[Surgical reconstruction of maxillary defects using a computer-assisted techniques]

The maxilla is the most important bony support of the mid-face skeleton and is critical for both esthetics and function. Maxillary defects, resulting from tumor resection, can cause severe functional and cosmetic deformities. Furthermore, maxillary reconstruction presents a great challenge for oral and maxillofacial surgeons. Nowadays, vascularized composite bone flap transfer has been widely used for functional maxillary reconstruction. In the last decade, we have performed a comprehensive research on functional maxillary reconstruction with free fibula flap and reported excellent functional and acceptable esthetic results. However, this experience based clinical procedure still remainssome problems in accuracy and efficiency. In recent years, computer assisted techniques are now widely used in oral and maxillofacial surgery. We have performed a series of study on maxillary reconstruction with computer assisted techniques. The computer assisted techniques used for maxillary reconstruction mainly include: (1) Three dimensional (3D) reconstruction and tumor mapping: providing a 3D view of maxillary tumor and adjacent structures and helping to make the diagnosis of maxillary tumor accurate and objective; (2) Virtual planning: simulating tumor resection and maxillectomy as well as fibula reconstruction on the computer, so that to make an ideal surgical plan; (3) 3D printing: producing a 3D stereo model for prebending individualized titanium mesh and also providing template or cutting guide for the surgery; (4) Surgical navigation: the bridge between virtual plan and real surgery, confirming the virtual plan during the surgery and guarantee the accuracy; (5) Computer assisted analyzing and evaluating: making a quantitative and objective of the final result and evaluating the outcome. We also performed a series of studies to evaluate the application of computer assisted techniques used for maxillary reconstruction, including: (1) 3D tumor mapping technique for accurate diagnosis and treatment of maxillary tumor; (2) Maxillary reconstruction with free fibula flap used computer assisted techniques; (3) Computer assisted orbital floor reconstruction after maxillectomy. The results suggested that computer assisted techniques could significantly improve the clinical outcome of maxillary reconstruction.

Celastrol, an active constituent of the TCM plant Tripterygium wilfordii Hook.f., inhibits prostate cancer bone metastasis

BACKGROUND

Treatment failure of prostate cancer (PCa) is often due to bone metastasis. Celastrol, an active constituent of Tripterygium wilfordii roots, has shown anti-tumor effects in previous studies in accordance with its indication in traditional Chinese medicine.

METHODS

Using a PC-3 cell model, in vitro assays were performed to evaluate the effects of celastrol on proliferation, migration (wound healing assay), tissues invasion (Transwell-Matrigel penetration assay) and vascular endothelial growth factor (VEGF) secretion (enzyme-linked immunosorbent assay). An intra-tibia injection mouse model was used to assess the effect of celastrol on PCa bone metastasis in vivo.

RESULTS

Pretreatment with celastrol significantly reduced proliferation of PC-3 cells in a dose-dependent manner and cell migration was much slower than in controls. Significantly fewer cells penetrated the gel-membrane after celastrol administration and their skeletal invasive ability was significantly reduced in a dose-dependent manner. Correspondingly, a significant, dose-dependent decrease in VEGF secretion was observed. In the in vivo mouse model, pretreatment with celastrol (8 μmol l^-1) inhibited the tumorigenicity of PC-3 cells so that almost no bone invasion occurred as compared with control injections. Histological examinations using hematoxylin and eosin staining showed that tibiae injected with celastrol pretreated PC-3 cells retained their natural bone structure.

CONCLUSIONS

Celastrol may have preventive potential against PCa bone metastasis.

Family member-based supervision of patients with hypertension: a cluster randomized trial in rural China

Empirical evidence has suggested that social support from family can help patients take their medicines correctly. This study aims to evaluate the role of a family member-based supervision package in the management of hypertension using a cluster randomized trial in rural China. We recruited patients with hypertension from four villages in Yangzhong and randomly allocated them to the control group (n=288) and the intervention group (n=266). A family member-based supervision package was applied to the intervention group, while the usual service was applied to the controls. Patients were followed for 12 months and completed face-to-face interviews at the end of 6 and 12 months. The primary outcomes were patients' medication adherence and frequency of blood pressure measurement. Secondary outcomes included changes in blood pressure, altered risk behaviours and occurrence of hypertension-related complications. To control for the effects of cluster randomization, multilevel mixed-effects regression models were used to compare group changes. We observed that the intervention improved patients' blood pressure measurement frequency (OR: 9.00, 95% CI: 4.52-17.91) and adherence to antihypertensive treatment (OR: 1.74, 95% CI: 0.91-3.32). Its effect on the blood pressure control rate was significant at the mid-term investigation (OR: 0.67, 95% CI: 0.40-0.93), but the long-term effect was not significant (OR: 0.89, 95% CI: 0.64-1.26). After 6 months of intervention, either systolic or diastolic blood pressure was significantly decreased in the intervention group. However, this difference was not significant at the final investigation. Findings from this study revealed that the family member-based supervised therapy may have positive effects on patients' adherence to blood monitoring and hypertensive medications.

Differential diagnosis of IgG4-related sialadenitis, primary Sjögren syndrome, and chronic obstructive submandibular sialadenitis

Our aim was to differentiate IgG4-related sialadenitis, primary Sjögren syndrome, and chronic obstructive submandibular sialadenitis by analysing clinical, radiographic, and pathological features. Fifty-five patients, 50, and 50 were enrolled, respectively and their baseline characteristics and serological, sialographic, and pathological findings compared. The male:female ratio for IgG4-related sialadenitis was 1:1.2 for primary Sjögren syndrome 1:15.7, and for chronic obstructive submandibular sialadenitis1:0.92. Numbers with enlarged salivary glands were 55, 16, and 50; with xerostomia 26, 48, and 0; with a history of allergy 26, 4, and 6, and with coexisting systemic disease 12, 19, and 0 (p=0.14). Mean (SD) serum IgG4 concentrations were 109.1 (97.9), 4.9. (1.9) g/L, and 5.3 (1.6) g/L, p<0.001 in all cases. Sialography showed enlargement of the gland, dilatation of the duct, and slightly decreased secretory function in IgG4-related disease; obvious sialectasia and decreased secretory function in Sjögren syndrome; and dilatation of Wharton's duct and filling defects in obstructive sialadenitis. Histopathological examination showed lymphoplasmacytic infiltration with storiform fibrosis, lymphoplasmacytic inflammation and lymphoepithelial lesions, and dilatation of the duct with epithelial metaplasia in the three groups, respectively. The number of IgG4-positive plasma cells was 123 (45)/HPF, 8 (3)/HPF, and 5 (4)/HPF, while the IgG4-/IgG-positive cell ratio was 71.7 (13.9)%, 4.6 (2.5)%, 18.9 (19.7)%, respectively (p<0.001). The three conditions have different clinical, radiographic, and pathological features that provide important clues to the differential diagnosis. Serological and histological tests are important, and comprehensive consideration is necessary.

Elimination of blinding trachoma in China

OBJECTIVE

To present the change in the prevalence of blindness caused by trachoma between 1987 and 2006 by secondary data analysis based on two China National Sample Surveys on Disability (CNSSD).

METHODS

Secondary data analysis was performed on two China National Sample Surveys on Disability (CNSSD), which were national representative household surveys conducted in 1987 and 2006. The prevalence of blindness caused by trachoma was estimated by 10-year age group. In addition, the proportion of various causes of blindness was evaluated. The geographical distribution of blindness caused by trachoma both in 1987 and 2006 was analyzed in order to visualize the hot spots of blinding trachoma in China.

RESULTS

The prevalence of blindness caused by trachoma in China decreased from 51.5/100,000 in 1987 to 17.6/100,000 in 2006. In addition, the proportion of blindness attributed to trachoma also decreased from 10.1% (1987) to 0.9% (2006). Moreover, the prevalence of blindness caused by trachoma was over 200/100,000 in 2.2% of sampled counties in 2006 as compared to 8.6% in 1987. The hot spots of blinding trachoma were shown to be limited to underdeveloped mountain areas in Hubei and Guizhou provinces.

CONCLUSION

Although blinding trachoma is no longer the leading cause of blindness in China since the 2000's, the prevalence of trachoma should still be monitored in some underdeveloped mountain areas. Therefore, health organization must continue to fight against blinding trachoma in underdeveloped areas.

Correlated Event-by-Event Fluctuations of Flow Harmonics in Pb-Pb Collisions at sqrt[s_{NN}]=2.76 TeV

We report the measurements of correlations between event-by-event fluctuations of amplitudes of anisotropic flow harmonics in nucleus-nucleus collisions, obtained for the first time using a new analysis method based on multiparticle cumulants in mixed harmonics. This novel method is robust against systematic biases originating from nonflow effects and by construction any dependence on symmetry planes is eliminated. We demonstrate that correlations of flow harmonics exhibit a better sensitivity to medium properties than the individual flow harmonics. The new measurements are performed in Pb-Pb collisions at the center-of-mass energy per nucleon pair of sqrt[s_{NN}]=2.76  TeV by the ALICE experiment at the Large Hadron Collider. The centrality dependence of correlation between event-by-event fluctuations of the elliptic v_{2} and quadrangular v_{4} flow harmonics, as well as of anticorrelation between v_{2} and triangular v_{3} flow harmonics are presented. The results cover two different regimes of the initial state configurations: geometry dominated (in midcentral collisions) and fluctuation dominated (in the most central collisions). Comparisons are made to predictions from Monte Carlo Glauber, viscous hydrodynamics, ampt, and hijing models. Together with the existing measurements of the individual flow harmonics the presented results provide further constraints on the initial conditions and the transport properties of the system produced in heavy-ion collisions.

Comparison of the efficacy of different treatment modalities for Kimura's disease

The objective of this study was to investigate the clinical features of Kimura's disease in the head and neck region and to compare the local recurrence rate between three therapies used for the treatment of this disease. The clinicopathological information of 46 hospitalized patients suffering from Kimura's disease in the head and neck region over a 10-year period was reviewed retrospectively. All lesions were clinically observed in the head and neck region. These 46 patients underwent a total of 58 treatments; nine patients underwent multiple treatments due to local recurrence. Of the 58 treatments, 32 involved surgical excision alone, 24 involved surgical excision and postoperative low-dose radiotherapy (20-40Gy), one was a combination of ultrasound-guided core needle biopsy and radiotherapy, and one was a combination of incisional biopsy and subsequent radiotherapy. During the follow-up period, nine patients suffered 16 local recurrences. The recurrence rate of surgical excision combined with low-dose radiotherapy was much lower than that of surgical excision alone or radiotherapy alone (both P<0.05). It is concluded that Kimura's disease is a benign condition with a good prognosis, and surgical excision combined with postoperative low-dose radiotherapy is associated with the lowest local recurrence rate in the treatment of this disease.

Spontaneous Lung Lesions in Aging Laboratory Rabbits (Oryctolagus cuniculus)

Spontaneous age-related lesions of laboratory rabbits are not well documented in the contemporary scientific literature. A retrospective study of diagnostic necropsies of 36 rabbits >2 years of age found a number of common lung lesions. Fibromuscular intimal hyperplasia affected medium and to a lesser extent large pulmonary arteries and was present to a variable extent in all 36 rabbits >2 years of age. The lesions were characterized by fragmentation and/or reduplication of the internal elastic lamina (IEL), proliferation of smoothelin+/alpha-smooth muscle actin (α-SMA)+/vimentin− smooth muscle cells and fewer smoothelin−/α-SMA+/vimentin+ myofibroblasts, and intimal deposition of collagen without thrombosis, embolism, or evidence of pulmonary hypertension. Pulmonary emphysema, present in 30/36 rabbits, was characterized by the loss of alveolar septa; most affected rabbits did not have clinical signs of respiratory disease. In 8/13 rabbits of the inbred EIII/JC audiogenic strain, we identified a unique syndrome of granulomatous pneumonia containing hyaline brown to gray, globular to ring-like acellular material that was Alcian blue and periodic acid-Schiff positive. The material was immunoreactive for surfactant protein-A and had the ultrastructural appearance of multilamellar vesicles, suggesting a genetic defect in surfactant metabolism. Additionally, we found small benign primary lung tumors (fibropapillomas, 5 rabbits) not previously described. Other findings included heterotopic bone (5 rabbits), subacute to chronic suppurative bronchopneumonia, pyogranulomatous pneumonia with plant material, and pulmonary artifacts from barbiturate euthanasia solution.

Use of three-dimensional color power doppler in imaging of liver cancer

We aimed to assess the role of three-dimensional color power Doppler (3D-CPD) imaging in diagnosis of liver cancer. First of all, we performed 2D- and 3D-CPD imaging on 96 cases of liver tumors with a total of 106 lesions to examine the characteristics of the vascular distribution patterns of the tumors, and in turn, compare the sensitivity and specificity. Also, with the use of three-dimensional volumetric measurement, we calculated the volume of tumors, quantity of intra-tumor blood vessels, and the ratio of the quantity of intra-tumor blood vessels to tumor volumes (vascular index, VI). Finally, we statistically analyzed the vascular index between benign and malignant tumors. We found that the sensitivity/specificity were 21.3%/100% for 2D-CPD, and 81.3%/100% for 3D-CPD, based on the use of type-III of blood vessels for diagnosis of the malignant lesions. In 3D-CPD, the type-III of blood vessels along with VI of > 0.3/cm3 can be used as the criteria for the diagnosis of liver cancer since we found that average VI was 0.38/cm3 in 75 malignant tumors, but 0.18/cm3 in 31 benign tumors (p less than0.05). The sensitivity and specificity in determining malignancy in the liver based on VI > 0.3/cm3 were 78.7% and 87.1%, respectively.

Cardiac Specific Overexpression of hHole Attenuates Isoproterenol-Induced Hypertrophic Remodeling through Inhibition of Extracellular Signal-Regulated Kinases (ERKs) Signalling

The human Hole gene (hHole) encodes a six-transmembrane protein with 319- amino acids. Our previous study showed that hHole was strongly expressed in adult heart and may act as a suppressor of extracellular signal-regulated kinases (ERKs), overactivation of which contributed to pathological cardiac hypertrophy. In this study, it was observed that Hole expression was up-regulated in murine hypertrophic hearts. In a cardiac specific transgenic mouse model, it was observed that overexpression of hHole specifically in heart attenuated cardiac hypertrophy and fibrosis induced by isoproterenol (ISO), with blunted transcriptions of ERK1/2, total ERK1/2 proteins and phosphorylated ERK1/2 (p-ERK1/2) levels. Furthermore, overexpression of hHole in mice by hydrodynamic tail-vein injection with hHole plamids also inhibited cardiac hypertrophy induced by ISO. Our work identified hHole as a novel repressor of cardiac hypertrophy, and provided new insights into the possible target for the prevention or treatment of cardiac diseases.

Enhancing immune responses of EV71 VP1 DNA vaccine by co-inoculating plasmid IL-12 or GM-CSF expressing vector in mice

Enterovirus 71 (EV71) is a major causative viral agent for large outbreaks of hand, foot, and mouth disease in children and infants, yet there is no vaccine or effective antiviral treatment for severe EV71 infection. The immunogenicity of EV71 VP1 DNA vaccine and the immunoregulatory activity of interleukin-12 (IL-12) or granulocyte-monocyte colony stimulating factor (GM-CSF) were investigated. DNA vaccine plasmids, pcDNA-VP1, pcDNA-IL-12 and pcDNA-GM-CSF were constructed and inoculated into BALB/c mice with or without pcDNA-IL-12 or pcDNA-GM-CSF by intramuscular injection. Cellular and humoral immune responses were assessed by indirect ELISA, lymphocyte proliferation assays, cytokine release assay and FACS. The VP1 DNA vaccine had good immunogenicity and can induce specific humoral and cellular immunity in BALB/c mice, while IL-2 or GM-CSF plays an immunoadjuvant role and enhances specific immune responses. This study provides a frame of reference for the design of DNA vaccines against EV71.

Cardiomyocyte-specific TβR2 knockout mice are more susceptible to cardiac hypertrophy induced by adrenergic agonist stimulation

TGF-β signaling is shown to be involved in cardiac remodeling, but the detailed function and underlying mechanism are still incompletely understood. In this study, we generated cardiomyocyte-specific TGF-β type 2 receptor (TβR2) knockout mice to study the function of TGF-β signaling in cardiac hypertrophy. Although the mutant mice displayed no obvious physiological abnormality, they developed severer cardiac hypertrophy in response to isoproterenol (ISO) stimulation than control mice did. The expression of p-Smad2 was markedly reduced, while the concentration of p-ERK was increased in the hearts of mutant mice. In addition, we also found that cardiomyocyte-specific Smad2 knockout mice did not demonstrate cardiac phenotype as observed on TβR2 knockout mice, while inhibition of MEK-1-mediated activation of MAPK using PD98059 partially rescued the phenotype of TβR2-deleted cardiomyocytes, indicating that activation of TGF- noncanonical signaling might contribute to cardiac phenotype observed in TβR2 knockout mice. Thus, our data provided the first in vivo genetic evidence to show that TβR2 may function as an anti-hypertrophic factor of cardiac hypertrophy subjected to adrenergic stimulation, suggesting the complex role of TβR2 in cardiac hypertrophy under stimulation of different stresses.

Partial sialoadenectomy for the treatment of benign tumours in the submandibular gland

The conventional treatment for benign tumours arising in the submandibular gland (SMG) has always involved whole gland excision with the tumour. In light of developments in parotid gland functional surgery, this prospective study was performed to evaluate the effectiveness and safety of partial sialoadenectomy (PS) for benign tumours in comparison with conventional total sialoadenectomy (TS). Thirty-one consecutive patients with a preoperative diagnosis of benign tumour in the SMG were included in the study from December 2008 to December 2010. Eleven patients were treated with PS and 20 patients underwent conventional TS. Salivary gland function and surgery-related complications were assessed. No difference in resting saliva flow was found between the two groups before the operation, while this was significantly higher in the PS group than in the TS group at 1 year after surgery (P=0.009). With regard to complications, there was less deformity in facial appearance in the PS group. There was no recurrence in any of the 31 patients during the follow-up period (range 41-82 months). It is believed that this modification to SMG surgery is consistent with the idea of functional and minimal invasive salivary gland surgery. This technique represents a good choice for the management of benign tumours of the SMG for appropriately selected cases.

Ultrastructural and Cytochemical Properties of Peripheral Blood Cells of Piebald Naked Carp (Gymnocypris eckloni)

The ultrastructural and cytochemical properties of peripheral blood cells of Gymnocypris eckloni were investigated by transmission electron microscopy and a range of cytochemical techniques to provide clear insight into the structure and function of blood cells from this fish. Ultrastructurally, erythrocytes, leucocytes (neutrophils, eosinophils, lymphocytes, monocytes), thrombocytes and plasma cells were identified in the peripheral blood of G. eckloni. The most special ultrastructural characteristics of blood cells in this fish were that neutrophils exhibited only one type of cytoplasmic granules containing an eccentric, spherical or oval electron-dense core, and eosinophils presented two types of granules with non-uniform electronic density and without crystalloids in their cytoplasm. Neutrophils, eosinophils, lymphocytes, monocytes and thrombocytes were positive for periodic acid-Schiff and α-naphthyl acetate esterase staining. Intense peroxidase positive staining was observed in neutrophils and monocytes, but not in eosinophils, lymphocytes and thrombocytes. Neutrophils, eosinophils and monocytes were stained positively for acid phosphatase, whereas lymphocytes and thrombocytes did not stain. Leucocytes and thrombocytes were negative for alkaline phosphatase and Sudan black B staining. Erythrocytes were negative for all cytochemical staining. The cytochemical and ultrastructural features of peripheral blood cells of G. eckloni were similar to those of other fish species. However, some important differences were identified in G. eckloni.

The Fusarium toxin zearalenone and deoxynivalenol affect murine splenic antioxidant functions, interferon levels, and T-cell subsets

This study aimed to evaluate the effects of the Fusarium toxin zearalenone (ZEA) and deoxynivalenol (DON) on splenic antioxidant functions, IFN levels, and T-cell subsets in mice. Herein, 360 mice were assigned to nine groups for a 12-day study. Mice were administered an intraperitoneal injection for 4 consecutive days with different concentrations of ZEA alone, DON alone, or ZEA+DON. Spleen and blood samples were collected on days 0, 3, 5, 8, and 12. Mice in each of the experimental groups showed dysreglated splenic antioxidant functions, IFN levels, and T-cell subset frequencies, suggesting that the immune system had been affected. The ZEA+DON-treated groups, especially the group that received a higher concentration of ZEA+DON (Group D2Z2), showed more obvious effects on the dysregulation of splenic antioxidant functions, IFN levels, and T-cell subsets. This finding suggested that DON and ZEA exerted synergistic effects.

Idiopathic massive fetomaternal hemorrhage in the third trimester of pregnancy causing neonatal death

Fetomaternal hemorrhage (FMH), which can occur throughout pregnancy, is still a poorly understood clinical condition. It is very difficult to be timely diagnosed and often results in poor pregnancy outcomes. Here the authors reported two rare cases of silent massive FMH of unknown cause in the third trimester of pregnancy, which presented with non-reactive fetal heart rhythm or decreased fetal movement at the very beginning, and resulted in severe fetal anemia and neonatal deaths. A pregnant woman at late pregnancy with a com- plain of unspecific signs such as decreased fetal movement should arouse a high index of clinical suspicion of idiopathic FMH, and an urgent ultrasound or lab tests detecting FMH could be suggested. Considering emergent delivery versus expectantly management will de- pend upon acute or chronic FMH, gestational age, results of fetal testing, availability of experienced personnel, and procedural difficulty.

Interaction of elemental mercury with defective carbonaceous cluster

The interaction of elemental mercury with defective carbonaceous clusters is investigated by the density-functional theory calculation. The defective carbonaceous cluster is represented by seven-fused benzene ring and single atomic vacancy at the surface. Also, the non-defective carbonaceous surface is employed for comparison. The defective carbonaceous cluster with chlorine is carried out to evaluate the effect of the statured carbon at the neighboring sites of vacancy on mercury adsorption. The results indicate that vacancy can promote the activity of its neighboring sites, and the defective carbonaceous cluster has much larger mercury adsorption energy than the non-defective carbonaceous cluster with and without chlorine. Cl atom can improve the activity of its neighboring sites on the non-defective carbonaceous surface, but the effect of Cl atom on mercury adsorption of vacancy is very complex, which depends on the Cl concentration. High concentration of Cl decreases the mercury adsorption because Cl competes for the active sites with mercury. Hence, we find that vacancy can be regarded as a potential functional group to improve the mercury adsorption on carbonaceous surface, but the saturated carbon at the neighboring sites of vacancy can rapidly decrease the mercury capture capacity.

Molecular identification of Echinococcus granulosus on the Tibetan Plateau using mitochondrial DNA markers

Cystic echinococcosis (CE) is an important worldwide zoonotic disease that causes large economic losses and human suffering. Echinococcus granulosus, the causative agent of CE, exhibits different genotypes in different locations. In order to identify its genotypes and analyze its genetic structure on the Tibetan Plateau, we collected 72 hydatid cysts from different intermediate hosts and amplified and sequenced their mitochondrial cytochrome c oxidase subunit 2 (cox2) genes. Seventy isolates were identified as the E. granulosus G1 genotype, while two isolates belonged to the G6 genotype. There were 18 haplotypes among the 70 E. granulosus isolates, which exhibited a star-like network pattern and shared a common haplotype (H1). There was little difference between geographical sub-populations. Our results suggest that a recent E. granulosus population expansion occurred on the Tibetan Plateau, suggesting that E. granulosus was introduced into China. This study increases the basic molecular data needed for the molecular diagnosis, epidemiology, prevention, and control of Echinococcus diseases.

A dead-zone free ⁴He atomic magnetometer with intensity-modulated linearly polarized light and a liquid crystal polarization rotator

We demonstrate an all-optical (4)He atomic magnetometer experimental scheme based on an original Bell-Bloom configuration. A single intensity-modulated linearly polarized laser beam is used both for generating spin polarization within a single (4)He vapor and probing the spin precessing under a static magnetic field. The transmitted light signal from the vapor is then phase-sensitively detected at the modulation frequency and its harmonics, which lead to the atomic magnetic resonance signals. Based on this structure, a liquid crystal is added in our magnetometer system and constitutes a polarization rotator. By controlling the voltage applied on the liquid crystal, the light linear polarization vector can be kept perpendicular with the ambient magnetic field direction, which in turn provides the maximum resonance signal amplitude. Moreover, the system exhibits a magnetic-field noise floor of about 2pT/√Hz, which is not degraded due to the presence of the liquid crystal and varying magnetic field direction. The experiment results prove that our method can eliminate the dead-zone effect, improve the system spatial isotropy, and thus be suitable in mobile applications.

[Strategy Discussion for Pollution Control of Post-Consumer Home Medical Equipment]

Compared with the recycle of post-consumer medical equipments in medical institutions, the treatment of post-consumer home medical equipments (HME) should be consummated in the field of academic research, policy and regulatory plus corresponding supporting industries. The HME industry situation and its classification, main components and properties are reviewed in this paper. The merits and demerits of various pollution control techniques in the recycle of post-consumer medical equipments are analysed. For instance, the source control techniques to improve the property of raw materials, the end treatment technique to recycle the HME and regenerate energy are also discussed. Further, the development prospect of pollution control technique in the recycle of HME and the challenges must face up to are also probed.

MicroRNAs in avian influenza virus H9N2-infected and non-infected chicken embryo fibroblasts

There is limited information about microRNAs (miR-NAs) in H9N2 subtype influenza virus-infected chicken cells or tissues. In this study, 10,487,469 and 13,119,795 reads were obtained from in-fected and non-infected chicken embryo fibroblasts, respectively. Seven hundred and thirty-six and 1004 miRNAs, including mature miRNAs and precursors, were obtained from the infected and non-infected fibro-blasts, respectively. Of those miRNAs, 48 were expressed differently between the groups: 37 had a low expression level in the infected chick-en embryo fibroblast, and the remaining 11 had a higher expression level. Every miRNA was predicted to target immune response-related genes. It has been found that some of the miRNAs, such as gga-miR-146c, gga-miR-181a, gga-miR-181b, gga-miR-30b, gga-miR-30c, gga-miR-30e, and gga-miR-455, are expressed differently in other types of influenza-infected chicken cells or tissues.

Reirradiation of nasopharyngeal carcinoma focusing on volumetric modulated arcs with flattening filter-free beams

OBJECTIVE

The goal of this study was to assess the role of flattening filter-free (FFF) beams in volumetric modulated arc radiotherapy for patients with recurrent nasopharyngeal carcinoma (rNPC).

METHODS

13 patients with rNPC were replanned for FFF RapidArc(®) (RA-FFF) and conventional RapidArc (RA) (Varian Medical Systems, Palo Alto, CA). Quantitative evaluation was performed for the planning target volume (PTV) and organs at risk (OARs). Phantom dose verifications, treatment delivery time and monitor units (MUs) were also assessed.

RESULTS

Each technique delivered similar doses to the PTV. RA-FFF had a better sparing effect on the brain stem and normal tissue when compared with RA, whereas RA provided lower mean doses to the skin. No significant difference between the two techniques could be established for other OAR parameters. Both techniques showed equally good gamma scores in dosimetric verification. RA-FFF required more MUs than RA, whereas the delivery time for RA-FFF was slightly shorter than for RA.

CONCLUSION

Both treatment plans met the planning objectives. Dose measurements also showed good agreement with computed doses. In addition to slightly faster delivery times, RA-FFF produced better sparing of brain stem and normal tissue with uncompromised target coverage compared with RA.

ADVANCES IN KNOWLEDGE

FFF beams have recently been assembled for clinical use. Our findings show RA-FFF is useful in the salvage treatment of rNPC owing to better brain stem and normal tissue sparing with uncompromised target coverage compared with RA. This may be beneficial in the case of tumour invasion close to the brain stem.

Effects of sex and age on chicken TBC1D1 gene mRNA expression

The objective of this study was to investigate the effects of sex and slaughter age of chickens on fatty acid composition and TBC1D1 gene expression in 4 different tissues: breast muscle, thigh muscle, abdominal fat, and subcutaneous fat. Sixty Erlang mountainous chickens (hybrid SD02 x SD03) were raised under the same conditions and slaughtered at 8, 10, and 13 weeks of age. The results showed that the sex of the animal significantly affected the content of arachidic acid (C20:0), sinapic (C22:1), linoleic (C18:2n-6), eicosapentaenoic (C20:5n-3), and docosahexaenoic acids (C22:6n-3), whereas other fatty acid contents were not affected. Age had a significant effect on most monounsaturated fatty acids, except for octadecenoic acid (C18:1). TBC1D1 mRNA was abundant in all tissues at all 3 ages of slaughter. Cocks exhibited higher TBC1D1 mRNA levels than hens in the thigh muscle and abdominal fat at 10 and 13 weeks, respectively.

Detection of the long noncoding RNAs nuclear-enriched autosomal transcript 1 (NEAT1) and metastasis associated lung adenocarcinoma transcript 1 in the peripheral blood of HIV-1-infected patients

OBJECTIVES

Long noncoding RNAs (lncRNAs) in HIV-1 infection have not been extensively studied. Here we detected two lncRNAs, nuclear-enriched autosomal transcript 1 (NEAT1) and metastasis associated lung adenocarcinoma transcript 1 (MALAT1), in peripheral blood mononuclear cells (PBMCs) and plasma of HIV-1-infected patients.

METHODS

Fifty-nine HIV-1-infected patients and 21 healthy controls were recruited for the study, of whom 31 patients were highly active antiretroviral therapy (HAART)-naïve and 28 patients had been receiving HAART for more than 1 year with undetectable viral loads. Total RNA was extracted from PBMCs and plasma, and levels of NEAT1 and MALAT1 were determined by quantitative real-time polymerase chain reaction.

RESULTS

We found that the levels of NEAT1 and MALAT1 in PBMCs were up-regulated in HAART-naïve patients and were reduced in patients receiving HAART. NEAT1 was down-regulated in the plasma of infected patients and expression was correlated with CD4 T-cell count.

CONCLUSIONS

Our findings suggest that NEAT1 and MALAT1 may interact with HIV-1 in vivo and that the presence of NEAT1 in plasma is a potential biomarker of HIV-1 infection.

A point mutation of zebrafish c-cbl gene in the ring finger domain produces a phenotype mimicking human myeloproliferative disease

Controlled self-renewal and differentiation of hematopoietic stem/progenitor cells (HSPCs) are critical for vertebrate development and survival. These processes are tightly regulated by the transcription factors, signaling molecules and epigenetic factors. Impaired regulations of their function could result in hematological malignancies. Using a large-scale zebrafish N-ethyl-N-nitrosourea mutagenesis screening, we identified a line named LDD731, which presented significantly increased HSPCs in hematopoietic organs. Further analysis revealed that the cells of erythroid/myeloid lineages in definitive hematopoiesis were increased while the primitive hematopoiesis was not affected. The homozygous mutation was lethal with a median survival time around 14-15 days post fertilization. The causal mutation was located by positional cloning in the c-cbl gene, the human ortholog of which, c-CBL, is found frequently mutated in myeloproliferative neoplasms (MPN) or acute leukemia. Sequence analysis showed the mutation in LDD731 caused a histidine-to-tyrosine substitution of the amino acid codon 382 within the RING finger domain of c-Cbl. Moreover, the myeloproliferative phenotype in zebrafish seemed dependent on the Flt3 (fms-like tyrosine kinase 3) signaling, consistent with that observed in both mice and humans. Our study may shed new light on the pathogenesis of MPN and provide a useful in vivo vertebrate model of this syndrome for screening drugs.

Effect of arousing stimuli on circulating corticosterone and the circadian rhythms of luteinizing hormone (LH) surges and locomotor activity in estradiol-treated ovariectomized (ovx+EB) Syrian hamsters

In most proestrous hamsters, novel wheel exposure phase advances activity rhythms and blocks the preovulatory LH surge, which occurs 2h earlier the next day. Because wheel immobilization does not prevent these effects we hypothesized that arousal alone blocks and phase advances the LH surge. Ovariectomized (ovx) hamsters received a jugular vein cannula and estradiol benzoate (EB) or vehicle was injected sc. The next day (Day 1), at zeitgeber time (ZT) 4-5 (ZT 12 = lights off), after obtaining a blood sample, each hamster was exposed to constant darkness (DD), and either remained in her home cage or was transferred to a new cage and exposed to a running wheel or a 2-hour arousal paradigm. Blood samples were obtained in dim red light and activity was recorded hourly until ~ZT 10-11 on Days 1 and 2. For the next 1-2 weeks, activity was monitored in DD. Plasma LH and corticosterone were assessed by RIA. Novel wheel exposure or arousal at ZT 4 greatly attenuated the Day 1 LH surge in ovx+EB hamsters, and phase advanced the Day 2 LH surge by about 2h. In proestrous hamsters, novel wheel exposure led to a prolonged (>2h) increase in corticosterone levels only when LH surges were blocked. Phase advances in activity rhythms were enhanced by estradiol and arousal. The results suggest that estradiol modulates the effectiveness of non-photic stimuli. The role of the increased activity of the hypothalamic-pituitary-adrenal axis associated with novel wheel-induced attenuation of LH surges in ovx+EB hamsters remains to be determined.

Comparison of valsartan and benazepril when combined with atorvastatin in protecting patients with early cardio-renal syndrome (CRS)

OBJECTIVE

The aims to investigate the different protective effects of valsartan and benazepril when combined with atorvastatin in the cardio-renal functions of cardio-renal syndrome (CRS) patients.

PATIENTS AND METHODS

A total of 200 early CRS patients were enrolled in the present study, including 104 males and 96 females, with an average age of 62.2 ± 7.7 years. The same group of patients were set as the control group prior to treatment, and then randomly divided into two groups; the A group was treated with valsartan (80 mg/d) and atorvastatin (20 mg/d); the B group was treated with benazepril (10 mg/d) and atorvastatin (20 mg/d). The treatment period was 24 months.

RESULTS

The clinical efficacy and clinical events were observed and the following parameters of each patient were measured before and after treatment: 24h urine protein; creatinine clearance; serum brain natriuretic peptide (BNP); high sensitivity C-reactive protein (hsCRP); blood lipid level; liver function and ejection fraction (EF) value. Compared with the control group, the clinical symptoms of the treatment groups were improved with decreased blood lipid levels, significantly decreased serum BNP and hsCRP levels and significantly increased EF values and creatinine clearance rates (p < 0.01). The differences between the two treatment groups were not statistically significant. The number of patients that stopped treatment due to the development of a cough was significantly higher in the B group than the A group (p < 0.01).

CONCLUSIONS

When combined with atorvastatin, both valsartan and benazepril effectively improved the cardio-renal functions of early CRS patients. There was no significant difference between the two treatments however, valsartan appeared to be better tolerated by patients.

Reconstruction of maxillary defects with free fibula flap assisted by computer techniques

OBJECTIVE

Free fibula flaps are widely used for maxillary reconstruction. The three-dimensional position of the fibula flap is very difficult to control in conventional operations based solely on the surgeon's experience. We aimed to improve this surgery by using computerized techniques.

METHODS

Twenty-seven patients with maxillary tumors underwent maxillectomy and free fibula flap reconstruction in our department between 2011 and 2013. Virtual planning and surgical navigation were used for eight patients, and conventional surgery was performed in 19 patients. The three-dimensional fibular positions were evaluated in the two groups. Differences between the postoperative position of the fibular segments and the virtual plans were evaluated in the computer-assisted surgery group.

RESULTS

The three-dimensional position of the fibula flap in the computer-assisted surgery group, including the vertical distance (p = 0.013), horizontal position (p = 0.019) and extension of the posterior end (p = 0.041), was significantly more accurate and nearer to the ideal position than that in the conventional surgery group. The average difference between the actual postoperative position of the fibular segments and the virtual plan in the computer-assisted surgery group was <5 mm.

CONCLUSION

Application of computer-assisted techniques such as virtual planning and surgical navigation significantly improve the clinical outcomes of maxillary reconstruction with free fibula flaps.

Assessment of re-aggregated human pancreatic islets for secondary drug screening

BACKGROUND AND PURPOSE

Insulin secretion from isolated pancreatic islets is a pivotal assay in developing novel insulin secretagogues, given its good correlation with in vivo efficacy. Because the supply of human islets is limited, this assay is typically run with rodent islets, which do not address species differences and are low-throughput, because of the size matching or volume normalization required. Here we have evaluated the suitability of human re-aggregated islets for this assay.

EXPERIMENTAL APPROACH

We generated re-aggregated human islets of a consistent size, using micromolds and compared their responses with those of native human and rat islets, to known secretagogues and inhibitors of insulin release.

KEY RESULTS

Insulin secretion from rat islets, human islets and human re-aggregated cell clusters was concentration-dependently increased by glucose. The calcium channel agonist, Bay K 8644, stimulated insulin secretion in native rat islets and human re-aggregated islets, but not native human islets. Glibenclamide and tolbutamide were more effective and potent in re-aggregated human clusters compared with the other two preparations. Rat islets outperformed both human preparations of islets in response to caffeine, carbachol and glucagon-like peptide-1. Re-aggregated human islet clusters were more sensitive to somatostatin, diazoxide and sodium azide, but rodent islets were more sensitive to nifedipine.

CONCLUSIONS AND IMPLICATIONS

Human re-aggregated clusters of islet cells, of a constant size were more responsive to all compounds tested than native human islets. Importantly, the assay variability was less in the re-aggregated cluster preparations, which suggests that such re-aggregated cells could be useful for drug development.