[Quantitative HER2 mRNA assay in breast cancer with HER2 immunohistochemistry 0]

Objective: To investigate HER2 mRNA expression in breast cancer with HER2 immunohistochemistry (IHC) 0 and to analyze the feasibility of distinguishing between the tumor with HER2 μltra-low expression and the one without expression of HER2 (no staining by IHC) by HER2 mRNA level preliminarily. Methods: HER2 mRNA was analyzed by reverse transcription digital PCR in 41 cases of formalin-fixed paraffin-embedded surgical tissue samples of invasive breast cancer obtained between January 2020 and March 2023 at Peking Union Medical College Hospital. The cohort included 21 HER2 IHC 1+ and 20 IHC 0 (12 ultra-low and 8 non-expression of HER2). HER2 mRNA expression level was quantitatively evaluated by the FAM (HER2)/VIC (reference gene) ratio. Results: The expression of HER2 mRNA for the cases with 1+, ultra-low, and non-expression of HER2 by IHC was 0.30 to 1.78 (average 0.90, median 0.82), 0.55 to 1.51 (average 0.93, median 0.90) and 0.22 to 0.78 (average 0.41, median 0.36), respectively. For the mean and median HER2 mRNA levels, there was no significant difference between HER2 IHC 1+ and HER2 ultra-low expression diseases (P=0.757). A remarkable difference in HER2 gene expression was found between the tumors with 1+ and non-expression of HER2 by IHC (P=0.002). And, HER2 ultra-low cases contained statistically higher levels of HER2 mRNA compared with non-expression of HER2 subgroup by IHC (P=0.001). Conclusions: Based on HER2 mRNA, HER2 non-expression and HER2 weak expression (including HER2 IHC 1+ and ultra-low) belong to two different types of the tumor and the disease with HER2 IHC 1+ and HER2 ultra-low expression may be the same. It is necessary to further test the performance of HER2 mRNA detection for stratifying the HER2 weak expression subgroup and to determine the threshold.

[Transitional urology-current status and prospects of pediatric over-age practice]

With the continuous advancement of medicine, more children with congenital or pediatric-onset chronic urologic conditions are surviving well into adulthood, which imposes an ever-rising need for adequate transition of these patients from pediatric to adult care. Transitional Urology focuses on the health care needs of adolescents and young adults with congenital urological disorders as they transfer from pediatric to adult care, maximizing the best interests of the children. Since Shanghai Children's Medical Center has been approved for over-age continuous medical care, this paper aims to analyze the currently perceived barriers in care transition within the urological context, explore the ways of previously implemented transition models, and propose the suggestions for improvement.

A pDNA/rapamycin nanocomposite coating on interventional balloons for inhibiting neointimal hyperplasia

Drug-coated balloon (DCB) is a therapeutic method that can effectively deliver antiproliferative drugs such as paclitaxel and rapamycin (RAPA) with no permanent implants left behind. However, delayed reendothelialization due to the toxicity of the delivered drugs leads to poor therapeutic effects. Here, we propose a new design of DCB coating, which incorporates both vascular endothelial growth factor (VEGF)-encoding plasmid DNA (pDNA) that can promote endothelial repair and RAPA into protamine sulfate (PrS). We demonstrate that the PrS/pDNA/RAPA coating had stability and good anticoagulation properties in vitro. We further show that the coating exhibited excellent transfer capacity from balloon substrates to vessel walls both in vitro and in vivo. Furthermore, the PrS/pDNA/RAPA coating effectively inhibited neointimal hyperplasia after balloon-induced vascular injuries through the down-regulation of the mammalian target of Rapamycin (mTOR) and promoted endothelium regeneration through increased expression of VEGF in vivo. These data indicate that our nanocomposite coating has great potential for use as a novel coating of DCB to treat neointimal hyperplasia after vascular injuries.

[Application of diffusion-weighted magnetic resonance imaging in evaluating the efficacy of radiotherapy and chemotherapy for esophageal cancer]

This study was a prospective single arm trial conducted in Zhejiang Jinhua Guangfu hospital from February 2018 to June 2020. A total of 39 patients (32 males and 7 females) with esophageal cancer, aged from 44 to 82 (69±9) years were enrolled. Diffusion weighted magnetic resonance imaging(MR-DWI) was implemented to evaluate the changes of apparent diffusion coefficient(ADC) value before and after chemoradiotherapy. The results showed that the ADC value after chemoradiotherapy was higher than that before treatment[(2.03±0.42)×10⁻³ mm ²/s vs (1.60±0.28)×10⁻³ mm²/s], and there was a positive correlation between the increase of ADC value and the prognosis of patients.

Research Progress on the Molecular Mechanisms of Toxicology of Ethanol-Aconitine Induced Arrhythmia

Abstract

Aconitum is one of the most widely used Chinese herbal medicines, and aconitine is the major toxic component in it. Aconitine can induce a variety of arrhythmias, resulting in death. Acute ethanol consumption causes arrhythmia as well. Poisoning cases caused by aconitum medicinal liquor are frequently encountered in the practice of forensic medicine. The molecular mechanisms of myocardial toxicity of these two drugs have much in common, and both of them affect the sodium channel, calcium channel and potassium channel of myocardial cell membrane and so on. This paper analyzes and discusses the possible co-effects of ethanol-aconitine on cardiomyocyte channel proteins, by reviewing researches on the mechanism of cardiotoxicity of ethanol and aconitine in recent years, in order to provide ideas and references for the research on the molecular mechanism of arrhythmia caused by combined poisoning.

[Advances in the research of pain assessment and non-drug intervention in burn children]

Children are a high-risk group of burn, and burn pain is a special type of pain. Because children of different ages have different cognitive ability and behavioral response to pain, thus it is particularly difficult to effectively evaluate the pain. It is very important for medical staff to understand the pain of children, to define the adverse reactions of pain, to evaluate and take appropriate pain intervention measures in time and effectively. In this paper, different evaluation methods of burn pain in children and non-drug intervention related measures were reviewed in order to provide references for clinical practice.

[Application of Mixed-effect Model in PMI Estimation by Vitreous Humor]

OBJECTIVES

To test the changes of the potassium （K⁺） and magnesium （Mg²⁺） concentrations in vitreous humor of rabbits along with postmortem interval （PMI） under different temperatures, and explore the feasibility of PMI estimation using mixed-effect model.

METHODS

After sacrifice, rabbit carcasses were preserved at 5 ℃, 15 ℃, 25 ℃ and 35 ℃, and 80-100 μL of vitreous humor was collected by the double-eye alternating micro-sampling method at every 12 h. The concentrations of K⁺ and Mg²⁺ in vitreous humor were measured by a biochemical-immune analyser. The mixed-effect model was used to perform analysis and fitting, and established the equations for PMI estimation. The data detected from the samples that were stoned at 10 ℃, 20 ℃ and 30 ℃ with 20, 40 and 65 h were used to validate the equations of PMI estimation.

RESULTS

The concentrations of K⁺ and Mg²⁺ [f（x,y）] in vitreous humor of rabbits under different temperature increased along with PMI （x）. The relative equations of K⁺ and Mg²⁺ concentration with PMI and temperature under 5 ℃~35 ℃ were f_K⁺（x,y）=3.413 0+0.309 2 x+0.337 6 y+0.010 83 xy-0.002 47 x² （P<0.000 1）, and f_Mg²⁺（x,y）=0.745 6+0.006 432 x+0.033 8 y （P<0.000 1）, respectively. It was proved that the time of deviation for PMI estimation by K⁺ and Mg²⁺ was in 10 h when PMI was between 0 to 40 h, and the time of deviation was in 21 h when PMI was between 40 to 65 h.

CONCLUSIONS

the ambient temperature range of 5 ℃-35 ℃, the mixed-effect model based on temperature and vitreous humor substance concentrations can provide a new method for the practical application of vitreous humor chemicals for PMI estimation.

[An adolescent with Hashimoto's encephalopathy after surgery and ¹³¹I radiotherapy for papillary thyroid carcinoma: one case report]

Hashimoto's encephalopathy is a rare brain disease. Its etiology is still unknown. In this paper, we reported a 15-year-old female patient underwent total thyroidectomy and lymph node dissection, due to a multifocal papilliferous carcinoma of the right lobus. Forty-two days after surgery, the patient was treated by ¹³¹I radiotherapy in another hospital and begun to have a headache after 48 hours. At last, the patient was diagnosed by HE on the basis of all considerations. She recovered from by i.v. Immunoglobulin. Till now, the patient has not relapsed for more than 4 years follow-up.

Ursolic acid inhibits proliferation and reverses drug resistance of ovarian cancer stem cells by downregulating ABCG2 through suppressing the expression of hypoxia-inducible factor-1α in vitro

Hypoxia in tumors is closely related to drug resistance. It has not been verified whether hypoxia-inducible factor-1α (HIF-1α) or ABCG2 is related to hypoxia-induced resistance. Ursolic acid (UA), when used in combination with cisplatin can significantly increase the sensitivity of ovarian cancer stem cells (CSCs) to cisplatin, but the exact mechanism is unknown. The cell growth inhibitory rate of cisplatin under different conditions was evaluated using Cell Counting Kit-8 (CCK-8) in adherence and sphere cells (SKOV3, A2780, and HEY). The expression of HIF-1α and ABCG2 was tested using quantitative PCR, western blotting, and immuno-fluorescence under different culture conditions and treated with UA. Knockdown of HIF-1α by shRNA and LY294002 was used to inhibit the activity of PI3K/Akt pathway. Ovarian CSCs express stemness-related genes and drug resistance significantly higher than normal adherent cells. Under hypoxic conditions, the ovarian CSCs grew faster and were more drug resistant than under normoxia. UA could inhibit proliferation and reverse the drug resistance of ovarian CSC by suppressing ABCG2 and HIF-1α under different culture conditions. HIF-1α inhibitor YC-1 combined with UA suppressed the stemness genes and ABCG2 under hypoxic condition. The PI3K/Akt signaling pathway activation plays an important functional role in UA-induced downregulation of HIF-1α and reduction of ABCG2. UA inhibits the proliferation and reversal of drug resistance in ovarian CSCs by suppressing the expression of downregulation of HIF-1α and ABCG2.

[Comparison of HER2 gene status between primary breast cancer and synchronous axillary lymph node metastasis]

OBJECTIVE

To investigate the discordant rate of HER2 gene status between primary breast cancer and synchronous axillary lymph node metastasis.

METHODS

One hundred and fifty cases of primary breast cancer with corresponding synchronous lymph node metastases were collected, including 50 cases of HER2 FISH positive, 50 cases of HER2 FISH negative and 50 cases of HER2 FISH equivocal primary tumors, at Peking Union Medical College Hospital between May 2012 and June 2015. The HER2 gene status in lymph node metastatic tumors was analyzed by FISH, and the discordance of HER2 gene status was identified between primary and metastatic tumors.

RESULTS

The incidence of discordant HER2 gene status between primary breast cancer and synchronous lymph node metastasis was 20.67%(31/150). Forty-four FISH positive, 3 FISH equivocal and 3 FISH negative cases were found in the first group of 50 patients with HER2 positive results in primary tumor. Forty seven FISH negative, 3 FISH equivocal cases were discovered in the second group of 50 patients with HER2 negative results in primary tumor. Four FISH positive, 18 FISH negative and 28 equivocal cases were observed in the third group of 50 patients with HER2 equivocal results in primary tumor. The discordance of HER2 gene status between primary tumor and lymph node metastasis in the third group of patients was significantly higher than the other two groups (P<0.05).

CONCLUSIONS

Significant discordance of HER2 gene status between the primary and lymph node metastatic tumors exists. Patients with lymph node metastasis, simultaneous testing of HER2 status may be performed in both primary breast tumor and its lymph node metastasis. HER2 status of nodal metastatic lesion may be more relevant for guiding anti-HER2 target therapy.

Transformation of microcystins to 2-methyl-3-methoxy-4-phenylbutyric acid by room temperature ozone oxidation for rapid quantification of total microcystins

Microcystins (MCs) are cyanobacterial hepatotoxins capable of accumulation into animal tissues. To determine the total microcystins in water, a novel analytical method, including ozonolysis, methylation of 2-methyl-3-methoxy-4-phenylbutyric acid (MMPB) with methylchloroformate (MCF) and gas chromatography mass spectrometry (GC-MS) detection was developed. The results show that MCs can be oxidized by ozone to produce MMPB at ambient temperature, proving ozonation is an effective, rapid and green method for the transformation of MCs to MMPB without secondary pollution. The oxidation conditions as well as the esterification process were optimized and, subsequently applied to analysis of environmental samples. The method shows wide linear range and high sensitivity with a detection limit of 0.34 μg L(-1). The established method was successfully applied to the analysis of microcystins in water samples.

Role of natural kill cells in hepatitis B virus infection

Natural killer (NK) cells are a unique group of lymphocytes with cytotoxicity, playing an important role in anti-tumor and anti-infection activities. Recently, NK cells are increasingly recognized to play a role during hepatitis B virus (HBV) infection. Studies have confirmed NK cells participate in anti-HBV responses by secreting cytokines, mediating apoptosis and killing target cells, indicating a potential strategy for controlling HBV infection via regulation of NK cell functions. This review discusses the contribution of NK cells to HBV elimination, liver injury, and other parts of immune system and the formulation of new therapeutic strategies.

[Research on HBV DNA inhibition of plasmid acute infection mouse with betulinic acid]

Betulinic acid is a naturally occurring pentacyclic triterpenoid, which has antiretroviral, antimalarial, and anti-inflammatory properties. The purpose of this study is to investigate the HBV DNA replication inhibition in the mouse model with betulinic acid. Hydrodynamic injection method via the tail vein with the Paywl. 3 plasmid was used to establish the animal mode (n = 15), and the mice were randomly divided into the PBS control group (n = 5), Betulinic acid treatment group (n = 5) and lamivudine control group (n = 5). The day after successful modeling , the mice would have taken Betulinic acid (100 mg x kg(-1)), lamivudine (50 mg x kg(-1)), PBS drugs orally, once daily for 7 days, blood samples were acquired from the orbital venous blood at 3, 5, 7 days after the administering, HBsAg and HBeAg in serum concentration were measured by ELISA and the mice were sacrificed after 7 days, HBV DNA southern detections were used with part of mice livers. The results showed that betulinic acid significantly inhibited the expression of HbsAg in the mice model at the fifth day compared with the control group, and there was no significant differences between the effects of lamivudine and the PBS control group; both the betulinic acid and lamivudine groups had no significant inhibition for the HBeAg expression; the HBV DNA expressions of the liver tissue from the betulinic acid and lamivudine groups were inhibited compared with the control group. Taken together, these results reveal betulinic acid can inhibit the HBsAg expression and replication of the liver HBV DNA in the mouse model.

CCAAT/enhancer-binding protein alpha antagonizes transcriptional activity of hypoxia-inducible factor 1 alpha with direct protein-protein interaction

Hypoxia-inducible factor 1 (HIF-1), a master heterodimeric transcriptional regulator consisting of HIF-1alpha and HIF-1beta subunits for cellular response to hypoxia, plays an important role in carcinogenesis, while CCAAT/enhancer-binding protein alpha (C/EBPalpha) is proposed to act as a tumor suppressor in C/EBPalpha-expressing tissues. Previously, we reported that ectopically expressed HIF-1alpha protein interacts with and enhances transcriptional activity of C/EBPalpha, which favors leukemic cell differentiation. Here we further showed that such an interaction also occurred in their endogenously expressing state of leukemic U937 cells. Glutathione S-transferase pull-down assay proposed that the protein-protein interaction was direct, and transactivation domains of C/EBPalpha and the basic helix-loop-helix domain of HIF-1alpha were essential for such an interaction. More intriguingly, we provided the first demonstration that C/EBPalpha competed with HIF-1beta for direct binding to HIF-1alpha protein. Correspondingly, C/EBPalpha overexpression significantly inhibited the DNA-binding ability of HIF-1 and expressions of hypoxia-responsive element-driven luciferase and HIF-1-targeted genes vascular endothelial growth factor, glucose transporter-1 and phosphoglycerate kinase 1. In parallel, suppression of C/EBPalpha expression by specific small hairpin RNA increased DNA-binding ability of HIF-1 and expression of these HIF-1-targeted genes in leukemic U937 cells. These results would provide new insights for antitumor potential of C/EBPalpha protein.

Does Endothelial Chimerism Correlate With Renal Allograft Rejection?

BACKGROUND

The blood vessels of a transplanted organ are an interface between the donor and the recipient. The endothelium is believed to be a major target for graft rejection. After transplantation endothelial cells of a transplanted organ may be of recipient origin.

OBJECTIVES

In this study we sought to determine whether endothelial chimerism correlates with graft rejection.

METHODS

Biopsy samples from 34 renal transplants of female recipients who received kidneys from male donors were studied for the presence of endothelial cells of recipient origin. Formalin-fixed, paraffin-embedded tissue sections of renal biopsy samples were examined by fluorescence in situ hybridization (FISH) for the presence of endothelial cells containing two X chromosomes, using a biotinylated Y-chromosome probe and digoxigenin-labeled X-chromosome probe.

RESULTS

The FISH methods identified endothelial cells of recipient origin. Endothelial chimerism was common, irrespective of rejection. Its presence was focal with these elements, coexisting in the biopsy.

CONCLUSIONS

We observed no correlation between the percentage of recipient endothelial cells among vascular elements and the type of graft rejection (P > .05).

Coupled reduction of chlorinated hydrocarbons and heavy metals by zerovalent silicon

The feasibility of using zerovalent silicon (Si0) as a novel reductant to remove chlorinated compounds and heavy metals in contaminated sites was investigated. The kinetics and degradation mechanism of carbon tetrachloride (CT) by Si0 were also examined. Results showed that zerovalent silicon could effectively dechlorinate the chlorinated compounds. A nearly complete dechlorination of CT by Si0 was obtained within 14 h. The produced concentrations of chloroform (CF) accounted for 71-88% loss of CT, showing that reductive dechlorination is the major degradation pathway for the degradation of chlorinated hydrocarbons by Si0. The degradation followed pseudo first-order kinetics and the normalized surface reaction rate constant (k(sa)) for CT dechlorination ranged between 0.0342 and 0.0454 L m(-2) h(-1) when CT concentrations were in the range of 3-20 microM. A linear relationship between the k(sa) and pH value was also established. In addition, zerovalent silicon has a high capability in the removal of heavy metals. 83% of Cr(VI) was removed by 0.5g Si0 within 5 h, which is higher than that by Fe0. The removal efficiency of divalent metal ions by Si0 followed the order of Cu(II) > Pb(II) > Ni(II). This indicates that zerovalent silicon is an alternative reductant and can undergo coupled reduction of heavy metals and chlorinated hydrocarbons in contaminated groundwater.

Effect of epristeride on the expression of IGF-1 and TGF-beta receptors in androgen-induced castrated rat prostate

The development of benign prostatic hyperplasia (BPH) is an androgen-dependent process that may be mediated by a number of locally produced growth factors. Among them, insulin-like growth factor 1 (IGF-1) and transforming growth factor beta (TGF beta) are thought important in regulating prostate growth and homeostasis, and their expression undergoes changes in proliferative prostatic disease. Epristeride, a 5 alpha-reductase inhibitor, is an effective drug in the treatment of BPH, inducing regressive changes in the prostate. This study was designed to assess the effects of epristeride on expression of these two factors at mRNA and protein levels in castrated rats maintained with exogenous testosterone. Epristeride treatment caused significant reduction in ventral prostate weight in a dose-dependent manner. There was a positive correlation between IGF-1 mRNA expression and ventral prostate weight and an inverse correlation between TGF-beta 1 mRNA expression and ventral prostate weight. Immunohistochemistry showed strong IGF-1 receptor immunoreactivity in the prostatic epithelial cells of untreated animals. In situ hybridization demonstrated high levels of IGF-1 mRNA expression both in the prostatic stromal and epithelial cells of untreated rats. In treated rats, both IGF-1 receptor protein and IGF-1 mRNA levels decreased significantly, and IGF-1 mRNA was mainly expressed in prostatic stromal cells. Weak expression of TGF beta receptors at the protein level and TGF beta at the mRNA level were found in the prostatic hyperplastic epithelial cells of untreated rats. In treated animals, intense T beta RII immunoreactivity was observed in epithelial cells, and a higher level of TGF beta mRNA was observed in both epithelial cells and stromal cells compared with control animals. In our opinion, the effect of epristeride on rat prostatic atrophy might be mediated via local growth factor(s).

Knockdown of IGF-IR by Antisense Oligodeoxynucleotide auguments the sensitivity of bladder cancer cells to mitomycin

AIM

To investigate whether insulin-like growth factor I receptor (IGF-IR) was involved in drug resistance of bladder cancer cells.

METHODS

RT-PCR was used to detect the mRNA expression of IGF-I, IGF-II, and IGF-IR in T24 cells and normal urothelial cells. Flow cytometry and MTT tests were used to assess the effect of antisense oligodeoxynucleotide (ODN) on drug sensitivities and apoptosis of T24 cells to mitomycin (MMC). Western blot was used to analyze the effect of ODN on expression of IGF-I R protein.

RESULTS

mRNA of IGF-I, IGF-II, and IGF-IR were strongly expressed in serum-free cultured T24 cell line, whereas normal urothelial cells did not express these factors/receptors or only in trace levels; knockdown of IGF-IR by antisense ODN greatly inhibited the growth of bladder cancer cells and enhanced sensitivity and apoptosis of T24 cells to MMC.

CONCLUSION

These results suggested that blockage of IGF-IR signaling might potentially contribute to the treatment of bladder cancer cells which were insensitive to chemotherapy.

Visualization of acoustic radiation from a vibrating bowling ball

This paper presents visualization of acoustic radiation from a vibrating bowling ball using the Helmholtz equation least squares (HELS) method. In conducting the experiments, the ball is excited by a vibration shaker using stationary random signals. The radiated acoustic pressures are measured using two microphones and taken as input to the HELS formulations. The reconstructed acoustic pressures on the bowling ball surface are compared with those measured at the same locations. Also shown are comparisons of the reconstructed and measured acoustic pressure spectra at various locations on the bowling ball surface. Results demonstrate that the accuracy of reconstruction based on measurements over a conformal surface is much higher than that over a finite planar surface. This is because the latter often extends beyond the near-field region, making the accuracy of measurements inconsistent. Nevertheless, satisfactory reconstruction of acoustic pressure fields over the entire bowling ball surface can still be obtained based on the measurements taken over a finite planar surface on one side of the source. In a similar manner, the normal component of the surface velocity is reconstructed. Once these acoustic quantities are determined, the time-averaged acoustic intensity is calculated. Also presented are the formulations for estimating a priori the numbers of expansion functions and measurements required by the HELS method and the guidelines for determining the reconstruction error and optimum measurement locations, given the overall dimensions of the source and the highest frequency of interest in reconstruction.

Effect of epristeride on expression of TGF-beta receptor in rat prostatic epithelial cells in vitro

AIM

To assess the effect of epristeride on the expression of transforming growth factor beta type II receptor (TbetaR II) in rat prostatic epithelial cells in vitro.

METHODS

RT-PCR and Western blot were used to quantitatively detect the mRNA and protein expressions of TbetaR II in rat prostatic epithelial cells treated or untreated with epristeride. Immunocytochemical staining method was used to qualitatively analyze the expression of TbetaR II protein.

RESULTS

After treatment with epristeride 180 or 360 nmol/L, TbetaR II mRNA expression levels were 0.56 +/- 0.08 and 0.59 +/- 0.07, respectively, which were significantly up-regulated compared with control cells (0.38 +/- 0.04, P < 0.05); expression level of TbetaR II protein were 3163 +/- 920 and 6769 +/- 1941, respectively, which were also markedly up-regulated compared with control cells (536 +/- 240, P < 0.05). Immunostaining showed weak positive reaction in control cells, while strong staining of TbetaR II was found in epristeride-treated cells.

CONCLUSION

Epristeride may up-regulate the expression of TbetaR II to induce apoptosis of prostatic epithelial cells.

Blockage of IGF-1R signaling sensitizes urinary bladder cancer cells to mitomycin-mediated cytotoxicity

A major problem which is poorly understood in the management of bladder cancer is low sensitivity to chemotherapy and high recurrence after transurethral resection. Insulin-like growth factor 1 receptor (IGF-1R) signaling plays a very important role in progression, invasion and metastasis of bladder cancer cells. In this study, we investigated whether IGF-1R was involved in the growth stimulating activity and drug resistance of bladder cancer cells. The results showed: The mRNAs of IGF-1, IGF-2 and IGF-1R were strongly expressed in serum-free cultured T24 cell line, whereas normal urothelial cells did not express these factors/receptors or only in trace levels; T24 cell responded far better to growth stimulation by IGF-1 than did normal urothelial cells; blockage of IGF1R by antisense oligodeoxynucleotide (ODN) significantly inhibited the growth of T24 cell and enhanced sensitivity and apoptosis of T24 cells to mitomycin (MMC). These results suggested that blockage of IGF-IR signaling might potentially contribute to the treatment of bladder cancer cells which are insensitive to chemotherapy.

[The development of a competency-based clinical performance examination model in maternity nursing for BSN graduates]

The purpose of the study was to establish a competency-based clinical performance examination model in maternity nursing for baccalaureate students. Action research was the main research methodology used in the study. A committee, consisting of nursing faculty, students and experienced obstetric nurses, was established to develop the model. Based on intensive literature reviews and standards of nursing practice in Taiwan, the first draft of the model, including the content and process, was created by the committee. The draft then was revised twice after expert review and pilot testing. The revised version of the model was formally implemented into the curriculum to examine the competencies of forty-one BSN students at the end of the perinatal nursing course. Responses from students, clinical examiners, clinical staff and clients were all gathered and integrated to refine the model. The model has content, expert and discriminative validity. The reliability of the model was proven by the high consistency in administration and scoring of the model among clinical examiners.

Inhibition of cultured rat prostatic epithelial cell growth by epristeride in vitro

AIM

To study the molecular mechanism of rat prostate atrophy induced by epristeride.

METHODS

MTT test was used to determine the effect of epristeride on the growth of prostatic epithelial cell induced by exogenous epithelial growth factor (EGF) or insulin-like growth factor-I (IGF-I). RT-PCR and flow cytometry were then used to quantitatively detect the mRNA and protein expressions of EGFR and IGF-I R of the epithelial cells treated or untreated with epristeride.

RESULTS

Epristeride attenuated growth of epithelial cells induced by exogenous EGF, IGF-I. Epristeride 360 nmol/L inhibited EGFR and IGF-I R expression at mRNA level, while epristeride 180 nmol/L had no marked effect on EGFR and IGF-I R mRNA expression. Both epristeride 180 nmol/L and 360 nmol/L could down regulate EGFR and IGF-I R protein levels.

CONCLUSION

The molecular mechanisms of prostatic epithelial cell atrophy induced by epristeride might be associated with alteration in the expression of growth factor receptors such as EGF and IGF-I.

[Characteristics of an established cervical carcinoma cell line HCE1]

This paper deals with a new cell line established from 5 carcinoma specimens of hysterectomy and designated as HCE1. This cell line has been passaged more than 80 times(more than 18 months). It has the characteristics: 1. The pathological features of the tumor transplanted in nude mice were similar to that of the original inoculated lesion; 2. Electromicroscopically, there were rich microvilli on the surface of the cells. Abundant ribosomes were also observed; 3. The growth curves of the 25th passage were determined, the population doubline time calculated in the log phase of growth was 45.8 h; 4. The cloning efficiency in soft agar averaged 14.8% after counting 6 plates; 5. Karyo-type analysis showed aneuploidy with the modal chromosomal number 64-97.

Experimental validations of the HELS method for reconstructing acoustic radiation from a complex vibrating structure

This paper presents experimental validations of the Helmholtz Equation Least Squares (HELS) method [Wang and Wu, J. Acoust. Soc. Am. 102, 2020-2032 (1997); Wu and Wang, U.S. Patent Number 5712805 (1998); Wu, J. Acoust. Soc. Am. 107, 2511-2522 (2000)] on reconstruction of the radiated acoustic pressures from a complex vibrating structure. The structure under consideration has geometry and dimensions similar to those of a real passenger vehicle front end. To simulate noise radiation from a vehicle, a high fidelity loudspeaker installed inside the structure at the location of the engine is employed to generate both random and harmonic acoustic excitations. The radiated acoustic pressures are measured over a finite planar surface above the structure by a microphone. The measured data are taken as input to the HELS formulation to reconstruct the acoustic pressures on the top surface of the structure as well as in the field. The reconstructed acoustic pressures are then compared with measured ones at the same locations. Also shown are comparisons of the reconstructed and measured acoustic pressure spectra at various locations on the surface. Results show that satisfactory reconstruction can be obtained on the top surface of the structure subject to both random and harmonic excitations. Moreover, the more measurements and the closer their distances to the source surface, the more accurate the reconstruction. The efficiency of the HELS method may decrease with increasing of the excitation frequency. This high frequency difficulty is inherent in all expansion theories.

On reconstruction of acoustic pressure fields using the Helmholtz equation least squares method

This paper presents analyses and implementation of the reconstruction of acoustic pressure fields radiated from a general, three-dimensional complex vibrating structure using the Helmholtz equation least-squares (HELS) method. The structure under consideration emulates a full-size four-cylinder engine. To simulate sound radiation from a vibrating structure, harmonic excitations are assumed to act on arbitrarily selected surfaces. The resulting vibration responses are solved by the commercial FEM (finite element method) software I-DEAS. Once the normal component of the surface velocity distribution is determined, the surface acoustic pressures are calculated using standard boundary element method (BEM) codes. The radiated acoustic pressures over several planar surfaces at certain distances from the source are calculated by the Helmholtz integral formulation. These field pressures are taken as the input to the HELS formulation to reconstruct acoustic pressures on the entire source surface, as well as in the field. The reconstructed acoustic pressures thus obtained are then compared with benchmark values. Numerical results demonstrate that good agreements can be obtained with relatively few expansion functions. The HELS method is shown to be very effective in the low-to-mid frequency regime, and can potentially become a powerful noise diagnostic tool.

Skin flap storage with intracellular and extracellular solutions containing trehalose

To evaluate and compare the effects of IT-Kyoto (IT-K) solution (intracellular type) and ET-Kyoto (ET-K) solution (extracellular type) on long-term skin flap preservation (from 24-120 hours), Japanese white rabbits were used as an animal model and Euro-Collins (EC) solution was used as a comparative solution. A total of 180 animals were divided randomly into 15 groups (N = 12) for 24, 48, 72, 96, and 120 hours of flap storage in three solutions. The survival rate, weight change, and histological appearance of flaps were compared among the three solutions. The survival rates in the IT-K and ET-K solutions were the same: 100%, 100%, 100%, 92%, and 50% in flaps preserved for 24, 48, 72, 96, and 120 hours, which were higher (p < 0.01 in the 72-, 96-, and 120-hour groups) than those in the EC solution group: 100%, 75%, 33%, 8.3%, and 0%. The flap weight gain in the IT-K and ET-K solution groups was less than that in EC solution group (p < 0.01). Histologically, flaps in the IT-K and ET-K solution groups showed a better appearance than those in the EC solution group. It was concluded that in a rabbit model IT-K and ET-K solutions are superior to EC solution for long-term skin flap preservation, and the safe preservation period for IT-K and ET-K solutions is approximately 96 hours. It was also concluded that the effects of intracellular (IT-K)-type solution and extracellular (ET-K)-type solution on rabbit skin flap preservation are similar.

The induction of apoptosis by SV40 T antigen correlates with c-jun overexpression

Simian virus (SV40) T antigen shares many characteristics with adenovirus E1A which is known to induce apoptosis. To verify the potential of SV40 T antigen-mediated apoptosis, we stably expressed T antigen in immortalized human epithelial cells (Z172 and HaCaT). We found that SV40 T antigen could directly cause apoptosis in 22-27% of these cells under normal growth condition as measured by chromatin condensation and nucleosomal fragmentation. The apoptosis of HaCaT cells which contain mutant p53 suggests the p53-independent nature of T antigen-mediated apoptosis. T antigen-induced apoptosis was associated with increased expression of c-Jun protein. Moreover, the overexpression of c-jun alone in these cells also induced apoptosis, indicating that c-jun might play an important role in T antigen-induced apoptosis.

Treatment of capillary vascular malformation (port-wine stains) with photochemotherapy

One-hundred and thirty patients (85 female, 45 male) with port-wine stains were treated with photodynamic therapy, also called photochemotherapy, which recently has become acknowledged as effective for a variety of malignant tumors. Probably based on the photochemical reaction with the generation of toxic species, photochemotherapy results in endothelial cell injury and death of abnormal capillaries under overlying epidermis. A retrospective review of 118 available patients with port-wine stains reveals that 98.3 percent responded to photochemotherapy with varying degrees of success after one-time treatment. Results were reported under a simple classification system ranging from ordinary to dilated to posttreatment type. In the ordinary group, the results evaluated as excellent, good, fair, and poor were 37.8, 53.7, 8.5, and 0 percent, respectively, before a second treatment; the treated area was an average of 9.8 (range 7 to 13) cm in diameter. In addition, hypertrophic scars, permanent hyperpigmentation, and hypopigmentation were not seen based on proper parameters. Photochemotherapy offers a potentially efficient and promising choice based on a completely different mechanism from that of selected photothermal therapy with the pulsed-dye laser.

Catabolic effect in premature infants with early dexamethasone treatment

To evaluate the catabolic effects of dexamethasone therapy on protein metabolism, amino acid concentrations and urinary 3-methylhistidine (3MH) were measured in 28 premature infants who were included in a double-blind controlled study using early dexamethasone therapy in the prevention of bronchopulmonary dysplasia. Fifteen infants received dexamethasone (0.5 mg/kg/day i.v.) and 13 infants received normal saline as control. Heparinized venous blood samples for amino acid analysis were obtained before the study and again at day 5 after starting the study. Urinary 3MH was measured on days 1, 3, 5, 7, 14, 21, and 28 of treatment. A substantial increase in amino acid concentrations was observed in infants receiving dexamethasone. Alanine, glutamine, citrulline, ornithine and cystine concentrations increased twofold or more. The 3MH:creatinine ratio was increased in the treated group. These metabolic effects were most likely due to an increase in protein catabolism.

Detection of congenital cytomegalovirus infection in Chinese newborn infants using polymerase chain reaction

Polymerase chain reaction (PCR) amplification was used to detect cytomegalovirus (CMV) in 1000 urine specimens from Chinese newborns for defining the incidence of congenital CMV infection in the Chinese population. The major immediate-early and the late antigen genes of CMV were amplified and detected by gel electrophoresis. There were 18 congenitally infected infants found when tests were performed with one or both primer pairs. Comparing with tissue culture, PCR of both primer sets provided a sensitivity of 94%, a specificity of 100% and a predictive value of positive result of 100%.

Typhlitis in acute childhood leukemia

Typhlitis is a necrotizing inflammation of the cecum usually found in acute leukemia patients on chemotherapy in the setting of agranulocytosis. We describe five cases of typhlitis, characterized by fever, abdominal pain, abdominal tenderness and watery diarrhea, occurring during periods of neutropenia. In 4 cases, sonography showed thickening of the cecum wall. Ultrasound appears to offer an easy noninvasive method of diagnosing this potential lethal disease. Four patients were treated successfully with broad-spectrum antibiotics and bowel rest. There was 1 death resulting from septic complication.

[Electrodiagnostic evaluation of conservative treatment in carpal tunnel syndrome]

The incidence of carpal tunnel syndrome ranks first by far among all entrapment neuropathies. Many foreign studies have been reported over the years concerning the diagnosis of carpal tunnel syndrome, but very few about its treatment effects. Moreover, data have been based on the patients' subjective reports of their symptoms. Our data, however, are wholly derived from objective electromyographic examination. Five treatment approaches were compared for patients suffering from carpal tunnel syndrome in this study. Ninety-nine hands of 61 patients were divided into five treatment groups vitamins B6 & B12, steroid injection, hand splint, splint combined with vitamins, and splint combined with injection. Each patient was evaluated with electrodiagnostic study before the treatment, and 1 and 2 months after the treatment. Treatment with hand splinting, local injection at wrist, and combined therapies were all superior in effect to vitamins B6 & B12 alone in sensory nerve conduction study. The effects of treatment appeared faster in the groups with local injection and local injection combined with hand splinting in the sensory and motor nerve conduction studies. The results of this study suggest that treatment with vitamins B6 & B12 alone does not suit carpal tunnel syndrome well and that hand splint combined with steroid injection is the better conservative treatment.

Limb salvage of infected diabetic foot ulcers with microsurgical free-muscle transfer

This study was comprised of 9 diabetic patients with 10 infected foot ulcers, including osteomyelitis in 4 limbs and gangrene in 3 limbs. Adequate debridement of these complicated wounds inevitably resulted in exposure of bones or tendons. All defects were successfully reconstructed with free gracilis muscle flaps covered with split-thickness skin grafts. No recurrence of ulcer or infection was noted in the muscle-transplanted area during the follow-up period. Laser Doppler perfusion monitor measurement showed that the perfusion unit of the denervated free muscle flap increased to a peak at the second week after transplantation; the neovascularization of the grafted skin, the progressive decrease of the muscle swelling, and the decreased interstitial pressure may be the main contributing factors. The perfusion unit of the muscle flap reached equilibrium with the surrounding tissue at about 8 weeks after microsurgical transfer. Lower extremity amputation is a major health problem in the diabetic population. The microvascular free-muscle transfer was proved to play an effective and important role in limb salvage in diabetic patients with infected foot ulcers. The gracilis muscle flap was recommended due to its lack of bulkiness and minimal donor site deformity.

[Bacterial meningitis in neonates]

A retrospective study of the clinical features and management of 27 newborns with meningitis is presented. All were treated in the China Medical College Hospital between July 1981 and July 1988. Seven were premature and twenty were full term. There were 11 males and 16 females. Five infants had low birth weight (less than 2500 g) and 12 cases were diagnosed in the first week of life (early onset). E.coli was the predominant pathogen. The most common presenting manifestations were nonspecific in nature-fever, poor feeding, respiratory distress and poor activity, etc... Six patients died during the period of acute illness and the case fatality rate was 22.2%. Of the 21 patients who survived, six had sequelae (four hydrocephalus, one subdural effusion, one microcephaly), giving an over-all rate of 19 percent in the survivors. The presence of gram-negative bacterial infection and high protein content in CSF correlated significantly with the higher mortality rate.

[Achalasia: report of two cases]

The first case, a two-month-old female infant, had frequent vomiting since 5 days of age. Dilated esophagus with narrowed distal end was noted on barium meal study. Panendoscopic examination revealed dilated esophagus and a pin-head sized, stenotic lumen at 15 cm from the incisor. Under the impression of esophageal stenosis, gastrostomy was performed for feeding. Esophagogram made at 6 months of age demonstrated good patency of the esophagus without stenosis and gastrostomy was subsequently closed at the age of 1 year. Unfortunately, swallowing disturbance had bothered her intermittently since. Barium esophagogram and panendoscopy made 8 years later again revealed distal esophageal obstruction with dilated proximal esophagus. The second case was a two and half year old boy who suffered from frequent regurgitation of undigested food for 6 months. Dilated esophagus with narrowing of the lower end of esophagus was noted on barium meal study. After admission, panendoscopic examination revealed the esophagus was very narrow at 25 cm from incisor and the proximal esophagus was dilated. The esophageal dilatation with mercury-weighted bougies was performed intermittently. At present he is doing well, and a barium meal study showed adequate esophageal emptying.

Role of anxiety and anger in acne patients: a relationship with the severity of the disorder

Studies investigating the possible role of personality and emotional factors in acne patients have yielded inconsistent and sometimes contradictory results. In the present study acne patients self-rated the severity of their conditions as mild, moderate, or severe and were compared to a control group on several personality variables. These self-ratings were compared to the objective ratings made by their dermatologists. Acne patients who self-rated their conditions as severe were found to experience significantly higher levels of trait anxiety than patients with mild and moderate conditions and control subjects; patients with severe and moderate conditions showed a higher state of anxiety than control subjects. Acne patients rated as severe by their dermatologists showed higher states of anxiety, "anger-in," and "anger-out" than the others. No other significant differences in terms of severity emerged, supporting the view that acne patients are not markedly neurotic. The results suggest that anxiety and anger are significant factors for severe acne patients and that future research should include severity ratings from both patients and physicians in the research design.

[Transplantation model of human lung oat cell carcinoma in nude mice]

A human lung oat cell carcinoma from a surgical specimen was successfully transplanted into nude mice and has been maintained for over four years through 14 passages. This transplanted tumor had a long latent period of more than one month, slowly growing in the initial inoculation and the following passages. The interval between two passages was about four months. 5 months after the inoculation, the transplanted tumor in nude mice grew to 2 cm in diameter. It was demonstrated that the transplanted tumor possessed the human isoenzyme pattern and human chromosome karyotype. The original human tumor and its transplanted counterparts in the nude mice were strikingly similar by histopathology. Besides, specific neuro-secretory granules in cytoplasm of the transplanted tumor were observed under transmission electron microscope.

[Chemotherapy combined with selective resection in small cell lung cancer--analysis of 239 patients]

From 1957 to 1976, 143 patients with small cell lung cancer (SCLC) were treated with surgical resection followed by chemotherapy. The 5 year survival rates were 38.7%, 8.7% and 3.5% in stages I, II and III. The prognostic factors were clinical stage and chemotherapy. 4 stage I and 1 stage II patients without chemotherapy have survived for more than 5 years. It seems to suggest that SCLC in stage I be indicated for surgery. 4 stage III have survived for more than 5 years, all of whom had received postoperative chemotherapy for more than 4 courses. From 1980 to 1982, 96 patients with SCLC were treated, 37 of whom by chemotherapy combined with surgery. 11/37 patients were alive for more than 2 years, 7 for more than 3 years and 4 for more than 4 years. In the preoperative chemotherapy followed by selective resection plus postoperative chemotherapy group (13 patients), the mean survival time was 22.7 months, but in the postoperative chemotherapy group (24 patients), it was 11.0 months. It indicates that full-dose chemotherapy before and after operation may be superior to the postoperative chemotherapy alone.

Establishment and characterization of human malignant pleural mesothelioma cell line SMC-1

A cell line (SMC-1) has been established from the resected tissue of a patient with malignant pleural mesothelioma which has been pathologically confirmed to be the mixed type. The cell line is characterized by the pleomorphy and multilayered growth of the cells with the population-doubling time of approximately 32 h, the highest mitotic index of 46--50% and the modal chromosome number of 69-70. Transplantation of the cells into the animals can produce tumors bearing histological resemblance to the original material. The cultured cells, xenografted tumor cells and the cells from the host specimen show similar histochemical expressions. These data meet the requirements of a human malignant pleural mesothelioma cell line. The establishment of this cell line will serve as a useful tool in clinical research of diagnosis and treatment of this devastating disease.

Critical evaluation of results of extension of indication for surgery for primary bronchogenic carcinoma

Among 3,120 surgically resected cases (1957-1983) in Shanghai Chest Hospital, 1,476 resections (47.3%) were performed under extended indication. Six categories--(1) aged 70-87 years (102), (2) associated with severe impairment of pulmonary function (25), (3) small-cell anaplastic type (143), (4) stage III lesion (1,145), (5) invading carina (29), (6) with disseminated pleural metastasis and effusion (32)--were critically evaluated. For the first four categories, long-term survival rates were very encouraging, whereas only technical advancement and short-term results were discussed for the last two. The authors present strategic points significant in availing higher overall operability and hence the overall survival rate, shedding light on the increase of curative potential for lung cancer.