Biomedical subjects

Lei Jin

Publications and source records attributed to Lei Jin.

At least 37 records · Page 2Linked to original sources

PubMed2005

[Expression of p57 and homeobox A10 during decidualization of endometrial stromal cell in vitro.].

In order to elucidate the function of homeobox A10 gene (HOXA10) and p57 during decidualization our present study was designed to observe the change of HOXA10 and p57 expression and subcellular localization of HOXA10 in the process of endometrial stromal cell (ESC) differentiation in vitro. Decidualization was induced by 0.5 mmol/L 8-Bromo-cAMP (8-Br-cAMP) together with 1x10(-6) mol/L medroxyprogesterone acetate (MPA). Expression of p57 and HOXA10 was detected by RT-PCR and Western blot after 1-day, 2-day, and 4-day treatment (D1, D2, D4). ESCs cultured in 2%FBS for 1 and 4 d were used as control (C1, C4). The location of HOXA10 was detected by indirect immunofluorescence and HOXA10-GFP transfection. The results are as follows: (1) The expression of HOXA10 decreased progressively during the course of decidualization, and showed significant difference compared to control group C4 after 2-day treatment (D2). (2) On the contrary, the expression of p57 increased progressively and also showed significant difference compared to the control group C4 after 2-day treatment (D2). (3) There was no significant change of HOXA10 and p57 expression after culturing ESCs in 2%FBS for 4 d (C1, C4). (4) HOXA10 located in the nucleus throughout the course. Cytoplasm and nucleus shuttle was not detected in the experiment. Our results suggest that the down-regulation of HOXA10 may contribute to the increase of p57 and that the up-regulation of p57 likely plays an important role in ESC differentiation. Progesterone receptor (PR) pathway may participate in promoting ESCs to exit cell cycle and enter differentiation.

English Abstract↗

PubMed2005

Structural and mutational analyses of the molecular interactions between the catalytic domain of factor XIa and the Kunitz protease inhibitor domain of protease nexin 2.

Factor XIa (FXIa) is a serine protease important for initiating the intrinsic pathway of blood coagulation. Protease nexin 2 (PN2) is a Kunitz-type protease inhibitor secreted by activated platelets and a physiologically important inhibitor of FXIa. Inhibition of FXIa by PN2 requires interactions between the two proteins that are confined to the catalytic domain of the enzyme and the Kunitz protease inhibitor (KPI) domain of PN2. Recombinant PN2KPI and a mutant form of the FXI catalytic domain (FXIac) were expressed in yeast, purified to homogeneity, co-crystallized, and the structure of the complex was solved at 2.6 angstroms (Protein Data Bank code 1ZJD). In this complex, PN2KPI has a characteristic, disulfide-stabilized double loop structure that fits into the FXIac active site. To determine the contributions of residues within PN2KPI to its inhibitory activity, selected point mutations in PN2KPI loop 1 11TGPCRAMISR20 and loop 2 34FYGGC38 were tested for their ability to inhibit FXIa. The P1 site mutation R15A completely abolished its ability to inhibit FXIa. IC50 values for the wild type protein and the remaining mutants were as follows: PN2KPI WT, 1.28 nM; P13A, 5.92 nM; M17A, 1.62 nM; S19A, 1.86 nM; R20A, 5.67 nM; F34A, 9.85 nM. The IC50 values for the M17A and S19A mutants were not significantly different from those obtained with wild type PN2KPI. These functional studies and activated partial thromboplastin time analysis validate predictions made from the PN2KPI-FXIac co-crystal structure and implicate PN2KPI residues, in descending order of importance, Arg15, Phe34, Pro13, and Arg20 in FXIa inhibition by PN2KPI.

Alanine↗

PubMed2005

Cholesterol-enriched lipid domains can be visualized by di-4-ANEPPDHQ with linear and nonlinear optics.

We present a membrane-staining dye, di-4-ANEPPDHQ, which differentiates liquid-ordered phases from liquid-disordered phases coexisting in model membranes under both linear and nonlinear microscopies. The dye's fluorescence emission spectrum is blue-shifted 60 nm in liquid-ordered phases compared with liquid-disordered phases, and shows strong second harmonic generation in the liquid-disordered phase compared with the liquid-ordered phase. The ease of staining and the ability of this single dye to detect both phases, should lead to broad applications in biophysical studies of lipid domains in model membranes and cells.

Biophysics↗

PubMed2005

[Serial analyses of viral levels and immunocytes during in vitro incubation of peripheral blood mononuclear cells from HIV-infected individuals].

OBJECTIVE: To investigate the dynamic changes of viral loads and immunocytes during the in vitro culture of peripheral blood mononuclear cells (PBMC) from HIV carriers. METHODS: The PBMCs from 14 HIV-infected individuals and 6 healthy persons were incubated in serum-free AIM-V medium containing cocktail cytokines. The phenotype of CD3, CD4, CD8, CD3CD56 and CD25 was identified by flow cytometric analysis every two days. The production of cytokines in the supernatants, including IL-1alpha, IL-12, TNF-alpha and IL-10 was measured by ELISA. The supernatant HIV-1 RNA load was also determined by Real-time fluorescent PCR. RESULTS: During a 21-day incubation period, The PBMCs multiplied approximately 60.7-fold and 16.8-fold respectively in the healthy controls and 7 out of the 14 HIV-infected subjects, however failed to multiply in the remaining 7 HIV-infected subjects. The expanded cells were phenotypically shown a heterogeneous cellular population with 23.3%-35% for CD3(+)CD4(+) T cells and 58.7%-72% for CD3(+)CD8(+) T cells, and approximate 17% CD3(+)CD56(+) cells at 16-day incubation for HIV-infected cases. HIV-1-positive PBMCs were found to produce an elevated ratios (value range 6.01 - 48.04) of IL-12:IL-10 compared to healthy individuals (6.65 - 10.2) at 16-day incubation. Furthermore, serial analyses of HIV-1 RNA levels showed an inverted V type dynamic change during 16 day in vitro incubation period. CONCLUSION: In vitro expansion of functional immunocytes of HIV-1 carrier origin is feasible and may facilitate the autologous antiviral immune therapy for HIV-infected patients.

CD3 Complex↗

PubMed2005

Combined linkage and association mapping of quantitative trait loci by multiple markers.

Using multiple diallelic markers, variance component models are proposed for high-resolution combined linkage and association mapping of quantitative trait loci (QTL) based on nuclear families. The objective is to build a model that may fully use marker information for fine association mapping of QTL in the presence of prior linkage. The measures of linkage disequilibrium and the genetic effects are incorporated in the mean coefficients and are decomposed into orthogonal additive and dominance effects. The linkage information is modeled in variance-covariance matrices. Hence, the proposed methods model both association and linkage in a unified model. On the basis of marker information, a multipoint interval mapping method is provided to estimate the proportion of allele sharing identical by descent (IBD) and the probability of sharing two alleles IBD at a putative QTL for a sib-pair. To test the association between the trait locus and the markers, both likelihood-ratio tests and F-tests can be constructed on the basis of the proposed models. In addition, analytical formulas of noncentrality parameter approximations of the F-test statistics are provided. Type I error rates of the proposed test statistics are calculated to show their robustness. After comparing with the association between-family and association within-family (AbAw) approach by Abecasis and Fulker et al., it is found that the method proposed in this article is more powerful and advantageous based on simulation study and power calculation. By power and sample size comparison, it is shown that models that use more markers may have higher power than models that use fewer markers. The multiple-marker analysis can be more advantageous and has higher power in fine mapping QTL. As an application, the Genetic Analysis Workshop 12 German asthma data are analyzed using the proposed methods.

Alleles↗

PubMed2005

Expression profiles of adiponectin receptors in mouse embryos.

Adiponectin is a protein secreted from adipocytes and it plays an important endocrine role in glucose and lipid homeostasis. A reverse correlation between plasma adiponectin concentrations and insulin resistance has been established in both animals and humans. Adiponectin exerts its function by interacting with membrane receptors, including AdipoR1 and AdipoR2. We investigated the expression pattern of these two adiponectin receptors in mouse embryos. At stages E12.5 and E15.5, both AdipoR1 and AdipoR2 are highly expressed in the nervous system including the trigeminal ganglion, glossopharyngeal ganglion and dorsal root ganglia. AdipoR1 is highly expressed in many tissues derived from primitive gut, including the lung, liver, pancreas and small intestines. Generally, the expression level of AdipoR2 is weaker and more restricted than AdipoR1 in most of the tissues. In addition, AdipoR1 expression can be found in heart, vertebrate, developing bones and cartilage, and many other tissues. This study reveals that AdipoR1 and AdipoR2 have differential but overlapping expression profiles during mouse development.

Adiponectin↗

PubMed2005

Longitudinal alteration of circulating dendritic cell subsets and its correlation with steroid treatment in patients with severe acute respiratory syndrome.

In this study, we found that 74 patients with severe acute respiratory syndrome (SARS) exhibited a rapid, dramatic decrease in numbers of circulating myeloid and plasmacytoid dendritic cells (mDCs and pDCs) during the first 2 weeks of illness (5.3- and 28.4-fold reductions for mDCs and pDCs compared with 25 healthy individuals, respectively), with slow return to normal cell numbers during convalescence (weeks 5-7 of illness on average). In addition, numbers of circulating CD4 and CD8 T cells exhibited milder reductions (2.1- and 1.8-fold at week 1) and earlier return to normal at a mean of weeks 3 and 4, respectively. A significant inverse correlation was found between numbers of DC and T-cell subsets and high-dose steroid treatment. Our novel findings thus suggest that the acute SARS-coronavirus infection probably contributes to the initial reduction of DC and T-cell subsets in blood, and that high-dose steroid administration may subsequently exacerbate and prolong low expression of the cell subsets. These findings will aid the framing of further studies of the immunopathogenesis of SARS.

Adrenal Cortex Hormones↗

PubMed2005

Expression pattern of TG-interacting factor 2 during mouse development.

TGIF2 is a close homologue of TGIF that functions as a transcriptional corepressor by interaction with transforming growth factor-beta (TGF-beta)-activated Smads. Mutations of TGIF have been found in holoprosencephaly, a genetic disease affecting forebrain and craniofacial developmental. Here we analyzed the expression pattern of TGIF2 during mouse embryogenesis. Expression of TGIF2 transcripts was detected at high level at E12.5 and E15.5 in the nervous system including neopallial cortex, mesencephalon, metencephalon, medulla oblongata, spinal cord, trigeminal ganglion, vestibulocochlear ganglion and dorsal root ganglion. In addition, TGIF2 transcripts could be detected in other tissues including heart, lung, liver, pancreas, kidney, small intestine and nasal cavity. These data indicated that TGIF2 has a wide but well controlled expression pattern during mouse development.

Animals↗

PubMed2005

Pedigree linkage disequilibrium mapping of quantitative trait loci.

In this paper, we propose to use pedigrees of any size and any types of relatives in joint high-resolution linkage disequilibrium (LD) and linkage mapping of quantitative trait loci (QTL) by variance component models. Two or multiple markers can be simultaneously used in modeling association with the trait locus, instead of using one marker a time in the analysis. The proposed method can provide a unified result by using two or multiple markers in the modeling. This may avoid the complications of different results obtained from the separate analysis of marker by marker. The models simultaneously incorporate both linkage and LD information. The measures of LD are modeled by mean coefficients, and linkage information is modeled by variance-covariance matrix. Using analytical formulas to calculate the regression coefficients, the genetic effects are shown to be decomposed into additive and dominance components. The noncentrality parameter approximations of test statistics of LD are provided to make power calculations. Power and type I error rates are explored to investigate the merit of the proposed method by both the analytical formulas and simulations. Comparing with the association between-family and association within-family ('AbAw') approach of Fulker and Abecasis et al, it is evident that the method proposed in this article is more powerful. The method is applied to investigate the relation between polymorphisms in the angiotensin 1-converting enzyme (ACE) genes and circulating ACE levels, with a better result than that of the 'AbAw' approach. Moreover, two markers I/D and 4656(CT)3/2 can fully interpret association with the trait locus at a 0.01 significance level, which provides a unique result for the ACE data.

Animals↗

PubMed2005

Use of a self-report-generated Charlson Comorbidity Index for predicting mortality.

BACKGROUND: The Charlson Comorbidity Index, a popular tool for risk adjustment, often is constructed from medical record abstracts or administrative data. Limitations in both sources have fueled interest in using patient self-report as an alternative. However, little data exist on whether self-reported Charlson Indices predict mortality. OBJECTIVES: We sought to determine whether a self-reported Charlson Index predicts mortality, its performance relative to indices derived from administrative data, and whether using study-specific weights instead of Charlson's original weights enhances model fit. METHODS: We surveyed 7761 patients admitted to a university medical service over the course of 4 years and extracted their administrative data. We constructed 6 different Charlson indices by using 2 weighting schemes (original Charlson weights and study-specific weights) and 3 different datasources (ICD-9CM data for index hospitalization, ICD-9CM data with a 1-year look-back period, and patient self-report of comorbidities.) Multivariate models were constructed predicting 1-year mortality, log total costs, and log length of stay. RESULTS: The 6 measures of the Charlson index all predicted 1-year mortality. Models with age and gender, with or without diagnosis-related group, had approximately the same predictive power regardless of which of the 6 Charlson indices were used. Nevertheless, there were small improvements in model fit using administrative data versus self-report, or study-specific versus original weights. All models obtained areas under the receiver operating curve of 0.70 to 0.77. CONCLUSIONS: Overall, self-reported Charlson indices predict 1-year mortality comparably with indices based on administrative data. Administrative data may offer some small improvements in predictive ability and may be preferred when readily available.

Adult↗

PubMed2005

Cloning, expression, and functional analysis of human dopamine D1 receptors.

AIM: To construct an HEK293 cell line stably expressing human dopamine D1 receptor (D1R). METHODS: cDNA was amplified by RT-PCR using total RNA from human embryo brain tissue as the template. The PCR products were subcloned into the plasmid pcDNA3 and cloned into the plasmid pcDNA3.1. The cloned D1R cDNA was sequenced and stably expressed in HEK293 cells. Expression of D1R in HEK293 cells was monitored by the [3H]SCH23390 binding assay. The function of D1R was studied by the cAMP accumulation assay, CRE-SEAP reporter gene activity assay, and intracellular calcium assay. RESULTS: An HEK293 cell line stably expressing human D1R was obtained. A saturation radioligand binding experiment with [3H]SCH23390 demonstrated that the Kd and Bmax values were 1.5+/-0.2 nmol/L and 2.94+/-0.15 nmol/g of protein, respectively. In the [3H]SCH23390 competition assay, D1R agonist SKF38393 displaced [3H]SCH23390 with an IC50 value of 2.0 (1.5-2.8) micromol/L. SKF38393 increased the intracellular cAMP level and CRE-SEAP activity through D1R expressed in HEK293 cells in a concentration-dependent manner with an EC50 value of 0.25 (0.12-0.53) micromol/L and 0.39 (0.27-0.57) micromol/L at 6 h/0.59 (0.22-1.58) micromol/L at 12 h, respectively. SKF38393 also increased the intracellular calcium level in a concentration-dependent manner with EC50 value of 27 (8.6-70) nmol/L. CONCLUSION: An HEK293 cell line stably expressing human D1R was obtained successfully. The study also demonstrated that the CRE-SEAP activity assay could be substituted for the cAMP accumulation assay for measuring increase in cAMP levels. Thus, both intracellular calcium measurements and the CRE-SEAP activity assay are suitable for high-throughput screening in drug research.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗

PubMed2005

Modulating effect of adenosine deaminase on function of adenosine A1 receptors.

AIM: To study the modulating effect of adenosine deaminase (ADA) on the adenosine A1 receptor (A1R) in HEK293 cells stably expressing the human A1R. METHODS: cDNA was amplified by RT-PCR using total RNA from human embryo brain tissue as the template. The PCR products were subcloned into the plasmid pcDNA3 and cloned into the plasmid pcDNA3.1. The cloned A1R cDNA was sequenced and stably expressed in HEK293 cells. The modulating effect of adenosine deaminase on A1R was studied by using [3H]DPCPX binding assay and an intracellular calcium assay. RESULTS: HEK293 cells stably expressing human A1R were obtained. Saturation studies showed that the K(D) value and B(max) value of [3H]DPCPX were 1.6+/-0.2 nmol/L and 1.819+/-0.215 nmol/g of protein respectively, in the absence of ecto-ADA respectively, and 1.3+/-0.2 nmol/L and 1.992+/-0.130 nmol/g of protein in the presence of ecto-ADA respectively, suggesting that the K(D) value and B(max) value of [3H]DPCPX were unaffected by ecto-ADA. In the case of [3H]DPCPX competition curves obtained from intact cells or membranes, A1R agonist CCPA/[3H]DPCPX competition curve could be fitted well to a one-site model in the absence of ecto-ADA and a two-site model in the presence of ecto-ADA with a K(H) value of 0.74 (0.11+/-4.8) nmol/L (intact cells) or 1.8 (0.25+/-10) nmol/L (membrane) and a K(L) value of 0.94 (0.62+/-1.41) micromol/L (intact cells) or 0.77 (0.29+/-0.99) micromol/L (membrane). The K(L) value is not significantly different from the IC50 value of 0.84(0.57+/-1.23) micromol/L (intact cells) or 0.84 (0.63+/-1.12) micromol/L (membrane) obtained in the absence of ecto-ADA. Similar results were obtained from the CPA/[3H]DPCPX competition curve in the absence or presence of ecto-ADA on intact cells or membranes. Intracellular calcium assay demonstrated that the EC50 value of CPA were 10 (5+/-29) nmol/L and 94 (38+/-229) nmol/L in the presence or absence of ecto-ADA, respectively. CONCLUSION: A1R stably expressed in the HEK293 cells display a low affinity for agonists in the absence of ADA and high and low affinities for agonists in the presence of ADA. The presence of ADA may promote the signaling through the adenosine A1 receptor in HEK293 cells.

Adenosine↗

PubMed2005

[Effect of CCR5delta32, CCR5m303, CCR2-64I and SDF1-3'A gene polymorphism on the prognosis of Chinese HIV-1 carriers].

OBJECTIVE: To study how CCR5delta32, CCR5m303, CCR2-64I, SDF1-3'A gene polymorphisms affect the prognosis of Chinese HIV-1 carrier. METHODS: Epidemiologic survey was done to the HIV-1 carriers who were found in Shenzhen area. PCR/RFLP technology was applied to analyze CCR5delta32, CCR5m303, CCR2-64I, SDF1-3'A gene polymorphisms of the HIV-1 carriers. The plasma virus load and CD4+ cell counting was assayed. The incubation period of some carriers was estimated. SPSS11.0 software was used to analyze the data. RESULTS: No persons with CCR5delta32 and CCR5m303 mutation genotype were found from 189 HIV-1 carriers. SDF1-3'A allele frequency was 26.14% and CCR2-64I allele 19.82%. The carriers were divided into high virus load group (virus load < 20,000 copies/ml) and low virus load group (virus load > or =20,000 copies/ml). It was found by one-way ANOVA analysis on the logarithm of virus load that there was no significant difference between CCR2-64I wild genotype and cross bred genotype (P=0.272). One-way ANOVA analysis on delitescence of some carriers showed that there was not significant difference between CCR2-64I wild genotype and cross bred genotype (P=0.662). One-way ANOVA analysis on the logarithm of virus load showed that there was significant difference among SDF1-3'A wild genotype, cross bred genotype and pure mutation genotype (P=0.001). CONCLUSION: CCR2-64I gene mutation may not significantly affect virus load of Chinese HIV-1 carriers, nor it affect the incubation period of HIV-1 carriers. SDF1-3'A gene mutation can decrease virus load, but it may not prolong the incubation period of HIV-1 carriers.

Acquired Immunodeficiency Syndrome↗

PubMed2005

[Vitrification of human cleaved embryos in vitro fertilization-embryo transfer].

OBJECTIVE: To assess the outcome of thawing human cleaved embryos from cryopreservation by vitrification. METHODS: A total of 957 day 2 or day 3 embryos from 219 patients were thawed after vitrification with ethylene glycol 5.5 solution and 0.25 ml straw between Jan 2003 and Jun 2005, 514 embryos were recovered and transferred in 178 patients. RESULTS: The survival rate of thawing embryos and the clinical pregnancy rate after transfer was 72.2% and 19.7% respectively. Twenty-two healthy babies were born from 16 deliveries, including 12 girls and 10 boys, 6 pregnancies ended in miscarriage and another 13 are ongoing. CONCLUSION: Vitrification method is an alternative for cryopreservation of human cleaved embryos because of high effectiveness, convenience and good cost efficiency.

Cryopreservation↗

PubMed2004

Crystal structures of the FXIa catalytic domain in complex with ecotin mutants reveal substrate-like interactions.

Thrombosis can lead to life-threatening conditions such as acute myocardial infarction, pulmonary embolism, and stroke. Although commonly used anti-coagulant drugs, such as low molecular weight heparin and warfarin, are effective, they carry a significant risk of inducing severe bleeding complications, and there is a need for safer drugs. Activated Factor XI (FXIa) is a key enzyme in the amplification phase of the coagulation cascade. Anti-human FXI antibody significantly reduces thrombus growth in a baboon thrombosis model without bleeding problems (Gruber, A., and Hanson, S. R. (2003) Blood 102, 953-955). Therefore, FXIa is a potential target for anti-thrombosis therapy. To determine the structure of FXIa, we derived a recombinant catalytic domain of FXI, consisting of residues 370-607 (rhFXI370-607). Here we report the first crystal structure of rhFXI370-607 in complex with a substitution mutant of ecotin, a panserine protease protein inhibitor secreted by Escherichia coli, to 2.2 A resolution. The presence of ecotin not only assisted in the crystallization of the enzyme but also revealed unique structural features in the active site of FXIa. Subsequently, the sequence from P5 to P2' in ecotin was mutated to the FXIa substrate sequence, and the structures of the rhFXI370-607-ecotin mutant complexes were determined. These structures provide us with an understanding of substrate binding interactions of FXIa, the structural information essential for the structure-based design of FXIa-selective inhibitors.

Anticoagulants↗

PubMed2004

Characterization of determinants of genotypic and phenotypic resistance to enfuvirtide in baseline and on-treatment HIV-1 isolates.

BACKGROUND: Enfuvirtide (ENF) is the first of a novel class of drugs that block HIV gp41-mediated viral fusion to host cells. Viruses with mutations at positions 36-38 in HIV-1 gp41 and/or reduced susceptibility to ENF have been selected both in vitro and in vivo. METHODS: An analysis of baseline and on-treatment ENF susceptibility in virus samples from Phase II clinical trial patients treated with ENF as functional monotherapy for 28 days (TRI-003) or in combination with oral antiretrovirals for >/= 48 weeks (T20-205, T20-206 and T20-208). Population sequencing identified amino acid (aa) substitutions at positions 36-45 of gp41 in plasma HIV-1. ENF susceptibility of virus isolates was tested in the cMAGI assay and viral DNA was sequenced for selected isolates. RESULTS: HIV-1 gp41 aa 36-45 were highly conserved in virus from ENF-naive patients, except for a 15% incidence of N42S which did not reduce sensitivity to ENF. Virus from patients experiencing viral load rebound exhibited reduced susceptibility to ENF and substitutions in gp41 aa 36-45. The most common substitutions observed on treatment were at positions 36, 38, 40, 42 and 43. On-treatment changes in the phenotypic susceptibility of virus isolates to ENF were generally associated with genotypic changes in aa 36-45. There was a relatively lower incidence of ENF resistance in patients with baseline sensitivity to more oral antiretrovirals in comparison to patients sensitive to fewer antiretrovirals. CONCLUSIONS: These data identify the importance of HIV-1 gp41 aa 36-45 in the emergence of resistance to ENF.

Adult↗

PubMed2004

The three-dimensional structure of the ZAP-70 kinase domain in complex with staurosporine: implications for the design of selective inhibitors.

The ZAP-70 tyrosine kinase plays a critical role in T cell activation and the immune response and therefore is a logical target for immunomodulatory therapies. Although the crystal structure of the tandem Src homology-2 domains of human ZAP-70 in complex with a peptide derived from the zeta subunit of the T cell receptor has been reported (Hatada, M. H., Lu, X., Laird, E. R., Green, J., Morgenstern, J. P., Lou, M., Marr, C. S., Phillips, T. B., Ram, M. K., Theriault, K., Zoller, M. J., and Karas, J. L. (1995) Nature 377, 32-38), the structure of the kinase domain has been elusive to date. We crystallized and determined the three-dimensional structure of the catalytic subunit of ZAP-70 as a complex with staurosporine to 2.3 A resolution, utilizing an active kinase domain containing residues 327-606 identified by systematic N- and C-terminal truncations. The crystal structure shows that this ZAP-70 kinase domain is in an active-like conformation despite the lack of tyrosine phosphorylation in the activation loop. The unique features of the ATP-binding site, identified by structural and sequence comparison with other kinases, will be useful in the design of ZAP-70-selective inhibitors.

Adenosine Triphosphate↗

PubMed2004

Pain and satisfaction with pain control in hospitalized medical patients: no such thing as low risk.

BACKGROUND: Pain is common in many populations of hospitalized patients. It is unknown if any populations of hospitalized patients are at low risk for pain. We studied the prevalence of pain and satisfaction with pain control in a general medicine inpatient service to determine if this population was at low risk for pain. METHODS: We performed a prospective cohort study of 5584 hospitalized patients. Pain and pain control were assessed in a follow-up telephone survey. Predictors of pain were determined through administrative databases and patient survey. RESULTS: Of the study patients, 59% had pain (28% reported severe, 19% moderate, and 12% mild pain). Among patients with common diagnoses, those with sickle cell crisis were the most likely and those with syncope were the least likely to report significant pain (90% and 34%, respectively). Patient characteristics significantly associated with increased pain included DRG (diagnosis related group) weight (odds ratio [OR], 1.19), Charlson Index score (OR, 1.03), age older than 65 years (OR, 0.65), female sex (OR, 1.17), and education level higher than high school (OR, 1.31). Pain was reported by 28% of patients without high-risk characteristics for pain; and 82.2% of patients were satisfied, 11.1% somewhat satisfied, and 6.7% dissatisfied with their pain treatment. CONCLUSIONS: Pain was common in the study population and more patients rated their pain as severe than as moderate or mild. Pain was dispersed among diagnoses. Although most patients thought that their pain was adequately controlled, 18% of patients with pain (10% of all patients) reported that their pain was inadequately controlled. Although patient characteristics were associated with pain or dissatisfaction with pain control, they were weak predictors and significant pain was common even in populations at the lowest-risk for pain.

Age Factors↗