Anesthetic Considerations for Cardiac Tamponade after Internal Jugular Central Line Placement during Trauma Resuscitation:A Case Report

Numerous complications are associated with central venous catheters. Among them, cardiac tamponade is a rare but well-documented catastrophic complication.A 22-year-old healthy male presented with Code 1 trauma resulting from gunshot wounds in the abdomen. Upon examination, he was found to have a large pericardial fluid collection, a large right supraclavicular hematoma, and significant amount of bilateral pleural effusions secondary to extraluminal placement of the right internal jugular central line during resuscitation. After repairing the internal jugular injury and draining the pericardial fluid, the patient was transferred from the intensive care unit to the regular hospital floor. However, 15 days later, imaging revealed re-accumulation of a large pericardial effusion, which was eventually treated with a pericardial window operation. This case report explores potential complications that could arise from central line placement and the anesthetic considerations in a patient with cardiac tamponade from extraluminal central line placement.

Progress of researches on Blastocystis hominis infection among patients with inflammatory bowel disease and irritable bowel syndrome / 中国血吸虫病防治杂志

Blastocystis is a common unicellular intestinal protozoa in humans and animals, and the most common clinical manifestations of infections include abdominal pain and diarrhea. Based on the sequence of the small-subunit ribosomal RNA (SSU rRNA) gene, 28 subtypes of B. hominis (ST1 to ST17, ST21 and ST23 to ST32) have been characterized. Previous studies have demonstrated that B. hominis infection is strongly associated with inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and other intestinal diseases, which threatens the health and quality of life among patients with B. hominis infection and is considered as an important public health problem. This review summarizes the progress of researches on B. hominis infection among IBD and IBS patients during the past 20 years, so as to provide insights into management of blastocystosis in China.

Study on genetic structure differences and adjustment strategies in different areas of China / 中华流行病学杂志

Objective: To describe the genetic structure of populations in different areas of China, and explore the effects of different strategies to control the confounding factors of the genetic structure in cohort studies. Methods: By using the genome-wide association study (GWAS) on data of 4 500 samples from 10 areas of the China Kadoorie Biobank (CKB), we performed principal components analysis to extract the first and second principal components of the samples for the component two-dimensional diagram generation, and then compared them with the source of sample area to analyze the characteristics of genetic structure of the samples from different areas of China. Based on the CKB cohort data, a simulation data set with cluster sample characteristics such as genetic structure differences and extensive kinship was generated; and the effects of different analysis strategies including traditional analysis scheme and mixed linear model on the inflation factor (λ) were evaluated. Results: There were significant genetic structure differences in different areas of China. Distribution of the principal components of the population genetic structure was basically consistent with the geographical distribution of the project area. The first principal component corresponds to the latitude of different areas, and the second principal component corresponds to the longitude of different areas. The generated simulation data showed high false positive rate (λ=1.16), even if the principal components of the genetic structure was adjusted or the area specific subgroup analysis was performed, λ could not be effectively controlled (λ>1.05); while, by using a mixed linear model adjusting for the kinship matrix, λ was effectively controlled regardless of whether the genetic structure principal component was further adjusted (λ=0.99). Conclusions: There were large differences in genetic structure among populations in different areas of China. In molecular epidemiology studies, bias caused by population genetic structure needs to be carefully treated. For large cohort data with complex genetic structure and extensive kinship, it is necessary to use a mixed linear model for association analysis.

Relationship between educational level and long-term changes of body weight and waist circumference in adults in China / 中华流行病学杂志

Objective: To evaluate the association of educational level with anthropometric measurements at different adult stages and their long-term changes in adults who participated in the second re-survey of China Kadoorie Biobank (CKB). Methods: The present study excluded participants who were aged >65 years, with incomplete or extreme measurement values, or with major chronic diseases at baseline survey or re-survey. The weight at age 25 years was self-reported. Body height, body weight and waist circumference at baseline survey (2004-2008) and re-survey (2013-2014) were analyzed. Results: The present study included 3 427 men and 6 320 women. Both body weight and waist circumference (WC) increased with age. From age 25 years to baseline survey (mean age 45.2±6.5), the mean weight change per 5-year was (1.70±2.63) kg for men and (1.27±2.10) kg for women. From baseline survey to re-survey (53.2±6.5), the mean changes per 5-year for body weight were (1.12±2.61) kg for men and (0.90±2.54) kg for women; and that for WC was (3.20±3.79) cm for men and (3.83±3.85) cm for women. Among women, low educational level was consistently associated with higher body mass index (BMI) and WC at age 25 years, baseline survey and re-survey. Among men, low educational level was associated with higher BMI at age 25 years. At baseline survey and re-survey, the educational level in men was not statistically associated with BMI; but men who completed junior or senior high school showed slight higher WC and increase of WC from baseline survey to re-survey than other male participants. Conclusions: Body weight and WC increased with age for both men and women. The associations of educational level with BMI and WC were different between men and women.

Prevalence of 'healthy lifestyle' in Chinese adults / 中华流行病学杂志

Objective: To examine the prevalence of 'healthy lifestyle' from data extracted from the China Kadoorie Biobank (CKB) of 0.5 million adults from ten areas across China. Methods: After excluding participants with self-reported histories of coronary heart disease, stroke or cancer, a total of 487 198 participants at baseline (2004-2008) and 22 604 participants at second survey (2013- 2014), were included for analysis. 'Healthy lifestyle' was defined as haing the following characteristics: a) never smoking or having stopped smoking for reasons other than illness; b) alcohol drinking <25 g/day (men)/<15 g/day (women); c) diet rich in vegetables, fruits, legumes and fish, but low in red meat; d) upper quarter of the physical activity level; e) body mass index of 18.5-23.9 kg/m(2) and waist circumstance <85 cm (men)/80 cm (women). We calculated the healthy lifestyle scores (HLS) by counting the number of all the healthy lifestyle factors, with a range from 0 to 6. Results: At baseline, prevalence rates of the above five healthy lifestyles (except physical activity) were 70.6%, 92.6%, 8.7%, 52.6% and 59.0%, respectively, with the mean HLS being 3.1±1.2. Most participants (81.4%) had2-4 healthy components, while only 0.7% (0.2% in men and 1.0% in women) of all the participants had all six healthy lifestyles. Participants who were women, at younger age, with more schooling and rural residents, were more likely to adhere to the healthy lifestyle. After ten years, the mean HLS showed a slight decrease. Conclusion: The prevalence of optimal lifestyles in Chinese adults appeared extremely low. Levels of 'healthy lifestyle' varied greatly among those populations with different socio-demographic characteristics across the ten areas in China.

Impact of menarche age on the near-term and long-term obesity of adult females / 中华流行病学杂志

Objective: To study the relationship between the age of menarche and the near-term/long-term obesity in adult women. Methods: We analyzed the baseline data of 30 895 women with complete data on menarche and body measurement that was from the China Kadoorie Biobank (CKB) study from 2004 to 2008. The age of menarche was divided into three groups: ≤12, 13-16 and ≥17 years old. Prematurity was set at age ≤12 years. Multivariate logistic regression was used to analyze the effects of menarche age on the near/long-term obesity in female adults. Results: The average menarche age of respondent appeared as (15.64±1.92) years old, with prematurity number as 1 421, accounting for 4.6% of the total numbers. Regarding the postponing of dates of birth, the age of menarche in women showed an advancing tendency. Among all the adult women under study, 803 developed near-term obesity, with the prevalence as 2.6%, while the number of long-term obesity was 3 738, accounting for 12.1%. Refining factors of age, lifestyle, menopausal status, hypertension and diabetes showed that the menarche age was related to the risks of both short-term and long-term obesity in women and the ORs (95%CI) were 2.45 (1.74-3.45) and 1.99 (1.69-2.34), respectively. There was no multiplicative interaction shown between the menarche age and menopausal status on long-term obesity (P=0.324). Conclusion: Premature menarche appeared a risk factor for near-term/long-term obesity in adult females.

Family history and risk of coronary heart disease / 中华流行病学杂志

Objective: To evaluate the association of family history with risk of major coronary events (MCE) and ischemic heart disease (IHD). Methods: After excluding participants with heart disease, stroke or cancer at baseline survey, a total of 485 784 participants from the China Kadoorie Biobank, who had no missing data on critical variables, were included in the analysis. Cox regression analysis was used to estimate the hazard ratios (HR) and 95% CI. Subgroup analyses were performed according to the baseline characteristics. Results: During a median of 7.2 years of follow-up, we documented 3 934 incident cases of MCE and 24 537 cases of IHD. In multivariable-adjusted models, family history was significantly associated with risk of MCE and IHD. The adjusted HRs (95%CI) were 1.41 (1.19-1.65) and 1.25 (1.18-1.33), respectively. History of disease among siblings was more strongly associated with early-onset MCE than parental history (HR=2.97, 95%CI: 1.80-4.88). Moreover, the association of family history with MCE and IHD was stronger in persons who were overweight or obesive, and the association between family history and MEC was stronger in smokers. Conclusion: This large-scale, prospective study indicated that family history was an independent risk factor for MCE and IHD in China. The intervention targeting major known lifestyle risk factors and the management of chronic diseases should be strengthened for Chinese population, especially for the individuals with family history were at high risk.

Application of generalized estimation equations to establish prediction equation for tuberculosis drug resistance in Zhejiang province / 中华流行病学杂志

Objective: Drug-resistant tuberculosis (TB) may be resistant to one or multiple anti-TB drugs. We used generalized estimation equations to analysis the risk factors of drug-resistant TB and provide information for the establishment of a warning model for these non-independent data. Methods: The drug susceptibility test and questionnaire survey were performed in sputum positive TB patients from 30 anti TB drug-resistance surveillance sites in Zhejiang province. The generalized estimation model was established by the GENMOD module of SAS, with resistance to 13 kinds of anti-TB drugs as dependent variables and possible influencing factors, such as age, having insurance, HBV infection status, and history of anti-TB drug intake, as independent variables. Results: In this study, the probability of drug resistance at baseline level was 20.26%. Age, insurance, whether being co-infected with HBV, and treatment history or treatment withdrawal were statistically significantly correlated with anti-TB drug resistance. The prediction equation was established according to the influence degree of the factors mentioned above on drug resistance. Conclusion: The generalized estimation equations can effectively and robustly analyze the correlated binary outcomes, and thus provide more comprehensive information for drug resistance risk factor evaluation and warning model establishment.

Levels of calcaneus bone mineral density in adults from 10 regions of China / 中华流行病学杂志

Objective: To describe the regional and population-related differences in calcaneus bone mineral density (BMD) across ten regions of China. Methods: Based on the results: from the second Re-survey of China Kadoorie Biobank project, in which 5% of the surviving participants were interviewed during 2013-2014 and 24 677 participants aged 38-87 years were included in the study. We excluded those people with missing data for BMD and important variables. Calcaneus BMD was measured using the quantitative ultrasound bone densitometer. We analyzed four indexes, including broadband ultrasound attenuation (BUA), speed of sound (SOS), stiffness index (SI), and T score. Results The average calcaneus BMDs of the present population were: BUA (109.7±12.6) dB/MHz, SOS (1 554.7±45.6) m/s, SI (88.3±18.8), T score (-0.74±1.28). Urban residents showed higher calcaneus BMD, so as in men. The calcaneus BMD decreased by age, with a larger decline seen in women. Current smokers and postmenopausal women presented lower calcaneus BMD, while in those who frequently drank milk or yogurt or being physically more active, had higher calcaneus BMD. Conclusion: Calcaneus BMD varied greatly among people from the ten regions of CKB study and among participants having different demographic characteristics, lifestyle behaviors or health conditions.

Association between central obesity and risk for heart disease in adults in China: a prospective study / 中华流行病学杂志

Objective: To understand the association between central obesity, assessed by waist circumference, and the risks for ischemic heart disease (IHD), major coronary event (MCE), and IHD death. Methods: After excluding participants with heart disease, stroke, cancer, COPD, and diabetes at baseline survey, we included a total of 428 595 participants from the China Kadoorie Biobank for the analysis. The baseline survey was conducted from June 2004 to July 2008. We used Cox proportional hazards model to estimate the hazard ratio (HR) and 95%CI. Results: During an average 9.1 years of follow-up (3 803 637 person-years), we documented 26 900 incident cases of IHD, 4 320 cases of MCE, and 2 787 of deaths from IHD. After adjustment for possible confounders and BMI, central obesity was found to be associated with increased risks for IHD, MCE, and IHD death. The adjusted HRs (for the participants who had waist circumference of 85.0-89.9 cm in men and 80.0-84.9 cm in women were 1.13 (95%CI: 1.09-1.17) for IHD, 1.15 (95%CI: 1.05-1.26) for MCE and 1.11 (95%CI: 0.98-1.24) for IHD death. The respective HRs for those central obese participants (men ≥90.0 cm, women ≥85.0 cm) were 1.29 (95%CI: 1.24-1.34), 1.30 (95%CI: 1.17-1.44) and 1.32 (95%CI: 1.16-1.51). Further stratification analysis according to BMI showed that the risks for incident IHD, MCE, and IHD death increased along with the increase of waist circumference even in the participants with normal weight. Conclusion: This large-scale prospective study revealed that central obesity was an independent risk factor for IHD in adults in China, and the risk of IHD would increase with the increase of waist circumference.

Association between tea drinking and stroke in adults in Zhejiang province: a prospective study / 中华流行病学杂志

Objective: To prospectively explore the association between tea drinking and incidence of stroke of adults of Zhejiang province. Methods: After excluding participants with heart disease, stroke, cancer and diabetes at baseline study, 53 916 participants aged 30-79 years in the China Kadoorie Biobank (CKB) study from Tongxiang were included for final analysis. Cox regression model was used to estimate the hazard ratio (HR) for the association of tea drinking with incident stroke. Results: The main type of drinking tea was black tea (79.78%), followed by green tea (20.08%). Of the 53 916 participants, the proportion of participants who drank tea at least once per week was 31.27%. The corresponding proportions for men and women were 60.24% and 10.30%, respectively. Among 391 512 person-years of the follow-up program (median 7.26 years), a total of 1 487 men and 1 769 women were diagnosed with stroke. After adjusting for socio-demographic status, lifestyle, BMI, waist circumference, and systolic blood pressure, HR for incident stroke decreased with the increase of daily average tea consumption amount (P=0.000 6). Compared with participants who did not drink tea weekly, the HRs for incident stroke in those consuming tea 0.1-, 3.0- and ≥5.0 g/d were 0.93 (95%CI: 0.85-1.00), 0.88 (95%CI: 0.77-0.99) and 0.79 (95%CI: 0.69-0.89), respectively. The HRs for incident stroke in smokers and non-smokers who consumed tea ≥5.0 g/d were 0.71 (95%CI: 0.59-0.86) and 0.97 (95%CI: 0.77-1.21), respectively, compared with current smokers and non-smokers who did not drink tea weekly (P=0.040 0). The corresponding HRs for alcohol drinkers and non-drinkers were 0.96 (95%CI: 0.76-1.22) and 0.70 (95%CI: 0.58-0.84), respectively (P=0.040 0). The corresponding HRs for central obese persons and non-central obese persons were 0.60 (95%CI: 0.44-0.81) and 0.86 (95%CI: 0.73-1.01), respectively (P=0.040 0). Conclusion: Tea drinking had an effect on reducing the possibility of incident stroke, especially among those who were current smokers, non-alcohol drinkers and central obese.

Effect of famine exposure on the risk of chronic disease in later life among population in Harbin / 中华流行病学杂志

Objective: To study the relations between famine exposure and the risk of chronic diseases as diabetes mellitus, obesity, hypertension, coronary heart disease and stroke in the population of Harbin. Methods: Our data was collected from the baseline survey-the China Kadoorie Biobank project (CKB) in Harbin. Retrospective cohort study design was used. Related risks on chronic diseases including diabetes mellitus, obesity, hypertension, coronary heart disease and stroke, were compared among the famine exposed or non-exposed people, respectively by logistic analysis method. Results: After adjusted for factors as age, sex, physical activity, smoking, alcohol intake, diet, family history of diseases, it appeared that the factor 'famine exposure' had increased the risks of diseases as obesity (OR=1.204, 95%CI: 1.104-1.313, P<0.01), hypertension (OR=1.315, 95%CI: 1.210-1.429, P<0.01) and coronary heart disease (OR=1.495, 95%CI: 1.369-1.632, P<0.01). The lower the age of population being exposed to famine, the greater the risk of the development of all kinds of chronic diseases. Conclusions: Famine exposure appeared a risk factor for obesity, hypertension, and coronary heart disease. It is of great significance to ensure the life-long nutrition of the people, especially in the early and adolescent stages, to prevent obesity, hypertension, and coronary heart disease in their later lives.

Epidemiological characteristics of household fuel use in 10 areas of China / 中华流行病学杂志

Objective: To describe the characteristics of cooking and heating fuel use in participants from the China Kadoorie Biobank (CKB) study. Methods: The CKB study recruited 512 891 adults from 10 areas in China during 2004-2008. Information on cooking fuel and heating fuel was collected using a questionnaire in baseline survey. The proportions of various fuels used in different areas, in different populations, and at different time points were calculated and compared. Results: Overall, 52.1% participants used solid fuel for cooking or heating. Rural areas had higher prevalence of solid fuel use than urban areas. The percentage of participants using solid fuel for cooking was 36.1% (coal 20.1%, wood/charcoal 16.0%); The percentage of participants using solid fuel for heating was 36.7% (coal 22.7%, wood/charcoal 14.0%). The prevalence of solid fuel use and the fuel type mainly used varied widely across 10 areas. The proportion of clean fuel use was lower in less-educated and lower-income people. Household coal and wood/charcoal use showed a declining trend, which was more remarkable in urban areas. Conclusion: There are still a large number of rural residents and people with low income relying on solid fuel in China, which is a serious public health concern.

Associations between family history of major chronic diseases and healthy lifestyles in Chinese adults / 中华流行病学杂志

Objective: To examine the associations between family history of major chronic diseases and healthy lifestyle in adults in China. Methods: Data were from the baseline and second survey of China Kadoorie Biobank study, which were conducted during 2004-2008 and 2013-2014, respectively. After excluding participants with self-reported histories of coronary heart disease, stroke, cancer or diabetes, a total of 461 213 adults from baseline survey and 20 583 adults from second survey were included in the current study. Participants who reported a family history of acute myocardial infarction, stroke, cancer, or diabetes of any first-degree relative (i.e., biological father, mother, or siblings) were defined as having a family history of major chronic diseases. Healthy lifestyles were defined as current nonsmoking, non-excessive alcohol drinking, eating vegetables and fruits daily, upper quarter of physical activity level, body mass index (BMI) of (18.5-23.9) kg/m(2), and waist- to-hip ratio (WHR) <0.90 (man)/<0.85 (women). Results: At baseline survey, 36.5% of the participants had family history of major chronic diseases. Proportions of the above six healthy lifestyles were 70.5%, 93.0%, 18.0%, 25.0%, 53.4%, and 43.5%, respectively. Compared with participants without family history, the proportions of current nonsmoking, non-excessive drinking, normal BMI, and normal WHR were lower in participants with family history of major chronic diseases, while the proportions of eating vegetables and fruits daily, and being physically active, were higher. In general, the absolute differences in these proportions between participants with and without a family history were only slight. Similar results were observed when other family history status (the type or number of disease, the category or number of affected family members) were analysed. The association between family history of major chronic diseases and healthy lifestyles was consistently observed in the second survey 10 years later. Conclusion: In Chinese population, adults with family history of major chronic diseases did not adopt healthier lifestyles.

HIV-1 gene subtypes among newly reported HIV/AIDS cases in two border areas of Yunnan province / 中华流行病学杂志

Objective: To explore the features of distribution on HIV-1 gene subtypes among newly reported HIV/AIDS cases in the border areas of Yunnan province. Methods: A total of 233 newly reported HIV/AIDS cases aged 18 or more were consecutively included in the border counties of Dehong Dai and Jingpo autonomous prefecture (Dehong prefecture), Honghe Hani and Yi autonomous prefecture (Honghe prefecture) of Yunnan province from November 2015 to October 2016. HIV-1 RNA was extracted with pol and env genes amplified. HIV-1 gene subtypes were determined through phylogenetic analysis. Results: A total of 146 out of 233 specimens were genotyped successfully. HIV-1 was found to have had 8 gene subtypes in Dehong prefecture, with the unique recombinant forms (URFs) as the predominant (52.8%, 57/108) type, including 56.8% (21/37) of the cases with Chinese ethnicity and another 50.7% (36/71) were Myanmar citizens. Four HIV-1 gene subtypes were detected in Honghe prefecture, with CRF01_AE as predominant (71.1%, 27/38), including 81.0% (17/21) Vietnamese and 58.8% (10/17) Chinese. Differences on the distribution of HIV-1 gene subtypes were seen statistically significant between Dehong prefecture and Honghe prefecture (χ(2)=61.072, P<0.001). Conclusions: The distribution of HIV-1 gene subtypes showed big difference in the two border areas of Yunnan province, suggesting that both Chinese or non- Chinese citizens living in the area should be taken good care of, in terms of HIV/AIDS prevention and control.

Detection of Rare Mutations in EGFR-ARMS-PCR-Negative Lung Adenocarcinoma by Sanger Sequencing

PURPOSE: This study aimed to identify potential epidermal growth factor receptor (EGFR) gene mutations in non-small cell lung cancer that went undetected by amplification refractory mutation system-Scorpion real-time PCR (ARMS-PCR). MATERIALS AND METHODS: A total of 200 specimens were obtained from the First Affiliated Hospital of Guangzhou Medical University from August 2014 to August 2015. In total, 100 ARMS-negative and 100 ARMS-positive specimens were evaluated for EGFR gene mutations by Sanger sequencing. The methodology and sensitivity of each method and the outcomes of EGFR-tyrosine kinase inhibitor (TKI) therapy were analyzed. RESULTS: Among the 100 ARMS-PCR-positive samples, 90 were positive by Sanger sequencing, while 10 cases were considered negative, because the mutation abundance was less than 10%. Among the 100 negative cases, three were positive for a rare EGFR mutation by Sanger sequencing. In the curative effect analysis of EGFR-TKIs, the progression-free survival (PFS) analysis based on ARMS and Sanger sequencing results showed no difference. However, the PFS of patients with a high abundance of EGFR mutation was 12.4 months [95% confidence interval (CI), 11.6−12.4 months], which was significantly higher than that of patients with a low abundance of mutations detected by Sanger sequencing (95% CI, 10.7−11.3 months) (p < 0.001). CONCLUSION: The ARMS method demonstrated higher sensitivity than Sanger sequencing, but was prone to missing mutations due to primer design. Sanger sequencing was able to detect rare EGFR mutations and deemed applicable for confirming EGFR status. A clinical trial evaluating the efficacy of EGFR-TKIs in patients with rare EGFR mutations is needed.

Adsorption of methyl tert-butyl ether using granular activated carbon: equilibrium and kinetic analysis

The adsorption of methyl tert-butyl ether by granular activated carbon was investigated. The experimental data were analyzed using the Freundlich isotherm and the Langmuir isotherm. Although equilibrium data were found to follow Freundlich isotherm model, it were fitted better by the Langmuir model with a maximum adsorption capacity of 204.1 mg/g. The kinetic data obtained at different concentrations were analyzed to predict the constant rate of adsorption using three common kinetic models: pseudo-first-order, pseudo-second-order equation and intraparticle diffusion equation. The pseudo-second-order model was suitable for describing the adsorption kinetics for the removal of methyl tert -butyl ether from aqueous solution onto granular activated carbon. Both the Lagergren first-order rate constant k[1] and pseudo-second-order rate constant k2 decrease with increasing initial concentrations of methyl tert-butyl ether and the intraparticle diffusion rate constant k[p] shows the reverse characteristic. Analysis of sorption data using a boyd plot confirmed that external mass transfer is the main rate-limiting step at the initial stage of adsorption. Results illustrate that granular activated carbon is an effective adsorbent for methyl tert-butyl ether and also provide specific guidance into adsorption of methyl tert-butyl ether on granular activated carbon in contaminated groundwater

Cleavage of Bcl-2 Protein by Activated Caspase-3 Is Associated with Inactivation of Lyn(p53/56) Kinase Activity in Human M-07e Leukemic Cells during Apoptosis / 中国实验血液学杂志

The growth of M-07e human megakaryocytic leukemia cells is strictly dependent on GM-CSF. In M-07e cells, the GM-CSF receptor (GM-CSF R) is composed of two subunits: a low affinity alpha subunit and a phosphorylated beta subunit, which is constitutively linked to lyn(53/56) protein tyrosine kinase. In this study, The role of lyn kinase in regulating TGF-beta 1-induced apoptosis in M-07e cells was examined. The removal of rhGM-CSF from the culture medium resulted in down-regulation of lyn kinase activity, followed by growth inhibition and programmed cell death. Apoptosis of M-07e cells was accompanied with a massive cleavage of Bcl-2 and Bax proteins into shortened fragments with molecular mass of 22 kD and 18 kD, respectively. Using specific inhibitors, the cleavage of Bcl-2, but not Bax, was found to be processed through activated caspase-3 (CPP32), which is abundantly expressed in M-07e cells. TGF-beta 1 inhibited rhGM-CSF-stimulated cell growth and promoted apoptosis in M-07e cells with a pattern identical to that induced by rhGM-CSF depletion, which included massive cleavage of both Bcl-2 and Bax proteins and inactivation of lyn kinase activity. TGF-beta 1 did not affect the levels of lyn protein or the beta-subunit, neither did it block the interaction between these two components. Also, TGF-beta 1 treatment did not diminish the expression of the alpha subunit in M-07e cells. Our results showed that TGF-beta 1 inhibits cell proliferation and promotes apoptosis in M-07e cells by inactivating the GM-CSF R-associated lyn kinase activity. Further, This study showed that Bcl-2 cleavage by activated CPP32 is a naturally occurring event associated with apoptosis, which is under the regulation of lyn kinase activation.