of stiffness for grades II and III astrocytoma and is the first to apply a neural network analysis to determine cell mechanical properties from a constriction channel device. Our results suggest that the stiffness of astrocytoma cells is not well-correlated with the cell grade. Furthermore, while other non-central-nervous-system cell types typically show reduced stiffness of malignant cells, we found that most astrocytoma cell lines had increased stiffness compared to healthy astrocytes, with lower-grade astrocytoma having higher stiffness values than grade IV glioblastoma. Differences in nucleus-to-cytoplasm ratio only partly explain differences in stiffness values. Although our study does have limitations, our results do not show a strong correlation of stiffness with cell grade, suggesting that other factors may play important roles in determining the invasive capability of astrocytoma. Future studies are warranted to further elucidate the mechanical properties of astrocytoma across various pathological grades.

Setting the new FRAX reference threshold without bone mineral density in Chinese postmenopausal women

PURPOSE

Despite the large number of osteoporosis patients in China, the diagnosis and treatment rates remain low. The Fracture Risk Assessment Tool (FRAX) can be used to effectively evaluate fracture risk. In this study, we explored the Chinese-specific thresholds of FRAX without the T-score.

METHODS

In all, 264 postmenopausal women aged > 50 years were randomly recruited from community-medical centers. All subjects completed self-reported questionnaires, BMD measurements, and spinal radiographs. The 10-year hip and major osteoporotic fracture risks were calculated by FRAX. A new threshold for both 10-year hip and major osteoporotic fracture risk was explored with receiver operating characteristic (ROC) curve analysis.

RESULTS

Overall, 92 subjects were diagnosed with osteoporosis. Among them, 14 participants with T-score > - 2.5 were diagnosed with osteoporosis based on clinical fractures. ROC analysis showed the cut-off value of the 10-year hip osteoporotic fracture for detecting osteoporosis was 0.95%, while that of 10-year major osteoporotic fracture was 4.95%. The sensitivity and specificity of the 10-year hip osteoporotic fracture probability for detecting osteoporosis were 0.86 and 0.59, respectively, while the guideline-recommended threshold had a sensitivity of 0.49 and specificity of 0.83. The sensitivity and specificity of the 10-year major osteoporotic fractures with the new threshold were 0.76 and 0.69, respectively, while the recommended threshold had a sensitivity of 0 and specificity of 1.

CONCLUSION

Current guideline-recommended FRAX thresholds without BMD showed low sensitivity. Therefore, 10-year osteoporotic hip fracture probability ≥ 0.95% and 10-year osteoporotic major fracture probability ≥ 4.95% are recommended as the new thresholds.

Comparison of therapeutic efficacy and mechanism of paclitaxel alone or in combination with methotrexate in a collagen-induced arthritis rat model

OBJECTIVE

To compare the therapeutic efficacy of paclitaxel (PTX) alone to its combination with methotrexate (MTX) on rheumatoid arthritis.

METHODS

A collagen-induced arthritis (CIA) rat model was established by induction of type II collagen. Rats were divided into blank control group, CIA model group, MTX group 1 mg/kg, PTX 1.5 mg/kg, PTX 2.5 mg/kg, PTX 3.5 mg/kg, and MTX 1 mg/kg + PTX 3.5 mg/kg, with 10 rats per group. The inflammation of the ankle joint was analyzed by H&E staining and interleukin (IL)-1β and IL‑6 expression was detected by immunohistochemistry. TUNEL assay was performed to detect synovial tissue cell apoptosis after administration of PTX and MTX either alone or in combination. TLR4 and p‑NF-κBp65 protein expression in synovial tissue and the changes of serum IL‑1β, IL‑6, IL‑12, MMP‑3, and TNFα protein factors were detected by western blot and ELISA, respectively.

RESULTS

PTX and MTX improved histopathological changes in CIA rats. Besides, the apoptosis rate of synovial tissue cells in the PTX 3.5 mg/kg group was more than that of the PTX + MTX group. Immunohistochemistry and western blot results indicated that PTX and MTX reduce the expression rate of IL‑6 and IL‑1β and downregulate TLR4 and p‑NF-κBp65 protein expression. Furthermore, TLR4 and p‑NF-κBp65 reduced the concentration of MMP‑3, IL‑12, IL‑6, IL1‑β, and TNFα.

CONCLUSION

Both PTX and MTX exert significant suppression on rheumatoid arthritis, and the combined effect of the two drugs is weaker than that of PTX alone. Moreover, intraperitoneal injection of PTX 3.5 mg/kg every other day was the optimal dose observed in this study.

Prognostic value of age-adjusted d-dimer cutoff thresholds in patients with myocardial infarction treated by percutaneous coronary intervention

Introduction

The association between D-dimer and outcomes of patients with myocardial infarction (MI) remains controversial. Using age-adjusted D-dimer cutoff thresholds significantly improves the accuracy of diagnosis for thrombotic diseases. This study aimed to investigate the prognostic value of age-adjusted D-dimer in MI patients treated by percutaneous coronary intervention (PCI).

Methods

In this observational study, 3614 consecutive patients with MI treated by PCI were retrospectively recruited. The baseline age-adjusted D-dimer threshold was 500 ng/mL, and was calculated as age × 10 in patients older than 50 years. Cox regression was used for outcome analysis. The primary outcome was all-cause death. Discrimination and reclassification were calculated to assess the additional prognostic value of D-dimer when combined with established clinical risk factors and the Global Registry of Acute Coronary Events (GRACE) risk score.

Results

During a median follow-up of 652 days, a total of 194 deaths occurred. High D-dimer level, as defined by age-adjusted thresholds, was an independent predictor for all-cause death (hazard ratio:1.67, 95% confidence interval: 1.23–2.27, P=0.001). Addition of D-dimer level (high or low) significantly improved risk classification for death when combined with established clinical risk factors (net reclassification index [NRI]: 0.601, P<0.001; integrated discrimination improvement [IDI]: 0.011, P=0.046) and GRACE score (NRI: 0.618, P<0.001; IDI: 0.015, P=0.011).

Conclusions

In patients with MI treated by PCI, D-dimer elevation defined by age-adjusted thresholds was an independent predictor for adverse outcomes, and provided additional prognostic value when combined with clinical risk factors and GRACE score.

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences

Association between pre-infarction angina and culprit-lesion morphology in patients with ST-segment elevation myocardial infarction: an optical coherence tomography study

Background

Previous studies reported the cardiac protection effect of pre-infarction angina (PIA) in patients with acute myocardial infarction (AMI). However, the association between PIA and culprit plaques characteristics in AMI patients through optical coherence tomography (OCT)assessment remains unclear.

Purpose

We sought to identify culprit-plaque morphology associated with PIA in patients with ST-segment elevation myocardial infarction (STEMI) using OCT.

Methods

A total of 279 STEMI patients who underwent intravascular OCT of culprit-lesion were included. Baseline clinical data and culprit-plaque characteristics were compared between the PIA group the non-PIA group.

Results

Patients with PIA represented 54.8% of the study population (153 patients). No differences were observed in clinical and angiographic data between two groups, except STEMI onset with exertion was significantly less common in PIA group (24.2% versus 40.5%, P=0.004). Patients with PIA exhibited a significantly lower incidence of plaque rupture (40.5% versus 61.9%, P<0.001) and lipid-rich plaques (48.4% versus 69.0%, P=0.001). The thin-cap fibroatheroma (TCFA) prevalence was lower in PIA group, presenting a thicker fibrous cap thickness, although statistically significant differences were not observed (20.3% versus 30.2%, P=0.070; 129.1±92.0μm versus 111.4±78.1μm, P=0.088; respectively). Multivariate logistic regression analysis indicated that PIA was an independent negative predictor for plaque rupture (odds ratio: 0.44, 95% confidence interval: 0.268–0.725, P=0.001).

Conclusion

STEMI patients with PIA showed a significantly lower prevalence of plaque rupture and lipid-rich plaques in culprit-lesion than non-PIA group, implying different mechanisms of STEMI attack.

Flow chart + Bar graphs of OCT findings

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): Association between pre-infarction angina and culprit-lesion morphology in patients with ST-segment elevation myocardial infarction: An optical coherence tomography study

[Features of gut microbiota in patients with idiopathic Parkinson's disease]

Objectives: To investigate whether the fecal microbiome of Parkinson's disease patients differs from that of healthy population and explore the pathogenesis and new treatment of idiopathic Parkinson's disease. Methods: A total of 30 patients diagnosed as idiopathic Parkinson disease (PD group) in Beijing Friendship Hospital between April 2017 and June 2018 were enrolled and 30 healthy controls (NC group) were recruited at the same time.Medical records and score of unified Parkinson's disease rating scale (UPDRS) were collected and fresh fecal samples were obtained and stored in refrigerator (-80℃). The microbial compositions of fecal samples were investigated by 16S rRNA gene sequencing targeting the V3-V4 region. The taxa abundance and microbial composition were tested. Results: There was no difference of age and sex in PD and NC groups. Chao1 and Shannon indexes tended to be higher in PD group, yet failed to reach statistic significance (P=0.115 and 0.052). Relative abundance of gut microbiota differed in each taxonomic category. The relative abundance of Firmicutes in PD group was 53.6%(41.7%-64.8%), while that of Bacteroidetes in NC group was 51.7%(31.7%-65.3%). The ratios of Firmicutes to Bacteroidetes were significantly different between the two groups (1.6(0.9-3.4) vs 0.7(0.5-1.4), P=0.001). In Clostridia, Bacilli and Erysipelotrichia of Firmicutes, the relative abundances of Clostridiales, Christensenellaceae, Peptoclostridium, Lactobacillus and Erysipelatoclostridium were higher in PD group (P=0.024, 0.046, 0.036, 0.022 and 0.037). The relative abundance of Prevotella of Bacteroidales, was lower in PD group, yet failed to reach statistic significance (P=0.121). The relative abundances of Alistipes of Rikenellaceae and Butyricimonas of Marinilabiliales in PD group were significantly higher than those in NC group (P=0.047 and 0.033). The relative abundance of Bifidobacterium of Actinobacteria was significanly higher in PD group when compared with NC group (P=0.009). Despite the relatively low abundance, Akkermansia of Verrucomicrobia was significantly higher in PD group than in NC group (P=0.025). Conclusion: The structures of the fecal microbiota differ significantly between PD patients and healthy controls.

Assessment of Apparent Internal Carotid Tandem Occlusion on High-Resolution Vessel Wall Imaging: Comparison with Digital Subtraction Angiography

BACKGROUND AND PURPOSE

Not all tandem occlusions diagnosed on traditional vascular imaging modalities, such as MRA, represent actual complete ICA occlusion. This study aimed to explore the utility of high-resolution vessel wall imaging in identifying true ICA tandem occlusions and screening patients for their suitability for endovascular recanalization.

MATERIALS AND METHODS

Patients with no signal in the ICA on MRA were retrospectively reviewed. Two neuroradiologists independently reviewed their high-resolution vessel wall images to assess whether there were true tandem occlusions and categorized all cases into intracranial ICA occlusion, extracranial ICA occlusion, tandem occlusion, or near-occlusion. DSA classified patient images into the same 4 categories, which were used as the comparison with high-resolution vessel wall imaging. The suitability for recanalization of occluded vessels was evaluated on high-resolution vessel wall imaging compared with DSA.

RESULTS

Forty-five patients with no ICA signal on MRA who had available high-resolution vessel wall imaging and DSA images were included. Among the 34 patients (34/45, 75.6%) with tandem occlusions on DSA, 18 cases also showed tandem occlusions on high-resolution vessel wall imaging. The remaining 16 patients, intracranial ICA, extracranial ICA occlusions and near-occlusions were found in 2, 6, and 8 patients, respectively, on the basis of high-resolution vessel wall imaging. A total of 20 cases (20/45, 44.4%) were considered suitable for recanalization on the basis of both DSA and high-resolution vessel wall imaging. Among the 25 patients deemed unsuitable for recanalization by DSA, 11 were deemed suitable for recanalization by high-resolution vessel wall imaging.

CONCLUSIONS

High-resolution vessel wall imaging could allow identification of true ICA tandem occlusion in patients with an absence of signal on MRA. Findings on high-resolution vessel wall imaging can be used to screen more suitable candidates for recanalization therapy.

Dual roles of misshapen/NIK-related kinase (MINK1) in osteoarthritis subtypes through the activation of TGFβ signaling

OBJECTIVE

To identify the role of misshapen/NIK-related kinase (MINK1) in age-related Osteoarthritis (OA) and injury-induced OA, and the effects of enhanced TGFβ signaling in these progresses.

DESIGN

The effect of MINK1 was analyzed with MINK1 knock out (Mink1-/-) mice and C57BL/6J mice. OA progress was studied in age-related OA and instability-associated OA (destabilization of the medial meniscus, DMM) models. The murine knee joint was evaluated through histological staining, Osteoarthritis Research Society International (OARSI) scores, immunohistochemistry, and μCT analysis. Primary chondrocytes were isolated from wild type and Mink1-/- mice and subjected to osteogenic induction and Western blot analysis.

RESULTS

MINK1 is highly expressed during cartilage development and in normal cartilage. Mink1-/- mice displayed markedly lower OARSI scores, aggrecan degradation neoepitope positive cells and increased Safranin O and pSMAD2 staining in aging-related OA model. However, in injury-induced OA, loss of MINK1 accelerates extracellular matrix (ECM) destruction, osteophyte formation, and subchondral bone sclerosis. Accelerated subchondral bone remodeling in Mink1-/- mice was accompanied with increased numbers of nestin-positive mesenchymal stem cells (MSCs) and osterix-positive osteoprogenitors. pSMAD2 staining was increased in the subchondral bone marrow of Mink1-/- mice and overexpression of MINK1 inhibited SMAD2 phosphorylation in vitro.

CONCLUSIONS

This study shows for the first time that activation of TGFβ/SMAD2 by MINK1 deficiency plays opposite roles in aging-related and injury-induced OA. MINK1 deficiency protects cartilage from degeneration in aging joints through increased SMAD2 activation in chondrocytes, while accelerating OA progress in injury-induced model through enhanced osteogenesis of MSCs in the subchondral bone. These findings provide insights for developing precision OA therapeutics targeting TGFβ/SMAD2 signaling.

106Plasma trimethylamine N-oxide is associated with culprit plaque characterization as assessed by optical coherence tomography in patients with acute myocardial infarction

Background

Previous study have demonstrated that plasma trimethylamine N-oxide (TMAO) is associated with vulnerable plaque characteristics as assessed by optical coherence tomography (OCT) in patients with coronary artery disease. However, the relation between TMAO and the culprit plaque characteristics as assessed by OCT in patients with acute myocardial infarction (AMI) exhibiting plaque rupture at the site of the culprit stenosis is unknown.

Objective

To explore the relation between plasma TMAO and coronary culprit plaque characterization assessed by OCT in AMI patients exhibiting plaque rupture.

Method

We prospectively enrolled 90 AMI patients with plaque rupture identified by OCT and collected demographic data, risk factors, coronary angiography and OCT data, medical history and laboratory findings of all patients. Plasma TMAO levels were detected by stable isotope dilution liquid chromatography tandem mass spectrometry. Macrophage presence in coronary culprit plaque was quantified by normalized standard deviation (NSD).

Result

All patients were divided into two groups (high TMAO group and low TMAO group) according to the median plasma TMAO level (3.22uM). The culprit plaques in the high TMAO group exhibited a thinner fibrous cap thickness (60um [60–100um] versus 90um [70–110um], P=0.013]), higher frequency of thin-cap fibroatheroma (TCFA) (15.6% versus 55.6%, P<0.001), microvessel (24.4% versus 4.4%, P=0.014) and macrophage infiltration (66.7% versus 26.7%, P<0.001) compared with the low TMAO group. Moreover, the level of TMAO was significantly positively associated with NSD (Pearson's correlation coefficient: r=0.766, P<0.001).

Conclusion

Plasma TMAO levels are associated with coronary plaque vulnerability and inflammation in patients with AMI exhibiting plaque rupture.

Acknowledgement/Funding

Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2016-I2M-1-009)

P819Post-procedural cholesterol and inflammatory risk in acute myocardial infarction patients undergoing percutaneous coronary intervention

Objective

This study sought to depict the combined association of post-procedural cholesterol and inflammatory risk with clinical outcomes among acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI) and pick out patients with highest comprehensive risk.

Methods

A total of 4802 AMI-PCI patients were divided into quartiles according to post-procedural low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP) level respectively and in combinations for risk analysis. Univariate and adjusted multivariate analysis with Cox model were performed. Hazard ratio (HR) for short-term (90 days) and long-term (1 year) were compared for major adverse cardiovascular events (MACE), including cardiac death, recurrent myocardial infarction and ischemic stroke.

Results

A significant change in the hazards of 90-day MACE was seen among patients in the highest quartile of post-procedural LDL-C [HR: 0.526 (0.291, 0.951), p=0.034] and highest quartile of CRP [HR: 2.119 (1.150, 3.920), p=0.016]. For 1-year outcomes, only a trend for increasing risk was seen in patients with higher post-procedural CRP (p-trend = 0.016). Combination analysis for cholesterol/inflammatory risk showed that patients lying simultaneously in the lowest quartile of LDL-C and highest quartile of CRP gained the highest risk in the 90-day [HR: 3.16 (1.124, 8.886), p=0.029] and 1-year [HR: 2.515 (1.153, 5.486), p=0.020] follow up.

Hazard ratios (HR) for short-term (90 days) and long-term (1 year) primary outcomes according to cholesterol and inflammatory risk 90 days 1 year Type of risk Unadjusted HR (95% CI) P value Adjusted HR (95% CI) P value P for trend Unadjusted HR (95% CI) P value Adjusted HR (95% CI) P value P for trend LDL, mmol/L   Quartile 2 0.742 (0.441, 1,248) 0.260 0.663 (0.390, 1.125) 0.128 0.033 0.722 (0.364, 1.125) 0.150 0.683 (0.435, 1.072) 0.097 0.251   Quartile 3 0.653 (0.381, 1.121) 0.122 0.597 (0.344, 1.038) 0.068 0.850 (0.557, 1.229) 0.453 0.850 (0.550, 1.312) 0.462   Quartile 4 0.517 (0.288, 0.928) 0.027 0.526 (0.291, 0.951) 0.034 0.673 (0.427, 1.061) 0.088 0.708 (0.444, 1.131) 0.149 CRP, mg/L   Quartile 2 1.365 (0.717, 2.599) 0.334 1.295 (0.654, 2.522) 0.448 0.007 1.063 (0.656, 1.722) 0.805 0.998 (0.608, 1.636) 0.992 0.016   Quartile 3 1.306 (0.681, 2.502) 0.442 1.279 (0.654, 2.499) 0.472 0.999 (0.612, 1.630) 0.996 0.968 (0.586, 1.597) 0.897   Quartile 4 2.354 (1.312, 4.221) 0.004 2.119 (1.150, 3.920) 0.016 1.657 (1.069, 2.570) 0.024 1.528 (0.967, 2.413) 0.069 Multivariate analysis was adjusted for age, sex and traditional cardiovascular risk factors.

Combined cholesterol/inflammatory risk

Conclusion

AMI-PCI patients with lower post-procedural LDL-C and higher CRP might encounter greater cardiovascular risk. Patients with the lowest LDL-C and highest CRP gained extremely high risk and required special attention.

A population-based study of the association between food insecurity and potentially avoidable hospitalization among persons with diabetes using linked survey and administrative data

Background

Studies have found food insecurity to be more prevalent among persons with diabetes mellitus. Other research using areal-based measures of socioeconomic status have pointed to a social gradient in diabetes hospitalizations, but without accounting for individuals’ health status. Linking person-level data from health surveys to population-based hospital records enables profiling of the role of food insecurity with hospital morbidity, focusing on the high-risk diabetic population.

Objective

This national study aims to assess the association between income-related household food insecurity and potentially avoidable hospital admissions among community-dwelling persons living with diagnosed diabetes.

Methods

We use three cycles of the Canadian Community Health Survey (2007, 2008, and 2011) linked to multiple years of hospital records from the Discharge Abstract Database (2005/06 to 2012/13), covering 12 of Canada’s 13 provinces and territories. We apply multiple logistic regression for testing the association of household food insecurity with the risk of hospitalization for diabetes and common comorbid ambulatory care sensitive conditions among persons aged 12 and over living with diabetes.

Analysis

Data linkage allowed us to analyze inpatient hospital records among 10,260 survey respondents with diabetes; 590 respondents had been hospitalized at least once for diabetes or a common comorbid chronic physical or mental illness. The regression results indicated that the odds of experiencing a preventable hospital admission were significantly higher among persons with diabetes who were food insecure compared to their counterparts who were food secure (OR=1.66 [95%CI=1.24-2.23]), after controlling for age, sex and other characteristics.

Conclusion

We found food insecurity to significantly increase the odds of hospital admission for ambulatory care sensitive conditions among Canadians living with diabetes. These results reinforce the need to consider food insecurity in public health and clinical strategies to reduce the hospital burden of diabetes and other nutrition-related chronic diseases, from primary prevention to post-discharge care.

Characterization of Ablation Thresholds for 3D-Cultured Patient-Derived Glioma Stem Cells in Response to High-Frequency Irreversible Electroporation

High-frequency irreversible electroporation (H-FIRE) is a technique that uses pulsed electric fields that have been shown to ablate malignant cells. In order to evaluate the clinical potential of H-FIRE to treat glioblastoma (GBM), a primary brain tumor, we have studied the effects of high-frequency waveforms on therapy-resistant glioma stem-like cell (GSC) populations. We demonstrate that patient-derived GSCs are more susceptible to H-FIRE damage than primary normal astrocytes. This selectivity presents an opportunity for a degree of malignant cell targeting as bulk tumor cells and tumor stem cells are seen to exhibit similar lethal electric field thresholds, significantly lower than that of healthy astrocytes. However, neural stem cell (NSC) populations also exhibit a similar sensitivity to these pulses. This observation may suggest that different considerations be taken when applying these therapies in younger versus older patients, where the importance of preserving NSC populations may impose different restrictions on use. We also demonstrate variability in threshold among the three patient-derived GSC lines studied, suggesting the need for personalized cell-specific characterization in the development of potential clinical procedures. Future work may provide further useful insights regarding this patient-dependent variability observed that could inform targeted and personalized treatment.

Intra-aortic balloon pumping and thrombocytopenia in patients with acute coronary syndrome : Incidence, risk factors, and prognosis

BACKGROUND

Thrombocytopenia is a frequently encountered phenomenon during intra-aortic balloon pumping (IABP), which may limit its prolonged utilization. The aim of the study was to explore the risk factors and clinical implications of IABP-associated thrombocytopenia in patients with acute coronary syndrome (ACS).

METHODS

We retrospectively analyzed the data of 222 patients with ACS undergoing invasive treatment strategy supported by IABP. The incidence and risk factors of IABP-associated thrombocytopenia, and the association between thrombocytopenia and relevant clinical endpoints (in-hospital death, bleeding according to the TIMI scale, and thromboembolic events), were analyzed.

RESULTS

IABP-associated thrombocytopenia was observed in 54.5% (121/222) of the patients. The incidence of thrombocytopenia was higher and the magnitude of reduction in platelet count was greater in the Arrow balloon group (n = 89) compared with the Datascope balloon group (n = 133; 68.5% vs. 45.1%, p = 0.001; 48.7% vs. 33.2%, p < 0.001; respectively). Independent predictors of thrombocytopenia included older age and Arrow balloon utilization (odds ratio [OR]: 1.054; 95% confidence interval [CI]: 1.028-1.080; p<0.001; OR: 2.468; 95%CI: 1.375-4.431; p = 0.002; respectively). The incidence of in-hospital death was higher in patients who developed thrombocytopenia than those who did not (9.1% vs. 2.0%, p = 0.041), and thrombocytopenia was correlated with in-hospital death (OR: 5.932; 95%CI: 1.221-28.822; p = 0.027). However, the rates of TIMI bleeding and thromboembolic events were similar between the two groups (5.8% vs. 5.0%, p = 1.000; 3.2% vs. 6.0%, p = 0.518; respectively), and thrombocytopenia was not associated with TIMI bleeding or thromboembolic events (OR: 0.940; 95%CI: 0.267-3.307; p = 0.923; OR: 0.541, 95%CI: 0.148-1.974, p = 0.352; respectively).

CONCLUSION

IABP-associated thrombocytopenia occurred in 54.5% of patients with ACS undergoing an invasive strategy and it was correlated with increased in-hospital mortality. Older age and use of the Arrow balloon may predict IABP-associated thrombocytopenia.

Nonlinear Transition from Mitigation to Suppression of the Edge Localized Mode with Resonant Magnetic Perturbations in the EAST Tokamak

Evidence of a nonlinear transition from mitigation to suppression of the edge localized mode (ELM) by using resonant magnetic perturbations (RMPs) in the EAST tokamak is presented. This is the first demonstration of ELM suppression with RMPs in slowly rotating plasmas with dominant radio-frequency wave heating. Changes of edge magnetic topology after the transition are indicated by a gradual phase shift in the plasma response field from a linear magneto hydro dynamics modeling result to a vacuum one and a sudden increase of three-dimensional particle flux to the divertor. The transition threshold depends on the spectrum of RMPs and plasma rotation as well as perturbation amplitude. This means that edge topological changes resulting from nonlinear plasma response plays a key role in the suppression of ELM with RMPs.

Effects of environmental factors on sperm motility and fertilization rate of Phascolosoma esculenta

The study investigated the effects of environmental factors (salinity, pH, ions and activation media) on sperm motility (activation rate, duration of quick movement, and lifespan) and fertilization rate of Phascolosoma esculenta. The results showed that spermatozoa in the coelom and nephridium are able to move quickly. The optimal salinity was 14.64 to 43.35 and the optimal pH was 6.46 to 9.53 for sperm activation and motility, whereas the ranges for fertilization were narrower (18.56 to 30.3 for salinity and 6.46 to 8.61 for pH). Of the ions studied, Na+ was indispensable for sperm motility and fertilization, and Ca2+ and Mg2+ were necessary for fertilization. P. esculenta sperm could not fertilize eggs and have short lifespans in 200 to 600 mmol/L NaCl and KCl solutions. Furthermore, they could not be activated or move in 200 to 600 mmol/L CaCl2, MgSO4, and sucrose solutions.

CMTM3 is frequently reduced in clear cell renal cell carcinoma and exhibits tumor suppressor activities

PURPOSE

CKLF-like MARVEL transmembrane domain containing member 3 (CMTM3) is silenced in many kinds of cancers and inhibits tumor cells growth. We investigated the expression and role of CMTM3 in clear cell renal cell carcinoma (ccRCC).

METHODS

The expression of CMTM3 was detected in ccRCC tissue microarray, specimens, and cell lines by immunohistochemistry, quantitative real-time polymerase chain reaction (qRT-PCR) and western blot, respectively. After transfected with CMTM3 plasmid or vector, the proliferation and migration of ccRCC 786-0 cells were determined by MTT assay and transwell assay, respectively. Furthermore, the anchorage-independent growth of transfected cells was assessed using soft agar colony formation assay.

RESULTS

CMTM3 was down-regulated in 84 % (63/75) of ccRCC tissues and its expression had no correlation with the gender, age, clinical staging and histologic grade. CMTM3 protein was undetectable by western blot in most detected ccRCC specimens and two RCC cell lines (786-0 and ACHN). qRT-PCR analysis showed that CMTM3 mRNA was dramatically down-regulated in 40 ccRCC cancer tissues as compared with the paired adjacent normal ones. Restoration of CMTM3 significantly suppressed the anchorage-independent growth, proliferation and migration of 786-0 cells.

CONCLUSION

These results indicate that CMTM3 is significantly down-regulated in ccRCC and exerts remarkable tumor-suppressive functions in 786-0 cells. Reduction of CMTM3 expression may contribute to the pathogenesis of ccRCC and CMTM3 may be a potentially target for therapeutic strategy.

Ethanol-induced neurodegeneration in NRSF/REST neuronal conditional knockout mice

The transcription regulator, neuron-restrictive silencer factor (NRSF), also known as repressor element-1 silencing transcription factor (REST), plays an important role in neurogenesis and various neuronal diseases such as ischaemia, epilepsy, and Huntington's disease. In these disease processes, neuronal loss is associated with abnormal expression and/or localization of NRSF. Previous studies have demonstrated that NRSF regulates the effect of ethanol on neuronal cells in vitro, however, the role of NRSF in ethanol-induced neuronal cell death remains unclear. We generated nrsf conditional knockout mice using the Cre-loxP system to disrupt neuronal expression of nrsf and its truncated forms. At postnatal day 6, ethanol significantly increased the expression of REST4, a neuron-specific truncated form of NRSF, in the brains of wild type mice, and this effect was diminished in nrsf conditional knockout mice. The apoptotic effect of ethanol was pronounced in multiple brain regions of nrsf conditional mutant mice. These results indicate that NRSF, specifically REST4, may protect the developing brain from ethanol, and provide new evidence that NRSF can be a therapeutic target in foetal alcohol syndrome (FAS).

Specific determinants of conantokins that dictate their selectivity for the NR2B subunit of N-methyl-D-aspartate receptors

Conantokins are naturally-occurring small peptide antagonists of ion flow through NMDA/glycine activated-N-methyl-d-aspartate receptor (NMDAR) ion channels. One member of the conantokin family, conantokin (con)-G, a 17-residue peptide, is selective for NMDARs containing the N-methyl-d-aspartate receptor subunit 2 B (NR2B), whereas the homologous peptides, con-T and con-R, show broader selectivity for NR2 subunits. In this study, con-G, con-R, and con-T variants were chemically synthesized and employed to investigate their subunit selectivities as inhibitors of agonist-evoked ion currents in human embryonic kidney-293 (HEK-293) cells expressing various combinations of NMDAR subunits that contain NR1a or NR1b combined with NR2A or NR2B. Using truncation and point mutants, as well as chimeric conantokins, we determined that the N-terminus of con-G contains all the determinants for NR2B selectivity. With this information, a large number of (con) variants were synthesized and used to establish minimal sequence determinants for selectivity. Tyr at position 5 broadens the NR2 selectivity, and recovery of NR2B selectivity in Tyr5 peptides was achieved by incorporating Ala or Gly at position 8. NR2B selectivity in con-R can be conferred through deletion of the Ala at position 10, thereby shifting the γ-carboxyglutamate (Gla) from position 11 to position 10, where a Gla naturally occurs in con-G and con-T. The nature of the amino acid at position 6 is also linked to subunit selectivity. Our studies suggest that the molecular determinants of conantokins that dictate NMDAR subunit selectivity are housed in specific residues of the N-termini of these peptides. Thus, it is possible to engineer desired NMDAR functional properties into conantokin-based peptides.

Study To Evaluate the Efficacy and Safety of Zoladex Combined with CEF Chemotherapy as Neo-Adjuvant Therapy in Hormone Responsive, Premenopausal, Operable Breast Cancer Patients

Purpose: To evaluate the efficacy and safety of Zoladex combined with CEF chemotherapy as neo-adjuvant therapy in hormone responsive, premenopausal, operable breast cancer patients.Patients and Methods: 119 patients with hormone responsive, premenopausal, operable breast cancer have been enrolled. Zoladex 3.6 mg was administered by subcutaneous injection per 4 weeks for 3 cycles, concurrently, CEF (CTX 600mg/m2, EPI 60-90 mg/m2, 5-Fu 500 mg/m2) were given per 3 weeks for 4 cycles as neo-adjuvant therapy. The primary objective was pathological complete response (PCR) rate in the breast. The secondary objectives included clinical complete response (CR) rate, clinical partial response (PR) rate, clinical overall response rate (ORR), safety and toxicity, change of biological marker status (ER, PR, HER-2) pre- and post-therapy.Results: 31 patients (26.1%) achieved clinical complete response and 76 patients (63.9%) achieved clinical partial response; the overall clinical response rate was 90.0%. 14 patients (11.8%) achieved pathologic complete response to T0/Tis, N0 and 20 patients (16.8%) achieved pathologic complete response to T0/Tis, Nx. When stratified by the clinical lymph-node status, the clinical partial response rate in clinical lymph-node negative group was significantly better than clinical lymph-node positive group (p=0.02). When stratified by the hormonal status, the clinical partial response rate in ER+PR+ group was significantly better than ER+PR- and ER-PR+ group (p=0.0471). There was no significant difference between HER-2+ group and HER-2- group when stratified by the HER-2 status. There was no treatment-related death and no grade 3 or grade 4 toxicity. The common adverse events were nausea (grade1 65.5%, grade2 18.5%), vomiting (grade1 58.8%, grade2 13.4%), alopecia (grade1 45.4%, grade2 54.6%). Other adverse events with more than 5% incidence included neutropenia (grade1 5.0%) and hepatic dysfunction (grade1 9.2%). There was no drug discontinuation and no drug delay or dose reduction occurred. Hormonal receptor became negative post-therapy in 11 patients' (9.2%), which clinical response rate significantly lower compared with post-therapy hormonal receptor positive group (p&lt;0.001). The change of HER-2 status had no relationship with clinical efficacy. 109(91.6%) patients achieved amenorrhea after the first cycle of Zoladex, 10(8.4%) patients achieved amenorrhea after the second cycle of Zoladex. Mean period of amenorrhea was 6 months (4–17 months). 43 patients have been followed up for more than 1 year after operation and among them 6(14.0%) patients still remain amenorrhea.Conclusion: Zoladex combined with CEF chemotherapy as neo-adjuvant therapy in hormone responsive, premenopausal breast cancer patients was more effective and had no more toxicity than CEF chemotherapy alone. This regimen was most effective especially in the clinical lymph-node negative group and ER/PR double positive group. The clinical response rate will be lower if the hormonal receptor became negative after therapy. The efficacy of this regimen has no relationship with HER-2 status.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4087.

Ischemia and reperfusion reduce the endogenous basic fibroblast growth factor in rat skeletal muscles: an immunohistochemical study

Polyclonal antibodies directed against human recombinant basic fibroblast growth factor were used in immunohistochemical studies to localize this growth factor in normal and wounded rat skeletal muscles. According to the intensity of the stain, three main classes of fibers could be identified: the strongly, moderately, and weakly stained fibers. Basic fibroblast growth factor immunoreactivity was found mainly in the extracellular matrix, primarily in the endomysium, which includes the heparin-containing basal lamina, and also in the capillary basal membrane of both normal and wounded muscles; however, the signal intensity was much stronger in normal muscles. The distribution of basic fibroblast growth factor in wounded muscles became markedly heterogeneous and sparse. After 4 hours of ischemia, about 40% of skeletal muscle fibers lost their basic fibroblast growth factor immuno-reactivity. Muscles which underwent 4 hours of ischemia and 24 hours of reperfusion had only a diminished basic fibroblast growth factor immunoreactivity. The pathologic results supported the concept of destroyed cell connection and fiber necrosis in ischemic and reperfused muscles. Potential mechanisms involved in this reduced concentration of basic fibroblast growth factor in wounded muscles may include oxygen free radical activation, a generalized effect of the inflammatory response, and reduced secretion of endogenous basic fibroblast growth factor. These results are only partially compatible with the established mitogenic role of this growth factor and suggest that a reduction of endogenous fibroblast growth factor may partly contribute to a delay in wound healing.

Acidic fibroblast growth factor reduces renal morphologic and functional indicators of injury caused by ischemia and reperfusion

Therapeutic effects of acidic fibroblast growth factor on postischemic renal injury were evaluated in a rat model of bilateral renal ischemia (60 minutes) and reperfusion (7 days). Twenty-four rats were randomly divided into two groups (12 rats each). After 60 minutes of ischemia and at the onset of reperfusion, rats in the acidic fibroblast growth factor-treated group received 2.6 microg of acidic fibroblast growth factor/rat in 50 microl of phosphate-buffered saline solution containing 0.1% heparin (w/v) through the jugular vein, whereas the rats in the phosphate-buffered saline solution-treated group received the same vehicle without acidic fibroblast growth factor. Compared with the phosphate-buffered saline solution-treated group, rats in the acidic fibroblast growth factor-treated group had significantly lower blood urea nitrogen (83.13 +/- 26.07 versus 176.36 +/- 62.36, p < 0.05) and serum creatinine (0.73 +/- 0.14 versus 1.14 +/- 0.36, p < 0.05) levels 1 day after occlusion. Histopathologic scores showed much less renal damage on day 1 in the acidic fibroblast growth factor-treated rats compared with the phosphate-buffered saline solution controls. We conclude that intravenous administration of acidic fibroblast growth factor offers significant protection against postischemic renal injury and these protective effects may come from its nonmitogenic effects such as the regulation of vessel tone and calcium concentration in the body.

Dedifferentiation of epidermal cells to stem cells in vivo

The effects of growth factors on wound healing have been studied extensively; however epidermal regeneration is not fully understood. We treated eight patients with leg ulcers with recombinant human epidermal growth factor (rhEGF) and compared biopsies of regenerating epidermis with those of controls who did not receive rhEGF. We used immunohistochemistry to identify cells expressing keratin 19 and beta1 integrin in regenerated epidermis from patients and controls. Patients treated with rhEGF had stem cells in the spinous and granular layers of regenerated epidermis. Histological analysis showed that these stem cells had reverted from differentiated to undifferentiated stem cells. Our findings provide evidence for epidermal cell reversion.

[Effect of sepsis on the expression of ubiquitin and ubiquitinated protein in rat skeletal muscle]

OBJECTIVE

To study the regularity of ubiquitin and ubiquitinated protein expression in rat skeletal muscle during sepsis, and the molecular mechanism of enhancement in skeletal muscle protein catabolism.

METHODS

Wistar rats with sepsis were administered endotoxin peritoneally. The rats were randomly divided into 4 groups rats: 2, 6, 12 and 24 h after administration of endotoxin; each group (16) included normal controls. In vitro muscle incubation system with sufficient oxygen supply was used with amino acid automatic analyzer for detecting the proteolytic rate of the extensor digitorium longus(EDL) and soleus(SOL) muscle in the sample. The expression of ubiquitin and ubiquitinated protein in rat EDL muscle was determined by western blot.

RESULTS

Total proteolytic rate in the EDL muscle increased slightly at 2 and 6 h after administering endotoxin into the peritoneal cavity, and no significant difference at 12 and 24 h was observed. There was a progressive increase of 155% and 220% in myofibrillar proteolytic rate at 2 and 6 h, and 40% at 12 h, respectively, as compared with that of the normal controls. The expression of ubiquitin and ubiquitinated protein in the EDL muscle rose by 46% and 2.4 fold at 2 h and 6 h after administering endotoxin, while the ubiquitinated protein of high molecular weight was determined. No significant changes were noted in the expression of ubiquitin and ubiquitinated protein at 12 and 24 h.

CONCLUSION

The results indicate that activation of ubiquitin-proteasome pathway occurs in rat skeletal muscle during sepsis, and high expression of ubiquitin and ubiquitinated protein means that the substrate flowing into ubiquitin-proteasome pathway increases markedly, and then leads to muscle wasting.

Expression of oncoproteins c-fos and c-jun in hypertrophic scars and chronic dermal ulcers and their regulation of basic fibroblast growth factor

OBJECTIVE

To explore the characteristics of oncoprotein expression of c-fos and c-jun in hypertrophic scars and chronic dermal ulcers and their regulation of basic fibroblast growth factor (bFGF).

METHODS

Tissues of hypertrophic scars (n = 8), chronic dermal ulcers (n = 8) and normal skin (n = 5) were taken from 21 patients with burns and chronic dermal ulcers in operation. The ABC immunohistochemical method was used to characterize the gene product expression of c-fos, c-jun and bFGF in the above tissues.

RESULTS

In normal skin, both c-fos and c-jun protein expression and bFGF protein expression were observed. The signals of both oncoproteins were localized mainly in subcutaneous fibroblasts, but, positive expression of the bFGF protein was mainly in keratinocytes. In hypertrophic scars, positive expression of both oncoproteins could be found mainly in fibroblasts, but bFGF was mainly in fibroblasts and endothelial cells. In chronic dermal ulcers, endothelial cells, some of inflammatory cells and fibroblasts were positive for both of oncoproteins, but the expression of bFGF was only seen in fibroblasts and endothelial cells.

CONCLUSIONS

The results indicate that the interaction between both oncoproteins and bFGF exists, and the regulating action between protooncogenes and bFGF is a major course in wound healing. The different expressions of c-fos and c-jun gene products play an important role in regulate bFGF action, thus affecting wound healing.

Chromosomal location of murine disabled-2 gene and structural comparison with its human ortholog

Disabled-2 (Dab2) is one of the two mammalian orthologs of the Drosophila Disabled. The three spliced forms, p96, p93, and p67 of murine Dab2 cDNAs were first isolated as phosphoproteins functioning in the macrophage CSF-1 signal transduction pathway. Subsequently, the involvement of Dab2 in ovarian cancer development has been investigated: Dab2 expression is lost or greatly diminished in breast and ovarian cancers, and gene deletions have been found. Regulation of Disabled-2 expression is also found to be important in development and physiological functions. Structural information of the murine Dab2 gene is essential for studies of transcription regulation and gene function in mouse models. In this study, the mouse Dab2 gene coding sequence was identified and sequenced from three lambda phage clones containing the gene. Two BAC clones of mouse genomic DNA were also used to identify the sequences of the non-coding first exon and promoter. The first exon is separated from the second exon by a large (15 kb) intron. The mouse gene is about 40 kb in size and consists of 15 exons, producing a 3.6 kb message. The translation initiation site resides in the middle of the second exon. The mouse Dab2 gene structure is very similar to that of its human ortholog in exon/intron sizes and promoter sequences. The chromosomal localization of mouse Dab2 was mapped by FISH to chromosome 15A2, a site of syntax with the human 5p12 where human Dab2 gene resides. The information on the mouse Dab2 gene structure and promoter will be invaluable in studies of the involvement of Dab2 gene in cancer, expression, physiological function, and development in mouse models.

[The predictive value of serum neopterin for multiple organ dysfunction syndrome in extensively burned patients]

OBJECTIVE

To evaluate the predictive value of serum neopterin for multiple organ dysfunction syndrome (MODS) in extensively burned patients.

METHODS

Twenty-nine burn patients with TBSA of more than 70% were included in this study, and these patients were divided into two groups according to the occurrence of MODS. Blood samples were obtained on 1, 3, 7, 14, 21 and 28 postburn days (PBDs). And serum neopterin levels were determined by radioimmunossay. To evaluate the predictive power of neopterin, sensitivity, specificity, predictive value of a positive/negative test were calculated for the diagnosis of MODS.

RESULTS

Serum neopterin levels in MODS group were significantly higher than those in non-MODS group on 3, 7, 14 and 21 PBDs (P < 0.05 similar 0.01). And a positive correlation was found between neopterin levels and MODS scores in patients who developed MODS on 3, 7 and 21 PBDs (r = 0.470 similar 0.811). In a period of up to 28 PBDs, neopterin levels exceeding 35.0 nmol/L were associated with MODS by a clinical sensitivity of 81.1%, a specificity of 89.9%, a positive predictive value of 81.1%, and a negative predictive value of 89.9%.

CONCLUSION

These data indicated that the presence of constant high neopterin serum levels appear to be associated with the development of postburn MODS. Serum levels of neopterin might be a useful marker for the early identification of extensive burned patients at risk for MODS.

[The effects of extensive excision of massive invasive infected burn wound on the REE of burn patients with sepsis]

OBJECTIVE

To explore the effects of extensive excision of massive invasive infected burn wound on the REE of burn patients with sepsis.

METHODS

REEs and plasma levels of IL -- 6, IL -- 8, TNFalpha and LPS were determined before and after surgical interventions and when patients', condition improved in 8 burned cases with sepsis.

RESULTS

All the 8 patients survived after treatment. The REE level in patients after operation was significantly lower than those before the operation (P < 0.01). REE in patients whose condition improved decreased obviously when compared to that after operation (P < 0.01). The plasma levels of IL -- 6, IL -- 8, TNFalpha and LPS decreased markedly after the operation when compared to those before operation (P < 0.05). and there were lower levels of these factors when the patients', condition improved (P < 0.001). Furthermore, there were closely positive correlations between REE and plasma IL -- 6, IL -- 8, TNFalpha and LPS (P < 0.01).

CONCLUSION

Over -- releasing of some inflammatory mediators could be corrected by means of extensive excision of massive invasively infected burn wound. This might be beneficial to the control or the amelioration of the hypermetabolism in burn patients with sepsis.

Advances in wound healing research in China: From antiquity to the present

China is the largest developing country in the world with wounds occuring everyday and everywhere, representing one of the main killers of people. Prevention and treatment of wounds are the main tasks for Chinese surgeons. Although wound care and management have a long history in China, wound healing research and management have made significant progress only in recent years. In this article we give a brief account of the history of wound care and management in China. In addition, we introduce the main research fields and achievements in tissue repair and regeneration during recent times in this country. We hope that these works will benefit our foreign colleagues to know our work and enhance the communication among us.

Angular distributions of fast electrons, ions, and Bremsstrahlung x/gamma-rays in intense laser interaction with solid targets

We study the angular distributions of fast electrons, ions, and bremsstrahlung x/ gamma-rays generated during the interaction of an ultrashort intense laser pulse with solid targets. A relation is found on the angular directions for fast electrons and ions as a function of the particle's kinetic energy, experienced Coulomb potential changes, and the incident angle of the laser pulse. It is valid independent of the acceleration mechanisms and the polarization of the laser pulse, as confirmed by particle-in-cell simulations. The angular distribution of bremsstrahlung x/gamma-rays is presented to show explicitly its correlation with the corresponding angular distributions of electrons.

Structure, sequence, and promoter analysis of human disabled-2 gene (DAB2)

Disabled-2 (DAB2 for human and Dab2 for other species) is one of two mammalian orthologues of Drosophila Disabled. DAB2 exhibits properties of a tumor suppressor gene: the expression of DAB2 is eliminated in 85-95% of breast and ovarian tumors; homozygous deletions of the gene have been found in some of these tumors; and reintroduction of DAB2 expression suppresses tumorigenicity of carcinoma cells. To study the mechanisms of loss of expression and to detect possible mutations in tumors, we have investigated the genomic structure of the DAB2 gene. The complete DAB2 gene was identified and sequenced from four overlapping BAC clones found to contain the gene. Complement factor 9 (C9) gene was localized next to the DAB2 gene at the 3'-end of the BAC DNA fragments. The human DAB2 gene is about 35 kb in size and consists of 15 exons and 14 introns, producing an approximately 4-kb message. A spliced variant corresponding to mouse Dab2 p93 and a 3'-end spliced variant were also identified. The translation initiation site resides in the second exon, and the noncoding first exon is separated from the second exon by a 14-kb intron. The 420-bp sequence 5' of exon 1 contains a CpG island (39 CpG sites). This 420-bp putative promoter was found to contain the site for transcription initiation, identified by RNase protection assay, and is sufficient for active transcription in epithelial cells. The information about the gene structure of DAB2 will enable us to analyze possible mutations and the mechanisms of loss of DAB2 expression in tumors.

Successful treatment of invasive burn wound infection with sepsis in patients with major burns

OBJECTIVE

To investigate the clinical characteristics of invasive burn wound infection with sepsis in patients with major burns and to summarize the successful experiences in the treatment of such patients.

METHODS

Eight patients with major burns, complicated by invasive burn would infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998. Among them, 6 patients developed multiple organ dysfunction syndrome (MODS) and 2 developed septic shock. The plasma concentrations of IL-6, IL-8, TNF alpha and lypopolysaccharide (LPS) were assayed before and after surgical intervention, as well as when the patient's vital signs became stable.

RESULTS

The patients' conditions usually deteriorated abruptly when extensive invasive burn wound infection emerged. While multi-microbial infection was usually found, Pseudomonas aeruginosa was the predominant bacteria isolated from the subeschar tissue. The plasma concentrations of IL-6, IL-8, TNF alpha and LPS before surgical intervention were significantly higher than those after surgical intervention (P < 0.05). The lowest levels of the inflammatory mediators were observed when the patients' conditions became stable, and the values were significantly lower than those before surgical intervention (P < 0.001).

CONCLUSION

Since the main cause of burn wound sepsis is the presence of a large area of infected burn wound, they should be excised and covered as early as possible. LPS and pro-inflammatory mediators play an important role in the pathogenesis of burn sepsis. Although favorable results should be attributed to comprehensive treatment, we believe that early, aggressive and thorough surgical excision of infected burn wounds, followed by sound and complete coverage of the area, play a crucial role.

[A system of microcomputer analysis for biological oxygen consumption and its application]

This paper introduces a microcomputer system of data analysis and methods of measuring oxygen consumption for biological materials. The system overcame some disadvantages of operating inconvenience and difficulties of collective and analytic data by traditional means. The system possesses functions of automatic enactment, collection, save/take and analysis for many experimental data. It can be used to measure oxygen consumption of tissues, cells and mitochondria.

Heparin-free hemodialysis in the treatment of hypernatremia in severely burned patients

BACKGROUND

Hypernatremia in severely burned patients is associated with high morbidity and mortality rates. As the causes of hypernatremia in major burn patients are still not clear, hemodialysis is the method of choice for the treatment. While hemodialysis is effective for the control of hypernatremia, it can cause bleeding complications that may be fatal for burn patients with extensive wounds and potential gastro-intestinal mucosal damage.

CLINICAL DATA

In the present study heparin-free hemodialysis in which the heparin is firmly absorbed to the haemofiltration membrane, hemophan, dispensed with systemic use of heparin. In two extensively burned patients with burn area of 100% TBSA and 98% TBSA respectively and hypernatremia with serum sodium concentration as high as 169 and 158 mmol/l respectively, heparin-free hemodialysis was performed five times and three times each.

RESULTS

Hypernatremia was satisfactorily corrected with no interference to the coagulation system in the two patients as indicated by clinical observation and biochemical analysis. The patient with burn area of 98% TBSA survived and the patient with burn area of 100% TBSA died of wound coverage failure 6 weeks after injury because of non-availability of autograft.

CONCLUSION

Heparin-free hemodialysis is an effective and safe method in the treatment of hypernatremia in extensively burned patients.

Restoration of positioning control following Disabled-2 expression in ovarian and breast tumor cells

The physical interaction of epithelial cells with the basement membrane ensures correct positioning and acts as a survival factor for epithelial cells. Cells that detach from the basement membrane often undergo apoptosis; however, in carcinomas, this positional control is absent, permitting disorganized cell proliferation. In the majority of breast and ovarian carcinomas (85-90%), the expression of a candidate tumor suppressor, Disabled-2 (Dab2), is frequently lost. The Dab2-negative tumor cells are no longer in contact with an intact basement membrane, as indicated by the absence of collagen IV (in about 90% of cases). However, in the subset (10-15%) of ovarian tumors in which Dab2 expression is positive, the presence of a basement membrane-like structure around tumor cells was observed. Recombinant adenovirus-mediated expression of Dab2 was used in Dab2-negative ovarian and breast cancer cells, and re-expression of Dab2 was found to lead to cell death or growth arrest. Dab2 expression suppressed MAPK activation and c-fos expression. Plating the infected cells on a basement membrane matrigel rescued the cells from death and growth arrest. Thus, Dab2 exhibits a negative activity for cell growth and survival, which can be countered by attachment of the cells to basement membrane matrix. We conclude that Dab2 functions in cell positioning control and mediates the exigency for basement membrane attachment of epithelial cells. Loss of Dab2 may contribute to the basement membrane-independent, disorganized proliferation of tumor cells in ovarian and breast carcinomas.