[Feasibility study of expectant management of different degrees of vaginal fluid in pregnant women with premature rupture of membranes in the second trimester]

Objective: To investigate the feasibility of expectant management of different degrees of vaginal fluid in pregnant women with premature rupture of membranes in the second trimester. Methods: A retrospective cohort study was conducted to collect 103 pregnant women who were diagnosed with premature rupture of membranes in the second trimester of pregnancy and insisted on continuing the pregnancy in Shanxi Bethune Hospital from July 2012 to July 2022. According to the degree of vaginal fluid, pregnant women were divided into rupture group (with typical vaginal fluid, 48 cases) and leakage group (without typical vaginal fluid, 55 cases). The rupture latency (the time from rupture of membranes to termination of pregnancy), gestational weeks of termination, indications and methods of termination of pregnancy, maternal infection related indicators and perinatal outcomes were compared between the two groups. Univariate regression model was used to analyze the correlation between different degrees of vaginal fluid in pregnant women with premature rupture of membranes and maternal and neonatal outcomes. Results: (1) Obstetric indicators: there was no significant difference in the gestational age of rupture of membranes between the two groups (P>0.05). However, the proportion of rupture latency >28 days in the leakage group was significantly higher than that in the rupture group [42% (23/55) vs 13% (6/48); χ2=33.673, P<0.001], and the incidence of pregnancy termination ≥28 weeks was significantly higher [47% (26/55) vs 19% (9/48); χ2=9.295, P=0.002]. (2) Indications and methods of termination: the incidence of progressive reduction of amniotic fluid as the indication for termination in the leakage group was significantly lower than that in the rupture group [22% (12/55) vs 42% (20/48); χ2=4.715, P=0.030], and the incidence of full-term termination in the leakage group was significantly higher than that in the rupture group [31% (17/55) vs 12% (6/48); χ2=5.008, P=0.025], while there were no significant differences in the indications of termination of pregnancy, including amniotic cavity infection, uterine contraction failure and fetal distress between the two groups (all P>0.05). The incidence of induced labor or spontaneous contraction in the leakage group was significantly lower than that in the rupture group [53% (29/55) vs 81% (39/48); χ2=9.295, P=0.002], while the cesarean section rate and vaginal delivery rate were similar between the two groups (both P>0.05). (3) Infection related indicators: the incidence of amniotic cavity infection in the leakage group was significantly higher than that in the rupture group [31% (17/55) vs 13% (6/48); χ2=4.003, P=0.045]. However, there were no significant differences in the elevation of inflammatory indicators, the positive rate of cervical secretion bacterial culture and the incidence of tissue chorioamnionitis between the two groups (all P>0.05). (4) Perinatal outcomes: the live birth rate in the leakage group was significantly higher than that in the rupture group [51% (28/55) vs 27% (13/48); χ2=5.119, P=0.024]. The proportion of live births with 1-minute Apgar score >7 in the leakage group was significantly higher than that in the rupture group [38% (21/55) vs 17% (8/48); χ2=4.850, P=0.028]. However, there were no significant differences in the birth weight of live births and the incidence of neonatal complications between the two groups (all P>0.05). (5) Univariate regression analysis showed that compared with the rupture group, the leakage group had a higher risk of pregnancy termination at ≥28 gestational weeks (RR=2.521, 95%CI: 1.314-4.838; P=0.002), amniotic infection (RR=2.473, 95%CI: 1.061-5.764; P=0.025), perinatal survival (RR=1.880, 95%CI: 1.104-3.199; P=0.014). Conclusion: Compared with pregnant women with typical vaginal fluid in the second trimester of premature rupture of membranes, expectant treatment for pregnant women with atypical vaginal fluid is more feasible, which could effectively prolong the gestational weeks and improve the perinatal live birth rate.

Long-Term Survival and Recurrence Patterns in Locally Advanced Esophageal Squamous Cell Carcinoma Patients with Pathologic Complete Response After Neoadjuvant Chemotherapy Followed by Surgery

BACKGROUND

The higher pathologic complete response (pCR) after neoadjuvant chemoradiotherapy compared with neoadjuvant chemotherapy for locally advanced esophageal squamous cell carcinoma (ESCC) has not translated into significant gains in overall survival. Data on the long-term survival of patients who obtained a pCR after neoadjuvant chemotherapy are scarce. Therefore, this study aimed to evaluate the long-term prognosis and recurrence patterns in these patients.

METHODS

The study enrolled patients with locally advanced ESCC after neoadjuvant chemotherapy followed by surgery in the authors' hospital between January 2007 and December 2020. The factors predictive of pCR were analyzed. Furthermore, propensity score-matching was performed for those who did and those who did not have a pCR using 1:5 ratio for a long-term survival analysis. Finally, the survival and recurrence patterns of patients obtaining pCR after neoadjuvant chemotherapy were analyzed.

RESULTS

A pCR was achieved for 61 (8.70%) of the 701 patients in the study. Univariate analysis showed that the patients without alcohol drinking had a higher possibility of obtaining a pCR, although multivariate analysis failed to confirm the difference as significant. After propensity score-matching, the 5-year overall survival was 84.50% for the patients who had a pCR and 52.90% for those who did not (p < 0.001). Among the 61 patients with a pCR, 9 patients (14.80%) experienced recurrence, including 6 patients with locoregional recurrence and 3 patients with distant metastasis.

CONCLUSION

Advanced ESCC patients with pCR after neoadjuvant chemotherapy had a favorable prognosis, yet some still experienced recurrence, particularly locoregional recurrence. Therefore, for this group of patients, regular follow-up evaluation also is needed.

[A retrospective analysis of 12 cases of primary thyroid lymphoma]

OBJECTIVE

To discuss the clinical characteristics and diagnostic and therapeutic considerations of primary thyroid lymphoma (PTL) by reviewing PTL cases.

METHODS

In the study, 12 cases of PTL diagnosed and treated in Peking University First Hospital between January 1995 and September 2015 were identified. The clinical characteristics, management experiences and prognosis of these cases were reviewed retrospectively.

RESULTS

A total of 12 PTL patients (four males and eight females) were collected, with an average age of 63 years (42 to 81 years) at the time of diagnosis. The average time to clarify diagnosis was 5 months (0.5 to 24 months). Eleven patients presented with a rapidly growing neck mass and visited surgical department, except one complained of coughing and suffocated. Seven patients were hypothyroid, and four were euthyroid at the time of diagnosis. In sonography of 11 cases, nine showed bilateral nodules, with an average diameter of 3.87 cm. Pathologic diagnosis of non-Hodgkin's lymphoma was confirmed in all the 12 cases by means of partial thyroidectomy (four) or core needle biopsy (eight). The pathological subtypes were diffuse large B cell lymphoma in nine patients, mucosa-associated lymphoid tissue lymphoma (MALToma) in two, and small B cell lymphoma in the other one patient. Five patients were concomitant with Hashimoto's thyroiditis. Eleven patients received chemotherapy. Only one patient did not have any further treatment after operation due to an inertia type of tumor. The median overall survival time was 24 months (1-117 months), three patients died. Among the patients who survived, seven completed chemotherapy without disease progression, one MALToma case did not receive chemotherapy after thyroidectomy but was still alive with PTL, and one patient just finished his second course of chemotherapy.

CONCLUSION

The diagnosis of PTL should be considered when dealing with rapidly growing goiters in elder female Hashimoto's thyroiditis patients whose B ultrasound indicates hypoechogenicity in thyroid nodules or parenchyma, especially with lymphadenopathy and tracheal compressions. Timely use of coreneedle biopsy on suspicious cases can avoid unnecessary surgical trauma, and chemotherapy is the main treatment.

Hydrogen peroxide is a critical regulator of the hypoxia-induced alterations of store-operated Ca2+ entry into rat pulmonary arterial smooth muscle cells

To investigate the association between store-operated Ca2+ entry (SOCE) and reactive oxygen species (ROS) during hypoxia, this study determined the changes of transient receptor potential canonical 1 (TRPC1) and Orai1, two candidate proteins for store-operated Ca2+ (SOC) channels and their gate regulator, stromal interaction molecule 1 (STIM1), in a hypoxic environment and their relationship with ROS in pulmonary arterial smooth muscle cells (PASMCs). Exposure to hypoxia caused a transient Ca2+ spike and subsequent Ca2+ plateau of SOCE to be intensified in PASMCs when TRPC1, STIM1, and Orai1 were upregulated. SOCE in cells transfected with specific short hairpin RNA (shRNA) constructs was almost completely eliminated by the knockdown of TRPC1, STIM1, or Orai1 alone and was no longer affected by hypoxia exposure. Hypoxia-induced SOCE enhancement was further strengthened by PEG-SOD but was attenuated by PEG-catalase, with correlated changes to intracellular hydrogen peroxide (H2O2) levels and protein levels of TRPC1, STIM1, and Orai1. Exogenous H2O2 could mimic alterations of the interactions of STIM1 with TRPC1 and Orai1 in hypoxic cells. These findings suggest that TRPC1, STIM1, and Orai1 are essential for the initiation of SOCE in PASMCs. Hypoxia-induced ROS promoted the expression and interaction of the SOC channel molecules and their gate regulator via their converted product, H2O2.

Crucial role of Notch signaling in osteogenic differentiation of periodontal ligament stem cells in osteoporotic rats

Estrogen deficiency-induced osteoporosis typically occurs in postmenopausal women and has been strongly associated with periodontal diseases. Periodontal ligament stem cells (PDLSCs) isolated from the periodontal ligament can differentiate into many types of specialized cells, including osteoblast-like cells that contribute to periodontal tissue repair. The Notch signaling pathway is highly conserved and associated with self-renewal potential and cell-fate determination. Recently, several studies have focused on the relationship between Notch signaling and osteogenic differentiation. However, the precise mechanisms underlying this relationship are largely unknown. We have successfully isolated PDLSCs from both ovariectomized (OVX) and sham-operated rats. Both the mRNA and protein levels of Notch1 and Jagged1 were upregulated when PDLSCs were cultured in osteogenic induction media. Mineralization assays showed decreased calcium deposits in OVX-PDLSCs treated with a γ-secretase inhibitor compared with control cells. Thus Notch signaling is important in maintaining the osteogenic differentiation of PDLSCs in osteoporotic rats, which help in the development of a potential therapeutic strategy for periodontal disease in postmenopausal women.

Multilayer limb quasi-static electromagnetic modeling with experiments for Galvanic coupling type IBC

Intra-body communication (IBC) is a new, emerging, short-range and human body based communication methodology. It is a technique to network various devices on human body, by utilizing the conducting properties of human tissues. For currently fast developed Body area network(BAN)/Body sensor network(BSN), IBC is believed to have advantages in power consumption, electromagnetic radiation, interference from external electromagnetic noise, security, and restriction in spectrum resource. In this article, the authors propose an improved mathematical model, which includes both electrical properties and proportion of human tissues, for IBC on a human limb. By solving the mathematical model analytically on four-layer system (skin, fat, muscle, and bone) and conducting in-vivo experiment, a comparison has been conducted.

Simple electrical model and initial experiments for intra-body communications

Intra-Body Communication(IBC) is a short range "wireless" communication technique appeared in recent years. This technique relies on the conductive property of human tissue to transmit the electric signal among human body. This is beneficial for devices networking and sensors among human body, and especially suitable for wearable sensors, telemedicine system and home health care system as in general the data rates of physiologic parameters are low. In this article, galvanic coupling type IBC application on human limb was investigated in both its mathematical model and related experiments. The experimental results showed that the proposed mathematical model was capable in describing the galvanic coupling type IBC under low frequency. Additionally, the calculated result and experimental result also indicated that the electric signal induced by the transmitters of IBC can penetrate deep into human muscle and thus, provide an evident that IBC is capable of acting as networking technique for implantable devices.

Modeling for intra-body communication with bone effect

Intra-body communication (IBC) is a new, different "wireless" communication technique based on the human tissue. This short range "wireless" communication technology provides an alternative solution to wearable sensors, home health system, telemedicine and implanted devices. The development of the IBC enables the possibilities of providing less complexity and convenient communication methodologies for these devices. By regarding human tissue as communication channel, IBC making use of the conductivities properties of human tissue to send electrical signal from transmitter to receiver. In this paper, the authors proposed a new mathematical model for galvanic coupling type IBC based on a human limb. Starting from the electromagnetic theory, the authors treat human tissue as volume conductor, which is in analogous with the bioelectric phenomena analysis. In order to explain the mechanism of galvanic coupling type technique of IBC, applying the quasi-static approximation, the governing equation can be reduced to Laplace Equation. Finally, the analytical model is evaluated with on-body measurement for testing its performance. The comparison result shows that the developed mathematical model can provide good approximation for galvanic coupling type IBC on human limb under low operating frequencies.

Neuroepithelial stem cells differentiate into neuronal phenotypes and improve intestinal motility recovery after transplantation in the aganglionic colon of the rat

The purpose of this study was to elucidate the possibility and the biological significance of intracolonic grafting of neuroepithelial stem cells (NESCs) as a therapeutic strategy for neuronal replacement in disorders of the enteric nervous system (ENS) such as aganglionosis. The enteric plexus of rat colon were eliminated by serosal application of the cationic surfactant benzalkonium chloride. NESCs were harvested from the neural tube of embryonic rat, labelled with bromodeoxyuridine (BrdU), and transplanted into the denervated colon. After 2, 4 and 8 weeks, grafted cells were visualized in colon sections by fluorescent double-staining for BrdU and neuronal, astrocytic, neurochemical or stem cell markers. Eight weeks post-transplantation, the intestinal motility was assessed by measuring the changes of intraluminal pressure responding to inflating stimulation and the responses to electrical field stimulation (EFS). Our results indicate that when transplanted into the denervated gut, NESCs survived and could differentiate into neurons and glial cells in vivo. Furthermore, inflation stimulated contraction and EFS-induced response were observed in NESCs grafted group compared with no reaction in denervated group. Therefore, NESCs can survive and function in the denervated rat colon in vivo, which indicates that NESCs provide a promising cellular replacement candidate for ENS.

QTLs for drought escape and tolerance identified in a set of random introgression lines of rice

A large set of 254 introgression lines in an elite indica genetic background were evaluated for grain yield (GY) and related traits under the irrigated (control) and drought (stress) conditions in two consecutive years for genetic dissection of adaptive strategies of rice to water stress. A total of 36 quantitative trait loci (QTLs) affecting heading date (HD), plant height (PH), GY and yield components were identified and most QTLs showed pronounced differential expression either qualitatively or quantitatively in response to drought. These QTLs could be grouped into three major types based on their behaviors under control and stress conditions. Type I included 12 QTLs that expressed under both the stress and non-stress conditions. Type II comprised 17 QTLs that expressed under irrigation but not under stress. Type III included seven QTLs that were apparently induced by stress. The observation that the Lemont (japonica) alleles at all HD QTLs except QHd5 resulted in early heading under stress appeared to be responsible for the putative adaptation of Lemont to drought by escaping, whereas the Teqing (indica) alleles at most PH/GY QTLs were consistently associated with increased yield potential and trait stability and thus contributed to DT. Our result that most DT QTLs were non-allelic with QTLs for drought escaping suggests that the two adaptive strategies in the parental lines are under possible negative regulation of two largely non-overlapping genetic systems.

[QTL analysis for epistatic effects and QTL x environment interaction effects on final height of rice (Oryza sativa L.)]

QTLs with epistatic effects and environmental interaction effects for final height of rice were studied by mixed-model based QTL mapping with a doubled haploid population from IR64/Azucena in four environments. The results demonstrated the importance of epistasis as a genetic basis of the quantitative traits and also revealed several important features of this phenomenon. In the results, 100 per cent of QTLs were involved in epistasis, of which 64 per cent were found with significant additive effects. This might mean that the usual estimates of the QTL additive effects could be confounded by epistatic interactions and result in biased estimation unless epistatic effect is separated. The other 36 per cent did not have any significant additive effects of their own but were involved in 48 per cent of the identified epistatic interactions. Such loci might play the role of modifying agents that tend to activate other loci or modify the action of other loci. The other features of epistasis include as follows: it was fairly common for the same locus to get involved in interactions with more than one locus; the QTLs with relatively high magnitude of effects might also be involved in epistasis; and epistasis was sensitive to environmental interactions for their expression. QTL x environment (QE) interaction effects were detected more often than QTL main effects for plant height behavior, as might indicate that gene expression could be greatly affected by environments.

[Induction of polyploid in the Pacific abalone by caffeine-heat shock treatments]

Polyploid of Pacific abalone, Haliotis discus hannai Ino, was induced by blocking Polar body I with caffeine-heat shock treatments. Fertilized eggs were treated with caffeine concentrations at: 2.5 mmol/L, 5 mmol/L and 10 mmol/L; heat shock temperatures at 24 degrees C, 26 degrees C, 28 degrees C, lasting for 10 min to 30 min, total 5 periods of time, beginning at 10 min post-fertilization. Both fertilizing and incubating at 21 degrees C sea water. The results of studies showed that the effective procedure for inducing triploid appeared to be 5 mmol/L and 10 mmol/L Caffeine concentration, heat shock temperature 26 degrees C, duration 10 min to 15 min, all beginning at 10 min after insemination. The percentage of triploid was 64.6%-77.8%, Comprehensive efficiency index of polyploid induction was 0.57-0.61. Under the condition of 5 mmol/L caffeine concentration and the temperature 26 degrees C for 30 min duration at 10 min post-fertilization, 2.8%-3.6% tetraploid embryos could be produced.

Identification of Ehrlichia chaffeensis by nested PCR in ticks from Southern China

A total of 717 ticks collected from southern China were examined by nested PCR for the presence of Ehrlichia chaffeensis. Sixteen (55. 2%) of 29 adult Amblyomma testudinarium ticks and 28 (11.7%) of 240 adult and at least 4.2% of 215 nymphal (pooled specimens) Haemaphysalis yeni ticks tested positive. Four other species of ticks were negative. Selected positive amplicons were confirmed by DNA sequencing.

Evaluation of the treatment for micromandibular deformity by distraction osteogenesis with submerged intraoral device

OBJECTIVE

To evaluate the results of distraction osteogenesis for correcting the micromandible with an intraoral device.

MATERIALS AND METHODS

Eight cases of micromandible resulting from temporomandibular joint (TMJ) ankylosis and first and second branchial arch syndrome received treatment by distraction osteogenesis. Subjects included 5 females and 3 males, ranging in age from 10 to 43 years (avg 20.25). Five micromandibles were associated with obvious mandibular asymmetry. An osteotomy was performed on bilateral mandibular bodies by intraoral approach. Elongation was started on the 5th or 6th day postoperation at a rate of 0.8 to 1 mm per day. The distractors were removed after a consolidation period from 71 to 139 days.

RESULTS

The distractions were fulfilled with a range of 8.5 to 24.4 mm. Pain appeared in osteotomy region when the 1 mm distraction was carried out once a day and disappeared when it was divided into twice a day. Mandibular lengthening was successful. Micromandible and facial asymmetries were corrected satisfactorily. The follow-up period ranged from a minimum of 1 month to a maximum of 10 months. There was no recurrence. One case of soft tissue infection and one case of lower lip numbness were reported. There were no cases of infection or other disturbance of wound healing or pseudarthrosis.

CONCLUSIONS

Because of its advantage in little injury, avoiding bone grafting, and few complications, intraoral distraction osteogenesis is a valuable approach to correct mandibular agenesis. However, in the management of mandibular deformities, distraction osteogenesis achieves better results when combined with other orthognathic operations. How to control the direction of distraction is a problem that needs further study.

[A preliminary cephalometric study on characters of facial soft tissue in mandibular asymmetry cases]

OBJECTIVE: To study the alterations of facial soft tissue in mandibular asymmetry cases.METHODS:The asymmetric rates of the bone were compared with that of soft tissue by cephalometric analysis in 20 mandibular asymmetry cases by study on the thickness of the soft tissue in special position.RESULTS:It showed that the soft tissue is more symmetric than the bones.CONCLUSION:It can be concluded that the facial soft tissue is not as asymmetric as the bone.This suggests that the reconstrction of the bony deformities and the soft tissue deformities should not be performed at same time.

[The changes of urine protein and serum beta 2-microglobulin in autoimmune thyroid disease]

Because of the different observed results about the microproteinuria in autoimmune thyroid disease, serum B2-MG, urine B2-MG, albumin and immunoglobin by RIA in 39 untreated autoimmune thyroid disease (AITD) (28 with Graves disease and 11 with Hashimoto disease) had been observed. Micro-proteinuria was found in 28.6% of patients with Graves disease and in 45.5% with Hashimoto disease; Serum B2-GM concentrations were significantly increased in Graves disease compared with that of controls. Our results suggest that the lesions present in both glomerulus and tubulus in AITD. The mechanism of them had been discussed in this paper.

[Ultrastructural observation of intratumoral neutrophils and macrophages induced by garlic oil]

After injection of garlic oil in tumor focus a large amount of neutrophils, macrophages and lymphocytes appeared. Some neutrophils and macrophages located adjacent to the tumor cells, some processes of neutrophils and macrophages penetrated into intracellular body of tumor cells. This result showed that garlic oil could induce neutrophils and macrophages against tumor.

Increase in plasma thrombomodulin and decrease in plasma von Willebrand factor after regular radiotherapy of patients with cancer

In this study, we investigated plasma levels of thrombomodulin (TM) and von Willebrand factor (vWF) in 51 patients suffering from cancer or tumor undergoing 60 cobalt radiotherapy. Plasma TM and vWF antigen were measured by immunoradiometric assay and ELISA, respectively. During radiotherapy, an increase in plasma TM in patients was observed, which was radiation-dose dependent and there was a positive correlation between plasma TM level and radiation doses. However, the level of plasma vWF in the patients was decreased during radiotherapy and there was an inverse correlation between the amount of plasma vWF and radiation doses. Our data indicate that plasma TM is an useful molecular marker for early detection of radiation injury to endothelial cells in patients undergoing radiotherapy.

[Flow cytometric analysis of the garlic oil effect on DNA content of cancer cell cycle]

Flow cytometry (FCM) is a new technique developed in the recent decade. This technique may measure DNA content of 5000 cells per second and trace the dynamic changes in cell proliferation cycle and offer a hint for designing clinical treatment protocol, monitor prognosis and elucidate the mechanisms of antitumor drugs. The authors previous studies showed significant effect of garlic oil on prolongation of life expectancy and inhibition of tumor growth in mice. Using FCM the authors analysed the effect of garlic oil on cell cycle in S180 tumor cells, 2-6 hrs after single administration or multiple administration the cell number in S phase rapidly decreased, in G1 phase increased. This suggests garlic oil may blockade cells to progress from G1 phase to S phase and result in accumulation of cells in G1 phase and directly inhibit the synthesis of DNA and the cell cycle. Theoretical basis for clinical application was offered and some aspects of antitumor mechanism of garlic oil were elucidated.

Hepatic resection under the guidance of B-mode ultrasonography

From Dec. 1987 to June 1988, we performed hepatic resection on 8 cases of primary liver cancer and 10 cases of benign liver tumor under the guidance of B-mode ultrasound. Of 18 cases, 2 received right hemihepatectomy, 5 underwent left hemihepatectomy or left lateral lobectomy, 9 had segmentectomy and 2 were treated by tumor removal. There was no operative death. Postoperatively, pleural effusion occurred in 3 cases and biliary fistula in 2 cases. The hospitalization time was 14-52 days with a mean of 29 days. Our results showed that the intraoperative B-mode ultrasound could not only demonstrate the number, size and boundary of lesions but also exhibit the location and orientation of the intrahepatic conduit system and its 3-dimensional relation with the lesions. It is very helpful in dealing with the intrahepatic vessels and ducts.

Morphological and functional investigations on macrophages with heterogeneous fluorescent staining

Four heterogeneous colors of fluorescence were demonstrated in macrophages from rabbit lymph nodes and mouse peritoneal exudate using fluorescent staining. They were bright blue, light blue, bluish green and yellow colors of fluorescence respectively. All of these 4 types of macrophages with heterogeneous colors of fluorescence could form EA or EAC rosettes and were able to phagocytose chicken erythrocytes and ink carbon granules. Among them the macrophages with bright blue color of fluorescence could form large EA or EAC rosettes and showed more rapid and stronger activity to phagocytose chicken erythrocytes, while those with bluish green and yellow colors of fluorescence showed stronger activity to phagocytose ink carbon granules.