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Background: Previous studies have reported conflicting findings regarding the relation of body mass index (BMI) to outcomes following percutaneous coronary interventions (PCI). No study to date has directly examined the effect of obesity on cardiovascular thrombotic events after stent implantation., Objective: To evaluate the effect of obesity on cardiovascular thrombotic events in patients undergoing PCI with drug-eluting stents., Methods: We studied 4972 patients between January 2004 and December 2006. Patients were divided into three groups according to body mass index: normal (BMI <24.9 kg/m(2), n = 1284), overweight (BMI 25-29.9 kg/m(2), n = 2475) and obese (BMI > or =30 kg/m(2), n = 1213). Median follow-up was 26 (interquartile range 20-33) months., Results: Composite cardiovascular thrombotic events, including cardiac death and non-fatal myocardial infarction, were significantly higher in obese patients (5.9%) than in normal (3.2%) and overweight (3.8%) patients (p = 0.001). The incidence of definite or probable stent thrombosis steadily increased with increasing body mass index (0.9% vs 1.0% vs 1.9% in normal, overweight and obese patients, respectively; p = 0.029). Multivariate analyses showed that obesity was an independent predictor of 3-year composite thrombotic events (hazard ratio 1.86; 95% confidence interval 1.25 to 2.75; p = 0.003) and definite or probable stent thrombosis (2.17; 1.04 to 4.55; p = 0.040)., Conclusions: Obese patients have a higher risk for long-term cardiovascular thrombotic events following PCI with drug-eluting stents than patients with normal weight.

Objective: To compare the 2 years outcome of elderly patients with ULMCA stenosis undergoing coronary artery bypass grafting (CABG) or drug eluting stent (DES)., Methods: From January 2004 to June 2006, 295 patients with ULMCA stenosis and age > or = 70 years undergoing coronary revascularization with either CABG (n = 206) or DES (n = 89) were enrolled in this analysis. All-cause death, non-fatal myocardial infarction and target lesion revascularization (TLR) were recorded during 2 years follow-up., Results: The cumulative rate of 2-year mortality were 10.2% (n = 21) in CABG-treated patients and 13.3% (n = 12) in DES-treated patients (P = 0.428). The survival rate during 2-year follow-up was 89.2% for CABG-treated patients and 86.4% for DES-treated patients (P = 0.668). The incidence of 2-year myocardial infarction was 7.8% (n = 16) in CABG-treated patients and 10.1% (n = 9) in DES-treated patients (P = 0.501). The incidence of target lesion revascularization (TLR) was 4.9% (n = 10) in CABG-treated patients and 13.5% (n = 12) in DES-treated patients (P = 0.015). In the multivariable analysis, age (HR: 1.04, 95% CI: 1.01-1.09, P = 0.024), left ventricular dysfunction (ejection fraction < 30%, HR: 4.97, 95% CI: 1.22-24.85, P = 0.018) and type 2 diabetes (HR: 2.22, 95% CI: 1.31-4.86, P = 0.001) were independent predictors of 2-year mortality., Conclusion: In this study, 2-year mortality was comparable in elderly patients with ULMCA stenosis underwent CABG or DES. However, the rate of TLR was significantly higher in patients treated with DES than that receiving CABG operation.

Human cytomegalovirus (HCMV) expresses several homologues of human interleukin 10 (hIL-10) possessing immunomodulatory properties which may promote viral infection by modulating the function of myeloid cells. We examined the phenotype and phagocytic capability of human monocytes exposed to hIL-10, an HCMV-encoded hIL-10 homologue expressed during the productive phase of infection (cmvIL-10), and a differentially spliced form of cmvIL-10 expressed during latent and productive phases of infection, (LAcmvIL-10). hIL-10 and cmvIL-10 upregulated expression of Fcgamma receptors, stimulated phagocytosis of IgG-opsonised erythrocytes and decreased MHC class II (HLA-DR) expression on purified monocytes within 24 h. In contrast, LAcmvIL-10 decreased HLA-DR expression at later times (48 h and 72 h) but did not increase Fcgamma receptor expression. We conclude that cmvIL-10 promotes differentiation of monocytes towards a pro-phagocytic phenotype and that LAcmvIL-10 does not affect monocytes by the same mechanism as cmvIL-10. The significance of these properties to cytomegalovirus pathogenesis is discussed.

Background: Chronic kidney disease (CKD) is a strong predictor of mortality after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), but the relative efficacy of the 2 revascularization strategies in this context remains unknown., Methods and Results: The 1,069 patients with CKD undergoing revascularization for multivessel coronary disease were evaluated. Of them, 532 patients were treated for 2-vessel disease (97 CABG, 435 PCI) and 537 for 3-vessel disease (248 CABG, 289 PCI). CKD was defined as estimated glomerular filtration rate <60 ml/min. No differences between the PCI and CABG groups in the 2-vessel population were observed in the composite of death, myocardial infarction (MI) or cerebrovascular events (10.6% vs 8.2%, P=0.493) and repeat revascularization (6.7% vs 3.1%, P=0.181) during the 2-year follow-up. In the 3-vessel population, patients undergoing PCI showed similar rate for the composite endpoint (6.7% vs 3.1%, P=0.181), but had a higher incidence of repeat revascularization (12.5% vs 4.4%, P=0.001) compared with the CABG group. After multivariate adjustment, revascularization strategy was not an independent predictor of the composite endpoint., Conclusions: Compared with PCI with a drug-eluting stent, CABG showed a similar incidence of death, MI or cerebrovascular events in patients with multivessel disease and CKD, but was associated with decreased repeat revascularization in the 3-vessel population.

Objective: To develop two new respirator fit test panels using data from anthropometric survey of Chinese adult workers: bivariate panel and principal component analysis (PCA) panel for meeting the requirements of respirator fit design and testing and evaluate the applicability of the two different fit test panels for current Chinese workers., Methods: An anthropometric database based upon anthropometric data of current Chinese workers was used for panel design. The bivariate panel was based upon the bivariate distribution of the face length and face width measurements, and the PCA panel was developed using principal components analysis of 10 stable facial dimensions (minimum frontal breadth, face width, bigonial breadth, face length, interpupillary distance, head breadth, nose protrusion, nose breadth, nasal root breadth, subnasale-sellion length). The distribution of Chinese workers across the panels was used to analyze the panels' applicability for Chinese workers., Results: The bivariate panel and PCA panel developed in this study consisted of 10 cells and 8 cells respectively, covered 96.9% (male 95.4%, female 98.4%) and 96.5% (male 95.1%, female 98.1%) of the current Chinese workers, respectively. The distribution of workers across both panels was uniform. Each cell contained 4.6% - 21.7% of the population in the bivariate panel and 10.4% - 14.6% of the population in the PCA panel. The LANL full-face piece respirator fit test panel covered only 70.9% of the Chinese workers, It was thought to be no longer adequate for the Chinese adult workers., Conclusion: New respirator fit test panels based on updated anthropometric database and distributions specific to Chinese workers may be more beneficial for applications in China.

Sixty-three episodes of isthmus-dependent atrial flutter (AFL) in 55 patients were studied to characterize variations in flutter wave morphology and to investigate the mechanisms of the atypical flutter waves on surface ECG. The activation patterns of coronary sinus (CS) and their relationship with flutter wave morphology on the ECG were analyzed. In 46 episodes of counterclockwise AFL (CCW-AFL), there were four types of flutter waves on ECG. Typical and atypical flutter waves were found in 47.8% and 13.0% of the episodes, respectively. Atypical flutter waves had broad positive terminal portion or entirely positive wave in the inferior leads and in V(1), with a distal-to-proximal or fused activation pattern in the CS, and an average activation time of 21.3 +/- 11.4 ms. In 17 episodes of clockwise AFL (CW-AFL), typical and atypical flutter waves were identified in 41.2% and 41.2%, respectively. Atypical flutter waves had negative waves in the inferior ECG leads and in V1, a proximal-to-distal activation pattern in the CS, and an average activation time of 42.4 +/- 14.4 ms. We conclude that atypical flutter waves are common in the isthmus-dependent AFL. The clockwise or counterclockwise conduction in the right atrium, and the activation patterns or conduction sequences between the right and the left atrium, are associated with the variations in the flutter wave morphology on body surface ECG.

Objectives: This study examines whether patient resistance to clopidogrel is associated with long-term thrombotic events after elective coronary drug-eluting stent (DES) implantation., Methods: We prospectively enrolled 386 patients with stable angina who received elective percutaneous coronary intervention (PCI) with DES. Before the procedure, platelet reactivity was measured by light transmittance aggregometry (LTA) at baseline and approximately 24 h after the 300 mg loading dose of clopidogrel. Clopidogrel resistance was conservatively defined as < or = 10% absolute difference between baseline and post-treatment platelet aggregation. All patients received chronic dual antiplatelet treatment (aspirin 300 mg and clopidogrel 75 mg daily) for 12 months. Patients were followed for 1 year after coronary stenting for the occurrence of composite thrombotic events, including cardiovascular death, non-fatal myocardial infarction (MI), stent thrombosis or cerebrovascular ischemic accident (CVA)., Results: Clopidogrel resistance was present in 65 patients (16.8%). During follow-up, composite thrombotic events occurred in 16.9% of clopidogrel resistant patients, yet in only 6.2% of non-resistant patients (p = 0.010). The incidence of definite or probable stent thrombosis was 9.2% in clopidogrel resistant patients and 2.5% in non-resistant patients (p = 0.018). After adjustment for other factors that affect cardiovascular outcome, clopidogrel resistance, diabetes, and left ventricular (LV) dysfunction were independently associated with 1-year composite thrombotic events. The hazard ratio (HR) for clopidogrel resistance was 2.44 (95% CI = 1.09 to 5.45; p = 0.031)., Conclusion: This study demonstrates the natural history of clopidogrel resistance among patients with stable cardiovascular disease, and shows that this resistance is an independent predictor of thrombotic events in patients undergoing PCI with DES.

The polymorphisms of HSP70-1 gene in 253 Chinese Holstein dairy cows were studied, and the association between the polymorphisms and somatic cell score (SCS) were analyzed. PCR-SSCP, PCR-RFLP and DNA sequencing were used to investigate mutations in the coding region of HSP70-1 gene. The G-->A-->C mutation at 1 623 bp and G-->A mutation at 2 409 bp were found and both of them were silence mutations that caused no alteration in amino acid sequence. Chi-square test showed both loci were'nt at Hardy-Weinberg disequilibrium in Chinese Holstein. In the meanwhile, the association of 2 409 locus and SCS was not significant. However, the polymorphism at 1623 locus affected SCS significantly (P<0.05). The SCS of genotype CC was significantly lower than that of genotype AG and GG (P<0.05), so genotype CC was mastitis resistant. These results suggest that genotype CC of HSP70-1 gene may be used as a molecular and genetic marker to improve the phenotype of anti-mastitis in Chinese Holstein dairy cows.

Objective: To observe the effects of upstream versus downstream application of tirofiban on platelet aggregation and clinical outcomes (major adverse cardiovascular event, MACE) in patients with high-risk non-ST-segment elevation acute coronary syndromes (NSTE-ACS) undergoing percutaneous coronary intervention (PCI)., Methods: From July 2006 to July 2007, 160 high-risk NSTE-ACS patients undergoing PCI were randomized to receive upstream (4-6 h prior PCI) tirofiban and downstream (immediately prior to PCI) tirofiban. Platelet aggregation inhibition was determined at admission, before coronary angiography and after PCI. Incidences of MACE at 1, 3, 7, 30 and 180 days after PCI were compared. The incidences of bleeding complications and thrombocytopenia during tirofiban treatments were recorded., Results: The extent of platelet aggregation inhibition post tirofiban was significantly greater in upstream tirofiban than that in downstream tirofiban group (8% vs. 42%, P<0.05). The incidences of MACE at various time points were similar between the two groups (all P>0.05). Aging, hypertension and type-2 diabetes were independent risk factors of MACE. The incidences of major and minor bleeding complications as well as mild thrombocytopenia during tirofiban treatments were similar between the two groups (2.5% vs. 1.3%, 1.3% vs. 1.3% and 1.3% vs. 1.3%, respectively; all P>0.05)., Conclusion: On top of aspirin and clopidogrel, upstream application of tirofiban is associated with increased platelet aggregation inhibition but the incidences of MACE up to 180 days post tirofiban are similar in the upstream and downstream tirofiban treated patients with high-risk NSTE-ACS after PCI. Aging, hypertension and type-2 diabetes were independent risk factors of MACE in these patients.

Objectives: This study was undertaken to compare the renal safety as well as cardiovascular (CV) effects and diagnostic image quality of iso-osmolar iodixanol vs. low-osmolar iopromide in patients with chronic kidney disease (CKD) undergoing coronary interventions., Background: With the growing number of contrast-enhanced procedures being performed for coronary artery disease management, the safety and efficacy of iodinated contrast media (CM) have come under increased scrutiny., Methods: : Patients with CKD (CrCl < or =60 mL/min) were randomized to iodixanol (n = 106) or iopromide (n = 102). The primary endpoint was incidence of contrast-induced nephropathy (CIN), defined as an increase in serum creatinine (SCr) > or =25% or 0.5 mg/dL within 72 hr of CM administration. Secondary endpoints were mean SCr increase, a composite of CV events in-hospital and 30 days postdischarge, and diagnostic image quality., Results: : CIN incidence was significantly lower with iodixanol than iopromide (5.7% vs. 16.7%; P = 0.011). Baseline SCr (OR 2.21, 95% CI: 1.25-3.47; P = 0.031), iopromide use (OR 2.56, 95% CI: 1.18-5.76; P = 0.024), and CM volume (OR 2.01, 95% CI: 1.01-3.21; P = 0.038) were identified as independent risk factors for CIN. Cardiovascular events were reduced with iodixanol (1.9% vs. 8.8%; P = 0.025); diagnostic image quality was similar for both CM (P = 0.353)., Conclusions: : Consistent with several previous trials comparing iso-osmolar iodixanol and low-osmolar comparator CM, iodixanol was associated with a lower incidence of CIN and fewer CV events than iopromide., (Copyright 2008 Wiley-Liss, Inc.)

Background: The radial artery is currently regarded as a useful vascular access site for coronary procedures. This study was conducted to investigate the feasibility and safety of the percutaneous radial artery approach for angioplasty in the elderly., Methods: Two thousand and fifty-eight consecutive patients (762 elderly, age = 65 years; and 1296 non-elderly, age < 65 years, respectively) who underwent transradial coronary angioplasty were recruited in this study. Study endpoints included procedure success rate, procedure time, vascular complications at access site, and major adverse cardiac and cerebrovascular events during hospitalization., Results: Elderly patients were more likely to present with unstable angina and renal dysfunction. The incidence of radial and brachiocephalic trunk anatomical tortuosity was higher in elderly patients than that in non-elderly patients (11.5% vs 3.7%; 8.9% vs 2.6%, P < 0.01, respectively). However, procedural success rate (94.7% vs 95.6%) and total mean procedure time ((67.9 +/- 27.3) minutes vs (58.6 +/- 38.5) minutes) for transradial coronary angioplasty were not significantly different between the two groups. Clinical course during the hospitalization was slightly worse in the elderly patients because of more adverse cardiac and cerebrovascular events after the procedure. However, the incidence of vascular complications was not significantly different between the elderly and non-elderly patients., Conclusion: Although the incidence of radial and brachiocephalic trunk anatomical tortuosity is higher in elderly patients, transradial coronary intervention can be performed with similar safety and procedural success in these patients as compared with non-elderly patients.

Background: Patients aged over 85 years have been under-represented in percutaneous coronary intervention (PCI) trials despite an increase in referrals for PCI. The long-term safety and efficacy of percutaneous coronary stenting in patients aged over 85 years with acute coronary syndrome (ACS) remain unclear. Moreover it is unknown whether there are differences between bare metal stent (BMS) and drug eluting stent (DES) in this special population., Methods: A total of 80 patients with ACS aged over 85 years undergoing stenting (BMS group n = 21 vs DES group n = 59) were retrospectively studied. In-hospital, one year and overall clinical follow-up (12 - 36 months) of major adverse cardiac events (MACEs) including cardiac deaths, myocardial infarction, target lesion revascularization (TLR) and target vessel revascularization (TVR) as well as stroke and other major bleeding were compared between the two groups., Results: In the entire cohort, the procedure success rate was 93.8% with TIMI-3 coronary flow post-PCI in 93.8% of the vessels and the procedure related complication was 17.5%. The incidence of in-hospital MACEs in BMS group was higher (14.3% vs 6.8%, P = 0.30). The 1-year incidence of MACEs in DES group was 7.0% while there was no MACE in the BMS group. Clinical follow-up for 12 - 36 months showed that the overall survival free from MACE was 82.9% and the incidence of MACE in the BMS group was lower (5.3% vs 21.1%, P = 0.20). Multivariate regression analysis showed that the creatinine level (OR: 1.013; 95% CI: 1.006 - 1.020; P = 0.004) and hypertension (OR: 3.201; 95% CI: 1.000 - 10.663; P = 0.04) are two major factors affecting the long-term MACE., Conclusions: Percutaneous coronary stenting in patients aged over 85 years is safe and provides good short and long-term efficacy. Patients with renal dysfunction and hypertension may have a relatively high incidence of MACE.

Background: Transradial coronary intervention has been widely used because of its effects in lowering the incidence of complications in vascular access site and improving patient satisfaction compared to the femoral approach. This study aimed to investigate the safety and feasibility of transradial approach for primary percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI)., Methods: A total of 103 consecutive elderly patients (age = 65 years) who were diagnosed as having AMI were indicated for PCI. Among them, 57 patients received primary PCI via the transradial approach (transradial intervention, TRI group), and 46 underwent primary PCI via the transfemoral approach (transfemoral intervention, TFI group). The success rate of puncture, puncture time, cannulation time, reperfusion time, the total time for PCI, the success rate of PCI, the use rates of temporary pacemaker and intra-aortic balloon pump (IABP), and the total length of hospital stay of the patients in the two groups were compared. After the procedure, vascular access site complications and major adverse cardiovascular events (MACE) in the two groups in one month were observed., Results: The success rates of puncture (98.2% vs 100.0%) and PCI (96.5% vs 95.7%) for the patients in the TRI and TFI groups were not statistically significant (P > 0.05). The puncture time ((2.4 +/- 1.1) vs (2.0 +/- 0.9) minutes), cannulation time ((2.7 +/- 0.5) vs (2.6 +/- 0.5) minutes), reperfusion time ((16.2 +/- 4.5) vs (15.4 +/- 3.6) minutes), total time of the procedure ((44.1 +/- 6.8) vs (41.2 +/- 5.7) minutes), use rates of temporary pacemaker (1.8% vs 2.2%) and IABP (0 vs 2.2%) in the two groups were not statistically significant (P > 0.05), but the hospital stay of the TFI group was longer than that of the TRI group ((10.1 +/- 4.6) vs (7.2 +/- 2.6) days, P < 0.01). A radial occlusion was observed in the TRI group, but no ischemic syndrome in hand. In the TFI group, 4 patients had hematosis, 1 had pseudoaneurysm, and 1 had major bleeding. Statistical significance in vascular access site complications was seen in the two groups (1.8 % vs 13.1%, P < 0.05). Three patients died in the two groups respectively in one month, and there was no statistical significance in MACE in the two groups (5.3% vs 6.5%, P > 0.05)., Conclusion: The transradial approach for primary PCI is safe and feasible for elderly patients with AMI.

Purpose: To investigate the influence of angiotensin-converting enzyme inhibitor (ACEI) on cardiac innervation and inducible ventricular arrhythmias (VAs) in healed myocardial infarction (MI)., Methods: Left anterior descending coronary artery was ligated to induce MI in 30 rabbits. After oral captopril (10mg/kg/d) for 8 weeks, electrophysiological study was performed to evaluate the incidence of inducible VAs. RT-PCR and immunohistochemistry were used to measure the cardiac innervation., Results: Eight weeks after the operation, the incidence of inducible VAs in the MI-placebo group was higher (58.3%, 7/12) than in the sham operation group (16.7%, 2/12, P < 0.05). However, the incidence of inducible VAs in the MI-captopril group was lower (27.2%, 3/11) than in the MI-placebo group (P < 0.05). Proliferation and growth of nerve fibres in the MI-placebo group were mainly distributed at the periphery of the infarcted and perivascular regions of the myocardium. The density of nerve fibres increased in the MI-placebo group (3889+/-521 microm2/mm2) compared with the sham group (1727+/-304 microm2/mm2, P < 0.01) at the infarct border. In the MI-captopril group, the density of nerve fibres (3507+/-433 microm2/mm2) at the infarct border did not differ from that in the MI-placebo group (P=0.07). MI-induced abnormal nerve fibre distribution was partly restored by captopril treatment., Conclusion: In this study, prolonged captopril treatment was effective in preventing VAs in healed MI, partly by attenuating the spatial heterogeneity of cardiac innervation.

Objective: To elucidate the incidence and risk factors of acute radial artery occlusion (RAO) following transradial percutaneous coronary intervention (TRI)., Methods: A total of 7215 patients who underwent TRI were divided into normal group and RAO group, according to whether the patient without and with RAO. Risk factors of RAO were analyzed by logistic regression model., Results: Acute RAO occurred in 68 patients (0.94%). As compared to the patients in normal group, there were more female and diabetes mellitus patients in RAO group. The dosage of heparin used in the operational procedure in RAO group were significantly less than normal group (3723 IU +/- 556 IU vs 7603 IU +/- 1533 IU, P < 0.01). The post-procedure duration of high-pressure compression hemostasis were longer in RAO patients than normal patients (103.8 min +/- 23.3 min vs 87.7 min +/- 31.2 min, P = 0.02). Logistic regression analyses showed that the dosage of heparin used in the procedure, the category and size of sheath and the post-procedure compression time were independent risk factors for RAO., Conclusion: The incidence of RAO can be minimized by appropriate anticoagulation, proper sheath selection, and avoiding prolonged duration of high-pressure compression hemostasis following the procedure.

Background: Neural remodeling is part of the pathophysiology of ventricular arrhythmias after myocardial infarction (MI). In this study, we developed a rabbit model of MI to investigate the effect of the beta-blocker metoprolol on ventricular neural remodeling and susceptibility to ventricular arrhythmias., Methods: MI was induced by ligation of the left anterior descending coronary artery in 30 rabbits, and sham operations were performed in 12 control animals. Metoprolol was then administered to 15 of the MI animals. After electrophysiological recordings, the expression of nerve markers was studied at the infarct border and the non-infarct left ventricle free wall (LVFW) by immunostaining or RT-PCR., Results: Eight weeks after MI, the incidence of inducible ventricular arrhythmias was significantly (P<0.01) higher in the MI group than in the sham group. However, metoprolol treatment decreased incidence of post-MI ventricular arrhythmias (8.3%) compared to those without treatment (58.3%, P<0.001). The density of nerve fibers was increased in MI group (3889+/-521 microm(2)/mm(2)) compared to the sham group (1727+/-304 microm(2)/mm(2)). Treatment of MI rabbits with metoprolol resulted in a partial reduction (2725+/-283 microm(2)/mm(2)). However, the shape and imbalance of nerve fibers appeared to be normalized by the metoprolol treatment. The expression levels of TH mRNA were reduced (P<0.01) by metoprolol treatment., Conclusion: Metoprolol reduces post-MI ventricular arrhythmias, partly by altering the neural remodeling process.

Objective: To study the anti-inflammatory and analgesic actions of Aike Mixture (AKM)., Methods: A total of 100 male mice were randomly assigned into 5 groups: a normal control group, a drug control group (a hydrocortisone subgroup and an atropine subgroup), a high-dose AKM group, a mid-dose AKM group and a low-dose AKM group. Xylene was spread on the left ear of the experimental mice to induce inflammation, and 1% acetic acid solution injected into the abdominal cavity to produce pain so as to cause the body bend. Different doses of AKM were given and their actions observed., Results: AKM had obvious anti-inflammatory effect on the xylene-induced ear tumefaction and inhibited the pain-caused body bend in the AKM groups, with significant difference from the normal control (P < 0.01)., Conclusion: AKM has good anti-inflammatory and analgesic effects, which is of clinical significance in the treatment of chronic prostatitis.

Background/purpose: Hypofunction of the salivary glands can substantially affect quality of life. Current treatments for salivary hypofunction are of limited effectiveness. Although the implantation of functional salivary gland tissue from autologous glandular cells represents a possible physiologic solution to this problem, tissue engineering of salivary glands would require the generation of a great number of acinar cells (ACs). The purpose of this study was to investigate the feasibility of transdifferentiation of bone marrow stem cells (BMSCs) into functional ACs using a co-culture system., Methods: BMSCs were isolated from adult rats and co-cultured with rat parotid ACs using a double chamber system. The transdifferentiation of BMSCs was evaluated by immunocytochemical analysis of alpha-amylase, which has unique functional expression in ACs., Results: Expression of alpha-amylase, indicating successful transdifferentiation of BMSCs into ACs, was found in 30% of BMSCs after co-culturing for 1 week, and in 50% after co-culturing for 2 and 3 weeks., Conclusion: This study has demonstrated the potential of rat BMSCs to transdifferentiate into ACs, and support the feasibility of application of BMSCs in salivary gland tissue engineering.

Objectives: Watchful waiting to manage depression in primary care may be an appropriate management approach for some patients who present with less severe depression. This study examined factors associated with primary care clinicians' choice of a watchful waiting approach to care management for depression., Methods: Secondary data were analyzed from Partners in Care, which examined dissemination of best practices for depression in primary care. Primary care clinicians' decisions regarding watchful waiting were examined by using the baseline survey data from Partners in Care completed by clinicians and patients from February 1996 to March 1997. Participants were 167 primary care clinicians from 46 practices of seven managed care organizations across the United States and their 1,187 patients with depression. Primary care clinicians' proclivity for watchful waiting was examined by using a brief scenario describing a patient with major depressive disorder., Results: Thirty-four clinicians (20 percent) reported a strong proclivity to use watchful waiting for the patient in the scenario. The proclivity was significantly associated with clinicians' reports of the proportion of their actual patients with whom they used this approach. Clinicians were significantly more likely to choose watchful waiting for their actual patients if they had more psychotherapy knowledge (p=.035) or perceived that the need to treat the patient's medical illness was more important than the need to treat his or her mental illness (p=.046) and were less likely to choose a watchful waiting approach if they perceived the lack of availability of mental health professionals as a barrier (p=.050)., Conclusions: Primary care clinicians' knowledge of treatment and perception of barriers influence their proclivity for watchful waiting. Clinician education to promote appropriate use of watchful waiting on the basis of clinical need is recommended.

Ni-doped ZnO films were deposited on Si(100) by pulsed laser deposition(PLD) at room temperature. Fluorescence emission properties of the films were measured using VARAIN Cary-Eclips 500 fluorescence spectrum analyzer. Two peaks centered respectively at about 360 and 380 nm were observed. The origin of the ultraviolet peak at 360 nm was investigated through doping Ni into the ZnO films. It was found that the intensity of this ultraviolet peak changed with Ni content while its position remained stable. The fluorescence emission of the samples was optimal when Ni:ZnO was 5 mol%, indicating that the peak centered at 360 nm might originate from the composite transition between the splitting valence band and conduction band, not from the entrance of the impurity energy level into the conduction band after doping.

Background: Recent studies have shown that thiazolidinediones (TZDs) could reduce in-stent restenosis and improve clinical outcomes in patients with type 2 diabetes after coronary stent implantation. It remains unclear whether nondiabetic patients with metabolic syndrome after stenting could also benefit from the treatment with TZDs., Methods: Three hundred and sixty patients with metabolic syndrome who underwent coronary stent implantation were randomly assigned to a rosiglitazone group (n = 180) or a control group (n = 180). Patients in the rosiglitazone treatment group were treated with rosiglitazone 1 day before coronary stenting (4 mg once daily) and treatment was continued until the 9 months follow-up; while in the control group, patients were treated with placebo 1 day before the procedure and until the 9 months follow-up. Adverse events were death, myocardial infarction and urgent target vessel revascularization within 9 months after coronary stenting., Results: One hundred and fifty two patients in the rosiglitazone group and 145 patients in the control group survived during the follow-up. Baseline characteristics among patients in the two groups were well balanced. There was no significant difference in target vessels or the procedure of stent implantation. Compared with the control group, treatment with rosiglitazone was associated with a lower rate of death, myocardial infarction and urgent target vessel revascularization (7.2% vs 14.5%, P = 0.044)., Conclusion: Rosiglitazone could reduce the risk of the adverse cardiovascular event and improve clinical outcomes in nondiabetic patients with metabolic syndrome after coronary stent implantation.

Objective: To construct a novel eukaryotic expression plasmid for recombinant immunotoxin DT390-Rantes and perform preliminary analysis of its function., Methods: The gene fragment coding for Rantes was obtained from the liver tissues of C57BL/6 mice using RT-PCR, and inserted into the eukaryotic expression plasmid SRalpha containing DT390 gene to construct the recombinant plasmid DT390-Rantes-SRalpha, which was transformed into E. coli JM109, followed by selection of the positive clones containing the target inserts. The eukaryotic expression plasmid was analysed by PCR, restriction endonuclease digestion and DNA sequencing. The recombinance plasmid DT390-Rantes-SRalpha was transfected into NIH3T3 cells and its expression was observed by immunofluorescence detection. The activity of the expressed DT390-Rantes in vitro was evaluated by MTT assay., Results: The gene fragment of Rantes was correctly inserted into the eukaryotic expression plasmid SRalpha as verified by restriction endonuclease digestion and DNA sequencing, and could be expressed in NIH3T3 cells. MTT assay confirmed that the expression product DT390-Rantes could kill activated T cells in vitro., Conclusions: The recombinant eukaryotic expression plasmid DT390-Rantes-SRalpha is successfully constructed and expressed in eukaryotic cells. The expressed product can specifically kill activated T cells in vitro.

N-terminal pyroglutamate (pGlu) formation from its glutaminyl (or glutamyl) precursor is required in the maturation of numerous bioactive peptides. The aberrant formation of pGlu may be related to several pathological processes, such as osteoporosis and amyloidotic diseases. This N-terminal cyclization reaction, once thought to proceed spontaneously, is greatly facilitated by the enzyme glutaminyl cyclase (QC). To probe this important but poorly understood modification, we present here the structure of human QC in free form and bound to a substrate and three imidazole-derived inhibitors. The structure reveals an alpha/beta scaffold akin to that of two-zinc exopeptidases but with several insertions and deletions, particularly in the active-site region. The relatively closed active site displays alternate conformations due to the different indole orientations of Trp-207, resulting in two substrate (glutamine t-butyl ester)-binding modes. The single zinc ion in the active site is coordinated to three conserved residues and one water molecule, which is replaced by an imidazole nitrogen upon binding of the inhibitors. Together with structural and kinetic analyses of several active-site-mutant enzymes, a catalysis mechanism of the formation of protein N-terminal pGlu is proposed. Our results provide a structural basis for the rational design of inhibitors against QC-associated disorders.

Summary The ratio of osteoprotegerin [OPG, tumour necrosis factor receptor superfamily, member 11b (TNFRSF11B)] to receptor activator of nuclear factor kappaB ligand [RANKL, tumour necrosis factor (ligand) superfamily, member 11 (TNFSF11)] in bone is critical for the regulation of bone remodelling. Myeloma cells can home to bone, triggering increased RANKL and decreased OPG expression by stromal cells, leading to osteolysis. Whether myeloma cells contribute directly to the pool of RANKL or OPG in bone has been contentious. Here we provide evidence of RANKL expression by reverse transcription polymerase chain reaction and in situ hybridization, demonstrating transcripts encoding both the membrane-bound and secreted forms of RANKL in five human multiple myeloma cell lines (LP-1, NCI-H929, OPM-2, RPMI8226, U266) and myeloma cells purified from bone marrow aspirates of myeloma patients. We demonstrated that RANKL encoding mRNAs are translated to protein by antibody detection of RANKL. In vitro assays showed that myeloma cells induced bone marrow derived mononuclear cells to differentiate into adherent tartrate-resistant acid phosphatase positive multinucleated cells, indicative of the formation of functional osteoclasts. This differentiation could also be achieved with passaged myeloma media alone, implicating secreted products. Finally, we provide evidence that the differentiation observed is at least in part the result of myeloma cell expression of RANKL. We therefore conclude that myeloma cells can directly contribute to the pool of RANKL in bone.

The present study investigated the intergenerational communications between Japanese Americans who were unjustly ordered into U.S. concentration camps during World War II and their offspring born after the war. Survey data were collected from 450 2nd-generation (Nisei) Japanese American former internees to assess patterns of communication with their children about the internment. The study and its results are discussed in relation to racial socialization and the influence of ethnicity on reactions to traumatic stress.

Confirmed and alleged misuses of flunitrazepam (FM2, Rohypnol) have brought about serious interest in the development of an analytical methodology that can be effectively used for preliminary screen and confirmatory test of FM2 (or its metabolites) in urine specimens under high-volume settings. Reported methods do not serve this need well for the following reasons: (1) common benzodiazepine (BZ) immunoassays (IAs) have broad cross-reactivities toward widely prescribed BZs (and their metabolites) and are therefore likely to generate an unacceptable number of false positives and (2) because FM2 is typically used at low doses (1-4 mg), IAs with low cross-reactivities toward FM2 (and its metabolites) are likely to generate false-negative results. In this current study, a familiar and effective two-step IA/gas chromatography-mass spectrometry (GC-MS) approach is successfully developed and applied to clinical specimens. Cross-reacting characteristics of the following BZ IAs toward various BZs (and their metabolites) are evaluated focusing on their effectiveness in serving as the preliminary test reagent in a two-step testing protocol: TDx, Beckman, CEDIA, Roche Cobas Integra, Emit II Plus, and Cozart ELISA. Although other IAs show broad cross-reactivities toward various BZs and their metabolites, diazepam is the only non-FM2 derived compound that exhibits noticeable cross-reactivity toward Cozart ELISA reagent. Cross-reactivity data and data derived from studies conducted on a limited number of clinical specimens demonstrate that, when used to monitor FM2 exposure in a large population group (including those exposed to other BZs), Cozart ELISA has the potential of being as effective as (or better than) those currently used in various workplace drug-testing programs for monitoring respectively targeted drugs. Data derived from this study further suggest that 50 ng/mL apparent 7-aminoflunitrazepam (Cozart ELISA) and 30 ng/mL free 7-aminoflunitrazepam (GC-MS) are potentially effective preliminary test and confirmation test cut-offs. To maximize efficiency, it is further suggested that urine specimens are first diluted by a factor of 5 for the preliminary test in which a 10-ng/mL 7-aminoflunitrazepam standard is used as the assay's cut-off standard.

Objective: To observe the effect of soothing Liver and activating Spleen method (SLAS) of TCM in treating ulcerative colitis (UC)., Methods: Patients were randomly divided into 2 groups, the 33 cases in the treated group were treated with Ningxie Powder (NXP) and the 30 cases in the control group were treated with salicylazosulfapyridine (SASP). The improvement in clinical symptoms scoring, therapeutic effect in various treatment courses, changes in immune indexes as well as the condition in 1-year follow-up were observed., Results: The initial therapeutic effect after 3 months treatment showed insignificant difference between the two groups. However, the effect in the treated group was better than that in the control group both short-term (after 9 months treatment) and long-term (for 1-year follow-up study) (P < 0.05)., Conclusion: NXP, a Chinese herbal drug for soothing Liver and activating Spleen, shows good and persistent effect in treating ulcerative colitis and has favorable prospect in application.

Although suppression of thermoregulatory mechanisms during anaesthesia is generally assumed, the extent to which thermoregulation may be inactive is unknown. Twenty unpremedicated, ASA physical status class I patients (17 men and 3 women) scheduled for retinal detachment surgery were studied to evaluate the different changes of core and two skin-surface temperatures during halothane or isoflurane anaesthesia. Anaesthesia was induced by mask inhalation of halothane or isoflurane in nitrous oxide 70% and oxygen and was maintained by mechanical ventilation during surgery with halothane or isoflurane in nitrous oxide 50% and oxygen only. Core temperature (rectus) and skin-surface temperatures (forearm and fingertip) were measured during surgery using three separate thermometers (Y.S.I.: Yellow springs instrument Co., Inc. G541-211-Y01-33A0). Operating room temperatures were recorded in every case. Significant vasoconstriction was prospectively defined by a skin-surface temperature gradient between two sampling sites > or = 4 degrees C. The result indicated that there was no significant difference between core temperatures and skin-surface temperature gradients during halothane anaesthesia and isoflurane anaesthesia. However, three of the ten patients had their skin-surface temperature gradients > or = 4 degrees C in the halothane group. None of the ten patients had their skin-surface temperature gradients > or = 4 degrees C in the isoflurane group.

The purpose of this study was to determine whether prior administration of a small, sub-paralytic dose of nondepolarizing muscle relaxant, vecuronium, would have a better intubating condition than a single bolus dose when vecuronium was used as the muscle relaxant during rapid sequence induction and tracheal intubation. Six groups of 15 patients each (ASA class I or II) were involved in this study. Anesthesia was induced with fentanyl 2-3 micrograms/kg and thiopental 4-5 mg/kg. In group 1, 2 and 3, the patients were given the same priming dose of 0.1 mg/kg. Four min later, different doses of vecuronium were given to each group: 0.09 mg/kg (Gp1), 0.14 mg/kg (Gp2), and 0.19 mg/kg (Gp3). In group 4, 5 and 6, no priming vecuronium was given and the intubating doses given to each group were as follow: 0.1 mg/kg (Gp4), 0.15 mg/kg (Gp5) and 0.2 mg/kg (Gp6). At the end of a 60 sec, the percentage of patient with excellent intubating condition were 46.6%, 66.6%, 86.6%, 20%, 40% and 80% respectively for group 1, 2, 3, 4, 5 and 6 respectively. The percentage with good intubating condition were 46.6%, 33.4%, 13.4%, 46.6%, 53.2%, and 20% for group 1, 2, 3, 4, 5 and 6 respectively. The percentage of poor intubating condition were 6.8% in group 1, 33.4% in group 4, 6.8% in group 5 and 0% in group 2, 3, 6. All patients receiving a priming dose could sustain head lift for 5 sec and did not complain any respiratory discomfort 3 min after the priming dose.(ABSTRACT TRUNCATED AT 250 WORDS)