[Yifei Sanjie Pills alleviates cancer-related skeletal muscle atrophy in mice possibly by lowering inflammatory insulin resistance].

OBJECTIVE: To evaluate the effects of Yifei Sanjie Pills (YFSJ) on weight, strength, pathology, glycogen and lipid contents and metabolism of skeletal muscles in tumor-bearing mice and explore the therapeutic mechanism of YFSJ for cancer-related skeletal muscle atrophy. METHODS: Sixteen female ICR mice bearing intraperitoneal Lewis lung adenocarcinoma xenografts were randomized into model group and YFSJ treatment group (daily dose of 4 g/kg for 21 days, n=8), with another 8 normal mice as the normal control group. The changes in body weight and gastrocnemius muscle weight of the mice were recorded. Liquid chromatography-mass spectrometry (LC-MS) was used to analyze the drug components in YFSJ entering the blood. Enzyme-linked immunosorbent assay was used to detect serum blood glucose and insulin concentrations and inflammatory cytokine levels in the serum and gastrocnemius. RNA-seq was performed to analyze the signaling pathways involved in the pathologies of the gastrocnemius muscle, and lipid contents in the muscle were observed using Oil red O staining. Adenosine triphosphatase staining was used to assess the metabolic intensity of the gastrocnemius muscle, and inflammatory cell infiltration and P-AKT level were evaluated using immunohistochemical staining; the contents of creatine kinase, lactate dehydrogenase and myoglobin in the gastrocnemius muscle were also detected. RESULTS: Treatment with YFSJ significantly increased skeletal muscle strength and gastrocnemius muscle weight (P < 0.001) and reduced the levels of gastrocnemius muscle injury markers in the tumor-bearing mice (P < 0.01). RNA-seq and LC-MS showed that YFSJ alleviated gastrocnemius muscle injury in the tumor-bearing mice possibly by improving inflammatory infiltration, insulin resistance and lipid metabolism (P < 0.05). YFSJ lowered inflammatory cytokine levels in both the serum and gastrocnemius muscle (P < 0.05), reduced pro-inflammatory cell infiltration, increased P-AKT level, and improved glycogen and lipid contents and metabolic levels in the gastrocnemius muscle. CONCLUSION: YFSJ alleviates cancer-related skeletal muscle atrophy possibly by reducing inflammatory insulin resistance.

[Treatment of equinus with serial casting]. / Tratamiento del equinismo con yesos progresivos.

INTRODUCTION: Equinus in children produces a pattern of unsteady gait and inefficient and inadequate positioning in the wheelchair. Treatment with a serial casting cycle maintains range of motion and facilitates the development of normal movement patterns. Its use in combination with botulinum toxin has proven benefits, but there is a lack of guidance on the optimal management protocol. OBJECTIVE: The aim of this study were to describe the characteristics of the population with equinus of diverse aetiology and to determine the effectiveness of treatment with serial casting. We also aimed to assess its use in conjunction with botulinum toxin in patients with spastic cerebral palsy. MATERIAL AND METHOD: This longitudinal retrospective study included a sample of 95 Achilles tendons of children attended in a children's rehabilitation clinic between 2012 and 2018, with ankle dorsal flexion less than 10°, treated by a cycle of serial casts with or without botulinum toxin. The variables analysed were sex, year when treatment started, age, BMI, diagnosis, previous and/or later treatment, spasticity (modified Ashworth), laterality, active and passive joint range of dorsal and plantar flexion along with R1 (Tardieu). Measurements were carried out with a mechanical inclinometer prior to the first, second and third cast, after the third cast and at 2, 8 and 14 months. The statistical analysis was performed with SPSS®. RESULTS: There was a statistically significant improvement of 10.02° between passive dorsal flexion prior to the first cast and after the third cast, which remained at 6.66° (P=.02) between the former and after 14 months. CONCLUSIONS: Serial casting is an effective method in the management of equinus of any aetiology and has a minimal complication rate.

Tumour-to-Tumour Metastasis Phenomenon: Metastatic Prostatic Adenocarcinoma within an Anaplastic Oligodendroglioma in the Brain of a Dog.

A 10-year-old entire male French bulldog was presented following clusters of generalized tonic-clonic epileptic seizures. Neurolocalization was consistent with a lesion in the left forebrain. Magnetic resonance imaging of the brain revealed a large, ill-defined, intra-axial, space-occupying lesion at the level of the left temporal and parietal lobes, causing marked compression of the adjacent parenchyma. Computed tomography of the thorax and abdomen was consistent with disseminated metastatic disease. The dog was humanely destroyed and subjected to necropsy examination. Histological examination of the brain revealed a metastasis of prostatic carcinoma within an anaplastic oligodendroglioma in the left forebrain. To the author's knowledge, this is the first report describing clinical, imaging and histopathological features of an intracranial tumour-to-tumour metastasis in the brain of a dog.

Performance evaluation of a dynamic telepathology system (Panoptiq™) in the morphologic assessment of peripheral blood film abnormalities.

INTRODUCTION: The study evaluated the performance of a dynamic imaging telepathology system (Panoptiq(™) ) as a diagnostic aid to the identification of peripheral blood film (PBF) abnormalities. METHODS: The study assumed a laboratory personnel working in a clinical laboratory were operating the telepathology system to seek diagnostic opinion from an external consulting hematopathologist. The study examined 100 blood films, encompassing 23 different hematological diseases, reactive or normal cases. RESULTS: The study revealed that with real-time image transmission in live scanning mode of operation, the telepathology system was able to aid reviewers in achieving excellent accuracy, that is correct interpretation of morphologic abnormalities obtained in 83/84 of the hematologic diseases and 12/12 of the reactive/normal conditions (Sensitivity: 0.99; Specificity: 1.00). In contrast, when only saved static images in digital capture mode of operation were reviewed remotely, interpretative omissions occurred in 8/84 of the hematologic diseases and 0/12 of the reactive/normal conditions (Sensitivity: 0.91; Specificity: 1.00). It is hypothesized that real-time operator-reviewer communication during live scanning played an important role in the identification of key morphologic abnormalities for review. CONCLUSION: Our study showed the Panoptiq system can be adopted reliably as a dynamic telepathology tool in aiding community laboratories in the triage of PBF cases for external diagnostic consultation.

Clinically significant heparin carryover on the ACL 300R.

Investigation of a patient with an unexpected prolonged activated partial thromboplastin time showed on repeat testing that the patient had normal coagulation times, but had been preceded on the automated coagulation analyzer run (ACL 300R--Instrumentation Laboratory, Lexington, MA) by a heparin-contaminated apheresis line sample taken from a different patient. Heparin carryover was suspected, and subsequent experiments showed that ex vivo heparinization of normal plasmas will produce similar effects in following normal plasma samples in a test series. This effect increases with the baseline activated partial thromboplastin time and the heparin concentration. It is recommended that coagulation analyzers that are susceptible to carryover be cleaned after testing of plasmas likely to have heparin concentration of more than 5 x 10(3) U/L. Furthermore, when using analyzers of this type, investigation of an unexplained activated partial thromboplastin time must include a review of the preceding samples tested, particularly when duplicate testing has been discontinued.

Effect of thromboplastin and coagulometer interaction on the precision of the International Normalised Ratio.

AIMS: To examine the magnitude of thromboplastin and coagulometer interactions on the precision of International Normalised Ratio (INR) values when the manufacturers' recommended instrument specific International Sensitivity Index (ISI) values are adopted for the INR calculation. METHODS: The variability of INR values obtained from four automated phototopical coagulometers frequently used in North American laboratories was studied. When used with five commercial thromboplastins of moderate to high sensitivity (ISI values 0.92-1.97), 20 prothrombin time results were generated for each of a population of 98 patients on established warfarin treatment. RESULTS: The mean INR values of the patients ranged from 2.05 to 2.81, depending on which reagent/coagulometer combination was used. Within patient variation increased as the median INR value increased. The mean coefficient of variation of within patient INR values was 10%; the mean coefficient of variation of the prothrombin time results in seconds and prothrombin time ratio were 21 and 18%, respectively. CONCLUSIONS: There was considerable bias in the estimated ISI values of the thromboplastins compared with the manufacturers' instrument specific ISI value. Despite this apparent imperfection, our study clearly showed that the INR is preferable to other prothrombin time reporting formats for assessing the degree of anticoagulation for patients on warfarin treatment.

Clinical and experimental observations on treatment of peptic ulcer with wei yang an (easing peptic-ulcer) capsule.

The therapeutic effects of peptic ulcer treated with cimetidine and Wei Yang An were compared clinically and experimentally by the double blind method. Results showed that the effects of the two are similar, but the long-term effect of Wei Yang An was better. Wei Yang An was also good for most cimetidine resistant ulcers, with few side effect. Animal experiment showed that Wei Yang An inhibited the ulcers.

[Effect of qigong on blood pressure and life quality of essential hypertension patients].

56 essential hypertension patients (stages I, II) received Qigong from Mar, 1989 to Sept, 1991, pre- and post-treatment comparison of BP and life quality (LQ) indices revealed that (1) It could efficiently lower BP(P < 0.001). Stroke, congestive heart failure and acute myocardial infarction did not occur. No side effects were observed as well. (2) It could markedly improve LQ of hypertensive patients. LQ examinations showed that significant difference (P < 0.001) existed among LQ indices except dysfunction, which might be due to the selection of non-dysfunctional patients. LQ should be widely used in clinical practice and medical research.

Association of the arterial access site at angioplasty with transfusion and mortality: the M.O.R.T.A.L study (Mortality benefit Of Reduced Transfusion after percutaneous coronary intervention via the Arm or Leg).

BACKGROUND: Bleeding and transfusion after percutaneous coronary intervention (PCI) are known predictors of mortality. Transradial arterial access reduces bleeding and transfusion related to femoral access complications, although its association with mortality is unknown. OBJECTIVE: To determine the association of arterial access site (radial or femoral) with transfusion and mortality in unselected PCIs. DESIGN, SETTING AND PATIENTS: By data linkage of three prospectively collated provincial registries, 38,872 procedures in 32,822 patients in British Columbia were analysed. The association between access site, transfusion and outcomes was assessed by logistic regression, propensity score matching and probit regression. MAIN OUTCOME MEASURES: 30-Day and 1-year mortality. RESULTS: 1134 (3.5%) patients had at least one blood transfusion. Transfused patients had a significantly increased 30-day and 1-year mortality, adjusted odds ratio (95% CI) 4.01 (3.08 to 5.22) and 3.58 (2.94 to 4.36), respectively. By probit regression the absolute increase in risk of death at 1 year associated with receiving a transfusion was 6.78%. The number needed to treat was 14.74 (prevention of 15 transfusions required to "avoid" one death). Radial access halved the transfusion rate. After adjustment for all variables, radial access was associated with a significant reduction in 30-day and 1-year mortality, odds ratio = 0.71 (95% CI 0.61 to 0.82) and 0.83 (0.71 to 0.98), respectively (all p<0.001). CONCLUSIONS: In a registry of all comers to PCI, transradial access was associated with a halving of the transfusion rate and a reduction in 30-day and 1-year mortality.

[Effect of qigong on sympathetico-adrenomedullary function in patients with liver yang exuberance hypertension].

By using the differential diagnosis of traditional Chinese medicine to determine the types of hypertension, using the diagnosis of western medicine (WM) to determine the phases of hypertension, 61 inpatients of Liver Yang exuberance type hypertension were randomly divided into Qigong group and WM group. The patients in the Qigong group were treated with both Qigong and antihypertensive drugs at low dosage, but those in the WM group were treated with the drugs alone. Several laboratory tests concerning sympathetico-adrenomedullary functions were conducted twice respectively at 1st and 9th week after hospitalization of the patients. The results indicated that the Qigong group after treatment of 9 weeks had more cases with normal sympathetico-adrenomedullary functions than it had before the treatment, and that their urinary CA, E, NE decreased, MHPG-SO4 increased, plasma cAMP and cGMP got down, but cAMP/cGMP ratio got up. It suggested that Qigong could modulate the sympathetico-adrenomedullary functions of patients with Liver Yang exuberance type hypertension.

[Influence of qi-gong on plasma TXB2 and 6-keto-PGF1 alpha in two TCM types of essential hypertension].

Forty-five patients of essential hypertension differentiated into two TCM types, i.e. Gan Yang Shang Kang Zheng (GYSK) and Yin Xu Yang Kang Zheng (YXYK) were randomly selected. Among them, the 31 patients received qi-gong therapy including 12 GYSK cases (group b) and 19 YXYK cases (group c) and 14 patients (group d) received nifedipine therapy. It was found that the plasma 6-K-PGF1 alpha was increased and TXB2 as well as TXB2/6-K-PGF1 alpha ratio were decreased after the therapy (P < 0.05) in group b, c and d. No statistical significant difference was found between group b and group c (P > 0.05). The results suggest that qi-gong is regulatory on TXB2 and 6-K-PGF1 alpha in patients with essential hypertension and is identical in the two different TCM Zheng types.

Long-term follow-up of hepatitis B vaccine in infants of carrier mothers.

A program of immunization against hepatitis B, consisting of one dose of hepatitis B immune globulin within 12 hours of birth and three doses of hepatitis B vaccine at 0, 1, and 6 months of age for all infants of carrier mothers, has been operating in British Columbia, Canada, since 1984. The authors report on a survey conducted in 1992 of children immunized between 1984 and 1989. The survey included blood tests obtained from the children and interviews of the mothers. A total of 770 of 1,135 eligible children participated. Thirty-one percent of the mothers had been positive for hepatitis B e antigen prior to the birth of the child. At follow-up, the overall antibody against hepatitis B surface antigen seropositivity rate for children was 87.9 percent. A total of 5.1 percent of children had evidence of previous hepatitis B infection, and 2.3 percent were hepatitis B surface antigen positive. In multiple logistic regression analysis, a delay in the initial dose of vaccine was associated with increased risk of infection, but the age of the child was not, even though antibodies against hepatitis B surface antigen declined with age. The authors conclude that most infections occurred early and resulted from prenatal infection, initial nonresponse, or a delay in the initial dose of vaccine, not from waning immunity. A booster dose of vaccine, at least up to age 8 years, is not necessary.

A new translocation, t(10;14)(q24;q11), in T cell neoplasia.

Four cases of T cell neoplasia are reported: three presenting as T cell acute lymphoblastic leukemia and one presenting in the leukemic phase of a T cell lymphoma. In all cases, the cells of the leukemic clone were characterized by an identical cytogenetic abnormality. This abnormality was a unique reciprocal translocation involving chromosomes 10 and 14. The breakpoint in chromosome 14 was in band q11, coincident with the assigned locus of the alpha-chain gene of the T cell antigen receptor. The breakpoint in chromosome 10 was in band q24, a region reported to include the locus of the terminal deoxynucleotidyltransferase (TdT) gene. Our observations suggest that translocation t(10;14)(q24;q11) is specific for T cell neoplasia and that a gene in chromosomal band 10q24, possibly the TdT gene, plays an important role in T cell neoplasia when its expression or coding sequence is altered by aberrant recombination involving a T cell antigen receptor gene.

Identification of hepatitis C virus genotypes among hospitalized patients in British Columbia, Canada.

The distribution pattern of hepatitis C virus (HCV) genotypes among patients from British Columbia has been investigated by reverse transcription polymerase chain reaction (PCR) amplification of the 5' noncoding region (NCR) and direct DNA sequencing of the PCR product. The sequence data obtained from the British Columbia isolates were compared with HCV sequences for the NCR obtained from GenBank for the construction of a phylogenetic tree using the GDE program, version 2.2. The data show that in British Columbia there are 7 subtypes distributed among major genotypes 1, 2, and 3. The study also shows a new subtype of genotype 1 that represents 29% of the analyzed cases.

Risk factors for acquisition of hepatitis C virus infection in blood donors: results of a case-control study.

BACKGROUND & AIMS: Few studies have explored risk factors predicting hepatitis C virus (HCV) infection in blood donors; their results are contradictory. The aim of this study was to evaluate the association between HCV infection and various risk factors in Canadian volunteer blood donors. METHODS: Four transfusion centers were involved in this case-control study. A total of 267 confirmed anti-HCV-positive blood donors were interviewed along with 1068 seronegative blood donors matched for sex, age, donation site, and date. Information was collected using a structured telephone interview. The main outcome measures were odds ratios (ORs) and 95% confidence intervals (CIs) for various risk factors from univariate and multivariate analyses using conditional logistic regression. RESULTS: By univariate analysis, 23 variables were associated with anti-HCV positivity. In the final multivariate analysis, only 5 factors remained independently predictive of HCV infection: previous intravenous drug use (OR, 127.5; 95% CI, 26.0-625.0), having lived in a prison or juvenile detention center (56.1; 11.4-275.7), previous blood transfusion (10.5; 4.7-23.2), sexual contact with an intravenous drug user (6.9; 3.1-15.2), and tattooing (5.7; 2.5-13). CONCLUSIONS: Most blood donors acquire infection by percutaneous exposure to contaminated blood. A role for sexual transmission is suggested by this study.

Peripheral T-cell lymphoma presenting as hemophagocytic syndrome.

Three patients with peripheral T-cell lymphoma presenting with pyrexia, wasting, hepatosplenomegaly and pancytopenia in the absence of myelophthisic lymphomatous involvement are reported. Early in the course of the disease when there was no significant lymphadenopathy, these cases created enormous diagnostic confusion. Although the clinical features were suggestive of malignant histiocytosis (MH), marrow findings showed phagocytic histiocytes which did not appear atypical, and the criteria for diagnosis of MH could not be satisfied. Lymph node enlargement was detected only after 14, 5, and 8 weeks from the onset of symptoms, and the diagnosis of T-lymphoma was then made on lymph node biopsies. Treatment with multiple agent chemotherapy was attempted. Two patients died 3 days and 11 weeks after treatment was started and the third was lost to follow-up. In contrast with most of the cases reported in the literature, our cases show that a reactive hemophagocytic syndrome can be an early and prominent manifestation of an underlying T-cell lymphoma. Differentiation from other causes of hemophagocytic syndrome can be difficult and lack of histological proof of malignancy in the initial stage often delays definitive diagnosis and treatment.

Reappraisal of optimal hemoglobin standards for female blood donors in Canada.

BACKGROUND: A hemoglobin (Hb) standard of 115 g per L on the copper sulfate test has been in use by the Canadian Red Cross Society Blood Services for female blood donor predonation screening since 1989. STUDY DESIGN AND METHODS: To determine if this lowered Hb standard results in increased iron deficiency in repeat blood donors, a study was conducted to evaluate the performance of the copper sulfate test and predonation capillary and venous Hb assays in a population of female blood donors most at risk of developing iron deficiency. RESULTS: Of the 174 donors who were of childbearing age, who were not taking iron supplements, and who had made at least three blood donations per year, 45 (25.9%) were iron deficient, and 64 (36.8%) had reduced iron stores; only 65 (37.3%) had normal iron stores. This study showed that capillary blood is more likely to have a higher Hb concentration (3.2 +/- 7.8 g/L) than venous blood samples, which could affect the performance of predonation screening assays that are based on capillary blood samples at a given discriminating value. With an Hb standard of 115 g per L, both the copper sulfate and capillary Hb assays were not sensitive enough to screen for iron deficiency (sensitivity, 27% and 33%; specificity, 96% and 93%, respectively) and were comparable only to the performance of a venous Hb assay with a cutoff value of 110 g per L (sensitivity, 27%; specificity, 99%). In contrast, an Hb standard of 125 g per L in the copper sulfate test could achieve a more optimal sensitivity of 79 percent and specificity of 78 percent. CONCLUSION: This study supports the use of a higher Hb cutoff value of 125 g per L for female blood donors in the predonation fingerstick copper sulfate test.