[Epidemiological investigation of iron deficiency among preschool children in 10 provinces, autonomous regions, or municipalities in China].

Objective: To understand the current status of anemia, iron deficiency, and iron-deficiency anemia among preschool children in China. Methods: A cross-sectional study was conducted with a multi-stage stratified sampling method to select 150 streets or townships from 10 Chinese provinces, autonomous regions, or municipalities (East: Jiangsu, Zhejiang, Shandong, and Hainan; Central: Henan; West: Chongqing, Shaanxi, Guizhou, and Xinjiang; Northeast: Liaoning). From May 2022 to April 2023, a total of 21 470 children, including community-based children aged 0.5 to<3.0 years receiving child health care and kindergarten-based children aged 3.0 to<7.0 years, were surveyed. They were divided into 3 age groups: infants (0.5 to<1.0 year), toddlers (1.0 to<3.0 years), and preschoolers (3.0 to<7.0 years). Basic information such as sex and date of birth of the children was collected, and peripheral blood samples were obtained for routine blood tests and serum ferritin measurement. The prevalence rates of anemia, iron deficiency, and iron-deficiency anemia were analyzed, and the prevalence rate differences were compared among different ages, sex, urban and rural areas, and regions using the chi-square test. Results: A total of 21 460 valid responses were collected, including 10 780 boys (50.2%). The number of infants, toddlers, and preschoolers were 2 645 (12.3%), 6 244 (29.1%), and 12 571 (58.6%), respectively. The hemoglobin level was (126.7±14.8) g/L, and the serum ferritin level was 32.3 (18.5, 50.1) µg/L. The overall rates of anemia, iron deficiency, and iron-deficiency anemia were 10.4% (2 230/21 460), 28.3% (6 070/21 460), and 3.9% (845/21 460), respectively. The prevalence rate of anemia was higher for boys than for girls (10.9% (1 173/10 780) vs. 9.9% (1 057/10 680), χ2=5.58, P=0.018), with statistically significant differences in the rates for infants, toddlers and preschoolers (18.0% (475/2 645), 10.6% (662/6 244), and 8.7% (1 093/12 571), respectively, χ2=201.81, P<0.01), and the rate was significantly higher for children in rural than that in urban area (11.8% (1 516/12 883) vs. 8.3% (714/8 577), χ2=65.54, P<0.01), with statistically significant differences in the rates by region (χ2=126.60, P<0.01), with the highest rate of 15.8% (343/2 173) for children in Central region, and the lowest rate of 5.3% (108/2 053) in Northeastern region. The prevalence rates of iron deficiency were 33.8% (895/2 645), 32.2% (2 011/6 244), and 25.2% (3 164/12 571) in infants, toddlers, and preschoolers, respectively, and 30.0% (3 229/10 780) in boys vs. 26.6% (2 841/10 680) in girls, 21.7% (1 913/8 821), 40.0% (870/2 173), 27.1% (2 283/8 413), 48.9% (1 004/2 053) in Eastern, Central, Western, and Northeastern regions, respectively, and each between-group showed a significant statistical difference (χ2=147.71, 29.73, 773.02, all P<0.01). The prevalence rate of iron-deficiency anemia showed a significant statistical difference between urban and rural areas, 2.9% (251/8 577) vs. 4.6% (594/12 883) (χ2=38.62, P<0.01), while the difference in iron deficiency prevalence was not significant (χ2=0.51, P=0.476). Conclusions: There has been a notable improvement in iron deficiency and iron-deficiency anemia among preschool children in China, but the situation remains concerning. Particular attention should be paid to the prevention and control of iron deficiency and iron-deficiency anemia, especially among infants and children in the Central, Western, and Northeastern regions of China.

Prognostic factors affecting overall survival in patients with spinal metastasis due to lung cancer: a systematic review and meta-analysis.

OBJECTIVE: Metastatic lung cancer often spreads to the musculoskeletal structures and spinal column. Patients suffering from spinal metastasis due to lung cancer present poorer prognostic outcomes in terms of overall survival compared to spinal metastases from other origins. To date, no meta-analysis has attempted to evaluate the prognostic impact of various predictive factors that may influence the overall survival of patients with spinal metastasis due to metastatic lung cancer. The aim of the study was to evaluate the prognostic impact of different predictive factors that might influence the overall survival of patients with spinal metastasis due to metastatic lung cancer. MATERIALS AND METHODS:  Five electronic databases (Web of Science, EMBASE, CENTRAL, Scopus, and MEDLINE) were screened for eligible studies according to PRISMA guidelines. We conducted a random-effects meta-analysis to evaluate the prognostic impact of aging, pre-ambulatory status, radiotherapy, adenocarcinoma, performance status, visceral metastasis, and number of affected vertebrae on the overall survival of patients with spinal metastasis due to lung cancer. RESULTS:  From 963 studies, we found 13 eligible studies with data on 1144 patients. Our meta-analysis revealed that pre-treatment ambulatory status (2.08), Eastern cooperative oncology group score (1.78), and aging (1.68) had significant impacts on overall survival. CONCLUSIONS:  We provide preliminary evidence highlighting three factors potentially predictive of overall survival for patients suffering from spinal metastasis due to metastatic lung cancer. These findings may help clinicians stratify and manage patients more effectively.

[Epidemiological and Etiologic characteristics of Meningococcal meningitis in Xinjiang Uygur Autonomous Region,1960-2019].

Objective: To understand the epidemiological and etiologic characteristics of meningococcal meningitis in Xinjiang Uygur Autonomous Region (Xinjiang). Methods: The epidemiological data about the meningococcal meningitis cases in Xinjiang from 1960 to 2019 were collected from the China information system for disease control and prevention and the Center for Disease Control and Prevention of Xinjiang. The epidemiological characteristics were analyzed. Clinical specimens from suspected cases were cultured and tested by real-time PCR method. A survey on the carriage rate of Neisseria meningitides (Nm) in the healthy population was performed. The serogroups of isolates were determined by serum-agglutination and PCR methods. Multi-locus sequence typing was used for subtyping the isolates. Results: The incidence rates of meningococcal meningitis in Xinjiang from 1960 to 2019 were 0.02/100 000-81.32/100 000, with the mortality as 1.05%-20.78%. The five districts with the most cases were Kashi prefecture, Aksu prefecture, Urumqi city, Changji Hui autonomous prefecture, and Hotan prefecture. Before 1990, serogroup A (81.82%) was the commonest group for cases and contacts. After 1990, 14.00% of the cases were caused by serogroups B, C, W, and Y. There was no predominant serogroup for contacts with serogroups B, C, W, Y, and C accounting for 23.28%, 18.53%, 15.52%, 9.91% and 7.33% respectively. The general Nm carriage rate was 15.50%, with the population of 16 - 20 years age group having the highest rate (25.53%). Serogroups B (52.11%), W (20.66%), C (12.21%), and Y (9.39%) occupied 52.11%, 20.66%, 12.21% and 9.39% respectively. The commonest clonal lineages of Nm isolates were ST-4821, ST-175, and ST-5 clonal complexes, while the ST-5 and ST-4821 clonal complexes were the major ones for invasive strains. Conclusions: There appeared regional differences in the incidence rates of Xinjiang meningococcal meningitis, and the carriage rate of Nm was high. The serogroups have been changing. It is necessary to strengthen the prevention and control of meningococcal meningitis to prevent any potential outbreak.

[Analysis on antimicrobial sensitivity of Neisseria meningitidis in China from 2005 to 2019].

Objective: To analyze the antimicrobial resistance characteristics of 538 Neisseria meningitidis isolated from 2005 to 2019 in China. Method: Total of 538 Neisseria meningitidis strains collected from 30 provinces in China from 2005 to 2019. Antimicrobial susceptibility test were performed based on the standards of clinical and laboratory standardization association (CLSI) including 11 recommended antibiotics. Gradient diffusion method was used to detect the antibiotic sensitivity of Neisseria meningitidis. Results: All 538 strains were sensitive to azithromycin, meropenem, chloramphenicol, rifampicin and ceftriaxone. As to other six antibiotics, the antibiotics sensitivity rates were cefotaxime (97.4%, 524 strains), ampicillin (87.7%, 472 strains), penicillin (84.8%, 456 strains), minocycline (95.2%, 512 strains), ciprofloxacin (24.9%, 134 strains) and trimethoprim/sulfamethoxazole (11.2%, 60 strains) respectively. Conclusions: Neisseria meningitidis isolated from 2005-2019 in China were all sensitive to azithromycin, meropenem, chloramphenicol, rifampicin and ceftriaxone. It should highlight Neisseria meningitidis resistant to cefotaxime, ampicillin and penicillin. Ciprofloxacin and sulfamethoxazole are not recommended as the priority choice for clinical treatment and prophylactic medication.

[Survey of antibody levels of pertussis, diphtheria and tetanus in 495 pregnant women in Nanshan District of 2019, Shenzhen].

Objective: The purpose of this study was to investigate the IgG antibody levels of whooping cough, diphtheria, and tetanus in pregnant women in Nanshan District. Methods: From January to March 2019, 495 pregnant women who met the inclusion criteria in a hospital in Nanshan District, Shenzhen were selected as the survey subjects. The enzyme-linked immunosorbent assay was used to detect serum levels of pertussis, diphtheria, and tetanus IgG antibodies and we compared the differences in antibody levels of pregnant women with different characteristics. Results: The maternal age was (29.23±4.08) years old. The geometric mean concentration of pertussis antibody was 2.589 (1.172-4.953) IU/ml, 1.01% (5 cases) of pregnant women had pertussis antibody concentration ≥ 40 IU/ml, and 75.15% (372 cases) of pregnant women had pertussis antibody concentration<5 IU/ml. The GMC value and antibody positive rate of diphtheria in pregnant women were 0.024(0.009-0.065) IU/ml and 72.53% (359 cases), respectively. The GMC value and antibody positive rate of tetanus in pregnant women were 0.014 (0.006-0.034) IU/ml and 53.74% (266 cases), respectively. There was no statistical difference in the antibody level and antibody positive rate among pregnant women of diphtheria and tetanus, respectively. Conclusion: The concentration of antibodies against pertussis, diphtheria, and tetanus in pregnant women are all at a low level, which is not enough to protect themselves from disease infection.

Long noncoding RNA UCA1 promotes multiple myeloma cell growth by targeting TGF-ß.

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "Long noncoding RNA UCA1 promotes multiple myeloma cell growth by targeting TGF-ß, by Z.-S. Zhang, J. Wang, B.-Q. Zhu, L. Ge, published in Eur Rev Med Pharmacol Sci 2018; 22 (5): 1374-1379-DOI: 10.26355/eurrev_201803_14481-PMID: 29565496" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/14481.

Efficacy of zoledronic acid with percutaneous kyphoplasty/vertebroplasty in the treatment of osteoporotic vertebral compression fractures: a systematic review and meta-analysis.

OBJECTIVE: The purpose of this study was to conduct a systematic review and meta-analysis analyzing the efficacy of zoledronic acid in improving outcomes with percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) surgeries for osteoporotic vertebral compression fracture (OVCF). MATERIALS AND METHODS: We electronically searched the databases of PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar up to 15th September 2020. All types of studies assessing the use of zoledronic acid with PKP/PVP surgeries were included. RESULTS: Seven studies were included. On meta-analysis of data from five studies reporting bone mineral density (BMD) as g/cm2, we found a statistically significant increase in BMD in the zoledronic group (MD: 0.14; 95% CI: 0.07, 0.21, I2=97%; p<0.001). On pooled analysis of two studies reporting T scores, a similar result in favour of the zoledronic acid group was noted (MD: 0.60; 95% CI: 0.23, 0.98, I2=76%; p=0.002). We also found a statistically significant reduction in pain scores (MD: -1.23; 95% CI: -1.59, -0.86, I2=97%; p<0.00001), ODI scores (MD: -9.54; 95% CI: -12.76, -6.31, I2=95%; p<0.00001) and serum type I procollagen peptide (CTX) levels (MD: -0.19; 95% CI: -0.25, -0.12, I2=98%; p<0.00001) with zoledronic acid as compared to control. Our analysis also found a significantly reduced risk of further vertebral fractures in patients receiving zoledronic acid as compared to control (RR: 0.17; 95% CI: 0.07, 0.39, I2=0%; p<0.00001). CONCLUSIONS: Our review indicates that the use of once-yearly zoledronic acid in the peri-operative period of PVP/PKP procedures for patients with OVCF leads to significant improvement of BMD, reduced pain scores, better ODI scores, and reduced incidence of further vertebral fractures. Our results have clinical significance as it encourages the use of zoledronic acid for such patients for better clinical outcomes.

[Epidemiological characteristics of scarlet fever in Hubei Province from 2009 to 2018].

Descriptive epidemiological methods were adopted to analyze the epidemiological characteristics of scarlet fever in Hubei Province from 2009 to 2018. During this study, the epidemiological data was obtained from the Chinese Center for Disease Control and Prevention Information System. The results showed that there were 7 329 cases of scarlet fever reported in Hubei Province from 2009 to 2018 and the annual average incidence was 1.25 per 10 000. The number of cases was increased by years, and in 2018 it was the highest peak during these ten years and up to 1 758 which was account for 24% in these ten years, and the incidence was 2.98 per 10 000. The number of reported cases of male and female was 4 473 and 2 856, respectively, and both of the incidence rates were on the rise. The reported cases were distributed in 0-60 year-old group, mainly in the <15-year-old group (98.4%, 7 214/7 329). The season with the highest incidence rates were summer and winter. There were cases in all cities and prefectures, and the number of cases were the highest in Wuhan (n=2 105), Yichang (n=1 390), Jingzhou (n=954) and Enshi (n=1 090). Hence, it was very necessary to be on guard for the outbreak of scarlet fever and strengthen the surveillance in summer and winter for the people who were younger than 15 years old, especially in Wuhan, Yichang, Jingzhou and Enshi.

[Molecular characteristics of serogroup B neisseria meningitidis, China].

Objective: To investigate the molecular characteristics of serogroup B neisseria meningitidis in China. Methods: Total of 485 (100 strains isolated from cerebrospinal fluid or blood samples of encephalomyelitis cases, and 385 strains isolated from nasopharynx of healthy carriers) Meningococcal serogroup B (MenB) strains, isolated from 29 provinces of China between 1968 and 2016, were analyzed by multilocus sequence typing (MLST) and PorA typing methods. Further, the genetic diversity of three MenB vaccine proteins, FHbp, NadA and NHBA, were analyzed. Results: The 485 study strains belonged to 270 sequence types (STs), 107 of which (representing 211 strains) could be grouped into ten clonal complexes (CC). CC4821 has been the predominant lineage in China since 2005 (28.7%, n=139). The most common PorA types of MenB strains from invasive meningococcal cases were P1.5-2,2-2 (10.0%, n=10), P1.5-1,2-2 (9.0%, n=9) and P1.5-1,10-4 (9.0%, n=9). Four hundred and twenty one strains had intact fhbp gene; variant 1, 2 and 3 accounted for 12.8% (54 strains), 85.0% (358 strains) and 2.2% (9 strains) respevtively. Ten out of 432 strains (2.3%) contained complete nadA gene. All the 172 strains for which the nhba gene was sequenced had intact gene sequence which corresponded to 68 peptide types. Conclusion: CC4821 was the predominant CC of MenB strains in China; the vaccine proteins were diverse about the sequences. The vaccine proteins should be carefully selected when developing MenB vaccines in China.

Effect of abnormal activated B cells in patients with ankylosing spondylitis and its molecular mechanism.

OBJECTIVE: Ankylosing spondylitis (AS) is a common clinical autoimmune disease, the pathogenesis of which, however, is not yet elucidated. In this study, we aim to explore the effect of B cells in the development and progression of AS and its underlying mechanism. PATIENTS AND METHODS: B cells were isolated from peripheral blood of AS patients and normal controls. Surface expression of CD40 in B cells was detected by flow cytometry. Expressions of downstream genes in MAPK pathway were detected by Western blot. Moreover, IL-10 expressions in peripheral blood of AS patients and normal controls were detected by ELISA. RESULTS: No difference was found in the surface expression of CD40 in B cells between AS patients and normal controls. However, CD40 expression was inhibited after B cells in peripheral blood were specifically stimulated by lipopolysaccharide (LPS) in vitro. Abnormal activated B cells, dysregulated p38 expressions and decreased serum expressions of IL-10 were also observed in AS patients. CONCLUSIONS: Abnormal surface expression of CD40 inn B cells of AS patients may lead to abnormal activation of B cells, thereby interfering the p38 MAPK pathway and reducing the IL-10 secretion.

Long noncoding RNA UCA1 promotes multiple myeloma cell growth by targeting TGF-ß.

OBJECTIVE: To investigate the role of long noncoding RNA (lncRNA) UCA1 in the multiple myeloma (MM) development. PATIENTS AND METHODS: In samples of MM, the expression of UCA1 and TGF-ß was investigated using real-time PCR. UCA1 lentiviral small hairpin RNA (shRNA) was transfected in MM cell lines. CCK-8 and colony formation assay were used to detect cell lines proliferation. The cell apoptosis assay was conducted to detect cell apoptosis. Western blot was utilized to detect the protein level of TGF-ß. RESULTS: The expression level of UCA1 increased in MM samples and cell lines, and its high expression was associated with poor MM prognosis. Downregulation of UCA1 significantly inhibited cell lines proliferation and promoted cell apoptosis. UCA1 could positively regulate TGF-ß in MM. Overexpression of TGF-ß partially reversed the effect of UCA1 knockdown. CONCLUSIONS: UCA1 promotes MM cell lines proliferation by targeting TGF-ß.

Multilocus variable-number tandem-repeat analysis of Neisseria meningitidis serogroup C in China.

This study characterized Neisseria meningitidis serogroup C strains in China in order to establish their genetic relatedness and describe the use of multilocus variable-number tandem-repeat (VNTR) analysis (MLVA) to provide useful epidemiological information. A total of 215 N. meningitidis serogroup C strains, obtained from 2003 to 2012 in China, were characterized by MLVA with different published schemes as well as multilocus sequence typing. (i) Based on the MLVA scheme with a combination of five highly variable loci, 203 genotypes were identified; this level of discrimination supports its use for resolving closely related isolates. (ii) Based on a combination of ten low variable loci, clear phylogenetic relationships were established within sequence type complexes. In addition, there was evidence of microevolution of VNTR loci over the decade as strain lineages spread from Anhui to other provinces, the more distant the provinces from Anhui, the higher the genetic variation.

Discovery of four natural clones in a crayfish species Procambarus clarkii.

Self-cloning is quite rare in shrimp, lobsters, crayfish and crabs. Here we report the discovery of four natural clones of red swamp crayfish (Procambarus clarkii), each containing 2-6 genetically identical individuals, during the genotyping of 120 individuals with five microsatellites. The four clones were heterozygote at most of the five microsatellite loci. Phylogenetic analysis using microsatellite genotypes suggests recent origin of the four clones. Sequencing a part of the mitochondrial gene Cox I confirmed that the four clones were from the species Procambarus clarkii.

Symptoms plus family history trump size in thoracic aortic aneurysm.

A 43-year-old woman presented with chest pain of unclear cause. The patient's mother and brother had suffered aortic dissection. Echocardiography had shown mild dilatation of the ascending aorta at 4.0 cm. Echocardiogram and magnetic resonance imaging were negative for dissection. The patient was taken to the operating room on the basis of her painful symptoms and her family history. Unexpectedly, a localized dissection was found in the ascending aorta (see Fig 2), which was too small for imaging detection. Without preemptive surgery, full-fledged dissection would have likely occurred with attendant short and long-term consequences. This case emphasizes that size criteria pertain to asymptomatic patients, and symptomatic patients with aneurysm require resection regardless of size.

Secondhand tobacco smoke impairs rabbit pulmonary artery endothelium-dependent relaxation.

OBJECTIVES: To determine whether secondhand smoke (SHS) induces pulmonary artery endothelial dysfunction, and whether dietary L-arginine supplementation is preventive. BACKGROUND: SHS causes coronary and peripheral arterial endothelial dysfunction. METHODS: The effects of L-arginine supplementation (2.25% solution) and SHS (10 weeks) on pulmonary vascular reactivity were examined in 32 rabbits fed a normal diet. Endothelium-dependent relaxation of precontracted pulmonary artery segments was studied using acetylcholine and calcium ionophore. Endothelium-independent relaxation was studied using nitroglycerin. Endothelial and serum L-arginine levels were measured by chromatography. In eight SHS-exposed and in eight control rats, pulmonary artery nitric oxide synthase (NOS) activity and arginase activity were studied using the titrated arginine to citrulline conversion assay. RESULTS: SHS reduced maximal acetylcholine-induced (p = 0.04) and calcium ionophore-induced (p = 0.02) relaxation. L-Arginine increased maximal acetylcholine-induced (p = 0.047) vasodilation. SHS and L-arginine did not influence nitroglycerin-induced relaxation. SHS reduced endothelial L-arginine (p = 0.04) but not serum L-arginine. L-Arginine supplementation increased endothelial (p = 0.007) and serum L-arginine (p < 0.0005). Endothelium-dependent relaxation induced by acetylcholine and calcium ionophore varied directly with endothelial (r = 0.67, r = 0.67) and serum L-arginine (r = 0.43, r = 0.45), respectively. SHS reduced constitutive NOS activity (p = 0.03). CONCLUSIONS: SHS reduces pulmonary artery endothelium-dependent relaxation by decreasing NOS activity and possibly by decreasing endothelial arginine content. L-Arginine supplementation increases serum and endothelial L-arginine stores and prevents SHS-induced endothelial dysfunction. L-Arginine may offset the deleterious effect of SHS on pulmonary arteries by substrate loading of the nitric oxide pathway.

Comparative effects of ACE inhibitors and an angiotensin receptor blocker on atherosclerosis and vascular function.

BACKGROUND: Both angiotensin-converting enzyme inhibitors (ACE-I(s)) and angiotensin receptor blockers (ARB(s)) provide vascular protection. This study was designed to compare ACE-I(s) with widely differing tissue affinity (captopril and quinapril) and an ARB (losartan) on vascular protection against the adverse effects of high cholesterol. METHODS AND RESULTS: Forty-two New Zealand rabbits on a 0.5% cholesterol diet were randomized into control, captopril (10 mg/kg/d), quinapril (0.3 mg/kg/d), and losartan (8 mg/kg/d) groups for 14 weeks. Captopril, quinapril, and losartan significantly attenuated aortic lipid lesions (P=0.001). Captopril and quinapril were more effective than losartan in preserving vascular relaxation. CONCLUSIONS: Captopril, quinapril, and losartan had similar protective effects against atherogenesis. Captopril and quinapril were more effective than losartan in preserving vascular function. Increased bradykinin by ACE inhibition may be responsible for this improved vascular endothelial function.

Nicotine does not influence arterial lipid deposits in rabbits exposed to second-hand smoke.

BACKGROUND: Second-hand smoke (SHS) accelerates atherogenesis and impairs vascular function. The role of nicotine in this process has not been defined. METHODS AND RESULTS: To examine the potential effects of nicotine on atherogenesis and vascular function, 48 rabbits receiving a 0.5% cholesterol diet were randomized to control (cholesterol diet only), SHS from nicotine-standard research cigarettes (SHS-ST), and SHS from nicotine-free research cigarettes (SHS-NF). The SHS rabbits were exposed to 48 nicotine-standard (12 animals) or nicotine-free (12 animals) cigarettes/d, 5 d/wk for 10 weeks. Air carbon monoxide and particulates and plasma carboxyhemoglobin were significantly higher in the 2 SHS groups than the control group (P<0.001). The SHS-ST group had significant increases in plasma nicotine and cotinine compared with the other groups (P<0.001). There was no difference in serum lipids. Lipid lesions were increased in both SHS groups (54+/-5% [SEM] aorta and 66+/-4% pulmonary artery, 53+/-7% and 69+/-4%, and 39+/-4% and 43+/-3% in the SHS-ST, SHS-NF, and control groups, respectively; P=0.049 aorta and P<0.001 pulmonary artery). CONCLUSIONS: SHS exposure increased arterial lipid lesions, but nicotine did not contribute significantly to this effect. This effect is presumably due to other combustion products in the smoke.

[Purification of vancomycin by using magnetic affinity technique].

A new kind of magnetic affinity microspheres (MAMS), whose ligand is D-Ala-D-Ala, was prepared using agarose as matrix. By using this new MAMS vancomycin was purified directly from crude fermentation liquor with only one step. The purity and the mass recovery of vancomycin measured by reverse-phase HPLC were 97% and 87%, respectively. The characteristic of this method was simpler, faster, cheaper and more effective than that of currently used ones.

Effects of L-arginine on atherogenesis and endothelial dysfunction due to secondhand smoke.

Secondhand smoke (SHS) and hypercholesterolemia increase cardiovascular risk. We hypothesized that L-arginine, the precursor of nitric oxide (NO), might protect against atherogenesis and endothelial dysfunction caused by SHS. The effects of L-arginine supplementation (2.25% solution ad libitum) and SHS (smoking chambers for 10 weeks) were examined in 32 hypercholesterolemic rabbits. Eight normal rabbits served as controls. Acetylcholine- and nitroglycerin-induced vasorelaxation was assessed in aortic rings precontracted with norepinephrine. Hypercholesterolemia increased intimal lesion area (P=0.012), reduced endothelium-dependent relaxation (P=0.009), and reduced basal (P=0.005) and stimulated (P<0.0005) production of NOs. SHS increased intimal lesion area (P=0. 01) norepinephrine-induced contraction (P=0.001) and reduced endothelium-dependent relaxation (P=0.02). SHS-induced increase in norepinephrine contraction was abolished by the inhibition of NO synthase and removal of endothelium. L-Arginine improved endothelium-dependent relaxation (P=0.001) and attenuated SHS-induced endothelial dysfunction (P=0.007) and atherogenesis (P=0. 001). Basal production of nitrogen oxides correlated inversely with intimal lesion area (r=-0.66; P<0.0005) and stimulated production of NOs correlated with endothelium-dependent relaxation (r=-0.66; P<0. 001). SHS causes endothelial dysfunction and increased adrenergic responsiveness and atherogenesis in hypercholesterolemic rabbits. Chronic dietary supplementation with the NO precursor L-arginine mitigates these effects. The adverse vascular consequences of SHS appear to be mediated via deleterious effects on endothelial function.