Acquired Immunodeficiency Syndrome ; drug therapy ; epidemiology ; Antiretroviral Therapy, Highly Active ; adverse effects ; methods ; China ; epidemiology ; Female ; HIV Infections ; drug therapy ; epidemiology ; Humans ; Male ; Minority Groups

Objective To retrospectively evalute the value and accuracy of adenosine stress and rest SPECT myocardial perfusion imaging. Methods A total of 1858 patients who were suspected or known for coronary artery disease (CAD) underwent 99Tcm-methoxyisobutylisonitrile ( MIBI ) myocardial perfusionSPECT with adenosine infusion using the standard 2-day protocol. Images were interpreted by two or more experienced nuclear medicine physicians . Coronary angiography was carried out in all patients within one month. Kappa test was used to analyze the correlation between the two imaging studies. Results By coronary angiography, there were 957 patients diagnosed of CAD (one-, two-, three-vessel disease: 506,256,195, respectively) and 901 normal. Stenosis was found in 1603 vessels, including left anterior descending coronary artery (LAD): 765, left circumflex coronary artery (LCX): 399 and right coronary artery (RCA): 439. By adenosine induced stress myocardial perfusion imaging, 876 patients were diagnosed of myocardial ischemia ( sensitivity: 876/957, 91.54% ) and 651 patients had negative findings ( specificity:651/901,72.25 % ). The positive and negative predictive values were 77.80% ( 876/1126 ) and 88.93% (651/732), respectively. The correlation coefficient between the two imaging studies was 0.641. The vessel-based sensitivity was 81.31% (622/765) for LAD, 56.64% (226/399) for LCX and 70.62% (310/439) for RCA, respectively. The sensitivity for detection of one-, two-, three-vessel stenosis was 87.55% (443/506), 94.92% (243/256) and 97.44% (190/195), respectively. The side-effects was mild and transient with an incidence rate of 84.12% ( 1563/1858), without major cardiac events. Conclusion Stress myocardial perfusion imaging induced by adenosine is reliable for the evaluation of myocardial blood supply in CAD patients.

Obesity has become a worldwide health problem. Orlistat, an inhibitor of pancreatic lipase, is currently approved as an anti-obesity drug. However, gastrointestinal side effects caused by Orlistat may limit its use. In this study the inhibitory activities of dandelion (Taraxacum officinale) against pancreatic lipase in vitro and in vivo were measured to determine its possible use as a natural anti-obesity agent. The inhibitory activities of the 95% ethanol extract of T. officinale and Orlistat were measured using 4-methylumbelliferyl oleate (4-MU oleate) as a substrate at concentrations of 250, 125, 100, 25, 12.5 and 4 microgram/ml. To determine pancreatic lipase inhibitory activity in vivo, mice (n=16) were orally administered with corn oil emulsion (5 ml/kg) alone or with the 95% ethanol extract of T. officinale (400 mg/kg) following an overnight fast. Plasma triglyceride levels were measured at 0, 90, 180, and 240 min after treatment and incremental areas under the response curves (AUC) were calculated. The 95% ethanol extract of T. officinale and Orlistat, inhibited, porcine pancreatic lipase activity by 86.3% and 95.7% at a concentration of 250 microg/ml, respectively. T. officinale extract showed dose-dependent inhibition with the IC50 of 78.2 microg/ml. A single oral dose of the extract significantly inhibited increases in plasma triglyceride levels at 90 and 180 min and reduced AUC of plasma triglyceride response curve (p<0.05). The results indicate that T. officinale exhibits inhibitory activities against pancreatic lipase in vitro and in vivo. Further studies to elucidate anti-obesity effects of chronic consumption of T. officinale and to identify the active components responsible for inhibitory activity against pancreatic lipase are necessary.
Animals ; Area Under Curve ; Corn Oil ; Ethanol ; Hymecromone ; Inhibitory Concentration 50 ; Lactones ; Lipase ; Mice ; Obesity ; Oleic Acid ; Plasma ; Taraxacum

BACKGROUND: Successful therapy for community-acquired pneumonia (CAP) requires appropriate empirical antimicrobial therapy based on the local microbe and resistance patterns. However, the available data on the bacterial etiology and antimicrobial susceptibility of CAP in Korea is very limited. MATERIALS AND METHODS: A nationwide prospective multicenter study of CAP in adult patients was carried out between March 2009 and February 2010. Most patients underwent detailed assessment for bacterial and viral pathogens (cultures, urinary antigen testing, serological methods and polymerase chain reaction). RESULTS: A total of 619 patients were studied. More than half (50.4%) of the patients were > or =65 years, 59.3% were males and 48.1% had underlying illness. The etiology was identified in 246 (39.7%) of the patients. The most common etiologic agent was Streptococcus pneumoniae (52 episodes, 21.1%), and the majority (36/52) of which were diagnosed by a positive urinary antigen test alone. The other common bacterial agents included Mycoplasma pneumoniae (41, 16.7%), Klebsiella pneumoniae (26, 10.6%), Chlamydia pneumoniae (13, 5.3%), Pseudomonas aeruginosa (11, 4.3%) and Staphylococcus aureus (8, 3.1%). All S. pneumoniae isolates were susceptible to penicillin with MIC of 2 microg/mL or less, only 1/16 (6.2%) was resistant to levofloxacin and 10/16 (62.5%) were resistant to erythromycin. Of the 26 K. pneumoniae isolates, 25 (96.2%) were susceptible to cefotaxime and ciprofloxacin. CONCLUSIONS: S. pneumoniae remains the most frequent pathogen in adults with CAP and this should be covered with empirical antimicrobial treatment. Atypical pathogens such as M. pneumoniae and C. pneumoniae were the second most common etiologic agents and they should be tested for. The rate of CAP caused by gram-negative bacilli such as K. pneumoniae and P. aeruginosa was high, which is similar to that of the previous Korean studies. Further study, with excluding healthcare-associated pneumonia, is needed to clarify the etiology of CAP in Korea.
Adult ; Cefotaxime ; Chlamydophila pneumoniae ; Erythromycin ; Humans ; Klebsiella pneumoniae ; Korea ; Male ; Mycoplasma pneumoniae ; Ofloxacin ; Penicillins ; Pneumonia ; Pneumonia, Bacterial ; Pneumonia, Mycoplasma ; Prospective Studies ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Streptococcus pneumoniae

OBJECTIVETo analyze the changing trends of frequency and localization of gastric cancers arising from the gastric cardia, corpus and antrum during the past 14 years in population of the high incidence area of esophageal and gastric carcinoma in Hebei province, China.

METHODSThe clinicopathological data of 4334 cases of gastric carcinomas among the local residents of Cixian and Zanhuang counties, initially diagnosed in our department from 1993 to 2006, were retrospectively analyzed. The proportion of gastric carcinomas arising from the gastric cardia, corpus and antrum in different years and in patients with different sex and ages were analyzed and compared, and the changing trends of the frequency of gastric carcinoma arising from different sites of the stomach were statistically analyzed.

RESULTSAmong all the 4334 gastric carcinomas, gastric cardia carcinoma accounted for 68.0%, significantly higher than that of corpus (24.2%) and antrum (7.9%; chi(2) = 124.396, P < 0.0001). An increasing tendency in the proportion of gastric cardia carcinoma from 1993 to 2006 was seen. The percentage of cardiac carcinoma in the high incidence area of esophageal carcinoma (Cixian county) was higher than that in the high incidence area of gastric cancer (Zanhuang county) (71.2% vs. 51.2%; chi(2) = 109.648, P < 0.0001). The increase in the incidence of cardiac carcinoma in Cixian county was mainly due to the increase of cardiac carcinoma from 1993 to 2006, while the contributing factor for the increase in the proportion of cardiac carcinomas was resulted from the decrease of incidence of antrum carcinoma in Zanhuang county during the same period. The occurring site of gastric carcinoma was related with age of patients (chi(2) = 58.380, P < 0.0001). The percentage of carcinoma of the gastric body was highest in < 50 year age group, while that in the gastric cardia was highest in 61 - 70 year age group (71.6%).

CONCLUSIONThe major occurring site of gastric carcinoma is the gastric cardia among the local residents in population of the high incidence areas of esophageal and gastric carcinomas during the past 14 years in Hebei province, China. The increasing trend of cardiac carcinoma and decreasing trend of corpus carcinoma in Cixian county and antrum carcinoma in Zanhuang county will be maintained in the coming years if the epidemiological conditions will not be changed.

Adolescent ; Adult ; Age Distribution ; Age Factors ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cardia ; pathology ; Child ; China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Pyloric Antrum ; pathology ; Retrospective Studies ; Stomach ; pathology ; Stomach Neoplasms ; epidemiology ; pathology ; Time Factors ; Young Adult

The aim of this study was to investigate the apoptosis-inducing effect of artemisinin derivative SM1044 on Kasumi-1 cells and its possible mechanism. Kasumi-1 cells were treated with different concentrations of SM1044, the cell viability was evaluated by MTT assay. Cell apoptosis and cell cycle progression were assessed by using flow cytometry with Annexin-V/PI double staining and flow cytometry with PI staining respectively. The expression of apoptosis-related proteins caspase 3, PARP and the fusion protein AML1-ETO were detected by Western blot. The results indicated that SM1044 inhibited cell growth of Kasumi-1 cells in time- and dose-dependent manners. After exposure of Kasumi-1 cells to 1 µmol/L SM1044 for 24 hours, the cell viability was decreased to 50%. IC(50) of SM1044 to Kasumi-1 cells at 48 hours was 0.17 ± 0.067 µmol/L. SM1044 induced cell apoptosis in a caspase-dependent manner, and the apoptotic rate of Kasumi-1 cells increased as SM1044 concentration increased. Flow cytometry with PI staining revealed that SM1044 induced cell cycle arrest, and the proportion of cells in G(0)/G(1) phase increased from 58.33 ± 4.46% to 71.75 ± 2.24% after exposure to 5 µmol/L SM1044 for 24 hours. Western blot showed that SM1044 increased the expression of apoptosis-related proteins cPARP and cleaved caspase 3 and also degraded the AML1-ETO fusion protein. It is concluded that SM1044 can inhibit the proliferation of Kasumi-1 cells, induce cell apoptosis which may be related to the increased level of cleaved PARP and cleaved caspase 3. SM1044 can also induce cell arrest in G(0)/G(1) phase. As the fusion protein AML1-ETO degrades obviously, it can be the potential target of SM1044 in Kasumi-1 cells.
Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Artemisinins ; pharmacology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Humans ; Leukemia, Myeloid, Acute ; pathology

OBJECTIVETo analyze the characteristics of cytogenetic aberration of adults with Philadelphia chromosome-positive (Ph+) and/or bcr-abl positive (bcr-abl+) acute lymphoblastic leukaemia (ALL), and investigate its influence on patients' outcomes.

METHODRetrospective analysis of 100 adult Ph+ ALL patients from January 1, 1996 to December 31, 2007 was carried out. The type, distribution and frequency of chromosome aberration were summarized, and compared among different subgroups.

RESULTS1) In all cases, 72 had chromosome aberrations, including 22 with sole Ph chromosome, 44 Ph+ with additional abnormalities, which included double Ph, monosomy 7, monosomy 20, trisomy 8 trisomy 21, 9p deletion and 22 deletion. 2) Patients with pseudodiploid and hyperdiploid had higher WBC count, and inferior outcome with lower rates of overall survival (OS) and relapse free survival (RFS). 3) Ph+ group also had higher WBC counts and inferior outcome with low OS and RFS rates. There was no statistic significance between sole Ph+ group and Ph plus additional aberrations group. 4) Patients with both abnormal and normal metaphase (AN) and with solely abnormal metaphase (AA) had higher WBC count, less frequent P190 occurrence and inferior outcome than those only normal metaphase (NN) group, whereas, there was no difference between AA and AN groups. 5) Double Ph chromosome had a lower frequency of P190 and inferior OS than non-double Ph group.

CONCLUSIONAdults with Ph+ ALL have complicated cytogenetic abnormalities, pseudodiploid and hyperdiploid indicate inferior outcome, and double Ph chromosome may be a unfavorable prognostic factor.

Adolescent ; Adult ; Chromosome Aberrations ; Female ; Fusion Proteins, bcr-abl ; genetics ; Humans ; Immunophenotyping ; Male ; Middle Aged ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; Prognosis ; Retrospective Studies ; Young Adult

Metabonomics, a new and rapid-developing technology, will be powerful means to the research of complexed theory system and modernization of traditional Chinese medicine (TCM). Discovery of biomarkers and analysis of common properties from the metabolome of a specific TCM syndrome will facilitate the modernized study of TCM system, promote the quantitative and scientific elucidation of TCM syndrome differentiation, provide an in-depth understanding of the TCM theory of Zang-xiang, help predict the disease on-set, and achieve a comprehensive evaluation of systemic clinical efficacy, safety and mechanism of action of the TCM combination formulas along with a better understanding of intestinal microflora ecology. The new approach with combined metabonomics and TCM methodologies will provide a new pathway and methodology for the study of complicated theory system of TCM and its modernization.
Biomarkers ; analysis ; metabolism ; Diagnosis, Differential ; Homeostasis ; Humans ; Medicine, Chinese Traditional ; methods ; Metabolism

OBJECTIVETo investigate the incidence, molecular features and clinical significance of CCAAT/enhancer binding protein alpha (CEBPA) gene mutation in patients with acute myeloid leukemia (AML).

METHODSMutation analysis of the entire coding region of CEBPA gene in 206 de novo AML patients was performed by using polymerase chain reaction (PCR) followed by sequence analysis and fragment length analysis.

RESULTSOf 206 AML patients, 31 (15%) had CEBPA gene mutations, including 23 with double mutations (duCEBPA) and 8 with single mutation (siCEBPA). CEBPA gene mutations presented mainly in M2 subtype or intermediate risk patients. As compared with those with wild type CEBPA gene, patients with mutated CEBPA gene were of higher white blood cell counts [20.92(0.86-351.43)× 10(9)//L vs 8.17(0.47-295.2) × 10(9)/L, P=0.003], higher hemoglobin levels [97.5(51-128) g/L vs 80.5(13-153) g/L, P=0.015] and lower platelet counts [27.5(5-81)× 10(9)//L vs 44(3-548)× 10(9)/L, P=0.004]. Patients with CEBPA gene mutation had higher complete remission (CR) rate than those with wild type (P=0.009). While co-existing of NPM1 and siCEBPA mutations was observed in M5 subtype (2/8, 25%), NPM1 gene mutation was not present in any patients with duCEBPA mutation (0/23, 0%). Dynamic tracking analysis showed that CEBPA mutations disappeared at CR, and the same mutations re-appeared at relapse. When compared to sequence analysis, the coincidence rate of CEBPA mutations detected by fragment length analysis was 100% (54/54).

CONCLUSIONCEBPA gene mutation is a recurring genetic change in AML patients and has a certain correlation with clinical and laboratory features. It could be reliably used as a potential marker for minimal residual disease follow up. The prognostic significance of co-existing of siCEBPA with NPM1 mutations in patients with AML-M5 subtype needs further investigation.

Adolescent ; Adult ; Aged ; CCAAT-Enhancer-Binding Proteins ; genetics ; DNA Mutational Analysis ; Female ; Gene Expression Regulation, Leukemic ; Genotype ; Humans ; Leukemia, Myeloid, Acute ; genetics ; therapy ; Male ; Middle Aged ; Mutation ; Polymorphism, Restriction Fragment Length ; Prognosis ; Young Adult

OBJECTIVETo investigate the availability of serum level of macrophage clony stimulating factor (M-CSF) as a marker for early diagnosis of Alzheimer's disease (AD).

METHODSThe serum levels of M-CSF in 70 patients with AD, 52 healthy controls, 22 patients with VAD (vascular dementia) were measured and the serum levels of IL-1 beta, IL-6, TNF-alpha in 32 patients with AD and 20 controls were measured as well.

RESULTSSerum levels of M-CSF were significantly elevated in patients with AD when compared with healthy controls (P < 0.01) and VAD controls (P < 0.05) respectively. At the early stage of mild dementia and middle dementia, serum levels of M-CSF were significantly elevated, but at the later stage of severe dementia, they returned to normal level. Serum levels of IL-1 beta were significantly elevated in AD patients compared with controls (P < 0.05), and serum levels of TNF-alpha and IL-6 were within the normal range in patients with AD.

CONCLUSIONSThe results suggest that serum M-CSF level may provide a convenient and sensitive means for the early diagnosis of Alzheimer's disease.

Aged ; Aged, 80 and over ; Alzheimer Disease ; blood ; Biomarkers ; blood ; Female ; Humans ; Interleukin-1 ; blood ; Interleukin-6 ; blood ; Macrophage Colony-Stimulating Factor ; blood ; Male ; Middle Aged ; Tumor Necrosis Factor-alpha ; metabolism