The optimal intravesical maintenance chemotherapy scheme for the intermediate-risk group non-muscle-invasive bladder cancer

OBJECTIVE

Although the current European Association of Urology(EAU) guideline recommends that patients with intermediate-risk non-muscle-invasive bladder cancer (NMIBC) should accept intravesical chemotherapy or Calmette-Guerin (BCG) for no more than one year after transurethral resection of bladder tumor(TURBT), there is no consensus on the optimal duration of chemotherapy. Hence, we explored the optimal duration of maintenance intravesical chemotherapy in patients with intermediate-risk NMIBC.

SUBJECTS AND METHODS

This was a real-world single-center retrospective cohort study. In total 158 patients with pathologically confirmed intermediate-risk NMIBC were included, who were divided into 4 subgroups based on the number of instillations given. We used Cox regression analysis and survival analysis chart to explore the 3-yr recurrence outcomes of tumor.The optimal duration was determined by receive operating characteristic curve (ROC).

RESULTS

The median follow-up was 5.2 years. Compared with instillation for 1-2 months, the Hazard Ratios(HR) values of instillation for less than 1 month, maintenance instillation for 3-6 months and > 6 months were 3.57、1.57 and 0.22(95% CI 1.27-12.41;0.26-9.28;0.07-0.80, P = 0.03;0.62;0.02, respectively). We found a significant improvement in 3-yr relapse-free survival in intermediate-risk NMIBC patients who maintained intravesical instillation chemotherapy for longer than 6 months, and the best benefit was achieved with 10.5 months of maintenance chemotherapy by ROC.

CONCLUSIONS

In our scheme, the optimal duration of intravesical instillation with pirrubicin is 10.5 months. This new understanding provides valuable experience for the precise medical treatment model of intermediate-risk NMIBC.

[Analysis of epidemiological characteristics of pulmonary tuberculosis patients in Fengtai District, Beijing City from 2011 to 2021]

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) in Fengtai District from 2011 to 2021. Methods: A retrospective study was conducted, the data of PTB patients in Fengtai District from 2011 to 2021 were collected in Chinese disease prevention and Control Information System, which included etiological classification, gender, age, occupation, onset time, demographic information etc. the epidemiological characteristics of reported PTB patients was analysis. Results: A total of 10 342 cases of PTB were reported from 2011 to 2021 in Fengtai District, with an average annual reported incidence rate of 42.87/ 100 000. The incidence rate was the highest in 2012(75.89/100 000), and significantly declined from 2013, which declined to 29.70/100 000 in 2017. It showed a slow rise from 2018 to 2021. The difference was statistically significant (χ²=1 471.77,P<0.001).There were 2 975 cases of etiologic positive PTB from 2011 to 2021, and 76 cases of Rifampicin-resistant PTB from 2017 to 2021. The ratio of male cases to female was 1.75, the average annual incidence rate of male (53.94/100 000) was higher, than female(31.57/100 000).(χ²=704.01,P<0.001). Among all age groups, 25-29 years group, 20-24 years group and 30-34 years group had the highest proportion, which were 1 506 cases (14.56%) , 1 292 cases (12.49%) and 1 024 cases (9.90%) respectively. The average annual incidence rate was the lowest in the group less than 10 years old (1.43/100 000), and the highest in the group 85 years old and over (195.20/100 000), the difference was statistically significant(χ²=3164.24, P<0.001). The top occupations from high to low were housework and unemployment (2 917 cases, 28.21%), retirees (2 308 cases, 22.32%), workers (1 047 cases, 10.12%), cadres and staff (950 cases, 9.19%), farmers (860 cases, 8.32%), business services (698 cases, 6.75%), teachers and students (455 cases, 4.40%). Conclusion: From 2011 to 2021, the incidence rate of PTB was decreased from 2012 to 2017, and slowly increased lately in Fengtai District. The epidemiological characteristics of PTB vary in different age and gender.

The mutation screening in candidate genes related to thyroid dysgenesis by targeted next-generation sequencing panel in the Chinese congenital hypothyroidism

OBJECTIVE

Congenital hypothyroidism (CH) is known to be due to thyroid dyshormonogenesis (DH), which is mostly inherited in an autosomal recessive inheritance pattern or thyroid dysgenesis (TD), whose inheritance pattern is controversial and whose molecular etiology remains poorly understood.

DESIGN AND METHODS

The variants in 37 candidate genes of CH, including 25 genes related to TD, were screened by targeted exon sequencing in 205 Chinese patients whose CH cannot be explained by biallelic variants in genes related to DH. The inheritance pattern of the genes was analyzed in family trios or quartets.

RESULTS

Of the 205 patients, 83 patients carried at least one variant in 19 genes related to TD, and 59 of those 83 patients harbored more than two variants in distinct candidate genes for CH. Biallelic or de novo variants in the genes related to TD in Chinese patients are rare. We also found nine probands carried only one heterozygous variant in the genes related to TD that were inherited from a euthyroid either paternal or maternal parent. These findings did not support the monogenic inheritance pattern of the genes related to TD in CH patients. Notably, in family trio or quartet analysis, of 36 patients carrying more than two variants in distinct genes, 24 patients carried these variants inherited from both their parents, which indicated that the oligogenic inheritance pattern of the genes related to TD should be considered in CH.

CONCLUSIONS

Our study expanded the variant spectrum of the genes related to TD in Chinese CH patients. It is rare that CH in Chinese patients could be explained by monogenic germline variants in genes related to TD. The hypothesis of an oligogenic origin of the CH should be considered.

[Clinical effects of application of antibiotic bone cement in wounds of diabetic foot ulcers]

Objective: To explore the clinical effects of antibiotic bone cement in the treatment of diabetic foot ulcers. Methods: According to the treatment methods, 18 patients with diabetic foot ulcers (11 males and 7 females, aged 53-79 years), who were conformed to the study criteria and admitted to our hospital from January 2016 to January 2017, were enrolled in traditional group; 18 patients with diabetic foot ulcers (11 males and 7 females, aged 55-80 years), who were conformed to the study criteria and admitted to our hospital from February 2017 to February 2018, were enrolled in bone cement group. Wounds of patients in traditional group were treated with vacuum sealing drainage after conventional debridement. Wounds of patients in bone cement group were covered with antibiotic bone cement after conventional debridement. The number of patients with positive bacterial culture in wound exudate in the 2 groups on admission and 3, 6, 9, and 15 days after surgery, the length of hospital stay, the number of operation, and the wound complete healing time were retrospectively recorded. Data were processed with Fisher's exact probability test and independent sample t test. Results: Compared with (29±10) d and (4.6±1.2) times of patients in traditional group, the length of hospital stay [(9±3) d] of patients was obviously shortened, the number of operation [(1.3±0.6) times] of patients was obviously reduced, the number of patients with positive bacterial culture in wound exudate at each time point post surgery was obviously reduced (t=8.177, 9.896, P<0.05 or P<0.01) in bone cement group. There were no statistically significant differences in the number of patients with positive bacterial culture in wound exudate on admission and wound complete healing time between patients in the 2 groups (t=0.175, P>0.05). Conclusions: The antibiotic bone cement treatment of diabetic foot ulcers can reduce the number of patients with positive bacterial culture in wound exudate and the number of operation, as well as shorten the length of hospital stay.

Commentary on "A novel treatment strategy for newly diagnosed high-grade T1 bladder cancer: Gemcitabine and cisplatin adjuvant chemotherapy-A single-institution experience."

BACKGROUND

Management of high-grade T1 (formerly T1G3) bladder cancer continues to be controversial. Should patients with T1G3 bladder cancer have an immediate radical cystectomy or should they receive intravesical bacillus Calmette-Guérin preserving bladder? Gemcitabine and cisplatin (GC) adjuvant chemotherapy may help to strike a balance between intravesical and early cystectomy. For purposes of this study, we continue to refer high-grade T1 lesion as "T1G3."

OBJECTIVE

To evaluate the characteristics and the long-term outcome of GC adjuvant chemotherapy in T1G3 bladder cancer after transurethral resection of bladder tumor (TURBT).

MATERIALS AND METHODS

We, retrospectively, reviewed 48 patients who were newly diagnosed with T1G3 bladder cancer between January 2009 and December 2012. A total of 48 patients received 4 cycles of GC adjuvant chemotherapy after TURBT. One month after 4 cycles of GC adjuvant chemotherapy, response was evaluated by re-TURBT. Median follow-up was 59.5 (range: 18-70) months, all patients have been observed for more than 3 years. Salvage cystectomy was recommended for patients with persistent disease and for tumor progression after initial complete response.

RESULT

Complete response was achieved in 44 (91.7%) patients. Of complete responders, 5 patients experienced recurrence and 5 patients showed progression. The progression rate and disease-specific survival rate were 10.4% and 91.7% at 3 years, respectively. More than 80% of survivors preserved their bladder. Kaplan-Meier curves showed that concomitant carcinoma in situ (CIS) was the only factor that had an influence on progression-free survival (P = 0.022) and disease-specific survival (P = 0.017). Concomitant CIS was the prognostic factor for progression rate and disease-specific survival rate at 3 years (P = 0.008 and P = 0.035).

CONCLUSION

GC adjuvant chemotherapy is a safe conservative treatment for T1G3 bladder cancer, but effective is really a phase II study. Patients with T1G3 bladder cancer with concomitant CIS should be treated more aggressively because of the high risk of progression.

[End tidal PCO(2) for evaluation of severity of disease in idiopathic pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension]

Objective: To explore the difference in end tidal PCO(2) (P(ET)CO(2)) between idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH), and to analyze the correlation between P(ET)CO(2) and the indexes of disease severity in IPAH and CTEPH patients. Methods: Data were retrieved from 68 IPAH patients and 52 CTEPH patients who all had received right-heart catheterization, pulmonary function test and cardiopulmonary exercise testing at Shanghai Pulmonary Hospital from October 2011 to October 2014. In addition, other clinical parameters were also collected. Results: The IPAH group had a significantly higher mPAP, PVR [(60±16) mmHg (1 mmHg=0.133 kPa), (13±6) Wood U ] than the CTEPH group [(46±12) mmHg, (9±4) Wood U, t=4.90, 4.83, all P<0.01]. Meanwhile, the IPAH group had a lower percentage of predicted peakVO(2), oxygen pulse [(45±15)%, (60±22)%] compared with the CTEPH group [(53±16)%, (68±21)%, t=-2.42, -1.96, all P<0.05]. The value of P(ET)CO(2) at rest, AT, peak in the IPAH patients [(27±5), (28±7), (25±7) mmHg] were higher than those in the CTEPH patients [(24±4) mmHg, (23±6) mmHg, (21±6) mmHg, t=3.22-4.54, all P<0.01]. There was a significantly difference in P(ET)CO(2) at AT and peak between WHO-FC Ⅰ-Ⅱ and Ⅲ-Ⅳ subgroups in IPAH (t=2.55, 2.60, all P<0.05) and CTEPH (t=2.39, P<0.05), except for P(ET)CO(2) at peak in the CTEPH patients (t=1.71, P>0.05). A moderately inverse correlation was found between P(ET)CO(2) at AT and NT-proBNP in the IPAH group (r=-0.58, P<0.01), meanwhile P(ET)CO(2) at AT in the CTEPH group was weakly correlated with NT-proBNP (r=-0.34, P<0.05). Conclusions: Compared with the CTEPH patients, the IPAH patients had significantly decreased exercise capacity and increased P(ET)CO(2). P(ET)CO(2) could reflect the disease severity in both IPAH and CTEPH patients, being superior in IPAH than in CTEPH. Furthermore, P(ET)CO(2) at AT might be better than P(ET)CO(2) at peak in reflecting the ventilatory efficiency.

Effects of dietary DL-2-hydroxy-4(methylthio)butanoic acid supplementation on growth performance, indices of ascites syndrome, and antioxidant capacity of broilers reared at low ambient temperature

This study examined the effects of dietary DL-2-hydroxy-4(methylthio)butanoic acid (DL-HMTBA) supplementation on growth performance, antioxidant capacity, and ascites syndrome (AS) in broilers reared at low ambient temperature (LAT) from 7 to 28 days of age. Eight hundred 7-day-old broilers were randomly assigned to two ambient temperatures (LAT and normal ambient temperature [NAT]), four supplemental DL-HMTBA levels (0.17, 0.34, 0.51, and 0.68 %) of the basal diet in a 2 × 4 factorial arrangement (ten replicate pens; ten birds/pen). LAT and NAT indicate temperatures of 12-14 and 24-26 °C in two chambers, respectively, and broilers were reared at these temperatures from 7 to 28 days of age. LAT significantly decreased body weight gain (P < 0.001), serum glutathione (GSH) content (day 14, P = 0.02; day 28, P = 0.045), glutathione peroxidase (GSH-Px) activity, and total antioxidant capacity (T-AOC) at 21 days (P = 0.001, 0.015) and 28 days (P = 0.017, 0.010) and increased feed conversion ratio (FCR) (P < 0.001), serum malondialdehyde (day 21, P = 0.000) and protein carbonyl Level (day 14, P = 0.003; day 21, P = 0.035). As for incidence of AS, there were significant effects of LAT on red blood cell (RBC) count (P < 0.05), hematocrit (HCT) (P < 0.05), and the right to total ventricular weight ratio (RV/TV) at 21 days (P = 0.012) and 28 days (P = 0.046). Supplementation of DL-HMTBA markedly decreased RV/TV at day 28 (P = 0.021), RBC (day 21, P = 0.008), HCT (day 21, P < 0.001), mean cell hemoglobin (day 14, P = 0.035; day 21, P = 0.003), and serum protein carbonyl level (day 21, P = 0.009), while significantly increased serum GSH content (day 14, P = 0.022; day 28, P = 0.001), SOD and GSH-Px activities at 21 days of age (P < 0.001 and P = 0.037). The optimal supplemental DL-HMTBA levels in basal diet of broilers aged from 7 to 28 days under low or normal temperatures were similar, so the authors recommended supplemental of DL-HMTBA level was 0.46 %.

Drug use and its associated factors among money boys in Hunan Province, China

OBJECTIVES

To describe drug use, types of drugs and related factors among money boys in Hunan Province, China.

STUDY DESIGN

A cross-sectional study was conducted between July 2012 and January 2013.

METHODS

Based on respondent-driven sampling, researchers located seven 'seeds' via a gay-dating website: http://www.ixxqy.org. After three waves of recruitment, 234 money boys were enrolled. They were asked to complete a 23-item questionnaire regarding demographic characteristics, drug use, a history of human immunodeficiency virus infection and family environment. Descriptive statistics and logistic regression analysis were conducted using Statistical Package for the Social Sciences Version 20.0.

RESULTS

In total, 205 valid questionnaires were collected. Based on the data collected, 80 (39.0%) money boys had used drugs within the last 3 months. Rush popper (36.6%) and methamphetamine (12.7%) were used most commonly, and other drugs used were ecstasy (7.8%), ketamine (5.9%), marijuana (2.4%), morphine (1.5%), heroin (1.0%) and cocaine (0.5%). Factors included in the logistic regression were length of service (odds ratio [OR] 0.395, 95% confidence interval [CI] 0.175-0.896), being an only child (OR 2.272, 95% CI 1.108-4.659), relationship between parents (OR 0.428, 95% CI 0.213-0.858) and social network (OR 2.387, 95% CI 1.144-4.970). A shorter length of service and a good relationship between parents were protective factors against drug use, while being an only child and having a wide social network were risk factors.

CONCLUSION

Drug use is common among money boys. This study found that length of service, being an only child, relationship between parents and social network are associated with drug use.

Seroprevalence of Toxoplasma gondii infection in pigs in Jilin Province, Northeastern China

In the present study, a total of 1,235 porcine serum samples were collected from 9 counties in Jilin Province (40°52'~46°18'N,121°38'~131°19'E), northeastern China from August to October 2013, and the seroprevalence of Toxoplasma gondii infection was tested by indirect haemagglutination assay (IHA). The results showed that antibodies to T. gondii were found in 19.1% (95% confidence interval [CI], 16.9% to 21.3%), with higher seroprevalence in the breeding boars (28.6%, 95% CI, 20.0% to 37.2%), and breeding sows (32.0%, 95% CI, 25.2% to 38.9%). No significant difference was found among the slaughter pigs, fattening pigs and the piglets. These results indicated that infection with T. gondii in pigs is widespread in Jilin province, and is of public health concern.

Ara-C increases gastric cancer cell invasion by upregulating CD-147-MMP-2/MMP‑9 via the ERK signaling pathway

Gastric cancer cell are not particularly sensitive to Ara-C, a deoxycytidine analog that affects DNA synthesis. In the present study, AGS and MKN-45 gastric cancer cell lines were treated with Ara-C to determine its role in cell prolife-ration and apoptosis. The antiproliferative effect of Ara-C was assessed using the Cell Counting kit-8. Gelatinase zymography was utilized to detect the activity of MMP-2 and MMP-9, and an in vitro invasion assay was performed. Using RT-PCR, CD-147, MMP-2 and MPP-9 mRNA levels were assessed in AGS cells with various doses of Ara-C treatment. CD-147, MMP-2 and MMP-9 protein levels were analysed in Ara-C‑treated AGS and MKN-45 cells. AGS cells were treated with or without U-0126 or siRNA-CD147 and/or Ara-C for 24 h, and an in vitro invasion assay was performed. Although low-dose Ara-C had no obvious effect on cell proliferation, it upregulated the expression of MMP-2, MMP-9 and CD-147 and ERK activation. Low-dose Ara-C increased gastric cancer cell invasion. U-0126 and siRNA-CD-147 inhibited the induction of Ara-C in gastric cancer cell invasion. Therefore, Ara-C enhances the invasiveness of gastric cancer cells by expression of CD-147 /MMP-2 and MMP-9 via the ERK signaling pathway. The results are therefore useful in the prevention of Ara-C collateral damage associated with standard, conventional protocols of chemotherapy administration.

Genetic variation of 5 SNPs of MC1R gene in Chinese indigenous sheep breeds

The purpose of this study was to assess genetic diversity, genetic differentiation.relationship and population structure among 10 Chinese sheep populations using 5 single nucleotide polymorphisms (SNPs). in MC1R gene. The genetic diversity indices suggested that the intra-population variation levels of Chinese Merino and Large-tailed Han,breeds were lowest than Kazakh Fat-Rumped. Chinese sheep breeds have maintained a high intra-population variation levels (95.23%). The genetic differentiation patterns and genetic relationships among Chinese sheep breeds displayed a high consistency with the traditional classification. The cluster trees were constructed by UPMGA method. The results showed that Chinese indigenous sheep populations have distinct genetic differentiation. The inter-population variation levels in Chinese sheep populations indicated three geographically independent domestication events have occurred. The Bayesian cluster analyses also showed a reliable clustering pattern, which revealed three major clusters in.Chinese indigenous sheep populations (Mongolian group, Kazakh group and Tibetan group), except for Duolang and Minxian Black-fur. There were probably caused by different breeding history, geography isolation and different levels of inbreeding. The findings supported the related records in literature, ten sheep populations originated on different time stage from the primogenitor population and communicated genetically with each other in the process of natural and artificial selection, and in different ecological environment. It is concluded that Chinese indigenous sheep have higher genetic variation and diversity, genetic differentiation exist between Chinese sheep populations. The majority breeds are consistent with the geographical distribution and breed characteristic.

Effects of dietary gossypol concentration on growth performance, blood profiles, and hepatic histopathology in meat ducks

The objective of this study was to determine the effects of gossypol from cottonseed meal (CSM) on growth performance, blood biochemical profiles, and liver histopathology of ducks. A total of 900 1-d-old ducks were randomly allocated to 5 treatments with 12 pens/treatment and 15 ducks/pen. The 5 experimental diets were formulated in such a way that 0% (a corn-soybean meal basal diet, diet 1), 25% (diet 2), 50% (diet 3), 75% (diet 4), and 100% (diet 5) of protein from soybean meal were replaced with that from CSM. All diets were formulated on a digestible amino acid basis. The experiment included 2 phases, the starter phase (1 to 3 wk) where the test diets contained graded levels of CSM and the growth phase (4 to 5 wk) where birds were fed a corn-soybean basal diet to examine the recovery of ducks after CSM withdrawal. Dietary CSM and gossypol linearly (P < 0.01) and quadratically (P < 0.01) decreased ADG and ADFI during d 1 to 14. The threshold of daily total gossypol (TG) and free gossypol (FG) intake based on ADG on d 1 to 7 and d 7 to 14 were 32.20 and 2.64 mg/d, and 92.12 and 9.62 mg/d, respectively. Serum alanine aminotransferase increased (P < 0.05) linearly with increasing level of gossypol in the diets (d 7), whereas aspartate aminotransferase increased (P < 0.05) linearly and quadratically (d 14). Serum albumin concentration decreased (P < 0.05) quadratically with increasing dietary CSM concentrations on d 21. The degree of damage to the liver increased markedly with increasing dietary CSM and gossypol content and the length of CSM and gossypol intake. On d 35, there was no difference on BW and blood profiles of ducks among all treatments. These results suggest that meat ducks’ dietary TG and FG concentration should be lower than 928.9 and 77.2 mg/kg, respectively, during d 1 to 21 of age and that a 2-wk withdrawal of diets containing gossypol should be considered.

Increased body mass index makes an impact on brain white-matter integrity in adults with remitted first-episode mania

BACKGROUND

Obesity is increasingly prevalent in bipolar disorder (BD) but data about the impact of elevated body mass index (BMI) on brain white-matter integrity in BD are sparse. Based on extant literature largely from structural magnetic resonance imaging (MRI) studies, we hypothesize that increased BMI is associated with decreased fractional anisotropy (FA) in the frontal, temporal, parietal and occipital brain regions early in the course of BD.

METHOD

A total of 26 euthymic adults (12 normal weight and 14 overweight/obese) with remitted first-episode mania (FEM) and 28 controls (13 normal weight and 15 overweight/obese) matched for age, handedness and years of education underwent structural MRI and diffusion tensor imaging scans.

RESULTS

There are significant effects of diagnosis by BMI interactions observed especially in the right parietal lobe (adjusted F(1,48) = 5.02, p = 0.030), occipital lobe (adjusted F(1,48) = 10.30, p = 0.002) and temporal lobe (adjusted F(1,48) = 7.92, p = 0.007). Specifically, decreased FA is found in the right parietal (F(1,48) = 5.864, p = 0.023) and occipital lobes (F(1,48) = 4.397, p = 0.047) within overweight/obese patients compared with normal-weight patients with FEM. Compared with overweight/obese controls, decreased FA is observed in right parietal (F(1,48) = 6.708, p = 0.015), temporal (F(1,48) = 10.751, p = 0.003) and occipital (F(1,48) = 9.531, p = 0.005) regions in overweight/obese patients with FEM.

CONCLUSIONS

Our findings suggest that increased BMI affects temporo-parietal-occipital brain white-matter integrity in FEM. This highlights the need to further elucidate the relationship between obesity and other neural substrates (including subcortical changes) in BD which may clarify brain circuits subserving the association between obesity and clinical outcomes in BD.

High expression of P53-induced Ring-h2 protein is associated with poor prognosis in clear cell renal cell carcinoma

PURPOSE

This study was carried out to examine P53-induced Ring-h2 protein (Pirh2) expression and investigate its clinical and prognostic significance in patients with clear cell renal cell carcinoma (ccRCC).

METHODS

Pirh2 mRNA and protein expressions were detected by quantitative reverse-transcription polymerase chain reaction (Q-RT PCR) and Western blotting in 35 frozen renal cancer tissue specimens and 35 adjacent normal renal tissue specimens of the same patients. Pirh2 protein expression was assessed by immunohistochemical analysis in 92 paraffin-embedded specimens of human ccRCC and 30 specimens of adjacent normal renal tissue. Correlations between Pirh2 and clinicopathologic features and prognosis were analyzed statistically.

RESULTS

Pirh2 mRNA and protein levels in ccRCC samples were increased significantly as compared with the adjacent normal renal tissues (P < 0.001). Pirh2 mRNA overexpression correlated with high stage and grade of the renal cancer (P < 0.001 and P < 0.001 respectively). Pirh2 protein expression was negative in most normal renal tissue specimens (23/30) but positive in 52.2% (48/92) of ccRCC specimens (P = 0.006). Pirh2 protein expression correlated with tumor grade and stage (P < 0.001 and P < 0.001 respectively). The median follow-up interval was 42.0 months. Overexpression of Pirh2 protein in ccRCC was significantly associated with shorter overall survival and recurrence-free survival (P = 0.001 and P = 0.003, respectively). Multivariate analysis showed that Pirh2 expression was an independent prognostic factor for ccRCC patients (P = 0.037).

CONCLUSIONS

Pirh2 was up-regulated in ccRCC at both transcriptional and translational levels compared with normal renal tissues, suggesting that Pirh2 may be a potential prognostic marker for ccRCC.

Association between HLA-A and -B polymorphisms and susceptibility to Henoch-Schönlein purpura in Han and Mongolian children from Inner Mongolia

We examined a possible association between HLA-A and -B polymorphisms and susceptibility to Henoch-Schönlein purpura (HSP) in Han and Mongolian children in Inner Mongolia, through a case-control study. Two hundred and sixty-eight unrelated children were enrolled, including 56 Mongolian and 50 Han children with HSP, 66 healthy Mongolian and 96 healthy Han children as a control group. HLA-A and -B alleles were indentified by PCR-sequence-specific oligonucleotide analysis and were further analyzed by PCR-sequencing-based typing (SBT). Frequencies of HLA-A*11, HLA-B*15 in Mongolian patients and HLA-A*26, HLA-B*35, HLA-B*52 in Han patients were higher than those in the corresponding control group (P < 0.05), while frequencies of HLA-B*07 and -B*40 in Mongolian HSP patients were lower than those in the control group (P < 0.05). Further analysis using PCR-SBT showed that all HLA-A*11 were HLA-A*1101, and most HLA-B*15 were HLA-B*1501 in Mongolian HSP patients. All HLA-A*26 were HLA-A*2601 and HLA-B*35 were mostly HLA-B*3503 in Han patients. There were more Han patients with severe manifestations than Mongolian patients (P < 0.05). Frequencies of HLA-A*26, HLA-B*35 and HLA-B*52 in Han patients were higher than in Mongolian patients (P < 0.05). We conclude that HLA-A*11(*1101) and -B*15(*1501) are associated with susceptibility to HSP in Mongolian children and HLA-A*26(*2601), HLA-B*35(*3503) and HLA-B*52 are associated with susceptibility to HSP in Han children. HLA-B*07 and -B*40 may be protective genes in Mongolian children. The different frequencies of HLA-A and -B in Mongolian and Han children may be responsible for the different manifestations in these two ethnic groups.

Analysis of the differentially expressed genes in Microsporum canis in inducing smooth skin and scalp tissue conditions

Microsporum canis is a common zoophilic dermatophyte, which causes a range of infections. To explore the pathogenic mechanism of tinea capitis, we used the suppression subtractive hybridization (SSH) technique to investigate the differences in gene expression between different cultures of Microsporum canis incubated on three different types of mineral media containing child glabrous skin, child scalp tissue and adult scalp tissue. Using dot-blot hybridization and real-time PCR technique, we successfully screened and identified a pair of genes that had expression levels 44.6 and 117 times higher in culture 1 (M. canis cultured in mineral medium with child scalp tissue) than in culture 2 (M. canis cultured in mineral medium with glabrous skin tissue), and another pair of genes with expression levels 78.2 and 9.8 times higher in culture 1 than in culture 3 (M. canis cultured in mineral medium with adult scalp tissue). These four genes were found to have 41%, 53%, 40% and 94% homology to those encoding a hypothetical protein [family of serine hydrolases 1; (FSH1)], PQ loop repeat protein (PQ-LRP), a predicted protein [porphyrin galactose 4; (P-GAL4)] and NADH dehydrogenase subunit (NADH)1, respectively. The upregulation of the FSH1, PQ-LRP, P-GAL4 and NADH1 genes in cultures of child scalp tissue indicates that they are essential in the pathogenesis of tinea capitis caused by M. canis.

Overexpression of HMGA2 in bladder cancer and its association with clinicopathologic features and prognosis HMGA2 as a prognostic marker of bladder cancer

PURPOSE

To examine HMGA2 expression and investigate its clinical and prognostic significance in human urothelial bladder cancer (BUC).

METHODS

We detected HMGA2 mRNA and protein expression by quantitative reverse-transcription polymerase chain reaction and western blotting, respectively in 44 frozen bladder cancer tissues and 18 adjacent normal bladder tissues. HMGA2 protein expression was assessed by immunohistochemical analysis of 148 paraffin-embedded specimens of human BUC and 30 specimens of adjacent normal bladder tissue. Correlations between HMGA2 and clinicopathologic features and prognosis were tested by statistical analyses.

RESULTS

HMGA2 mRNA and protein levels in bladder cancer samples were significantly increased compared with adjacent normal bladder tissues (P < 0.001). mRNA overexpression correlated with high stage and grade of the bladder cancer (P < 0.001 and P = 0.002 respectively). HMGA2 protein expression was negative in all normal urothelial tissue samples, but positive in 52% (77/148) of bladder cancers (P < 0.001). HMGA2 expression correlated with tumor grade and stage (P < 0.001 and P = 0.003 respectively), Overexpression of HMGA2 protein in non-muscle-invasive bladder cancer was significantly associated with shorter recurrence-free survival (P < 0.001), and progression-free survival (P = 0.0004). Multivariate analysis showed that HMGA2 expression was an independent prognostic factor for both tumor recurrence (P < 0.001) and tumor progression (P = 0.006).

CONCLUSIONS

HMGA2 is up-regulated in bladder cancer at both the transcriptional and translational levels compared with normal bladder tissue, HMGA2 protein is thus a potential prognostic marker for predicting tumor recurrence and progression.

The application of C12 biochip in the diagnosis and monitoring of colorectal cancer: systematic evaluation and suggestion for improvement

BACKGROUND

The 12 tumor markers' (TMs) biochip diagnostic (C12) system has been proven useful in some previous studies but its value for colorectal cancer (CRC) only was not systematically investigated.

AIMS

To evaluate the value of C12 system for CRC.

SETTINGS AND DESIGN

The associations between TMs and clinicopathological characteristics were evaluated. The most relevant TMs, the most useful combinations, and the correlations between TM levels were assessed.

MATERIALS AND METHODS

The TMs detected by the C12 system in the sera of 170 pathologically confirmed CRC patients were analyzed. One or more TMs higher than or equal to reference value were defined as positive.

STATISTICAL ANALYSIS

Chi-square test, Spearman rank correlation test and Receiver-operating characteristic (ROC) curves were used for the analysis.

RESULTS

The overall positive rate was 41.76%, and was low in stage 0-I (12.90%). Carcinoembryonic cantigen (CEA) had the highest positive rate of 36.47%. The positive rates were significantly correlated to clinical stages and lymph node status, but not to age, sex, tumor location and pathological types. Any combinations of the five highest positive TMs did not have significantly improvements. The levels of three most related TMs (CEA, CA19-9, CA242) of CRC had positive correlation with each other. CA242 and beta-HCG levels were associated with lymph node metastasis.

CONCLUSIONS

C12 system has some value in advanced CRC, but not in early CRC.

Invited article: development of high-field superconducting Ioffe magnetic traps

We describe the design, construction, and performance of three generations of superconducting Ioffe magnetic traps. The first two are low current traps, built from four racetrack shaped quadrupole coils and two solenoid assemblies. Coils are wet wound with multifilament NbTi superconducting wires embedded in epoxy matrices. The magnet bore diameters are 51 and 105 mm with identical trap depths of 1.0 T at their operating currents and at 4.2 K. A third trap uses a high current accelerator-type quadrupole magnet and two low current solenoids. This trap has a bore diameter of 140 mm and tested trap depth of 2.8 T. Both low current traps show signs of excessive training. The high current hybrid trap, on the other hand, exhibits good training behavior and is amenable to quench protection.

Neuroradiology imaging database: using picture archive and communication systems for brain tumour research

INTRODUCTION

Disease registries and databases form an important component of research in clinical medicine, and can be useful to support retrospective studies and prospective clinical trials. However, analysis of radiological imaging databases has not been explored: imaging and clinical data often exist as separate silos of information, even in modern digital-enabled hospitals in Singapore. We describe a computerised method for creating a radiological research database using data from the picture archive and communication system (PACS) and hospital information system (HIS).

METHODS

Using a relational database and Java programming language, we created the neuroradiology imaging database (NRID). A web-interface for keyword searches were tested with the clinical data from PACS of a tertiary referral hospital for neurological diseases. Keyword and wildcard searches were conducted for various brain neoplasms and compared to HIS discharge diagnosis.

RESULTS

The NRID was deployed successfully and keyword search could be completed in real time. Lists of patients with meningioma, oligodendroglial tumour, neurocytomas, cerebral abscess, and neurocysticercosis could be exported and compared with the HIS discharge diagnosis. Patients with neurological diseases could be obtained by manually combining lists.

CONCLUSION

An imaging database can be created using clinical PACS data, which can enable keyword search functions to support brain tumour research. Radiological databases can help support clinical research, but further work needs to be done in order to take full advantage of the potential of digital health information.

Determination of the Neutron Lifetime Using Magnetically Trapped Neutrons

We report progress on an experiment to measure the neutron lifetime using magnetically trapped neutrons. Neutrons are loaded into a 1.1 T deep superconducting Ioffe-type trap by scattering 0.89 nm neutrons in isotopically pure superfluid (4)He. Neutron decays are detected in real time using the scintillation light produced in the helium by the beta-decay electrons. The measured trap lifetime at a helium temperature of 300 mK and with no ameliorative magnetic ramping is substantially shorter than the free neutron lifetime. This is attributed to the presence of neutrons with energies higher than the magnetic potential of the trap. Magnetic field ramping is implemented to eliminate these neutrons, resulting in an [Formula: see text] trap lifetime, consistent with the currently accepted value of the free neutron lifetime.

[Determination of the pKa value of icariin and its content in the Chinese herb medicine epimedium grandiflorum morr. by capillary electrophoresis]

Knowledge of dissociation constants is important for prediction and understanding the migration behavior of analytes in capillary electrophoresis. Icariin is the active component of the Chinese herb medicine Epimedium grandiflorum Morr.. In order to determine the dissociation constant of icariin and to show many important pharmacology activities, a CZE method has been used to determine the ion mobility (mu A-) and the pKa value of icariin based on the non-linear relation between mu eff and [H+] and the linear relation between the reciprocal of effective mobility of the solute (1/mu eff) and the [H+] of the buffer solution. In addition, the change of pKa of icariin with the increase of ethanol concentration in the buffer was also investigated. Under the buffer condition of 24 mmol/L phosphate + 30% ethanol, the content of the active component icariin in Chinese herb Epimedium grandiflorum Morr. was quantitatively determined. The linear correlation equation was Y = 6.96 x 10(-3) + 17.0X, and the linear range is 0.032 g/L-0.354 g/L.

[Determination of the active components in Chinese herb Aloe vera L. var. chinensis (Haw.) Berger by capillary zone electrophoresis]

It has been proved that the Chinese herb Aloe vera L. var. chinensis (Haw.) Berger as well as its active components showed many important pharmacology activities. In order to find an easy and low-cost method to control the quality of the herb, a CZE method for the determination of the active components aloin and aloe-emodin in Aloe vera L. var. chinensis (Haw.) Berger was developed in this work. Under the buffer conditions of 24 mmol/L phosphate (pH 10.52), applied voltage of 15 kV and detector wavelength of 254 nm, baseline separation of the active compounds in Aloe vera L. var. chinensis (Haw.) Berger was achieved and the active components were quantitatively analyzed. The linear calibration equations of the two components are: Y= -0.140 + 57.2X (r = 0.997) for aloin and Y = -0.393 + 1.08 x 10(2) X (r = 0.999) for aloe-emodin respectively. In addition, the effects of buffer pH value and organic modifier on the migration behavior of the solutes were also investigated.

Computer-aided stereotactic functional neurosurgery enhanced by the use of the multiple brain atlas database

This paper introduces a computer-aided atlas-based functional neurosurgery methodology and describes NeuroPlanner, a software system which supports it. NeuroPlanner provides four groups of functions: 1) data-related for data reading, interpolation, reformatting, and image processing; 2) atlas-related for multiple atlases reading, atlas-to-data global and local registrations, two-way anatomical indexing, and multiple labeling in two and three dimensions; 3) atlas-data exploration-related for three-dimensional (3-D) display and real-time manipulation of cerebral structures, continuous navigation, two-dimensional (2-D), triplanar, 3-D presentations, and 2-D interaction in four views; and 4) neurosurgery-related for targeting, trajectory planning, mensuration, simulating the insertion of microelectrode, and simulating therapeutic lesioning. All operations, excluding atlas and data reading, are real time. The combined anatomical index of the multiple brain atlas database containing complementary 2-D and 3-D atlases has about 1000 structures per hemisphere, and over 400 sulcal patterns. Neurosurgical planning with mutually preregistered multiple brain atlases in all three orthogonal orientations is novel. The approach is validated with 24 intraoperative and postoperative datasets for thalamotomies, thalamic stimulations, pallidotomies, and pallidal stimulations. Its potential benefits include increased accuracy of target definition, reduced time of the surgical procedure by decreasing the number of tracts, facilitated planning of more sophisticated trajectories, lowered cost by reducing the number of microelectrodes used, reduced surgical complications, and the extra degree of confidence given to the neurosurgeon.

Significance of monoclonal antibody SC3A expression in gastric carcinoma and precancerous lesion

AIM: To study the significance of monoclonal antibody SC3A expression in gastric carcinoma and precancerous lesions.

METHODS: Immunohistochemical staining and mucin histochemical staining were performed on paraffin-embedded sections from gastric benign and malignant lesions from 101 patients.

RESULTS: SC3A positive rate was 80.3% (57/71) in lesions of gastric carcinoma. The expression of SC3A was not related to the classification, differentiation, metastasis and or survival rates. The positive rate of SC3A in cancers secreting acid mucin (90.2%) or sulphomucin (91.3%) was higher than that in cancers without acid mucin (20.0%) or sulphomucin (60.0%) (P < 0.01). The positive rate of sulphomucin was higher in cases of intestinal metaplasia with cancer (88.9%) than that of cases of intestinal metaplasia with a benign lesion (35.3%) (P < 0.01). Additionally, the positive rate of SC3A with sulphomucin in intestinal metaplasia (60.9%) was higher than that without sulphomucin (31.3%) (P < 0.05).

CONCLUSION: SC3A monoclonal antibody might be helpful in the diagnosis of gastric cancer and the discernment of histogenesis.

Ultrastructural cytochemical study of enzymes expressed by signet ring cells in gastric cancer

AIM: To study the ultrastructural localization of five marker enzymes (ALPase, ACPase, G6Pase, TPPase and CCOase) in gastric cancer signet ring cells to demonstrate their biologic behaviors.

METHODS: Five marker enzymes were examined in signet ring cells of seven gastric cancer patients by ultrastructural enzyme cytochemical techniques.

RESULTS: The number of corresponding organelles and the activities of marker enzymes, especially ACPase and TPPase, increased, leading to stronger mucus synthesis, secretion and digestion in gastric cancer signet ring cells. There was a lack of collagenous fibers in the stroma around the cancer nests.

CONCLUSION: Signet ring cell carcinoma is very invasive with metastasis rates due to the secretion of proteolytic enzymes.

[Light and electron microscopic histochemical studies of alkaline phosphatase (ALP) isoenzymes in gastric cancer]

By using light and electron microscopic histochemical techniques, the activities and distributions of ALP isoenzymes in gastric cancers and benign gastric diseases were examined. The results showed: Nagao, Regan and Kasahara isoenzymes, which were not expressed in normal gastric mucosae and non-malignant lesions, may be considered as the tumor markers of gastric cancer. The epithelium of intestinal metaplasia exhibited intestinal-type ALP only, which was one of the markers of well-differentiated intestinal metaplasia. In the view-point of the gene expression of ALP isoenzymes, two mutation hypothesis and recessive-gene mutation hypothesis may be proper for gastric cancer.

[Synthesis and biological activity of an analogue of active fragment (SP-6) of substance P]

SP-6 was synthesized by solid phase method in 95% purity on HPLC. The data obtained from amino acid analysis and fast atom bombardment were in good agreement with theoretical values. Intravenous injection of SP-6 in rabbits at the dosage of 14.3 micrograms/kg. resulted in blood pressure reduction of 4.4 kPa, i.e. 34% (P < 0.001). When the concentration of SP-6 in Tyrode solution was 5.2 x 10(-4) mg/ml the contraction of rabbit duodenum longitudinal muscle increased by 105%. (P < 0.001). When the concentration was more than 1 x 10(-3) mg/ml, the contractile effect was restrained significantly. Dropping 30 microliters of SP-6 (1 x 10(-3) mg/ml) to toad intestinum tenue mesenteriale in situ, the mesentery arterioles were expanded by 30%.

A conditional bootstrap procedure for reconstruction of the incubation period of AIDS

Data on the incubation period of AIDS patients are often fragmented and censored. parametric models have been proposed in the literature to impute the missing segment of the incubation period. The numerical results vary widely with the parametric models used. We propose a nonparametric conditional bootstrap (CB) procedure for imputation. The quality of the CB data is studied by checking the asymptotic accuracy of the CB estimators. We establish the asymptotic accuracy of the CB procedure for two basic nonparametric estimators: the empirical distribution function and a kernel-type conditional empirical distribution function. The rates of convergence of the CB approximation are obtained. The results for the kernel-type estimators hold also for the nearest-neighbor-type estimators.

Cell survival probability under ionizing radiation

The survival probability of a living cell exposed to ionizing radiation in an experimental setup is derived. The survival of a cell depends on the severity of the radiation damage and efficiency of the cellular repair. The formula of the survival probability is expressed as a function of dose, nonlinear rate of lesion induction, nonlinear rate of cellular repair, and a key experimental parameter--the holding time. The result is an extension of the Markovian dose-response model developed by Yang and Swenberg.

A stochastic two-stage carcinogenesis model: a new approach to computing the probability of observing tumor in animal bioassays

A new definition of probability of observing tumor in animal bioassay is developed. It is derived from a two-stage stochastic model for carcinogenesis with time-dependent birth and death rates for cell proliferation. The model takes into account the method of collecting data on preneoplastic and neoplastic lesions. The new definition is appropriate for analyzing the presence or absence of tumors in animal bioassays.

A stochastic model for analyzing prevalence surveys of hepatitis A antibody

Epidemiologic surveys of the age-specific prevalence of antibody to hepatitis A virus (anti-HAV) provide information on the spread of infection such as the infection rate and age-dependent characteristics. However, the data on prevalence are confounded with the mortality and diminished immunity of surveyed individuals. Through modeling, the age-specific prevalence of an individual can be separated from these confounding factors. A Markov chain is used to model the process of acquisition of anti-HAV by an individual and to derive the age-specific prevalence. Data from Frösner et al. [Am. J. Epidemiol. 110:63-69 (1979)] are used for illustration and estimation of parameters. The model offers an explanation of the well-known phenomenon of a decline in prevalence in older age. In addition to hepatitis, the framework of the model can be adapted to analyzing seroepidemiologic surveys of other diseases.

[Distribution and ultrastructural localization of carcino-embryonic antigen (CEA) in signet-ring cells of gastric cancer]

The distribution and ultrastructural localization of CEA in signet-ring cells of 15 gastric cancer specimens were observed by PAP and immunoelectron microscopic methods. The mechanism of abnormal distribution of CEA in the signet-ring cell and its biological significance are discussed. The results showed that the CEA positive rate in signet-ring cells was 100% with the polarity lost in distribution. Under the light microscope, the CEA stain patterns were of two types-cytoplasmic and membranous types. The former was predominant. Under the electron microscope, most of the CEA was distributed on the cell membrane and cytoplasm. CEA was found in intracellular membranous structure of the cancer cells, especially in protein synthesis and transport organellae (RER, Golgi Complex etc). The synthesis of CEA in cancer cells increased, yet its elimination was somewhat hampered. The result was that the RER became extended and were full of CEA (+) material. In the free signet-ring cell, there was a small and short contact plane. The tight junction was severed as the cell junction was reduced. The antigenic determinant of CEA was glycoprotein. The abnormal distribution of CEA in signet-ring cells might be the morphologic reflection of the glycosylation of surface glycoprotein of tumor cells. These abnormal changes would lead to mal-functions and biologic misbehavior in the cells. It may even lead to disturbances in connection and recognition, loss of contact inhibition and decrease in the adhesion between tumor cells and therefore may easily give rise to infiltration and metastasis.

A quantitative index for evaluating patient care with longitudinal data

This paper describes a patient-outcome based index of the quality of health care useful to health services researchers and planners. This index is applicable in any health care situation where longitudinal data are available from patients who can be classified into mutually exclusive stages of severity by functional status, psychological well-being or diagnosis and followed over a period of time. The rationale of the index is presented, along with an illustrative example based on a study on long-term care. The procedure for generating weights for the index is briefly described.