[Association of skin lesion severity with clinical features of psoriatic arthritis].

Objective: To investigate the relationship between psoriasis severity and clinical features in psoriatic arthritis (PsA). Methods: Patients were recruited from the Chinese REgistry of Psoriatic ARthritis (CREPAR) between December 2018 and June 2021, and data were collected including the baseline demographic characteristics, various clinical manifestations (including arthritis, nail disease, comorbidities), laboratory tests[including erythrocyte sedimentation rate(ESR), C-reactive protein (CRP)], health assessment questionnaire (HAQ). Body surface area (BSA) and psoriasis area and severity index (PASI) were selected for the tools of assessment of cutaneous psoriasis. Patients were divided to two groups, including the severe psoriasis group (BSA>10%) and the non-severe psoriasis group (BSA≤10%). Disease assessment included ankylosing spondylitis disease activity score (ASDAS), disease activity score 28 (DAS28) and disease activity in psoriatic arthritis (DAPSA). Results: 1 074 eligible patients with PsA were recruited, and 106 (9.9%) had severe psoriasis. Compared with non-severe psoriasis group, the severe psoriasis group had more peripheral joint involvement (including patients with ever or current peripheral arthritis, 94.3% vs. 85.6%), more polyarticular joint involvement (including patients with current peripheral arthritis, 74.0% vs. 58.2%), more axial joint involvement (51.4% vs. 39.9%), more nail disease (72.6% vs. 61.4%), more frequency of smoking (20.2% vs. 18.7%), and higher proportion of hypertension (23.4% vs. 14.4%). In addition, the severe psoriasis group had higher level of ESR [33(10, 70) mm/1h vs. 20(9, 38) mm/1h] and CRP [18.6(5.0, 60.8) mg/L vs. 7.0(2.4, 18.1) mg/L], higher values of DAS28-ESR (4.5±1.7 vs. 3.7±1.5), DAS28-CRP (4.2±1.5 vs. 3.4±1.4), ASDAS-ESR (3.5±1.4 vs. 2.6±1.2), and ASDAS-CRP(3.4±1.6 vs. 2.5±1.2), higher scores of HAQ [0.6(0.1, 1.0) vs. 0.3(0.0, 0.8)]. Conclusion: Patients with PsA with severe psoriasis bore a heavier disease burden. Therefore, clinicians were supposed to pay more attention to them. In addition to skin lesions, they should also focus on examination of other clinical manifestations, such as joints and nails.

Characterization of grass carp spleen transcriptome during GCRV infection.

The aim of the study was to investigate the grass carp hemorrhagic infection pathway and its key-related genes. Grass carp reovirus (GCRV) might cause hemorrhagic disease in grass carps. Healthy grass carp fingerlings (N = 60) were divided into control and infected groups. Fish in the control group were intraperitoneally (ip) injected with 0.6% fish physiological saline; the infected group received 5,000,000 50% tissue culture infective doses of GCRV 873 standard strain, a double-stranded RNA (dsRNA) virus strain, ip, in 0.5 mL. Illumina HiSeqTM 2000 was used for transcriptome sequencing, and real-time polymerase chain reaction (PCR) used to detect complement factors II (C2), III (C3), and V (C5); profibrinolysin (PLG); and coagulation factor II (F2) expression. A total of 2,722,223 reads were detected in the control group, and 2,751,111 in the infected group. Among 11,023 unigenes obtained after transcriptome assembly, 10,021 unigenes were significantly differentially expressed. Gene ontology and KEGG analysis, a collection of databases dealing with genomes and biological pathways, were performed to classify unigenes into functional categories, to understand gene function and identify regulatory pathways. Real-time PCR analysis showed that C2, C3, C5, PLG, and F2 expression levels were down-regulated, confirming results of pathway-enrichment analysis. This is the first application of high-throughput sequencing technology to investigate the in vivo effects of GCRV, on genes and pathways involved in the immune response to infection in grass carp.

Cloning, characterization and expression analysis of coagulation factor II gene in grass carp (Ctenopharyngodon idella).

Here, we characterized the structure and function of the coagulation factor II (FII) gene in grass carp and determined its role in coagulation mechanisms. The FII gene EST was obtained using a constructed splenic transcriptome database; the full-length FII gene sequence was obtained by 3' and 5' RACE. The open reading frame (ORF) of FII was cloned and the full-length gene was found to be 1718 bp, with an ORF of 1572 bp; the gene contained a 25 bp 5'-untranslated region (UTR) and 108 bp 3'-UTR. The ORF encoded 524 amino acids, including 74 alkaline amino acids (arginine and lysine) and 69 acidic amino acids (aspartic acid and glutamic acid). The theoretical pI was 6.22. The calculated instability index (II) was 39.81, indicating that FII was a stable protein; the half-life period was predicted to be approximately 30 h. Amino acid sequence comparisons indicated that grass carp FII showed most similarity (71%) to FII of Takifugu rubripes, followed by Oplegnathus fasciatus (48% similarity) and Larimichthys crocea (47% similarity). A real-time reverse transcription PCR analysis showed that under normal circumstances, FII was most highly expressed in the liver, followed by the gill, spleen, thymus, and head-kidney (P < 0.001). After injection of the grass carp reovirus 873 (GCRV873), the pattern of FII expression was significantly altered (P < 0.001); gene expression was high after injection, suggesting a response involving the initiation of the coagulation system and defense of the body in combination with the platelet and complement system.

[Orodental phenotype and genotype findings in 8 Chinese children with hypophosphatasia].

Objective: To analyze the oral phenotype and gene variation of children with hypophosphatasia (HPP), and explore the genotype-phenotype correlations. Methods: Eight children diagnosed with HPP from January 2008 to January 2023 in Children's Hospital,Zhejiang University School of Medicine were recruited in this study. The pathogenic genes of 5 of them were sequentially analyzed and all of their oral manifestations, laboratory tests and genetic variation types were retrospectively analyzed. Results: A total of 8 children were recruited in the study, 3 males and 5 females, aged from 20 months to 104 months, whose main complaints were premature deciduous tooth loss. Among them, 3 children were diagnosed with odonto HPP, and the other 5 children were diagnosed with childhood HPP, including 2 children was odonto HPP at the first diagnosis and modified as childhood HPP at the age of 5. The age range of first deciduous tooth loss is 9 to 18 months, and the age range of diagnosis is 20 to 104 months. The patients of odonto HPP only showed premature loss of deciduous anterior tooth, while the patients with childhood HPP also showed premature loss of multiple deciduous molars. Panoramic radiographic film revealed enlarged pulp chambers and radicular canals in some primary and permanent teeth. The enamel hypoplasia, hypoplastic short roots, and alveolar resorption of deciduous molar were observed in some cases. The serum alkaline phosphatase (ALP) (30-107 U/L) levels of all the patients were lower than that in the normal children of same age and gender, and the ALP value of the 1-3 years old girls with childhood HPP (30-33 U/L) was lower than that of the three children with odonto HPP (61-107 U/L), but there was no significant difference in statistical analysis. There were 8 variation sites of ALP liver/bone/kidney (ALPL) gene detected in 5 children and their families, all of which were missense variation, including the new variants in the mutations of c.1334C>G(p.Ser445Cys) and c.1259G>T(p.Gly420Val) that were not reported in the literature. One case was autosomal dominant inheritance and other 4 cases were complex heterozygous variation with autosomal recessive inheritance. Conclusions: Pediatric stomatologists are often the first doctors to detect childhood and odonto HPP. Diagnosis of mild HPP is often delayed. The severity of HPP is related to serum ALP level and ALPL gene mutation sites.

[Effect of baseline CD(4)(+) T cell count on drop-out of antiretroviral therapy in HIV infected persons in Guangxi Zhuang Autonomous Region, 2008-2015].

Objective: To investigate the effect of baseline CD(4)(+) T cell count (CD(4)) on drop-out of antiretroviral therapy (ART) in HIV infected persons. Methods: Retrospective cohort was conducted in this study. HIV infected persons aged≥18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System, with follow-up conducted till May 30, 2016. Cause-specific Cox proportional hazard models were used to evaluate effect of different CD(4) on the drop-out of ART in the HIV infected persons. Results: A total of 58 502 eligible study participants were included in this retrospective cohort study. The average drop-out ratio was 4.8/100 person-years. After controlling the following baseline covariates: age, sex, marital status, route of HIV infection, WHO clinical stage before ART, initial/current ART regiment, ART regiment adjustment, and year of initiating ART for potential confounding, the adjusted HR of drop-out for HIV infected persons with 200- cells/µl, 351-cells/µl and ≥500 cells/µl were 1.110 (95%CI: 1.053-1.171, P<0.001), 1.391 (95%CI: 1.278-1.514, P<0.001) and 1.695 (95%CI: 1.497-1.918, P<0.001), respectively, in risk for drop-out compared with those with baseline CD(4)<200 cells/µl. Among the HIV infected persons, 56.0% (1 601/2 861) of drug withdrawal was due to poor compliance with medication. Conclusions: With the increase of baseline CD(4) when initiating ART, the risk for the drop-out in HIV infected persons increased significantly. To further reduce the drop-out of ART, it is important to take CD(4) into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.

Humoral and cellular immunity induced by tumor cell vaccine based on the chicken xenogeneic homologous matrix metalloproteinase-2.

Matrix metalloproteinase-2 (MMP-2) has been used as a target for cancer immunotherapy. The activation of immunization by breaking immune tolerance to self-MMP-2 may be one of the promising approaches for the treatment of MMP-2-positive tumors. In this study, we constructed the xenogeneic tumor cell vaccine c-MMP-2 by transfecting CT26 and LLC cells with chicken MMP-2 cDNA constructs. MMP-2-specific autoantibodies in sera and tumor cells were found in mice immunized with c-MMP-2. Protection against tumor growth was evaluated in respect of the relative contributions of autoantibodies, CD4+, and CD8+ T cells. Treatment with this vaccine (c-MMP-2) also prolonged the survival time of mice bearing cancer. The specific cytotoxic T-cell responses suggested that the treatment increased CD8+ T-cell activity. The antitumor activity of c-MMP-2 was abrogated by in vivo depletion of CD4+ and CD8+ T-lymphocytes and improved by adoptive transfer of CD4+ and CD8+ T-lymphocytes from the mice treated with c-MMP-2. An alternative DNA vaccination strategy for cancer therapy was identified in this study by eliciting humoral and cellular immunoresponse with a crossreacting transfectant.

The association of human papillomavirus 16/18 infection with lung cancer among nonsmoking Taiwanese women.

Lung cancer is the leading cause of cancer death in Taiwanese women since 1982. High lung cancer mortality ratio of male:female in Taiwan (2:1) was observed, although less than 10% of female lung cancer patients are smokers. Until now, the etiological factor remains unknown. We hypothesize that high-risk human papillomavirus (HPV) 16/18 may be associated with lung cancer development based on high prevalence of p53 negative immunostainings in female lung tumors compared with that of male lung tumors. In this study, 141 lung cancer patients and 60 noncancer control subjects were enrolled to examine whether HPV 16/18 DNA existed in lung tumor and normal tissues by nested PCR and in situ hybridization (ISH), respectively. The concordant detection of HPV 16 and 18 DNA between nested PCR and ISH method was 73 and 85.5%, respectively. Our data showed that 77 (54.6%) of 141 lung tumors had HPV 16/18 DNA compared with 16 (26.7%; P = 0.0005) of 60 noncancer control subjects. In addition, ISH data showed that HPV 16/18 DNA was uniformly located in lung tumor cells, but not in the adjacent nontumor cells. When study subjects were stratified by gender, age, and smoking status, nonsmoking female lung cancer patients who were older than 60 years old had significantly high prevalence of HPV 16/18 infection. The odds ratio of HPV 16/18 infection of nonsmoking female lung cancer patients is much higher at 10.12 (95% confidence interval, 3.88-26.38) compared with 1.98 (95% confidence interval, 0.84-4.76) of nonsmoking male lung cancer patients. This result strongly suggests that HPV infection is associated with lung cancer development of nonsmoking female lung cancer patients. The high prevalence of HPV 16/18 infection may explain to a certain extent why Taiwanese women nonsmokers had a higher lung cancer mortality rate.

Histopathological study of Sauropus androgynus-associated constrictive bronchiolitis obliterans: a new cause of constrictive bronchiolitis obliterans.

The development of constrictive bronchiolitis obliterans in patients who have ingested Sauropus androgynus juice has not been previously reported. We describe four patients with S. androgynus-associated constrictive bronchiolitis obliterans who underwent open lung biopsies for histopathological analysis. This article aims to recognize the possible pathogenesis of the disease. The spectrum of histologic changes ranged from slight bronchiolar inflammation and fibrosis to marked submucosal fibrosis causing complete cicatricial obliteration of the lumen. A dense eosinophil infiltrate was noted in the bronchiolar submucosa or fibrotic tissue of the completely obliterated bronchioles in two patients. Immunohistochemical studies revealed that lymphocytic infiltrate consisted mainly of T lymphocytes in all patients. Immunofluorescent stains for immunoglobulin (Ig)G, IgA, IgM, C1q, C3, and C4 were negative. Electron microscopy disclosed no immune complex deposition in the specimens examined. Although the role of antibody- and complement-mediated reaction is not supported by the negative results of immunofluorescent and electron microscopic studies, the common finding of the predominant T-lymphocytic infiltrate suggests that a T-cell mediated immune response is involved in the pathogenesis of the disease. Furthermore, the finding of a heavy lymphocytic infiltrate in many bronchioles without significant collagen deposition suggests that the lymphocytic infiltrate may precede the tissue fibrosis. In addition, the presence of a dense eosinophil infiltrate may combine with lymphocytes and other immunologic and mesenchymal cells to promote antigen-specific stimulation of lymphocytes and induction of fibrosis.

A double-blind, placebo-controlled trial of extract of Ginkgo biloba added to haloperidol in treatment-resistant patients with schizophrenia.

BACKGROUND: Many studies have indicated that excess free radical formation may be involved in the pathogenesis of patients with schizophrenia. Some investigators suggested that the use of free radical scavengers might provide improvement in schizophrenia. The aim of this study was to determine the effectiveness and to evaluate the side effects of extract of Ginkgo biloba (EGb) plus haloperidol in chronic, treatment-resistant inpatients with schizophrenia. METHOD: One hundred nine patients meeting DSM-III-R criteria for schizophrenia completed a double-blind, placebo-controlled, parallel-group study of EGb plus haloperidol. Fifty-six of the patients were randomly assigned to receive a fixed dose of 360 mg/day of EGb plus a stable dose of haloperidol, 0.25 mg/kg/day, and 53 were assigned to receive placebo plus the same dose of haloperidol for 12 weeks. Patients were assessed using the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS), and the Scale for the Assessment of Positive Symptoms (SAPS) at baseline, week 6, and week 12 and the Treatment Emergent Symptom Scale (TESS) for side effects at week 12. RESULTS: There was a significant reduction in both groups in BPRS total score after 12 weeks of treatment (p < .05). However, a significant reduction in total SAPS and SANS scores was noted in the EGb group (p < .05), but not in the placebo group. There was a lower SAPS total score in the EGb group than in the placebo group at the end of 12 weeks of treatment (p < .05). Of those treated with EGb plus haloperidol, 57.1% were rated as responders as compared with only 37.7% of those receiving placebo plus haloperidol when assessed by the SAPS (chi2 = 4. 111, p = .043). After 12 weeks of treatment, TESS subscore 1 (behavioral toxicity) and subscore 3 (symptoms of nerve system) were significantly decreased in the EGb group compared with the placebo group (p < .05). CONCLUSION: EGb treatment may enhance the effectiveness of antipsychotic drugs and reduce their extrapyramidal side effects.

Giant bronchoesophageal fistula: a rare complication of bronchial artery embolization.

Bronchoesophageal fistulas after bronchial artery embolization are rare. In the previous literature only 2 cases were recorded. Here we report treatment of a giant bronchoesophageal fistula on both the left and right bronchus. Our surgical treatment included fistula exclusion by esophageal diversion, and esophageal reconstruction was made by retrosternal stomach. The result was good, and the patient made a satisfactory recovery.

Gender difference in DNA adduct levels among nonsmoking lung cancer patients.

Lung cancer is the leading cause of cancer mortality in Taiwanese women. Cigarette smoking cannot explain the high lung cancer mortality in this population because less than 10% of women in Taiwan are smokers. Therefore, environmental factors other than smoking may play an important role in lung cancer development in female nonsmokers. The purpose of this study was to elucidate the role of environmental carcinogen exposure in lung cancer development in Taiwanese female nonsmokers, based on DNA adduct formation. We collected nontumorous lung tissues resected from 62 nonsmoking lung cancer patients and 20 noncancer controls to investigate whether differences in susceptibility to DNA adduct formation exist between men and women. (32)P-postlabeling and ELISA (enzyme-linked immunosorbent assay) with polyclonal antibody against BPDE (7,8-dihydroxy-anti-9,10-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene)-DNA adduct were used to evaluate DNA adduct levels in lung tissues of study subjects. Our data showed that the DNA adduct levels of lung cancer patients determined by both assays were significantly higher than those of noncancer controls (P = 0.0001 for (32)P-postlabeling; P = 0.01 for ELISA). Moreover, DNA adduct levels in females were markedly greater than those in males (P = 0.014 for (32)P-postlabeling; P = 0.001 for ELISA). The difference in DNA adduct levels could not be explained by genetic polymorphisms of cytochrome P-4501A1 (CYP1A1) or glutathione S-transferase (GSTM1), as determined by polymerase chain reaction and restriction fragment length polymorphism. These results demonstrate that lung cancer patients have a higher susceptibility to DNA damage than that of noncancer controls. In addition, differences in susceptibility to DNA damage derived from environmental carcinogen exposure were observed between male and female nonsmokers. In conclusion, high susceptibility to DNA damage in females may partially explain the high mortality rate of lung cancer in nonsmoking Taiwanese women.

Expression of estrogen and progesterone receptors in non-small-cell lung cancer: immunohistochemical study.

Estrogen receptor (ER) and progesterone receptor (PgR) have been recognized as being involved in the tumourigenesis of non-small-cell lung cancer (NSCLC). Forty-nine resected NSCLC (39 males and 10 females) were studied immunohistochemically in formalin-fixed, paraffin-embedded sections for ER and PgR. There were 26 squamous cell carcinomas, 22 adenocarcinomas and one adenosquamous carcinoma. 38.8% (19/49)NSCLC had either a positive ER or PgR status of which one was ER+/PgR+, 2 were ER+/PgR- and 16 were ER-/PgR+. There was no statistical difference in hormone receptors status for sex and histological subtypes (p > 0.05). The immunohistochemical assay of formalin-fixed paraffin-embedded sections allows the retrospective analysis of ER and PgR in NSCLC. The ER-/PgR+ status was detected in about one third NSCLC. The discordance between these receptors is suggested to be due to either the presence of functioning variant ER or the constitutive synthesis of PgR independent of estrogen induction in certain ER-/PgR+ NSCLC.

A numerical simulation of steady flow fields in a bypass tube.

Steady flow in a complete by-pass tube was simulated numerically. The study was to consider a complete flow field, which included both the by-pass and the host tubes. The changes of the hemodynamics were investigated with three parameters: the inlet flow Reynolds number (Re), anastomotic angle (alpha) and the position of the occlusion in the host tube. The baseline flow field was set up with Re=200, alpha=45 degrees and the centered position of occlusion. The parametric study was then conducted on combination of Re=100, 200, 400, alpha=35 degrees, 45 degrees, 60 degrees, 75 degrees, 90 degrees and three occlusion positions: left, center and right. It was found that in the baseline case, large slow/recirculation flows could be seen in the host tube both upstream and downstream of the occlusion. The separation points were on the opposite walls to the junctions. Recirculation zones were also found near the toe and in the proximal outer wall of the by-pass tube. Their sizes were about one diameter of the tube or smaller. In some cases, pairing vortices could be seen in the host tube upstream of the occlusion. The shear rate distribution associated with the flow fields was presented. The flow pattern obtained was agreeable to those observed experimentally by other investigators. The difference of the flow fields between a complete bypass and simple anastomosis was discussed. The present numerical code provides a preliminary simulation/design tool for bypass graft flows.

Lowering storage temperature during ovary transport is beneficial to the developmental competence of bovine oocytes used for somatic cell nuclear transfer.

The objective of this study was to determine the effect of storage temperature during ovary transport on the developmental competence of bovine oocytes for use in somatic cell nuclear transfer (SCNT). Ovaries obtained from a slaughterhouse were stored in physiological saline for 3-4h at one of the three temperatures: 15 °C, 25 °C, or 35 °C. The developmental competence of oocytes used for SCNT was ascertained by cleavage and blastocyst formation rate, total cell number, apoptosis index, and the relative abundance of Bax and Hsp70.1 in day 7 blastocysts. Ovaries stored at 35 °C for 3-4h reduced the recovery rate of grade I and II oocytes compared with those stored at 25 °C or 15 °C (45.1±0.7% vs. 76.7±1.2% or 74.8±2.0%, P<0.05). The proportion of oocytes matured to the MII stage (maturation rate) for oocytes stored at 35 °C was significantly lower than those stored at 25 °C or 15 °C (51.3±0.9% vs. 75.1±1.4% or 71.7±1.3%, P<0.05). Cleavage rate (77.7±2.1%, 77.9±1.1% and 72.1±0.7% for 15 °C, 25 °C and 35 °C groups, respectively) and blastocyst formation rate (39.1±0.5%, 36.8±1.4% and 32.2±0.9% for 15 °C, 25 °C and 35 °C groups, respectively) following SCNT were not significantly different between treatments. Oocytes from ovaries stored at 15 °C, however, produced blastocysts with higher cell numbers (97.3±8.6 vs. 80.2±10.8 or 77.4±11.7; P<0.05) and lower apoptotic index (5.1±1.3 vs. 13.5±1.6 or 18.6±1.1, P<0.05) than those stored at 25 °C or 35 °C. The relative abundance of Bax and Hsp70.1 in day 7 blastocysts produced from oocytes derived from ovaries stored at 15 °C was lower than those stored at 25 °C or 35 °C (P<0.05). It was concluded that a storage temperature of 15 °C for a 3-4h period had a significant beneficial effect on the quality and developmental competence of oocytes used for SCNT due to the alleviation of stresses on the oocytes compared with those subjected to storage temperatures of 25 °C or 35 °C.

Analysis of phenanthrene biodegradation by using FTIR, UV and GC-MS.

The aim of this paper is to assess the biodegradation of phenanthrene by Flavobacteria FCN2 which was isolated from coke plant sludge via a classical shaken liquid medium enrichment method. The strain FCN2 can decompose phenanthrene (50 mg l(-1)) completely within 5 days. The values of pH decrease to 6.7 from 7.2 during degradation periods. And a detailed phenanthrene metabolism was assayed by using FTIR, UV and GC-MS. For FTIR, appearance of new broad absorption bands at 2858 cm(-1), 2927 cm(-1), 2955 cm(-1) and another new strong absorption band at 1734 cm(-1) in metabolites demonstrates that carboxyl group produced during phenanthrene degradation. Besides this, a very strong absorption band appears at 1260 cm(-1). It is ascribed to C-C stretching vibration band in carbonyl group of arone. Two weak adsorption at 334 nm and 349 nm in UV spectra were assigned to the n-pi* transition of CO of aldehyde. Two metabolites, phenanthrene-dihydrodiol and naphthalene-1-diol were identified in neutral fraction of phenanthrene degradation by using GC-MS. As a result carboxylic acids and arone were generated during biodegradation of phenanthrene by Flavobacteria FCN2.

Differential expression of survivin splice isoforms in medulloblastomas.

Survivin, a member of the inhibitor of apoptosis protein family, is implicated in the dysregulation of apoptosis in human cancers. Survivin and survivin-deltaEx3, one of its two alternatively spliced isoforms, confer anti-apoptotic activities in human tumours, while survivin-2B antagonizes such anti-apoptotic properties. The current study was undertaken to examine the mRNA expression of survivin isoforms and their correlation with clinical staging and outcome in 20 medulloblastoma (MB) tumours, three MB cell lines and normal brain tissues (a foetal and an adult cerebellum) by densitometry scanning of 32p-dCTP incorporated reverse transcription polymerase chain reaction (RT-PCR) products and quantitative real-time PCR. Our results showed that the normal adult brain only expressed low levels of survivin-deltaEx3 mRNA, while the foetal brain expressed all three isoforms, with wild-type survivin as the dominant transcript. All three survivin isoforms were detected in all the MB cell lines and tumours analysed. Immunohistochemical staining also demonstrated survivin protein expressions in all five paraffin-embedded MBs, with predominant nuclear localization. Although overexpressions of survivin were not associated with the presence of metastatic MB or tumour histological subtypes, elevated expressions of survivin-deltaEx3 were significantly associated with progressive/recurrent tumours (P-value = 0.024). Our data demonstrated that overexpression of survivin mRNA is a common feature in MBs, may contribute to their anti-apoptosis properties and clinical behaviours, and predicts a poor clinical outcome, independent of clinical staging or tumour histology.

Mannan-modified adenovirus as a vaccine to induce antitumor immunity.

Tumor vaccine is a useful strategy for cancer therapy. However, priming of the immune system requires the relevant antigen to be presented by antigen-presenting cells (APCs). Here, we employed telomerase reverse transcriptase as a model antigen to explore the feasibility of using mannan-modified adenovirus as a tumor vaccine. We found that tumor immunogene therapy with the vaccine was effective at protective antitumor immunity in mice. The antigen-specific cytotoxic T lymphocytes were found in in vitro cytotoxicity assay. The elevation of the killing activity could be abrogated by anti-CD8 or anti-major histocompatibility complex-I antibodies. Adoptive transfer of purified CD8+ cells, and CD4+ cells to a less extent, was effective at antitumor activity. In vivo antitumor activity could be abrogated by depleting CD4+ T lymphocytes. A possible explanation for the antitumor effects may be the antigen was transferred to APCs in the presence of mannan. These observations provide insights into the design of novel vaccine strategies and might be important for the future application of antigens identified in other diseases.

The effect of extract of ginkgo biloba added to haloperidol on superoxide dismutase in inpatients with chronic schizophrenia.

The purpose of the study was to evaluate the effect of the classic antipsychotic haloperidol plus extract of ginkgo biloba (EGb) on treatment-resistant chronic schizophrenia and on blood superoxide dismutase (SOD) levels. Eighty-two patients with chronic refractory schizophrenia were studied. Forty-three patients were treated with haloperidol plus extract of ginkgo biloba (group 1), and 39 received haloperidol plus placebo (group 2). SOD levels of these patients were measured before and after treatment and were compared with SOD levels of 30 healthy volunteers. Therapeutic efficiency was equated with a change in clinical rating scores assessed by standardized measurement tools that included the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms (SANS) over this period. Patients in group 1 improved significantly as demonstrated by scores from these two assessment instruments; those in group 2 improved significantly only as shown by scores on SANS. SOD levels before treatment in all patients were significantly higher than those in healthy controls; after treatment, the SOD level decreased significantly in group 1 but not in group 2. These results suggest that EGb may enhance the efficiency of the classic antipsychotic haloperidol in patients with schizophrenia, especially on their positive symptoms, and that EGb may work through an antioxidant effect that is involved in the therapeutic mechanism in patients with chronic refractory schizophrenia.

Management for acute corrosive injury of upper gastrointestinal tract.

BACKGROUND: It is imperative that the surgeon promptly determine the severity of any acute injury of the upper gastrointestinal (UGI) tract by caustic material ingested and the definite therapy be instituted. Prognostic factors of such injuries have not been clearly demonstrated in previous reports. Here, some prognostic factors and recommended emergency surgical indications in clinical assessment are discussed. METHODS: Forty-six patients (22 men and 24 women; age range 19 to 77 years), sustaining acute corrosive injuries to the UGI tract, were retrospectively assessed from November 1990 to May 1993. Immediate management was given to prevent shock, to identify any associated injury and to observe patency of the airway. Emergency operation was performed if any signs of peritonitis, mediastinitis or sepsis were present. Age, sex, time interval between ingestion and initial resuscitation, consciousness, peritoneal sign, shock index, pH value and [HCO3-] in arterial blood gas were evaluated as prognostic factors with respect to mortality. Chi-square test with Yates' correction was used. A p value less than 0.05 was regarded as statistically significant. RESULTS: Suicide attempt by caustic ingestion was in 40 patients (87%) and ingestion was accidental in 6 (13%). Acidic injury was specified in 36 patients (78.3%). In 14 severely injured patients, emergency exploratory laparotomy with or without esophagogastrectomy was performed in 9 (19.6%), of whom 2 survived. The other five patients were treated conservatively, and all died. Overall mortality rate was 26.1% (12/46). A significantly higher mortality rate was observed in patients with age > or = 50 years, positive peritoneal sign, shock index > 1, pH below 7.2 and bicarbonate concentration below 16 mEq/L as revealed by arterial blood gas (p < 0.05). CONCLUSIONS: The prognostic factors related to a higher mortality rate included age 50 years old or more, positive peritoneal sign, shock index above 1, pH below 7.2 and [HCO3-] below 16 mEq/L in arterial blood gas. Recognition of these factors indicates further detailed study will be required to propose a caustic injury score for predicting severity. Nevertheless, emergency operation is recommended if there are positive signs of peritonitis or mediastinitis, shock index above 1, pH below 7.0 and [HCO3-] below 10 mEq/L in arterial blood gas.