Efficacy of Kanglaite against radiotherapy-induced mucositis in head and neck cancer, a phase II trial.

PURPOSE: To explore the potential protective effect of Kanglaite injection against radiotherapy-induced mucositis in patients with head and neck cancer. PATIENTS AND METHODS: This was an open-label, single-arm, and phase II trial. The primary endpoint was the incidence of grade 3-4 radiation-induced mucositis. The secondary endpoints were hematological toxicity, non-hematological toxicity, nutritional status, and quality of life. All patients received 20g Kanglaite daily concurrently with radiotherapy. RESULTS: The data of 46 patients were available for analysis. The incidence rates of grade 3 mucositis, pain, dysphagia, and neutropenia were 10.9%, 2.2%, 10.9%, and 6.5%, respectively, while the incidence of grade 4 acute toxicities was zero. The rate of opioid use was 2.2%. Radiotherapy dose reduction was 2.2% and no irradiation field was modified. The nutritional supports were oro-enteral nutritional supplements (13.0%), TPN (10.9%), and feeding tubes (0%) during radiotherapy. After radiotherapy, 52.2% of patients lost weight, and the weight loss was <10%. The mean pain score in the QLQ-H&N35 and QLQ-C30 was <50. Patients had nearly normal physical, emotional, and cognitive functions. CONCLUSIONS: A low incidence of grade 3-4 radiation-induced mucositis and no severe acute toxic events, with favorable nutritional status and quality of life, were observed in cancer patients after Kanglaite injection. Our findings highlight the need for a prospective, multicenter, and randomized study to investigate the effect of Kanglaite injection on the reduction of radiation-induced mucositis in patients with head and neck cancer.

RNA interference-mediated silencing of Foxo3 in antigen-presenting cells as a strategy for the enhancement of DNA vaccine potency.

The transcription factor Forkhead box O3 (Foxo3) has a critical role in suppressing the expansion of antigen-specific effector T-cell populations; hence, Foxo3 is a potential target for enhancing the antitumor immunity of cancer vaccines. In this report, we evaluated the potential of RNA interference (RNAi)-mediated silencing of Foxo3 in antigen-presenting cells as an adjuvant for HER2/neu DNA cancer vaccines. Bicistronic plasmids expressing the N-terminal extracellular domain of human HER-2/neu and the Foxo3 short hairpin RNA (hN'-neu-Foxo3 shRNA) or the scrambled control (hN'-neu-scramble shRNA) were subcutaneously injected into mice by gene gun administration to elicit antitumor immunity against p185neu-overexpressing MBT-2 bladder tumor cells. We found that mice treated with hN'-neu-Foxo3 shRNA showed greater reductions in tumor growth and longer survival times than mice treated with hN'-neu-scramble shRNA, indicating that the silencing of Foxo3 enhanced the antitumor efficacy of the HER-2/neu cancer vaccine. Cytotoxicity analyses further revealed that the Foxo3 shRNA-enhanced antitumor effect was associated with significant increases in the number of functional CD8(+) T cells and in the levels of cytotoxic T lymphocytes activity. Interleukin-6 was induced by hN'-neu-Foxo3 shRNA treatment but did not have a critical role in the antitumor effect of the hN'-neu-Foxo3 shRNA vaccine. Moreover, in vivo lymphocyte depletion analyses confirmed that the antitumor efficacy of the hN'-neu-Foxo3 shRNA vaccine depended on functional CD8(+) T cells. Finally, Foxo3 suppression was shown to markedly improve the effect of the HER-2/neu DNA vaccine in limiting the growth and lung metastases of MBT-2 cells. Overall, these results support RNAi-mediated silencing of Foxo3 as an effective strategy to enhance the therapeutic antitumor effect of HER-2/neu DNA vaccines against p185neu-positive tumors.

Surface hardening of NiTi shape memory alloy induced by the nanostructured layer after surface mechanical attrition treatment.

To conduct grain refinement induced by plastic deformation, NiTi shape memory alloy is processed by surface mechanical attrition treatment. The process leads to surface nanocrystallization and consequently surface hardening. The cross sectional microhardness of the treated NiTi is measured and compared to those of annealed NiTi specimens with residual stress relaxation and recrystallization. Our results show that surface nanocrystallization induced by surface mechanical attrition treatment is an effective method to enhance the surface hardness and anti-wear properties of NiTi shape memory alloy for the biomedical application.

Surface nanomechanical behavior of ZrN and ZrCN films deposited on NiTi shape memory alloy by magnetron sputtering.

Surface nanomechanical behavior under nanoindentation of ZrN and ZrCN film on NiTi substrate was studied. The surface hardness and modulus of the films increase initially with larger nanoindentation depths and then reach their maximum values. Afterwards, they diminish gradually and finally reaching plateau values which are the composite modulus and composite hardness derived from the ZrN/ZrCN film and NiTi substrate. They are higher than those of electropolished NiTi SMA due to the properties of ZrN and ZrCN. In comparison, the surface nanomechanical properties of electropolished NiTi exhibit a different change with depths.

Ameliorative effect of quercetin on the destruction caused by experimental periodontitis in rats.

BACKGROUND AND OBJECTIVE: The purpose of this study was to evaluate the effect of quercetin, a flavonol that exhibits anti-inflammatory properties, on experimental periodontal destruction in rats. MATERIAL AND METHODS: Osteoclast formation on maxillary palatal alveolus was induced with daily lipopolysaccharide (LPS) injections (0, 1 or 5 mg/mL) for 3 d. Five days later, the osteoclasts on bony surfaces were counted after histochemical staining for tartrate-resistant acid phosphatase. The effect of intragastric quercetin on the osteoclast formation was evaluated in the following three groups: quercetin (75 mg/kg/d by oral feeding); LPS (5 mg/mL); and quercetin plus LPS. Moreover, the effect of quercetin on the ligature-induced periodontitis around maxillary second and mandibular first molars was further evaluated by microcomputerized tomography (on days 0, 4, 8 and 12) and by histometry (on day 8). RESULTS: A dose-dependent increase in osteoclasts occurred after LPS injections. However, quercetin (75 mg/kg) reduced the 5 mg/mL LPS-induced osteoclasts. Using microcomputerized tomography, the bone crest levels at ligation sites were found to be significantly more apical than at the control sites on days 8 and 12; however, the apically located bone crests rebounded in rats from the quercetin-plus-ligation group. Histometry demonstrated significantly more coronal alveolar crest bone levels, less inflammatory cell-infiltrated connective tissue areas and less connective tissue attachments in the ligation-plus-quercetin group compared with those in the ligation group. CONCLUSION: As the quercetin could reduce the LPS-induced osteoclast formation and the ligature-enhanced periodontal inflammation and bone loss, we suggest that it may have an ameliorative effect on periodontal destruction.

Nano-scale surface morphology, wettability and osteoblast adhesion on nitrogen plasma-implanted NiTi shape memory alloy.

Plasma immersion ion implantation (PIII) is an effective method to increase the corrosion resistance and inhibit nickel release from orthopedic NiTi shape memory alloy. Nitrogen was plasma-implanted into NiTi using different pulsing frequencies to investigate the effects on the nano-scale surface morphology, structure, wettability, as well as biocompatibility. X-ray photoelectron spectroscopy (XPS) results show that the implantation depth of nitrogen increases with higher pulsing frequencies. Atomic force microscopy (AFM) discloses that the nano-scale surface roughness increases and surface features are changed from islands to spiky cones with higher pulsing frequencies. This variation in the nano surface structures leads to different surface free energy (SFE) monitored by contact angle measurements. The adhesion, spreading, and proliferation of osteoblasts on the implanted NiTi surface are assessed by cell culture tests. Our results indicate that the nano-scale surface morphology that is altered by the implantation frequencies impacts the surface free energy and wettability of the NiTi surfaces, and in turn affects the osteoblast adhesion behavior.

Surface characteristics, biocompatibility, and mechanical properties of nickel-titanium plasma-implanted with nitrogen at different implantation voltages.

NiTi shape memory alloy is one of the promising orthopedic materials due to the unique shape memory effect and superelasticity. However, the large amount of Ni in the alloy may cause allergic reactions and toxic effects thereby limiting its applications. In this work, the surface of NiTi alloy was modified by nitrogen plasma immersion ion implantation (N-PIII) at various voltages. The materials were characterized by X-ray photoelectron spectroscopy (XPS). The topography and roughness before and after N-PIII were measured by atomic force microscope. The effects of the modified surfaces on nickel release and cytotoxicity were assessed by immersion tests and cell cultures. The XPS results reveal that near-surface Ni concentration is significantly reduced by PIII and the surface TiN layer suppresses nickel release and favors osteoblast proliferation, especially for samples implanted at higher voltages. The surfaces produced at higher voltages of 30 and 40 kV show better adhesion ability to osteoblasts compared to the unimplanted and 20 kV PIII samples. The effects of heating during PIII on the phase transformation behavior and cyclic deformation response of the materials were investigated by differential scanning calorimetry and three-point bending tests. Our results show that N-PIII conducted using the proper conditions improves the biocompatibility and mechanical properties of the NiTi alloy significantly.

Nickel release behavior, cytocompatibility, and superelasticity of oxidized porous single-phase NiTi.

Porous NiTi shape memory alloys are one of the promising biomaterials for surgical implants because of their unique shape memory effects and porous structure with open pores. However, the complex surface morphology and larger area of porous NiTi compared to dense NiTi make it more vulnerable from the viewpoint of release of nickel, which can cause deleterious effects in the human body. It is also more difficult to modify the exposed surfaces of a porous structure using conventional surface modification technologies. In this work, oxidation in conjunction with postreaction heat treatment was used to modify the surfaces of porous single-phase NiTi prepared by capsule-free hot isostatic pressing to mitigate Ni leaching and enhance the surface properties. Differential scanning calorimetry thermal analysis, uniaxial compression tests, inductively-coupled plasma mass spectrometry, and cell cultures reveal that porous NiTi alloys oxidized at 450 degrees C for 1 h have an austenite transition temperature below 37 degrees C, excellent superelasticity, lower nickel release, and no cytotoxicity.

Surface structure and properties of biomedical NiTi shape memory alloy after Fenton's oxidation.

Fenton's oxidation is traditionally used to remove inorganic and organic pollutants from water in waster water treatment. It is an advanced oxidation process in which H2O2 is catalytically decomposed by ferrous irons into hydroxyl radicals (*OH) which have a higher oxidation potential (2.8V) than H2O2. In the work reported here, we for the first time use Fenton's oxidation to modify the surface of biomedical NiTi shape memory alloy (SMA). The influences of Fenton's oxidation on the surface microstructure, blood compatibility, leaching of harmful Ni ions and corrosion resistance in simulated body fluids is assessed using scanning electron microscopy, X-ray diffraction, X-ray photoelectron spectroscopy, inductively coupled plasma mass spectrometry, electrochemical tests, hemolysis analysis and the blood platelet adhesion test. The mechanical stability of the surface titania film produced by Fenton's oxidation as well as their effects on the shape memory behavior of the SMA are studied by bending tests. Our results show that Fenton's oxidation produces a novel nanostructured titania gel film with a graded structure on the NiTi substrate without an intermediate Ni-rich layer that is typical of high-temperature oxidation. Moreover, there is a clear Ni-free zone near the top surface of the titania film. The surface structural changes introduced by Fenton's oxidation improve the electrochemical corrosion resistance and mitigate Ni release. The latter effects are comparable to those observed after oxygen plasma immersion ion implantation reported previously and better than those of high-temperature oxidation. Aging in boiling water improves the crystallinity of the titania film and further reduces Ni leaching. Blood platelet adhesion is remarkably reduced after Fenton's oxidation, suggesting that the treated SMA has improved thrombo resistance. Enhancement of blood compatibility is believed to stem from the improved hemolysis resistance, the surface wettability and the intrinsic electrical characteristics of the titania film. The titania film produced by Fenton's oxidation has good mechanical stability and does not adversely impact the shape memory behavior of NiTi. Our work suggests that Fenton's oxidation is a promising low-temperature, low-cost surface modification method for improving the surface properties of biomedical NiTi SMA.

Surface characteristics, mechanical properties, and cytocompatibility of oxygen plasma-implanted porous nickel titanium shape memory alloy.

Good surface properties and biocompatibility are crucial to porous NiTi shape memory alloys (SMA) used in medical implants, as possible nickel release from porous NiTi may cause deleterious effects in the human body. In this work, oxygen plasma immersion ion implantation (O-PIII) was used to reduce the amount of nickel leached from porous NiTi alloys with a porosity of 42% prepared by capsule-free hot isostatic pressing. The mechanical properties, surface properties, and biocompatibility were studied by compression tests, X-ray photoelectron spectroscopy (XPS), and cell culturing. The O-PIII porous NiTi SMAs have good mechanical properties and excellent superelasticity, and the amount of nickel leached from the O-PIII porous NiTi is much less than that from the untreated samples. XPS results indicate that a nickel-depleted surface layer predominantly composed of TiO(2) is produced by O-PIII and acts as a barrier against out-diffusion of nickel. The cell culturing tests reveal that both the O-PIII and untreated porous NiTi alloys have good biocompatibility.

In vivo study on biocompatibility and bonding strength of hydroxyapatite-20vol%Ti composite with bone tissues in the rabbit.

Biocompatibility and bonding strength of hydroxyapatite-20vol%Ti composite fabricated by hot-pressing technique with bone tissues in the rabbit were investigated by in vivo studies in comparison with those of Ti metal and dense HA ceramic. Although fibrous tissues formed at the interface between the composite and bone tissues at 3 weeks in vivo, bonding strength of the composite increases faster than that of dense HA after 4 weeks. At 3 months in vivo, bonding strength of the composite is higher than that of dense HA and exceeds 6.5 MPa. Moreover, as compared with the visible bonding interfaces between dense HA and new bones, the bonding interfaces for the composite cannot already be distinguished and the composite was osseointegrated fully with bone tissues into one bony body. The shear fracture of bonding strength test for the composite occurred in new bone zones near the interface, which indicates that bonding strength of the composite could even exceed the shear strength of new bones after 3 months in vivo. In conclusion, HA-Ti composite has better osteoconduction and osseointegration abilities than Ti metal and dense HA ceramic after 3 months in vivo and is a promising biomaterial for hard tissue replacement.

Paxillin confers resistance to tyrosine kinase inhibitors in EGFR-mutant lung cancers via modulating BIM and Mcl-1 protein stability.

Tyrosine kinase inhibitors (TKIs) have been documented to have substantial clinical benefits to non-small cell lung cancer with epidermal growth factor receptor (EGFR) mutation. TKI resistance occurs in nearly all patients who receive TKI-targeting therapy, resulting in a modest overall survival benefit. Therefore, establishing a biomarker for early prediction and exploring the mechanism of primary TKI resistance is essential for improving the therapeutic efficacy in non-small cell lung cancer patients. In this study, we provide evidence indicating that paxillin (PXN) overexpression may confer TKI resistance in EGFR-mutant lung cancer cells. Mechanistically, PXN-mediated extracellular signal-regulated kinases (ERK) activation is responsible for TKI resistance via decreased Bcl2-interacting mediator of cell death (BIM) and increased Mcl-1 expression due to modulating their protein stabilities by phosphorylation of BIM at serine 69 and Mcl-1 at threonine 163. The mechanistic action in the cell model was further confirmed by the observation of xenograft tumors in nude mice, revealing that the PXN-mediated TKI resistance was conquered by ERK inhibitor (AZD6244) and Bcl-2 family inhibitor (obatoclax), but the TKI resistance overcome by AZD6244 is more effective than that of obatoclax. Therefore, we suggest that PXN expression may be useful in predicting primary TKI resistance, and combining TKI with ERK inhibitors may clinically benefit EGFR-mutant non-small cell lung cancer patients whose tumors exhibit high PXN expression.

Fabrication and apatite inducing ability of different porous titania structures by PEO treatment.

Plasma electrolytic oxidation (PEO) was employed to grow different porous titania structures on Ti6Al4V alloy (TC4) substrate using various parameters. It was found that the PEO voltage and working frequency could affect the morphology, the pore size, the pore density, the thickness and the phase composition of titania structures. Thereafter, three typical porous titania structures with nanosize pores, microsize pores and microsize grooves were respectively selected to estimate their bioactivity using SBF immersion test. After soaking at different durations (3-28d), the surface morphology, the chemical composition as well as the phase structure of deposited apatite layers on porous titania were evaluated using SEM, EDS, and XRD. The formation of various biomimetic apatite layers indicated the different influence due to the characteristics of porous titania structures. The porous titania structure with nanosize pores could induce a fast apatite growth at the early immersion stage (~7d), while the one with microsize pores exhibited the best apatite inducing ability at long term immersion (~28d). Based on the experimental results, the formation mechanism of biomimetic apatite affected by the pore structure of titania was discussed as well.

Purification and partial characterization of human angiotensinogen.

Renin substrate was initially extracted from human plasma by (NH4)2SO4 followed by chromatography on Sephadex G-150, DEAE cellulose, calcium phosphate gel, isoelectric focusing and preparative polyacrylamide gel electrophoresis. On the basis of one mol of angiotensin per mol of substrate, the purity of the preparation is in excess of 95%. On analytical polyacrylamide gel electrophoresis in the presence of 1% sodium dodecyl sulfate or 8 M urea, the protein appears homogenous. In addition, the purified protein shows only one preciptin line against anti-normal human serum on either Ouchterlony immunodiffision or immunoelectrophoresis. The biological activity appears similar to "native" renin substrate since the Km is the same as that reported for the renin reaction in whole plasma. The molecular weight was determined as 110 000 by gel filtration and polyacrylamide gel electrophoresis; amino acid analysis of the human substrate differs from that reported for hog, especially in the Asp, Glu and Gly composition.

Inhibition of plant vacuolar H(+)-ATPase by diethylpyrocarbonate.

Treatment of the tonoplast H(+)-ATPase from mung bean seedlings (Vigna radiata L.) with histidine-specific modifier, diethyl pyrocarbonate (DEP), caused a marked loss of the ATP hydrolysis activity and the proton translocation in a concentration-dependent manner. The reaction order of inhibition was calculated to be 0.98, suggesting that at least one histidine residue of vacuolar H(+)-ATPase was modified by DEP. The absorbance of the vacuolar H(+)-ATPase at 240 nm was progressively increased after incubation with DEP, suggesting that N-carbethoxyhistidine had been formed. Hydroxylamine, which could break N-carbethoxyhistidine, reversed the absorbance change and partially restored the enzymic activity. The pK(a) of modified residues of vacuolar H(+)-ATPase was kinetically determined to be 6.73, a value close to that of histidine. Thus, it is assuredly concluded that histidine residues of the vacuolar H(+)-ATPase were modified by DEP. Kinetic analysis showed that V(max) but not K(m) of vacuolar H(+)-ATPase was decreased by DEP. This result is interpreted as that the residual activity after DEP inhibition was primarily due to the unmodified enzyme molecules. Moreover, simultaneous presence of DEP and DCCD (N,N'-dicyclohexyl-carbodiimide), an inhibitor modified at proteolipid subunit of vacuolar H(+)-ATPase, did not induce synergistic inhibition, indicating their independent effects. The stoichiometry studies further demonstrate that only one out of four histidine residues modified was involved in the inhibition of vacuolar H(+)-ATPase by DEP. Mg(2+)-ATP, the physiological substrate of vacuolar H(+)-ATPase, but not its analogs, exerted preferentially partial protection against DEP, indicating that the histidine residue involved in the inhibition of enzymatic activity may locate at/or near the active site and directly participate in the binding of the substrate.

Fabrication and characteristics of bioactive sodium titanate/titania graded film on NiTi shape memory alloy.

A bioactive sodium titanate/titania graded film was formed in situ on NiTi shape memory alloy (SMA) by oxidizing in H(2)O(2) solution and subsequent NaOH treatment and characterized by scanning electron microscopy, Raman spectroscopy, X-ray diffraction, Fourier transform infrared spectroscopy, and X-ray photoelectron spectroscopy (XPS). The bioactivity of the film was investigated using a simulated body fluid (SBF) soaking test. A titania (TiO(2)) layer was first found on NiTi substrate after oxidized in H(2)O(2) solution, and then a porous sodium titanate (Na(2)TiO(3))/titania film with many Ti--OH groups and a trace of Ni(2)O(3) was formed by the reaction of partial TiO(2) phase with NaOH solution. After immersion in SBF for 12 h, apatite was observed to nucleate and grow on the film. With longer soaking time, more apatite appeared on its surface but our control experiments didn't reveal any apatite formation on the chemically polished NiTi SMA, which indicates the bioactivity of NiTi implants could be improved by the formation of the bioactive film. Moreover, XPS depth profiles of O, Ni, Ti, and Na show the bioactive film possesses a smooth graded interface structure to NiTi substrate, which is in favor of sufficient mechanical stability of apatite layer by subsequent deposition in SBF.

First Report of Alternaria raphani Causing Black Patches on Chinese Radish During Postharvest Storage in Canada.

During November of 2003, Chinese radishes (Raphanus sativus cv. Taibai) harvested in St. Catharines, Ontario and stored in less than 1°C with 98% relative humidity (RH) and 5°C with 96% RH showed symptoms of black and dark brown, irregular patches, with or without decay. The symptoms were closely associated with skin wounds and damaged root hairs. Fungal DNA was extracted from discolored skin samples peeled from a radish, and 18S rRNA genes were amplified with fungal-specific PCR primers (1) EF4f (5'-ggaagggrtgtatttattag-3') and EF3r (5'-tcctctaaatgaccagtttg-3'). The cloned genes were sequenced using the primer EF4f and compared directly with nonredundant nucleotides in GenBank with BLAST. The results indicated that more than 75% of the fungal microflora on the diseased radish were Alternaria spp. Alternaria sp. was successfully isolated from discolored and decayed radish tissues. Morphological and molecular identification indicated that the isolated Alternaria sp. cultures belong to A. raphani, which was previously reported to cause leaf and pod blight on radish (2). For pathogenicity studies, a spore suspension (1 × 105 conidia/ml) obtained from a 4-week-old A. raphani culture was used to inoculate 'Taibai' Chinese radish tissues, including inner tissues and wounded and nonwounded skin. All tests were carried out at room temperature (22 to 24°C). On inner tissue and wounded skin, symptoms of dark brown-to-black patches appeared 2 days after inoculation and progressed with time. No symptoms developed on the noninoculated control or the nonwounded, inoculated treatment. A. raphani was reisolated from symptomatic tissue. Further evidence of pathogenicity was obtained by an additional inoculation and observation of symptoms. The results indicated that A. raphani was the causal agent of the black patches observed on Chinese radish, and to our knowledge, this is the first report that A. raphani could cause a postharvest disease on Chinese radish in storage. References: (1) J. D. Van Elsas et al. J. Microbiol. Methods 43:133, 2000. (2) M. S. Sangwan et al. J. Mycol. Plant Pathol. 32:125, 2002.

Effects of rice bran on sensory and physico-chemical properties of emulsified pork meatballs.

Four kinds of bran, which are milled from important rice cultivators in Taiwan, have high contents of dietary fiber, fat and protein. The use of rice bran in Kung-wan, an emulsified pork meatball, was investigated. It was found that protein and fat contents, and white index of meatballs decreased as the amount of bran increased. A texture profile analysis (TPA) also indicated the hardness, gumminess and chewiness of the Kung-wan decreased. The sensory scores of taste, texture and overall acceptability of meatballs with less than 10% added bran showed no significant difference from those for meatballs without bran. However, the added amount of 15% enriched meatballs resulted in inferior sensory scores. The bran's particle size profoundly affected the sensory and physico-chemical properties of the meat products. Meatballs enriched with smaller bran particles possessed higher TPA indices and sensory scores than those added with larger ones. No significant differences in proximate composition, cooking yield, color and sensory quality were found among emulsified meatballs enriched with four different kinds of bran. Conclusively, the suitable amount of rice bran that should be added to emulsified pork meatballs was less than 10% and a smaller particle size would result in better quality.

Characterising atherothrombosis in Hong Kong: results of the Hong Kong data from a global atherothrombosis epidemiological survey.

OBJECTIVES: To describe the characteristics of patients in Hong Kong with or at risk of atherothrombosis, to determine the proportion of symptomatic patients with more than one vascular bed affected, and to assess the relationship between ankle brachial index and disease severity. DESIGN: Local participation in an international prevalence study. SETTING: Five centres in Hong Kong. PARTICIPANTS: A total of 210 subjects were recruited (105 women and 105 men). Patients were divided into the symptomatic group (with current or previous atherothrombotic symptoms, n=101) and at-risk group (with no current or previous symptoms, but aged over 55 years with at least two specified risk factors, n=109). MAIN OUTCOME MEASURES: Patient characteristics were described, including the number of arterial beds affected, ankle brachial index, presence of risk factors, and medications taken. RESULTS: Of the symptomatic patients, 30% had more than one arterial bed involved. A total of 55.4% of the symptomatic group and 18.4% of the at-risk group had abnormal ankle brachial index values. Lower ankle brachial indices were associated with a greater number of affected arterial beds. Diabetes mellitus and hypertension were the most prevalent risk factors in the at-risk group. Symptomatic patients were commonly treated with antihypertensive and antiplatelet agents, whereas at-risk patients were mostly treated with antihypertensive and antidiabetic agents. Only 20% of at-risk patients were taking antiplatelet agents. CONCLUSIONS: Ankle brachial index is a useful tool for predicting those at risk of atherothrombosis. This simple measurement can be used as part of the screening process in the general practice. The role of antiplatelet agents in primary prevention of atherothrombotic events in at-risk patients deserves further attention.

Biodegradable poly-lactic acid based-composite reinforced unidirectionally with high-strength magnesium alloy wires.

Biodegradable poly-lactic acid (PLA)--based composites reinforced unidirectionally with high-strength magnesium alloy wires (MAWs) are fabricated by a heat-compressing process and the mechanical properties and degradation behavior are studied experimentally and theoretically. The composites possess improved strengthening and toughening properties. The bending strength and impact strength of the composites with 40 vol% MAWs are 190 MPa and 150 kJ/m(2), respectively, although PLA has a low viscosity and an average molecular weight of 60,000 g/mol. The mechanical properties of the composites can be further improved by internal structure modification and interface strengthening and a numerical model incorporating the equivalent section method (ESM) is proposed for the bending strength. Micro arc oxidization (MAO) of the MAWs is an effective interfacial strengthening method. The composites exhibit high strength retention during degradation and the PLA in the composite shows a smaller degradation rate than pure PLA. The novel biodegradable composites have large potential in bone fracture fixation under load-bearing conditions.