[Epidemiological study of bone and joint injury based on urban medical insurance database]

OBJECTIVE

To estimate the prevalence rate of bone and joint injury in China and to describe the three-dimension distribution of the disease (area, time and people).

METHODS

Based on a cross-sectional design, a retrospective study was conducted by using Chinese basic medical insurance database from January 1, 2013 to December 31, 2017 to analyze the epidemiological characteristics of bone and joint injury. The prevalence rate of bone and joint injury in each city was calculated, and then using meta-analyses to estimate the pooled prevalence of each area and the whole country. The pooled prevalence rates were compared among the different groups of populations, in terms of geographical area, time and population characteristics (age and gender).

RESULTS

A total of 28 419 264 subjects were included in this study, including 705 793 patients with bone and joint injury. From 2013 to 2017, in Chinese basic medical insurance database, the overall prevalence rate of bone and joint injury was 141.5(95%CI: 90.4－203.7) per 10 000 population, and the prevalence rates of non-specific or polyarticular disease, knee disease, and shoulder disease were 101.6 (95%CI: 63.5－148.4)per 10 000 population, 22.5(95%CI:15.1－31.4)per 10 000 population and 10.9 (95%CI: 6.4－16.4)per 10 000 population. The prevalence rates varied across the areas, the highest rate was observed in North China, with the prevalence of 310.6 (95%CI: 12.6－989.7) per 10 000 population, and the lowest rate was observed in Southwest China, with the prevalence of 59.0 (95%CI: 37.5－85.2) per 10 000 population. The prevalence rate of bone and joint injury increased over the study period, from 111.1 (95%CI: 56.0－182.5)per 10 000 population in 2013 to 175.5 (95%CI: 116.8－245.5)per 10 000 population in 2017. The prevalence of bone and joint injury in the female population was 149.1 (95%CI: 94.2－215.9) per 10 000 population, which was higher than that of men [133.6(95%CI: 86.2－190.9) per 10 000 population]. The higher prevalence of knee disease, unspecified or polyarticular disease, and bone and joint injury were observed in people aged 60 years and older, while the prevalence of shoulder disease peaked in 40－59 years old people [20.6 (95%CI: 12.5－30.5) per 10 000 population].

CONCLUSION

This study reported a relative low prevalence of bone and joint injury in China from 2013 to 2017. The prevalence increased over the study period, and the highest prevalence rate was observed in North China. The prevalence rate showed differences among different groups of populations, and higher rates were observed in females and people aged 60 years and older.

Enhanced thermal conductivity and tensile strength of Al-17Si-3.5Cu with SiC-nanoparticle addition

The morphology and size of primary Si has a significant influence on the thermal conductivity (TC) and strength of Al–17Si–3.5Cu. In this study, the effect of a 1–3 wt% SiC nanoparticle (SiC_nps) addition on TC and tensile strength of Al–17Si–3.5Cu was investigated. Nanoparticles distributed at the interface between primary Si and Al led to a significant refinement of primary Si; for example, a primary Si size of 2 μm with 3 wt% SiC_nps addition was achieved. TC of SiC_nps/Al–17Si–3.5Cu improved with an increase in nanoparticle content. Nanoparticles distributed at the interface between Si and Al reduced the interfacial thermal resistance. Thus, the effective TC of eutectic Si increased. Owing to the refinement of the primary Si and the increased interfacial thermal resistance, originating from the high content of SiC_nps at the interface, the effective TC of primary Si decreased. Compared with Al–17Si–3.5Cu, contribution to the improvement of the TC of SiC_nps/Al–17Si–3.5Cu resulted mainly from eutectic Si. Due to the refinement of primary Si, the tensile strength of SiC_nps/Al–17Si–3.5Cu improved with an increase in SiC_nps content. When the SiC_nps content was 3 wt%, the yield strength, ultimate tensile strength and elongation of SiC_nps/Al–17Si–3.5Cu were ∼176 MPa, 418 MPa and 7%, respectively, which were improved by 37.5%, 53.7% and 218%, respectively, when compared with Al–17Si–3.5Cu.

An interfacial nanocomposite layer was proposed to investigate the effect of SiC_nps on interfacial thermal resistance between Si and Al.

Expression of transforming growth factor-β1 in neonatal rats with hyperoxia-induced bronchopulmonary dysplasia and its relationship with lung development

The aim of this study was to detect the expression of transforming growth factor-ß1 (TGF-ß1) in neonatal rats with hyperoxia-induced bronchopulmonary dysplasia (BPD) and to explore its relationship with lung development. Forty-eight rats (2-3 days old) were randomly divided into a hyperoxia group and a control group (N = 24) which were then fed in ≥95% oxygen atmosphere and air, respectively. On the 1st, 3rd and 7th days of hyperoxia exposure, morphological changes of lung tissues were observed under an optical microscope. TGF-ß1 mRNA and protein levels in lung tissues were detected by real-time quantitative polymerase chain reaction and western blot, respectively. With increasing time of hyperoxia exposure, the hyperoxia group gradually suffered from pathological changes such as poor development of lung tissues, alveolar simplification, decrease in the number of alveoli, and hindered pulmonary microvascular development. On the 7th day of hyperoxia exposure, TGF-ß1 mRNA and protein levels (relative to b-actin) of the hyperoxia group (0.34 ± 0.19 and 0.21 ± 0.09, respectively) were significantly lower than those of the control group (0.83 ± 0.45 and 0.57 ± 0.45, respectively; P < 0.05). TGF-ß1 participates in the pathogenesis of BPD as an important regulatory factor during pulmonary vascular development.

Biomarkers of peritoneal fluid in endometriosis identified by surface-enhanced laser desorption/ionization time-of-flight

OBJECTIVES

This work aims to detect the peritoneal fluid proteomic patterns in endometriosis patients, build diagnostic models, and evaluate its clinical significance.

STUDY DESIGN

The authors used SELDI-TOF-MS protein chip array technology to detect biomarkers of peritoneal fluid in endometriosis patients. Fourteen endometriosis patients and 16 persons without endometriosis as control group were tested.

RESULTS

Four potential biomarkers (4428m/z, 6891m/z, 13766m/z, and 6427m/z) were found.

CONCLUSIONS

This method showed great potential in screening better biomarkers for endometriosis.

RNAi-mediated knockdown of FANCF suppresses cell proliferation, migration, invasion, and drug resistance potential of breast cancer cells

Fanconi anemia complementation group F protein (FANCF) is a key factor, which maintains the function of FA/BRCA, a DNA damage response pathway. However, the functional role of FANCF in breast cancer has not been elucidated. We performed a specific FANCF-shRNA knockdown of endogenous FANCF in vitro. Cell viability was measured with a CCK-8 assay. DNA damage was assessed with an alkaline comet assay. Apoptosis, cell cycle, and drug accumulation were measured by flow cytometry. The expression levels of protein were determined by Western blot using specific antibodies. Based on these results, we used cell migration and invasion assays to demonstrate a crucial role for FANCF in those processes. FANCF shRNA effectively inhibited expression of FANCF. We found that proliferation of FANCF knockdown breast cancer cells (MCF-7 and MDA-MB-435S) was significantly inhibited, with cell cycle arrest in the S phase, induction of apoptosis, and DNA fragmentation. Inhibition of FANCF also resulted in decreased cell migration and invasion. In addition, FANCF knockdown enhanced sensitivity to doxorubicin in breast cancer cells. These results suggest that FANCF may be a potential target for molecular, therapeutic intervention in breast cancer.

Discovery of altered protein profiles in epithelial ovarian carcinogenesis by SELDI mass spectrometry

OBJECTIVE

Identification of proteomic alterations in epithelial ovarian tumorigenesis may facilitate the understanding of progression of this disease.

METHODS

Specific protein peak patterns were identified in 20 microdissected epithelial ovarian tumors (13 epithelial ovarian cancers (EOCs) and 7 low malignant potential (LMP) tumors), as well as in the matched normal cells. Protein profiles were generated by surface-enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) from all the different types of cells.

RESULTS

Among seven protein peaks from EOC cells, six were significantly increased while one was decreased compared with normal cells, and three peaks from LMP cells were markedly increased while one was decreased compared with normal cells.

CONCLUSIONS

The combination of SELDI and laser capture microdissection (LCM) is effective in finding the key molecules in ovarian tumorigenesis. Further identification of these protein peaks is important and these malignant protein signatures lend themselves to identification of populations at high-risk for EOC and for monitoring response to EOC chemopreventive agents.

HLA-A, HLA-B, and HLA-DRB1 alleles and haplotypes in Naxi and Han populations in southwestern China (Yunnan province)

The frequencies of the human leukocyte antigen alleles HLA-A, HLA-B, and HLA-DRB1 and the A-B-DRB1, A-B, and B-DRB1 haplotypes were studied in Naxi and Yunnan Han populations using polymerase chain reaction (PCR)-sequence-specific amplification for alleles A and B and a PCR-microtiter plate hybridization method for the DRB1 allele. A total of 8 A, 19 B, and 30 DRB1 alleles were found in the Naxi population, and 15 A, 21 B, and 36 DRB1 alleles were found in Yunnan Han population. The common A-B-DRB1 haplotypes in the Naxi population were A*24-B*15-DRB1*1202, A*11-B*15-DRB1*0405, A*11-B*15-DRB1*1202, A*11-B*38-DRB1*08032, and A*11-B*55-DRB1*0405; the common A-B haplotypes were A*11-B*15, A*11-B*38, and A*24-B*15; and the common B-DRB1 haplotypes were B*15-DRB1*1202, B*38-DRB1*08032, and B*48-DRB1*1201. In the Yunnan Han population, the common A-B-DRB1 haplotypes were A*24-B*15-DRB1*1501, A*24-B*46-DRB1*08032, and A*24-B*15-DRB1*1201; the common A-B haplotypes were A*24-B*15, A*24-B*46, and A*34-B*46; and the common B-DRB1 haplotypes were B*15-DRB1*1501, B*46-DRB1*09012, and B*46-DRB1*1401. Phylogenetic tree and principal component analyzes based on HLA-A, HLA-B, and DRB1 allele frequencies suggested that the Naxi ethnic group belongs to the southern Chinese groups, while the Yunnan Han population is a characteristic population located intermediate between northern and southern Chinese groups, although they live in the southwest of China.

[Distribution of MICA microsatellite in 13 population groups of China]

The genetic data of MICA microsatellite were obtained by genotyping 577 samples in 13 population groups of China, which are Han-YN, Han-GD, Han-SD, Bai, Dai, Lahu, Li, Naxi, Sala, She, Tu, Wa and Zang-YN, with genescan. Five alleles have been observed in the population groups, which are A4, A5, A5.1, A6 and A9. A5 allele is the most frequent in all population groups except Lahu and Li, while the most frequent allele for Lahu and Li is A5. 1 and A4 respectively. The second most frequent allele is the A5.1 in Han-YN, Han-SD, Dai, Naxi, Sala, She, and Wa. The lest frequent allele for Han-YN, Han-GD, Lahu, Naxi, She, Wa is the A6 which is not observed in Li. A4 allele is the lest frequent in Han-SD, Bai, Dai, Sala, Tu, Zang-YN. The results show that the distribution of MICA microsatellite is different in these population groups, and the polymorphism information contents (PIC) of this microsatellite is high. It is a potential useful marker in the study of human origin and migration, personal identification, gene mapping and location, and disease diagnosis.

[Genetic relationships among six Chinese populations revealed by analysis of 30 autosomal STRs]

30 autosomal STRs of 6 Chinese populations (Bai, Naxi, Tu, Sala, Han in Shandong, She) were amplified by multiplex PCRs using fluerescein-labelled primers. Shriver's Dsw was estimated on the basis of the results of the genescanning and genotyping after running unnatural PAGE of the PCRs' products on ABI 377 sequencer. Phylogenetic trees were constructed by using Neighbor-Joining and UPGMA method based on Dsw, and then the genetic relationships among them were analyzed referring to some relative informations. Our results indicated that the genetic distance between Sala and Tu is near, 0.033. But the distances between Sala and other four populations are far, over 0.12; Tu is close to Naxi and Shandong Han, and the distances are 0.038, 0.063 respectively; The distance between Bai and Han is the nearest, 0.007, but there is a distance, 0.075, between Bai and Naxi, and a far distance, 0.112, between Bai and Tu; The distance between Naxi and Han is 0.100 and the distances between She and other 5 populations are all over 0.12. In both of the NJ and UPGMA phylogenetic trees, Naxi, Tu and Sala is one cluster and Bai and Han is another cluster. She is a single branch. These results, basically consistent with 6 Chinese populations' geographic distribution and histories, can provide some genetic information to comprehensively study their origin, migration, formation and development with their historical records and archaeological evidence.

Effects of hydromorphone or oxymorphone, with or without acepromazine, on preanesthetic sedation, physiologic values, and histamine release in dogs

OBJECTIVE

To compare hydromorphone with oxymorphone, with or without acepromazine, for preanesthetic sedation in dogs and assess changes in plasma concentration of histamine after drug administration.

DESIGN

Randomized clinical study.

ANIMALS

10 healthy mixed-breed dogs.

PROCEDURE

Dogs were treated IM with hydromorphone (group H), oxymorphone (group O), hydromorphone with acepromazine (group H/A), or oxymorphone with acepromazine (group O/A). Sedation score, heart rate, respiratory rate, systolic blood pressure, and oxygen saturation were recorded at baseline immediately after drug administration (T0) and every 5 minutes for 25 minutes (T25). Plasma histamine concentration was measured at baseline and T25.

RESULTS

Sedation was similar between groups H and 0 at all times. Sedation was significantly greater for groups H/A and O/A from T10 to T25, compared with other groups. Systolic blood pressure was significantly reduced at T25 in group H/A, compared with group H, and in group O/A, compared with group O. Prevalence of panting at T25 was 50% for groups H and O, compared with 20% for group H/A and 30% for group O/A. By T25, heart rate was significantly lower in all groups. Oxygen saturation was unaffected by treatment. Mean +/- SD plasma histamine concentration was 1.72 +/- 2.69 ng/ml at baseline and 1.13 +/- 1.18 ng/ml at T25. There was no significant change in plasma histamine concentration in any group.

CONCLUSIONS AND CLINICAL RELEVANCE

Hydromorphone is comparable to oxymorphone for preanesthetic sedation in dogs. Sedation is enhanced by acepromazine. Neither hydromorphone nor oxymorphone caused an increase in plasma histamine concentration.

Strategies for amplification by polymerase chain reaction of the complete sequence of the gene encoding nuclear large subunit ribosomal RNA in corals

The nearly complete nuclear large subunit ribosomal RNA (LSU rRNA) gene in corals was amplified by primers designed from polymerase chain reaction (PCR) strategies. The motif of the putative 3'-terminus of the LSU rRNA gene was sequenced and identified from intergenic spacer (IGS) clones obtained by PCR using universal primers designed for corals. The 3'-end primer was constructed in tandem with the universal 5'-end primer for the LSU rRNA gene. PCR fragments of 3500 bp were amplified for octocorals and non- Acropora scleractinian corals. More than 80% of the Acropora LSU rRNA gene (3000 bp) was successfully amplified by modification of the 5'-end of the IGS primer. Analysis of the 5'-end of LSU rDNA sequences, including the D1 and D2 divergent domains, indicates that the evolutionary rate of the LSU rDNA differs among these taxonomic groups of corals. The genus Acropora showed the highest divergence pattern in the LSU rRNA gene, and the presence of a long branch of the Acropora clade from the other scleractinian corals in the phylogenetic tree indicates that the evolutionary rate of Acropora LSU rDNA might have accelerated after divergence from the common ancestor of scleractinian corals.

Clinical significance of early diastolic notch depth: uterine artery Doppler velocimetry in the third trimester

OBJECTIVE

Our purpose was to evaluate the usefulness of early diastolic notch depth in predicting adverse perinatal outcome.

STUDY DESIGN

Uterine artery Doppler velocimetry is widely applied in predicting pregnancy outcomes. Recent studies of uterine artery early diastolic notch have demonstrated its usefulness as a marker for fetal well-being. The early diastolic notch represents the reflected blood flow of uteroplacental circulation. This study was carried out under the hypothesis that when early diastolic notch is present evaluating its depth plays a significant role in predicting poor pregnancy outcomes. Its ability to predict adverse perinatal outcomes was evaluated in 198 pregnant women with early diastolic notch after 28 weeks' gestation.

RESULTS

The incidence of adverse perinatal outcome (5-minute Apgar score <7, cesarean delivery because of fetal distress, admission to neonatal intensive care unit, fetal growth restriction, or perinatal death) was 90.5% when the notch index was </=0.70. When the notch index range was 0.70 to 0.79, 0.80 to 0.89, and >/=0.90, the respective incidences were 72.3%, 46. 9%, and 28.1%.

CONCLUSION

This study suggests that evaluating notch depth in the presence of early diastolic notch on uterine artery velocimetry during the third trimester would be a useful method for predicting adverse perinatal outcomes.

Universal Primers for Amplification of Mitochondrial Small Subunit Ribosomal RNA-Encoding Gene in Scleractinian Corals

We describe the construction of polymerase chain reaction primers designed to amplify a portion of the mitochondrial (mt) small subunit ribosomal (SSU) RNA-encoding genes in scleractinian corals. Combinations of cloning and sequencing show that the amplified fragments are between 694 and 896 bp in length. Alignment of the amplified DNA sequences to the published mt SSU rRNA genes of Metridium senile and Sarcophyton glaucum indicates several conserved regions among actiniarian, corallimorpharian, octocorallian, and scleractinians, suggesting this primer set can successfully amplify over 80% of the mt SSU rDNA region of scleractinian corals. Surveys of sequence variation and estimation of the rate of evolution show an extremely slow divergence of the SSU rRNA gene in the family Acroporidae.

Percutaneous A1 pulley release for trigger digits

BACKGROUND

Recently, percutaneous trigger digit release has been reported as a safe, effective office procedure. The purpose of this study was to further assess the safety and efficacy of this technique.

METHODS

From November, 1996, to August, 1997, 69 consecutive patients with 71 primary trigger digits were treated with percutaneous A1 pulley release. The operations were performed using the tip of a 19-gauge needle, mounted on a 3-ml syringe. The mean age of the patients was 66 years. The mean duration of follow-up was 21 weeks. The patients were prospectively classified into two groups according to age, sex, digit involved, duration of symptoms and whether or not they had had previous local steroid injection.

RESULTS

Sixty-three digits were completely free of triggering. Residual triggering or inadequate release was found in eight digits at final follow-up. The success rate was not associated with sex, age, digit involved, duration of symptoms or history of local steroid injection. No major complications were found in this study, but minor complications included persistent local tenderness in nine digits and subcutaneous hematoma in six digits. Risk factors related to persistent local tenderness were female gender and trigger thumb.

CONCLUSIONS

Percutaneous A1 pulley release is an effective, safe and convenient procedure for the treatment of trigger digits.

Intrahepatic cholangiocarcinoma masquerading as the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) in pregnancy: case report

A young woman was seen at 26 weeks' gestation with a clinical profile consistent with the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count). The patient underwent cesarean delivery and was found to have a massive tumor involving the liver. After correction of the coagulopathy, a liver biopsy specimen demonstrated an intrahepatic cholangiocarcinoma. The patient died 3 weeks after diagnosis.

Vascularized iliac bone graft for treating avascular necrosis of the femoral head

BACKGROUND

Nontraumatic avascular necrosis of the femoral head (ANFH) is a common disorder causing disability of the hip joint. The means for optimally treating this disease are still controversial. In this study we evaluated the relatively new technique of vascularized iliac bone grafting for treating ANFH.

METHODS

From March 1990 to March 1992, 17 hips (15 patients) with ANFH were treated using the vascularized iliac bone grafting technique in our hospital. The patients included 12 men and three women, with an average age of 38 years. Steinberg's classification was used to categorize the severity of hip disease. The clinical results were classified as excellent, good, fair and poor according to symptoms, hip function and roentgenographic changes after surgery. Life-table analysis was applied to assess graft survival and the log rank test was used to compare statistical differences between the steroid-related and nonsteroid-related groups.

RESULTS

Cumulatively, 16 hips (14 patients), excluding one patient (one hip) lost to follow-up, were clinically evaluated for an average of 68 months. Among 12 hips at Steinberg stage II, eight progressed to stage IV, three to stage III and only one remained at stage II. Although most hips at stage II showed mild to moderate disease progression on plain radiography, 58% of the hips (7/12) that progressed to less than IVb showed good to excellent results. In the three hips at stage III, one progressed to stage IVa and two to stage V. In the two hips at stage IV, one remained at stage IV at final follow-up and the other was lost to follow-up. The steroid-related and nonsteroid-related groups did not differ with respect to clinical results. Both groups had 63% (5/8) good to excellent results (p > 0.05, log rank test). Only four hips were converted to prosthetic arthroplasties at final follow-up. Overall, 63% (10/16) of the hips had good to excellent results, 12% had fair results and 25% had poor results. Graft survival after seven years of follow-up was 63%.

CONCLUSIONS

While treatment of ANFH still poses a challenge to orthopedic surgeons, the vascularized iliac bone grafting technique is a clinically acceptable option for treating the early stages of ANFH.

[The relationship between experimental changes in the stress-strain distribution and the tissues structural abnormalities of the cervical column]

Using 45 rabbits, the authors made a research on the relationship between the experimental change of the stress-strain distribution and the tissues structural abnormalities of the cervical column. After having changed the stress and strain distribution on the rabbits' cervical vertebrae by letting them bow their heads, we measured the strain distribution in Vivo with resistant strain gauges, inspected the pathological changes of the cervical vertebrae, the nuchal ligaments, the capsular ligaments, the neck muscles and the attachments of the capsular ligament to bones, by ligh microscope and electron microscope. We found that the greater the level of the strain and the longer time the strain was loaded, the more evident the morphological abnormalities of the cervical vertebrae. The increase of the stress and strain could also cause degeneration of the nuchal ligaments, capsular ligaments and neck muscles. We believe that the abnormalities of the of the soft tissues around the cervical vertebral bones play an important part in the development of the cervical spondylosis. We think that the morphological changes of the cervical column is the basis of the biomechanical pathogenesis of the cervical spondylosis.

Lack of site specific recombination of exogenous DNA in mouse L cells

Plasmids were constructed containing the HSV thymidine kinase gene and two copies of X. borealis 5S rDNA. Mouse L TK- cells were transformed with these DNAs, with selection for the TK+ gene. Transformed cells were then analyzed by Southern blot hybridization and hybridization in situ to determine whether integration of the exogenous DNA occurred at regions of chromosomal homology i.e., at the 5S rDNA regions. Four cell lines were analyzed by Southern blots. Differences in restriction endonuclease specificity strongly suggested that integration was at a different site in each cell line. Two cell lines were further analyzed by hybridization in situ; each showed a single integration site, both different from each other and different from the mouse L cell 5S rDNA sites. Therefore, the presence of two copies of the 5S rDNA gene in the DNA introduced by gene transfer and approximately 300-350 copies of the mouse 5S rDNA gene was not sufficient in these experiments to produce homologous integration into a specific site.

Differential activation of the mouse beta-globin promoter by enhancers

A series of plasmids was constructed to study the effect of two enhancers, the simian virus 40 72-base-pair repeat and the Harvey sarcoma virus 73-base-pair repeat, on the mouse beta maj-globin promoter. These plasmids contain the mouse beta maj-globin promoter linked to the Escherichia coli galK gene, thus allowing galactokinase enzyme activity to be used as a measure of promoter function. In CV-1 (primate) cells, it was found that an enhancer is required for optimal promoter activity and that the simian virus 40 (primate) enhancer increases galactokinase fourfold more than the Harvey sarcoma virus (mouse) enhancer. In L (mouse) cells, however, the Harvey sarcoma virus enhancer is 1.3-fold stronger than the simian virus 40 enhancer. These data support the hypothesis that enhancer activity can be species specific. Furthermore, when both enhancers are present on the same plasmid, their effect is additive on the beta-globin promoter whether the plasmid is in CV-1 cells or L cells.