[Endoscopic lateral neck dissection via the breast and transoral approaches for papillary thyroid carcinoma: a report of 10 cases]

Objective: To investigate the feasibility of endoscopic lateral neck dissection via the breast and transoral approaches (ELNDBTOA) for papillary thyroid carcinoma (PTC). Methods: From February 2015 to April 2019, 10 patients with PTC (cN1b) including 1 male and 9 females aged from 22 to 53 years old received ELNDBTOA in the General Surgery Department of Zhongshan Hospital, Xiamen University. Total thyroidectomy, the central lymph node dissection and the selective neck dissection (levels Ⅱ, Ⅲ and Ⅳ) were performed endoscopically via the breast approach, and then the residual lymph nodes were dissected via transoral approach. The medical records, operation time, blood loss, complications and postoperative follow-up outcomes were analyzed retrospectively. SPSS 22.0 software package was used for statistical processing of clinical data of patients. Results: All cases were successfully treated with ELNDBTOA without transfer to open surgery. The average operative time was (362.5±79.7) min, the blood loss was (23.0±14.9) ml, and the postoperative hospital stay was (5.1±1.3) days. The mean number of harvested cervical lymph nodes were (34.2±25.8), and the mean number of positive lymph nodes were (6.5±4.9). Lymph nodes were dissected by the further dissection via oral approach in 6 patients and a total of 9 lateral lymph nodes were havested from 2 of the 6 patients, with 3 positive lymph nodes. Two patients had transient skin numbness in the mandibular area and recovered within two weeks. One patient developed transient hypoparathyroidism and recovered within two months. No secondary bleeding, recurrent laryngeal nerve paralysis, chylous leakage, neck infection, permanent hypoparathyroidism or other complications were observed. The follow-up time was from 16 to 66 months with a median of 42.5 months, no tumor recurrence or metastasis occurred, and also no obvious deformity, abnormal sensation or movement in the chest, neck and mouth was observed. Conclusions: ELNBTOA is safe and feasible, with good cosmetic outcome.

[Characteristics of PD-L1 expression in tumor cells and tumor microenvironment of DLBCL with MYD88 L265P mutation]

Objective: To study the effect of MYD88 L265P mutation on the expression of PD-L1 in tumor cells and tumor microenvironment in diffuse large B-cell lymphoma (DLBCL), and to provide theoretical basis for immunotherapy for patients. Methods: Multiplex ligation-dependent probe amplification (MLPA) was used to detect the frequency of MYD88 L265P mutation in 72 cases of DLBCL diagnosed by pathologists in Cancer Hospital of Chinese Academy of Medical Sciences from August 2008 to May 2010. Expression of PD-L1 in tumor cells and tumor microenvironment in all samples was evaluated using PD-L1 (22C3) and PD-L1 (SP142) with Ventana automatic immunohistochemical (IHC) platform. The relationship between MYD88 L265P mutation and the expression of PD-L1 in DLBCL tumor cells and tumor microenvironment was assessed. Results: Of the 72 cases of DLBCL, MYD88 L265P mutation was detected in 15 (20.8%) cases. Nine cases with JAK2 amplification were excluded, and the remaining 63 cases of DLBCL were divided into MYD88 L265P mutant group (n=14) and MYD88 L265P wild-type group (n=49). IHC results showed that among the 14 cases of MYD88 L265P mutant groups, PD-L1 (22C3) was positive in 7 cases (7/14) of tumor cells and PD-L1 (SP142) was positive in 4 cases (4/14) of tumor microenvironment. Among the 49 cases of MYD88 L265P wild-type group, 9 cases (18.4%) were positive for PD-L1 (22C3) in tumor cells, and 38 cases (77.6%) were positive for PD-L1(SP142) in tumor microenvironment. In addition, among the 16 cases with PD-L1(22C3) expression in tumor cells, only 2 of the 7 cases with MYD88 L265P mutation were positive for PD-L1 (SP142) in tumor microenvironment. All 9 cases with wild-type MYD88 L265P were positive for PD-L1 (SP142) in tumor microenvironment. Statistical analysis showed that the expression level of PD-L1 (22C3) in tumor cells in the MYD88 L265P mutant group was significantly higher than that in the MYD88 L265P wild-type group (P=0.017). The expression level of PD-L1 (SP142) in tumor microenvironment in the MYD88 L265P mutant group was significantly lower than that in the MYD88 L265P wild-type group (P=0.001). Conclusions: MYD88 L265P mutation may play an important role in the regulation of PD-L1 expression in DLBCL tumor cells and tumor microenvironment. Further studies will provide a theoretical basis for immunotherapy of DLBCL patients with MYD88 L265P mutation.

[Survey of current status of prevention of venous thromboembolism after thoracic surgery in China]

Objective: To investigate the current status of prevention and treatment of venous thromboembolism (VTE) after thoracic surgery in China. Method: Chinese thoracic surgeons were investigated by the online questionnaire which was based on the Chinese version of International VTE questionnaire added with 6 extra questions with Chinese characteristics. Results: A total of 1 150 valid questionnaires were retrieved, accounting for about 20% of all the Chinese thoracic surgeons. The surgeons participating in this survey came from all over the country, most of whom were experienced professionals with high academic titles.For lung cancer patients, 66.96% (770/1 150) of the surgeons suggested that VTE prophylaxis should start 1 day after lung cancer resection, and 64.61% (743/1 150) of the surgeons suggested extending after discharge. For esophagestomy patients, and 48.35% (514/1 063) of the surgeons suggested that there was no need for patients to extend VTE prophylaxis after discharge. More than half of the surgeons participating in this survey made decision of the method and duration of VTE prophylaxis after lung cancer resection (53.91% (620/1 150)) or esophagectomy (52.49% (558/1 063)) depending on the clinical experience.Low molecular weight heparin was the common choice of most surgeons in VTE prophylaxis. More than half of the surgeons thought that previous history of VTE, advanced age, complicated with thrombophilia, obesity (body mass index>30 kg/m²), duration of surgery longer than 6 hours and family history of VTE were key risk factors of the occurrence of postoperative VTE. Conclusions: The results of this survey are highly credible and are a good reflection of the current status of VTE prevention and treatment after thoracic surgery in China. This survey will play an important role in promoting VTE prevention and treatment in Chinese thoracic surgery department, it will also provide data support for government setting new policies, hospital construction of VTE prevention and control as well as raising physicians' awareness.

HPV genotype analysis for women in Shaanxi Province of China

The aim of this study was to examine the subtype distribution of human papilloma virus (HPV) in women in the Shaanxi Province of China. A DNA chip, along with polymerase chain reaction amplification and reverse dot blot technology, was adopted to analyze the HPV genotypes of 22,937 cases of cervical cell specimens. The HPV infection rate was 18.70%, wherein high-risk, low-risk, and high- and low-risk multiple infection rates were 15.75, 2.96 and 1.91%, respectively. High-risk infections accounted for 84.20% of total infections. The rate of HPV infection in women with rural residence, high school education or less, a low income, or age over 40 years was significantly higher than that in the control group (negative HPV infection women). Of the 18 detected high-risk HPV subtypes, the most common in single infections were, in the order of prevalence, HPV16, 58, 18, 52, 33, and 56. For multiple high-risk infections, the most common subtypes in the order of prevalence were HPV16, 52, 58, 18, 56, and 33. Age was a factor in the rate of infection, as the 41-50-year age group had a significantly higher risk of infection than the other groups (P < 0.05). In multiple infections, double infections were common, accounting for 77.10% of multiple infections, and triple or more infections were more common in women aged 51-60 years. In Shaanxi Province, high-risk HPV infection in women was mainly attributed to rural residence, age over 40 years, low income, and low education level.

Prevalence of human papillomavirus genotypes among women with cervical lesions in the Shaanxi Province of China

This study aimed to investigate human papilloma virus (HPV) genotypes among women with cervical lesions in Shaanxi Province, China, to obtain information regarding cervical lesion prevention and treatment. The study included 4508 HPV-positive subjects; cervical swab specimens were collected and tested for HPV infection status and HPV genotypes using polymerase chain reaction and reverse dot-blot hybridization. Women positive for HPV with cervical lesions, including chronic cervicitis, cervical intraepithelial neoplasia, and cervical squamous cell carcinoma (SCC), were examined; HPV-positive women with no cervical lesions were controls. Data were pooled and weighted estimates have been presented. For women with no cervical lesions and positive for one HPV genotype, HPV 52, 16, 58, 81, 33, and 56 were the most common; for multiple-HPV genotype infection, HPV 16, 52, 6, 18, 58, and 66 were the most common. Collectively, HPV 16, 58, 52, 18, 33, and 81 were the most common in women with cervical lesions. HPV 16 comprised 26.71% of single-genotype and 15.64% of multiple-genotype infections. The proportion of HPV-16-positive cases was 29.15%, which was the highest among all HPV genotypes (P < 0.01). Single-HPV genotype infection was the most common in cervical HPV infection (77.48%); infection with two HPV genotypes comprised 72.22% of multiple-genotype infections. The proportion of single-low-risk HPV genotype infections decreased with increase in cervical lesion severity; there were no single- or multiple-low-risk genotype HPV infections in cervical SCC patients. The proportion of multiple-genotype HPV infections with at least one high-risk genotype increased with cervical lesion severity.

Prevalence and patterns of multimorbidity in northeastern China: a cross-sectional study

OBJECTIVES

Information on multimorbidity in the general populations of developing countries is lacking. We examine the prevalence and patterns of multimorbidity in northeastern China.

STUDY DESIGN

A cross-sectional study was conducted on adult residents in Jilin Province, northeastern China from June 2012 to August 2012.

METHODS

Data were collected from a large cross-sectional study (n = 21,435) of adult community residents in Jilin Province in northeastern China. Multimorbidity, or co-morbidity, was defined as having two or more of 18 specified prevalent chronic diseases. A range of demographics, socio-economic factors, other risk factors and general mental health were used in describing the distribution of multimorbidity and in exploring the associations between them.

RESULTS

Almost a quarter (24.7%) of the adults were found to be multimorbid for chronic diseases. Multimorbidity was more common among older adults, women, rural residents and those with low income. Smoking, increasing BMI and psychological distress were independently associated with multimorbidity. Multimorbid patients were frequent users of primary care. Most dyads of chronic diseases co-occurred more frequently than would be expected on the basis of chance.

CONCLUSIONS

Researchers, clinicians and policy makers need to pay special attention to the health care challenges of multimorbidity and develop effective intervention strategies and programs to reduce the burden of multimorbidity.

Metabolic and muscular responses during and after a 100 km hill walk

AIM

Aim of the study was to assess different metabolic and muscular responses of recreational hikers during and after a hill walk of 100 km duration.

METHODS

Nine subjects (6 males and 3 females) completed the 100 km hill walk within 40 hrs. Physiological and muscular responses, and biomarkers were measured during- and 18 hrs after the exercise.

RESULTS

On average, exercise intensity was moderate with reference to %HRmax (64±7.1), with a declining trend. Energy expenditure ranged from 102.5 kcal/km to 186.2 kcal/km in different sections. Using a visual analog scale, left and right quadriceps, and left and right calf muscles had elevated values of perceived muscular soreness (5±2.4, 5±2.4, 4.6±2.7 and 4.6±2.7, respectively). Ranges of motion at hip and knee joints decreased at 47.4 km (P<0.05). Creatine kinase for male subjects increased 16-fold (from 106.8±95 U/L to 1747.6±1834.2 U/L) at 79.6 km. Creatine kinase-MB and lactate dehydrogenase for males were also elevated at 79.6 km and peaked at 100 km. Following recovery, creatine kinase for male subjects was still slightly higher than resting level (321.1±283.6 U/L vs. 106.8±95 U/L). Ranges of motion at hip and knee joints were higher than pre-walk level (P<0.05).

CONCLUSION

The data suggest that healthy recreational hikers with average physical fitness can complete a 100 km hill walk within 40 hours without showing excessively stressful physiological responses. However, complete recovery would probably require more than 18 hours.

Induction of inflammatory cytokine release from human umbilical vein endothelial cells by agonists of proteinase-activated receptor-2

1. Human endothelial cells express proteinase-activated receptor-2 (PAR-2), inflammatory cytokines and trypsin (EC 3.4.21.4). However, little is known about the mechanism through which trypsin induces cytokine release from endothelial cells. 2. In the present study, we investigated the effect of trypsin on cytokine release from primary cultures of human umbilical vein endothelial cells (HUVEC) using an antibody based protein microarray and ELISA. 3. The results showed that 1 microg/mL trypsin induced release of 32 different inflammatory factors, whereas 100 micromol/L Ser-Leu-Ile-Gly-Lys-Val-NH2 (SLIGKV-NH2) only stimulated secretion of 16 inflammatory factors from HUVEC, as assessed by an antibody based protein microarray. Because the release of interleukin (IL)-1a, IL-8, IL-10 and IL-12 was markedly increased following PAR-2 activation, their release was investigated further using ELISA. Increases in release of up to approximately 4.8-, 4.3-, 4.1- and 1.8-fold were observed for IL-1a, IL-10, IL-12 and IL-8, respectively, when HUVEC were challenged with trypsin for 16 h. Agonist peptides of PAR-2, namely SLIGKV-NH2 and trans-cinnamoyl-Leu-Ile-Gly-Arg-Leu-Orn-NH2 (tc-LIGRLO-NH2), also provoked significant release of IL-8. Trypsin-induced cytokine release was inhibited by its inhibitors soybean trypsin inhibitor, alpha1-antitrypsin and the inhibitor peptide of PAR-2 Phe-Ser-Leu-Leu-Arg-Tyr-NH2 (FSLLRY-NH2). 4. These data indicate the action of trypsin on HUVEC is most likely through activation of PAR-2, suggesting that PAR-2-related mechanisms are involved in the inflammatory process in humans.

Modulation of expression and function of Toll-like receptor 3 in A549 and H292 cells by histamine

It was reported recently that histamine induced Toll-like receptor (TLR)2 and TLR4 expression in endothelial cells and enhanced their sensitivity to Gram-positive and Gram-negative bacteria; and that TLRs were expressed in airway epithelial cells and that several inflammatory mediators modulated their expression. However, little is known of potential influence of histamine on TLRs in pulmonary epithelial cells. In the present study, effects of histamine on expression of TLRs in both human A549 and NCI-H292 cell lines were examined by using real-time quantitative RT-PCR analysis, flow cytometry and immunofluorescent staining. The results revealed that both cell types constitutively expressed mRNAs for TLR1-TLR10. Histamine up-regulated the expression of TLR3 mRNA by 12.3- and 11.6-fold, respectively in both cell types. The time course showed that histamine induced TLR3 mRNA expression was initiated at 30 min, nearly reached peak levels after 2 h and was sustained at least until 12 h. Histamine also induced TLR3 protein expression in A549 and NCI-H292 cells. Histamine and poly (I:C), a specific TLR3 ligand stimulated interleukin (IL)-8 secretion from both cell types. Moreover, histamine enhanced poly (I:C)-induced IL-8 secretion and phosphorylation of NF-kappaB in the two cell types, and histamine H1 receptor antagonists inhibited the action of histamine. In conclusion, histamine selectively up-regulated expression of TLR3, and stimulated IL-8 secretion from the cells. Histamine also enhanced poly (I:C) induced IL-8 secretion and phosphorylation of NF-kappaB. These observations suggest that histamine might play an important role in enhancing the innate immune responses of airway to viral infection.

Potent histamine-releasing activity of atrahagin, a novel snake venom metalloproteinase

Poisonous snakebite wound is a popular disease worldwide. However, the pathogenesis remains unclear. In the present study, a novel metalloproteinase atrahagin in Chinese cobra (Naja atra) snake venom was purified, using heparin-sepharose followed by Superdex 75 gel filtration chromatography. Apart from its alpha-fibrinogenase activity, atrahagin potently activated human colon, lung and tonsil mast cells with the net histamine release being 25.9+/-4.4, 17.0+/-1.9, 13.2+/-3.6%, respectively. Time course studies revealed that the peak histamine release induced by atrahagin occurred at 12, 12 and 8 min following incubation of the enzyme with colon, lung and tonsil mast cells, respectively. The response of mast cells to atrahagin was abolished by preincubation of the cells with metabolic inhibitors or pertussis toxin, and by removal of Ca2+ and Mg2+ from the challenge buffer. In conclusion, activation of human mast cells by atrahagin indicated that the enzyme might contribute to the pathogenesis of snakebite wound.

Inhibition of tryptase release from human colon mast cells by histamine receptor antagonists

The main objective of this study was to investigate the ability of histamine receptor antagonists to modulate tryptase release from human colon mast cells induced by histamine. Enzymatically dispersed cells from human colon were challenged with histamine in the absence or presence of the histamine receptor antagonists, and the tryptase release was determined. It was found that histamine induced tryptase release from colon mast cells was inhibited by up to approximately 61.5% and 24% by the H1 histamine receptor antagonist terfenadine and the H2 histamine receptor antagonist cimetidine, respectively, when histamine and its antagonists were added to cells at the same time. The H3 histamine receptor antagonist clobenpropit had no effect on histamine induced tryptase release from colon mast cells at all concentrations tested. Preincubation of terfenadine, cimetidine or clobenpropit with cells for 20 minutes before challenging with histamine did not enhance the ability of these antihistamines to inhibit histamine induced tryptase release. Apart from terfenadine at 100 microg/ml, the antagonists themselves did not stimulate tryptase release from colon mast cells following both 15 minutes and 35 minutes incubation periods. It was concluded that H1 and H2 histamine receptor antagonists were able to inhibit histamine induced tryptase release from colon mast cells. This not only added some new data to our hypothesis of self-amplification mechanisms of mast cell degranulation, but also suggested that combining these two types of antihistamine drugs could be useful for the treatment of inflammatory bowel disease (IBD).

[Inhibition of platelet function by L-arginine.L-aspartate salt]

The effects of L-arginine.L-aspartate salt (DR) on platelet aggregation, adhesion and release were investigated. Platelet aggregation induced by adenosine 5 -diphosphate (ADP) was significantly inhibited (P<0.01) by intravenous injection of DR (15 mg/kg) in rats or oral administration (15 mg/kg) in rabbits, the inhibitory effect on rabbit platelet aggregation lasting for more than 8 h (P<0.01). Platelet aggregation induced by ADP, collagen or thrombin in rats was all markedly inhibited by 7.5, 15 or 30 mg/kg of DR (bid for 3.5 d, ig, P<0.01). Platelet adhesion to foreign objects was inhibited by 30 mg/kg of DR (ig). Bleeding time in rat tails was prolonged by 30 mg/kg of DR (P<0.05). Furthermore, PGI(2) released from the vascular wall was increased in DR-treated rats (P<0.05), however, TXA(2) released from platelets was not affected. These data demonstrate the inhibitory effect of DR on platelet function, suggesting that its action target may be different from that of acetylsalicylic acid, and that the increase of PGI(2) release may be responsible partly for this effect. It is suggested that DR may probably be used as a new agent for regulating platelet function.

Management of descending necrotizing mediastinitis

BACKGROUND

Descending necrotizing mediastinitis (DNM) is uncommon, and may be lethal if not treated adequately and promptly. Delayed diagnosis of the disease is sometimes encountered in clinical practice.

METHODS

Eight consecutive patients with acute DNM were identified between 1991 and 1995, including five men and three women. The mean age was 45.8 years (range, 22-71 years). The infectious sources consisted of six esophageal perforations, one cervical cutting injury and one tonsillitis. The clinical presentations were evaluated. Diagnostic procedures including chest radiograph, sonogram and computerized tomography scans of the chest and neck were examined. Diagnosis and treatment, including culture results from drained fluids and debrided tissues, and antibiotic and supportive therapies were reviewed.

RESULTS

Six patients who underwent aggressive surgical treatment recovered well. Two patients who received supportive treatment died of sepsis alone. The cultured bacteria included: Klebsiella oxytoca, Staphylococcus aureus, Trichosporum and other mixed oral cavity flora.

CONCLUSIONS

Early diagnosis and adequate antibiotic and support therapies are essential to achieve good patient outcomes in acute descending mediastinitis. Adequate drainage and debridement, appropriate antibiotic therapy, and sufficient nutritional and respiratory support are the main treatment elements.

Absence of relationship between Schistosoma japonicum and hepatitis B virus infection in the Dongting lake region, China

In order to determine whether infection with Schistosoma japonicum is related to a higher rate of infection with hepatitis B virus and/or to a higher probability of HBsAg chronic carriage, a population based survey was carried out in China in which HBV markers were studied in 112 subjects with long-lasting S. japonicum infection, and 93 subjects with no S. japonicum infection 37.5% of the cases and 40.9% of controls showed no markers of HBV infection. The prevalence rate of HBsAg was 12.5% in the cases and 12.9% in the controls. For anti-HBc and anti-HBs the figures were 59.8% and 59.8%, and 27.9% and 35.0%, respectively. These data do not support the hypothesis of an interaction between infection with hepatitis B virus and S. japonicum.

The distribution of Schistosoma japonicum eggs in faeces and the effect of stirring faecal specimens

Experiments were performed to determine whether Schistosoma japonicum eggs are randomly dispersed in faeces and the effect of stirring faecal specimens prior to sampling. For each of 13 patients infected with S. japonicum, eggs were counted in 150 subsamples from a single stool specimen, using the Kato-Katz smear technique. Eggs were non-randomly distributed in all 13 stools, and showed an aggregated distribution. In most patients there were significant differences in the distribution of eggs between the centre and the surface of the stool. Stirring of the stool prior to sampling decreased the variability of counts.

The effects of temperature, light and water upon the hatching of the ova of Schistosoma japonicum

Eggs of Schistosoma japonicum were obtained from infected patients' feces from Yujiang City, China to observe the effects of temperature, light and water on the hatching of eggs. The temperature of water and light played important roles on the hatching of S. japonicum, but the type of water did not. A constant temperature of 28 degrees C and electrical light produced the highest rate of hatching, and reproducible results, whereas a temperature of 4 degrees C or 37 degrees C, and the absence of light inhabited the hatching of eggs. The percentage of eggs hatched during the first 8 hours of 24 hours incubation was 94.90%, so that using the hatching rate of the first 8 hours could approximate the total hatching rate of samples.

The non-randomness of the distribution of Trichuris trichiura and Ascaris lumbricoides eggs in faeces and the effect of stirring faecal specimens

Experiments were performed to describe the distribution of Trichuris trichiura and Ascaris lumbricoides eggs in faeces and to test for the effect of stirring faecal specimens prior to sampling. For each of 5 volunteers infected with A. lumbricoides and 7 volunteers infected with T. trichiura, helminth eggs were counted in 150 samples from a single stool specimen using the Kato-Katz smear technique. No significant differences between the distribution of eggs in samples from the surface and the centre of the specimens were found. Prior to stirring, eggs were found to be aggregately distributed in four of the specimens with T. trichiura and all of the specimens with A. lumbricoides. The distributions of eggs were not significantly altered by stirring the stool prior to sampling except in the case of one volunteer infected with A. lumbricoides for whom stirring reduced variability.

[Risk factor scoring model of STD for pregnant women in antenatal clinic]

OBJECTIVE

To develop a case finding strategy for STD among pregnant women based on risk assessment in China.

METHODS

A prospective, random/double blind study of the high risk factors for STD in 1,656 pregnant women was conducted from June 1995 to February 1996. It was carried out at four Guangzhou hospitals on nine types of STD, their relative risk factor questionnaire and gynecologic examination.

RESULTS

The total prevalence of six main STD was 20.89% (346/1656); No HIV and syphilis cases were found; The most common disease is cervical chlamydial trachomatis at (19.08% 316/1,656). Through statistical calculations with COX proportional hazard model, STD symptoms' high risk factors scoring system revealed the following: (1) More than one sexual partner in the preceding one year; (2) Vulvular lesion vegetation; (3) Dysusia/increased vaginal discharge; plus one of the following: 1. unemployed status; 2. sex partner unemployed; 3. age (less than 25 years of between 30-34 years of age). These six items with "three-three" scoring system can be used as a model to primary screening new STD cases using clinical data. Both sensitivity and specificity exceeded 60% (61.7% and 67.3% respectively).

CONCLUSION

These are significantly better than the foreign recommended model and the scoring system in China. It is simple, convenient and applicable.

Genital human papillomavirus infections in young women with vulvar and vestibular papillomatosis

Possible involvement of human papillomaviruses (HPV) in the development of vulvar and vestibular papillomatosis was investigated by using PCR to determine whether HPV DNA was present in lesions. Fourteen of 272 (5.1%) young women studied were found on gross and histological examination to have vulvar or vestibular papillomatosis. HPV DNA sequences were detected in cervicovaginal lavage specimens of 2 of 14 (14.3%) papillomatosis patients and 1 of 17 (5.9%) matched individuals in the control group without lesions. The difference in HPV prevalence between these two groups was not statistically significant (x2 = 0.51, p > 0.2). Furthermore, none of the 14 vulvar or vestibular papillomatosis biopsy tissues contained HPV DNA. The results suggest that vulvar and vestibular papillomatosis has an etiology other than HPV infection.

[Diagnosis between condyloma acuminatum and pseudocondyloma in lower female genital tract as determined by a PCR-based method]

From Jan. 1990-Aug. 1992, 616 patients with papillomatous growth of the lower female genital tract (the nodular type 307 cases, the papular type 309 cases) were investigated as determined by a PCR (polymerase chain reaction)-based method, associated with immunohistochemistry avidin biotin complex (ABC), electron microscopy, histopathology, colposcopy and clinical follow-up. The PCR is the most sensitive and specific method. Using PCR the HPV DNA 6.11.16.18.33 were positive in 97.90% of the nodular type. However HPV DNA were positive in 1.10% of the papular type. In the patients with both type, HPV DNA were also positive in nodular, but negative in papular. In the nodular type the HPV-Ag present in 53.55% by ABC method, the koilocytes were 70.49% by microscopy, HPV particles were seen in 5 out of 85 samples by electron microscopy. So that the nodular type (typical cauliflower like) is genital warts (condyloma acuminatum) by HPV infection. The papular type (typical papular or finger like) growth on the mucosal surface of the labia minora of lower vagina. They were negative for HPV DNA, HPV-Ag, HPV particles and koilocytes. On follow-up observation for 3 months to 2 years they had not developed to nodular type and no sexually transmitted feature was observed. The papular type is pseudocondyloma.

[Primary report of a specific light absorption peak of red blood cells in pregnancy induced hypertension--one drop blood assay with photoacoustic spectroscopy]

One drop of red blood cells (RBC) was assayed with double beam photoacoustic spectroscopy device (PAS) in 89 blood samples collected from 71 pregnant women during 3rd trimester of pregnancy. A specific light absorption peak at a spectral range of 620-650 nm was showed in 86.36% of women with pregnancy induced hypertension (PIH), while only 16.67% of normal pregnant women (P < 0.01). However we can not identify the component which induced this specific peak in RBC. Our conclusion is that this simple assay could be used promisingly in prediction and differential diagnosis for PIH in clinic.

Magnesium levels in middle ear fluids and sera in otitis media with effusion

Middle ear fluids (MEE) and matched sera (S) were obtained from 50 patients with serous otitis media and magnesium levels were measured to determine if magnesium concentration was distinctly varied in otitis media with effusion (OME). The MEE/S ratio was considerably raised along with transient sensory hearing loss in chronic OME when compared with acute OME. The higher magnesium level found in the MEE implies that it is probably produced locally by the middle ear mucosa and may contribute to the hearing loss found. We also regard the MEE/S ratio as a prognostic factor in OME.

[Clinical analysis of 5905 female patients with sexually transmitted diseases in Guangzhou]

In accordance with National Venereal Prevention and Research Center's uniform requirement, 4 main STDs were intensively monitored in 48 hospitals of Guangzhou from Jan. 1986 to June 1989. They were, gonorrhoea, syphilis, nongonococcal urethritis (NGU), and condyloma acuminatum. The total number of cases was 14,513, in which female cases were 5,905, with a male: female ratio of 1.5:1. However, the incidence of women grew faster then that of men. The rate of mixed STDs infection was two times higher in women then in men. Gonorrhoea is the most common STD co-existing with NGU, condyloma acuminatum or even syphilis. Combination use of antibiotics recommended.

[Trace elements in the serum and cancerous tissue in patients with trophoblastic carcinoma]

In the serum and cancer tissue of 155 patients with trophoblastic tumor and in 114 patients with benign or malignant gynecologic tumor, 22 elements (17 trace and 5 major elements) were determined by neutron activation analysis. The serum and tissue level of Cr, the serum Zn level in patients with hydatidiform mole was significantly higher than that of the control group (P less than 0.01). The serum Se level in Patients with invasive mole and choriocarcinoma was lower (less than 1.0 mumol/l), but Cu/Zn ratio was higher (greater than 2.0) in comparison with that of the controls (P less than 0.01). With remission of the disease levels of the essential trace elements went up approaching the normal levels. There was a negative relationship between the serum Zn level and hCG content. The authors point out that the low level of Zn and Se, the high level of Cr may be related to the development of trophoblastic tumors.