Construction of a hypoxic immune microenvironment associated gene-based model for prognosis prediction of lung adenocarcinoma.

OBJECTIVE: Lung adenocarcinoma (LUAD) accounts for the majority of cancer deaths worldwide, with a high incidence rate and mortality. It is highly important to develop biomarker model to accurately predict the prognosis. MATERIALS AND METHODS: RNA-Seq data and clinical follow-up data of LUAD were downloaded from The Cancer Genome Atlas (TCGA) database. Hypoxia-related gene sets were collected from the Gene Set Enrichment Analysis (GSEA) website. A gene signature model was established using the Limma package in the R software, univariate and multivariate survival analyses, and least absolute shrinkage and selection operator (LASSO) algorithms. RESULTS: Two hypoxia subtypes (C1 and C2) were classified according to the expressions of 55 prognostic hypoxic-related genes. Differentially expressed genes (DEGs) between two hypoxia subtypes and immune group were analyzed. Then, 390 DEGs related to hypoxic immune microenvironment were filtered. According to hypoxia type and immune type, the samples were classified into hypoxia-high & immune-low group, hypoxia-low & immune-high group. Based on these differentially expressed genes (DEGs), a 5-genes signature model, which showed a stable prediction performance on datasets of different platforms and immunotherapy datasets, was finally developed. Meanwhile, it demonstrated a better performance compared with other existing models. The AUC of the 5-gene signature was high in both the training dataset and 4 independent validation datasets and was confirmed as a clinical feature-independent prognostic model. CONCLUSIONS: This study developed a hypoxic immune microenvironment associated gene-based model for prognostic prediction of LUAD, providing clinicians with a reliable prognostic assessment tool and facilitating clinical treatment decision-making.

[Maternal periconceptional folic acid supplementation and its effects on the prevalence of fetal neural tube defects].

OBJECTIVE: To find out the status of folic acid supplementation among women, to evaluate the prevention effects on neural tube defects (NTDs), and to explore the factors impact on folic acid supplementation compliance. METHODS: Based on the routine data of 92 121 women in prenatal health care and birth defect surveillance system in Tongzhou District of Beijing from 2013 to 2018, we described the prevalence of periconceptional folic acid supplementation, pre-pregnancy folic acid supplementation and regularly folic acid supplementation (compliance supplementation). Trend χ2 tests were used to evaluate the change of folic acid supplementation prevalence. The prevalence difference among the women with folic acid supplementation and without supplementation were tested with Fisher's exact test. Factors asso-ciated with folic acid supplementation compliance rate were analyzed with univariate and multivariate Logistic regression model. RESULTS: The prevalence of periconceptional folic acid supplementation during the six years was 90.08% and it was increased from 2013 to 2018, but the rate of pre-pregnancy and regular supplementation was only 41.5% and declined from 2013 to 2018, especially 2013 to 2015. The prevalence of NTDs among the fetuses whose mothers took folic acid during periconceptional period was 5.5/10 000, while the prevalence for the fetuses whose mothers did not take folic acid was 19.7/10 000 (P < 0.001), the rates ratio was 27.9% (χ2=23.74, P < 0.001). The difference between the prevalence of NTDs among the fetuses whose mothers took folic acid only and multiple micronutrients was not statistically significant. After controlling the confounding factors, it was found that the compliant folic acid supplementation rates in women, whose household registrations were outside Beijing and whose education levels were junior high school or below, and who were younger than 25 years old, and who were multiparas and who were pre-pregnancy underweight or obese, were lower than those of the corresponding control groups (P < 0.05). CONCLUSION: The rate of folic acid supplementation among women in Tongzhou District of Beijing was relatively high, but their compliance was poor. Women who did not take folic acid during periconception seriously affected the prevention effect of NTDs. We should focus on women who are younger than 25 years old, lower educated, pre-pregnancy underweight or obese, multiparas and nonlocal household registers, in order to improve the periconceptional folic acid supplementation compliance and improve the effects of NTDs prevention.

Cytomegalovirus-associated acute respiratory failure in lupus patients: case reports in relation to cytomegalovirus biology.

With the wide use of immunosuppressive agents, life-threatening cytomegalovirus-associated acute respiratory failure occurs frequently. However, this condition is yet to be fully recognized and the therapeutic approach to it can only be based on comprehensive protocols rather than the biological characteristics of cytomegalovirus. We describe three acute respiratory failure events that were related to the pathogenicity of cytomegalovirus, the primary cytopathic effect and secondary antiviral immunity-mediated damage. All cytomegalovirus infection occurred after immunosuppressive usage while the acute respiratory failure events took place in different clinical settings. The first acute respiratory failure event originated from the immunoinflammatory response after cytomegalovirus infection was circumscribed, while the second resulted from cytomegalovirus reactivation and the third was caused by the combined effect of acute cytomegalovirus infection and the subsequent immunoinflammatory response. According to the clinical setting, corresponding therapeutic approaches (sequential or combined strategy) were carried out. All the patients here presented were responsive to the above therapeutic strategies. Consequently, cytomegalovirus-associated acute respiratory failure in systemic lupus erythematosus patients should be carefully differentiated and a sequential or combined strategy should be carried out according to the clinical setting. Overall, we find that there are three patterns of cytomegalovirus-associated acute respiratory failure in systemic lupus erythematosus patients and propose a novel therapeutic strategy in relation to cytomegalovirus biology.

[Effects of different time of cryoablation on the proliferation of airway traumatic granuloma and its mechanism in rabbits].

Objective: To investigate the effect of different cryoablation time on tracheal traumatic granulation formation and its mechanism. Methods: A total of 32 rabbits were randomly assigned into four groups (A-D). Group A underwent tracheotomy alone. Group B, C and D received intra-tracheal brush rubbing to establish airway granulation model. Group C and D underwent 30 s and 2-minute cryoablation respectively. Tracheal specimens of all groups were collected to examine pathological changes using HE staining. Levels of transforming growth factor beta 1 (TGF-ß(1)) and CD34 in tracheal granulation were evaluated using immunohistochemistry (IHC) and real-time quantitative reverse transcription polymerase chain reaction (RT-qCR). Results: Tracheal lumens of group A were smooth without granulation. While the growth of granulation and luminal stenosis were most severe in Group B, followed by Group D and C. Submucosa thickness of Group B was largest as compared with other groups (0.20±0.07, 0.77±0.28, 0.44±0.13 and 0.55±0.18 mm for Group A to D, respectively. P<0.05). And the submucosa layer of Group C was thinner than Group D (P<0.05). The expression and transcription levels of TGF-ß(1) of trachea were highest in Group B as detected by IHC and RT-qPCR (P<0.05), followed by Group D and C (IHC: 0.48±0.01 vs 0.43±0.01, P<0.05; RT-qPCR: 12.61±2.14 vs 2.38±0.10, P<0.05). Both protein and mRNA levels of CD34 were highest in Group B as detected by IHC and RT-qPCR (P<0.05). Tracheal mRNA levels of CD34 were more abundant in Group D than Group C (4.92±0.90 vs 2.09±0.10, P<0.05), while no significant difference was found between groups regarding protein levels measured by IHC. Conclusions: Cryoablation could alleviate the hyperplasia of tracheal traumatic granulation, possibly due to the inhibition of TGF-ß(1) and CD34 expression. The effect of 30 s cryoablation for tracheal traumatic granulation is better.

[Efficacy and safety of oseltamivir in children with suspected influenza: a multicenter randomized open-label trial].

Objective: To evaluate the efficacy and safety of oseltamivir in the treatment of suspected influenza in children. Method: A multicenter, randomized and open-label trial was conducted among 229 individuals with suspected influenza which were collected from the clinic of 5 hospitals in Guangdong province (Guangzhou Women and Children's Medical Center, Shenzhen Baoan District Maternity and Child Care Service Center, the Second Affiliated Hospital of Shantou University Medical College, Dongguan Maternity and Child Care Service Centre, Yuexiu District Children's Hospital of Guangzhou) from April to July 2015. They were randomized either to oseltamivir group (oseltamivir 30-75 mg, twice daily for 5 days) or control group who were given symptom relief medicines for 5 days. Result: No significant difference was found between two groups in influenza symptoms of the patients before the treatment(P>0.05). Altogether 229 individuals (114 in oseltamivir group, 115 in control group) were analyzed for efficacy, in which 73 individuals (42 oseltamivir, 31 control), 31.9%, were identified as influenza-infected through laboratory test. No significant difference was found between the two groups in the duration of fever although shortened. In the 229 individuals , the cumulative alleviation proportion between oseltamivir and control group was not significantly different (P>0.05): the median duration of illness was 69.9 hours (95% CI 65.3-91.5) in oseltamivir group and 75.4 hours (95%CI 63.9-91. 7) in control group; the median duration of fever was 40.4 hours (95%CI 31.5-53.4) in oseltamivir group and 44.0 hours (95%CI 33.2-50.0) in control group. In the 73 individuals, the cumulative alleviation proportion between oseltamivir and control group was significantly different (P<0.05). The median duration of illness was 61.2 hours (95%CI 48.0-121. 0) in oseltamivir group, being significantly shorter than that of 116.0 hours (95%CI 91.5-175.0) in control group. But it was not significantly different that the median duration of fever was 32.8 hours (95%CI 24.0-47.0 ) in oseltamivir group and 55.8 hours (95%CI 43.6-78.3 ) in control group (P>0.05). And the median duration of fever in 60 individuals (38 oseltamivir, 22 control) was significantly different between two groups(P<0.05), who had finished a course of taking oseltamivir in the 73 individuals, 34.8 hours (95%CI 24.0-48.5 ) in oseltamivir group being significantly shorter than that of 53.3 hours (95%CI 43.6-104.0 ) in control group. There was certain difference in side effects rate between the two groups (oseltamivir 10%, control 2%, P<0.05). The main side-effects were gastrointestinal symptoms (stomachache, diarrhea, poor appetite, vomiting). Conclusion: The duration of illness and fever in suspected influenza patients treated with oseltamivir was shorter than those in the patients treated with no oseltamivir, the difference was not statistically significant, when 31.9% was confirmed with positive result of virus test in suspected influenza in children. But in these patients with positive result of virus test, the duration of illness was significantly shortened with treatment with oseltamivir as compared with no treatment with oseltamivir, and it would be better if full oseltamivir course was completed for reducing the duration of fever. Oseltamivir treatment was safe with mild side effects.

The potential impact of sleep-related movement disorders on stroke risk: a population-based longitudinal study.

BACKGROUND: Sleep-related movement disorders (SRMD) have been shown to increase the risk of cardiovascular diseases. However, the relationship between SRMD and stroke remains unclear. AIM: To explore the relationship between SRMD and stroke in the general population. DESIGN: Two cohorts of patients with SRMD and without SRMD were followed up for the occurrence of hemorrhagic and ischemic stroke. METHODS: The study cohort enrolled 604 patients who were initially diagnosed as SRMD between 2000 and 2005. 2,416 age- and sex-matched patients without prior stroke were selected as the comparison cohort. A Cox-proportional hazard regression analysis was performed for multivariate adjustment. RESULTS: Patients with SRMD had a higher risk for developing all-cause stroke [adjusted hazard ratio (HR) = 2.29, 95% confidence interval (CI) = 1.42-3.80]. Patients of below 45 years old had the greatest stroke risk (HR = 4.03, 95% CI = 3.11-5.62), followed by patients aged ≥65 years (HR = 2.64, 95% CI = 1.12-3.44) and 45-64 years (HR = 1.07, 95% CI = 1.02-1.71). The age-stratified analysis suggested that the increased risk of hemorrhagic stroke was more significant than ischemic stroke among all age groups. Furthermore, males with SRMD were at greater risk to develop all-cause stroke (HR = 2.98, 95% CI = 1.74-4.50) than that of females (HR = 1.94, 95% CI = 1.01-3.77). CONCLUSIONS: Patients with SRMD were found to have an increased risk of all-cause stroke along with a higher possibility of hemorrhagic stroke over ischemic stroke.

MNS, Duffy, and Kell blood groups among the Uygur population of Xinjiang, China.

Human blood groups are a significant resource for patients, leading to a fierce international competition in the screening of rare blood groups. Some rare blood group screening programs have been implemented in western countries and Japan, but not particularly in China. Recently, the genetic background of ABO and Rh blood groups for different ethnic groups or regions in China has been focused on increasingly. However, rare blood groups such as MN, Duffy, Kidd, MNS, and Diego are largely unexplored. No systematic reports exist concerning the polymorphisms and allele frequencies of rare blood groups in China's ethnic minorities such as Uygur and Kazak populations of Xinjiang, unlike those on the Han population. Therefore, this study aimed to investigate the allele frequencies of rare blood groups, namely, MNS, Duffy, Kell, Dombrock, Diego, Kidd, Scianna, Colton, and Lutheran in the Uygur population of Xinjiang Single specific primer-polymerase chain reaction was performed for genotyping and statistical analysis of 9 rare blood groups in 158 Uygur individuals. Allele frequencies were compared with distribution among other ethnic groups. Observed and expected values of genotype frequencies were compared using the chi-square test. Genotype frequencies obeyed the Hardy-Weinberg equilibrium (P > 0.5) and allele frequencies were stable. Of all subjects detected, 4 cases carried the rare phenotype S-s- of MNS blood group (frequency of 0.0253), and 1 case carried the phenotype Jka-b- (frequency of 0.0063). Frequencies of the four groups, MNS, Duffy, Dombrock, and Diego, in the Uygur population differed from those in other ethnic groups. Gene distribution of the Kell, Kidd, and Colton was similar to that in Tibetan and Han populations, though there were some discrepancies. Gene distribution of Scianna and Lutheran groups showed monomorphism similar to that in Tibetan and Han populations. These findings could contribute to the investigation of the origin, evolution, and hematology of Uygur population of Xinjiang and assist in screening of rare blood groups in ethnic minorities, meeting of clinical blood supply demands, and building of the national rare blood group library.

Defining reasonable patient standard and preference for shared decision making among patients undergoing anaesthesia in Singapore.

BACKGROUND: A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. METHODS: A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients' perception of material risks, by trained interviewers. Patients' demographics were obtained. Mann-Whitney U test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. RESULTS: Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education (p < 0.007), being employed (p < 0.046) and younger age group (p < 0.003) are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea (64.8%), Drowsiness (62.4%) and Surgical Wound Pain (58.8%). Patients ranked Heart Attack (59.3%), Death (53.8%) and Stroke (52.7%) as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist (52.2%), instead of letting the doctor decide (37.1%) or deciding for themselves (10.7%). Discussion with the anaesthetist (61.3%) is the preferred medium of communication compared to reading a pamphlet (23.4%) or watching a video (15.4%). CONCLUSION: Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship.

Assessment of treatment response in non-alcoholic steatohepatitis using advanced magnetic resonance imaging.

BACKGROUND: Magnetic resonance imaging-derived measures of liver fat and volume are emerging as accurate, non-invasive imaging biomarkers in non-alcoholic steatohepatitis (NASH). Little is known about these measures in relation to histology longitudinally. AIM: To examine any relationship between MRI-derived proton-density fat-fraction (PDFF), total liver volume (TLV), total liver fat index (TLFI), vs. histology in a NASH trial. METHODS: This is a secondary analysis of a 24-week randomised, double-blind, placebo-controlled trial of 50 patients with biopsy-proven NASH randomised to oral ezetimibe 10 mg daily (n = 25) vs. placebo (n = 25). Baseline and post-treatment anthropometrics, biochemical profiling, MRI and biopsies were obtained. RESULTS: Baseline mean PDFF correlated strongly with TLFI (Spearman's ρ = 0.94, n = 45, P < 0.0001) and had good correlation with TLV (ρ = 0.57, n = 45, P < 0.0001). Mean TLV correlated strongly with TLFI (ρ = 0.78, n = 45, P < 0.0001). After 24 weeks, PDFF remained strongly correlated with TLFI (ρ = 0.94, n = 45, P < 0.0001), maintaining good correlation with TLV (ρ = 0.51, n = 45, P = 0.0004). TLV remained strongly correlated with TLFI (ρ = 0.74, n = 45, P < 0.0001). Patients with Grade 1 vs. 3 steatosis had lower PDFF, TLV, and TLFI (P < 0.0001, P = 0.0003, P < 0.0001 respectively). Regression analysis of changes in MRI-PDFF vs. TLV indicates that 10% reduction in MRI-PDFF predicts 257 mL reduction in TLV. CONCLUSIONS: The MRI-PDFF and TLV strongly correlated with TLFI. Decreases in steatosis were associated with an improvement in hepatomegaly. Lower values of these measures reflect lower histologic steatosis grades. MRI-derived measures of liver fat and volume may be used as dynamic and more responsive imaging biomarkers in a NASH trial, than histology.

Genetic polymorphism at the KIR gene locus: determination of gene, genotype, and haplotype frequencies in the Xinjiang Han population.

The aim of this study was to explore the genetic polymorphism, genotype, and haplotype characteristics of the KIR locus in the Xinjiang Han population in order to establish a foundation for future analysis of the relationship between KIR genes and disease. KIR genes were detected by sequence-specific primer-polymerase chain reaction in 184 randomly selected, healthy individuals from the Han population in Xinjiang, China. Standard genotype and haplotype analyses were conducted using Hsu's standards classified for analysis. Sixteen KIR genes were detected: 3DL3, 2DL4, 3DL2, and 3DL2 (100%); 2DL1 and 2DP1 (99.46%); 2DL3 (98.91%); and so on. The 2DS2 gene frequency was the lowest at 21.74%. Twenty-one genotypes were detected: AJ (2, 2) was relatively common (42.39%), followed by AH (5, 2), AE (2, 8) and H (2, 4), with frequencies of 17.39, 11.96, and 8.15%, respectively. In addition, six novel genotypes were identified in 11 Han individuals as well as in other populations in China, which could not be classified for analysis. These results indicated that the Xinjiang Han population shares KIR gene, genotype, and haplotype frequency distributions with the Chinese Han population, but also has unique genotypes and haplotypes.

Prone and direct posterior approach for management of posterior column tibial plateau fractures.

INTRODUCTION: The three-column fixation concept is becoming popular in orthopedic practice. Posterior column fracture is an uncommon type of tibial plateau fracture. The supine position for the surgical approach is familiar to most surgeons; however, it is difficult to achieve good reduction and fixation in posterior column fracture. HYPOTHESES: The prone position and direct posterior approach can achieve proper reduction and fixation for posterior column tibial plateau fracture, yielding good functional outcome. MATERIALS AND METHODS: Between January 2010 and January 2012, 184 tibial plateau fractures were diagnosed and operated on in our institution. Sixteen posterior column tibial plateau fractures (10 male and 6 female patients, with a mean age of 41.5 ± 14.3 years) were diagnosed by preoperative plain films and CT scans. Ten patients presented with fracture-dislocation of the knee joint. A direct posterior approach in prone position was used to reduce the tibial condyle and fix it with an anti-glide buttress plate. Radiographic evaluation included reduction quality and bone union. Functional evaluation included Lysholm score and Tegner activity score. RESULTS: All fractures healed within 6 months, without secondary displacement. Ten knees had postoperative anatomic reduction (0mm step-off) and 6 had acceptable reduction (< 2mm step-off). At 34.4 ± 9.6 months, median extension was 3 (5-10) and flexion 135 (100-145). The mean Lysholm score was 95 (75-100) and the mean Tegner activity score was 6 (5-8). All patients were satisfied with the operation. No cases of post-traumatic osteoarthritis of the knee occurred during follow-up. CONCLUSIONS: The prone position and direct posterior approach has great advantages in terms of reduction and stable fixation, yielding good results.

KIR gene polymorphism study in the Uygur population in Xinjiang, China.

We analyzed killer cell immunoglobulin-like receptor (KIR) gene polymorphisms and genotype and haplotype characteristics in the Uygur population, a non-nomadic ethnic group found in Xinjiang, China, to provide a basis for studies on relationships between KIRs and diseases in this group. Sequence-specific primer PCR was used to detect the KIR gene in 84 Uygur individuals. A standard genotype and haplotype analysis was conducted using Hsu's standards. Sixteen KIR genes were detected; the 3DL3, 2DL4, 3DL2 genes were found in all individuals. The 2DL1, 3DP1, 2DP1, 2DL3 genes were relatively common, followed by 2DS4, 3DL1, 2DL5, 2DS2, 2DL2, 2DS1, 2DS5, and 3DS1. The 2DS3 gene had the lowest frequency. A total of 19 genotypes were detected, the AJ (2,2), AH (5,2) and M (2,8) genotypes were relatively common, with frequencies of 25, 10.7 and 10.7%, respectively; they were followed by P (2,17), AI (1,5), H (2,4), and C (5,3), with frequencies of 9.52, 5.95, 5.95, and 4.76%, respectively. The U (17,21), and T (8,8) genotypes, found in four individuals, had not been reported in the Han Chinese population. Eleven haplotypes were detected; the most common haplotype 2 (N = 74) was accounting for 48.7%, followed by haplotype 5 (N = 24), accounting for 15.8%. In addition, three new genotypes were found, for which haplotype analysis could not be performed based on existing standards. We conclude that the Xinjiang Uygur population has unique KIR gene frequency, genotype frequency and haplotype frequency distributions; there also appears to be new genotypes and haplotypes in this population.

Effect of Repeated Wuniu Early Tea Administration on the CYP450 Activity Using a Cocktail Method.

Wuniu early tea (Camellia sinensis) is an important beverage consumed in China. Up to date, a lot of methods for identifying and chemical analysing have been done. However, there is no report on the effects of Wuniu early tea on cytochrome P450 isozymes. Therefore, the present objective of our study was to evaluate the potential effects of Wuniu early tea on cytochrome P450 isozymes P2C9, P1A2, P2C19 and P2B6 in rats with a cocktail approach including, matching probe drugs of tolbutamide, phenacetin, omeprazole and bupropion. These four probe drugs were simultaneously administered to rats after repeated Wuniu early tea administration. The pharmacokinetics of the probes in the plasma was simultaneous determined by high-performance liquid chromatography-mass spectrometry. The t1/2 and AUC(0-∞) of tolbutamide increased significantly and CLz decreased remarkably in test rats after repeated Wuniu early tea administration. However, the main pharmacokinetic parameters of the other three probe drugs were not significantly different between control and test rats. The findings in this study suggested that Wuniu early tea could inhibit cytochrome P2C9 while did not influence on cytochrome P1A2, cytochrome P2C19 and cytochrome P2B6.

Recent Chlamydia pneumoniae infection is highly associated with active ankylosing spondylitis in a Chinese cohort.

OBJECTIVE: The aim of the present study was to investigate the presence of anti-Chlamydia pneumoniae (Cp) antibodies in patients with ankylosing spondylitis (AS) to determine whether there is an association with AS disease activity. METHODS: Seventy-nine AS outpatients and 73 normal controls were enrolled in this case-control study. Serum anti-Cp immunoglobulins (CpIg) were detected by enzyme-linked immunosorbent assay (ELISA). Antibodies to Epstein-Barr virus (EBV), cytomegalovirus (CMV), and Chlamydia trachomatis (Ct) were also measured. Clinical and experimental data were collected, and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was determined. Patients with positive Cp IgM or Cp IgA were considered to have had a recent Cp infection. RESULTS: Cp IgG was detected in the majority of AS patients and also controls (88.8% vs. 91.8%, respectively). The seroprevalence of Cp IgA and Cp IgM was significantly higher in AS patients than in the controls (51.9% vs. 31.5%, p = 0.010 for Cp IgA; 79.7% vs. 20.5%, p < 0.0001 for Cp IgM). Seropositivity of Cp IgM was associated with elevation of the disease activity index, including erythrocyte sedimentation rate (ESR; p = 0.021), C-reactive protein (CRP; p = 0.007) and the BASDAI (p = 0.009). Persistent positive Cp IgM was associated with active disease, while seroreversion of Cp IgM was associated with a reduction in these disease activity indices. There was no correlation between Cp IgM or Cp IgA and symptomatic upper respiratory infections or other clinical manifestations. CONCLUSIONS: Recent Cp infections occur frequently in AS patients and Cp IgM antibody is correlated with active disease. These findings indicate that Cp infections may be a triggering factor for active AS.

Trapping of anionic organic radicals by (TpMe2)2Ln (Ln = Sm, Eu).

Stoichiometric reaction of [ Sm(Tp(Me2))2 ], 1, with a variety of reducible ketone- and quinone-type substrates gave thermally stable, isolable radical anions/ketyls in moderate to good yields. Thus reaction with benzophenone gave [Sm(Tp(Me2))2(OCPh2)], 2, with fluorenone [Sm(Tp(Me2))2(eta1-OC13H8)], 3, and di-tert-butylparaquinone [Sm(Tp(Me2))2(eta1-OC6H2(tBu)2O)], 4, each of which was structurally characterized. In the case of the less-hindered benzoquinone, an unimetallic semiquinone [Sm(Tp(Me2))2(OC6H4O)], 5, could be isolated, although it was unstable with respect to formation of the dimetallic complex [Sm(Tp(Me2))2]2(mu-OC6H4O), 6. Compound 6 was structurally characterized, as was its anthraquinone analogue [Sm(Tp(Me2))2]2(mu-OC14H8O), 7. When the analogous reaction was carried out between the less-reducing [Eu(Tp(Me2))2] and benzoquinone, only the europium analogue of the semiquinone 5, [Eu(Tp(Me2))2(OC6H4O)], 8, could be isolated. The use of the sterically hindered 3,5-di-tert-butyl-o-benzoquinone allowed isolation of [Sm(Tp(Me2))2(DTBSQ)], 9.

De novo calcification of liver and nodal metastases in prostate carcinoma.

Prostate cancer has a distinctly recognized pattern of metastases: multifocal and osteoblastic lesions involving the axial skeleton and non-calcified lymph nodes in the pelvic and lumbar aortic groups. Most adenocarcinomas are capable of producing macrocalcification. We report a case of prostate cancer with de novo calcified metastases to the liver and retroperitoneal lymph nodes mimicking the pattern usually seen in mucin-producing adenocarcinomas arising from the gastrointestinal tract. To our knowledge, this is the first such case to be reported in the literature. We propose a multifactorial mechanism that supports dystrophic calcification in this case. The knowledge of atypical presentation of metastatic disease can prevent diagnostic delay and prompt initiation of therapy.

Enhancement of the resolution of surface plasmon resonance biosensors by control of the size and distribution of nanoparticles.

A new resolution-enhanced surface plasmon resonance (SPR) biosensor offers a tenfold improvement in resolution compared with conventional SPR biosensors in the detection of the surface coverage of biomaterials. The proposed optical biosensor, based on the attenuated total-reflection method, excites both the surface plasmons and particle plasmons to enhance the local electromagnetic field by control of the size and volume fraction of embedded Au nanoparticles to increase the resolution of the device. The SPR biosensor design is based on the Maxwell-Garnett model and the Fresnel equations, and the device is fabricated with a cosputtering deposition system.