Evaluating the value of progressive muscle relaxation therapy for patients with lumbar disc herniation after surgery based on a difference-in-differences model.

We evaluate the value of progressive muscle relaxation (PMR) for patients with lumbar disc herniation after surgery based on a difference-in-differences model. A total of 128 patients with lumbar disc herniation who underwent surgery were randomly assigned to undergo either conventional intervention (conventional intervention group, n = 64) or conventional intervention combined with PMR (PMR group, n = 64). Perioperative anxiety level, stress level and lumbar function were compared between the two groups and compared pain between the two groups before and 1 week and 1 and 3 months after surgery. After 3 months, no one was lost to follow-up. At 1 day before surgery and 3 days after surgery, Self-rating Anxiety Scale score in the PMR group was significantly lower than that in the conventional intervention group (P < 0.05). At 30 min before surgery, heart rate and systolic blood pressure in the PMR group were significantly lower than those in the conventional intervention group (P < 0.05). After intervention, the scores of subjective symptoms, clinical signs and restrictions on activities of daily living were significantly higher in the PMR group than those in the conventional intervention group (all P < 0.05). Visual Analogue Scale score in the PMR group was significantly lower than that in the conventional intervention group (all P < 0.05). The amplitude of change in VAS score in the PMR group was greater than that in the conventional intervention group (P < 0.05). PMR can relieve perioperative anxiety and stress in patients with lumbar disc herniation, reduce postoperative pain and improve lumbar function.

Non-typhoidal Salmonella infections among children in a tertiary hospital in Ningbo, Zhejiang, China, 2012-2019.

BACKGROUND: Non-typhoidal Salmonella (NTS), a common cause of diarrheal enterocolitis, may also cause severe invasive diseases. Limited information on NTS infections in children is available in China. METHODS: We performed a retrospective study of children admitted to the Ningbo Women and Children's Hospital with culture-confirmed NTS infections between January 2012 and December 2019. Clinical and microbiological information were collected. We compared demographic, clinical and antibiotic resistance variables of invasive NTS (iNTS) infections and non-invasive NTS (non-iNTS) infections, and explored associations between hospitalizations for pediatric NTS infections and temperature and rainfall. RESULTS: A total of 166 pediatric hospitalizations due to NTS infection were identified during the 8-year study period. Most of the 166 children were <5 years old (93.4%). The primary serotype was Salmonella Typhimurium (62.6%). Of 166 children with NTS infections, 11 had invasive infection. Compared to 155 children with non-iNTS infections, we found that iNTS infections were more likely to occur in infants ≤6 months or children with an underlying medical condition of leukemia at admission, but iNTS infections less often presented with a symptom of diarrhea (P <0.05 in all cases). The resistance rates of non-iNTS isolates to ceftazidime, ceftriaxone, cefepime, and aztreonam were significantly higher than those of iNTS isolates (P <0.05 in all cases). In addition, compared with iNTS isolates, non-iNTS isolates were significantly associated with resistance to ≥4 CLSI (Clinical and Laboratory Standard Institute) classes (P = 0.041, OR: 0.089, 95% CI: 0.009-0.901) and ≥2 first-line treatment agents (P = 0.040, OR: 0.159, 95% CI: 0.028-0.916). On the other hand, we found that seasonal NTS hospitalizations were positively associated with average seasonal temperature (r = 0.961, P = 0.039) and average monthly rainfall (r = 0.921, P <0.001). CONCLUSION: Non-iNTS accounts for the majority of infections in this study; infants ≤6 months and children with underlying medical conditions of leukemia are more likely to have invasive infection. The rates of antibiotic resistance in the iNTS isolates are generally lower than those in the non-iNTS isolates. On the other hand, high temperatures and heavy rainfall are positively associated with NTS hospitalizations among children in Ningbo.

Effects of Pest Management Practices on Soil Nematode Abundance, Diversity, Metabolic Footprint and Community Composition Under Paddy Rice Fields.

The wide-scale adoption of transgenic crops has aroused public concern towards potential impacts to the ecological services of soil fauna, such as soil nematodes. However, few studies has examined whether the cultivation of transgenic rice would pose greater threats to soil nematode community and associated ecological functions than insecticides application. Moreover, what are determinants of soil nematode community in paddy fields remains unclear. During a 3-year field study, rhizosphere soil samples of transgenic-Bt rice, its counterpart non-Bt parental rice and not-Bt rice with insecticides application were taken at four times in the rice developmental cycle using a random block design with three replications for each treatment. We hypothesized that the effects of pest management practice on soil nematode abundance and metabolic footprint change with trophic group and sampling time. We also predicted there were significant differences in structure and composition of soil nematode community across the three treatments examined and sampling times. In agreement with our expectation, the effects of pest management practice on nematode abundance and metabolic footprints depend on trophic group and sampling time. However, pest management practice exerted no apparent effect on nematode diversity and community composition. Soil nutrient availability and C:N molar ratio are the primary regulating factor of soil nematode community in rice paddy fields. In conclusion, our findings implied that changes in abundance, diversity, metabolic footprints associated with the crop growth stage overweighed the application of Bt rice and insecticides. The cultivation of Bt rice Huahui-1 exerted no measurable adverse effect on soil nematode community in rhizosphere soil over 3 years of rice cropping.

Development of long-circulating lapachol nanoparticles: formation, characterization, pharmacokinetics, distribution and cytotoxicity.

Lapachol is an active compound for the treatment of malignant brain glioma. However, its physicochemical properties limit its clinical application. The purpose of this study is to develop a nano-drug delivery system (LPC-LP) loaded with lapachol (LPC), which remarkably prolongs the half-life in the body, and increases the brain intake, therefore, achieving a better anticancer effect in the treatment of glioma. In order to optimize the formulation of liposomes, an orthogonal design was adopted with entrapment efficiency (EE) as the index. The characterization of the optimized formulation was evaluated in vitro. To assess the safety profile and effect of LPC-LP, a rapid and sensitive ultra-fast liquid chromatography with tandem mass spectrometry (UPLC-MS/MS) method was developed for studying the pharmacokinetics and brain distribution of LPC-LP and LPC. Finally, the cytotoxicity of the two preparations on C6 cells was studied by the MTT assay. The results showed that the average particle size of LPC-LP was 85.92 ± 2.35 nm, the EE of liposomes was 92.52 ± 1.81%, and the charge potential was -40.70 ± 9.20 mV. An in vitro release study showed that the release of lapachol from LPC-LP was delayed compared to LPC, indicating that LPC-LP was a sustained and controlled release system. The UPLC-MS/MS method was fully validated in both plasma and brain tissue according to the Food and Drug Administration (FDA) recommended guidelines, and successfully used for quantification of lapachol in vivo. After intravenous administration, LPC-LP prolonged circulation time of lapachol in the body and increased brain intake. Besides, the MTT results revealed that the IC50 value of LPC-LP on C6 cells significantly decreased, compared with LPC, which further confirmed that LPC-LP enhanced the inhibition of C6 cells and improved the anti-glioma effect. In conclusion, LPC-LP could serve as a promising candidate for the clinical application of lapachol in the treatment of glioma.

Long-term cultivation of Bt rice expressing the Cry1Ab/1Ac gene reduced phytoparasitic nematode abundance but did not affect other nematode parameters in paddy fields.

The uncertainty of ecological risks and the effects of growing transgenic Bt rice on the environment hamper its commercial production. Here, soil nematode communities were used as an indicator of soil health and soil food web structure to evaluate the potential effects of growing Bt rice without chemical insecticides for 3years in the paddy field. The nematodes and soil physicochemical properties of Bt rice fields were compared to the near-isogenic control, non-Bt rice fields. A total of 108,363 specimens belonging to 28 different genera were enumerated. The Hirschmanniella, Tobrilus, Dorylaimus and Filenchus were dominant genera. A three-year paddy rice cultivation of Bt rice (Huahui 1) negatively affected the abundance of phytoparasitic nematodes but did not affect the total number of nematodes, the abundance and relative abundance of free-living nematodes, genera richness, diversity indices, soil food web conditions, or community compositions. However, apparent seasonal and inter-annual changes in these variables were observed, indicating that the impact of environmental factors was more stronger than that of the Bt toxin. In conclusion, the potential ecological risks of Bt rice on soil health and sustainability warrant further research to disentangle the impacts from various confounding environmental factors.

Inhibitory effects of lapachol on rat C6 glioma in vitro and in vivo by targeting DNA topoisomeraseⅠ and topoisomeraseⅡ / 中国药理学与毒理学杂志

OBJECTIVE Lapachol is a natural naphthoquinone compound that possesses extensive biological activities. The aim of this study is to investigate the inhibitory effects of lapachol on rat C6 glioma both in vitro and in vivo, as well as the potential mechanisms. METHODS The antitumor effect of lapachol was firstly evaluated in the C6 glioma model in Wistar rats. The effects of lapachol on C6 cell proliferation, apoptosis and DNA damage were detected by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS)/ phenazinemethosulfate (PMS) assay, hoechst 33358 staining, annexinⅤ-FITC/PI staining, and comet assay. Effects of lapachol on topoisomerase I (TOP I) and topoi?somerase Ⅱ (TOP Ⅱ) activities were detected by TOP Ⅰ and TOP Ⅱ mediated supercoiled pBR322 DNA relaxation assays and molecular docking. TOPⅠ and TOPⅡ expression levels in C6 cells were also determined. RESULTS High dose lapachol showed significant inhibitory effect on the C6 glioma in Wistar rats (P<0.05). It was showed that lapachol could inhibit proliferation, induce apoptosis and DNA damage of C6 cells in dose dependent manners. Lapachol could inhibit the activities of both TOPⅠ and Ⅱ. Lapachol-TOPⅠ showed relatively stronger interaction than that of lapachol-TOPⅡ in molecular docking study. Also, lapachol could inhibit TOPⅡ expression levels, but not TOPⅠ expression levels. CONCLUSION These results showed that lapachol could significantly inhibit C6 glioma both in vivo and in vitro, which might be related with inhibiting TOPⅠ and TOPⅡ activities, as well as TOPⅡ expression.

Inhibitory effects of lapachol on rat C6 glioma in vitro and in vivo by targeting DNA topoisomerase I and topoisomerase II.

BACKGROUND: Lapachol is a natural naphthoquinone compound that possesses extensive biological activities. The aim of this study is to investigate the inhibitory effects of lapachol on rat C6 glioma both in vitro and in vivo, as well as the potential mechanisms. METHODS: The antitumor effect of lapachol was firstly evaluated in the C6 glioma model in Wistar rats. The effects of lapachol on C6 cell proliferation, apoptosis and DNA damage were detected by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS)/ phenazinemethosulfate (PMS) assay, hoechst 33358 staining, annexin V-FITC/PI staining, and comet assay. Effects of lapachol on topoisomerase I (TOP I) and topoisomerase II (TOP II) activities were detected by TOP I and TOP II mediated supercoiled pBR322 DNA relaxation assays and molecular docking. TOP I and TOP II expression levels in C6 cells were also determined. RESULTS: High dose lapachol showed significant inhibitory effect on the C6 glioma in Wistar rats (P < 0.05). It was showed that lapachol could inhibit proliferation, induce apoptosis and DNA damage of C6 cells in dose dependent manners. Lapachol could inhibit the activities of both TOP I and II. Lapachol-TOP I showed relatively stronger interaction than that of lapachol-TOP II in molecular docking study. Also, lapachol could inhibit TOP II expression levels, but not TOP I expression levels. CONCLUSION: These results showed that lapachol could significantly inhibit C6 glioma both in vivo and in vitro, which might be related with inhibiting TOP I and TOP II activities, as well as TOP II expression.

Effect of xanthone derivatives on animal models of depression.

BACKGROUND: Extracts of the plant Hypericum perforatum L. have been traditionally used in folk medicine for the treatment of depressive disorders. Xanthone, a component of Hypericum perforatum L., has been shown to be effective in animal models of depression. OBJECTIVE: We investigated if 2 xanthone derivatives (1101 and 1105) were as effective as venlafaxine, which is a serotonin-norepinephrine reuptake inhibitor and was used as a positive control, in animal models of depression. METHODS: A series of derivatives from xanthone were designed and synthesized. After preliminary experiments, 2 xanthone derivatives (1101 and 1105) were considered to be effective in our mouse depression model. To further determine their effects on depression, classical behavioral despair animal models (forced swim and tail suspension tests) were used to assess the efficacies of these derivatives, whereas venlafaxine hydrochloride was used as a positive control. Oral acute toxicity studies were used to determine if the derivatives were toxic in mice. RESULTS: The oral acute toxicity studies of 2 xanthone derivatives (1101 and 1105) did not show any toxic effect until the dose at 1000 mg/kg body weight, and xanthone derivatives 1101 and 1105 resulted in a significant decrease of the immobility period (in seconds) compared with the untreated control group during the forced swim test with rats (dose = 12 mg/kg; P < 0.05) and mice (dose = 25 mg/kg; P < 0.001). At lower doses, derivatives 1101 and 1105 also decreased the immobility period of rats and mice during the forced swim test but significant differences were only found in mice compared with the untreated control group (P < 0.05). No difference was found between the groups treated with xanthone derivatives and the positive control group during the swimming period in both mice (dose = 25 mg/kg) and rats (dose = 12 mg/kg) (P > 0.05). In the tail suspension test, derivatives 1101 and 1105 produced marked effects with regard to the motion of mice (P < 0.01 or 0.001, respectively) and the derivatives were also noted to have some effects on rats at a dose of 12 mg/kg (P < 0.05). Compared with the positive venlafaxine control group, no differences were found between those treated with either derivative 1101 or derivative 1105 and venlafaxine (P > 0.05). CONCLUSIONS: Within certain dose ranges, xanthone derivatives 1101 and 1105 have similar effects to venlafaxine hydrochloride in the treatment of depression as suggested by behavioral despair animal models using rats and mice.

[A study on the epidemic of pneumonia among children in Ningbo City, Zhejiang province, 2009-2012].

OBJECTIVE: To analyze the epidemiological characteristics and the bacterial pathogen composition of pneumonia among children under 5 years old in Ningbo. METHODS: In 2013 February-April, we selected pediatric ward in three hospitals according to stratified cluster random sampling, and from which we collected all 57 556 hospitalized cases in January 2009-December 2012 period of children under 5 years old. A total of 16 740 medical records and bacterial spectrum records of pneumonia or bronchial pneumonia cases among children under 5 years old were described to calculate the proportions of children pneumonia or bronchial pneumonia hospitalized cases accounted for hospitalized children over the same period(referred to as proportions of pneumonia incidence), the detection rate of bacterial pathogens, proportions of bacterial spectrum, and to analyze the characteristics and bacterial pathogen composition of pneumonia among children under 5 years. RESULTS: The proportions of children pneumonia in 2009-2012 were 26.16% (2 882/11 017), 31.23% (4 004/12 819), 29.35% (4 898/16 689) and 29.10% (4 956/17 031)(Z = 3.13, P < 0.01), and were in a downward trend by the increasing of age(Z = -113.74, P < 0.01). The proportions of children pneumonia of 0-5 age group were 50.71% (6 756/13 318), 26.60% (3 159/11 877), 24.17% (2 574 /10 648), 22.36% (2 509 /11 223) and 16.63% (1 745 /10 490). The proportions of children pneumonia with different season were 26.90% (3 725/13 850), 26.51% (3 788/14 287), 29.59% (4 442/15 011) and 33.21% (4 785 /14 408) (χ² = 198.77, P < 0.01). The proportions of severe children pneumonia of 0-5 age group were 1.10% (74/6 753), 0.47% (15/3 159), 0.19% (5 /2 574),0.08% (2 /2 509) and 0.06% (1 /1 745), with a downward trend by the age(F = 57.62, P < 0.01). The detection rate of Klebsiella pneumoniae, Haemophilus influenzae,Acinetobacter baumannii, Escherichia coli, Staphylococcus aureus, and Streptococcus pneumoniae was 19.3% (540/2 805), 16.4% (460/2 805), 13.6% (381/2 805), 11.9% (335/2 805), 11.5% (323/2 805) and 6.8% (192/2 805). CONCLUSION: In 2009-2012, the proportions of children pneumonia under 5 year old constituted a relatively high proportion in Ningbo city. Children under 1 year old were the major suffering group of pneumonia and severe pneumonia, which should be the key prevention group. The major bacterial pathogens of children's pneumonia in Ningbo are gram-negative bacteria.

Synthesis and characterization of quaternized beta-chitin.

Water-soluble 2'-O-hydroxypropyltrimethylammoniumchitin chloride (2'-O-HTACCt) was prepared directly from beta-chitin and 3-chloro-2-hydroxypropyltrimethylammonium chloride (CTA) in basic medium. The effect of alkali concentration, reaction temperature, reaction time, and dosage of CTA on yield and degree of substitution (DS) of 2'-O-HTACCt were studied. These quaternized chitin derivatives were characterized by FTIR and (1)H NMR spectroscopy, conductometric titration, and elemental analysis methods. Research results indicate that beta-chitin can react directly with CTA to produce a water-soluble 2'-O-HTACCt derivative with a high DS. The optimal preparation conditions were determined to be 35-40 wt% (aq NaOH), 40 degrees C (reaction temperature), 6h (reaction time), and 4 (molar ratio of CTA to beta-chitin unit).

Preparation and characterization of carboxymethylated beta-chitins and their abilities of moisture absorption and retention.

Carboxymethyl chitins (CM-chitins) with a high degree of substitution (DS), a low degree of deacetylation (DD), and high molecular weight were prepared directly from beta-chitin and characterized using (1)H NMR, FT-IR, TA, potentiometric titration, and elemental analysis methods. CM-chitins with different molecular weight were prepared using ultrasonic degradation method. Their abilities of moisture absorption and retention were investigated. The moisture-absorption ratio and moisture-retention ratio of CM-chitins increased as their DS increased. The moisture-absorption ratio and moisture-retention ratio of CM-chitins with high DS were close to that of hyaluronic acid (HA). The effect of molecular weight (>10(6)) of CM-chitin on its moisture-absorption ratio and moisture-retention ratio is neglectable.

Plasma BNP levels are determined by the severity of left ventricular systolic dysfunction but not the types of underlying heart disease.

OBJECTIVES: The primary aim of the study was to investigate whether there is a difference in plasma B-type natriuretic peptide (BNP) levels among the left ventricular systolic dysfunction caused by different types of heart disease. METHODS AND RESULTS: Plasma BNP was measured in patients with left ventricular systolic dysfunction as a result of mitral valve regurgitation (n=26), hypertension (n=36), coronary heart disease (n=37) and dilated cardiomyopathy (n=32). The left ventricular end-diastolic diameter and ejection fraction were assessed with echocardiography. The valvular heart disease group had more women and was younger (p < 0.05). There was no significant difference in the New York Heart Association functional class, left ventricular end-diastolic diameter and ejection fraction among the four groups (p < 0.05). The average plasma BNP was also similar among the four groups of patients. In each group, a significant correlation between the levels of BNP and the left ventricular end-diastolic diameter or ejection fraction was identified (p < 0.001). CONCLUSION: Plasma BNP concentrations during left ventricular systolic dysfunction are associated with left ventricular diameter and function, but they are not determined by the causes of the heart failure.

Effect of radiofrequency catheter ablation on plasma B-type natriuretic peptide.

The study was designed to investigate the impact of radiofrequency catheter ablation on the plasma level of B-type natriuretic peptide (BNP). In 36 patients who underwent catheter ablation of paroxysmal supraventricular tachycardia, the plasma level of BNP was analyzed before and after the ablation procedures. The plasma BNP at baseline, 30 minutes after the ablation, 3 and 24 hours after the ablation was 12.78 +/- 2.47, 18.45 +/- 4.02 (P = 0.446), 43.54 +/- 8.12 (P = 0.0001), and 17.88 +/- 4.71 (P = 0.493) pg/mL, respectively. Plasma troponin I was also increased 3 and 24 hours after the ablation (n = 10, P < 0.05). Multivariate regression analysis showed a significant correlation between the levels of BNP 3 hours after ablation and the preablation BNP and the total radiofrequency energy used for the ablation. We conclude that radiofrequency catheter ablation of supraventricular tachycardia increases the plasma level of BNP. The clinical significance of the ablation-induced increase in BNP needs to be further investigated.

Bedside tests of B-type natriuretic peptide in the diagnosis of left ventricular diastolic dysfunction in hypertensive patients.

AIMS: To investigate the value of B-type natriuretic peptide (BNP) in diagnosing left ventricular diastolic dysfunction in patients with hypertension. METHODS: The left ventricular diastolic function and plasma BNP levels were assessed prospectively in 135 hypertensive patients. RESULTS: The plasma BNP in patients with (n=61) and without (n=74) diastolic dysfunction was 122+/-105 and 18+/-16 pg/ml, respectively (p<0.001). Increased BNP levels were associated with systolic blood pressure (p<0.05), left ventricular mass index (p<0.001), the E/A ratio of transmitral flow (p<0.01) and the isovolumic relaxation time (p<0.01). A receiver-operator characteristic curve showing the sensitivity and specificity of BNP against the echocardiography diagnosis of diastolic dysfunction revealed an area under the curve (accuracy) of 0.904 (p<0.01). Using a cut-off value of >40 pg/ml, the sensitivity and specificity of plasma BNP in diagnosing left ventricular diastolic dysfunction were 79% and 92%, respectively. CONCLUSIONS: The plasma BNP levels in patients with hypertension are closely related to left ventricular hypertrophy and filling impairment. Plasma BNP may be used to facilitate the diagnosis of left ventricular diastolic dysfunction.

Predicting factors of depression in patients with primary hypertension: a community-based study.

OBJECTIVE To investigate the factors that may predict the occurrence of depression in patients with primary hypertension. METHODS We conducted a cross-sectional survey on 891 hypertensive patients and 651 normal subjects (control group) from a single community. Zung self-rating depression scale (SDS) was applied to evaluate the symptoms of depression, which was diagnosed when the SDS score was >41. RESULTS There was no significant difference in gender distribution (female, 48.5 vs. 47.6%) and age (65.3±9.2 vs. 64.0±7.9 years) between the hypertensive control groups (P>0.05). Depression was diagnosed in 139 hypertensive patients (15.6%) and 27 (4.2%) control subjects (P<0.01). The average SDS score was higher in patients with hypertension duration of more than 3 years (33.3±9.0 vs. 30.6±7.6, P<0.001), in patients with severe hypertension (44.0±7.8 vs. 28.9±4.9, P<0.001) and in patients with a history of hospitalization for cardiovascular disorders (38.1±9.3 vs. 32.0±8.4, P<0.001). Multivariate regression analysis showed that the degree and the duration of hypertension, as well as hospitalization history, were independent predictors of depression in the hypertensive patients. CONCLUSIONS Hypertension is associated with a higher prevalence of depression that can be predicted by the duration and severity of hypertension as well as a history of hospitalization.

[High efficiency of L-glutamine production by coupling genetic engineered bacterial glutamine synthetase with yeast alcoholic fermentation system].

Glutamine is an important conditionally necessary amino acid in human body. The effort is to establish a new and high efficient L-glutamine production system instead of traditional fermentaion. In this paper, high efficiency of L-glutamine production is obtained by coupling genetic engineered bacterial glutamine synthetase (GS) with yeast alcoholic fermentation system. Glutamine Synthetase gene (glnA) was amplified from Bacillus subtilis genomic DNA with primers designed according to sequences reported in EMBL data bank, then it was inserted into expression vector PET28b, the sequence of glnA was proved to be the same as that reported in the data bank by DNA sequencing. After transformation of this recombinant plasmid PET28b-glnA into BL-21 (DE3) strain, Lactose and IPTG were used to induce GS expression at 37 degrees C separately. Both of them can induce GS expression efficiently. The induced protein is proved to be soluble and occupies about 80% of the total proteins by SDS-PAGE analysis. The soluble GS was purified by Ni2+ chelating sepharose colum. After purification, the purified enzyme was proved active. Results reveal that the optmum temperature of this enzyme is 60 degrees C and optmum pH is 6.5 in biosynthetic reaction by using glutamate, ammonium choloride and ATP as substrates. After induction, the enzyme activity in crude extract of BL-21/PET28b-glnA is 83 times higher than that of original BL-21 extract. Mn2+ can obviously increase the activity and stability of this enzyme. Experiments show that the transformation efficiency of glutamate to glutamine is more than 95%. Because of the high cost from ATP, a system coupling GS with yeast for ATP regenaration was established. In this system, GS utilizes ATP released by yeast fermentation to synthesize L-glutamine. Yeast was treated by 2% toluence to increase its permeability and a yeast named YC001 with high yield of glutamine by coupling with recombinant GS was obtained. The good efficiency was achieved with the presence of 250 mmol/L glucose and 200 mmol/L phosphate, the transformation efficiency of glutamate to glutamine in this system is more than 80%, the average yield of glutamine is about 22g/L. This provides the basis for future large scale production of L-glutamine.

Influence of commissural calcification on the immediate outcomes of percutaneous balloon mitral valvuloplasty.

OBJECTIVES: To evaluate the impact of mild to moderate commissural calcification on the immediate outcomes of percutaneous balloon mitral valvuloplasty (PBMV). METHODS AND RESULTS: We analysed the results of 223 consecutive patients (mean age 37.6 +/- 8.7 years) who underwent PBMV for rheumatic mitral stenosis. Commissural calcification was identified with a two-dimensional echocardiography (echo) in 65 (29.1%) patients with the severity of calcification being graded from 0-3. The anatomy and function of the mitral valve were assessed byWilkins echo score. In patients with no commissural calcification the increase in mitral valve area after PBMV was 0.90 +/- 0.42 cm2, which was greater than the increase in those with calcification grade 1 (0.83 +/- 0.42 cm2, p < 0.05), grade 2 (0.72 +/- 0.38 cm2, p < 0.05) and grade 3 (0.63 +/- 0.13 cm2, p < 0.05). In patients with an echo score of < or = 8, the presence of commissural calcification was associated with a smaller increase in mitral valve area (p < 0.05) and a smaller reduction in New York Heart Association (NYHA) function class after PBMV (p < 0.05). In patients with an echo score of more than 8, commissural calcification had no significant effect on the valve area increase and NYHA function class reduction (p > 0.05). CONCLUSIONS: Commissural calcification has an adverse effect on the clinical results of PBMV. Detailed pre-procedural assessment of commissural calcification with echocardiography must be performed to provide background information on the immediate outcomes of PBMV.