Dietary Exposure to Benzyl Butyl Phthalate in China.

OBJECTIVE: Benzyl butyl phthalate (BBP) is a plasticizer used in food contact materials. Dietary exposure to BBP might lead to reproduction and developmental damages to human. The present paper was aimed to assess the health risk of BBP dietary exposure in Chinese population. METHODS: The BBP contents were detected in 7409 food samples from 25 food categories by gas chromatography-mass spectrometry operated in selected ion monitoring (SIM) mode. The dietary exposures of BBP in different age and sex groups were estimated by combining the content data with food consumption data derived from 2002 China National Nutrient and Health Survey, and evaluated according to the tolerable daily intake (TDI) of BBP established by European Food safety Agency. RESULTS: It was found that BBP was undetectable in most samples and the highest level was 1.69 mg/kg detected in a vegetable oil sample. The average dietary exposure of BBP in people aged ⋝2 years was 1.03 µg/kg bw per day and the highest average exposure was found in 2-6 years old children (1.98 µg/kg bw per day). The BBP exposure in 7-12 months old children excessed 10% of tolerable daily intake (TDI) in worst scenario. . CONCLUSION: The health risk of BBP dietary exposure in Chinese population is low and, considering BBP alone, there is no safety concern.

Trans Fatty Acid Levels in Foods and Intakes among Population Aged 3 Years and above in Beijing and Guangzhou Cities, China.

OBJECTIVE: To understand the dietary intake levels of trans fatty acids (TFA) in a Chinese population and establish a basis for health risk assessment of trans fatty acids. METHODS: The TFA contents data of 2613 food items and food consumption data of 10,533 people aged 3 years and above in two large cities in China were matched and a simple assessment method was used to estimate the distribution of dietary TFA intake. RESULTS: The mean content of TFA was highest in margarine (1.68 ± 0.83 g/100g), followed by chocolate and candy (0.89 ± 2.68 g/100g), edible vegetable oils (0.86 ± 0.82 g/100g), milk (0.83 ± 1.56 g/100g), and bakery foods (0.41 ± 0.91 g/100g). TFA intake accounted for 0.34%, 0.30%, 0.32%, and 0.29% of the total energy intake in the 3-6, 7-12, 13-17, and ⋝18 year age groups, respectively. Of the populations studied, 0.42% demonstrated TFA intakes (as percentage of energy intake) greater than 1%. The main sources of dietary TFA intake were edible vegetable oils, milk, mutton, and beef, and baked foods, which accounted for 49.8%, 16.56%, 12.21%, and 8.87%, respectively. CONCLUSION: The current intake of TFA among people in two cities did not appear to be of major health concern regarding the threshold of TFA intake as the percentage of total energy recommended by the World Health Organization. Because most TFA were derived from industrially processed foods, the government should reinforce nutrition labeling and regulate food producers to further reduce TFA in food and to provide scientific instruction for consumers to make sound choices.

Methodology and application for health risk classification of chemicals in foods based on risk matrix.

The method has been developed to accurately identify the magnitude of health risks and provide scientific evidence for implementation of risk management in food safety. It combines two parameters including consequence and likelihood of adverse effects based on risk matrix. Score definitions and classification for the consequence and the likelihood of adverse effects are proposed. The risk score identifies the intersection of consequence and likelihood in risk matrix represents its health risk level with different colors: 'low', 'medium', 'high'. Its use in an actual case is shown.

Endocrine disruption of cadmium in rats using the OECD enhanced TG 407 test system.

OBJECTIVE: To evaluate the endocrine disrupting effects of cadmium (Cd) using OECD enhanced TG407 test guideline. METHODS: Sprague-Dawley (SD) rats were randomly divided into six groups and accordingly administered with 0, 1, 2.5, 5, 10, 20 mg/kg•BW/day of Cd by gavage for 28 days. Body weight, food consumption, hematology, biochemistry, sex hormone levels, urinary ß2-microglobulin, organ weights and histopathology and estrous cycle were detected. RESULTS: Cd could significantly decrease animals' body weight (P<0.05). Serum luteinizing hormone (LH) at 10-20 mg/kg•BW groups and testosterone (T) at 2.5 and 10 mg/kg•BW groups decreased significantly (P<0.05). However, no statistically significant change was found in urinary ß2-microglobulin among Cd-treatment groups (P>0.05). Endpoints related to female reproduction including uterus weight and histopathological change at 10-20 mg/kg•BW groups showed significant increase (P<0.05). While among male rats in 2.5, 10, 20 mg/kg•BW groups, weight of prostate, thyroids, and seminal vesicle glands significantly decreased (P<0.05). Moreover, no histopathological change was observed in kidney. CONCLUSION: Results suggested that Cd can cause endocrine disrupting effects in SD rats. Comparing with possible renal toxicity of Cd, its toxicity on endocrine system was more sensitive.

The Effect and Mechanism of Fructus lycii on Improvement of Exercise Fatigue Using a Network Pharmacological Approach with in vitro Experimental Verification.

Objective: This study aimed to investigate the effect and underlying mechanism of Fructus lycii in improving exercise fatigue. Methods: A network pharmacological approach was used to explore potential mechanisms of action of Fructus lycii. Skeletal muscle C2C12 cells and immunofluorescence were employed to verify the effect and mechanism of the representative components in Fructus lycii predicted by network pharmacological analysis. Results: Six potential active components, namely quercetin, ß-sitosterol, stigmasterol, 7-O-methylluteolin-6-C-beta-glucoside_qt, atropine, and glycitein, were identified to have potency in improving exercise fatigue via multiple pathways, such as the PI3K-Akt, neuroactive ligand-receptor interaction, IL-17, TNF, and MAPK signaling pathways. The immunofluorescence results indicated that quercetin, a significant active component in Fructus lycii, increased the mean staining area of 2-NBDG, TMRM, and MitoTracker, and decreased the area of CellRox compared to the control. Furthermore, the protein expression levels of p-38 MAPK, p-MAPK, p-JNK, p-PI3K, and p-AKT markedly increased after quercetin treatment. Conclusion: Fructus lycii might alleviate exercise fatigue through multiple components and pathways. Among these, quercetin appears to improve exercise fatigue by enhancing energy metabolism and reducing oxidative stress. The PI3K-AKT and MAPK signaling pathways also appear to play a role in this process.

Bioaccessibility and bioavailability assessment of cadmium in rice: In vitro simulators with/without gut microbiota and validation through in vivo mouse and human data.

Assessing the bioaccessibility and bioavailability of cadmium (Cd) is crucial for effective evaluation of the exposure risk associated with intake of Cd-contaminated rice. However, limited studies have investigated the influence of gut microbiota on these two significant factors. In this study, we utilized in vitro gastrointestinal simulators, specifically the RIVM-M (with human gut microbial communities) and the RIVM model (without gut microbial communities), to determine the bioaccessibility of Cd in rice. Additionally, we employed the Caco-2 cell model to assess bioavailability. Our findings provide compelling evidence that gut microbiota significantly reduces Cd bioaccessibility and bioavailability (p<0.05). Notably, strong in vivo-in vitro correlations (IVIVC) were observed between the in vitro bioaccessibilities and bioavailabilities, as compared to the results obtained from an in vivo mouse bioassay (R2 = 0.63-0.65 and 0.45-0.70, respectively). Minerals such as copper (Cu) and iron (Fe) in the food matrix were found to be negatively correlated with Cd bioaccessibility in rice. Furthermore, the results obtained from the toxicokinetic (TK) model revealed that the predicted urinary Cd levels in the Chinese population, based on dietary Cd intake adjusted by in vitro bioaccessibility from the RIVM-M model, were consistent with the actual measured levels (p > 0.05). These results indicated that the RIVM-M model represents a potent approach for measuring Cd bioaccessibility and underscore the crucial role of gut microbiota in the digestion and absorption process of Cd. The implementation of these in vitro methods holds promise for reducing uncertainties in dietary exposure assessment.

[Applicability of thresholds of toxicological concern in the chronic dietary risk assessment of transformation products of pesticide active substance].

OBJECTIVE: To establish the threshold of toxicological concern(TTC) approach and to apply it in the risk assessment of metabolites, degradation and reaction products of pirimicarb. METHODS: TTC decision tree approach based on Cramer classification was established and Lazar software was used to predict the genotoxicity of the seven transformation products of pirimicarb, namely, R34836, R34885, R35140, R31805, R34865, R16210 and R16192. Dietary exposure in general population as well as in six age population groups was estimated by using data from the Chinese National Nutrition and Health Survey and pirimicarb residue data from national chemical surveillance data in 2011. TTC decision tree approach was used for risk assessment and the exposure was compared with the corresponding TTC values. RESULTS: Of the seven transformations of pirimicarb active substance, namely, R34836, R34885, R35140, R31805, R34865, R16210 and R16192, the maximum dietary exposure of mean and large portion(P 97.5) were all belong to 2-6 age group. The mean exposures of the seven transformation products for 2-6 age group,were 0.0290, 0.0207, 0.0015, 0.0320, 0.0005, 0.6918 and 0.1274 µg/kg,respectively, and the corresponding P 97.5 exposures were 0.0817,0.0581,0.0042,0.0900,0.0014, 1.9459 and 0.3585 µg/kg. Besides, the mean and P 97.5 exposure of R16210 for 2-6 age group was the largest,which were 0.6918 and 1.9459 µg/kg, accounting for 46.12% and 129.73% of the TTC threshold,respectively. CONCLUSION: TTC decision tree approach is a useful tool for prior screening and primary risk assessment of the transformation products of pesticide active substance.

[Development of a model diets for consumers with high exposure to food chemicals].

OBJECTIVE: To develop and verify a model diet for consumers with high exposure to food chemicals. METHODS: Based on the assumption that a person might consume average amounts of several different foods but only two or three at high levels, a model diet were put forward to calculate the high exposures to certain food chemical.Important parameters of this model were selected by comparing the outputs of this model with those of a reference model-semi-probabilistic model that is based on individual data. The concentration data of lead, cadmium and mercury (45 832, 43 862 and 25 243 samples respectively) from the national risk surveillance for chemical contaminations and harmful factors (2011), and the consumption data from the national survey on nutrition and health status in Chinese population (2002) were used in this model optimization process. The final model was verified using concentration data of eight chemical contaminations from national surveillance database of 2010. RESULTS: When 90, 95 and 97.5 percentile exposure being calculated under the conditions that 7, 12, 20 and 30 food categories was used respectively, the model containing two high consumption foods (2+x model) got results lower than the reference values (the relative deviation < 0) , the model containing three high consumption foods (3+x model) got results higher than the reference values (the relative deviation > 0 ),but the relative deviation of the two models were both within 20%. The verification results showed that the dietary exposure results of 8 food contaminations got from 3+x model were all higher than and(or) close to those got from semi-probabilistic model, and the relative deviations were between -5% and 25%. CONCLUSION: The 3+x model diet can fulfill the demands of "conservative" and "accurate" on exposure assessment model, and can give reliable estimations of high exposure to food chemicals occurred in various food categories.

A modified RBL-2H3 mediator release assay for the detection of polyclonal IgE antibody.

RBL-2H3 mediator release assay, developed for specific IgE screening studies, was not as sensitive as passive cutaneous anaphylaxis (PCA) assay in the polyclonal antibody detection. In the present investigation, the detection sensitivity of RBL-2H3 assay was elevated by modifying the experiment protocols from choosing the proper releasing medium and optimizing the sensitization manner. The polyclonal antibody was generated from Brown Norway (BN) rats exposed to Ovalbumin (OVA). In contrast to Tyrode buffer A, RBL-2H3 cells cultured in DMEM had a lower spontaneous secretion and a higher response to antigen stimulation, both of which could help to increase the detection sensitivity. The rat sera used in the sensitization process should be diluted appropriately to avoid the proliferation-promoting effect on RBL-2H3 cells. The results of the kinetics of sensitization showed that prolonging the sensitization time and then reculturing the cells in IgE free medium for a further 24 h after the removal of rat sera could reach a marked increase in the degree of sensitization. The highest anti-OVA antibody titer detected by the modified RBL-2H3 assay was 4096, while PCA assay was 1024. These data provide evidence that the modified RBL-2H3 mediator release assay has a promising prospect in the determination of the biologic activity of polyclonal antibody.

Analysis of furan and its major furan derivatives in coffee products on the Chinese market using HS-GC-MS and the estimated exposure of the Chinese population.

The current study analysed concentrations of furan and its derivatives in coffee products commercially available in China based on an improved headspace gas chromatography-mass spectrometry (HS-GC-MS) method and estimated health risks. A total of 101 samples of coffee products on the Chinese market was analysed. Furan (98%, ND-6569 µg/kg) and 2-methylfuran (100%, 2-29639 µg/kg) were the compounds with the highest concentrations and detection rates in coffee products. The mean dietary exposure of Chinese consumers to furan and the sum of furan, 2-methylfuran and 3-methylfuran in coffee products was 0.09 and 0.46 µg/kg bw/day, respectively. For the neoplastic effects of furan, the margin of exposure (MOE) was 14,556 for the mean dietary exposure of consumers. For the non-neoplastic effects of furan, MOEs were 711 and 139 for furan and the sum of furan, 2-methylfuran and 3-methylfuran, respectively. Overall, a health concern is indicated for coffee consumers with MOEs below 10000.

Dietary iodine intake in the Chinese population.

OBJECTIVE: To evaluate dietary iodine intake and its potential risks among the Chinese population. METHODS: Individual dietary iodine intake was calculated using food consumption data multiplying by iodine concentration in foods, table salt and drinking water, followed by summing, and then compared with the corresponding age-specific reference values, including Upper Intake Level (UL) and Recommended Nutrient Intake (RNI). RESULTS: In areas with water iodine concentration (WI) lower than 150 µg/L, 80.8% of residents had iodine intake between the RNI and UL, 5.8% higher than UL, and the remaining (13.4%) lower than RNI if iodized salt was consumed. However, in the uniodized salt consumption scenario, only 1.0% of residents between RNI and UL, 1.4% higher than UL, and a large part of residents (97.6%) lower than RNI. In areas with WI higher than 150 µg/L, all residents had iodine intake between RNI and UL if iodized salt was consumed, except 10.5% and 24.9% of residents higher than UL in areas with WI at 150-300 µg/L and higher than 300 µg/L respectively. However, in the uniodized salt consumption scenario, only 1.5% and 1.7% of residents had higher iodine intake than UL respectively. CONCLUSION: The findings suggested that in general, the dietary iodine intake by the Chinese population was appropriate and safe at the present stage. People in areas with WI lower than 150 µg/L were more likely to have iodine deficiency. While people in areas with WI higher than 150 µg/L were more likely to have excessive iodine intake if iodized salt was consumed.

Baicalin attenuates focal cerebral ischemic reperfusion injury through inhibition of nuclear factor κB p65 activation.

Baicalin is a flavonoid compound purified from plant Scutellaria baicalensis Georgi. We aimed to evaluate the neuroprotective effects of baicalin against cerebral ischemic reperfusion injury. Male Wistar rats were subjected to middle cerebral artery occlusion (MCAO) for 2 h followed by reperfusion for 24 h. Baicalin at doses of 50, 100 and 200 mg/kg was intravenously injected after ischemia onset. Twenty-four hours after reperfusion, the neurological deficit was scored and infarct volume was measured. Hematoxylin and eosin (HE) staining was performed to analyze the histopathological changes of cortex and hippocampus neurons. We examined the levels of NF-κB p65 in ischemic cortexes by Western blot analysis and RT-PCR assay. The results showed that the neurological deficit scores were significantly decreased from 2.0 ± 0.7 to 1.2 ± 0.4 and the volume of infarction was reduced by 25% after baicalin injection. Histopathological examination showed that the increase of neurons with pycnotic shape and condensed nuclear in cortex and hippocampus were not observed in baicalin treated animals. Further examination showed that NF-κB p65 in cortex was increased after ischemia reperfusion injury, indicating the molecular mechanism of ischemia reperfusion injury. The level of NF-κB p65 was decreased by 73% after baicalin treatment. These results suggest that baicalin might be useful as a potential neuroprotective agent in stroke therapy. The neuroprotective effects of baicalin may relate to inhibition of NF-κB p65.

Estrogen receptor α and ß expressions in hypothalamus-pituitary-ovary axis in rats exposed lactationally to soy isoflavones and bisphenol A.

OBJECTIVES: This paper aims to investigate the uterotrophic activities of lactational exposure to combination of soy isoflavones (SIF) and bisphenol A (BPA) and to examine estrogen receptor α (ERα) and estrogen receptor ß (ERß) expressions in hypothalamus-pituitary-ovary axis and uterus. METHODS: Maternal rats that were breeding about 8 litters were randomly divided into four groups with seven dams in each group. Dams in different treatment groups received corn oil (control), 150 mg/kg BW of SIF, 150 mg/kg BW of BPA or combination of 150 mg/kg BW of SIF and 150 mg/kg BW of BPA, respectively, from postnatal day 5 to 11 (PND5-11) by gavage. On PND12 and PND70, 10 female litters were killed and hypothalamus, pituitary, ovary and uterus were collected. ERα and ERß expressions in these organs were detected with Western blotting assay. And vaginal opening time and estrus cycle were examined in animals fed for PND70. RESULTS: On PND12, the relative uterine weight of rats treated with ISF or BPA or their combination was significantly higher than that of untreated rats (P<0.05). But the relative uterine weight of rats in the co-exposure group was slightly lower than that in the group only exposed to SIF or BPA. On PND 70, however, the relative uterine weight in each treatment group was not statistically different from that in the control group (P>0.05). Vaginal opening time and estrus cycle in groups treated with SIF or BPA or their combination were similar to those in the control group (P>0.05). Exposure to SIF or BPA or their combination could up-regulate or down-regulate ERα and ERß expressions in hypothalamus, pituitary, ovary and uterus on PND12 and PND70. These regulation patterns for ERα and ERß were different in different organs at different time points. CONCLUSION: Lactational exposure to ISF or BPA or their combination could induce uterotrophic responses in neonate rats, which disappeared in later life. But these data fail to suggest a possibility for synergic actions between SIF and BPA. It was also demonstrated that the uterotrophic effects of SIF and BPA exposure might, at least, involve modification of ERα or ERß expressions in the hypothalamus-pituitary-ovary axis.

[Cardiovascular events in patients with chronic kidney disease].

OBJECTIVE: Cardiovascular event is common and is an important cause of death for patients with chronic kidney disease (CKD). The purpose of current study is to analyze the related risk factors of cardiovascular event in patients with CKD. METHODS: Clinical data from 557 patients with CKD (stage III-V) who hospitalized in our hospital from Jan 2006 to Dec 2006 were retrospectively analyzed focusing on the risk factors of cardiovascular event and their impacts on death. RESULTS: Among the 557 patients with CKD, 332 were male and 225 were female. There were totally 163 patients (163/557, 29.3%) suffered from cardiovascular events during hospitalization. The independent risk factors for cardiovascular event were age, history of coronary heart disease, anemia and fasting blood glucose level. The mortality was significantly higher in patients suffered from cardiovascular events than that in patients without cardiovascular events (9.82% vs. 2.28%, P<0.001). CONCLUSIONS: For patients with CKD, anemia is another independent risk factor for cardiovascular events besides traditional risk factors and the mortality was significantly higher in CKD patients with cardiovascular events compared to CKD patients without cardiovascular events.

MiR-214 Regulates the Human Hair Follicle Stem Cell Proliferation and Differentiation by Targeting EZH2 and Wnt/ß-Catenin Signaling Way In Vitro.

miR-214 plays a major role in the self-renewal of skin tissue. However, whether miR-214 regulates the proliferation and differentiation of human hair follicle stem cells (HFSCs) is unknown. Primary HFSCs were isolated from human scalp skin tissue, cultured, and identified using flow cytometry. An miR-214 mimic and inhibitor were constructed for transfection into HFSCs. The MTS and colony formation assays examined cell proliferation. Immunofluorescence detected the localization and expression levels of TCF4, ß-catenin, and differentiation markers. Luciferase reporter and TOP/FOP Flash assays investigated whether miR-214 targeted EZH2 and regulated the Wnt/ß-catenin signaling pathway. Western blot determined the expression levels of enhancer of zeste homolog 2 (EZH2), Wnt/ß-catenin signaling-related proteins, and HFSC differentiation markers in cells subjected to miR-214 transfection. miR-214 expression was remarkably decreased during the proliferation and differentiation of HFSCs into transit-amplifying (TA) cells. Downregulation of miR-214 promotes the proliferation and differentiation of HFSCs. Overexpression of miR-214 led to decreased expression of EZH2, ß-catenin, and TCF-4, whereas downregulation of miR-214 resulted in increased expression of EZH2, ß-catenin, and TCF-4 as well as TA differentiation markers. Immunofluorescence assay revealed that inhibiting miR-214 triggered the entry of ß-catenin and TCF-4 into the nucleus. The luciferase reporter and TOP/FOP Flash assays demonstrated that miR-214 directly targets EZH2 and affects Wnt/ß-catenin signaling. The miR-214/EZH2/ß-catenin axis could be considered a candidate target in tissue engineering and regenerative medicine for HFSCs.

Effects of scutellarin on apoptosis induced by cobalt chloride in PC12 cells.

The present study investigated the protective effects of scutellarin on cobalt chloride (CoCl2)-induced apoptosis in PC12 cells. Incubation of PC12 cells with 500 microM CoCl2 for 24 h resulted in significant apoptosis as evaluated by the crystal violet, electron microscopy and flow cytometry assays. The increase of caspase-3 activity, decrease of Bcl-XL expression, phosphorylation of p38 mitogen-activated protein kinase (MAPK) and accumulation of intracellular reactive oxygen species (ROS) were also seen in CoCl2-treated PC12 cells. Scutellarin at 0.1, 1 and 10 microM significantly protected against the apoptotic cell death induced by CoCl2. Scutellarin decreased caspase-3 activity, increased Bcl-XL expression, inhibited p38 phosphorylation and attenuated ROS production. These results demonstrate that scutellarin can protect PC12 cells from cobalt chloride induced apoptosis by scavenging ROS, inhibiting p38 phosphorylation, up-regulating Bcl-XL expression and decreasing caspase-3 activity, and may reduce the cellular damage in pathological conditions associated with hypoxia-mediated neuronal injury.

[The effect of different loading doses of clopidogrel on platelet aggregation].

OBJECTIVE: To compare the short-term efficacy and safety of high loading dose (600 mg) clopidogrel treatment with those of routine loading dose (300 mg) in patients with acute coronary syndrome and provide evidence for planning clopidogrel treatment. METHODS: 60 patients were randomized into two groups, One group received 300 mg loading dose clopidogrel, while the other received 600 mg and both were followed by 75 mg daily thereafter. Adenosine diphosphate (ADP) (5 micromol/L and 20 micromol/L) induced platelet aggregation was examined at baseline (before administration), 2 hours and 6 hours after administration and the count of white blood cell and platelet 3 days after loading dose. The primary end points were hemorrhagic events, granulocytopenia and thrombocytopenia within 3 days after administration. RESULTS: With a high-dose agonist (20 micromol/L ADP), loading doses of clopidogrel at 300 mg and 600 mg both produced greater inhibition of baseline ADP (20 micromol/L) induced aggregation 6 hours after administration than 2 hours [group of 300 mg: (29.75+/-12.11)% vs (43.63+/-14.31)%, P<0.05. Group of 600 mg: (28.86+/-10.24)% vs (34.86+/-10.84)%, P<0.05]. Treatment with clopidogrel at 600 mg loading dose had a marked earlier effect on platelet aggregation 2 hours after administration than that of 300 mg [(34.86+/-10.84)% vs (43.63+/-14.31)%, P<0.05]. The platelet aggregation of the two groups tended towards similar at 6 hours after the procedure [(28.86+/-10.24)% vs (29.75+/-12.11)%, P>0.05]. There were no episodes of hemorrhagic events, granulocytopenia and thrombocytopenia within 3 days after the procedure. CONCLUSIONS: In Chinese patients with acute coronary syndrome platelet aggregation can be inhibited more rapidly and more effectively with clopidogrel at 600 mg loading dose when compared with that at 300 mg loading dose and the safety aspect between the two different loading doses is equivalent.

[The clinical features and outcomes of immunoglobulin light-chain amyloidosis with heart involvement].

OBJECTIVE: To analyze the clinical features and outcomes of patients with immunoglobulin light-chain amyloidosis (AL) who had heart involvement. METHODS: Clinical features and outcomes of AL amyloidosis patients with heart involvement in the past 7 years in our hospital were retrospectively analyzed. RESULTS: Cardiac involvement was seen in 36 out of the 60 AL patients (60%). The clinical manifestations of cardiac amyloidosis included heart failure (50%), low QRS voltage (47.2%) and pseudomyocardial infarction (33.3%) in electrocardiography, as well as thickening of ventricular wall (63.9%), echo of granular sparkling texture (11.1%), atria dilation (33.3%) and diastolic dysfunction (30.6%) in echocardiography. The prognosis was poor, with a median survival time of 13.9 months. CONCLUSION: Patients of AL amyloidosis with cardiac involvement are not rare. Thickening of ventricular wall and diastolic dysfunction are the most common characteristics. Special attention should be paid to this disease.

Clinical characteristics and outcomes of Chinese patients with cholesterol crystal embolism after coronary intervention.

BACKGROUND: Cholesterol crystal embolism (CCE) is a complication of atherosclerosis. Vascular surgery, vascular angiography, and anticoagulation have been identified as inciting factors. HYPOTHESIS: This paper sought to analyze the clinical characteristics of patients with CCE after percutaneous coronary intervention. METHODS: Six patients with atherosclerosis presenting with simultaneous occurrence of acute renal failure and peripheral ischemic changes were diagnosed with CCE and their clinical data were analyzed. RESULTS: The average age of the patients was 72 years. Most had risk factors of atherosclerosis such as hypertension, diabetes, and smoking. The levels of serum creatinine increased progressively after coronary angiography. All patients had concomitant skin lesions, including blue toes. Cholesterol crystal emboli were found in arterioles by cutaneous biopsy in one patient. All patients received statins and two of these received dialysis therapy. Three patients died and three remained in chronic renal failure. CONCLUSION: Since CCE is a severe complication of coronary intervention, special attention should be paid to this disease.