American Adult Use of Complementary and Alternative Medicine

Editor's Note: In 2004, a study of usage of complementary and alternative medicine among 31,000 American adults revealed that 36% of the population now uses CAM. CAM is defined and usage patterns are described. The survey instrument was developed by the National Center for Complementary and Alternative Medicine and the Center for Disease Control and Prevention National Center for Health Statistics.     

Relationship between lipogenesis,ketogenesis, and malonyl-CoA content in isolated hepatocytes from the obese Zucker rat adapted to a high-fat diet

The relationship between lipogenesis and ketogenesis and the concentration of malonyl coenzyme A (CoA) was investigated in hepatocytes from adult obese Zucker rats and their lean littermates fed either a control low-fat diet or a high-fat diet (30% lard in weight). With the control diet, lipogenesis—although strongly inhibited in the presence of either 1 mmol/L oleate, 10^?6 mol/L glucagon or 0.1 mmol/L TOFA (a hypolipidemic drug)—remained about fifteen-fold higher in the obese rats than in the lean rats. In contrast, ketogenesis under some conditions (oleate + TOFA) was not significantly lower (30%) as compared with the lean rats. After adaptation to the high-fat diet, lipogenesis was depressed fourfold in the lean rats and ninefold in the obese ones; however its magnitude remained significantly higher in the latter, namely at a value close to that measured in control-fed lean rats. Ketogenesis was comparable in lean and obese rats and much higher in the presence of 1 mmol/L oleate than of 0.3 mmol/L oleate, whereas lipogenesis did not vary with increasing oleate concentration in the medium. Acetyl-CoA carboxylase activity measured in liver homogenates was higher in the obese group, but was stepwise inhibited by increasing concentrations of oleyl-CoA regardless of the diet for both lean and obese rats, thus showing no abnormality of in vitro responsiveness to this inhibitor. With the control diet, hepatocyte malonyl-CoA levels were significantly higher in the obese rats, both in the basal state and after inhibition of lipogenesis by oleate and TOFA. However, after the high-fat diet, there was no longer a significant difference between the genotypes. These results show that in the obese Zucker rats, ketogenesis is dependent on hepatocyte malonyl-CoA content in the sense that their ketogenic capacity becomes “normalized” when malonyl-CoA is decreased to the levels found in the lean littermates, as it is the case after fat-feeding. This normalization of malonyl-CoA levels in spite of higher lipogenesis in the obese rats may result from the activities of enzymes of its formation and utilization.     

Studies of HBV replication during acute hepatitis followed by recovery and acute hepatitis progressing to chronic disease

The serologic and viral profiles of 24 patients who presented with acute hepatitis B virus (HBV) infection were studied. Although in rare cases, HBV-DNA was detectable before hepatitis B surface antigen (HBsAg) and e antigen (HBeAg), in the majority the viral proteins appeared first. In acute hepatitis followed by recovery, as IgM anti-HBc (hepatitis B core antigen) titres rose, the level of HBV replication fell and serum transaminases became elevated. In patients progressing to chronic HBV infection, IgM anti-HBc titres rose early, viral replication was initially low but continued to rise as the serum transaminase levels became elevated. 7S IgM anti-HBc, although present in the phase of established chronic HBV infection, was not found in the early phase of the chronic infection. Thus this antibody appears to be a consequence of, rather than a causative factor in, chronic HBV infection.     

Dissociation of uterine eosinophilia and water imbibition from other estrogen-induced responses by nafoxidine pretreatment

We investigated the effect of pretreatment of immature rats with 5 or 50 micrograms nafoxidine (UA), or with 0.05 micrograms 17 beta-estradiol (E2) on several uterine responses elicited by treatment with a test injection of 15 micrograms E2, administered 48 h after pretreatment. Early (6 h) and late (24 h) responses were measured, including wet weight, RNA, protein and glycogen content and number of blood eosinophils per uterus. The results showed that, like a 24 h pretreatment with 5 micrograms UA, a 48 h pretreatment with either of the UA doses dissociated the early wet weight response from the late responses to E2 treatment, only the former being restored. In the case of E2 pretreatment, both types of response to E2 treatment were reinstalled. By contrast, uterine eosinophilia, induced 6 and 24 h after E2 treatment, was not only restored but even markedly amplified following any of the 3 pretreatments. This was obtained without amplification of the early wet weight response and with various levels of the other parameters at the time of administration of the test E2 injection (i.e. due to the pretreatment alone). From this it may be concluded that if the previously documented correlation between estrogen-induced eosinophilia and edema actually reflects the existence of a causal link between the 2 responses, as postulated by Tchernitchin in 1972, this would be with eosinophils controlling edema, rather than the reverse. Testable working hypotheses for the mechanism of amplification of the eosinophil response are proposed.     

Acute effect of propranolol on splanchnic circulation in normal and portal hypertensive rats

Propranolol decreases portal venous pressure in patients with cirrhosis but no method is available in man to study the effect of this beta-blocker on splanchnic organ blood flow. Because in rats, the microsphere method allows evaluation of regional blood flow, the acute effect of propranolol on both splanchnic and systemic circulations was studied in normal rats and in rats with portal hypertension due to portal vein stenosis. Portal venous pressure significantly decreased during propranolol administration in normal (5.6 +/- 1.0-4.7 +/- 1.1 mm Hg; mean +/- SD) as well as in portal hypertensive rats (11.7 +/- 2.3-10.3 +/- 1.8 mm Hg). Propranolol slightly decreased cardiac output and arterial pressure in all rats. Portal tributary blood flow was significantly reduced by propranolol in normal rats (17.4 +/- 3.0-11.3 +/- 2.2 ml/min) and in portal hypertensive rats (23.7 +/- 5.0-16.6 +/- 3.3 ml/min). Accordingly vascular resistance of the different organs in the portal venous territory increased in these rats receiving propranolol. The percentage of the decrease in portal tributary blood flow was significantly more marked than the percentage of reduction in cardiac output in portal hypertensive rats but, in normal rats, these percentages were parallel. Hepatic arterial blood flow did not change or slightly increased and, consequently, hepatic arterial vascular resistance decreased. These findings further clarify the marked effects of propranolol on splanchnic circulation.     

Long-Term Results from the Pivotal Multicenter Trial of Ultrasound-Guided Percutaneous Arteriovenous Fistula Creation for Hemodialysis Access

PurposeTo report the 5-year results from the Pivotal Multicenter Trial of Ultrasound-Guided Percutaneous Arteriovenous Fistula (pAVF) Creation for Hemodialysis Access.Materials and MethodsThe retrospective review of 107 intent-to-treat (ITT) patients from the pivotal trial provided a long-term follow-up population (LTP) of 85 patients with a median follow-up duration of 50 months (range, 12–60 months). Data evaluated in the LTP group were fistula maturation and usage, secondary procedures, and complications. The Kaplan-Meier analysis of primary patency, assisted primary patency, cumulative patency, and functional patency (time from 2-needle cannulation to abandonment) were performed for the ITT population.ResultsIn the LTP, 99% (84 of 85) of fistulae were mature, with 99% (78 of 79) of patients requiring hemodialysis using their pAVF. Sustained fistula use (2-needle cannulation at the prescribed rate, 2 of 3 sessions) was achieved in 92% (78 of 85) of patients, with 7 patients not using their pAVF because they were not on dialysis (n = 4), were on peritoneal dialysis (n = 2), and refused to use fistula (n = 1). Fistula maintenance was required in 31.8% (27 of 85) of patients and included fistula dysfunction (21.2%), thrombosis (5.9%), cannulation injury (12.9%), and arm swelling (4.7%). The number of procedures performed per patient per year to maintain function and patency was 0.32 (91 of 288) for years 2–5. The cumulative patency rates were 89.5%, 88.4%, 88.4%, 85.6%, and 82.0% for years 1, 2, 3, 4, and 5, respectively. The functional patency was 91.8% at the end of the study. There were no major complications related to pAVF during the long-term follow-up.ConclusionsPercutaneous fistulae have provided clinically effective and durable access for hemodialysis with low complications. The continued use and evaluation of pAVF are warranted.     

“U”形耳廓软骨在鼻翼缺损修复中的应用

目的:观察应用"U"形耳廓软骨支架修复鼻翼软骨缺损的临床疗效,总结其优越性。方法:本组35例鼻翼缺损患者,采取单侧或双侧耳甲腔、耳屏间切迹和耳屏区域的"U"形耳廓软骨,将其游离移植修复鼻翼支架缺损,并对其疗效进行评估。结果:应用耳甲腔、耳屏间切迹和耳屏区域的"U"形耳廓软骨修复鼻翼缺损,效果良好、可靠,不易遗留供区缺损、畸形。结论:采取的耳甲腔、耳屏间切迹、耳屏区域的"U"形耳廓软骨的局部解剖形态与鼻翼软骨较为相似,应用其修复鼻翼缺损,手术效果可靠,疗效满意,值得推广。     

SENP1、SENP2和SENP6蛋白在人恶性胶质瘤组织和细胞中的表达及其意义

目的：观察SUMO特异性蛋白酶（SENPs）家族成员SENP1、SENP2和SENP6在人恶性胶质瘤组织和细胞中的表达,阐明其在恶性胶质瘤发生中的作用。方法：取人脑正常组织和恶性胶质瘤组织样品分别作为正常对照组和恶性胶质瘤组;培养Cos7细胞和恶性胶质瘤LN443和U343细胞,Cos7细胞作为正常细胞对照组,LN443和U343作为恶性胶质瘤细胞组;采用Western blotting法检测SENP1、SENP2和SENP6蛋白在人恶性胶质瘤组织和细胞中的表达水平。结果：在脑组织中,与正常对照组比较,恶性胶质瘤组恶性胶质瘤组织中SENP1、SENP2和SENP6蛋白表达水平均明显升高（P<0.05）。在细胞中,与正常细胞对照组比较,恶性胶质瘤细胞组LN443和U343细胞中SENP1、SENP2和SENP6蛋白表达水平均明显升高（P<0.05）。结论：SENP1、SENP2和SENP6在恶性胶质瘤组织和细胞中高表达,其可能对恶性胶质瘤的发生起到了重要的促进作用。     

胶质瘤中miR-383与其靶向circ_001634相互调控机制及作用研究

目的研究脑胶质瘤中circ_001634的表达以及与miR-383的相互调控关系及在胶质瘤发生发展中的作用。方法实时定量聚合酶链反应(Real-time PCR)检测脑胶质瘤组织中circ_001634的表达情况,及分别过表达circ_001634与miR-383后对相互的影响,非锚定依赖性生长实验检测转染circ_001634后胶质瘤U251细胞生长情况,Western blot检测miR-383下游基因CCND1蛋白表达情况。结果 circ_001634在胶质瘤中的表达显著升高;过表达circ_001634能抑制胶质瘤细胞生长,且能下调miR-383表达,并抑制CCND1表达;同时过表达miR-383,也能够抑制circ_001634表达。结论胶质瘤特异性circ_001634表达升高是miR-383表达下调和功能受抑制重要调控机制,circ_001634与miR-383的相互调控很可能是胶质瘤发生发展的重要原因。     

巨噬细胞对内皮细胞系同源盒B2基因和血管内皮生长因子受体mRNA及整合素αvβ3表达的影响

目的　体外观察巨噬细胞(M)对血管内皮细胞同源盒(HOX)B2基因mRNA和血管内皮生长因子(VEGF)受体KDRmRNA及整合素ανβ3表达的影响。　方法　体外培养人脐静脉血管内皮细胞系ECV304,分为(1)ECV304组; (2)ECV304 伴刀豆球蛋白A(conA,终浓度25mg/L)组; (3)ECV304 人M系U937组:ECV304细胞中加入1×105 /mlU937细胞; (4)ECV304 U937 conA组:ECV304中加入1×105 /mlU937细胞及终浓度25mg/L的conA.反应48h后,用免疫荧光技术检测各组ECV304细胞整合素ανβ3的表达情况,并用逆转录聚合酶链反应(RT PCR)技术检测细胞KDRmRNA和HOXB2基因mRNA的表达水平。　结果　ECV304组细胞的整合素ανβ3、KDRmRNA及HOXB2基因mRNA的表达水平分别为6. 7±1. 5、0. 633±0. 012、0. 674±0. 004。ECV304 U937 conA组细胞上述指标较ECV304组均明显上调(P<0. 01 ),分别为10. 2±1. 7、0. 879±0 003、0. 947±0 003。其余两组细胞上述指标与ECV304组比较,差异均无统计学意义(P>0. 05).结论　被conA活化的M通过影响内皮细胞的KDRmRNA、HOXB2mRNA基因及整合素ανβ3的表达,来促进内皮细胞增殖、迁移及与基质黏附,从而调节血管生成。