[Curative effect of percutaneous microwave ablation therapy on hepatocellular carcinoma survival: a 15-year real-world study]

Objective: To evaluate the long-term efficacy of percutaneous microwave ablation (MWA) therapy for hepatocellular carcinoma. Methods: 2054 cases with Barcelona Clinic Liver Cancer (BCLC) stage 0~B at the Fifth Medical Center of the Chinese People's Liberation Army General Hospital from January 2006 to September 2020 were retrospectively collected. All patients were followed up for at least 2 years. The primary endpoint of overall survival and secondary endpoints (tumor-related survival, disease-free survival, and postoperative complications) of patients treated with ultrasound-guided percutaneous MWA were analyzed. Kaplan-Meier method was used for stratified survival rate analysis. Fine-and-Gray competing risk model was used to analyze overall survival. Results: A total of 5 503 HCC nodules [mean tumor diameter (2.6±1.6) cm] underwent 3 908 MWAs between January 2006 and September 2020, with a median follow-up time of 45.6 (24.0 -79.2) months.The technical effectiveness rate of 5 375 tumor nodules was 97.5%. The overall survival rates at 5, 10, and 15-years were 61.6%, 38.8%, and 27.0%, respectively. The tumor-specific survival rates were 67.1%, 47.2%, and 37.7%, respectively. The free tumor survival rates were 25.8%, 15.7%, and 9.9%, respectively. The incidence rate of severe complications was 2.8% (108/3 908). Further analysis showed that the technical effectiveness and survival rate over the passing three time periods from January 2006-2010, 2011-2015, and 2016-September 2020 were significantly increased, with P < 0.001, especially for liver cancer 3.1~5.0 cm (P < 0.001). Conclusion: Microwave ablation therapy is a safe and effective method for BCLC stage 0-B, with significantly enhanced technical efficacy and survival rate over time.

[Spatial distribution pattern of local tumor progression analysis after microwave ablation of hepatocellular carcinoma based on three-dimensional magnetic resonance imaging]

Objective: To investigate the spatial distribution pattern of local tumor progression (LTP) for hepatocellular carcinoma (HCC) ≤5 cm after microwave ablation. Methods: A retrospective analysis was performed on 169 HCCs with matched MRI before and after ablation from December 2009 to December 2019. A tumor MRI was reconstructed using three-dimensional visualization technology. LTP was classified as contact or non-contact, early or late stage, according to whether LTP was in contact with the edge of the ablation zone and the occurrence time (24 months). The tumor-surrounded area was divided into eight quadrants by using the eight-quadrant map method. An analysis was conducted on the spatial correlation between the quadrant where the ablative margin (AM) safety boundary was located and the quadrant where different types of LTP occurred. The t-test, or rank-sum test, was used for the measurement data. 2-test for count data was used to compare the difference between the two groups. Results: The AM quadrant had a distribution of 54.4% LTP, 64.2% early LTP stage, and 69.1% contact LTP, suggesting this quadrant was much more concentrated than the other quadrants (P < 0.001). Additionally, the AM quadrant had only 15.2% of non-contact type LTP and 17.1% of late LTP, which was not significantly different from the average distribution probability of 12.5% (100/8%) among the eight quadrants (P = 0.667, 0.743). 46.6% of early contact type LTP was located at the ablation needle tip, 25.2% at the body, and 28.1% at the caudal, while the location distribution probabilities of non-early contact LTP were 34.8%, 31.8%, and 33.3%, respectively. Conclusion: LTP mostly occurs in areas where the ablation safety boundary is the shortest. However, non-contact LTP and late LTP stages exhibit the feature of uniform distribution. Thus, this type of LPT may result from an inadequate non-ablation safety boundary.

[Correlation analysis between Pirani score and talo-navicular angle,calcaneo-cuboid angle and tibio-calcaneall angle of infant clubfoot under ultrasound]

Objective: To explore the evaluation effect of ultrasonography and Pirani score on tarsal deformity, treatment effect and pseudo-correction of congenital clubfoot in infants and young children, and the correlation between the two methods. Methods: This is a retrospective case series study. The clinical data of 26 children (40 feet) with congenital clubfoot who were evaluated by ultrasonography in the Third Affiliated Hospital of Zhengzhou University from January 2020 to January 2023 were retrospectively collected. There were 16 males and 10 females. The age at the first ultrasound examination was (M(IQR)) 9.0 (18.0) days (range: 1 to 46 days). All patients were treated with Ponseti method by the same physician. The Pirani scores before and after treatment and at the last examination, and the talonavicular angle, calcaneocuboid angle and tibiocalcaneal angle measured by ultrasound were collected, and the treatment and follow-up were recorded. Paired sample t test, repeated measures analysis of variance or Kruskal-Wallis test were used for data comparison, and Spearman correlation analysis was used for correlation analysis. The receiver operating characteristic curve was used to calculate the efficacy of ultrasound in evaluating different Pirani scores. Results: The number of plaster fixation in 26 children was 4.0 (1.0) times (range: 2 to 8 times). The medial talonavicular angle and posterior tibiocalcaneal angle were significantly improved after treatment and at the last follow-up compared with those before treatment, and the differences were statistically significant (all P<0.01). There was no difference in lateral calcaneocuboid angle before and after treatment and at the last follow-up (F=1.971, P>0.05). Pseudo-correction occurred in 2 cases (2 feet) during the treatment, with an incidence of 5%. Correlation analysis showed that there was a moderate positive correlation between talonavicular angle and Pirani midfoot score (r=0.480, P<0.01). There was no correlation between calcaneocuboid angle and Pirani midfoot score (r=0.114, P=0.105). There was a moderate negative correlation between tibial heel angle and Pirani hindfoot score (r=-0.566, P<0.01). The cut-off point of Pirani midfoot score of 1.5 was 38.78°, the sensitivity was 0.90, the specificity was 0.56, and the area under the curve was 0.75. The cut-off value of angle was 27.51 °, the sensitivity was 0.16, the specificity was 0.92, and the area under the curve was 0.44.The cut-off points of Pirani midfoot score of 3.0 were 45.08°and 9.96°, the sensitivity was 0.94 and 0.91, the specificity was 0.37 and 0.42, and the area under the curve was 0.59 and 0.62, respectively. The cut-off values of Pirani hindfoot score of 2.0 and 3.0 were 167.46° and 160.15°, respectively. The sensitivity was 0.75 and 0.67, the specificity was 0.81 and 0.83, and the area under the curve was 0.78 and 0.71, respectively. Conclusion: Ultrasound can complement with Pirani score, visually and dynamically observe the morphology and position changes of talonavicular joint, calcaneocuboid joint and tibiotalocalcaneal joint, monitor the recovery and pseudo-correction of tarsal bones, and better evaluate the therapeutic effect.

[Surgical treatment for obstructive hypertrophic cardiomyopathy: a five-year single-center experience of 421 cases]

Objectives: To examine the short-term and mid-term effects of surgical treatment of obstructive hypertrophic cardiomyopathy (HCM) in one center. Methods: The perioperative data and short-term follow-up outcomes of 421 patients with obstructive HCM who received surgical treatment at Department of Cardiac Surgery, Zhongshan Hospital, Fudan University from January 2017 to December 2021 were analyzed retrospectively. There were 207 males and 214 females, aged (56.5±11.7) years (range: 19 to 78 years). Preoperative New York Heart Association (NYHA) classification included 45 cases of class Ⅱ, 328 cases in class Ⅲ, and 48 cases in class Ⅳ. Fifty-eight patients were diagnosed with latent obstructive HCM and 257 patients had moderate or more mitral regurgitation with 56 patients suffering from intrinsic mitral valve diseases. All procedures were completed by a multidisciplinary team, including professional echocardiologists involving in preoperative planning for proper mitral valve management strategies and intraoperative monitoring. A total of 338 patients underwent septal myectomy alone, and 59 patients underwent mitral valve surgery along with myectomy. A single transaortic approach was used in 355 patients, and a right atrial-atrial septal/atrial sulcus approach was used in 51 other patients. Long-handled minimally invasive surgical instruments were used for the procedures. Student t test, Wilcoxon rank sum test, χ² test or Fisher exact test were used to compare the data before and after surgery. Results: The aortic cross-clamping time of septal myectomy alone was (34.3±8.5) minutes (range: 21 to 94 minutes). Eighteen patients had intraoperative adverse events and underwent immediate reoperation, including residual obstruction (10 patients), left ventricular free wall rupture (4 patients), ventricular septal perforation (3 patients), and aortic valve perforation (1 patient). Four patients died during hospitalization, and 11 patients developed complete atrioventricular block requiring permanent pacemaker implantation. After discharge, 384 (92.1%) patients received a follow-up visit with a median duration of 9 months. All follow-up patients survived with significantly improved NYHA classifications: 216 patients in class Ⅰ and 168 patients in class Ⅱ (χ²=662.73, P<0.01 as compared to baseline). At 6 months after surgery, follow-up echocardiography showed that the thickness of the ventricular septum ((13.6±2.5) mm vs. (18.2±3.0) mm, t=23.51, P<0.01) and the peak left ventricular outflow tract gradient ((12.0±6.3) mmHg vs. (93.4±19.8) mmHg, 1 mmHg=0.133 kPa, t=78.29, P<0.01) were both significantly lower than baseline values. Conclusion: The construction of the surgical team (including echocardiography experts), proper mitral valve management strategies, identification and management of sub-mitral-valve abnormalities, and application of long-handled minimally invasive surgical instruments are important for the successful implementation of septal myectomy with satisfactory short-and medium-term outcomes.

[Cluster classification and clinical prognostic modeling based on m6A RNA methylation regulators in liver cancer]

Objective: Cluster classification based on m6A methylation regulators and construct prognostic evaluation model. Methods: Utilizing consensus cluster to classify the liver cancer samples form TCGA based on the expression of 13 m6A methylation regulators, and verify the function and prognostic significance of the clustered subtypes. Marker genes were further screened to construct a risk prediction model for evaluating the prognosis of liver cancer patients. Results: The two clustered subtypes based on m6A methylation regulators showed significant differences in the prognosis value of liver cancer patients (P=0.048), and 38 prognostic markers related to m6A methylation in liver cancer were screened from the subgroup with poor prognosis. Two m6A regulatory genes, YTHDF1 and YTHDF2, are proved with adverse prognosis by univariate cox analysis (P<0.05, Hazard ratio>1). We used Lasso regression method to build risk assessment model and effectively predicted the prognosis status of liver cancer patients within 4 years (4-year AUC=0.685, 3-year AUC=0.669). Moreover, the assessment model was validated in another dataset of Asia liver cancer patients. Conclusion: The study provided ideas for studying m6A methylation in liver cancer, and the risk prediction model can be used to evaluate the short-term prognosis of liver cancer patients.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

[Application of oral fluid in SARS-CoV-2 nucleic acid and antibody detection]

This study aimed to explore the application value of new biological specimen oral fluid in SARS-CoV-2 nucleic acid and antibody detection. Oral fluid and paired respiratory and blood specimens from 7 confirmed cases of two COVID-19 cluster epidemic were collected in Beijing from October to November 2021. SARS-CoV-2 virus and IgG antibody were detected by real time PCR kits and serum antibody detection reagents, and SARS-CoV-2 IgG antibody in oral fluids was detected by a new established method of magnetic particle chemiluminescence. The results showed that the nucleic acid amplification test of SARS-CoV-2 on nasopharyngeal swabs, throat swabs and oral fluid specimens from 3 confirmed cases of COVID-19 was positive, among which the Ct value for ORF1a/b and N gene of oral fluid samples in 2 cases was close to that of throat swab, and the Ct value of oral fluid sample for 1 case was higher than that of throat swab. The complete genome sequence of one oral fluid specimen was obtained, which belonged to the VOC/Delta variant strain. The SARS-CoV-2 IgG antibodies of the paired oral fluid and serum were all positive, and the S/CO values of oral fluid were all lower than those of serum. The series of oral fluid results showed that SARS-CoV-2 IgG antibody level increased from 11 to 32 days after the onset of the disease.

[Investigation on high-frequency hearing loss of noise workers in an automobile factory]

Objective: To investigate the high-frequency hearing loss (HFHL) of workers in an automobile factory and its influencing factors, so as to provide a scientific basis for occupational health management of noise workers. Methods: From March to July 2019, 2647 workers from an automobile factory were selected as the research objects by cluster sampling method. The basic personal information (such as gender, age, education level, height, weight, etc.) , history of ear disease, the history of detonation, history of exposure to ototoxic drugs, history of exposure to occupational noise, etc., were investigated by questionnaire and occupational health examination. Chi-square test was used to compare the detection rates of HFHL in different populations, and multivariate logistic regression model was used to analyze the influencing factors of HFHL. Results: The noise level of 2647 individual workers ranged from 75.0 dB (A) to 92.0 dB (A) , with an average of (84.14±2.47) dB (A) . The detection rate of HFHL was 17.2% (456/2647) . There were significant differences in the the detection rate of HFHL among workers of different gender, age, educational level, working age, noise exposure level, diabetes history, detonation history, smoking and drinking workers (P<0.05) . Multivariate logistic regression analysis showed that male, age ≥30 years old, smoking and noise exposure were risk factors for HFHL (P<0.05) . Conclusion: The detection rate of HFHL in automobile factory workers is high. Gender, age, smoking and noise are the influencing factors of HFHL. It is necessary to strengthen the noise control in the workplace and guide workers to choose healthy lifestyle.

[Study on the mechanism of resistance to cypermethrin in Culex pipiens pallens using proteomics]

OBJECTIVE

To compare the differentially expressed proteins between cypermethrin-resistant and -sensitive Culex pipiens pallens, so as to unravel the mechanism underlying the resistance to cypermethrin in Cx. p. pallens.

METHODS

A quantitative proteomic analysis was performed among cypermethrin-sensitive and -resistant isolates of Cx. p. pallens using isobaric tags for relative and absolute quantification (iTRAQ) labeling coupled with liquid chromatography with tandem mass spectrometry (LC-MS/MS).

RESULTS

A total of 164 differentially expressed proteins were identified between cypermethrin-sensitive and -resistant isolates of Cx. p. pallens, including 54 up-regulated proteins and 110 down-regulated proteins. A large number of cuticular proteins, larval cuticular proteins, pupal cuticular proteins and cuticular structural constituent proteins, which are associated with cytoskeletal structure and components, were differentially expressed between cypermethrin-sensitive and -resistant isolates of Cx. p. pallens. Thirteen proteins, which were involved in energy production and conversion, translation, ribosomal structure and biogenesis, lipid transport and metabolism, post-translational modification, protein turnover, chaperones, cytoskeleton and intracellular transportation, were validated to be differentially expressed between cypermethrin-sensitive and -resistant isolates of Cx. p. pallens, which may serve as potential markers of cypermethrin resistance.

CONCLUSIONS

Multiple insecticide resistance mechanisms contribute to the resistance to cypermethrin in Cx. p. pallens, including cuticular resistance and metabolic resistance, and the cuticular protein genes and cytochrome P450 enzymes may play an important role in the resistance of Cx. p. pallens to cypermethrin.

Comparing the efficacy of endovascular treatment for iliac vein compression syndrome with or without acute deep venous thrombosis: A single-center retrospective study

BACKGROUND

To compare the efficacy of endovascular treatment for iliac vein compression syndrome (IVCS) with or without acute deep venous thrombosis of lower extremity.

METHODS

This study retrospectively analyzed the clinical data of 300 IVCS patients, who received endovascular treatment between January 2013 and December 2017. According to whether IVCS was complicated by deep venous thrombosis or not, these patients were divided into non-thrombotic iliac vein lesion group (NIVL group, n = 127) and post-thrombotic iliac vein lesion group (PIVL group, n = 173). After endovascular treatment, all patients were followed up to assess the symptoms improvement and to evaluate the patency of iliac vein.

RESULTS

The technical success rate was 98% (294/300), and percutaneous transluminal angioplasty with stenting was adopted in 294 cases. The incidence of perioperative complications was 36.33% (109/300), but no severe complications occurred. During a mean follow-up of 22.3 months (range 6-30 months), 9(6.82%, 9/132) patients in PIVL group had recurrence of deep venous thrombosis, but nobody had deep venous thrombosis and varicose veins recurrence in NIVL group. The effective rate of endovascular treatment in NIVL group and PIVL group was 96.88% and 90.15% (P = 0.050), while the cumulative primary patency of iliac vein in NIVL group was significantly higher than that in PIVL group (P = 0.008).

CONCLUSIONS

The endovascular treatment is an effective, feasible, safe method for treating IVCS. There is no difference in the efficacy of IVCS patients with or without deep venous thrombosis, but the medium and long-term patency of patients with deep venous thrombosis is lower than that in patients without deep venous thrombosis.

[Effects of maslinic acid on isoproterenol-induced myocardial fibrosis in mice]

Objective: To investigate the effect of maslinic acid (MA) on isoproterenol (ISO)-induced myocardial fibrosis in mice. Methods: ISO was used to induce myocardial fibrosis in adult male C57BL/6 mice, and MA was administered for two weeks to detect the effects of MA on cardiac function and fibrosis. Molecular changes of fibrosis markers and signaling pathways were detected by RT-PCR and western blotting. Phosphate buffer saline (PBS), PBS+SB203580 (p38 MAPK inhibitor), PBS+MA, ISO, ISO+SB203580, ISO+MA were added to the primary cultured rat fibroblasts. Cells were collected after 48 h for subsequent detection. Results: In this study, the mouse model of myocardial fibrosis was successfully established. The left ventricular faction shortening (FS) and maximum rate of rise and maximum rate of fall of pressure in left ventricular chamber (±dp/dt) of the ISO+MA group were significantly higher than those of the ISO group ((35.1±1.8)% vs (28.5±2.6)%, (7 256±153) mmHg/s vs (6 402±240) mmHg/s, (7 156±163) mmHg/s vs (6 319±219) mmHg/s, all P<0.05). The levels of interstitial and perivascular collagen deposition in the ISO+MA group were higher than those in the ISO group (P<0.05), the relative mRNA levels of COL-1, COL-3 and TGF-β in the ISO+MA group were significantly lower than those in the ISO group, with the relative expression levels of 1.70±0.24 vs 3.69±0.34, 1.72±0.56 vs 4.84±0.82, 1.52±0.19 vs 2.64±0.29, respectively (all P<0.05). The phosphorylation levels of p38 MAPK, Smad3 and protein expression level of TGF-β1 in ISO+MA group were lower than those in ISO group (relative expression levels were 1.67±0.35 vs 2.61±0.58, 1.68±0.23 vs 2.52±0.19,1.56±0.15 vs 2.48±0.26, respectively, all P<0.05). The results of in vitro cell experiments showed that the mRNA levels of COL-1, COL-3 and TGF-β in the SB203580 and MA groups were significantly lower than those in the ISO group (relative expression levels were 2.25±0.51, 2.16±0.48 vs 5.29±1.21; 1.58±0.34, 1.69±0.29 vs 4.97±1.32; 1.41±0.31, 1.55±0.38 vs 3.53±0.56, respectively, all P<0.05). The phosphorylation levels of p38 MAPK and Smad3 in the SB203580 MA groups was significantly lower than those in the ISO group, and the protein expression level of TGF-β1 was lower than that in the ISO group (1.81±0.18, 1.77±0.16 vs 2.56±0.32; 1.85±0.21, 1.81±0.17 vs 2.48±0.37; 1.84±0.24, 1.72±0.17 vs 2.52±0.29, all P<0.05). Conclusion: Maslinic acid can inhibit the phosphorylation of p38 MAPK, thereby preventing the canonical TGF-β1/Smads fibrosis signaling pathway to achieve an anti-fibrosis role.

[Clinical analysis of the double-wing flap for treatment of toe syndactyly]

Objective: To explore the clinical effect of double-wing flap for the treatment of toe syndactyly. Methods: Retrospective analysis of 47 patients (60 syndactyly toes) who underwent double-wing flap to reconstruct toe web space in orthopedics department of the Third Affiliated Hospital of Zhengzhou University from February 2010 to October 2017.There were 21 males and 26 females, with an average age of 18.9 months (range: 10-48 months). All patients were treated with zigzag incisions to separate the toe syndactylys without skin grafts.The condition of wound healing and appearance of toes were observed. Results: The average follow-up time was 62.3 months (range: 6 to 80 months). There were no complications such as hematoma, infection, flap necrosis and no flexion contracture and obvious scar hyperplasia in all the 47 cases, 4 of the 60 webs developed web creep.All webs had good appearance with 45 degrees inclination from the dorsal to the metatarsal side and had good flexion and abduction function. Conclusions: The double-wing flap is a simple and safe operation for toe syndactyly which has a good clinical effect.

[A cohort study on body mass index and risk of all-cause mortality among hypertensive population]

Objective: To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population. Methods: All participants were selected from a prospective cohort study based on a rural population from Henan province, China. Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality. Restricted cubic spline models were used to detect the dose-response relation. Results: Among the 5 461 hypertensive patients, a total of 31 048.38 person-years follow-up was conducted. The median of follow-up time was 6 years, and 589 deaths occurred during the follow-up period. Compared to normal weight group (18.5 kg/m(2)<BMI<24.0 kg/m(2)) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (<18.5 kg/m(2), 24-28 kg/m(2), and ≥28 kg/m(2)) were 0.83 (95%CI: 0.37-1.87), 0.81 (95%CI: 0.67-0.97), and 0.72 (95%CI: 0.56-0.91), respectively. The dose-response analysis showed a nonlinear, reverse "S" shaped relationship (non-linearity P<0.001). Conclusion: Overweight or obese might have a protective effect on all-cause mortality in hypertensive population, which supports the "obesity paradox" phenomenon.

[Extensive burns complicated with infective endocarditis and septic pulmonary embolism: case report and literature review]

Objective: To improve the clinical recognition of infective endocarditis (IE) and septic pulmonary embolism (SPE) in patients with extensive burns. Methods: A case of large area burn complicated with IE and SPE confirmed by blood cultures and echocardiography was described. A literature review was performed with "burn" and "infective endocarditis" as the Chinese key words in Wanfang database; with "burn" and "infective endocarditis" as Mesh terms in PubMed. Results: The patient was a 37-year-old male with large area burn, who presented with fever and hemoptysis. Blood cultures were positive for methicillin resistant Staphylococcus aureus (MRSA). Echocardiography disclosed vegetations located in the tricuspid valve. Multiple wedge-shaped lesions were found on chest CT. From January 1978 to December 2015, 26 related articles were retrieved and 134 burned patients complicated with endocarditis were reported, of which, 97 cases were IE and 1 case with SPE. Of the 134 cases, 120 cases were dead, 12 cases cured and 2 cases unknown. The mortality was 89.6%. Conclusions: There was a high mortality of burned patients complicated with IE. SPE should be considered for patients with multiple peripheral nodules in both lungs and a positive blood culture. Combination and prolonged anti-infective therapy may increase the treatment success and reduce the risk of recurrence.

Effect of TIMP1 transfection on PTEN expression in human kidney proximal tubular cells

To explore the role of metalloproteinase-1 (TIMP-1) tissue inhibitor in the mechanisms of kidney aging, we observed the effects of sense and antisense transfection of TIMP-1 and of metalloproteinase (MMP) inhibitors on phosphatase and tensin homolog (PTEN), vascular endothelial growth factor (VEGF), and Flk-1 expression in TIMP-1 transgenic human proximal tubular epithelial cells (HKCs). Transfected HKCs were co-incubated with 100 μM MMP-2 and MMP-9 inhibitor III for 24 h to affect enzyme inhibition. TIMP-1, MMP-2, MMP-9, PTEN, VEGF, and Flk-1 mRNA expression was detected by reverse transcription-polymerase chain reaction. PTEN, VEGF, and Flk-1 protein expression in cells of each experimental group was measured by indirect immunofluorescence. We found that PTEN expression was up-regulated (P < 0.05) in the sense TIMP-1-transfected group (P < 0.05) compared with the non-transfected and empty vector groups, and that expression of VEGF and Flk-1 was down-regulated (P < 0.05). In contrast, the antisense TIMP-1 transgenic group showed the opposite results (P < 0.05). No significant differences in expression of PTEN, VEGF, or Flk-1 were observed among the MMP- 2/MMP-9 inhibitor III, non-transfected, and empty vector groups (P > 0.05). These results suggest that in the progression of renal aging, high expression of TIMP-1 up-regulates PTEN expression through an MMP-independent pathway, and subsequently down-regulates the expression of VEGF and Flk-1, indicating that PTEN and TIMP-1 are involved in the aging-associated impairment of renal angiogenesis. Our study provides a theoretical basis for further exploration of the mechanism underlying TIMP- 1 participation in renal aging progression.

Sapphire-based graphene saturable absorber for long-time working femtosecond lasers

We report a long-time working femtosecond laser using metal-free sapphire-based graphene as a saturable absorber (SA). The sapphire-based graphene yielded excellent nonlinear saturable absorption properties and was demonstrated to be suitable as an SA for an ultrafast solid-state laser. Stable mode-locked pulses of 325 fs were obtained at a central wavelength of 1032 nm with a repetition rate of 66.3 MHz. At pump power of 8.23 W the average output power was 1.78 W and the highest pulse energy reached 26.8 nJ with a peak power of 72.6 kW. Our work opens up a facile route for making reliable graphene SA in the mode-locking technique and also displays an exciting prospect in making low-cost and ultrafast lasers.

Facile fabrication of graphene-topological insulator Bi2Se3 hybrid Dirac materials via chemical vapor deposition in Se-rich conditions

Direct deposition of a uniform and high-quality Bi₂Se₃ thin film on a graphene film (layer controlled) is performed using a catalyst-free vapor deposition system in a Se-rich environment.

DNA damage-induced centrosome amplification occurs via excessive formation of centriolar satellites

Centrosome amplification is a frequent phenomenon in malignancies and may facilitate tumorigenesis by promoting chromosomal instability. On the other hand, a centrosome inactivation checkpoint comprising centrosome amplification leading to elimination of cells by mitotic catastrophe has been described in response to DNA damage by ionizing radiation or cytostatic drugs. So far, the exact nature of DNA damage-induced centrosome amplification, which might be overduplication or fragmentation of existing centrosomes, has been controversial. To solve this controversy, we have established a method to distinguish between these two possibilities using A549 cells expressing photoconvertible CETN2-Dendra2. In response to various DNA-damaging treatments, centrosome amplification but not fragmentation was observed. Moreover, centrosome amplification was preceded by excessive formation of centrin-containing centriolar satellites, which were identified as de novo-generated atypical centrin dots staining positive for centriolar satellite markers but negative or only weakly positive for other established centrosomal markers, and which could be verified as centriolar satellites using immunogold electron microscopy. In line with this notion, disruption of dynein-mediated recruitment of centrosomal proteins via centriolar satellites suppressed centrosome amplification after DNA damage, and excessive formation of centriolar satellites could be inhibited by interference with Chk1, a known mediator of centrosome amplification in response to DNA damage. In conclusion, we provide a model in which a Chk1-mediated DNA damage checkpoint induces excessive formation of centriolar satellites constituting assembly platforms for centrosomal proteins, which subsequently leads to centrosome amplification.

Gpnmb/osteoactivin, an attractive target in cancer immunotherapy

Cancer is a complex disease with interactions between normal and neoplastic cells. Since current therapies for cancer largely rely on drugs or radiation that kill dividing cells or block cell division, these treatments may have severe side effects on normal proliferating cells in patients with cancer. Recently, immunotherapeutic approaches for cancer therapy, by which monoclonal antibodies (Mabs) target tumor specific antigens, have shown great potential. Glycoprotein non-metastatic melanoma protein B(Gpnmb)/Osteoactivin (OA) is a transmembrane glycoprotein highly expressed in various types of cancer. Gpnmb/OA promotes the migration, invasion and metastasis of tumor cells. CR 011-vcMMAE is a Mab-drug conjugate being developed for the treatment of Gpnmb/OA-expressing cancers. Gpnmb/OA represents an attractive target in cancer immunotherapy and CR011-vcMMAE holds promise as a reagent in targeted therapy for Gpnmb/OA-expressing malignancies.

Transfection of hairpin small interfering RNA expression vector targeting rat nuclear factor (NF) (κB) inhibits rat cell proliferation induced by NF-κB signal pathway activation

OBJECTIVE

The aim of this work was to construct one small interfering RNA (siRNA) eukaryotic expression vector targeting rat nuclear factor (NF)κB p65 and identify its inhibition effect on cell proliferation according to its down-regulation of NF-κB pathway.

METHODS

The p65siRNA expression vector "pGenesil-1.2-p65siRNA" and negative control plasmid "HK" were transfected into the cultured rat cells. After transfection, cells were divided into 4 treatment groups: 1) control cells cultured in complete. Dulbecco modified Eagle medium; 2) lipopolysaccharide (LPS) (1 μg/mL); (3) LPS (1 μg/mL) + HK-transfected; 4) LPS (1 μg/mL) + p65siRNA (pGenesil-1.2-p65siRNA). Thereafter, the protein levels of NF-κB p65 in the cells were detected by Western blotting at 72 hours after LPS stimulation. Furthermore, to observe cell proliferation, the proliferative rate of the cell growth was evaluated by the methylthiazolyl tetrazolium assay (at 24, 48, and 72 hours). The cell cycle distribution at 72 hours was detected by flow cytometry.

RESULTS

p65siRNA effectively down-regulated the protein level of p65 (P < .05). Meanwhile, the proliferation of cells transfected with p65siRNA expression vector was significantly inhibited (P < .05), the ratio of cells at G(0)/G(1) stage markedly increased, and the proportion of cells at S stage was significantly decreased among transfected compared with control cells (P < .05).

CONCLUSIONS

p65siRNA effectively suppressed NF-κB, expression, inhibiting rat cell proliferation induced by NF-κB signal pathway activation.

Comparison of quantitative 99mTc-HMPAO and 67Ga citrate lung scans in patients with active diffuse infiltrative lung disease

Diffuse infiltrative lung disease (ILD) is a heterogeneous group of disorders that predominantly affect the lung parenchyma and spare the airway. To objectively assess the degree of pulmonary vascular endothelium damage in active ILD, lung/liver uptake ratios (L/L ratios) on 99mTc hexamethylpropylene amine oxime (99mTc-HMPAO) lung scans were determined in 21 patients with active ILD. Meanwhile, the 67Ga citrate uptake index (GUI) on 67Ga lung scans was measured in order to evaluate the severity of lung inflammation in active ILD. The results show there were statistically significant differences between normal controls and patients with active ILD, as shown in the L/L ratio and GUI. However, when the patients were divided into two groups: (1) eight patients with normal chest X-ray findings, and (2) 13 patients with abnormal X-ray findings, there was no significant difference between groups 1 and 2 for the results of L/L ratio and GUI. In addition, no correlation between the degree of damage to the pulmonary vascular endothelium and the severity of lung inflammation was found. In conclusion, L/L ratios on 99mTc-HMPAO lung scans and GUI on 67Ga lung scans are different to the findings of chest X-rays and have the potential to objectively detect the degree of damage to the pulmonary vascular endothelium and the severity of lung inflammation in active IDL. However, the relationship between L/L ratio and GUI in active ILD is not significant.

Complete 1H and 13C assignments of 8-C-beta-D-[2-O-(E)-p-coumaroyl]glucopyranosyl-2-(2-hydroxy)propyl-7-methoxy-5-methylchromone

1H and 13C NMR spectra of 8-C-beta-D-[2-O-(E)-p-coumaroyl] glucopyranosyl-2-(2-hydroxy)propyl-7-methoxy-5-methylchromone were completely assigned by 2D NMR observations. Especially the 1H assignments of the glucosyl and hydroxyl protons were achieved by utilizing HMQC, HMBC, 1H-1H COSY and DEPT techniques together with a heavy water exchange 1H NMR experiment.

Mapping QTLs and candidate genes for rice root traits under different water-supply conditions and comparative analysis across three populations

To investigate the genetic factors underlying constitutive and adaptive morphological traits of roots under different water-supply conditions, a recombinant inbred line (RIL) population derived from a cross between the lowland rice variety IR1552 and the upland rice variety Azucena with 249 molecular markers, was used in cylindrical-pot experiments. Eighteen QTLs were detected for seminal root length (SRL), adventitious root number (ARN), and lateral root length (LRL) and lateral root number (LRN) on the seminal root at a soil depth of from 3 to 6 cm under flooding and upland conditions. One identical QTL was detected under both flooding and upland conditions. The relative parameters under the two water-supply conditions were also used for QTL analysis. Five QTLs for upland induced variations in the traits were detected with the positive alleles from Azucena. A comparative analysis was performed for the QTLs detected in this study and those reported from two other populations with Azucena as a parent. Several identical QTLs for root elongation were found across the three populations with positive alleles from Azucena. Candidate genes were screened from ESTs and cDNA-AFLP clones for comparative mapping with the detected QTLs. Two genes for cell expansion, OsEXP2 and endo-1,4-beta-D-glucanase EGase, and four cDNA-AFLP clones from root tissues of Azucena, were mapped on the intervals carrying the QTLs for SRL and LRL under upland conditions, respectively.

Using 99mTc HMPAO brain SPECT to evaluate the effects of anticoagulant therapy on regional cerebral blood flow in primary antiphospholipid antibody syndrome patients with brain involvement-a preliminary report

Technetium-99m hexamethylpropylene amine oxime ((99m)Tc HMPAO) brain single photon emission computed tomography (SPECT) was used to evaluate the effects of anticoagulant therapy (ACT) on regional cerebral blood flow (rCBF) in patients with primary antiphospholipid antibody syndrome (PAPS). Sixteen female PAPS patients with neuropsychiatric manifestations and hypoperfusion lesions demonstrated on initial (99m)Tc HMPAO brain SPECT images were enrolled in this study. Follow-up (99m)Tc HMPAO brain SPECT images were performed 1 month after ACT. Meanwhile, serum anticardiolipin antibodies (ACA) were measured before and after ACT. Before ACT, 14 (87.5%) patients had positive ACA. After ACT, all 16 PAPS patients showed decreased serologic findings, and their neuropsychiatric manifestations subsided. After ACT, 11 (68.8%) patients showed complete recovery of regional cerebral blood flow (rCBF) and five (31.2%) patients showed partial recovery in the follow-up (99m)Tc HMPAO brain SPECT images. This type of imaging is a logical and objective tool for measuring the effects of ACT in PAPS patients with brain involvement by determining changes in rCBF.

Usefulness of quantitative Tc-99m HMPAO and Ga-67 citrate lung scans in detecting pulmonary vascular endothelium damage and lung inflammation in patients with systemic lupus erythematosus: a preliminary report

Pulmonary vascular endothelium damage in 34 patients with systemic lupus erythematosus (SLE) was measured by technetium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) lung scan. The degree of damage was represented as lung/liver uptake (L/L) ratio. The patients were divided into two subgroups according to the following criteria: (a) clinical features, separated as stable or flare stage and (b) chest X-ray findings separated as positive or negative results. Meanwhile, quantitative gallium-67 citrate (Ga-67) lung scan was performed as Ga-67 uptake index (GUI) to evaluate the severity of inflammation in the SLE lungs. The results show (a) no significant statistical differences in the degree of pulmonary vascular endothelium damage (the L/L ratio on Tc-99m HMPAO lung scan) between the two subgroups according to clinical features or chest X-ray findings and (b) no good correlation between the degree of pulmonary vascular endothelium damage and lung inflammation (GUI on Ga-67 lung scan). In conclusion, the change in pulmonary vascular endothelium damage in SLE may be unrelated to the clinical presentation or chest X-ray findings, and its degree is not related to the severity of pulmonary inflammation.

Usefulness of Tc-99m ECD brain SPECT to evaluate the effects of methylprednisolone pulse therapy in lupus erythematosus with brain involvement: a preliminary report

Methylprednisolone pulse therapy (MPT) was introduced to avoid life-threatening complications in systemic lupus erythematosus (SLE) with brain manifestations. However, its efficacy in SLE patients remains uncertain and needs to be objectively evaluated. In this study, technetium-99m ethyl cysteinate dimer (Tc-99m ECD) brain single photon emission computed tomography (SPECT) was used to detect regional cerebral blood flow (rCBF) in SLE patients with normal brain magnetic resonance imaging (MRI) findings. Twelve female SLE patients with neuropsychiatric symptoms were enrolled in this study. All patients had normal brain MRI and abnormal Tc-99m ECD brain SPECT findings. The Tc-99m ECD brain SPECT studies were performed 2 weeks after MPT. Pre- and post-MPT serum levels of anticardiolipin antibodies (ACA) and antiribosomal P antibodies (anti-P) were also measured. Before MPT, four patients had positive ACA and seven had positive anti-P. After MPT, all 12 patients demonstrated negative serologic findings and no neuropsychiatric symptoms. After MPT, ten patients showed complete recovery and two showed partial recovery of rCBF in the follow-up Tc-99m ECD brain SPECT images. This imaging is a logical and objective tool for measuring the effects of MPT in SLE patients with brain involvement by the determination of rCBF changes.

Poor agreement between dipyridamole-stress technetium-99m-tetrofosmin myocardial perfusion single photon emission computed tomography and two-dimensional echocardiography in Kawasaki disease

To establish a noninvasive diagnostic method for early assessment of cardiac involvement in Kawasaki disease (KD), 28 children with KD were included in this study. Two-dimensional echocardiography (2D-Echo) to detect the aneurysms of coronary arteries (CA), as well as rest and dipyridamole-stress technetium-99m tetrofosmin (Tc-TF) myocardial perfusion single photon emission computed tomography (SPECT) to detect abnormal myocardial perfusion were performed in all of the 28 children with KD and to compare each other. The results showed that (1). 42.9% of cases had no aneurysm and 57.1% had significant aneurysms detected by 2D-Echo; (2). 42.9% of cases had normal perfusion and 57.1% of cases had abnormal myocardial perfusion assessed by Tc-TF myocardial perfusion SPECT; (3). 25.0% of cases showed both normal 2D-Echo and Tc-TF myocardial perfusion SPECT findings and 39.3% of cases showed both abnormal 2D-Echo and Tc-TF myocardial perfusion SPECT findings; and (4). there was poor agreement between 2D-Echo and Tc-TF myocardial perfusion SPECT findings (P>0.05). We concluded that poor agreement exists between aneurysms and abnormal myocardial perfusion detected by 2D-Echo and Tc-TF myocardial perfusion SPECT findings in patients with KD.

[Treatment of cervical carcinoma in mice by injecting monoclonal antibody of epidermal growth factor receptor into solid tumor]

OBJECTIVE

To observe the effect of treating cervical carcinoma in mice by injecting monoclonal antibody of epidermal growth factor receptor (EGFR-McAb) into solid tumor.

METHODS

Six hundred and fifteen strain mice bearing U14 cervical cancer cell were subcutaneously injected with EGFR-McAb in Group A and B. The mice in control Group A and B were injected with 0.9% sodium chloride instead of EGFR-McAb. The volume of the tumor in Group A as measured for 2 weeks consecutively. The survival time of the mice both in Group A and in control Group A were observed. The mice in Group B were killed in the 4th, 7th, 10th, 14th, 16th, and 17th days. Tissue section of the tumor as stained immunohistochemically for CD31. Active areas of angiogenesis chosen under microscope and average microvessels counted per field(40x) were taken as intratumor microvessel density(IMD).

RESULTS

(1) The mean survival time in Group A was 42.8 day while in control Group A it was 28.3 day. (2) The tumor growth inhibitory rate in Group A in the 4th, 7th, 10th, and 14th days was 13%, 42%, 83%, and 84%, respectively, and in the 7th, 10th and 14th days there was a significant difference(P < 0.05). (3) The Group B was 15.6 +/- 4.0, while in control Group B it was 31.1 +/- 14.6. The average IMD in the Group B was lower than that in the control Group B.

CONCLUSIONS

An effective treatment to cervical cancer in mice can be made with EGFR-McAb. It is suggested that EGFR-McAb may be a target for treating cervical cancer.

[Changes of renal blood flow and serum NO2-/NO3- in rabbits treated with mannitol at different dosages]

To observe the changes of renal blood flow and serum NO2-/NO3- in rabbits administrated with mannitol at different dosages, and investigate the mechanism of acute renal failure (ARF) induced by massive mannitol. Eighteen healthy male Zealand rabbits were randomly divided into 3 groups: minor mannitol group(n = 6, 8 g.kg-1 within 2 hours), control group (n = 6, saline of the same volume), massive mannitol group with free water taking(n = 6, mannitol 40-60 g.kg-1 with 3 days). The changes of renal function, renal blood flow and NO2-/NO3- in serum and urine were observed. The results showed that: no significant change in creatinine clearance (Ccr), renal blood flow (RBF) and serum NO2-/NO3- was found between minor mannitol group and control group. In massive mannitol group with free water taking, Ccr and RBF significantly decreased and serum NO2-/NO3- significantly increased (P > 0.05). The results suggest that ARF induced by massive mannitol is associated with a significant decline of RBF, on the other hand, endothelium-derived relaxing factor(EDRF) maybe compensatively increase.

[Protective effect of ginsenosides on human peritoneal mesothelial cell against lactate-based peritoneal dialysis solutions--induced injury in vitro]

OBJECTIVE

The aim of this research was to observe the influence of ginsenosides (GS) on viability and proliferation of human peritoneal mesothelial cell (HPMC) which were inhibited by L-PDS in vitro.

METHOD

Mesothelial cells were isolated from human omental specimens by trypsin disaggregation and established a stable HPMC culture model. The viability and capacity of proliferation of HPMC were assessed by lactate dehydrognase (LDH) release and tetrazolium salt colorimetry assay (MTT assay).

RESULTS

Compared with the control group, the release of LDH in L-PDS groups (2.5%, 4.25% glucose) significantly increased. But there was no difference between the two glucose concentrations. As HPMC pre-exposed to L-PDS prolonged, the viability of cells decreased gradually. GS decreased the release of LDH and increased the cells viability (P < 0.01), as well as enhanced the proliferation of HPMC.

CONCLUSION

The results suggest that GS has some protective effects on cell viability and proliferation of HPMC inhibited by L-PDS in vitro.

[Culture and characterization of human peritoneal mesothelial cells]

OBJECTIVE

To establish a reproducible model for culture of human peritoneal mesothelial cells (HPMCs), and observe the expressions of extracellular matrix (ECM) protein and interleukin-8 (IL-8) in HPMC.

METHODS

Mesothelial cells were isolated from human omenta by trypsin EDTA disaggregation. HPMCs were identified by morphology and streptomyces protein-peroxidase (SP) method. In the same way, expressions of fibronectin, collagen type III, V and transforming growth factor beta 1 (TGF beta 1) were measured. Expression of IL-8 mRNA and FN mRNA in the HPMCs was detected by reverse transcription (RT) and polymerase chain reaction (PCR) amplification.

RESULTS

Confluent HPMCs appeared multipolar under microscope; numerous surface microvilli and an abundant endoplasmic reticulum were observed. Cultured HPMCs coexpressed cytokeratin and vimentin, and synthesized fibronectin, TGF beta 1 and collagen types III (instead of type V). Expressions of IL-8 mRNA and FN mRNA were also observed in HPMCs.

CONCLUSION

Establishment of cultured HPMCs model will provide the basis of the research in preventment of peritoneal fibrosis and roles of IL-8 in peritoneal dialysis.

[Inositol 1,4,5-triphosphate receptors (IP(3)Rs) in myocardial nuclei involved in pressure overload-induced hypertrophy of rat heart]

In order to clarify the importance of nuclear IP(3)Rs in the development of myocardial hypertrophy, a hypertensive rat model was established by abdominal aortic constriction, and velocity and isopyknic gradient centrifugation was employed to fractionate the cardiac nuclei. The maximal number of binding sites (B(max)) and dissociation constant (Kd) of IP(3) to the nuclear envelopes were measured by [(3)H] IP(3) binding assay. The existence of IP(3)Rs on myocardial nuclear envelope was confirmed. [Ca(2+)] inhibited [(3)H] IP(3) binding to its receptors in cardiac nuclear envelopes in a concentration-dependent way. Phosphorylation by CaM and endogenous PKC decreased B(max) of nuclear IP(3) receptors. B(max) and Kd of nuclear IP(3)Rs were increased by 1.217 (P<0.01) and by 2.149-fold (P<0.01) respectively in hypertrophic myocardium as compared with those of the control. The above results suggest that IP(3)Rs exist in myocardial nuclei and are down regulated by CaM, PMA and free Ca(2+). The increase of the binding sites of IP(3)Rs in the nuclear envelopes and the decrease of their affinity might play importment roles in the development of overload induction of cardiac hypertrophy.

[Relationship between protein loss and dialysis duration results of PET and KT/Vurea in CAPD patients]

The study focused on the relationship between protein loss and dialysis duration, results of PET and KT/Vurea in two groups of CAPD patients. 16 patients of one group were included in CAPD for only 30 days while 19 patients of the other group were included in CAPD for more than one year. The results showed that value of protein loss had no obvious significance between both groups. Compared with the patients with value of PET D/Pcr < 0.65, the patients with value of PET D/Pcr > or = 0.65 had no significant protein loss. Between the patients whose index of urea clearance > or = 2.0, and those index of uera clearance < 2.0 the protein loss had no difference. It is suggested that, in routine dialysis duration peritoneal transport of small solutes and dialysis adequency. The conclusion shows furtherly that transportion of large protein and small solutes through different ways.

[Study of Chlamydia trachomatis infection on cervical secretion of women with early pregnancy and secondary sterility]

OBJECTIVE

This study was to investigate the Chlamydia trachomatis (CT) infection rate in cervical secretion of early pregnant and secondary sterility women.

METHODS

CT-DNA in the cervical secretion of the early pregnant, the secondary sterility, and the control women was detected with polymerase chain reaction (PCR).

RESULTS

The infection rates of CT in the early pregnant and secondary sterility women (14.28% and 13.33%) were higher than in the control women (3.33%, P < 0.05), and there was no significant difference between the former two groups (P > 0.05).

CONCLUSION

There are higher infection rates in the early pregnant and secondary sterility women. Detecting CT and treating in the perinatal period are needed in the early pregnant women who want to be pregnant again.

[Vacuole formation and endothelial damage in microvessels after ischemia reperfusion]

AIM

Damage of endothelial cells and adhesion of leukocytes and platelets were studied in rat mesentery microvessels after ischemia reperfusion.

METHODS

The model was made by losing blood and reperfusion from carotid artery in rat. Changes of mesentery microvessels were observed by high magnify microscope.

RESULTS

Leukocytes and platelets adhesions were found in venules and co capillaries 1-3 hours after ischemia reperfusion. Endothelial cells were edema and vascular walls were thickening. Vacuoles formed in intracytoplasm of some vascular endothelium and some bigger endothelial vacuoles prominence toward the luminal surface. Vacuoles liked circle shape and the diameter was 10-30 microm. More vacuoles were found in arterioles, even there were several vacuoles in a arteriole. The biggest vacuole almost occupied 2/3 of vascular lumen.

CONCLUSION

Edema and vacuole formation in vascular endothelium indicate that endothelial cells are injured seriously after ischemia reperfusion.

[Application of capillary chromatography in benzene boiling range analysis]

The experimental data were analyzed by regression analytical method and the relation between the quantity of impurities and the boiling range of benzene was demonstrated. It was proved that when the quantity of hydrocarbon impurities was within certain limits, the quality of benzene fractions can be determined by analyzing the hydrocarbon impurities in it. So the distillation method for analyzing benzene boiling range may be replaced by capillary chromatography for analyzing the hydrocarbon impurities. The practical applications support the above suggestion.

[Expression of bcl-2 in the normal endometrium and endometrium of adenomyosis]

Using immunohistochemical ABC staining, we detected the expression and role of bcl-2 in normal endometrium(n = 17) and eutopic and ectopic endometrium with adenomyosis(n = 16) during the menstrual cycle. The first result was that the expressions of bcl-2 in the eutopic endometrium were the same as the normal endometrium, showing predominantly in the glandular epithelial cells, and obviously cyclic changes throughout the menstrual cycle. This result suggests that these changes may be regulated by ovarian hormone and play an important role in the proliferation and physiologic death of normal endometrial glandular epithelial cells to regulate the menstrual cycle. Bcl-2 expression in the glandular cells of ectopic endometrium of adenomyosis had no cyclic change and bcl-2 staining had remained in the whole menstrual cycle. The second result suggests that the above mentioned phenomena may play an important role in the pathogenesis of adenomyosis.

Nephrotoxicity of high- and low-osmolar contrast media. The protective role of amlodipine in a rat model

PURPOSE

To evaluate the nephrotoxicity of high- and low-osmolar contrast media (HOCM, LOCM) on kidneys in Sprague-Dawley rats. The protective role of amlodipine was studied.

MATERIAL AND METHODS

Forty rats of both sexes were randomly divided into 5 groups (n=8/group) and glycerine for inducing renal failure was given to all rats except controls.

RESULTS

In diatrizoate-injected rats, blood urea nitrogen (BUN) and serum creatinine (SCr) were increased; levels of phospholipase A2 (PLA2), lipid peroxide (LPO) and calcium were also increased in renal tissues. There was no significant difference between LOCM (iohexol) animals and glycerol controls either in the renal levels of PLA2, LPO and calcium or in the levels of BUN and SCr. The histologic changes were milder in the LOCM animals than in the HOCM animals. In the group pretreated with amlodipine, no increase in the levels of BUN or SCr was discovered and the renal content of PLA2, LPO and calcium were significantly lower than in the HOCM group; the renal injuries induced by diatrizoate were alleviated.

CONCLUSION

The HOCM, diatrizoate, was more toxic to rat kidneys than the LOCM iohexol; PLA2, LPO and calcium load played a role in producing renal function impairment induced by diatrizoate meglumine; amlodipine protected the renal tissue from nephrotoxicity induced by diatrizoate.

[Effects of nitroprusside and vibration on peritoneal transport of solutes in continuous ambulatory peritoneal dialysis patients]

To explore the relationship between peritoneal transport of solutes and permeability of the peritoneum capillary as well as peritoneal stagnant fluid layer within dwell time, we observed the effects of nitroprusside and vibration on peritoneal transport of solutes in continuous ambulatory peritoneal dialysis(CAPD) patients. Twelve stable, routine CAPD patients were involved, who had no peritonitis for at least 4 weeks before the test. Standard peritoneal equilibrium tests(PETs) were performed, and mass transfer area coefficiency(MTAC) were calculated after adding nitroprusside to the dialysate or vibrating the patients's peritoneum. The concentrations of total protein, albumin and immunity globulin G in total drained dialysate were examined, and total drained volumes were recorded. Compared with the control, the MTACs value of BUN, Creatinine(Cr) increased significantly both in the nitroprusside group and vibration group(P < 0.05); the concentration of immunoglobin G in the total drained fluid was higher in the nitroprusside group than that in the control(P < 0.05); However, there was no significant difference in the total drained volume among the three groups. We conclude that nitroprusside and vibration can increase the peritoneal transport of small molecular solutes, and vibration has less influence on the loss of protein in CAPD. It suggests that moderated movement may improve the removal of the small molecules in CAPD patients.

[The effect of increasing ventral movement on the small solutes transport during peritoneal dialysis]

OBJECTIVE

To investigate whether the small solutes transport and the efficiency of peritoneal dialysis can be improved through ventral movement.

METHODS

Eighteen continuous ambulatory peritoneal dialysis (CAPD) patients and 6 male New Zealand rabbits peritoneal dialysis models were observed. Through self and pre-post control, we compared the concentration ratio of the solutes in effluent dialyste(D) to the solutes in plasma(P), mass transfer area coefficient and the drained volume.

RESULTS

The animal experiments showed that the D/P value for BUN was different prominently when comparing the vibration and non-vibration groups in 45 min and 60 min separately(P < 0.05). On the contrary, no obvious difference existed between the two groups when comparing the D/P values for protein and drained volume. The clinical study showed: D/P value for BUN at the 2 and 4 hr and D/P value for creatinine at the 2 hr increased obviously either in the low or high frequency group when compared with the control group(P < 0.01, P < 0.01, P < 0.05, respectively). D/P for protein and drained volume had no difference compared with the control group(P > 0.05).

CONCLUSION

The ventral movement and vibration could efficiently increase the transport of small solutes such as BUN and creatinine while had no influence on the transport of large molecular solutes such as protein and the ultrafiltration volume. It suggested that increasing the movement of CAPD patients can improve the efficiency of peritoneal dialysis.

[Effects on simvastatin in continuous ambulatory peritoneal dialysis patients with hyperlipidemia]

The therapeutic effects of simvastatin on hyperlipidemia and its protective effects on residual renal function (RRF) in continuous ambulatory peritoneal dialysis (CAPD) patients with hyperlipidemia were observed. Forty-seven CAPD patients were randomly divided into two groups, the treatment group and control group. The treatments of two groups were the same except that the treatment group patients were additionally given simvastatin 20 mg.d-1. The results were that, after 12-week treatment, the total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), and apoprotein B100 (ApoB100) in the treatment group significantly decreased, but high density lipoprotein (HDL) and apoprotein A1 (ApoA1) significantly increased compared with the control group (all P < 0.05); one year later, RRF of patients of both groups all decreased but there was no significant difference between them. The results suggest that simvastatin can effectively normalize lipidemia, but has no protective effect on RRF in CAPD patients.

["Bu-yang huanwu tang" inhibited the pathogentic process of atherosclerosis induced by cholesterol-rich diet in rabbits]

BACKGROUND AND OBJECTIVE

"Bu-yang huanwu tang", a decoction of Chinese herbs widely used in the treatment for cardio- and cerebro-vascular diseases, has been demonstrated to be able to inhibit platelet adhesion and aggregation, to lower blood lipids, to regulate vascular tone from animal experiments. The aim of this study is to determine whether this decoction inhibits the pathogentic process of atherosclerosis induced by cholesterol-rich diet in rabbits.

METHODS

Three groups of rabbits received the following different diets for 9 weeks: 1. standard diet; 2. atherogenic diet(standard diet plus 1% cholesterol and 3.3% fat); 3. atherogenic diet plus this decoction(5 g.kg-1.d-1). Plasma lipids, 6-keto-PGF1 alpha, endothelin levels were detected and the histological atherosclerotic changes were evaluated.

RESULTS

This decoction inhibited the progression of aortic and abdominal aortic intimal plaques and reduced aortic intimal thickening.

CONCLUSION

The anti-atherogenic mechanism might be related to the decrease of plasma cholesterol and triglycerides and the increase of PGI2. The facts suggest that "Bu-yang huanwu tang" has antiatherogenic and antithrombotic effects.

[Revision of the biological significance of the contact system]

Current concept of blood coagulation is divided into two stages: an "initiation" stage which is handled by tissue factor pathway, and an "augmentation" stage handled by intrinsic pathway beginning in factor XI. Recent studies have demonstrated that the contact system is a modulator for vascular biology with vascular tone regulation, anticoagulant, profibrinolytic, antiadhesive and proinflammatory functions. Changes of contact system are associated with sepsis, thrombosis, etc.

Assessment of renal function in the early stages of nephrotoxicity induced by iodinated contrast media

To determine whether there are early renal function parameters (RFP) which can be monitored to rapidly detect nephrotoxicity induced by contrast media (CM), we observed RFP in 16 patients with normal renal function before and after administration of CM. Forty-eight hours after diatrizoate meglumine administration, blood urea nitrogen (BUN) and serum creatinine (SCr) increased (p < 0.05). In all patients, acute tubular damage was revealed by early urinary RFP. Increases in levels of serum angiotensin-I-converting enzyme (ACE), beta(2)-microglobulin (beta(2)M) and urinary albumin (Alb) were associated with alterations in glomerular function. The changes in early RFP occurred earlier than those of BUN and SCr. The present study demonstrates that serum ACE, beta(2)M, urinary Alb, gamma-glutamyl-transpeptidase and N-acetyl-beta-D-glucosidase are sensitive parameters for the early assessment of subclinical nephrotoxicity induced by CM.

Assessment of urinary endothelin-1 and nitric oxide levels and their relationship with clinical and pathologic types in primary glomerulonephritis

To determine the relationship between the urinary endothelin (ET-1), nitric oxide (NO) levels and the clinical, pathologic types of primary glomerulonephritis (GN) patients, urinary levels of ET-1 and NO were detected in 27 patients with biopsy-proven primary GN and 12 normal controls by radioimmunoassay and by copper-plated and cadmium column reduction assay, respectively. The results showed that urinary ET-1 levels in the patients with primary GN were significantly higher than in normal controls (p < 0.01), while the urinary ET-1 levels in patients with moderate mesangial proliferation GN were significantly higher than those in patients with mild mesangial proliferation GN (p < 0.05). Urinary ET-1 levels in patients whose clinical feature was nephrotic syndrome were found to be higher than in patients whose clinical feature was nephritic syndrome. However, urinary NO levels were to the contrary (p < 0.05). The ratio of ET-1/NO in primary GN patients was significantly higher than that in normal controls, and it positively correlated with the 24-hour urinary excretion of protein. These results suggest that urinary ET-1 levels are related to the proliferation of mesangial cells. The imbalance between ET-1 and NO may be related to the pathogenesis of primary GN and the occurrence of proteinuria.

False-positive 2-[F-18]-fluoro-2-deoxy-D-glucose positron emission tomography studies for evaluation of focal pulmonary abnormalities

Positron emission tomography (PET) with 2-[F-18]-fluoro-2-deoxy-D-glucose (FDG) can demonstrate the glucose metabolism characteristics of a lesion, which may be helpful in differentiating between benign and malignant focal pulmonary lesions. Malignant cells demonstrate higher glucose metabolic activity than benign lesions. However, some inflammatory processes also show significant FDG uptake. We present two cases where high FDG uptake was found in inflammatory lesions in the lungs. The first case was that of a 38-year-old woman with chronic cough for more than 20 years. FDG PET revealed a hypermetabolic lesion with a lesion-to-background ratio of 8.0 at the posterior aspect of the right middle lung. She underwent thoracotomy and tumor resection, and was diagnosed with cryptococcosis. The second case was that of a 72-year-old woman who had pulmonary tuberculosis previously with cavitation in the left lower lobe. She suffered from fever, chills and severe hemoptysis for several days before this admission. FDG PET revealed a hypermetabolic ring at the periphery of the cavity. The lesion-to-background ratio was 7.8. Echo-guided biopsy showed no evidence of malignancy. She was treated with antibiotics and the symptoms subsided gradually. Lung abscess complicating a pre-existing cavity was diagnosed. These two cases substantiate that positive FDG PET results should be interpreted with caution in differentiating benign from malignant pulmonary abnormalities, especially in regions with a high prevalence of granulomatous lesions.

Effects of vitamin C on myocardial mitochondrial function and ATP content in hypoxic rats

AIM

To observe the effects of large dose of vitamin C (Vc) on myocardial mitochondrial function, ATP content, and myocardial structure in acute and chronic hypoxic rats.

METHODS

Rats were exposed to a simulated altitude 4000 m (barometric pressure = 43 kPa) for 3 and 30 d. Vc (0.75 g.kg-1.d-1) was injected i.p. The heart mitochondrial respiratory function were determined by Clark-type O2 electrode; mitochondrial membrane fluidity (MMF) were assayed through fluorescence polarizative method; the contents of ATP, ADP, and AMP in myocardial tissue were measured with HPLC.

RESULTS

After administration of Vc, the ATP content was increased from 35 +/- 3 mg.g-1 to 53 +/- 3 mg.g-1 in acute hypoxic rats (P < 0.01), from 42 +/- 4 mg.g-1 to 48 +/- 3 mg.g-1 in chronic hypoxic rats (P < 0.01); Pa, O2 was increased from 7.2 +/- 1.4 kPa to 9.5 +/- 1.2 kPa in acute hypoxic rats (P < 0.01); mitochondrial respiratory control rate (RCR) was increased from 2.1 +/- 0.6 to 4.7 +/- 0.5 in acute hypoxic rats (P < 0.01), and from 3.3 +/- 0.7 to 4.5 +/- 0.6 in chronic hypoxic rats (P < 0.01); MMF was increased in acute and chronic hypoxic rats (P < 0.05); the degree of myocardial necrosis in vitamin C preventive rats was attenuated as compared with those of acute hypoxic rats.

CONCLUSION

Vc is effective on improving myocardial energy metabolism and protecting against myocardial structural injury in hypoxic rats.