[Staged and segmented two hybrid surgeries for total repair of Debakey type â aortic dissection: a series of 10 cases].

Objective: To examine the efficacy and experience of staged and segmented two hybrid surgeries for total repair of Debakey type Ⅰ aortic dissection (TIAD). Methods: This study was a retrospective case series. The clinic data of 10 patients with acute TIAD who were admitted to the Department of Cardiac Surgery, Second Hospital of Lanzhou University or the First People's Hospital of Lanzhou, between January 2016 and August 2022, were retrospectively studied. Ten patients underwent hybrid surgeries in two hospitalizations (stages), including 7 males and 3 females with an age of (60±7) years (range: 49 to 71 years). In stage 1, the first type Ⅱ hybrid arch repair was performed to treat the ascending, total arch, and descending thoracic aorta for acute TIAD without circulatory arrest. In stage 2, the second hybrid surgery including infrarenal abdominal aorta replacement, visceral arteries bypass and endovascular thoracoabdominal aortic repair was performed to treat residual thoracoabdominal aortic dissection after the first hybrid operation (segmented). Basic data, preoperative concomitant diseases, high-risk factors, surgical approaches and postoperative complications of all important organs, as well as CT imaging were analyzed. Results: There was no death in the 20 hybrid surgical procedures. In stage 1 type Ⅱ hybrid surgery, 4 cases underwent reconstruction of the aortic sinutubular junction, while Bentall and David surgery was performed for 3 cases, respectively. A patient received coronary artery bypass grafting. Then all patients were sequentially treated with arch debranching and thoracic aortic endovascular repair. Postoperative complications included renal insufficiency (4/10), hemofiltration (1/10), hypoxemia (4/10), neurologic event (1/10) and type Ⅱ endoleak (1/10). Complete false lumen thrombosis occurred in 9/10 of the patients. All complications recovered successfully at discharge and the average hospital stay was (21±4) days (range: 16 to 28 days) in the first hospitalization. At stage 2, the second hybrid surgery was successfully performed in all patients. No paraplegia, hepatic or renal insufficiency, or endoleak occurred. However, branch graft embolism of the left renal artery was found in one patient 3 days after laparotomy, as well as of superior mesenteric artery in another. Superior mesenteric artery occlusion was successfully treated by endovascular recanalization. Complete false lumen thrombosis occurred in all patients. Although all patients had different degrees of intestinal dysfunction, they were gradually relieved at discharge, and the average hospital stay was (19±2)days (range:16 to 21 days) in the second hospitalization. During follow-up, CT angiography showed aortic remodeling in all patients. Conclusion: Staged and segmented two hybrid surgeries are safe and feasible for total repair of Debakey type Ⅰ aortic dissection and are associated with acceptable early and midterm outcomes.

[Role of MAIT cells in immunity against Mycobacterium tuberculosis].

Mucosal-associated invariant T cells (MAIT cells) are a class of innate immune-like T cells that are widely distributed in the human body. During infection, antigens such as vitamin B metabolites synthesized by microorganisms are presented to MAIT cells by MR1 (major histocompatibility complex class Ⅰ-like molecule), and MAIT cells are activated and exert antibacterial, antiviral, anticancer and tissue repair effects by releasing cytokines and cytotoxic molecules. Animal and in vitro studies have shown that the number of MAIT cells in the peripheral blood of patients with active tuberculosis is reduced and the cells exhibit a functional exhaustion phenotype. MAIT cells are activated by Mycobacterium tuberculosis antigens and produce inflammatory cytokines such as TNF-α, IFN-γ and cytotoxic molecules such as granzyme B to exert anti-tuberculosis effects that are MR1-dependent and cytokine-dependent. In addition, MAIT cells can also act as a bridge between innate and acquired immunity by initiating a conventional T-cell response. Currently, there are also relevant experimental studies on vaccines and drugs targeting MAIT cells, which show great potential in the prevention and control of tuberculosis. In this article, we will review the discovery and grouping, development and activation of MAIT cells, their role in Mycobacterium tuberculosis infection, and their application in tuberculosis prevention and treatment, in order to provide new immunological targets for tuberculosis prevention and treatment.

[A study on longitudinal changes in white matter microstructure of parents who have lost their only child based on diffusion tensor imaging and its relationship with symptoms of posttraumatic stress disorder].

Objective: To investigate the longitudinal changes of white matter microstructural based on diffusion tensor imaging in parents who lost their only child without psychiatric disorders and its relationship with symptoms of posttraumatic stress disorder (PTSD). Methods: Parents who had who lost their only child and without psychiatric disorders in Jiangsu Province, from September 2016 to March 2017, were retrospectively collected (TENP group, 32). MRI scans were performed at baseline and at the end of 5-year follow-up, and the Clinician Administered PTSD Scales (CAPS) were used for assessing the severity of symptoms. Additionally, sex, age and education level matched healthy subjects were recruited as healthy controls (control group, 27) and underwent MRI scanning using the same protocol. The differences of fractional anisotropy (FA) values between TENP group and control group at baseline were analyzed by using Tract-based spatial statistics method, and the brain areas of lateral differences were used as the regions of interest for longitudinal follow-up analysis of TENP group. Partial correlation analysis was used to evaluate the relationship between FA values changes in longitudinal differences in brain regions and CAPS scores. Results: Compared with the control group, FA values of the right cingulate gyrus, Uncinate fasciculus, superior longitudinal fasciculus, corticospinal tract, Inferior fronto-occipital fasciculus, Inferior longitudinal fasciculus and forceps major in TENP group were decreased at baseline ((0.613±0.032) vs (0.631±0.034), (0.539±0.048) vs (0.563±0.045), (0.534±0.033) vs (0.558±0.039), (0.560±0.038) vs (0.580±0.030), (0.519±0.023) vs(0.549±0.024), (0.489±0.038) vs (0.518±0.027), (0.499±0.027) vs (0.533±0.032); all P<0.05). From baseline to follow-up, scores of trauma reexperience symptoms and avoidance/numbness symptoms were decreased ((5.2±2.8) vs (8.1±4.9), (4.0±3.2) vs (6.6±5.4); all P<0.05); FA values of the right corticospinal tract, Inferior fronto-occipital fasciculus, Inferior longitudinal fasciculus and forceps major were decreased ((0.523±0.049) vs (0.537±0.049), (0.568±0.052) vs (0.590±0.050), (0.540±0.063) vs (0.559±0.059), (0.520±0.059) vs (0.547±0.059); all P<0.05); The decrease of FA values of the right Inferior fronto-occipital fasciculus and right Inferior longitudinal fasciculus was negatively correlated with the decrease of avoidance/numbness symptoms scores (r=-0.458, -0.374, respectively, all P<0.05). Conclusions: The trauma of parents who lost their only child can result in impaired microstructural integrity of white matter. As the post-traumatic time goes by, parents who have lost their only child do not develop to PTSD and other psychiatric disorders, and the clinical symptoms are alleviated, the damage of the white matter microstructure continued to progress.

[Quantitative hepatitis B core antibody levels can be used as a predictive index of HBsAg clearance].

Objective: To explore the possibility of hepatitis B core antibody (anti-HBc) in predicting hepatitis B virus surface antigen (HBsAg) clearance. Methods: Sixty cases with chronic hepatitis B who were previously treated with peginterferon α-2a combined with nucleos(t)ide analogues (NAs) antiviral therapy were divided according to the HBsAg clearance or non-clearance; 41 cases in the clearance group and 19 cases in the non-clearance group. Double antigen sandwich method was used to detect patients anti-HBc quantitative levels during the course of treatment and at baseline, 24, 48, 72 and 96 weeks. Logistic regression analysis and receiver operating characteristic curve (ROC) were used to evaluate the predictive ability of related influencing factors for HBsAg clearance. Results: With antiviral treatment prolongation, anti-HBC quantitative levels in the overall population showed a progressive downward trend in the clearance group and the non-clearance group, but the anti-HBC level in the clearance group was significantly higher than non-clearance group at the baseline and successive detection time points during the antiviral treatment (P < 0.05). Multivariate logistic regression showed that baseline quantitative anti-HBC level, HBsAg decline at week 24 (log10 IU / ml), and alanine aminotransferase (ALT) > 1.5 times the upper limit of normal value (ULN) were all influencing factors for HBsAg clearance during the treatment (OR = 0.156, P = 0.026; OR = 0.134, P = 0.023; OR = 0.239, P = 0.028). Among them, the baseline quantitative anti-HBc level was the best independent predictor for HBsAg clearance (OR = 0.235; P = 0.004), and the sensitivity and specificity for predicting HBsAg clearance at > 3.40 log10 IU/ mL were 56.1% and 89.5%, respectively. Logistic regression model was used as a reference to construct combined predictors in order to improve the prediction accuracy. Among them, the combined factor 3 had the highest predictive value (the area under the ROC curve had reached up to 0.870; 95%CI was 0.781 ~ 0.960; P < 0.001). The cut-off value of combined factor 3 was > 0.386, and the sensitivity and specificity were 80.5% and 78.9%, respectively. In addition, the combined index had further improved the predictive value, which is the combination of any two or more indexes based on the baseline quantitative anti-HBC level, and HBsAg clearance predictive rate had reached 94.12% ~ 100%. Conclusion: The baseline quantitative anti-HBC level has the highest predictive value for HBsAg clearance. The combination of ALT > 1.5×ULN and HBsAg decline at 24 weeks during the treatment can more precisely predict HBsAg clearance. Therefore, it is a reliable non-invasive biomarker.

Ultrastrong and Stiff Carbon Nanotube/Aluminum-Copper Nanocomposite via Enhancing Friction between Carbon Nanotubes.

Researchers have been aiming to replace copper with carbon nanotube/copper nanocomposites, which are lighter and exhibit better electrical, mechanical, and thermal properties. However, the strength is far below pure carbon nanotube assembly and even much lower than some copper-based alloys. This disadvantage hinders the extensive application of carbon nanotube/copper nanocomposites. In this study, the carbon nanotube/aluminum-copper nanocomposites with ultra-strength and stiffness were prepared. The strength and elasticity modulus of composite reached as high as 6.6 and 500 GPa, respectively, while a high conductivity of 1.8 × 107 S/m was maintained. This can be attributed to the diffusion of Cu and Al atoms into the carbon nanotube fiber, which enhances friction between the carbon nanotubes by "pinning" and "bridging". This structure provides us with novel insights into the design of carbon nanotubes/metal nanocomposites with ultrahigh strength and conductivity.

[Clinical study on liver function, virology, serological changes and the safety of drug withdrawal in pregnant women who are chronic HBV carriers during pregnancy and postpartum].

Objective: To observe the changes of liver function, virology and serology and the safety of drug withdrawal in pregnant women who are chronic hepatitis B virus (HBV) carriers. Methods: A prospective clinical cohort was established to enroll pregnant women who are chronic HBV carriers and they were divided into the nucleoside/nucleotide analogs (NAs) intervention group and the non-NAs intervention group according to patients' wishes. Liver function, HBV DNA and HBV serological markers were detected at gestation, postpartum 6 weeks, 12 weeks, 24 weeks, 36 weeks and 48 weeks. Results: 351 patients were enrolled, 320 in the NAs intervention group and 31 in the non-NAs intervention group. The proportion of postpartum hepatitis flares in both groups was higher than that in pregnancy (39.4% vs 12.5%, P < 0.001; 38.7% vs 3.2%, P = 0.001). Six weeks postpartum was the peak period of hepatitis flares, and 96.0% (121/126) of the hepatitis flares occurred within 24 weeks postpartum. At 6 weeks postpartum, there were 6 cases of alanine aminotransferase (ALT) ≥ 10 times upper limit of normal (ULN) in the NAs intervention group. The rate of the hepatitis flare after drug withdrawal was 16.7% (34/203). Conclusion: Regardless of the presence or absence of NAs intervention, pregnant women who are chronic HBV carriers have a certain proportion of hepatitis flares during pregnancy and postpartum, and the hepatitis flare even have a tendency to be severe. Therefore, drug withdrawal after delivery is not always safe, which requires close observation and classification. At 6 weeks postpartum, the incidence of hepatitis flares was high, and those who meet the treatment indications can get better therapeutic effects if given appropriate treatment. The vast majority (96%) of postpartum hepatitis flares occur within 24 weeks, so it is recommended to follow up to at least 24 weeks postpartum after discontinuation.

[Low-levels of HBsAg quantification at 48-week in HBeAg-negative chronic hepatitis B patients are the advantageous population for HBsAg clearance].

Objective: To analyze the therapeutic effect on HBeAg-negative chronic hepatitis B patients treated with Peg-IFNα-2a combined with NAs to obtain the influencing factors for predicting HBsAg clearance. Methods: A retrospective study was conducted to investigate the effect of pegylated interferon alpha-2a combined with nucleoside analogues (lamivudine/adefovir dipivoxil) on HBeAg-negative chronic hepatitis B. The treatment course was 96 weeks. Patients were followed up 120 weeks after the treatment. HBsAg clearance at 120 weeks was taken as the objective of the study. Logistic regression and receiver operating characteristic curve analysis screened the related factors affecting HBsAg clearance. χ (2) test was used to compare count data. Results: 111 patients were treated with pegylated interferon alpha-2a combined with nucleoside analogues, and 107 patients completed the scheduled course of treatment and follow-up. HBsAg clearance rate at120 week was 29.0% (31/107). The influencing factors for analysis were: (1) gender had no effect on HBsAg clearance rate; age and baseline levels of HBV DNA and alanine aminotransferase had no significant effect on HBsAg clearance; low baseline level of HBsAg (< 3.023 lgIU/ml) was beneficial to HBsAg clearance. The area under the working characteristic curve of the subjects was 0.746, the positive predictive value was 44.4%, and the negative predictive value was 86.8%. (2) HBsAg quantification or decline in 24 weeks and 48 weeks of treatment had a good predictive effect on HBsAg clearance, and the 48 weeks predicted value was higher than 24 weeks. When the HBsAg quantification was≤2.070 lgIU/ml at 48 weeks, the area under the receiver operating characteristic curve was 0.931, the positive predictive value was 52.8%, and the negative predictive value was 94.4%. When HBsAg decreased from baseline to≥0.991 lgIU/ml, the area under the receiver operating characteristic curve was 0.888, the positive predictive value was 50.8%, and the negative predictive value was 97.9%. (3) The analysis of HBsAg subgroup levels at 48 weeks suggested that the "interval analysis" can forecast HBsAg clearance more exactly than "nodal analysis" .The final HBsAg clearance rate of 100 IU/ml < HBsAg≤1 000 IU/ml, 10 IU/ml < HBsAg≤100 IU/ml and HBsAg≤10 IU/ml groups reached 6.7%, 31.8% and 67.7%, respectively. (4) The ALT abnormal group in the course of treatment obtained a higher HBsAg clearance rate (48.0%, 12/25). Conclusion: 96-weeks long-term treatment with pegylated interferon-alpha -alpha-2a combined with nucleoside analogues for HBeAg-negative chronic hepatitis B has a good predictive value for HBsAg clearance at baseline and during treatment. The "interval level" of HBsAg at 48-weeks is more accurate in predicting HBsAg clearance, suggesting that HBeAg-negative chronic hepatitis B patients with low HBsAg levels at 48-weeks are the advantageous populations with HBsAg clearance. These patients are worthy of prolonged treatment to pursue "clinical cure".

Association between ERCC1 and ERCC2 gene polymorphisms and chemotherapy response and overall survival in osteosarcoma.

We aimed to evaluate the influence of four SNPs in ERCC1 and ERCC2 on the response to cisplatin-based treatment and on clinical outcome in patients with osteosarcoma. We identified 186 patients with osteosarcoma diagnosed between April 2009 and April 2011 who were eligible for inclusion in our study. Genotyping of ERCC1 rs11615, rs3212986, and rs2298881; and ERCC2 rs1799793 and rs13181 was conducted by a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. By conditional logistic regression analysis, patients carrying the CC genotypes of ERCC1 rs11615 and rs2298881 were shown to be more likely to have good response to chemotherapy when compared with patients carrying wild-type genotypes; the ORs (95%CIs) were 2.56 (1.02-7.35) and 3.01 (1.07-9.71), respectively. By Cox regression analysis, individuals carrying the CC genotype of ERCC1 rs11615 were associated with longer overall survival time and decreased risk of death from osteosarcoma; the hazards ratio (95%CI) was 0.32 (0.07-0.98). In summary, our results suggested that the ERCC1 rs11615 and rs2298881 polymorphisms play important roles in the response to chemotherapy mediated by the DNA repair pathway and in the clinical outcome of osteosarcoma.

Cutaneous adverse drug reactions in a hospital-based Chinese population.

BACKGROUND: Cutaneous adverse drug reactions (CADRs) are common skin adverse reactions associated with drugs. AIM: To assess recent trends in CADRs and the drugs associated with them, using data from the past 5 years in the largest single database available on a hospital-based population in China. METHODS: All clinical records of inpatients admitted with a diagnosis of CADR to the Dermatology Ward, Huashan Hospital from January 2004 to December 2008 were retrospectively studied. RESULTS: In the 734 patients, the three most common types of CADRs were nonsevere reactions, erythema multiforme (EM)-like eruptions (n = 255), urticaria (n = 192) and exanthematous reactions (n = 159), followed by three severe reactions: Stevens-Johnson syndrome (n = 58), toxic epidermal necrolysis (n = 29) and exfoliative dermatitis (n = 22). The most common single drug associated with the development of all drug eruptions was allopurinol, followed by amoxicillin, cephalosporins, antiepileptic agents and antipyretic/analgesic agents. However, the most common single drugs associated with severe reactions were antiepileptic agents, followed by allopurinol, antipyretic/analgesic agents and cephalosporins. In contrast to patients with nonsevere reactions, patients with severe reactions were more likely to be male (P < 0.001) and to have a greater mean age of onset (P < 0.001), a longer latency period (P < 0.001) and a longer duration of hospitalization (P < 0.001). CONCLUSION: In contrast to previous studies, we found allopurinol to be the most common single drug associated with CADRs followed by antibiotics (amoxicillin and cephalosporins), and antiepileptic, especially carbamazepine. A higher incidence of EM-like eruptions and urticaria was also seen.

Effects of ZEB1 on regulating osteosarcoma cells via NF-κB/iNOS.

OBJECTIVE: Osteosarcoma is one common malignant bone tumors, as it frequently has invasion, metastasis and recurrence, causing unfavorable prognosis of patients. Osteosarcoma has complicated pathogenesis, which has not been elucidated fully. Therefore, the identification of effective molecular target of osteosarcoma onset can help to improve treatment efficacy and prognosis of osteosarcoma. Zinc finger E-box binding homeobox 1 (ZEB1) protein is one member of zinc finger E-box binding protein family, and participates in embryonic genesis and development. A recent study found the participation of ZEB1 in mediating multiple tumor onset and its up-regulation of osteosarcoma. The regulatory mechanism of ZEB1 in osteosarcoma has not been illustrated yet. MATERIALS AND METHODS: In vitro cultured osteosarcoma MG-63 cells were transfected with ZEB1 siRNA. Real-time PCR and Western blot were tested for ZEB1 mRNA/protein expression. MTT was used to test MG-63 cell proliferation, whilst cell invasion was used to describe the effect of ZEB1 on MG-63 cells. Caspase-3 activity assay was employed to test MG-63 cell apoptosis. Western blot was employed to detect nuclear factor kappa B (NF-kB) and inducible nitric oxide synthase (iNOS) protein expression. RESULTS: After transfecting with ZEB1 siRNA, MG-63 cell proliferation or invasion was inhibited accompanied with lower ZEB1 mRNA/protein expression. Caspase3 activity was also increased after transfection (p < 0.05), along with down-regulation of NF-kB and iNOS proteins in MG-63 cells (p < 0.05). CONCLUSIONS: Inhibition of ZEB1 can facilitate osteosarcoma cell apoptosis and inhibit cell proliferation or invasion via down-regulating NF-kB/iNOS signal pathway.

Effect of ß-arrestin on damage of human umbilical vein endothelial cell induced by angiotensin II.

OBJECTIVE: ß-arrestin (ARRB2) is a member of arrestin family and a negative regulatory protein of G-coupling receptor, which is closely associated with the pathogenesis of several autoimmune diseases. This study aimed to investigate the mechanism of the effect of ARRB2 on the damage of human umbilical vein endothelial cells (HUVECs), which is induced by angiotensin II (Ang II). MATERIALS AND METHODS: ARRB2 at different concentration was used to interfere with the damage of HUVECs induced by Ang II or RNA interference technology to interfere with the expression of HUVECs followed by addition of Ang II to culture for 24 hours. Nitrate reduction method was used to measure the content of nitric oxide (NO) and radioimmunoassay was used to measure endothelin-1; Western blot assay was used to detect the expression of B-cell lymphoma-2 (Bcl-2), and flow cytometry was used to detect the intracellular level of reactive oxygen (ROS) and apoptosis of HUVECs. RESULTS: Our study found that ARRB2 could significantly reduce the generation and release of ROS, endothelin-1 (ET-1), lactic dehydrogenase (LDH) of HUVECs induced by Ang II and promote the generation of NO, superoxide dismutase (SOD) and scavenging in a dose-dependent manner. On the contrary, when expression of ARRB2 was disturbed by siRNA, increased generation and release of ROS, ET-1, and LDH were observed with reduced generation of NO, SOD and scavenging. In addition, ARRB2 could reverse the apoptosis of HUVECs induced by Ang II and was related to upregulate the expression of Bax. CONCLUSIONS: ARRB2 could protect the damage of HUVECs induced by Ang II and the mechanism was associated with upregulation of the expression of apoptosis and anti-apoptosis protein of Bcl-2.

The study of the distribution character of cerebral arterial stenosis in patients with ischemic cerebrovascular disease by means of 64 slices CT.

OBJECTIVE: The aim of this study is to investigate the distribution of cerebral artery stenosis in patients with the ischemic cerebrovascular disease. PATIENTS AND METHODS: One hundred and forty-four patients with ischemic cerebrovascular disease were enrolled and divided into three age brackets, the youth group (18-44 years old, 12 cases), middle-aged group (45-59 years old, 45 cases), and the old-aged group (≥60 years old, 87 cases). They were then ensued the analysis of the distribution of characteristics of cerebral artery stenosis. RESULTS: A total of 414 pathological vessels had been detected from the 144 patients with arteriostenosis or occlusion, amongst which were 24 single vascular stenosis (16.7%) and 120 multiple stenosis. (83.3%, p<0.01) The incidence of single arteriostenosis was 16.7%, and the multiple arteriostenosis 83.3%. The incidence rate of single intracranial artery stenosis was significantly higher than that of the coexistence of extracranial and intracranial artery stenosis (60.4% vs. 31.3% vs. 8.3%, p<0.01). The respective parts that were subject to intracranial and extracranial artery lesions were: a middle cerebral artery and extracranial vertebral artery. The incidence of pure anterior circulation stenosis and anterior and posterior circulation stenosis was significantly higher than that of pure posterior circulation stenosis (83.3% vs 41.7% vs. 22.9%, p<0.05, p<0.01). The pure intracranial artery stenosis of young and middle-aged group was significantly higher than that of extracranial artery stenosis of the old-aged group (83.8% vs. 75.6% vs. 49.4%, p<0.05). The incidence of pure intracranial artery stenosis of the old-aged group was significantly higher than that of the middle-aged group (12.6% vs. 2.2%, p<0.05). CONCLUSIONS: Cerebral artery stenosis in patients with the ischemic cerebrovascular disease was dominated by multiple stenosis. The incidence of intracranial artery stenosis was significantly higher than that of extracranial artery stenosis. The distribution of cerebral artery stenosis varied with age.

Rhythmic auditory stimulation with visual stimuli on motor and balance function of patients with Parkinson's disease.

OBJECTIVE: Discuss the effect of rhythmic auditory stimulation with visual stimuli on motor and balance function in patients with Parkinson's disease (PD). PATIENTS AND METHODS: One hundred and sixteen patients with PD participated in this study. The control group used a routine drug treatment for eight weeks. The comprehensive treatment group used conventional drug treatment with sound rhythm metronome released as the rhythmical auditory stimulation, in accordance with the ground fixed ribbon rhythmic visual stimulation walking training for eight weeks. After four and eight weeks, the two groups of subjects took the walking parameters test, and used the disease Parkinson score scale to assess the damaged degree of motor function of PD patients. The Berg Balance Scale was used to evaluate the balance function of the PD patients. A six minute walk test was used to evaluate the walking motor function of the patients. RESULTS: The comparison between the groups suggests that after treatment of rhythmic auditory stimulation with visual stimulation group, the step size increased, frequency decreased, pace increased, and PD score scale part II decreased. As well, the PD score scale part III reduced, the six minute walking distance increased, and the Berg Balance Scale score increased significantly. There were significant differences compared with the control group after the treatment (p < 0.01). Comparison of time points suggests that after rhythmic auditory stimulation with visual stimulation group trained for eight weeks, the step size increased, frequency decreased, pace increased, and PD score scale part II were reduced. As well the PD score scale part III reduced, six minute walking distance increased, Berg Balance Scale increased. There were significant differences compared with the parameters of training for four weeks (p < 0.01). CONCLUSIONS: Rhythmic auditory stimulation with visual stimulation can improve motor and balance function of patients with PD.

Recurrent ischemic events and risk factors in patients with symptomatic intracranial artery stenosis.

OBJECTIVE: To evaluate the recurrent ischemic events and risk factors in patients with symptomatic intracranial artery stenosis. PATIENTS AND METHODS: Patients with acute cerebral infarction or transient ischemia attach (TIA) and intracranial arterial stenosis confirmed through CTA examination, were enrolled from the Department of Neurology. All cases were followed-up regularly and divided into recurrent group and non-recurrent group according to occurrence of cerebrovascular events. Major observation index: (1) the occurrence of endpoint; (2) new stroke in responsible artery; (3) drug therapy compliance was used. RESULTS: A total of 142 cases fulfilled the inclusion criteria, among them 121 cases (85.2%) completed the follow-up, and in 16 cases (13.2%) ischemic cerebrovascular stroke events occurred within one year, while among these vascular lesions recurred on the ipsilateral side in 12 cases (75%). Single factor analysis showed that difference between recurrent group and non-recurrent group on irregular use of statins (p = 0.017), diabetes mellitus (p = 0.017) and severe arterial stenosis (p = 0.030) were statistically significant. Logistic regression analysis showed that irregular use of statins (OR=3.719, p = 0.005), diabetes (OR=1.842. p = 029) and severe arterial stenosis (OR=1.503. p = 0.045) were correlated with the recurrence of symptomatic intracranial artery stenosis. CONCLUSIONS: Patients with symptomatic intracranial artery stenosis had a higher recurrence rate of stroke; whereas patients with irregular use of statins, diabetes and severe arterial stenosis had a higher recurrence risk of stroke.

Selenium geochemistry of paddy soils in Yangtze River Delta.

Selenium (Se) content both in total and bioavailable forms were very low (25-35 and 9.5 micrograms/kg, respectively) in waterlogged paddy soils in the central Yangtze River Delta. This was due to changes in geochemistry and the inherent properties of the parent materials of these lowland paddy soils. The very low Se content (23 micrograms/kg) in the parent material resulted in low total Se content in the soil. The main chemical changes under long-term waterlogged conditions are depletion of molecular oxygen, decrease of redox potential, and reduction of Fe (III) to Fe (II) and SeO3(2-) to Se0. This led to low availability of Se in soils, and subsequently low Se content (29 micrograms/kg) in brown rice grain produced in this region. It has been suspected that low Se content in staple food might be one of the major reasons for a high infection rate of the intestine and stomach cancers and the higher death rate caused by these diseases in the region. Foliage spray of Na2SeO3 at early heading stage of rice plant growth improved the Se content of brown rice grain, hull, and straw, and would improve human and animal health.

Copper contamination in paddy soils irrigated with wastewater.

Copper (Cu) contamination was investigated in paddy soils where Cu-rich wastewater (12 mg Cu/l) was used for irrigation. The results showed that Cu contamination increased the soil Cu content from 17.0 mg Cu/kg in the non-wastewater irrigated soils (NWIS) to 101.2 mg Cu/kg in the wastewater irrigated soils (WIS), and Cu accumulated mostly in the surface layer (0-10 cm) of the paddy soil. The average Cu contents in brown rice, rice hull and rice straw from NWIS were 1.4, 7.3 and 14.5 mg Cu/kg, while those from WIS were 15.5, 133.2, and 101.4 mg Cu/kg, respectively. Correlation analysis revealed that the relationship between the Cu content in the rice straw and the rice hull with the total Cu content of the soil could be described by an exponential function (R2 = 0.921 and 0.831, respectively; P <0.01). Rice plants grown in the WIS showed symptoms of black roots, less effective tiller, etc. Subsequently, the rice yield decreased by 18-25%, compared with that grown in NWIS.

Mechanisms of nitrite accumulation occurring in soilnitrification.

Because low concentration of nitrite could be toxic to biological systems and high amounts of nitrite have been observed in a river of northern China since 1990, nitrite from agricultural soil sources should be investigated. In this paper, effects of levels of ammonium-N (NH4+-N), soil pH and nitrification inhibitors on NO2- accumulation, and duration of nitrite in soils were studied. Application of 11.2 mg of nitrapyrin kg(-1) soil or 11.2 mg of sodium azide kg(-1) soil dramatically suppressed nitrite occurrence. Within all incubation times and at all levels of ammonium-N input, we did not detect any measurable NO2-N accumulation in samples of Yellow-brown earth (pH 5.67), but observed huge accumulation in the 2 alkaline soils, Fluvo-aquic loam (pH 7.89) and Fluvo-aquic sand (pH 8.20). The concentrations of nitrite in both alkaline soils were related to ammonium-N levels. The effect of pH on nitrite accumulation was demonstrated by using slurries of Fluvo-aquic sand under continuous aeration and buffers of different pH. Data showed that nitrite concentration increased with the elevated pH, yet that ammonia oxidizers from the original soil (pH 8.2) could adapt to the new medium of low pH (pH 5.35). Dynamic changes of nitrite in soils amended with different rates of nitrite-N were also measured in 6 days. Thereby, we concluded that nitrite was unstable in acid soils, but durable in alkaline soils. The authors suggested that NO2- accumulation in field soils and its subsequent environmental impact should receive more attention.

Effect of phosphate fertilizer application on phosphorus (P) losses from paddy soils in Taihu Lake Region. I. Effect of phosphate fertilizer rate on P losses from paddy soil.

A field plot study was conducted on two types of paddy soils in the Taihu Lake Region, during the rice season of year 2000 in order to assess phosphorus (P) losses by runoff and vertical leaching, which are considered the two main pathways of P movement from paddy soil into its surrounding water course. Commercial NPK compound fertilizer and single superphosphate fertilizer were applied to furnish 0, 30, 150, and 300 kg applied P ha m(-2). The experiments consisted of three replicates of each treatment in Changshu site and four replicates in Anzhen site, with a plot size of 5 x 6 m2 in a randomized block. Results revealed that the average concentration range for total P (TP) in runoff was 1.857-7.883, 1.038-5.209, 0.783-1.255 and 0.572-0.691 mg P l(-1) respectively for P300, P150, P30 and P0 in Anzhen, while it was 2.431-2.449, 1.578-1.890, 1.050-1.315 and 0.749-0.941 mg P l(-1) respectively in Changshu. In all treatments, particulate P (PP) represented a major portion of the TP lost in runoff, it was 80% in Anzhen, and it was even more (>90%) in Changshu. Phosphate fertilizer treatments significantly affected P concentrations and P loads in the runoff. The mean concentration and average seasonal TP load from the P150 plots were 1.809 mg P l(-1) and 395 g P ha m(-2) season(-1) respectively, and lower than that from the P300 plots (2.957 mg P l(-1) and 652 g P ha m(-2) season(-1)). These were obviously higher than from the P30 (0.761 mg P l(-1) and 221 g P ha m(-2) season(-1)) and P0 (0.484 mg P l(-1) and 146 g P ha m(-2) season(-1)) respectively. There was no significant difference found between the P30 and the P0 in both sites. Under usual P application rate, there were total 31.7 and 20.6 tones P removed by runoff from permeable (Anzhen site) and waterlogged (Changshu site) paddy soils in the southern Jiangsu region (major part of the TLR) in the rice season of the year 2000. But if the P application rate is unusual high, or the Olsen P in soil accumulates to above a certain level, then this could sharply increase in the future. The average concentration of molybdate reactive phosphorus (MRP) in the vertical leachate from the four different P treatments ranged from 0.058 to 0.304 mg P l(-1) in Anzhen and from 0.048 to 0.394 mg P l(-1) in Changshu. P application rate significantly affected the MRP concentration at each depth in both sites, except for the 90 cm in Anzhen. The average MRP loads during the rice season moved by vertical leaching from the four treatments ranged from 163 to 855 g P ha m(-2) season(-1) in Anzhen and 208-1,825 g P ha m(-2) season(-1) in Changshu. Vertical leachate movement does not necessarily mean that it moves towards surface water and contaminate the watercourses in this flat plain paddy soil region, it does, however, imply that P can move down from surface layers of soil to deeper levels.

The transportation, time-dependent distribution of heavy metals in paddy crops.

Sixteen experimenmtal plots (5 m x 6 m = 30 m2) were designed with four different levels of heavy metals (HMs) concentration in soil. The concentrations of heavy metals in soils, and paddy plant during the different periods of growth were investigated. A relationship between the total HM content in plants and the HM level in soil was found for a wide range of concentrations. The exchangeable fraction of HMs extracted with 1 M MgCl2 solution according to Tessier's method increased correlation with the dosage of supplemented HMs, then decreased as time went on. The time-related variation of exchangeable HMs in soil demonstrated that the amount of effective HMs taken up by paddy differed at various growth phases. The amount of HMs accumulated in different parts of paddy followed the order of root > stem > grain, leaf. The transportation potential of the HMs in paddy in present study followed the order of Zn, Cr > Cd, Cu > Pb. The HM content in root, stem and leaf of paddy plant (dry weight) was low at time of seedling. The concentration in the root increased sharply at time of tillering, decreased thereafter. The concentrations in stem and leaf reached the highest at time of tillering, then decreased, while rose slightly at following time.

Interactions between arbuscular mycorrhizae and heavy metals under sand culture experiment.

A sand culture experiment was established to determine interactions between arbuscular mycorrhizae and heavy metals. Mycorrhizal infection rates, spore densities, maize root and shoot weights, and heavy metal contents in maize were as indexes of responses of arbuscular mycorrhizal fungi (Acaulospora laevis, Glomus caledonium and Glomus manihotis) to heavy metals (Cu and Cd). The mycorrhizal infection rates of G. caledonium were the highest among these three mycorrhizal fungi, but the sporulating ability of G. caledonium was the poorest in the heavy metal treatments. The shoot and root weights of non-mycorrhizal plants were usually greater than those of mycorrhizal plants when the Cu concentrations in solutions are less than 3 mg l(-1) or Cd concentrations less than 1 mg l(-1). When Cd concentrations were 0.5 and 1 mg(-1), the root and shoot weights of plants inoculated with A. laevis were significantly (p < 0.05) lower than those of other treatments. Copper concentrations in shoots of mycorrhizal plants were higher than those of non-mycorrhizal ones at all Cu concentrations in solution, especially at low Cu concentrations. As to A. laevis, Cu concentrations in roots and shoots of the host were higher than those of non-mycorrhizal plants in these treatments. Thus A. laevis was sensitive to Cu and Cd, especially Cd, and G. caledonium was more tolerant to these two heavy metals. It is suggested that G. caledonium might be a promising mycorrhizal fungus for bioremediation of heavy metal contaminated soil.