[Endovascular therapy accompanied by spontaneous portosystemic shunts for overt hepatic encephalopathy].

Objective: To preliminarily evaluate the safety and efficacy of shunt-related interventional therapy accompanied with spontaneous portosystemic shunts (SPSS) in patients with hepatic encephalopathy (HE). Methods: Case data on six patients who underwent interventional therapy accompanied by SPSS for HE from January 2017 to March 2021 were collected to evaluate the efficacy and postoperative complications. Results: All six patients underwent SPSS. Four patients had hepatitis B cirrhosis; one had alcoholic cirrhosis; and one had hepatic arterioportal fistula-induced portal hypertension. Child-Pugh liver function scores were C and B in three and three cases, respectively. The SPSS type was gastrorenal shunt in two cases; portal-thoracic-azygos venous in two cases; portal-umbilical-iliac venous in one case; and portal-splenic venous - inferior vena cava in one case. Two of them had previously had a transjugular intrahepatic portosystemic shunt (TIPS), and there were SPSS prior to TIPS. Five cases (5/6) successfully underwent shunt embolization, and one case (1/6) underwent stent implantation for flow restriction (portal-umbilical-iliac vein). The technical success rate was 100%. HE did not recur during hospitalization or the three-month follow-up period. However, one case had a recurrence of HE within a year after surgery and was treated symptomatically, while another experienced gastrointestinal bleeding a year after surgery.. Conclusion: SPSS embolization or flow restriction is effective and safe for improving HE patients' symptoms.

Fast Bayesian Variable Screenings for Binary Response Regressions with Small Sample Size.

Screening procedures play an important role in data analysis, especially in high-throughput biological studies where the datasets consist of more covariates than independent subjects. In this article, a Bayesian screening procedure is introduced for the binary response models with logit and probit links. In contrast to many screening rules based on marginal information involving one or a few covariates, the proposed Bayesian procedure simultaneously models all covariates and uses closed-form screening statistics. Specifically, we use the posterior means of the regression coefficients as screening statistics; by imposing a generalized g-prior on the regression coefficients, we derive the analytical form of their posterior means and compute the screening statistics without Markov chain Monte Carlo implementation. We evaluate the utility of the proposed Bayesian screening method using simulations and real data analysis. When the sample size is small, the simulation results suggest improved performance with comparable computational cost.

Isolation and characterization of microsatellite markers of sea cucumber Stichopus horrens.

Curry fish (Stichopus horrens) is a tropical holothurian species and is widely distributed in the India-West Pacific. In the present study, 9 polymorphic microsatellite loci were isolated and characterized for S. horrens. These loci were tested in 30 individuals from Hainan Island in China. The number of alleles ranged from 2 to 5. The polymorphism information content ranged from 0.348-0.584. The levels of observed and expected heterozygosities varied from 0.1500-0.8000 and from 0.2014-0.5000, respectively. Most loci were in Hardy-Weinberg equilibrium, except HCS1-27 and HCS2-7, after sequential Bonferroni's correction, and no significant linkage disequilibrium was detected for any pairwise combination of loci. These polymorphic microsatellite loci will be useful for studying population structure and conservation strategy design for S. horrens.

Isolation and characterization of polymorphic microsatellite loci in the sea cucumber Holothuria scabra.

The sea cucumber Holothuria scabra is an endangered species. In this study, nine new polymorphic microsatellite loci were developed and tested in 30 individuals. The number of alleles ranged from 2 to 5, and the observed and expected heterozygosities ranged from 0.1200 to 0.7391 and from 0.2408 to 0.5983, respectively. No loci significantly deviated from the Hardy-Weinberg equilibrium af-ter a Bonferroni correction, and no significant linkage disequilibrium was found between pairs of loci. These polymorphic microsatellite loci will be useful in studying the genetic diversity of H. scabra and its conservation.

S-allyl cysteine restores erectile function through inhibition of reactive oxygen species generation in diabetic rats.

Excessive production of reactive oxygen species (ROS) by an overactive nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system in penile tissue is an important mechanism of erectile dysfunction (ED). S-allyl cysteine (SAC), a bioactive component derived from garlic, was recently reported to exert versatile antioxidant properties. We hypothesized that SAC would be able to resolve diabetes-related ED by reducing ROS generation, and designed this study to investigate this possibility as well as to determine the related underlying mechanisms. A streptozotocin-induced diabetes rat model was established and used for comparative analysis of 4-week treatment regimens with insulin or SAC. The ratio of maximal intracavernous pressure (ICP) to mean arterial blood pressure (MAP) was measured to determine erectile function. Differential levels of ROS, NADPH oxidase subunits, nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) signalling pathway, and apoptosis were evaluated in cavernous tissues. Max ICP/MAP was found to be markedly decreased in untreated diabetic rats; SAC, but not insulin, treatment restored the ratio to baseline (in non-diabetic untreated controls). The corpus cavernosum of untreated diabetic rats showed increased p47(phox) and p67(phox) expression, ROS production and penile apoptotic index, and decreased phospho-endothelial nitric oxide synthase (phospho-eNOS, Ser1177) expression, cGMP concentration, B-cell lymphoma 2 (Bcl-2)/Bcl-2-associated X protein (Bax) ratio and smooth muscle cell number. SAC treatment normalized all the diabetes-induced effects, whereas insulin treatment partially normalized the alterations, but produced no effects on P47(phox) expression, penile ROS level, apoptotic index, Bcl-2/Bax ratio and smooth muscle cell number. Collectively, these data indicate that SAC treatment can restore erectile function in diabetic rats by preventing ROS formation through modulation of NADPH oxidase subunit expression. Furthermore, the poor efficacy of conventional insulin treatment for diabetic ED may be associated with an elevated level of ROS in penile tissue.

Age-related changes in kallikreins-kinins system in rat corpus cavernosum.

Many factors, such as nitric oxide synthase, androgen and growth factors, can regulate the tone of corpus cavernosum (CC) smooth muscle with an age-related tendency. It has been shown that the active metabolites of kallikreins-kinins system (KKS), including bradykinin, Lys-BK and Met-Lys-BK, can also relax the CC smooth muscle significantly in vitro. Our aim was to evaluate the specific association between KKS and age in rat CC. CC and thoracic aorta were isolated from rats at postnatal weeks (PW) of 2, 8, 12, 20, 30, 40 and 60, respectively. Tissue kallikrein-I (KLKI) and kinin B2 receptor (B2R) mRNA in CC and thoracic aorta were detected by real-time polymerase chain reaction (PCR). Protein expression of KLKI and B2R were determined with immunofluorescence in situ and Western blot. Real-time PCR, immunofluorescence in situ and Western blot all demonstrated that the age-related changes in expression of KLKI were similar between the CC and thoracic aorta. It significantly increased with age from PW2 to PW30, reached the peak at PW30 and then declined gradually. However, there was no statistically significant difference among PW30, PW40 and PW60. Similarly, the expression of B2R increased gradually with age reached and remained at the peak during adult stages and no significant differences were found among PW20, PW30 and PW40; then, it decreased significantly at PW60. The changes in the expression of B2R in CC and age-matched aorta were similar except that it was significantly less than that in the aorta at PW60. The expression of KLKI and B2R changed in an age-dependent pattern in rat CC and have a tendency to decline during ageing, which is of the same tendency as reported for erection capacity in ageing males and suggests why ageing is an independent predictor of ED, to some extent.

Electronic and optical properties of finite carbon nanotubes in an electric field.

The effects, caused by the geometric structure and an electric field (E), on the electronic and optical properties of quasi-zero-dimensional finite carbon nanotubes are explored by employing the tight-binding model coupled with curvature effects. Electronic properties (state energies, symmetry of electronic states, energy spacing and state degeneracy) are significantly affected by the magnitude and the direction of the electric field and the geometric structure (radius, length and chirality). The electric field, by lowering the symmetry of finite carbon nanotubes, modifies the electronic properties. Thus, the optical excitation spectra, excited by electric polarization parallel to the nanotube axis, exhibit rich delta-function-like peaks, which reveal the characteristics of the electronic properties. Therefore it follows that geometric structure and E influence the low-energy absorption spectra, i.e. the change of frequency of the first peak, the alternation of the peak height and the production of the new peaks. There are more absorption peaks when E is oriented closer to the cross-section plane. Moreover, the very complicated optical absorption spectra are characteristic for the individual chiral carbon nanotube due to its specific geometric structure. Above all, the predicted absorption spectra and the associated electronic properties could be verified by optical measurements.

Renal ablative cryosurgery in selected patients with peripheral renal masses.

OBJECTIVES: To present the preliminary results of renal ablative cryosurgery in selected patients. METHODS: Seven patients were treated, all of whom had small peripheral tumors and chose not to undergo partial or radical nephrectomy. Four patients underwent a rib-sparing flank incision; the remaining three underwent laparoscopy. All tumors were biopsied before cryoablation. Intraoperative ultrasound was used to monitor the cryolesion. RESULTS: There were no intraoperative complications. The estimated blood loss averaged 111 mL. To date, 6 of the 7 patients have undergone at least one follow-up computed tomography scan (14.2 months average follow-up); all these scans demonstrated partial resolution of the lesion. Clinically, the patients tolerated the procedure without any renal complications or significant changes in creatinine. CONCLUSIONS: This limited clinical trial has demonstrated the feasibility of treating small peripherally located renal tumors with cryosurgery with minimal morbidity and a favorable outcome. Further studies are necessary to determine the long-term efficacy of this treatment modality.

Laparoscopic renal cryoablation: acute and long-term clinical, radiographic, and pathologic effects in an animal model and application in a clinical trial.

OBJECTIVES: To evaluate renal cryosurgery by studying the feasibility of laparoscopic delivery and the radiographic characteristics and histopathologic effects in a porcine model using different freeze cycles. On the basis of the results, a clinical trial of laparoscopic cryosurgical ablation in select patients with clinical stage T1 renal tumors was started. MATERIALS AND METHODS: Twelve kidneys from six farm pigs underwent cryosurgery. Each kidney was treated with two freeze cycles to -180 degrees C. Six kidneys were retroperitonealized, and six were not. An abdominal CT scan was performed at various times to evaluate for the presence of urinoma or hematoma and to monitor lesion changes. Organs were harvested at times ranging from 24 hours to 13 weeks. Radiographic and histopathologic changes were recorded for each time period. Eight patients with small (average 2-cm) exophytic renal masses underwent laparoscopic biopsy and cryosurgical ablation using a 3- or 4.8-mm probe (Cryomedical Sciences Inc., Rockville, MD) for one 15-minute or two 5-minute freeze cycles to a temperature of -180 degrees C to extend the ice ball at least 7 mm beyond the tumor margin. RESULTS: Dense adhesions between the bowel and cryoablated renal tissue were encountered in all non-retroperitonealized kidneys, but no fistula formation was present. The retroperitonealized kidneys had minimal adhesion formation. None of the animals developed a urinary fistula. At 24 hours and 1 week, CT scanning demonstrated an enhancement defect corresponding to the region of the ice ball with no urinoma or hematoma. At 13 weeks, only a nonenhancing cortical defect was seen. At immediate harvest, hemorrhage was noted in the area of the ice ball with a sharp demarcation at the edge of the freeze zone. At 1 week, four distinct zones were seen: central necrosis, inflammatory infiltrate, hemorrhage, and fibrosis with regeneration. At 13 weeks, the necrotic tissue had been replaced with a circumscribed area of fibrosis. There were no intraoperative or postoperative complications in the eight patients. The estimated blood loss was 140 mL, and the mean hospital stay was 3.5 days. At a mean clinical follow-up of 7.7 (range 1-18) months and radiographic follow-up of 5 months; there have been no tumor recurrences or significant changes in the serum creatinine concentration. At 24 hours, there was an enhancement defect in the area of the ice ball. The CT images at 13 weeks showed a nonenhancing cortical defect in the area of the ice ball. CONCLUSIONS: Cryosurgery can be readily delivered laparoscopically, creating a discrete lesion at the time of treatment that appears to be consistent over time. In the animal studies, complete tissue necrosis developed in the freeze zone, followed by reabsorption, and by 13 weeks, fibrous tissue had replaced the defect. In the animal and human trials, there were no operative complications, urinomas, hematomas, or bowel or urinary fistulas. Follow-up imaging in human trials revealed a persistent nonenhancing defect in the area of the freeze zone. Long-term clinical follow-up will be necessary to determine the cancer-free survival rate.

[HLA-Cw genotyping of serologically and non-serologically defined alleles using sequence-specific primers (PCR-SSP) in a Shanghai Han population].

The new classical complement-mediated microlymphocytotoxicity test can detect a total of 10 different serologically defined antigen specificities (CWl-10) encoded by HLA-Cw locus. However, the blank amounts to 20%-50% for there are Cw antigens which can not be detected with antisera available. We adopted a PCR-SSP method to genotype a sample of 70 subjects collected from a Chinese Han population in Shanghai. We identified for the first time the following non-serologically defined HLA-Cw alleles in the Chinese Han population: Cw*1201/1202,1203,1301,14,1601,1602,1701, and also the serologically defined HLA-Cw alleles such as: Cw*01,02,0302/0304,0303,04,0501,0602,0701/0702/0703,08. With this sample we have made a survey of HLA-Cw allele frequencies in a Chinese Han population in Shanghai, with blank frequency being lowered from 0.307 to 0.028. The Cw*08 was originally considered to be rare in Chinese population. However, we found 12 cases of Cw*08 in this sample, which clearly does not coincide with the original point of view. Our results confirmed that PCR-SSP typing is rapid and accurate for HLA-Cw alleles.

Flow cytometric analysis of primary and metastatic squamous cell carcinomas of the oral and maxillofacial region.

OBJECTIVE: To elucidate characteristic changes in nuclear DNA content and cell kinetics in primary lesions and metastatic lymph nodes of squamous cell carcinomas of the oral and maxillofacial region. MATERIALS AND METHODS: Materials used were paraffin-embedded tissue specimens obtained from 96 primary lesions of 96 patients and 85 metastatic lymph nodes of 41 patients with squamous cell carcinoma of the oral and maxillofacial region. Single cell suspensions for flow cytometry analysis were prepared, and cell cycle analysis was performed. RESULTS: The incidence of aneuploidy in 41 carcinomas with metastasis was 39%, which was significantly higher than the 16% incidence in 55 carcinomas without metastasis. In terms of T classification and mode of invasion, the incidence of aneuploidy and metastasis increased with the increase in gradings. Forty-four of 46 metastatic lymph nodes associated with 25 diploid primary tumors remained diploid, whereas a shift down to diploidy was observed in 25 of 39 metastatic lymph nodes associated with 16 aneuploid primary tumors. The incidence of aneuploidy and S-phase fractions of 85 metastatic lymph nodes in 41 patients were 19% and 9.6%, respectively. The values were significantly lower than the 39% and 14.3% of the corresponding primary lesions. CONCLUSIONS: The chance of evolution of metastatic cell lines is higher in aneuploid carcinomas than diploid carcinomas, possibly because the former are more heterogenous; however, most cell lines responsible for causing lymph node metastasis are diploid.

Amelioration of azidothymidine-induced erythroid toxicity by hemin and stem cell factor in immune-suppressed mice.

Recombinant cytokines such as stem cell factor (SCF) are currently being tested for the ability to ameliorate 3'azido-3'deoxythymidine (AZT)-induced anemia in AIDS patients. Recently, we showed that SCF greatly increased burst-forming units-erythroid (BFU-E) but failed to increase hematocrits of AZT-treated immune-deficient (MAIDS) mice. We reasoned that hemin, previously shown to both enhance BFU-E proliferation and accelerate erythroid maturation, might bring about differentiation of this large SCF-induced pool of BFU-E and further protect BFU-E from AZT's toxic effect. We therefore studied, in vitro, the effect of combinations of hemin and SCF on growth of BFU-E from MAIDS mice. Hemin, at concentrations of 10 to 100 microM, ameliorated the growth-inhibitory effect of AZT. 50 microM hemin increased the ED50 of AZT from 1 x 10(-7) M to 1.7 x 10(-6) M. SCF also ameliorated AZT-induced toxicity, but to a lesser extent. SCF and hemin increased the number of BFU-E colonies observed in the presence of AZT in an additive fashion. The resistance of BFU-E to AZT's cytotoxic effect was greater in cultures receiving hemin and SCF together than in cultures receiving SCF or hemin alone. Zinc and tin protoporphyrins (Zn and Sn PP) increased the numbers of BFU-E observed. However, neither zinc nor tin protoporphyrins increased the ED50 of AZT. Combinations of SCF and hemin may prove useful in ameliorating AZT toxicity in both immune-suppressed mice and human immunodeficiency virus (HIV)-infected patients.

Impaired ability of bone marrow cells from immunodeficient mice to establish long-term cultures.

Haemopoiesis is often depressed in patients suffering from acquired immune deficiency syndrome (AIDS). Although several mechanisms have been postulated to be responsible for depressed haemopoiesis in AIDS patients, the aetiology of this disorder is still unknown. We hypothesized that failure of the stromal microenvironment may account for part of the haemopoietic defect observed in patients with AIDS. We therefore studied a murine model of AIDS (MAIDS) caused by infection with LP-BM5 virus to determine the ability of bone marrow cells from immunodeficient mice to establish long-term stromal cultures. In addition, normal and MAIDS mice received AZT (2 mg/ml) in their drinking water for up to 1 month to determine the effects of AZT treatment in vivo on the ability of bone marrow cells to support haemopoiesis in long-term cultures. Decreased numbers of non-adherent cells were observed in long-term bone marrow cultures (LTBMC) of MAIDS mice when compared to cultures derived from normal mice. Decreased numbers of non-adherent cells were observed in cultures of bone marrow cells from AZT-treated normal mice, when compared to untreated normal controls. Cells from AZT-treated MAIDS mice produced the smallest number of non-adherent cells. BFU-E and CFU-G/M were decreased in cultures of MAIDS mice when compared to those of normal mice. AZT-treatment further decreased the number of colony-forming cells in both MAIDS mice and normal cultures. Stromal cell function of MAIDS mice was also assessed by inoculating non-adherent cells from normal mice onto confluent irradiated MAIDS LTBMC. Stroma from MAIDS mice was unable to support haemopoietic function of normal bone marrow cells. Polymerase chain reaction (PCR) analysis of steady state levels of cytokine mRNAs of cells from confluent cultures revealed that levels of interleukin-6 mRNA were unchanged in MAIDS mice, as compared to normal controls, but the levels of GM-CSF were decreased in MAIDS mice. These data suggest that LP-BM5 MuLV infection alters the functioning of the haemopoietic stroma and that one mechanism of this depression in haemopoiesis may be via alterations of cytokine production.

Sustained elevation of platelet counts by long-term azidothymidine treatment of immunosuppressed mice.

Azidothymidine (AZT) has been demonstrated to increase platelet counts in patients suffering from acquired immunodeficiency syndrome (AIDS). However, the ability of long-term AZT treatment to sustain increases in platelet counts is controversial. We have recently demonstrated that AZT elevates the levels of circulating platelets in both normal C57BL/6 mice and mice made immunodeficient by infection with LP-BM5 murine leukemia virus (MAIDS mice). We therefore studied the effect of long-term AZT administration on platelet formation in both normal and MAIDS mice. Peripheral blood indices, levels of femoral and splenic megakaryocyte colony forming units (CFU-MK), and plasma levels of cytokines important in platelet formation-interleukin-6 (IL-6) and granulocyte-macrophage colony-stimulating factor (GM-CSF)--were examined. Platelet counts remained elevated throughout a 120-day AZT treatment period. Splenic CFU-MK were not significantly changed in MAIDS mice, except at day 15 when they were elevated. Splenic CFU-MK were significantly decreased in normal mice at days 8 and 120, and increased at day 30. Bone marrow CFU-MK were increased by AZT treatment at all time points tested in both normal and MAIDS mice. Plasma levels of GM-CSF were unchanged by AZT treatment in both normal and MAIDS mice. Plasma levels of IL-6 were unchanged in AZT-treated normal mice but decreased in AZT-treated MAIDS mice. These results indicate that long-term AZT treatment maintains elevated levels of platelets in both normal and MAIDS mice and affects CFU-MK colony formation. Our studies add to a growing body of work suggesting that AZT can ameliorate thrombocytopenia associated with HIV disease.

Flow cytometric analysis of squamous cell carcinomas of the oral cavity in relation to lymph node metastasis.

Nuclear DNA content and cell kinetics were studied in 40 squamous cell carcinomas of the oral cavity by flow cytometry to evaluate the diagnostic significance of the method in predicting lymph node metastasis. The presence of lymph node metastasis was confirmed histologically in 20 carcinomas. The incidence of metastasis was 36% in group A (22 carcinomas of the tongue and floor of the mouth) and 67% in group B (18 carcinomas of the alveolus and gingiva). On flow cytometric analysis, DNA aneuploidy was observed in 23 tumors (58%). The incidence of lymph node metastasis in the aneuploid tumors was 70%, which was significantly higher than the 24% for the diploid tumors. This also was the case for both of the subgroups. The incidence of aneuploidy and the DNA index for tumors with metastasis were 80% and 1.58, respectively. These values were significantly higher than the 35% and 1.16 for tumors without metastasis, but there were no significant differences in the S phase and G2M phase fractions between the tumors with and without metastasis. The incidence of aneuploidy in tumors with metastasis was also higher in group A (75% versus 36%) and group B (83% versus 33%). In terms of histologic differentiation, the incidence of metastasis and aneuploidy increased as the degree of differentiation decreased. Similar relationships were found between the histologic grade of malignancy and the incidence of metastasis and aneuploidy. The results indicate that nuclear DNA content analysis by flow cytometry is useful as a supplement to clinical and histologic evaluation in predicting the tendency of squamous cell carcinomas of the oral cavity to metastasize to regional lymph nodes.

Evaluation of a bone substitute prepared from alpha-tricalcium phosphate and an acid polysaccharide solution.

Tissue response to a readily consolidating material prepared by mixing alpha-tricalcium phosphate (alpha-TCP) powder with a glycolic acid dextran solution and to this consolidating material combined with particulate hydroxylapatite (HA) was studied after implantation in the subperiosteal space of the mandible in rabbits. Active new bone formation comparable to that seen on HA implants was observed around the two compounds. The newly formed bone was in direct contact with the HA as well as the readily consolidated material and little adverse effect resulting from the glycolic acid and dextran was observed. Because the readily consolidating material was firm and could be contoured into any shape during the process of consolidation, it may be quite useful as a bone substitute and as an adherent for HA particles for reconstructive bone surgery, overcoming the disadvantages inherent to the particulate form of HA.

Recent trends in the timing of first births in the United States.

We use vital registration data published since 1979 to update trends in the timing of first births. Two important trends are documented. First, the likelihood that childless women over age 30 will have a first birth has increased since the 1970s. This change shows that women born in the 1950s are "catching up" on fertility postponed at younger ages. Second, racial differences in the timing of first births are very large. For those born in the 1950s, nonwhites have first births much earlier, and far fewer nonwhite than white women will remain permanently childless. In the second part of the paper, we use these data for recent years to assess earlier projections of childlessness based on cohort and period approaches. We also assess the accuracy of stated intentions to have no children.

[The study of dermatoglyphic parameters on 1000 Tibetans].

This paper reports 14 dermatoglyphic parameters of 1000 Tibetans sampled in Tibet. Relatedness between Tibetans and Hans is much closer than that between Tibetans and Minnesotians in the USA. Compared with 12 nationalities. The Tibetan showed smaller difference with the Hani and the Han and greater difference with the Uygur. Comparison among the Tibetans living in different regions suggests that the Tibetans in Tibet have less difference with the Tibetans in Pingwu Region of Sichuan Province and much difference with the Tibetans in Gannan Region of Gansu Province. This report indicates that dermatoglyphic Parameters should not be used indifferently in different ethnic groups or even in different geographic groups of the same nationality.