Freezing therapy by liquid nitrogen on trachoma and rehabilitation

INTRODUCTION８５６casesofseveretrachomaweretreatedfromMay１９８４byfreez－ingcombinedwithdrugs，theeffectsweresatisfying．MATERIALSANDMETHODSMaterials８５６patientswithtrachomatreatedfromMay１９８４toFebruary２００１wereinvestigatedincluding３６８malesand４８８femalesaged６－５３（mean：２１．３）yearswiththoseat１０－２０yearsconsistingthemost．Accordingto１９７９secondnationalophthalmologyconferencediagnosisstandards，１８９caseswerediagnosedasI；５０４caseswerediagnosedasI；１…     

Does a liquid supplement improve energy and protein consumption in nursing home residents?

One popular strategy to improve the acceptance and efficacy of oral liquid supplements in long-term care is dispensing them during the medication pass, although few studies support its effectiveness. This study evaluated the impact of a supplement medication pass program on energy and nutrient consumption and weight in nursing home residents. Findings indicate that residents maintained their prestudy weight and had a 29% decrease in supplement energy intake, a 19% increase in food energy intake, and a 17% decrease in net energy intake (supplement plus food). Supplement and food protein intake remained stable. Over longer periods, this reduced energy consumption could lead to weight loss, so routine monitoring and periodic evaluations of resident intake (both food and supplement) are recommended to ensure residents are receiving and consuming adequate amounts of daily energy and nutrients.     

Determination of free tetrahydrocortisol and tetrahydrocortisone ratio in urine by liquid chromatography‐tandem mass spectrometry

Objective. Measurement of urinary free tetrahydrocortisol and tetrahydrocortisone ratio (allo‐THF+THF)/THE is clinically important in the diagnosis of hypertension caused by congenital absence of 11β‐hydroxysteroid dehydrogenase type 2 (apparent mineralocorticoid excess, AME) or inhibition of the enzyme after licorice ingestion. Although gas chromatography‐mass spectrometry (GC‐MS) provides reliable results, it requires derivatization and is lengthy and time‐consuming. The purpose of this study was to demonstrate that detection by liquid chromatography‐mass spectrometry (LC‐MS) is a potentially superior method. Material and methods. The analysis utilizes 1 mL urine. The samples were extracted with solid‐phase extraction (SPE) using ethyl acetate as eluent. The extract was evaporated to dryness, and allo‐tetrahydrocortisol (allo‐THF), THF and THE concentrations were analyzed by LC‐MS/MS operating in the negative mode after separation on a reversed‐phase column. The calibration curves exhibited consistent linearity and reproducibility in the range of 7.5–120 nmol/L. Interassay CVs were 7.0–10 % at mean ratios of (allo‐THF+THF)/THE of 0.54–1.9. The detection limit of the analytes was 0.4–0.8 nmol/L (signal‐to‐noise ratio = 3). The mean recovery of the three analytes ranged from 88 to 95 %. The regression equation for the free ratio using the LC‐MS/MS (x) method and the total ratio using the GC‐MS (y) method was: y = 0.30x+0.91 (r = 0.61; n = 25). Conclusions. The sensitivity and specificity of the LC‐MS/MS method offer an advantage over GC‐MS by eliminating derivatization. The high costs of equipment are balanced by higher through‐put, owing also to shorter chromatographic run times.     

Detection of α-globin gene deletions using denaturing high-performance liquid chromatography and multiplex ligation-dependent probe amplification

Background: Multiplex ligation‐dependent probe amplification (MLPA) has been used to detect deletions and mutations of the α‐globin gene for diagnosis of α‐thalassemia. MLPA reaction products are usually separated and analyzed by high‐voltage capillary gel electrophoresis (CGE). The goal of this study was to find and use a cost‐effective method to separate and analyze MLPA products. Methods: Blood samples were collected from China. DNA was extracted and amplified by PCR using fluorescently labeled primers. In this study, denaturing high‐performance liquid chromatography (DHPLC) was used to separate and analyze the reaction products. And the optimal separation conditions were determined using nondenaturing columntemperature. Results: The DHPLC conditions were optimized and have been applied to separate MLPA products and 27 of the MLPA products from 50 to 320 bp were well separated. DHPLC was able to separate up to 37 reaction products that differed by 4–12 base pairs and detected target gene deletions by differences in peak size. Compared with CGE, both the specificity and sensitivity of DHPLC for the 107 DNA samples were 100%. Conclusions: DHPLC could be used to test routinely for α‐globin gene mutations and deletions. Combined with MLPA, DHPLC is a low‐cost, simple to use, accurate technique with practical value. J. Clin. Lab. Anal. 25:426–431, 2011. © 2011 Wiley Periodicals, Inc.     

The effect of PDGFmRNA and IGFmRNA in the platelet concentrated liquid on ulna fracture healing in rabbit

Objective By hybridization in situ and biomechanical approach of platelet-derived growth fator mRNA(PDGFmRNA) and insulin-like growth factor mRNA(IGFmRNA), we discussed the influence of the platelet conentrated liquid on the healing of rabbit ulna fracture.Method We selected 24 New Zealand rabbits,divided them into 4 groups randomly (blank group,serum-control group,group with platelet concentrated liquid and group with bone graft and platelet concentrated liquid), and then made the fracture model on the middle of ulna which was fixed by finger armor plate.Before the operation, we drew out 6 ml blood from femoral artery, performed anti-coagulation with the Sodium Citrate and centrifugated by low and the followed high speed. We purified the white blood plate and injected it into the fracture position. The rabbits were killed at 1st,2nd,5th and 6th week.Qualitative analysis by hybridization in situ of PDGFmRNA and IGFmRNA and biomechanical measurement on the yth week sample were made. Result Bone callus could be seen on the radius spectimen in various degrees when the rabbits were killed at 1st. 2nd, 4th and 6th week, particularly in the last week. The average maximum destructive load on the fracture tip is higher to the control, and there is significant difference (P&;lt;0.01). Conclusion The local application of platelet concentration on the fracture tip can accelerate its healing.     

Diversity,Epidemiology, and Genetics of Class D β-Lactamases

Class D β-lactamase-mediated resistance to β-lactams has been increasingly reported during the last decade. Those enzymes also known as oxacillinases or OXAs are widely distributed among Gram negatives. Genes encoding class D β-lactamases are known to be intrinsic in many Gram-negative rods, including Acinetobacter baumannii and Pseudomonas aeruginosa, but play a minor role in natural resistance phenotypes. The OXAs (ca. 150 variants reported so far) are characterized by an important genetic diversity and a great heterogeneity in terms of β-lactam hydrolysis spectrum. The acquired OXAs possess either a narrow spectrum or an expanded spectrum of hydrolysis, including carbapenems in several instances. Acquired class D β-lactamase genes are mostly associated to class 1 integron or to insertion sequences.Class D β-lactamases, also known as oxacillinases or OXA-type β-lactamases (OXAs), are active-serine-site enzymes like Ambler class A and class C β-lactamases, differing from class A and C enzymes in amino acid structure, whereas class B β-lactamases are metalloenzymes with a Zn²⁺ ion(s) in the active site (4, 71, 78). Even though class D includes mostly enzymes with higher hydrolysis rates for cloxacillin and oxacillin than for benzylpenicillin (hence the name oxacillinases), not all class D β-lactamases have this characteristic. Most of the class D enzymes belong to group 2d of the Bush functional classification scheme for β-lactamases (23). Among the four β-lactamase molecular classes, class D β-lactamases are the most diverse enzymes (107). This diversity is observed at both the genetic and biochemical levels, with enzymes possessing either a narrow or expanded spectrum of hydrolysis. In addition, several class D β-lactamases have an expanded spectrum of activity resulting from point mutations.Although many class D β-lactamase genes are embedded into class 1 integrons, recent reports indicated that other specific genetic structures, including insertion sequences and transposons, may be associated with class D β-lactamase genes. Numerous class D β-lactamase genes have been identified as a source of acquired resistance in gram-negative bacteria, but recent studies have shown that class D β-lactamases are also naturally produced in clinically significant pathogens and environmental species (107).This review focuses on the diversity and substrate profiles of class D β-lactamases, their sources, and the genetics of acquisition of the corresponding genes. All the class D β-lactamases for which a sequence is available in the GenBank databases are listed in Table ​Table11.

TABLE 1.

Features of oxacillinases

Association of Higher Plasma Vitamin D Binding Protein and Lower Free Calcitriol Levels with Tenofovir Disoproxil Fumarate Use and Plasma and Intracellular Tenofovir Pharmacokinetics: Cause of a Functional Vitamin D Deficiency?

Tenofovir disoproxil fumarate (TDF) causes bone, endocrine, and renal changes by an unknown mechanism(s). Data are limited on tenofovir pharmacokinetics and these effects. Using baseline data from a multicenter study of HIV-infected youth on stable treatment with regimens containing TDF (n = 118) or lacking TDF (n = 85), we measured cross-sectional associations of TDF use with markers of renal function, vitamin D-calcium-parathyroid hormone balance, phosphate metabolism (tubular reabsorption of phosphate and fibroblast growth factor 23 [FGF23]), and bone turnover. Pharmacokinetic-pharmacodynamic associations with plasma tenofovir and intracellular tenofovir diphosphate concentrations were explored among those receiving TDF. The mean age was 20.9 (standard deviation [SD], 2.0) years; 63% were male; and 52% were African American. Compared to the no-TDF group, the TDF group showed lower mean estimated glomerular filtration rates and tubular reabsorption of phosphate, as well as higher parathyroid hormone and 1,25-dihydroxy vitamin D [1,25-OH(2)D] levels. The highest quintile of plasma tenofovir concentrations was associated with higher vitamin D binding protein, lower free 1,25-OH(2)D, higher 25-OH vitamin D, and higher serum calcium. The highest quintile of intracellular tenofovir diphosphate concentration was associated with lower FGF23. Higher plasma tenofovir concentrations were associated with higher vitamin D binding protein and lower free 1,25-OH(2)D, suggesting a functional vitamin D deficiency explaining TDF-associated increased parathyroid hormone. The finding of lower FGF23 accompanying higher intracellular tenofovir diphosphate suggests that different mechanisms mediate TDF-associated changes in phosphate handling. Separate pharmacokinetic properties may be associated with distinct TDF toxicities: tenofovir with parathyroid hormone and altered calcium balance and tenofovir diphosphate with hypophosphatemia and FGF23 regulation.(The clinical trial registration number for this study is {"type":"clinical-trial","attrs":{"text":"NCT00490412","term_id":"NCT00490412"}}NCT00490412 and is available online at http://clinicaltrials.gov/ct2/show/{"type":"clinical-trial","attrs":{"text":"NCT00490412","term_id":"NCT00490412"}}NCT00490412.)     

Independent association between 1,25-dihydroxyvitamin D, 25-hydroxyvitamin D and the renin–angiotensin system: The Ludwigshafen Risk and Cardiovascular Health (LURIC) study

BackgroundAntihypertensive and tissue-protective properties of vitamin D metabolites are increasingly attributed to the inhibition of renin synthesis by 1,25-dihydroxyvitamin D [1,25(OH)2D] in the kidney.MethodWe aimed to document a potential association between 25-hydroxyvitamin D [25(OH)D], 1,25(OH)2D and the circulating renin–angiotensin system (RAS) in a large cohort of patients referred (n = 3316) to coronary angiography.ResultsOf the 3316 subjects, 3296 (median age: 63.5 (56.3–70.6) years; 30.2% women) had a baseline measurement of 25(OH)D [median: 15.6(10.1–23.0) µg/L)], 1,25(OH)2D [median: 33.2(25.2–42.9) pg/mL], plasma renin concentration [PRC; median: 11.4(6.0–24.6) pg/mL] and angiotensin 2 [median: 20.0(12.0–35.0) ng/L]. Multivariate adjusted ANCOVA showed a steady increase of PRC values across declining deciles of 25(OH)D and 1,25(OH)2D values (P = 0.013 and P = 0.045), respectively. Additionally, mean angiotensin 2 values increased significantly across decreasing 25(OH)D and 1,25(OH)2D values (P = 0.020 and P = 0.024, respectively). In contrast, multivariate adjusted ANCOVA revealed no significant associations between aldosterone, aldosterone-to-renin ratio and 25(OH)D/1,25(OH)2D values. In multivariate stepwise regression analyses both, 25(OH)D and 1,25(OH)2D emerged as independent predictors of plasma renin and angiotensin 2 concentrations.ConclusionsOur data showed for the first time in humans that both, lower 25(OH)D and 1,25(OH)2D values are independently related to an upregulated circulating RAS.