Analysis of risk factors of suicidal ideation in adolescent patients with depression and construction of prediction model

BACKGROUND

Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group. Most adolescent patients with depression have suicidal ideation (SI); however, few studies have focused on the factors related to SI, and effective predictive models are lacking.

AIM

To construct a risk prediction model for SI in adolescent depression and provide a reference assessment tool for prevention.

METHODS

The data of 150 adolescent patients with depression at the First People's Hospital of Lianyungang from June 2020 to December 2022 were retrospectively analyzed. Based on whether or not they had SI, they were divided into a SI group (n = 91) and a non-SI group (n = 59). The general data and laboratory indices of the two groups were compared. Logistic regression was used to analyze the factors influencing SI in adolescent patients with depression, a nomogram prediction model was constructed based on the analysis results, and internal evaluation was performed. Receiver operating characteristic and calibration curves were used to evaluate the model's efficacy, and the clinical application value was evaluated using decision curve analysis (DCA).

RESULTS

There were differences in trauma history, triggers, serum ferritin levels (SF), high-sensitivity C-reactive protein levels (hs-CRP), and high-density lipoprotein (HDL-C) levels between the two groups (P < 0.05). Logistic regression analysis showed that trauma history, predisposing factors, SF, hs-CRP, and HDL-C were factors influencing SI in adolescent patients with depression. The area under the curve of the nomogram prediction model was 0.831 (95%CI: 0.763-0.899), sensitivity was 0.912, and specificity was 0.678. The higher net benefit of the DCA and the average absolute error of the calibration curve were 0.043, indicating that the model had a good fit.

CONCLUSION

The nomogram prediction model based on trauma history, triggers, ferritin, serum hs-CRP, and HDL-C levels can effectively predict the risk of SI in adolescent patients with depression.

[Analysis of the efficacy of transnasal endoscopic annulus of zinn area decompression in the treatment of dysthyroid optic neuropathy]

Objective: To evaluate the early efficacy and safety of transnasal endoscopic decompression in the annulus of zinn (AZ) region for refractory dysthyroid optic neuropathy (DON) and to preliminarily analyze the correlated factors of postoperative visual function outcome. Methods: From July 2021 to January 2023, 35 patients (56 eyes) with DON who received AZ area decompression in Peking University Third Hospital were included retrospectively, including 9 males (13 eyes) and 26 females (43 eyes), aging (52.2±12.0) years. Among them, 35 eyes underwent two-wall (medial and inferior) orbital decompression using an endonasal endoscopic approach, while 21 eyes received three-wall (medial, lateral, and inferior) orbital decompression through a combined approach. Key parameters such as best corrected visual acuity (BCVA), visual field (MD value), eyeball prominence, intraocular pressure, and complications were recorded. Postoperative data were collected one month after surgery. The statistical analysis was performed using paired t-test and Spearman correlation analysis. Results: Significant outcomes were observed post surgery in BCVA, visual field, intraocular pressure and proptosis (t value was 8.37, 6.17, 4.50, and 9.20, respectively, all P<0.001). The reduction in proptosis was statistically significant between the 2-wall and 3-wall orbital decompression groups (t=-2.82, P=0.007). Changes in BCVA, visual field, and intraocular pressure before and after surgery was greater in the 3-wall orbital decompression group compared to 2-wall orbital decompression group, although the difference was not statistically significant (all P>0.05). Change in postoperative visual acuity and visual field was significantly positively correlated with preoperative visual acuity and preoperative visual field (all P<0.001). Similarly, change in intraocular pressure and proptosis was positively correlated with preoperative intraocular pressure and preoperative protrusion (all P<0.001). Preoperative diplopia was reported in seven patients (20.0%), and two new cases (5.7%) were noted post-operation, which resolved within 3 months after surgery. Conclusions: Endoscopic endonasal decompression of the AZ area is a safe and effective surgical treatment for DON, with notable improvements in BCVA. Furthermore, three-orbital wall decompression seems to yield better outcomes in terms of eye retraction.

[A case of orbital rhabdomyosarcoma combined with neurofibromatosis type 1 in a child]

This article presents a case of orbital rhabdomyosarcoma (RMS) in a child who also had neurofibromatosis type 1 (NF-1). Although NF-1 is a common neurogenetic disease, there are few reports of its combination with orbital RMS. The patient underwent surgical removal of the tumor at the age of one, but the cancer recurred after five years. Following pathological and genetic diagnosis, the patient was confirmed to have orbital RMS combined with NF-1. After surgical treatment and chemotherapy, the patient's eye condition has stabilized. This article focuses on analyzing the clinical manifestations of this case and reviews relevant literature to improve our understanding of this disease in children.

[Correlation analysis of age and microbial characteristics in saliva and feces of high-risk population of upper gastrointestinal cancer]

Objective: To explore the correlation between age and diversity and microbial composition in saliva and feces microbiota in high-risk population of upper gastrointestinal cancer. Methods: Based on the national project on early diagnosis and early treatment of upper gastrointestinal cancer, 38 participants were enrolled in Linzhou in Henan province in August 2019. The participant information was collected by questionnaire. Saliva and feces specimens were collected from each participant for 16S rRNA sequencing and bioinformatics analysis. Spearman rank correlation was used to analyze the correlation between age and α diversity (Observed ASVs and Shannon index) and relative abundance of microbiota (phyla, genera, and species) in saliva and feces. Results: The median age (age range) of 38 participants was 54 (43-60) years old, and there were 16 males (42.1%). The Observed ASVs of saliva was negatively correlated with age (r_s=-0.35, P<0.05), but the observed ASVs of feces was not correlated with age. In saliva, the relative abundance of Treponema (r_s=‒0.44, P<0.05), Alloprevotella (r_s=‒0.42, P<0.05), and Porphyromonas (r_s=‒0.41,P<0.05) were significantly negatively correlated with age. At the species level, the relative abundance of Porphyromonas endodontalis, Alloprevotella tannerae, Haemophilus influenza, Moraxella bovoculi, Prevotella sp.oral clone ID019, and Prevotella sp.oral clone ASCG10 in saliva were significantly negatively correlated with age, and the r_s values were -0.50, -0.40, -0.38, -0.35, -0.33 and -0.33 (P<0.05), respectively. In feces, the relative abundance of Enterobacteria (r_s=-0.35, P<0.05), Escherichia (r_s=-0.33, P<0.05), and Bifidobacteria (r_s=0.33, P<0.05) were correlated with age. At the species level, the relative abundance of Romboutsia sedimentorum, Citrobacter murliniae, and bacteroides uniformis in feces were correlated with age, and the r_s values were -0.42, -0.37 and 0.36 (P<0.05), respectively. Conclusion: Age of the high-risk population of upper gastrointestinal cancer is correlated with the relative abundance of microbiota in saliva and feces.

Primary ascending colon cancer accompanying skip metastases in left shoulder skin and left neck lymph node: A case report

BACKGROUND

Lymph node skip metastases are common in lung, breast, and thyroid cancer patients, but are rare in colon cancer patients. Specifically, lymph node skip metastases occur in 1%-3% of colon cancer patients. Previous reports have demonstrated colon cancer skip metastases involving the retropancreatic and portocaval lymph nodes and Virchow's node; however, reports involving skip metastases into the left neck lymph nodes and left shoulder skin are extremely rare, as are related reports of clinical treatment and prognosis.

CASE SUMMARY

A 44-year-old Chinese man was admitted to the hospital for evaluation of persistent shoulder pain for 3 d and a cutaneous mass (3.0 cm × 2.0 cm) on the left shoulder. The left shoulder cutaneous mass was excised and bisected, revealing tissues with a fish-like appearance. The pathologic diagnosis of the cutaneous mass suggested a signature [CDX-2 (++), CK20 (++), Ki-67 (+) > 50%] of infiltrating or metastatic colorectal adenocarcinoma. An enhanced computed tomography scan of the abdomen revealed chronic appendicitis with fecal stone formation, cecal edema, and a pelvic effusion. A colonoscopy revealed a cauliflower-like mass within the ascending colon area that involved the lumen. The surface of the ascending colon mass was eroded and bleeding; a biopsy was performed. The pathologic diagnosis of the colonoscopy biopsy was an ascending colon mucinous adenocarcinoma. The patient underwent a laparoscopic radical resection of the right colon based on the pathological diagnosis. The tumor was 5.0 cm × 4.5 cm × 1.8 cm in size and infiltrated the entire thickness of the intestinal wall with vascular tumor thrombi. No nerve tissue involvement was noted. The ileum and colon resection margins were negative. The postoperative pathologic analysis revealed non-metastatic involvement of ileocecal, pericolic, or peri-ileal lymph nodes. The postoperative medical examination revealed palpably enlarged lymph nodes in the left neck, and the following color Doppler ultrasound examination of the neck confirmed enlarged lymph nodes in the left neck. After surgical resection and pathologic diagnosis, a common pathologic signature consistent with resected cutaneous mass and right colon was identified, suggesting skip metastasis of left cervical lymph nodes. The patient was then treated with eight courses of chemotherapy and under follow-up evaluations for 4 years; currently, no tumor recurrences or metastases have been noted.

CONCLUSION

We report an abnormal skip metastasis involving the left shoulder skin and left neck lymph node in a patient with ascending colon adenocarcinoma. Specifically, we observed non-metastatic involvement of the lymph nodes around the tumor site but with metastases to the cervical lymph nodes. The standard surgical operations were performed to resect the cutaneous mass, tumor tissue, and cervical lymph nodes, followed by chemotherapy for eight courses. The patient is healthy with no tumor recurrences or metastases for 4 years. This clinical case will contribute to future research about the abnormal skip metastasis in colon cancers and a better clinical treatment design.

[Progress in risk factors and potential biomarkers of esophageal squamous cell carcinoma]

Esophageal cancer is the main malignant cancer in China. In 2015, the incidence and mortality of esophageal cancer were 17.87 per 100 000 and 13.68 per 100 000, respectively, ranking 6th and 4th in the incidence and death. Esophageal squamous cell carcinoma (ESCC) is the main pathological type of esophageal cancer, accounting for 86.3% of new cases. ESCC's pathogenesis is still not clear and its related risk factors remain to be explored. There are no detection biomarkers that can be widely applied in the whole country nowadays. In order to provide a scientific basis for exploring the pathogenesis of ESCC and improve screening technology, this paper summarizes the research status of various risk factors and potential biomarkers of ESCC.

[Identification of the feature of immune cells infiltration in inherited renal carcinoma with von Hippel-Lindau syndrome]

Objective: To investigate the feature of immune cells infiltration in inherited renal carcinoma with von Hippel-Lindau (VHL) syndrome and their relationship with clinicopathological characteristics and prognosis. Methods: The samples were collected from patients with VHL syndrome renal carcinoma who were diagnosed and treated surgically at the Department of Urology, Peking University First Hospital from 2010 to 2019. RNA-Seq was performed on 6 pairs of VHL syndrome renal carcinoma and adjacent normal tissues. To identify the specific infiltrated immune cells, RNA-Seq data was converted into the infiltration data of 14 types of immune cells using the TIP tool. Immunohistochemical staining was used to verify the expression of the markers of these specific infiltrated immune cells in the paraffin sections of 54 paired VHL syndrome renal carcinoma and adjacent normal tissues, and to analyze their relationship with clinicopathological characteristics and prognosis. Results: Compared with adjacent normal tissues, CD4 Naive infiltration level was significantly down-regulated (0.289±0.009 vs 0.200±0.012,P<0.001) and CD4 Memory infiltration level was significantly up-regulated (0.123±0.014 vs 0.222±0.016,P<0.001) in VHL syndrome renal carcinoma. Immunohistochemical staining results showed that CD45RA (a CD4 Naive cell marker) expression was significantly reduced (50.9±1.9 vs 15.6±0.9,P<0.001) and CD45RO (a CD4 Memory cell marker) expression was significantly increased (22.2±1.1 vs 80.8±4.3,P<0.001) in VHL syndrome renal carcinoma. Besides, lower CD45RA expression and higher CD45RO expression were associated with higher histological grade, advanced tumor stage and shorter disease-free survival (all P<0.01). In addition, CD45RA expression was positively correlated with VHL expression (r=0.693 3, P<0.000 1) and CD45RO expression was negatively correlated with VHL expression (r=-0.609 0, P<0.000 1). Conclusions: This study found that CD4 Naive and CD4 Memory cells may be differentially infiltrated immune cells in VHL syndrome renal carcinoma, and their infiltration levels were associated with the expression of VHL and the prognosis of patients.

[Clinicopathological and prognostic characteristics of clear cell papillary renal cell carcinoma]

Objective: To analyze the epidemiological, clinicopathological and prognostic characteristics of clear cell papillary renal cell carcinoma (CCPRCC) based on Chinese patient population. Method: Patients with renal cell carcinoma diagnosed at Peking University First Hospital from June 2016 to June 2020 were included in this study based on the inclusion and exclusion criteria. All cases were grouped according to CCPRCC, clear cell renal cell carcinoma (ccRCC), and papillary renal cell carcinoma (pRCC), and the general clinical, postoperative pathological and follow-up data of the patients were retrospectively analyzed. Result: A total of 18 CCPRCC patients were enrolled in this study, accounting for 0.44% (18/4 110) of the postoperative pathologically confirmed renal cell carcinoma cases in our hospital during this time period. The age range of the included patients was 28-86 years old, with a median age of 49.5 years old. There were 11/18 males and 7/18 females. All CCPRCC patients had no family history of renal malignant tumors. Among them, only one patient with CCPRCC had related clinical symptoms, that was intermittent waist and abdomen pain, while the other 17 cases were found by physical examination without any related symptoms. Compared with ccRCC and pRCC, there was no significant difference in their end stage renal disease history(χ²_ccRCC=0.291, χ²_pRCC=1.161,all P>0.05). The maximum diameter of CCPRCC tumor was smaller than pRCC (χ²=-2.280,P =0.027) but not significantly different from ccRCC (χ²=-0.579,P =0.565). The majority of patients with CCPRCC were in pT1, their pathological stage was earlier than the other two types, and their overall survival was better than ccRCC and pRCC (P<0.05). Conclusion: CCPRCC is a type of renal cell carcinoma with unique epidemiology, clinicopathology and prognostic characteristics. Patients with this subtype have an earlier clinical stage and a better prognosis than ccRCC and pRCC.

[Introduction of the Prediction model Risk Of Bias ASsessment Tool: a tool to assess risk of bias and applicability of prediction model studies]

This paper introduceds the tool named as "Prediction model Risk Of Bias ASsessment Tool" (PROBAST) to assess the risk of bias and applicability in prediction model studies and the relevant items and steps of assessment. PROBAST is organized into four domains including participants, predictors, outcome and analysis. These domains contain a total of 20 signaling questions to facilitate structured judgment of risk of bias occurring in study design, conduct or analysis. Through comprehensive judgment, the risk of bias and applicability of original study is categorized as high, low or unclear. PROBAST enables a focused and transparent approach to assessing the risk of bias of studies that develop, validate, or update prediction models for individualized predictions. Although PROBAST was designed for systematic reviews, it can be also used more generally in critical appraisal of prediction model studies.

[Status of non-steroidal anti-inflammatory drugs use in areas with a high incidence of upper gastrointestinal cancer in China: a multi-center cross-sectional survey]

Objective: To describe the status of non-steroidal anti-inflammatory drugs (NSAIDs) use in areas with a high incidence of upper gastrointestinal cancer in China. Methods: This study was based on the National Key Research and Development Program of "National Precision Medicine Cohort of Esophageal Cancer" and "Study on Identification and Prevention of High-risk Populations of Gastrointestinal Malignancies (Esophageal cancer, Gastric cancer and Colorectal cancer)" . From January 2017 to August 2018, 212 villages or communities with a high incidence of esophageal cancer or gastric cancer were selected from 12 regions in 6 provinces. A total of 35 910 residents aged between 40 and 69 years old who met the inclusion criteria and signed the informed consent were investigated and enrolled in this study. The use of NSAIDs, demographic characteristics, health-related habits, height, weight, and blood pressure were collected by the questionnaire and physical examination. The status of main NSAIDs (aspirin, acetaminophen and ibuprofen) use with the difference varying in genders, age groups and regions were analyzed by using χ(2) test and Cochran-Armitage trend analysis method. Results: Of 35 910 subjects, the mean age was (54.6±7.1) years old and males accounted for 43.42% (15 591). The overall prevalence of NSAIDs intake was 4.56% (1 638), but it significantly varied in different provinces (P<0.001). The overall prevalence of NSAIDs intake was 4.87% (1 750) in females, which was significantly higher than that in males 4.24% (1 524) (P<0.001). The prevalence of NSAIDs intake increased with age (P for trend <0.001). As the frequency of NSAIDs intake increased, the incidence of gastrointestinal symptoms, gastrointestinal ulcers and black stools increased (P for trend <0.05 for all). Conclusion: The use of NSAIDs is prevalent in some areas with a high incidence of upper gastrointestinal cancer in China. The increased use of NSAIDs may lead to more adverse effects related to the gastrointestinal tract.

[Dentification and correction of the lead-time bias and length bias in cancer screening studies]

Lead-time bias and length bias were common systematic errors in observational screening studies, which might be a common cause of overstating or distorting the true screening effects. One of key concerns in observational screening studies was how to estimate the screening effects based on the consideration of these two biases. This paper illustrated how to identify and correct the lead-time bias using the tumor volume doubling time and the non-homogeneous Poisson process, and how to correct the length bias using a weighted method. The application conditions of each method were also discussed to present several useful toolboxes to correct the lead-time bias and length bias appropriately and evaluate the effectiveness of the cancer screening program accurately.

[Clinical application and optimization of HEAD-US quantitative ultrasound assessment scale for hemophilic arthropathy]

目的

评价HEAD-US评估量表在血友病性关节病临床应用的可行性，提出优化的超声评估量表HEAD-US-C。

方法

2015年7月至2017年8月期间，91例血友病患者接受1 035例次关节超声检查，分别采用Melchiorre、HEAD-US、HEAD-US-C量表进行评分，分析与血友病关节健康评分量表（HJHS）评分之间的相关性并比较上述量表评价血友病性关节病的敏感性。

结果

91例患者均为男性，中位年龄16（4~55）岁，血友病A 86例，血友病B 5例。1 035例次关节检查Melchiorre、HEAD-US、HEAD-US-C量表的评分[M（P₂₅, P₇₅）]分别为2（0,6）、1（0,5）、2（0,6），均与HJHS评分之间存在相关关系（相关系数分别为0.747、0.762、0.765，P值均<0.001）。Melchiorre、HEAD-US-C、HEAD-US评分量表的阳性率分别为63.0%（95%CI 59.7%~65.9%）、59.5%（95%CI 56.5%~62.4%）、56.6%（95%CI 53.6%~59.6%），差异有统计学意义（P<0.001）。336例次无症状关节（HJHS评分0分）Melchiorre、HEAD-US-C、HEAD-US评分量表的阳性率分别为25.0%（95%CI 20.6%~29.6%）、17.0%（95%CI12.6%~21.1%）、11.9%（95%CI 8.4%~15.7%）（P<0.001）。40例有关节出血症状的血友病患者（107例次）关节出血前、出血后超声评分差异有统计学意义（P<0.05）。HEAD-US-C与HEAD-US评分的变化幅度比较，差异有统计学意义（P<0.001）。

结论

与Melchiorre比较，HEAD-US、HEAD-US-C与HJHS之间具有相似的良好的相关性。HEAD-US-C评分量表较HEAD-US更为敏感，尤其适合亚临床状态血友病性关节病的评估。

[A brief review on studies of the Chinese Red Army medical aid]

The Chinese Red Army medical aid not only has collected and collated existing data but also has studied related contents.With regard to the collection of data and materials, there were both medical-health thematic data and medical-health data covered by the comprehensive data, reprinted and translated of documentary data.With respect to medical aid research, there were both comprehensive and thematic studies. Among thematic studies, included medical institutions, health teams, methodology, role of health work, medical aid with traditional Chinese Medicine, and the research of Red Army medical staff.Looking forward to the future research, we should focus on literature mining and data expansion, innovation of research perspective, integrated application of multidisciplinary research methods, diversity of research subjects and the "normalization" of research results.

[An analysis of the new "three tubes" method in the treatment of spontaneous esophageal rupture]

To investigate the clinical efficacy, feasibility and safety of new "three tubes" method in the treatment of spontaneous esophageal rupture. A total of 22 patients with spontaneous esophageal rupture were retrospectively analyzed. Through the new "three tubes" method of treatment, patients achieved leak cured with reduced hospital stay, less medical expenses and early resumption of oral diet. The new "three tubes" method for spontaneous esophageal rupture has the advantages of easy handling, minimal invasion, few complication and exact curative effect.

[Effectiveness of unilateral selective laser trabeculoplasty for primary open angle glaucoma]

OBJECTIVE

To study the effectiveness of unilateral selective laser trabeculoplasty (SLT) on the both eyes of patients with primary open-angle glaucoma (POAG).

METHODS

This was a self-controlled clinical study. Thirty-two patients of 32 eyes with OAG who used same anti-glaucoma medications for both eyes were included aat the Department of Ophthalmology Peking University third Hospital from February 2010 to April 2014. SLT was performed for the poorly controlled eye for each patient. Patients were examined before operation and 1 hour, 1 week, 1 month, 3 months and 6 months after operation. The intraocular pressure was examined after 1 hour of SLT. The rest time points were examined by visual acuity, intraocular pressure (IOP), slit lamp microscope, fundus ophthalmoscope and visual field. The paired t test (Bonferroni) was used to compare the IOP at each time point after SLT with the baseline IOP before SLT. Single factor analysis of variance was used to compare the percentage of IOP drop. Linear correlation analysis was used to analyze the amplitude of the decrease of IOP between treated eyes and untreated eyes at 6-month post-operatively and analyze the IOP between preoperative eyes and 6-month post-operative eyes. The magnitude of the decrease of IOP in patients with glaucoma medication and 6 months after surgery was analyzed. We also analyzed the types of antiglaucoma medications and IOP reductions range for 6 month after SLT.

RESULTS

The preoperative mean IOP was (18.9±2.5) mmHg (1 mmHg=0.133 kPa) in the treated eye of patients with OAG. Mean IOP reduction for 1 week, 1, 3, and 6 months after SLT were (1.7±2.9) mmHg, (2.5±2.5) mmHg, (3.5±2.8) mmHg, (3.4±2.5) mmHg and the percentage of IOP reduction were (8±16) %, (13±13) % (18±14) %, (18±12) % respectively (compared with the baseline, P< 0.05) . With the success criteria of IOP reduction ≥3.0 mmHg or ≥20%, the success rate of SLT in the treated eye after 1 week, 1, 3, 6 months was 38%, 52%, 50% and 60% respectively. For the untreated fellow eyes, the preoperative mean IOP was (17.3±2.4) mmHg. Mean IOP reduction for 1 week, 1month, 3 month, and 6 month after SLT were (1.1±2.0) mmHg, (1.0±2.7) mmHg, (2.6±2.2) mmHg and (2.5±2.2) mmHg respectively (compared with the baseline, P<0.05) . There was a positive correlation between preoperative IOP and IOP reduction either in the treated or in the untreated eyes at 6-month post-SLT (R=0.63, P<0.01; R=0.60, P<0.01) . There was a positive correlation in IOP reduction between treated eyes and untreated eyes at 6-month post-operative (R=0.66, P<0.01). All patients didn't need further treatment such as another laser treatment or surgery. Anti-glaucoma medications were remained unchanged after SLT.

CONCLUSIONS

In poorly anti-glaucoma medication controlled Chinese POAG eyes with mean IOP about 18.0 mmHg, unilateral STL can reduce the IOP about 18% at 6-month post-operative for the treated eyes. There was also a continuous IOP reduction effects for the fellow eyes.(Chin J Ophthalmol, 2016, 52: 410-415).

Effects of microwave radiation and conductive heating on Tribolium castaneum microstructure

Microwave radiation and conductive heating were used to completely kill adult Tribolium castaneum (Coleoptera: Tenebrionidae) in wheat flour to protect the flour during storage without significantly effecting its quality. The microstructure of T. castaneum was analyzed to reveal the mechanisms leading to death under microwave and heat treatments. Microwave radiation and conductive heating had different effects on the microstructure of the cuticle of adult T. castaneum and on the ultrastructure of the cells of the epidermis, fat body, and midgut. Both treatments caused a large cavity to appear in the nucleus and the disappearance of mitochondria and the Golgi apparatus. After microwave treatment, there was little change in the surface microstructure but the epidermis was of uneven thickness and the four outer layers of the cuticle were thinner. Nuclear size was essentially unchanged, but fat body cells were fewer and coalesced together. In contrast, conductive heating led to a disordered arrangement of cells on the surface of T. castaneum and indistinct boundaries between layers of the cuticle. The nuclei were enlarged and the fat body cells noticeably fewer and indistinct with a scattered distribution. Thus, microwave treatment produced less severe effects on the surface microstructure and cellular ultrastructure of T. castaneum than did conductive heating. It is concluded that these cellular and surface changes were responsible for the death of T. castaneum.

[Cloning and characterization of three novel genes encoding transmembrane proteins of Schistosoma japonicum]

OBJECTIVE

To clone and analyze novel antigen molecules of Schistosoma japonicum (Sj), and to provide effective vaccine candidate antigens against schistosomiasis japonica.

METHODS

Sj adult cDNA library was screened using sera of mice infected with Trichinella spiralis (Ts) and the inserts of positive clones were specifically amplified by PCR. The positive clones were sequenced and the sequence data were analyzed using Nucleotide BLAST software of NCBI and Expert Protein Analysis System of Swiss Institute of Bioinformatics.

RESULTS

Nine positive clones were obtained after three rounds of immunoscreening. The size of these inserts ranged from 0.6 kb to 2.1 kb. Among five novel genes, Sj-Ts1, Sj-Ts3 and Sj-Ts5 (GenBank accession number: AY005816, AF299080 and AY024352, respectively) encode trans-membrane proteins with 83, 83 and 233 amino acids, respectively. Sj-Ts1 protein predicted contains one possible trans-membrance helix, one N-myristoylation site, two phosphorylation sites for protein kinase C and one for tyrosine kinase, Sj-Ts3 protein contains two possible transmembrance helices and one casein kinase II phosphorylation site, whereas Sj-Ts5 protein has five possible transmembrance helices, one N-glycosylation site, one N-myristoylation site, two phosphorylation sites for cAMP- and cGMP-dependent protein kinase and four for protein kinase C and one for casein kinase II.

CONCLUSION

Three novel genes encoding three transmembrane proteins might be developed as new vaccine candidates against Sj infection.

[Evaluation of Schistosoma japonicum tegumental membrane antigen (SjMAg) in immunodiagnosis and efficacy assessment]

OBJECTIVE

To evaluate the specificity and sensitivity of SjMAg in detecting specific antibodies in sera of patients with schistosomiasis japonica and in assessing therapeutic efficacy.

METHODS

SjMAg-ELISA was used to determine the specific IgG and IgG4 in sera of patients with schistosomiasis japonica at different time points after chemotherapy.

RESULTS

SjMAg-ELISA was as sensitive and specific as SEA-ELISA. The negative conversion rate of IgG detected by SjMAg-ELISA 12 months after treatment was 80.0%, being significantly higher than 43.3% by SEA-ELISA. The negative conversion rate of IgG4 detected by SjMAg-ELISA 12 months after treatment was 93.3%, being significantly higher than 60.0% by SEA-ELISA. The negative conversion rates of IgG and IgG4 2 yr after treatment were 92.9% and 97.6% respectively.

CONCLUSION

SjMAg-ELISA is comparable to SEA-ELISA in diagnosing schistosomiasis japonica and is more effective in assessing therapeutic efficacy.

A catalogue of molecular, physiological and symbiotic properties of soybean-nodulating rhizobial strains from different soybean cropping areas of China

We have analysed 198 fast-growing soybean-nodulating rhizobial strains from four different regions of China for the following characteristics: generation time; number of plasmids; lipopolysaccharide (LPS), nodulation factors (LCOs) and PCR profiles; acidification of growth medium; capacity to grow at acid, neutral, and alkaline pH; growth on LC medium; growth at 28 and 37 degrees C; melanin production capacity; Congo red absorption and symbiotic characteristics. These unbiased analyses of a total subset of strains isolated from specific soybean-cropping areas (an approach which could be called "strainomics") can be used to answer various biological questions. We illustrate this by a comparison of the molecular characteristics of five strains with interesting symbiotic properties. From this comparison we conclude, for instance, that differences in the efficiency of nitrogen fixation or competitiveness for nodulation of these strains are not apparently related to differences in Nod factor structure.

[Immunoscreening of Schistosoma japonicum adult worm cDNA library by sera from rabbits vaccinated with ultraviolet-attenuated cercariae]

OBJECTIVE

To find out the major antigenic molecules of radiation-attenuated cercariae, and provide some useful candidate antigens for developing schistosomiasis vaccine.

METHODS

Schistosoma japonicum (Sj) adult worm cDNA library was screened by sera of rabbits vaccinated with ultraviolet-attenuated cercariae, and the inserts of positive clones were specifically amplified by PCR and sequenced.

RESULTS

Ten positive clones were obtained after three rounds of screening, and the size of Sj cDNA fragments of the positive clones ranged from 1.5 kb to 1.8 kb. Five partial sequences were got after preliminary sequencing. Two of them had significantly homology with Sj dynein light chain 5(DLC 5) gene and Sj mitochondrial gene, respectively, and the others were identified as partial sequences of novel genes for they showed only partial homology with non-schistosome genes or other organism in the database.

CONCLUSIONS

The positive clones may be the genes encoding the antigens that can elicit protective immunity against Sj.

[Experimental study on immunization of mice with nucleic acid vaccine Sj31BIN combining IL-12 against Schistosoma japonicum]

Based on the anti-fecundity effect of Schistosoma japonicum nucleic acid vaccine Sj31BIN, we combined Sj31BIN with IL-12 in vaccination of mice to explore the role of IL-12 as an adjuvant. The result showed that immunization of the mice with Sj31BIN + IL-12 led to a significant decrease in adult worm recovery, a liver egg count reduction of 59.74%, an intestine egg count reduction of 59.60% and a liver surface egg granuloma reduction of 71.3%. In addition, vaccination of the mice with IL-12 alone also led to some but not significant decrease in adult worm recovery and the egg counts. It is concluded that Sj31BIN plus IL-12 induces significant anti-fecundity immunity.

[Preliminary report on immunoscreening of Schistosoma japonicum adult worm cDNA library by sera from infected Microtus fortis]

Microtus fortis (Mf) is resistant to Schistosoma japonicum (Sj) infection. To explore if Mf responses to special Sj antigens after infection, Sj adult worm cDNA library was screened with sera from infected Mf. Twelve positive clones were obtained after rescreening. After automatically excised with the helper phage, positive clones were further identified by PCR. The size of Sj cDNA fragments in positive clones ranged from 300 bp to 1.8 kb. Six of these fragments were 300 bp, one was 1 kb, and five were 1.8 kb in size. The results indicate that the infected Mf serum could recognize Sj specific antigens. It is valuable to further study the immune protection of these cloned molecules.

[Expression and purification of recombinant Schistosoma japonicum paramyosin]

Paramyosin of Schistosoma japonicum was expressed at a high level in E. coli. The recombinant protein could be easily purified from bacteria lysate by fast protein liquid chromatography(FLPC) on a TALON resin column, due to the protein being expressed with a tag of six histidine residue fused to the N-terminus. The protein was completely soluble and could be eluted under non-denaturing condition using imidazole. To eliminate imidazole and residue of E. coli, the elution was further purified by ion-exchange chromatography. The purified protein will be used in water buffaloes in the study on protective immunity against Schistosoma japonicum.

[Improvement of nitrogen fixation efficiency and plasmid stability in Bradyrhizobium japonicum by the introduction of dctABD and parCBA/DE genes]

A recombinant plasmid pHN207 containing C4-dicarboxylic acid transport genes (dctABD) from Sinorhizobium meliloti, parCBA/DE genes from pTR102 and reporter genes luxAB from pDB30 was constructed by using pLAFR3 as the vector. The pHN207 was then introduced into the Bradyrhizobium japonicum TA11 and CB1809 by bi-parental mating. It was confirmed that parCBA/DE genes could increase the stability of pLAFR3 in the transconjugants under both free-living and symbiotic condition. The results of plant pot experiment indicated that the introduction of dctABD genes could significantly improve the symbiotic nitrogen fixation efficiency of TA11 and CB1809 with soybean varieties of Heilong 33, Ningzhen No. 1 and Yudou No. 1. Compared with the control, the shoot dry weight (biomass) and total nitrogen content of the plants tested were significantly increased.

[Clinical and experimental study of shengxue syrup in treating chronic aplastic anemia]

The Shengxue Syrup (SXS) composed of Chinese medicinal herbs for invigorating the function of Spleen and resplenishing the Kidney was used in treating 115 chronic aplastic anemia patients. The SXS group consisted of 67 patients. After the median 20 months treatment the total effective rate (TER) was 97.0%. The other group was SXS + testosterone group consisted of 48 patients. After median 17.5 month treatment the TER was 95.8%. The difference of TER between two groups was insignificant. The result of animal experiment showed that SXS could markedly enhance the hematopoietic stem cells as well as progenitor cells proliferation of bone marrow in mice.

Studies on the synthesis and biological activities of 4'-(R)-hydroxy-5'-(S)-hydroxymethyl-tetrahydrofuranyl purines and pyrimidines

A series of 4'-(R)-hydroxy-5'-(S)-hydroxymethyl-tetrahydrofuranyl purines and pyrimidines were synthesized by the reaction of 3,4-epoxy-5-(S,trans)-dimethoxymethyl-tetrahydrofuran and nucleobases under the catalysis of potassium tert-butoxide and 18-crown-6. Compounds 6a, 6c and 7b have shown significant inhibition on the growth of HL-60 cells. The phosphotriester and phosphodiester of isonucleoside 8a-d were synthesized and cytotoxic activities were reported. The conformation of isonucleosides in solution was studied by 1H NMR.

[Clinical study of recombinant human granulocyte colony stimulating factor (rhG-CSF) on leukopenia induced by chemotherapy in cancer patients]

The clinical usefulness of Recombinant Human Granulocyte Colony Stimulating Factor (rhG-CSF, Filgrastim, GRAN) was evaluated in patients with leukopenia and neutropenia following chemotherapy for non-Hodgkin's lymphoma, lung cancer and breast cancer. During chemotherapy when patients' leukocyte count (WBC) fell below 4.0 x 10(9)/L.rhG-CSF(GRAN) at a dose of 75 micrograms/body.day was given subcutaneously 48 hours after the termination of chemotherapy. The results indicated that rhG-CSF(GRAN) could elevate nadirs of WBC and significantly shortened leukopenic period with WBC below 4.0 x 10(9)/L and expedited the recovery of WBC. rhG-CSF (GRAN)'s side effects were mild.

[High dose cisplatin combination chemotherapy for advanced breast cancer--a report on 50 cases]

Fifty patients with advanced breast cancer were treated by high dose cisplatin (DDP) combination chemotherapy during the period of August 1984 to June 1991. All of them had measurable disease. Among the fifty patients, 24 had previously received chemotherapy. DDP was given at a dose of 50-128 mg/m2 intravenously every 3 weeks. The regimen was PCMF (DDP + CTX + MTX + 5FU), PA (DDP+ADM) +/- other agents or PF (DDP + 5FU) +/- other agents. The overall response rate was 76% (38/50) with a CR rate of 20% (10/50). The median response duration and median survival time were 5.5 months and 15 months, respectively. Best response was obtained in soft tissue metastasis (83.3%, 40/48), and in lung metastasis (79.3%, 23/29). The response rate was lower in liver metastasis (40%, 2/5) and lowest in bone metastasis (0/9). Marked gastrointestinal reaction was observed in most patients (84%). These results indicate that high dose cisplatin combination chemotherapy is an effective regimen for advanced breast cancer.

[Experimental study on the Biomaterial/Porous Titanium composite dental implants]

This study investigated the tissue compatibility of bone morphogenetic protein (BMP) /biologic ceramic/porous titanium implant,BMP/porous titanium implant,biologic ceramic/porous titanium implant and porous titanium implant by LM,SEM,EDXA.The results showed that the new bone formation and new bone mature were earlier in the BMP composite implants treated group.BMP uncomposite implants had no evident difference in the time of new bone formation, but the interface bonding ways had significant difference.

[Effect of bone morphogenetic protein: experimental study of the implants-bone interface integration]

We investigated the effect of bone morphogenetic protein (BMP) on the implants--bone integration by light microscope, ABC technique, and EDXA. The results showed that there was difference between the BMP of foreign origin and internal origin in the time of inducing new bone formation and in the starting mechanism of new bone formation. The BMP composite implants could accelerate the osseointegration between implants and bone, and would be of value in clinical application.

[External pituitary irradiation therapy for acromegaly]

128 acromegaly patients were followed up for 1-23 years (mean 5.9 +/- 5.0 years) after external pituitary irradiation; among them 104 patients received fractional irradiation with an ultimate total dose of 4000-5000 rad. The remaining patients received a total dose of either < 4000 rad or > 5000 rad. Human growth hormone (hGH) level was measured after an oral load of 100g glucose to evaluate the effect of irradiation. After external pituitary irradiation, the serum level of hGH decreased progressively. The decrease was more rapid in the first three years with a decrement of 35.1% per year. 36.2% of all the patients has been judged as clinically inactive with low serum hGH level of < or = 5 ng/ml. 62.1% of the patients was considered as slightly active with hGH level < or = 10 ng/ml in the 15th year after therapy. The effect of irradiation was not influenced by the age of the patients, the course of acromegaly, the size of sella turcica and operation prior to irradiation. If the total dose of irradiation is lower than 4000 rad, the effect will not be good.

[Randomized trial of combined chemotherapy including high dose cisplatin and radiotherapy for esophageal cancer]

A prospective randomized trial in 64 esophageal cancer patients was conducted from 1986 to 1989. The patients were randomized into two groups-PPF (DDP 100 mg/m2 + pingyangmycin + 5-FU) regimen plus radiotherapy (combined group) or radiotherapy alone (control group). The overall response rate and CR rate in the combined group were 87.5% (28/32) and 40.6% (13/32). Those of the control group were 81.3% (26/32) and 21.9% (7/32), respectively. The overall response rates were similar in these two groups, but the CR rate in the combined groups was higher than that of the control group. The 1-year survival rates in the combined and control groups were 77.4% (24/31) and 45.2% (14/31) (p less than 0.01). The 2-year survival rates were 56.3% (9/16) and 34.6% (9/26), respectively (p greater than 0.05). Our preliminary results show that combined chemotherapy including high dose cisplatin and radiotherapy may improve the therapeutic result of esophageal cancer.

[High-dose methotrexate with citrovorum factor rescue (HD-MTX-CFR) in the treatment of malignant solid tumors--clinical analysis of 62 patients]

From 1977 to 1982, 62 patients with various advanced malignant solid tumors were treated by HD-MTX-CFR therapy and totally 129 courses were given. Majority of the patients suffered from malignant lymphoma (10), osteogenic sarcoma (11), lung cancer (16), esophageal cancer (3), breast cancer (3) and malignant melanoma (4). All were confirmed by cytology or pathology except one primary liver cancer. There were clinically measurable lesions in 59 patients for evaluation of the treatment, and 3 osteogenic sarcoma patients without metastasis were given a postoperative adjuvant chemotherapy. 33 out of 62 had received chemotherapy and/or radiotherapy before. Dose of MTX ranged from 2 to 3 gm per course in most patients and dose of CF, from 9 to 12 mg every 6 hours for 3 days. 2 (3.4%) patients achieved complete remission (1 osteogenic sarcoma and 1 malignant lymphoma) and 8 (13.6%), partial remission (1 osteogenic sarcoma, 5 malignant lymphoma, 1 esophageal cancer and 1 breast cancer) with a total response rate of 15.9%. No response was observed in all 16 lung cancers. The main side effects of HD-MTX-CFR therapy were leukopenia, thrombocytopenia, elevation of SGPT, nausea, vomiting, mucositis, skin rash, fever and fatigue. All patients were followed more than 3 years. 4 patients are still alive (9, 9, 4 and 7 years, respectively), including 3 osteogenic sarcoma patients who received postoperative adjuvant chemotherapy and 1 mycosis fungoides.

[COMVp regimen in the treatment of small cell lung cancer--report of 106 patients]

One hundred and six consecutive small cell lung cancer patients were treated by a combination regimen COMVp (CTX 1,000-1,400 mg IV D 1,8; VCR 1-2 mg IV D 1,8; MTX 20-40 mg IV or IM D 3,5,10,12; VP-16 100 mg IV drip D 3-7; three weeks as a cycle and 2-3 cycles as a course) in our hospital during 1983 to 1984. Among the 95 patients who were evaluated, 10 (10.5%) gave CR, 57 (60%) PR, 19 (20%) no change and 9 (9.5%) progression. The overall response rate was 70.5%. In this paper, factors influencing the response and side effects are also analysed. The data show that COMVp regimen is one of the good front line combination chemotherapy regimens currently available in the management of small cell lung cancer.

[Evaluation of combined chemotherapy including high-dose cisplatin in the treatment of malignant tumors]

The results of 63 patients with advanced malignant tumors treated by combined chemotherapy including high-dose cisplatin (HD-DDP) (single dose 50-100 mg/m2) are reported. The remission rates and duration of the remission for various malignant tumors were: 40% (10 PR out of 25 patients) and 3-8 months for non-small cell lung cancer (NSCLC) treated by PMFV (DDP, MMC, 5FU and VCR) regimen; 87% (4 CR and 9 PR out of 15) and 3-14 months for breast cancer treated by PCMF (DDP, CTX, MTX and 5FU) regimen; 100% (1 CR and 3 PR out of 4) and 3-10 months for testicular cancer treated by PPV (DDP, Pingyangmycin and VCR) regimen; 57% (1CR and 3 PR out of 7) and 5-12 months for malignant melanoma treated by PBDV (DDP, BCNU, DTIC and VCR) regimen; 33% (2 PR out of 6) and 5 months for esophageal cancer treated by PPV regimen. In 6 patients with other malignant tumors, the remission rate was 50% (3 PR). The results show that the combined regimens including HD-DDP in the treatment of breast cancer and NSCLC (remission rate 87% and 40%, respectively) are better than that including low-dose DDP (17% and 7%) (P less than 0.001, P less than 0.01) and that including adriamycin (30% and 13%) (P less than 0.001, P less than 0.05). In the treatment, obvious gastrointestinal reaction, leukopenia, thrombocytopenia and mild functional damage of the liver and kidney were observed.

Reproductive capacity of bacteroids in nodules of Trifolium repens L. and Glycine max (L.) Merr

Reproductive growth of intracellular bacteria from isolated protoplasts in nodules of clover and soybean was directly investigated using a microchamber with visual and video recording. Differentiated bacteriods from clover nodules uniformly failed to reproduce. Such growth as occurred came from undifferentiated rhizobia from within the protoplast or extracellularly in the nodule. Plating investigation gave results in agreement with this conclusion. Osmoprotective media failed to secure the reproduction of differentiated clover bacteroids. Reproductive growth of bacteroids from protoplasts and crushed nodules of soybean was regularly observed in the microchamber and determined as proportionate colony-forming ability (CFA) on laboratory media. The CFA markedly increased with age of nodule and with the addition of nodule or root extract. The promoting effect of such extracts was reduced after heating for 60 min at 100°C, and lost completely after 20 min at 121°C. High osmolarity in the suspending and culture media was detrimental to bacteroid recovery.