肺癌患者血脂水平与临床特征的相关性研究

目的 观察肺癌患者的血脂代谢特点,并分析血脂与肺癌患者临床特征的关系.方法 选取首都医科大学附属北京世纪坛医院经病理组织学确诊的肺癌760例为研究对象,400例健康体检者作为对照组,早晨空腹抽取静脉血,检测胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),并分析上述指标与临床特征的关系.结果 与对照组相比,肺癌患者血清TC、LDL-C、HDL-C水平明显减低,而肺癌组与对照组相比血清TG水平差异无统计学意义.不同病理类型肺癌各组间血脂水平存在差异.肺癌患者年龄越大,血清TC、LDL-C和TG越低.吸烟组TC、HDL-C和LDL-C水平明显低于不吸烟组.男性患者血清TC、HDL-C和LDL-C较女性患者降低.Ⅲ～Ⅳ期较Ⅰ～Ⅱ期肺癌患者,以及有淋巴结转移较无淋巴结转移患者的血清TC、HDL-C、LDL-C和TG水平都低.结论 肺癌患者存在血脂紊乱,其血脂异常与肺癌临床特征具有一定相关性,测定肺癌患者血脂水平,可为临床评估病情提供相关依据.     

DM2患者非高密度脂蛋白胆固醇与胰岛素抵抗的相关性分析

血清非高密度脂蛋白胆固醇(non-high density lipoprotein cholesterol,non-HDL-C)是除了HDL-C以外的各种脂蛋白胆固醇的总和,包括了致动脉粥样硬化的所有血脂因素。近年来,non-HDL-C在评估冠心病及2型糖尿病(DM2)大血管并发症风险的价值备受关注[1-2],但与DM2胰岛素抵抗(IR)之间的关系,却少见报道。因此,本文通过检测70例DM2患者及50例正常人血清总胆固醇(total cholester,TC)、三酰甘油(triglycerid,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)及低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、空腹胰岛素(fasting plasma insulin,fINS)、空腹血糖(fasting plasma glucose,fPG),并     

DM2患者检测non-HDL-C、AIP和BIL的意义

目的：探讨DM2患者血清非高密度脂蛋白胆固醇（non-HDL-C）、致动脉硬化指数（AIP）和胆红素（BIL）的临床意义。方法：采用全自动生化分析仪测定77例DM2患者fBG、TC、TG、HDL-C、TBIL、DBIL,计算出non-HDL-C、AIP及间接胆红素（NDBIL）,与65例正常对照组比较。结果：DM2组的血清TG、non-HDL-C和AIP水平显著高于正常对照组（P〈0.01）;而TBIL、NDBIL和HDL-C水平显著低于正常对照组（P〈0.01）;TC和DBIL与正常对照组相比无显著性差异。结论：DM2患者的高non-HDL-C、高AIP和低胆红素使得体内抗氧化活性减低,氧化LDL形成增多,增加了DM患者并发动脉粥样硬化的危险性。     

肺癌患者手术及化疗前后血脂水平的变化及意义

目的探讨肺癌患者血总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)及化疗前后或手术前后水平的变化及其意义。方法测定600例肺癌组患者血脂水平与对照组比较;并对不同类型肺癌间血脂水平进行比较。同时观察患者化疗、手术前后血脂水平变化。结果肺癌患者TC、LDL-C、HDL-C均较对照组明显减低,而两组间血TG水平无明显差异。化疗及手术后肺癌组患者,血TC、LDL-C、HDL-C及TG水平均较化疗前明显升高,但差异无统计学意义(P>0.05)。结论肺癌患者存在低血胆固醇倾向,化疗或手术治疗可以提高血清TC及LDL-C水平。     

妊娠高血压孕妇血脂代谢变化研究

目的探讨妊娠高血压与血脂代谢变化的关系。方法对妊娠高血压孕妇轻度、中度、重度各30例进行血甘油三酯(TG)、载脂蛋白A(APO-A)、载脂蛋白B(APO-B)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)水平测定,同时选择30例无妊娠并发症的健康孕妇作为对照组。结果妊娠高血压组血TG高于对照组(P0.01)。APO-A、HDL-C低于对照组(P0.05)。APO-B明显高于对照组(P0.01),LDL-C也高于对照组(P0.05)。且上述变化随着病情的加重而进一步发展。结论高TG血症、APO-A、HDL-C水平降低、APO-B、LDL-C增高与妊娠高血压发病有关。     

超敏C反应蛋白和中性粒细胞/高密度脂蛋白胆固醇比值在2型糖尿病发生急性心肌梗死中的价值分析

目的:探讨超敏C反应蛋白(hs-CRP)和中性粒细胞/高密度脂蛋白胆固醇比值(NHR)与2型糖尿病(T2DM)发生急性心肌梗死(AMI)的相关性。方法:选取2021-12-2022-09本院确诊的T2DM患者217例,依据是否合并AMI将其分为T2DM+AMI组(n=108)和T2DM组(n=109),选取同期本院体检健康人群作为对照组(n=86)。检测外周血中白细胞总数(WBC)、中性粒细胞数(NEU)、hs-CRP、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)和总胆固醇(TC),同时计算NHR,分析各组间上述指标的差异。采用单因素和多因素Logistic回归分析相关指标与T2DM并发AMI的危险因素。应用ROC曲线用于评估hs-CRP和NHR对T2DM患者发生AMI的预测价值。结果:与对照组比较,T2DM组和T2DM+AMI组WBC、NEU、TC、TG、hs-CRP和NHR水平均升高,HDL-C水平降低;与T2DM组比较,T2DM+AMI组WBC、NEU、TG、hs-CRP和NHR升高,差异均有统计学差异(P<0.05或P<0.0...     

2型糖尿病合并冠心病患者的血清25-羟基维生素D和血脂水平变化及其相关性

目的:回顾性分析2型糖尿病(T2DM)合并冠心病(CHD)患者血清25-羟基维生素D[25(OH)VitD]和血脂水平变化及其相关性。方法:2017-03—2018-03武汉大学中南医院收治的129例T2DM合并CHD患者,按其血清25(OH)VitD水平分为25(OH)VitD缺乏组(A组,n=93)和25(OH)VitD正常组(B组,n=36)。比较分析两组25(OH)VitD、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)水平差异以及25(OH)VitD与上述指标的相关性。结果:A组25(OH)VitD显著低于B组(P0.01),TC、LDL-C水平明显高于B组(均P0.05),TG、HDL-C、FBG水平两组无显著差异(均P0.05)。T2DM合并CHD患者血清25(OH)VitD与TC、LDL-C水平呈显著负相关(P0.05),25(OH)VitD与TG、HDL-C和FBG无明显相关性(P0.05)。结论:T2DM合并CHD患者VitD缺乏,胆固醇代谢不良。     

2型糖尿病视网膜病变患者超敏C反应蛋白、血脂指标变化及相关危险因素分析

目的:观察2型糖尿病视网膜病变(DR)患者超敏C反应蛋白(hs-CRP)、血脂代谢相关指标变化,并分析其危险因素。方法:回顾性分析2018-02—2019-08本院收治的161例2型糖尿病(T2DM)患者,将其分成A组(Ⅰ型,未发生视网膜病变,62例);B组[Ⅱ、Ⅲ型,非增殖性的糖尿病性视网膜病变(NPDR),43例];C组[Ⅳ、Ⅴ型,增殖性的糖尿病性视网膜病变(PDR),56例],以同期体检健康者52例作为对照组。比较各组hs-CRP、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)及TG/HDL-C、TC/HDL-C、LDL-C/HDL-C比值水平变化差异,采用Spearman分析hs-CRP与各检测指标的相关性,Logistic回归分析DR可能的危险因素。结果:除LDL-C,hs-CRP、血脂代谢(TG、TC、HDL-C)及比值(TG/HDL-C、TC/HDL-C、LDL-C/HDL-C)在各组间比较,差异有统计意义(均P<0.05)。DR患者血液hs-CRP与TG(r=0.505)、TC(r=0.236)、LDL-C(r=0.313)、TG/HDL-C(r=0.50)、TC/HDL-C(r=0.385)、LDL-C/HDL-C(r=0.405)水平均呈正相关(均P<0.05),Logistic回归模型分析发现除了TC外其余各项指标均为T2DM患者发生DR的可能危险因素。结论:DR患者hs-CRP和血脂代谢指标对评估DR患者风险具有预测价值。     

精神分裂症共病代谢综合征患者血清同型半胱氨酸的对照研究

目的对精神分裂症共病代谢综合征(MS)患者血清同型半胱氨酸(Hcy)水平进行对照研究。方法 33例首次确诊为MS的精神分裂症患者作为观察组,33例不伴有MS的精神分裂症患者作为对照组,分别测定其空腹血清Hcy水平;同时测定腰围、体质量指数(BMI)、空腹血糖(FBG)、血脂[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、血压[收缩压(SBP)/舒张压(DBP)]等MS相关指标。结果①观察组血清Hcy水平显著高于对照组,两组比较差异有统计学意义(t=-2.775,P0.01);②观察组高Hcy血症的发生率显著高于对照组,两组比较差异有统计学意义(χ2=6.061,P0.05);③观察组的血清Hcy水平与HDL-C、LDL-C具有相关性(r=-0.346,0.373;P0.05),而与腰围、BMI、FBG、TC、TG、SBP、DBP均无显著的相关;对照组的血清Hcy水平与腰围、BMI、FBG、TC、TG、HDL-C、LDL-C、SBP、DBP均无显著的相关性。结论与不伴发MS的精神分裂症患者相比,伴发MS的精神分裂症患者血清Hcy水平显著增高;伴发MS的精神分裂症患者的血清Hcy水平与HDL-C、LDL-C有关。     

血脂异常与老年冠心病患者冠脉病变程度的相关性研究

目的 探讨血脂异常与老年冠心病患者冠脉病变程度的相关性。方法 选取2015年5月~2017年1月本院心内科住院的明确诊断为冠状动脉粥样硬化性心脏病（CHD）的150例老年患者设为CHD组。选取同期收治的150例非CHD患者为对照组。比较两组血清中总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）水平,并计算N-HDL-C、LDL-C/N-HDL-C、LDL-C/HDL-C、TC/HDL-C、TG/HDL-C值。比较不同冠脉病变支数、不同病情严重程度的CHD患者的血脂及其比值。对血脂与冠脉病变支数、病情严重程度积分进行相关性分析。结果 CHD组患者LDL-C、TG、TC、N-HDL-C水平、LDL-C/HDL-C、TC/HDL-C、TG/HDL-C值均高于对照组,HDL-C水平低于对照组,差异均有统计学意义（P＜0.05）;不同冠脉病变支数各亚组间的TC、TG、N-HDL-C水平、TC/HDL-C比值差异存在统计学意义（P＜0.05）;TC、TG、N-HDL-C水平、TC/HDL-C比值均与冠脉病变支数均呈正相关（P＜0.05）;不同病情严重程度亚组间的LDL-C、TC、TG、N-HDL-C水平、LDL-C/HDL-C、TC/HDL-C、TG/HDL-C比值差异存在统计学意义（P＜0.05）;CHD患者LDL-C、TC、TG、N-HDL-C水平、LDL-C/HDL-C、TC/HDL-C、TG/HDL-C比值与冠状动脉病变积分均呈正相关（P＜0.05）。结论 可以通过对血脂指标的监测,并计算N-HDL-C、TC/HDL-C、LDL-C/HDL-C、TC/HDL-C、TG/HDL-C值,来评估CHD病情的临床进展。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.