Current management of subarachnoid hemorrhage in a northern urban Chinese population: a multi-center surveillance study.

OBJECTIVE: The current management of subarachnoid hemorrhage (SAH) in the urban Chinese population remains unclear and the relevant literature is still lacking. Therefore, this work aimed to investigate the recent clinical practice in the management of spontaneous SAH in an urban population-based setting. PATIENTS AND METHODS: From 2009 to 2011, the China Epidemiology Research In Subarachnoid Hemorrhage (CHERISH) project, which was a two-year prospective, multi-center, population-based, case-control study, was performed in the northern urban Chinese population. SAH cases were described in terms of their features, clinical management, and in-hospital outcomes. RESULTS: Totally of 226 cases were enrolled with a final diagnosis of primary spontaneous SAH (65% of females; mean age, 58.5±13.2 years; range, 20-87 years). Among them, 92% of these patients received nimodipine, while 93% took mannitol. Meanwhile, 40% of them received traditional Chinese medicine (TCM), while 43% took neuroprotective agents. Endovascular coiling was applied in 26% of 98 angiography-confirmed intracranial aneurysms (IA) cases, while neurosurgical clipping was in 5% of them. CONCLUSIONS: Our findings on the management of SAH in the northern metropolitan Chinese population reveal that nimodipine is an effective medical therapy with a high rate of use. There is also a high utilization rate of alternative medical interventions. Endovascular coiling occlusion is more common than neurosurgical clipping. Therefore, regionally traditional therapy may be a key factor for the difference in the treatment of SAH between northern and southern China.

High dislocation density-induced large ductility in deformed and partitioned steels.

A wide variety of industrial applications require materials with high strength and ductility. Unfortunately, the strategies for increasing material strength, such as processing to create line defects (dislocations), tend to decrease ductility. We developed a strategy to circumvent this in inexpensive, medium manganese steel. Cold rolling followed by low-temperature tempering developed steel with metastable austenite grains embedded in a highly dislocated martensite matrix. This deformed and partitioned (D and P) process produced dislocation hardening but retained high ductility, both through the glide of intensive mobile dislocations and by allowing us to control martensitic transformation. The D and P strategy should apply to any other alloy with deformation-induced martensitic transformation and provides a pathway for the development of high-strength, high-ductility materials.

Scalable nano-patterning of graphenes using laser shock.

Nano-patterning of graphene film by a novel approach making use of laser ablation generated pressure is presented in this paper. Arrays of nanoscale holes were fabricated by applying laser shock pressure on graphene film suspended on well trenches in silicon substrate. Round holes with diameters ranging from 50 to 200 nm on graphene film were successfully punched. The critical pressure was found to be dependent on the diameter of holes. The smaller the diameters, the higher the critical pressure, which was also captured by the molecular dynamic (MD) simulations. The laser shock based approach presented in this paper provides an effective way to pattern graphene film with nanoscale features in an easy, fast, and scalable manner.

Estrogen receptor beta in breast cancer.

Estrogen is essential for normal growth and differentiation in the mammary gland. It also supports growth of approximately 50% of primary breast cancers. For this reason, removal of estrogen or blocking of its action with the anti-estrogen, tamoxifen, is the main treatment for estrogen receptor alpha (ERalpha)-positive tumors. In 1996, when oncologists became aware of a second ER, ERbeta, there was some doubt as to whether this receptor would be of importance in breast cancer because the clinical consensus was that responsiveness to tamoxifen is related to the presence of ERalpha in breast cancer. Today we know that ERalpha and ERbeta have distinct cellular distributions, regulate separate sets of genes and can oppose each other's actions on some genes. We also know that ERbeta is widely expressed in both the normal and malignant breast and that there are proliferating cells in the breast which express ERbeta. In this review we summarize what is known about ERbeta in breast cancer and examine the possibility that ERbeta-selective ligands may well represent a useful class of pharmacological tools with a novel target, namely proliferating cells expressing ERbeta.

Evans antigen: a new hybrid structure occurring on background of D.. and D-- Rh complexes.

BACKGROUND AND OBJECTIVES: Previously, the Evans antigen (RH37) of the Rh blood group system was shown to be specified by a novel CE-D-CE hybrid gene. We studied further the heterogeneity of Evans and report here its new molecular type resulting from a novel intraexon fusion event on the background of D. and D-- complexes. MATERIALS AND METHODS: A white family with 2 Evans+ and 2 Evans- members was analyzed by serological methods and molecular techniques. RESULTS: The Evans+ proband (JD) typed D+C-c-E-e- and showed a partial loss of RHCE but an increased dose of RHD on DNA blots. On sequencing of Rh cDNAs, a normal D and 3 hybrid transcripts were detected. The D-CE hybrid is characterized by a single breakpoint located in exon 6. The CE-D hybrid derived its exon 1 (or 1 and 2) from RHCE and exons 2-10 (or 3-10) from RHD. The CE-D-CE hybrid had its internal exons 2-7 (or 3-7) from RHD. Family studies showed that the D-CE and CE-D hybrids were linked and cotransmitted from JD to his son, whereas RHD and CE-D-CE hybrid were transmitted from JD to his daughter. CONCLUSION: In this family, Evans is specified by the novel D-CE intraexon fusion gene which occurs in cis to CE-D and trans to CE-D-CE interexon fusion genes. The observed large duplication of RHD reflects a convergent mosaicism underlying the enhancement of D and ablation of CcEe antigens.

Rhmod syndrome: a family study of the translation-initiator mutation in the Rh50 glycoprotein gene.

Rhmod syndrome is a rare genetic disorder thought to result from mutations at a "modifier" but not at the suppressor underlying the regulator type of Rhnull disease. We studied this disorder in a Jewish family with a consanguineous background and analyzed RH and RHAG, the two loci that control Rh-antigen expression and Rh-complex assembly. Despite the presence of a d (D-negative) haplotype, no other gross alteration was found at RH, and cDNA sequencing showed a normal structure for D, Ce, and ce Rh transcripts in family members. However, analysis of RHAG transcript, which encodes Rh50 glycoprotein, identified a single G-->T transversion in the initiation codon, causing a missense amino acid change (ATG[Met]-->ATT[Ile]). This point mutation also occurred in the genomic region spanning exon 1 of RHAG, and its genotypic status in the mother and two children was confirmed by analysis of single-strand conformation polymorphism. Although blood typing showed a very weak expression of Rh antigens, immunoblotting barely detected the Rh proteins in the Rhmod membrane. In vitro transcription-coupled translation assays showed that the initiator mutants of Rhmod-but not those of the wild type-could be translated from ATG codons downstream. Our findings point to incomplete penetrance of the Rhmod mutation, in the form of "leaky" translation, leading to some posttranslational defects affecting the structure, interaction, and processing of Rh50 glycoprotein.

[Studies on desensitization of GABAB receptor coupled adenylate cyclase].

After preincubation of crude synaptic membranes (P2 membranes) with phorber ester (PMA) or GABAB receptor agonist baclofen (BAL), the rate of inhibition of BAL on basal adenylate cyclase (AC) activity and forskolin-stimulated AC activity significantly reduced (desensitized). This effect of BAL did not change after preincubation with forskolin suggesting that the desensitization mechanism of GABAB receptor coupled AC is related with activation of protein kinase C (PKC), but not with protein kinase A. It was further found that the equilibrium dissociation constant (Kd) of GABAB receptor was increased during desensitization. Our results suggest that PKC activation may cause some structural or conformational changes of GABAB receptor, resulting in an uncoupling from G protein and desensitization of GABAB receptor-coupled AC.

[Improvement of learning and memory functions by GABAB receptor antagonists in mice].

In one trial passive avoidance response in mice, the effects of gamma-aminobutyric acid (GABA)B receptor agonist baclofen and antagonist CGP35348 and CGP36742 on acquisition, consolidation and retrieval of memory were observed. The results showed that the antagonists could significantly promote the acquisition impairment induced by baclofen, the consolidation impairment induced by baclofen and NaNO2, and the retrieval impairment induced by baclofen and 30% alcohol. These results suggest that the GABAB receptor antagonists may become a novel type of drug for the treatment of Alzheimer's disease.

Nylestriol replacement therapy in postmenopausal women. A three-year prospective study.

A three-year prospective study was carried out in 283 postmenopausal women to evaluate the effects of a long-acting estriol derivative-nylestriol. The women were randomly assigned into 3 groups: group A (136 cases, nylestriol 2 mg/2 wk), group B (97, nylestriol 1 mg/2 wk) and group C (50, placebo/2wk). LDL-C decreased and HDL-C increased after 3 months of medication (P < 0.05), but TC and TG not significantly changed in any group (P > 0.05). No changes of lipids were found in group C (P > 0.05). Serum ALP, Ca/Cr and Hpr/Cr in fasting urine decreased in 3 months in both group A and B (P < 0.05), but not in group C (P > 0.05). Forearm bone mineral content loss was restrained in groups A and B (P > 0.05), but decreased markedly in group C (P < 0.01). The Kupperman index scores decreased by about 50% after 3 months and 80% in 12 months in groups A and B. Nylestriol induced mild stimulatory effect on the uterine endometrium, and addition of 6 mg of provera daily for 7-10 days every 6 months is recommended. Nylestriol exhibited no obvious effect on the breast. This study demonstrated that nylestriol can be used as an effective and acceptable estrogen replacement therapy for postmenopausal women.

[Prospective study on nylestriol replacement therapy in postmenopausal women].

A prospective study was carried out on 283 postmenopausal women to evaluate the nylestriol effect from Jan. 1989 to July 1992. Menopausal year ranged from 1-26 years. The women were divided randomly into three groups. Group A: the nylestriol were given 2 mg/2 weeks, 136 cases, group B: 1 mg/2 weeks, 97 cases, group C: placebo/2 weeks, 50 cases. The results showed: (1) High-density-lipoprotein cholesterol increased and low-density-lipoprotein cholesterol decreased in both group A and B (P < 0.05), but not in the placebo group (P < 0.05). (2) Both the group A and B had significant lessening of serum alkaline phosphatase, ratios of calcium to creatinine and hydroxyproline to creatinine (P < 0.05). (3) The mineral content of distal and proximal forearm bone remained unchanged in both group A and B (P > 0.05), but decreased significantly in placebos (P < 0.01). (4) The Kupperman index score in both group A and B decreased significantly in 3 month (P < 0.05). (5) Curettage were performed 205 times in group A and B. Histological diagnosis revealed neither carcinoma nor atypical endometrial hyperplasia. (6) No breast cancer was found. In conclusion, nylestriol is a convenient and acceptable drug which was beneficial for relieving climacteric syndrome, preventing osteoporosis and improving lipoprotein lipid pattern.

Prospective double-blind study of CEE3 in peri- and postmenopausal women: effects on bone loss and lipoprotein lipids.

A prospective double-blind study was carried out in 136 women 0.5 to 21 years since menopause (YSM) in order to demonstrate the effects of a long-acting estriol derivative-Nylestriol (CEE3) on bone loss and lipoprotein lipids. They were orally administered at 2 mg of CEE3 or placebo every 2 weeks. Among 90 subjects who finished 1 year of medication, 49 received CEE3 and 41 placebo. The results were: 1. Serum ALP, Ca/Cr and Hop/Cr in fasting urine decreased in 3 months (P < 0.05); 2. Menopause-related reduction of forearm bone density was restrained; 3. LDL-C decreased in 3 months and HDL-C increased in 6 months (P < 0.05), with no significant changes in TC and TG; 4. Side effects were mild. 1/3 of those with intact uterus had spotting and another 1/3 had moderate withdrawal bleeding after the addition of medroxyprogesterone acetate at the end of 12 months of CEE3 therapy. This study demonstrates that CEE3 is effective and acceptable for preventing osteoporosis and lipoprotein lipids disorder in postmenopausal women. Long-term application awaits further studies.

[A prospective study of nylestriol on plasma lipids in postmenopausal women].

A prospective, double-blind clinical study has been carried out in 90 chinese women with postmenopausal period covering 0.5 to 21 years by administering a synthetic long-acting estriol derivative-nylestriol in the regimen of 2 mg every 2 weeks for 1 year (49 treated and 41 placebo). The result were: Total cholesterol (TC) and triglyceride (TG) remained unchangeable (P greater than 0.05), while high-density-lipoprotein cholesterol (HDL-C) increased after 6 months, low-density lipoprotein cholesterol (LDL-C) and TC/HDL-C,LDL-C/HDL-C ratios decreased after 3 months of medication (P less than 0.05); FSH were restrained (P less than 0.05), but LH did not change significantly (P greater than 0.05). One third of the women with intact uterus had spotting withdraw bleeding and another one third had moderate amount after the addition of medroxyprogesterone acetate 6 mg daily for 7 days at the end of the 12 months treatment. Side effects included breakthrough bleeding (10.3%), breast tenderness (11.8%), leukorrhagia (29.4). None showed abnormal liver function (GPT).

Immunosuppression in mice induced by cold water stress.

A number of studies indicate that stress can result in suppression of the immune system in animals and man. Most of the studies have focused on alterations of lymphocyte function while only a few have investigated alterations of macrophage function or macrophage cytokine production. Macrophages play an essential role in homeostasis of the immune response. Indeed, the earliest events of the immune response occur in cells of the monocytic lineage, and their secretion of various cytokines may have both immunological and nonimmunological effects. The present studies were undertaken to determine whether alterations in macrophage physiology occur in mice subjected to a stress stimulus. Our studies in mice exposed to cold water stress for 4 days indicated reduced numbers of thymocytes and splenocytes, decreased T-cell blastogenesis, and reduced NK activity. Examination of elicited peritoneal macrophages from stressed mice revealed increased prostaglandin E2 (PGE2) secretion and decreased immune region associated antigen (Ia) expression in response to interferon-gamma. Despite elevated PGE2 levels, indomethacin was generally unable to restore depressed immune function. Of special interest was the finding that cell-associated and secreted interleukin 1 were significantly higher from unstimulated elicited macrophages from stressed mice. These results suggest that early in the response to stress, functions of a variety of cells within the immune system, especially macrophages, are altered and that dysregulated macrophage function may well contribute to the generalized suppression of the immune response in cold water stressed mice.

[Effect of menopause and sex hormones on plasma lipids].

Plasma cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and estradiol, FSH, LH, testosterone, prolactin were determined in 102 cases of perimenopausal women. HDL-C HDL-C/TC, HDL-C/LDL-C decreased and LDL-C increased significantly after menopause, while TG increased in group of menopausal years beyond 11 (P less than 0.01). Postmenopausal women also showed abrupt decrease of estradiol and increase of FSH, LH, and slight decrease of prolactin (P less than 0.01), but no change in testosterone. Plasma lipids showed no correlation with sex hormones except estradiol, which was positively related with HDL-C and negatively with TC, LDL-C (P less than 0.001) but no relationship with TG (P greater than 0.05). The effects of surgical menopause was greater than that of natural menopause. This study suggested that the postmenopausal changes of plasma lipids are related to the decrease of estradiol and the ovaries should be preserved when perimenopausal women received pelvic operation whenever possible.

[Predictive impact on malaria prevalence by hydraulic project of three gorges of the Yangtze River].

Malaria had a wide distribution and high prevalence throughout the Three Gorges region of the Yangtze River. After antimalarial program, its incidence rate was reduced to 2.2% in 1985, but sporadic cases still occurred in 34.7% of the townships and local outbreaks were not uncommon. Therefore, potential factors of malaria outbreak are still present. It is predicted that maximum risk of malaria outbreak will take place, during construction and after the completion of the reservoir, the breeding sites of Anopheles would be extended to irrigation network, low-lying of flooded land, and malaria prevalence might be increased.

[Pulmonary parenchymal and pleural fibrosis as an expression of Recklinghausen's neurofibromatosis]. / Lungengerüst- und Pleurafibrose als Ausdruck der Neurofibromatose von Recklinghausen.

We report three patients with neurofibromatosis, lung parenchymal, and pleural changes. Lung fibrosis occurs in 10% of patients with neurofibromatosis. Pleural involvement is less common. We are presenting one such case.