A multivariate model based on gadoxetic acid-enhanced MRI using Li-RADS v2018 and other imaging features for preoperative prediction of dual‑phenotype hepatocellular carcinoma

OBJECTIVE

To investigate the diagnostic value of liver imaging reporting and data system (LI-RADS) v2018 and other imaging features in dual-phenotype hepatocellular carcinoma (DPHCC), establish a prediagnostic model based on gadoxetic acid-enhanced MRI, and explore the prognostic significance after surgery of the DPHCC.

MATERIALS AND METHODS

Preoperative enhanced MRI findings and the clinical and pathological data of patients with surgically confirmed HCC were analysed retrospectively. Image analysis was based on LI-RADS v2018 and other image features. Univariate analysis was used to screen for predictive factors of DPHCC, and multivariate logistic regression analysis was used to determine the predictive factors. A regression diagnostic model was established. Receiver operating characteristic (ROC) curve analysis was used to determine the critical value, area under curve (AUC), and the corresponding 95% confidence interval (95% CI). The diagnostic performance was verified by fivefold cross-validation. Cox regression analysis was used to determine the prognostic factors associated with early recurrence after surgical resection.

RESULTS

In total, 158 patients were included, of whom 79 had DPHCC and 79 had non-DPHCC. Multivariate analysis showed that rim arterial phase hyperenhancement (Rim APHE) and targetoid restriction were independent risk factors for DPHCC (P < 0.05). The AUC (95% CI) of the model was 0.862 (0.807-0.918), sensitivity was 81.01%, and specificity was 89.874%. Cox regression analysis showed that DPHCC, microvascular invasion, tumour diameter, and an increase of alpha-fetoprotein were independent factors for recurrence.

CONCLUSION

Rim APHE and targetoid restriction were sensitive imaging features of DPHCC before surgery, and the identification of DPHCC has important prognostic significance for early recurrence.

Using pre-operative radiomics to predict microvascular invasion of hepatocellular carcinoma based on Gd-EOB-DTPA enhanced MRI

Objectives

We aimed to investigate the value of performing gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) radiomics for preoperative prediction of microvascular invasion (MVI) of hepatocellular carcinoma (HCC) based on multiple sequences.

Methods

We randomly allocated 165 patients with HCC who underwent partial hepatectomy to training and validation sets. Stepwise regression and the least absolute shrinkage and selection operator algorithm were used to select significant variables. A clinicoradiological model, radiomics model, and combined model were constructed using multivariate logistic regression. The performance of the models was evaluated, and a nomogram risk-prediction model was built based on the combined model. A concordance index and calibration curve were used to evaluate the discrimination and calibration of the nomogram model.

Results

The tumour margin, peritumoural hypointensity, and seven radiomics features were selected to build the combined model. The combined model outperformed the radiomics model and the clinicoradiological model and had the highest sensitivity (90.89%) in the validation set. The areas under the receiver operating characteristic curve were 0.826, 0.755, and 0.708 for the combined, radiomics, and clinicoradiological models, respectively. The nomogram model based on the combined model exhibited good discrimination (concordance index = 0.79) and calibration.

Conclusions

The combined model based on radiomics features of Gd-EOB-DTPA enhanced MRI, tumour margin, and peritumoural hypointensity was valuable for predicting HCC microvascular invasion. The nomogram based on the combined model can intuitively show the probabilities of MVI.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12880-022-00855-w.

[Study on determination of 2-thioxothiazolidine-4-carboxylic Acid in urine by high performance liquid chromatography]

Objective: To establish a high performance liquid chromatography method for the determination of 2-thioxothiazolidine-4-carboxylic acid (TTCA) in urine. Methods: After acidification with hydrochloric acid, TTCA in urine was first extracted by ethyl acetate with excessive sodium chloride, then gradient separated by a symmetry C18 column and then detected by a diode array detector. The quantification was based on a working curve of external standard method. Results: The linear relationship of TTCA in urine was good in the range of 0.03-10.00 mg/L, and the correlation coefficient was 0.9999. The detection limit and minimum quantitative concentration of TTCA in urine were 0.008 mg/L and 0.027 mg/L. The intra-assay precision of the method was 0.9%-1.4%, the inter-assay precision was 1.3%-3.5%, and the average recovery was 85.0%-92.7% while the concentrations of TTCA in urine was 0.8, 2.0 and 8.0 mg/L, respectively (n=6) . Conclusion: The gradient elution high performance liquid chromatography method has simple operation and high sensitivity, and it is suitable for the determination of TTCA on a low level in urine for occupational workers exposure to carbon disulfide.

[Determination of five phenolic compounds in workplace air by composite sampling tube-high performance liquid chromatography]

Objective: To develop a method for simultaneous determination of Dydroquinone, Resorcinol, Pyrocatechol, 4-Nitrophenol and 2, 4-Dinitrophenol in workplace air by high performance liquid chromatography. Methods: Air samples were collected by composite tube (front end glass fiber filter membrane, back section silica gel) , 10% methanol was desorbed, separated by C18 chromatographic column, detected by photo-diode array (PDA) detector, and quantitatively determined by external standard method at the wave-length of 230 nm. Results: The linear relationship of 5 phenolic compounds was good (r>0.999) . The detection limit of glass fiber filtration membrane and silica gel adsorbent were 0.13-0.41 g/ml and 0.16-1.04 g/ml respectively. The quantitative limit of glass fiber filtration membrane was 0.44-1.36 g/ml, and the silica gel adsorbent was 0.52-3.46 g/ml. The average desorption efficiency of glass fiber membrane and silica gel adsorbent were 97.5%-100.1% and 86.9%-100.3%, respectively. In and between batches, the precision glass fiber filtration membrane was 0.71%-4.88%, 0.91%-4.82%, silica gel adsorbent was 0.47%-4.62%, 0.76%-5.52%. Samples can be stored for at least 30 days at -20 ℃. The possible co-existing interferences of aniline, phenol, p-nitrochlorobenzene, o-nitrophenol and trinitrophenyl did not interfere with the determination. Conclusion: The sensitivity, precision, accuracy and linear range of this method all meet the requirements of the specification. The collection and preservation of samples can also meet the requirements of the limits. It is suitable for the simultaneous determination of hydroquinone, resorcinol, hydroquinone, hydroquinone, hydroquinone, p-nitrophenol and 2, 4-dinitrophenol in the air of the workplace.

[Clinical characteristics, diagnosis and treatment of human babesiosis: a review]

Babesiosis is an important tick-transmitted zoonosis caused by hematotropic parasites of the genus Babesia, zoonosis disease, which is widely distributed across the world. There are 12 species of Babesia causing human diseases, including B. microti, B. divergens, B. venatorum and B. duncani. The clinical symptoms of human Babesia infections mainly include fever, headache, chills, myalgia and fatigue, and severe infections may cause death. The diagnosis of babesiosis mainly depends on laboratory testing combined with clinical manifestations and epidemiological surveys, and the diagnostic techniques mainly include microscopic examinations of the blood smears, serological tests and molecular biological assays. Currently, azithromycin-atova-quone or clindamycin-quinine combinations are common treatments for babesiosis. This review summarizes the clinical features following human infections with various species of Babesia, the diagnostic techniques and diagnostic criteria of babesiosis and the currently available treatments for babesiosis.

Quantitative assessment of liver function with hepatocyte fraction: Comparison with T1 relaxation-based indices

PURPOSE

This study aimed to assess the use of hepatocyte fraction in gadoxetic acid-enhanced magnetic resonance imaging (MRI) for quantitatively evaluating the liver function in comparison with T1 relaxation-based indices.

METHODS

This retrospective study included 79 patients with chronic liver disease, who were divided into 2 groups based on the results of the indocyanine green retention test (ICG). All patients underwent a gadoxetic acid-enhanced MRI of the liver. Pre- and post-contrast Look-Locker sequences were used 20 min after gadoxetic acid administration to acquire T1 mapping. Two readers independently identified and measured the MRI parameters [five T1 relaxation-based indices (T1pre, T1post, rrT1, R1post/R1pre and ΔR1) and two hepatocyte fraction indices (HeF and K_Hep)]. An Independent-samples t test was used to compare each parameter for the two groups. Pearson correlation analysis was used to analyze the correction in each parameter and 15-minute ICG retention rate (ICG-R15). Receiver operating characteristic analyses were performed to differentiate the diagnostic performance of each parameter in ICG-R15 ≤ 20 % and ICG-R15 > 20 % groups.

RESULTS

T1pre and T1post were significantly lower in the ICG-R15 ≤ 20 % group than in the ICG-R15 > 20 % group (P < 0.05). rrT1, R1post/R1pre, ΔR1, HeF, and K_Hep were significantly higher in the ICG-R15 ≤ 20 % group than in the ICG-R15 > 20 % group (P < 0.05). The correction coefficients between T1pre, T1post, rrT1, R1post/R1pre, ΔR1, HeF, K_Hep, and ICG-R15 were 0.343, 0.783, -0.833, -0.781, -0.803, -0.819, and -0.832, respectively. The area under the curves (AUCs) of T1pre, T1post, rrT1, R1post/R1pre, ΔR1, HeF, and K_Hep in assessing the ICG-R15＞20 % groups were 0.761, 0.945, 0.912, 0.912, 0.948, 0.945, and 0.950, respectively. K_Hep had the highest AUC, sensitivity, and specificity.

CONCLUSION

Hepatocyte fraction based on gadoxetic acid-enhanced T1-mapping MRI is an efficient diagnostic tool for the quantitative evaluation of liver function.

Practices and thinking of laboratory detection in the aid to West Africa to fight against Ebola

BACKGROUND

The outbreak of Ebola virus disease in West Africa has brought great disaster to the people's health in affected countries. China dispatched first group of public health experts and medical staff to Sierra Leone in September 2014 to fight Ebola.

METHODS

To systematically collect huge amount of primary data, and to make analysis, draw conclusions and lessons in terms of six aspects, respectively as training before departure, local disease information, track of epidemic situation, transformation of temporary laboratory, detection of Ebola virus samples as well as assessment through single blind test.

RESULTS

1) Our team has launched preparatory works in advance before going to Sierra Leone. 2) Malaria is the country's severest infectious disease. 3) Observation centers were overcrowded with large number of suspected cases being inspected, implying high risk of nosocomial infection. 4) A BSL-II laboratory with 3 work areas and 2 buffer areas was built, achieving several major functions within 6 days. 5) Confirmed by South African Raqqa laboratory, our detection accuracy reached 100%. 6) At one week before return, the daily average sample amount of our team reached 66 cases and our detection capability was equivalent to that of USA.

CONCLUSIONS

Successful experience from fighting against Ebola in Sierra Leone could be summarized as: 1) Optimized processes and scientific security measures are prerequisite to improving the detection ability. 2) The close collaboration between laboratory and observation center has created a new model of China's foreign aid. 3) Comprehensive information investigation and training lay a solid foundation for the successful completion of tasks.

Salicylic acid-induced changes in physiological parameters and genes of the flavonoid biosynthesis pathway in Artemisia vulgaris and Dendranthema nankingense during aphid feeding

Phloem-feeding aphids cause serious damage to plants. The mechanisms of plant-aphid interactions are only partially understood and involve multiple pathways, including phytohormones. In order to investigate whether salicylic acid (SA) is involved and how it plays a part in the defense response to the aphid Macrosiphoniella sanbourni, physiological changes and gene expression profiles in response to aphid inoculation with or without SA pretreatment were compared between the aphid-resistant Artemisia vulgaris 'Variegata' and the susceptible chrysanthemum, Dendranthema nankingense. Changes in levels of reactive oxygen species, malondialdehyde (MDA), and flavonoids, and in the expression of genes involved in flavonoid biosynthesis, including PAL (phenylalanine ammonia-lyase), CHS (chalcone synthase), CHI (chalcone isomerase), F3H (flavanone 3-hydroxylase), F3'H (flavanone 3'-hydroxylase), and DFR (dihydroflavonol reductase), were investigated. Levels of hydrogen peroxide, superoxide anions, MDA, and flavonoids, and their related gene expression, increased after aphid infestation and SA pretreatment followed by aphid infestation; the aphid-resistant A. vulgaris exhibited a more rapid response than the aphid-susceptible D. nankingense to SA treatment and aphid infestation. Taken together, our results suggest that SA could be used to increase aphid resistance in the chrysanthemum.

Effects of alfalfa meal on growth performance and gastrointestinal tract development of growing ducks

A study was conducted to evaluate effects of alfalfa meal on growth performance and gastrointestinal tract development of growing layer ducks to provide evidence for application of alfalfa meal in the duck industry. Two hundred and fifty-six healthy Shaoxing 7-wk old growing layer ducks were selected and randomly allocated to 1 of 4 dietary treatments based on corn and soybean meal and containing 0, 3, 6, and 9% of alfalfa meal for 8 wks. Each treatment consisted of 4 replicates of 16 ducks each. Briefly, birds were raised in separate compartments, and each compartment consisted of three parts: indoor floor house, adjacent open area and a connecting water area. The results showed: i) Growing ducks fed alfalfa meal diet were not significantly different in average daily gain, feed intake and gain-to-feed ratio from those fed no alfalfa diet (p>0.05). ii) Alfalfa meal increased the ratio crop, gizzard to live weight, caecum to live weight, the caecum index of growing ducks (p<0.05). iii) Villus height in duodenum and jejunum of growing ducks increased significantly with the increase of alfalfa meal levels (p<0.05). Crypt depth in duodenum and jejunum of growing ducks decreased significantly with the increase of alfalfa meal levels (p<0.05). This experiment showed that feeding of alfalfa meal to growing layer ducks could improve gastrointestinal tract growth and small intestinal morphology without effect on performance. This experiment provides evidence that alfalfa meal is a very valuable feedstuff for growing layer ducks.

Effects of alfalfa meal on the intestinal microbial diversity and immunity of growing ducks

This study was conducted to investigate the effects of alfalfa meal diets on the intestinal microbial diversity and immunity of growing egg-type ducks. A total of 128 healthy 7-week-old female egg-type Shaoxing ducks were selected and randomly assigned into four dietary treatments: 0%, 3%, 6% and 9% alfalfa meal for 8 weeks. Each treatment consisted of four replicates of eight ducks each. Polymerase chain reaction denaturing gradient gel electrophoresis (PCR-DGGE) was used to characterize the microbiota. The results showed that the DGGE fingerprints of the V6-V8 fragments of the 16S rRNA from the caeca and faeces of ducks fed 3%, 6% and 9% alfalfa meal had significantly higher microbiota species richness than those fed 0% alfalfa meal (p < 0.05). The Shannon-Weiner index of the microbiota from the caeca and faeces of ducks fed 3%, 6% and 9% alfalfa meal was significantly higher than those fed 0% alfalfa meal (p < 0.05). Molecular analysis of the caecal and faecal DNA extracts showed that the alfalfa meal diet promotes the intestinal microbial diversity, as indicated by their higher species richness and Shannon-Weiner index. However, the groups did not significantly differ in terms of average daily gain, feed intake and gain-to-feed ratio (p > 0.05), and the 3-9% alfalfa meal did not affect the growth performance of the growing egg-type ducks. The proliferation of T and B lymphocytes was significantly greater (p < 0.05) in the groups supplemented with 3%, 6% and 9% of alfalfa meal than the unsupplemented control group, and alfalfa meal promoted the lymphocytes proliferation of the growing egg-type ducks. Dietary alfalfa meal supplementation increases intestinal microbial community diversity and improves of the immune response growing egg-type ducks.

New insights into the prolactin-RsaI (PRL-RsaI) locus in Chinese Holstein cows and its effect on milk performance traits

Prolactin (PRL) plays central roles in mammals' reproduction, gland development, milk secretion, and the expression of milk protein genes. In dairy cattle, the PRL gene is a potential quantitative trait locus and genetic marker related to milk performance traits. Here, a total of 586 randomly selected Chinese Holstein cows were genotyped for locus PRL-RsaI. One haplotype block containing eight SNPs was identified in the region from intron 3 to intron 4 of the PRL gene in Chinese Holstein cows. One tag SNP (7545 G → A) was selected to represent the haplotype block defined by the genotypic data. The cows with genotype AA of this tag SNP had a higher milk yield at 305 days (8457 ± 938 kg) than the cows with GA (7537 ± 1278 kg; P < 0.01) or GG (7757 ± 1174 kg; P < 0.05). This suggests that the haplotype block examined in this study contains important markers for milk production traits in Chinese Holstein cows.

Expression profiling analysis of hypoxic pulmonary disease

Exposure of humans to low levels of environmental oxygen results in alveolar hypoxia and normally causes chronic pulmonary hypertension and morphological alterations of precapillary pulmonary vessels. In this study, the microarray dataset GSE11341 was used to identify potential differentially expressed genes related with human lung microvascular endothelial cell hypoxia. In addition, gene ontology term enrichment analysis was performed to explore their underlying functions. In addition, we also investigated the small molecules by comparing with the Connectivity Map. We found that hypoxia samples of 3, 24, and 48 h relative to 0 h displayed 22, 21, and 29 differentially expressed genes, respectively. Among them, six genes (ADM, HMOX1, VEGFA, EGLN3, APOLD1, and ANGPTL4) were closely related to pulmonary microvascular endothelial cell hypoxia response. Three drugs (pindolol, sulfapyridine, and ciclopirox) were selected as candidates to treat hypoxia-related pulmonary diseases. In conclusion, our results provide some underlying drug targets for treatment of hypoxic pulmonary patients.

An SduI polymorphism at intron 20 of the Chinese Holstein cow STAT4 gene and its effect on milk performance traits

The signal transducer and activator of transcription (STAT) genes are responsive to a wide range of cytokines, growth factors, and hormones, and thus control important biological processes. In humans, STAT4 mutations have been identified as genetic markers for rheumatoid arthritis, systemic lupus erythematosus, and primary Sjögren's syndrome, whereas little research has been conducted on bovine STAT4 mutations and their potential effects. Herein, 585 Chinese Holstein cows were used to investigate STAT4 mutations and their effects on milk performance traits. One haplotype block, containing g.95879G>A, g.96013G>C, was identified in intron 20 of the bovine STAT4 gene by restriction fragment length polymorphism-polymerase chain reaction and DNA sequencing. Two single nucleotide polymorphisms were significantly associated with milk yield at 305 days (P < 0.05), and with protein percentage (P < 0.05). Chinese Holstein cows with the haplotype GGGG had higher milk yields at 305 days and lower protein percentages. These results suggest that the 2 single nucleotide polymorphisms of STAT4 could be used as genetic markers for milk performance traits in Chinese Holstein cows.

Re-analysis of expression profiles for revealing new potential candidate genes of heart failure

BACKGROUND

Chronic heart failure (HF) is characterized by diminished cardiac output and pooling of blood in the venous system.

AIM

We used the GSE1145 microarray data to identify potential genes that related to heart failure to construct a regulation network.

MATERIALS AND METHODS

In the network, some of transcription factors (TFs) and target genes have been proved to be related to heart failure in previous study. The gene MYC, RELA, HIF1A, NFκB1 and SMAD3 are as hub nodes in our transcriptional network and have a close relationship with heart failure.

RESULTS

The study did not address regulation network but researched for the significant pathways related to chronic heart failure. Besides, RELA and NFκB1 interfere with each other in response to HF.

CONCLUSIONS

It is demonstrated that transcriptional network analysis is useful in identification of the candidate genes in heart failure.

DNA polymorphisms of the Hu sheep melanocortin-4 receptor gene associated with birth weight and 45-day weaning weight

The melanocortin-4 receptor (MC4R) has important roles in regulating food intake, energy balance, and body weight in mammals. In pigs and cattle, MC4R mutations have been identified as genetic markers for growth and traits. Compared with abundant research conducted on other livestock species, little is known about mutations of the ovine MC4R gene. We investigated the effect of MC4R polymorphisms on birth weight and on 45-day weaning weight in 144 Hu sheep. Four single nucleotide polymorphisms (SNPs; g.1016 G/A, g.1240 T/C, g.1264 G/A, and g.1325 A/G) were identified in the 3ꞌ-untranslated region of Hu sheep MC4R by PCR-single-strand conformation polymorphism and DNA sequencing. A haplotype block, containing g.1240 T/C, g.1264 G/A, and g.1325 A/G, was constructed within the Hu sheep MC4R gene. Four SNPs were found to be significantly associated with 45-day weaning weight, while the haplotype block was significantly associated with birth weight. Hu sheep with the genotypes GG in g.1016 G/A or with the genotype CCAAGG in the haplotype block, had higher 45-day weaning weights. We conclude that these 4 SNPs of the MC4R gene have potential as genetic markers for early growth traits in Hu sheep.

Antioxidant and antiapoptotic function of metallothioneins in HL-60 cells challenged with copper nitrilotriacetate

Antioxidant activity is believed to be an important intracellular function of metallothioneins (MT), yet the specific mechanisms of their antioxidant action are not known. Under conditions when cells are challenged with elevated concentrations of free copper as a result of metabolic disturbances or environmental and occupational exposures, MTs may be ideally suited for antioxidant function as effective copper chelators. In the study presented here, we tested this hypothesis using a recently established model of copper nitrilotriacetate-induced oxidative stress in HL-60 cells. Since copper-induced oxidative stress triggers apoptosis, we further investigated antiapoptotic function of MTs in HL-60 cells. Using a Sephadex G-75 chromatographic partial purification of MTs from cell homogenates with subsequent immuno-dot-blot assay, we showed that zinc pretreatment yielded a pronounced induction of MTs in HL-60 cells. We report that zinc-induced MTs were able to (i) completely bind intracellular copper, (ii) completely quench redox-cycling activity of copper, (iii) significantly inhibit copper-dependent oxidative stress in membrane phospholipids, and (iv) prevent copper-dependent apoptosis and its characteristic biochemical features (cytochrome c release from mitochondria into cytosol, caspase-3 activation, and externalization of phosphatidylserine in plasma membranes). In separate experiments, we used lung fibroblasts derived from MT1, MT2 knockout mice (MT(-)(/)(-)) and MT wild-type (MT(+/+)) mice. ZnCl(2) pretreatment resulted in a more than 10-fold induction of MTs in MT(+/+) cells, whereas the MT content in MT(-)(/)(-) cells remained low, at levels approximately 100-fold lower than in their MT wild-type counterparts. MT(-)(/)(-) cells were very sensitive to Cu-NTA and, most importantly, showed no response to ZnCl(2) pretreatment. In contrast, MT(+/+) cells were relatively more resistant to Cu-NTA, and this resistance was remarkably enhanced by ZnCl(2) pretreatment. Combined, our results demonstrate that metallothioneins function as effective antioxidants and an antiapoptotic mechanism in copper-challenged HL-60 cells.

Regulation of telomerase activity in camptothecin-induced apoptosis of human leukemia HL-60 cells

AIM

To explore the regulation of telomerase activity in camptothecin induced apoptosis of human leukemia HL-60 cells.

METHODS

Apoptosis of HL-60 cells was induced by camptothecin (1 mg/L) for 2, 4, and 6 h. Apoptosis was determined by agarose electrophoresis and flow cytometry analysis. To assess telomerase activity, a PCR-based telomeric repeat amplification protocol assay (TRAP) was used. RT-PCR was performed to examine the mRNA levels of hTR (human telomerase RNA component), hEST2/hTERT (human telomerase reverse transcriptase), TLP1/TP1 (telomerase association protein 1), and bcl-2 (B cell leukemia/lymphoma 2 gene) in HL-60 cells before and after camptothecin treatment.

RESULTS

Telomerase activity was decreased in a time-dependent manner during the camptothecin induced apoptosis of HL-60 cells. However, no difference in expression of each telomerase subunit was detected, while expression of bcl-2 was progressively down-regulated.

CONCLUSION

These lines of evidences indicated that down-regulation of the telomerase activity in HL-60 cells was closely related to camptothecin-induced apoptosis, and the telomerase activity was not blocked at the transcriptional levels of the genes of the known ribonucleoprotein (RNP) complex components. We also found that bcl-2 did not regulate the mRNA expressions of telomerase subunits directly.

Differentiation-inducing action of 10-hydroxycamptothecin on human hepatoma Hep G2 cells

AIM

To study the mechanism of differentiation-inducing action of 10-hydroxycamptothecin (HCPT) on human hepatoma Hep G2 cells.

METHODS

The proliferating cell nuclear antigen (PCNA) expression was studied by immunocytochemical staining method. The cell cycle distribution and the wild-type protein p53 expression were measured by flow cytometry. Telomerase activity was assayed with telomeric repeat amplification protocol (TRAP).

RESULTS

After treatment with HCPT at differentiation-inducing concentrations 5-20 micrograms.L-1 for 6 d, Hep G2 cells were mainly arrested at G2/M phase and the PCNA expression rate was lower than that of control cells. When Hep G2 cells grew in a medium containing HCPT 5 micrograms.L-1 for 6 d, the p53 expression level markedly increased in comparison with the control cells. The telomerase activity did not change in Hep G2 cells treated with HCPT 5-20 micrograms.L-1 for 8 d.

CONCLUSION

The differentiation-inducing effect of HCPT on Hep G2 cells is related with the cell cycle arrest at G2/M phase, down-regulation of PCNA and up-regulation of wild-type protein p53.

Circulatory crisis caused by cigarette smoking in tissue transfer. Clinical and experimental studies

Cigarette smoking-induced circulatory crisis occurred in two patients receiving toe transfer and one patient having musculocutaneous flap. After anticoagulation and antispasm treatment, one survived and two failed. Experimental studies demonstrated that cigarette smoking is harmful to the healing of endothelia at the anastomotic site of vessels. Five days after operation, the complete recovery rate of the endothelium over sutures of anastomotic sites was 16%-19% in smoking groups, but 75% in the control group. The mechanism and characteristics of circulatory crisis caused by cigarette smoking are discussed.

Clinical and experimental studies of cigarette smoking in microvascular tissue transfers

Circulatory crisis, attributed to cigarette smoking, in three microvascular cases (two toe transfers, one musculocutaneous flap) is reported. After anticoagulation and antispasm treatment only one transfer survived. Coordinated experimental studies in the rat demonstrated that cigarette smoking delayed anastomotic healing. Five days after anastomoses were performed, endothelial cells completely covered the sutures in the experimental smoking group in only 16-19% of sutures, while the control group had a 75% coverage rate. Mechanisms and characteristics of circulatory crisis caused by cigarette smoking are discussed.

Experimental study of free toe replantation in rats

A rat model for free second toe replantation, free hallux-to-thumb transplantation, and combined free hallux-to-thumb transplantation and free second-toe-to-index transfer is described. Experimental devices, operative methods, and the keys to success are discussed.

A new embedding method for tendon suturing

A new embedding method in tendon suture was designed for interembedding of tendon ends to obtain interlock and strengthen antitension strength. Experiments showed that the embedding method might result in greater antitension strength than the conventional end-to-end method (Bunnell's method) or weaving method. Statistically, difference was significant. Dynamic studies on tendon healing showed that a prominent reaction of surrounding tissues occurred in 3 to 5 days after operation. In this period the antitension strength is likely to decrease and be broken with a rate of 28.1% in Bunnell's method, 5.25% in weaving method and 0% in embedding method. Clinically, the embedding method has been used in 125 cases of tendon-broken repair in which a 87.8% of good and excellent effect was resulted.

Scanning electron microscopic observations on the endothelial healing mechanism of vessels

Systematic scanning electron microscopic observations of the healing mechanism in the endothelium of rat carotid arteries were carried out at the site of anastomosis. The site of needle holes and stitches are the main locations for thrombocyte adhesion and aggregation in normal vascular anastomosis. The repair process in endothelial injury can be divided into three stages. A thrombocyte-adhesion and filling stage is apparent at 1 hr postoperatively; this is also the period when thrombus is most likely to occur. A fibrin-covering stage is apparent at 2 hr after operation and reaches its peak in 24 hr. The formation of fibrin provides a framework for endothelial growth. In this period, there is still the possibility of thrombus formation. At 48 hr postoperatively, endothelial growth can be seen at the site of some needle holes. At 72 hr after operation, 47 percent of needle holes have endothelial growth, and the possibility of thrombus formation at the anastomotic site declines. The data suggest that eversion of the intima in vascular anastomosis and minimization of endothelial injury by considering the size of the needle hole, the duration of ischemia time, and perfection of surgical technique, are keys to the prevention of thrombus formation at the anastomotic site.