Ultrasound-guided medial branch of the superior laryngeal nerve block to reduce peri-operative opioids dosage and accelerate patient recovery

BACKGROUND

To explore whether the medial branch block of superior laryngeal nerve can reduce the stress response of patients undergoing intubation and further reduce the dosage of opioids.

METHODS

80 patients undergoing gynecological laparoscopic surgery were selected, and randomly divided into 4 groups. All patients in the experimental groups received bilateral internal branch of superior laryngeal nerve block and transversus abdominis plane block. But the dosage of sufentanil used for anesthesia induction in the group A, B, and C was 0.4, 0.2, and 0μg/kg, respectively. Group D do not underwent supralaryngeal nerve block and the dosage of sufentanil was 0.4μg/kg. The heart rate (HR) and mean arterial pressure(MAP) were recorded at the time of entering the operating room(T1), before intubation after induction(T2), immediately after intubation(T3), 5min after intubation(T4), before extubation(T5), immediately after extubation(T6), 5min after extubation(T7). We also recorded the stay time in the recovery room, the number of cases of postoperative sore throat, the number of cases of nausea and vomiting, the first intestinal exhaust time, the length of hospital stay after operation.

RESULTS

The HR of group A, C and D at T3 was significantly higher than that at T2(P < 0.01), while the HR of group B had no significant change. The HR of group A, C and D at T4 was lower than that at T3(P < 0.01), while the HR of group B had no obvious change. The HR of group C and D at T3 was significantly higher than that at T1 (P < 0.01). The MAP of group A and D at T4 was significantly lower than that at T1 (P<0.001). The first postoperative intestinal exhaust time in group A, B and C was significantly shorter than that in group D. The length of hospital stay after operation in group B and C was shorter than that in group D.

CONCLUSIONS

Ultrasound-guided superior laryngeal nerve block combined with 0.2μg/kg sufentanil can reduce the intubation reaction, have better hemodynamic stability, reduce the first postoperative intestinal exhaust time and postoperative hospital stay, thereby accelerating the postoperative recovery of patients.

Predictive value of endometrial receptivity evaluated by three-dimensional ultrasound in ectopic pregnancy after in vitro fertilization-embryo transfer

OBJECTIVE

The aim of this study was to use three-dimensional (3D) ultrasound to detect ultrasound parameters related to the uterine artery and endometrium, evaluate endometrial receptivity, and investigate the predictive value of each parameter for ectopic pregnancy (EP) after in vitro fertilization-embryo transfer (IVF-ET).

PATIENTS AND METHODS

Fifty-seven cases of pregnancy following IVF-ET in our institution were collected and split into EP and intrauterine pregnancy (IP) groups based on the location of pregnancy, with 27 cases in EP and 30 cases in IP. Endometrial thickness, type, volume, endometrial blood flow parameters, and uterine artery blood flow parameters were all measured one day before transplantation in both groups, and the differences between the two groups were examined.

RESULTS

There were differences in endometrial blood flow typing between the two groups, with type III endometrium accounting for the highest proportion in both; the uterine spiral artery pulsatility index PI was significantly higher in the EP group than in the IP group; there were no statistical differences in uterine volume, uterine artery resistance index mRI, or uterine artery resistance index S/D between the two groups; there were no statistical differences in uterine volume, or uterine artery.

CONCLUSIONS

Intracavitary 3D ultrasound can assess endometrial tolerance and may predict pregnancy outcome after IVF-ET.

[Diagnostic value of novel hepatic fibrosis markers in assessing cirrhosis in patients with chronic hepatitis C]

Objective: To investigate the efficacy of chitinase-3-like protein 1 (CHI3L1) and Golgi protein 73 (GP73) in the diagnosis of cirrhosis and the dynamic changes of CHI3L1 and GP73 after HCV clearance in patients with chronic hepatitis C (CHC) treated with direct-acting antiviral drugs (DAAs). The comparison of continuous variables of normal distribution were statistically analyzed by ANOVA and t-test. The comparison of continuous variables of non-normal distribution were statistically analyzed by rank sum test. The categorical variables were statistically analyzed by Fisher's exact test and χ(2) test. Correlation analysis was performed using Spearman correlation analysis. Methods: Data of 105 patients with CHC diagnosed from January 2017 to December 2019 were collected. The receiver operating characteristic curve (ROC curve) was plotted to study the efficacy of serum CHI3L1 and GP73 for the diagnosis of cirrhosis. Friedman test was used to compare CHI3L1 and GP73 change characteristics. Results: The areas under the ROC curve for CHI3L1 and GP73 in the diagnosis of cirrhosis at baseline were 0.939 and 0.839, respectively. Serum levels of CHI3L1 and GP73 in the DAAs group decreased significantly at the end of treatment compared with baseline [123.79 (60.25, 178.80) ng/ml vs. 118.20 (47.68, 151.36) ng/ml, P = 0.001; 105.73 (85.05, 130.69) ng/ml vs. 95.52 (69.52, 118.97) ng/ml, P = 0.001]. Serum CHI3L1 and GP73 in the pegylated interferon combined with ribavirin (PR) group were significantly lower at the end of 24 weeks of treatment than the baseline [89.15 (39.15, 149.74) ng/ml vs. 69.98 (20.52, 71.96) ng/ml, P < 0.05; 85.07 (60.07, 121) ng/ml vs. 54.17 (29.17, 78.65) ng/ml, P < 0.05]. Conclusion: CHI3L1 and GP73 are sensitive serological markers that can be used to monitor the fibrosis prognosis in CHC patients during treatment and after obtaining a sustained virological response. Serum CHI3L1 and GP73 levels in the DAAs group decreased earlier than those in the PR group, and the serum CHI3L1 levels in the untreated group increased compared with the baseline at about two years of follow-up.

[Preliminary application of the Asia-Pacific colorectal screening score combined with the quantitative fecal occult blood in colorectal neoplasia screening]

To evaluate the efficacy of the Asia-Pacific colorectal screening (APCS) score combined with the quantitative fecal immunochemical test in colorectal neoplasia screening. Subjects who appointment to receive colonoscopy were recruited from August 2017 to May 2019 in the digestive endoscopy center. Before the colonoscopy, all subjects were scored by the Asia Pacific colorectal cancer screening scoring system and measured by quantitative fecal immunochemical test (QFIT). The detection rates of colorectal neoplasia were compared to evaluate the efficacy of the combined assay in colorectal neoplasia screening between APCS score and QFIT. A total of 1 420 subjects were enrolled in this study, APCS score medium-risk (MR) and high-risk (HR) groups were 847 (59.7%) and 573 (40.4%) and 26 cases (1.8%) of colorectal cancer, 196 cases (13.8%) of advanced adenoma, and 395 cases (27.8%) of non-advanced adenoma were detected. With the combination of APCS score and QFIT, participants were classified into 4 groups high-risk with positive QFIT result group G1, high-risk with negative QFIT result group G2, medium-risk with positive QFIT group G3, medium-risk negative QFIT group G4. The prevalence of colorectal neoplasia was 64.3%, 16.4%, 55.0%, and 9.8%, respectively. The prevalence of advanced neoplasia in high-risk with QFIT results was significantly higher than that in other 3 groups. HR and positive QFIT were the indicators for further colonoscopy, and MR with FIT negative group could postpone colonoscopy and conduct annual QFIT follow-up. The combination of APCS score and QFIT for colorectal neoplasia screening can reduce unnecessary colonoscopy, improve colonoscopy compliance and screening efficiency, and has important clinical significance and promotion value in colorectal tumor screening.

FOXN2 suppresses the proliferation and invasion of human hepatocellular carcinoma cells

OBJECTIVE

The aim of this study was to explore the roles of FOXN2 (Fork head Box N2) in mediating the proliferation and invasion of hepatocellular carcinoma (HCC) cells.

PATIENTS AND METHODS

Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was used to determine expression of FOXN2 in HCC tissues and cells. Transfection of plasmid containing FOXN2 was used to exogenously overexpress FOXN2 in vitro. Cell Counting Kit-8 (CCK-8) assay and transwell assay were applied to detect the proliferation and invasion of HCC cells, respectively.

RESULTS

FOXN2 expression decreased significantly in both HCC tissues and cells (p<0.05). Upregulation of FOXN2 significantly inhibited the proliferation and invasion of HCC cells (p<0.05).

CONCLUSIONS

FOXN2 acts as a regulator in the progression of HCC. Our findings suggest that FOXN2 may be a novel therapeutic monitoring and prognosis biomarker in HCC.

[The optimal thresholds of the quantitative fecal immunochemical test for opportunistic screening of colorectal neoplasia]

Objective: To investigate the significance of quantitative fecal immunochemical test (FIT) for opportunistic screening of colorectal neoplasia, and to propose the most optimal thresholds to improve the screening level of early colorectal neoplasia. Methods: The opportunistic screening participants were recruited from the Department of Gastroenterology & GI Endoscopy Center of the Seventh Medical Center of PLA General Hospital, and stool sample was collected before colonoscopy and the quantitative FIT was analyzed by OC-MICRO analysator for each patient. We assessed test performance in detecting colorectal neoplasia (advanced adenoma and CRC)with different thresholds on sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: A total of 1 448 objects were enrolled in this study, including 714 male (49.3%)and 734 female (50.7%).All participants were classified according to the result of colonoscopy and pathology, and 242 cases of colorectal neoplasia were found, containing 157 advanced adnoma and 85 colorectal cancer. The FIT threshold increased from 50 μg/L to 200 μg/L, while the positivity rate dropped from 11.5% to 8.6% and the sensitivity in detecting colorectal neoplasia dropped from 47.9% to 38.8%. However, the specificity increased from 96.8% to 98.2% and the positive predictive value increased from 82.3% to 87.0%.The miss rate of colorectal cancer increased from 11.8% (n=10) to 17.6% (n=15) along with the increase in FIT thresholds, but the miss rate of 100 μg/L and 150 μg/L was the same as 12.9% (n=11). Conclusions: Quantitative FIT,which is simple and fast,with the threshold of 100 μg/L for opportunistic screening, has a high sensitivity and specificity for the diagnosis of colorectal neoplasia,and is an important index in screening and diagnosis of colorectal neoplasia.

[Association of sleep with anxiety in the elderly aged 60 years and older in China]

Objective: To investigate the relationship of sleep duration and sleep quality with anxiety in the elderly aged 60 years and older in China. Methods: The elderly aged 60 years and older were selected from the China Short-term Health Effects of Air Pollution Study conducted between July 18, 2017 and February 7, 2018. Multivariate logistic regression models were used to analyze the association of sleep duration and sleep quality with anxiety. Results: A total of 3 897 elderly aged 60 years and older were included in the study. The age of the elderly was (73.4±8.0) years old. Among the elderly surveyed, 6.5% were defined with anxiety, and 18.7% reported poor sleep quality. Multivariate logistic regression models showed shorter sleep duration was the risk factor for anxiety in the elderly that after adjusting for factors such as general demographics, socioeconomic factors, lifestyle, health status, social support and ambient fine particulates exposure. Compared with the elderly with 7 hours of sleep duration daily, the OR (95%CI) of anxiety for those with sleep duration ≤ 6 hours was 2.09 (1.49-2.93). Compared with those with good sleep quality, the OR (95%CI) of anxiety for those with poor sleep quality was 5.12 (3.88-6.77). We also found statistically significant correlations of the scores of subscales of Pittsburgh sleep quality index with anxiety, in which the effects of sleep disturbance, subjective sleep quality and daytime dysfunction scores were most obvious, the ORs (95%CI) were 4.63 (3.55-6.04), 2.75 (2.33-3.23) and 2.50 (2.19-2.86), respectively. Subgroup analysis showed that the association of sleep duration and sleep quality with anxiety was more obvious in males and in those aged <80 years. Conclusion: Shorter sleep duration and poor sleep quality are associated with anxiety in the elderly in China.

[Prediction of 6-year incidence risk of chronic kidney disease in the elderly aged 65 years and older in 8 longevity areas in China]

Objective: To establish a prediction model for 6-year incidence risk of chronic kidney disease (CKD) in the elderly aged 65 years and older in China. Methods: In this prospective cohort study, we used the data of 3 742 participants collected during 2008/2009-2014 and during 2012-2017/2018 from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey. Two follow up surveys for renal function were successfully conducted for 1 055 participants without CKD in baseline survey. Lasso method was used for the selection of risk factors. The risk prediction model of CKD was established by using Cox proportional hazards regression models and visualized through nomogram tool. Bootstrap method (1 000 resample) was used for internal validation, and the performance of the model was assessed by C-index and calibration curve. Results: The mean age of participants was (80.8±11.4) years. In 4 797 person years of follow up, CKD was found in 262 participants (24.8%). Age, BMI, sex, education level, marital status, having retirement pension or insurance, hypertension prevalence, blood uric acid, blood urea nitrogen and total cholesterol levels and estimated glomerular filtration rate in baseline survey were used in the model to predict the 6-year incidence risk of CKD in the elderly. The corrected C-index was 0.766, the calibration curve showed good consistence between predicted probability and observed probability in high risk group, but relatively poor consistence in low risk group. Conclusion: The incidence risk prediction model of CKD established in this study has a good performance, and the nomogram can be used as visualization tool to predict the 6-year risk of CKD in the elderly aged 65 years and older in China.

[Influencing factors for depressive symptoms in the elderly aged 65 years and older in 8 longevity areas in China]

Objective: To analyze influencing factors for depressive symptoms in the elderly aged 65 years and older in 8 longevity areas in China. Methods: We recruited 2 180 participants aged 65 years and older in 8 longevity areas from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey in 2017. Multivariate logistic regression analysis was performed to evaluate the relationships of socio-demographic characteristics, behavioral lifestyle, chronic disease prevalence, functional status, family and social support with depressive symptoms in the elderly. Results: The detection rate of depression symptoms was 15.0% in the elderly aged 65 years and older in 8 longevity areas of China, and the detection rate of depression symptoms was 11.5% in men and 18.5% in women. Multivariate logistic regression analysis results showed that the detection rate of depressive symptoms was lower in the elderly who had regular physical exercises (OR=0.44, 95%CI: 0.26-0.74), frequent fish intakes (OR=0.57, 95%CI: 0.39-0.83), recreational activities (OR=0.65, 95%CI: 0.44-0.96), social activities (OR=0.28, 95%CI: 0.11-0.73) and community services (OR=0.68, 95%CI: 0.50-0.93). The elderly who were lack of sleep (OR=2.04, 95%CI: 1.49-2.80), had visual impairment (OR=1.54, 95%CI: 1.08-2.18), had gastrointestinal ulcer (OR=2.97, 95%CI: 1.53-5.77), had arthritis (OR=2.63, 95%CI: 1.61-4.32), had higher family expenditure than income (OR=1.80, 95%CI: 1.17-2.78) and were in poor economic condition (OR=4.58, 95%CI: 2.48-8.47) had higher detection rate of depressive symptoms. Conclusion: The status of doing physical exercise, fish intake in diet, social activity participation, sleep quality or vision, and the prevalence of gastrointestinal ulcers and arthritis were associated with the detection rate of depressive symptoms in the elderly.

Prevalence of bovine tuberculosis in the Aksu Region of Xinjiang, China, between 1985 and 2016

ABSTRACT Prevalence of bovine tuberculosis infection in cattle in Aksu Prefecture determined by intradermal tuberculin skin test (TST), between 1985 and 2016. Cattle were analyzed according to region, feeding pattern, herds and age. A total of 890,009 cattle were tested, with overall bovine tuberculosis prevalence of 0.13% (1172/890009). Statistically significant difference was found in feeding pattern and herds. Prevalence in cows (0.19%, 615/327022) was higher than that in beeves (P< 0.01, OR= 1.903, 95% CI = 1.696 to 2.134). Significant difference (P< 0.01; OR= 2.238, 95%; CI= 1.937 to 2.585) was evident for rates for bovine tuberculosis in the peasant household (0.12%, 942/802343) and farm groups (0.26%, 230/87666). The overall prevalence of bTB was decreased in the Aksu Prefecture, especially the positive rate was under 0.1% in 2010s. We concluded that the control measures forbovine tuberculosis in the Aksu region cattle herds are effective.

MiR-4505 aggravates lipopolysaccharide-induced vascular endothelial injury by targeting heat shock protein A12B

Heat shock protein family A member 12B (HSPA12B) is a heat shock protein primarily expressed in endothelial cells. Our previous study showed that it was protective against endothelial injury induced by lipopolysaccharide (LPS). The present study was performed to investigate whether micro (mi)RNA was involved in HSPA12B expression in endothelial cells challenged by LPS. We first screened the miRNA candidates potentially related to HSPA12B by bioinformatics analysis. Then the mimics of the miRNA candidates were transfected into human umbilical vein endothelial cells (HUVECs) to investigate the miRNAs that negatively regulated HSPA12B expression. The miRNA expression was also determined in LPS‑stimulated HUVECs. Dual luciferase activity assay was performed to confirm the relationship between the candidate miRNA and HSPA12B. Role of nuclear factor (NF)‑κB in the miRNA expression was investigated by using its inhibitor. Finally, the role of the miRNA on LPS induced injury was investigated. Eleven miRNAs were screened by bioinformatics analysis and 4 of them could inhibit HSPA12B expression at both mRNA and protein levels. Among the 4 miRNA candidates, only miR‑4505 was highly expressed in HUVECs stimulated by LPS. Luciferase analysis showed that miR‑4505 directly interacted with the 3'untranslated region of HSPA12B. LPS‑induced upregulation of miR‑4505 was blocked by NF‑κB inhibitor. Transfection with miR‑4505 mimics reduced the transendothelial electrical resistance and vascular endothelial‑cadherin expression. The scratch test demonstrated that miR‑4505 inhibited endothelial migration capacity. In conclusion, miR‑4505 downregulates the expression of HSPA12B and aggravates the LPS‑induced vascular endothelial cell injury.

Heat Shock Protein A12B Protects Vascular Endothelial Cells Against Sepsis-Induced Acute Lung Injury in Mice

BACKGROUND

Pulmonary endothelial injury is a critical process in the pathogenesis of acute lung injury (ALI) during sepsis. Heat shock protein A12B (HSPA12B) is mainly expressed in endothelial cells and protects against several harmful factors. However, the effects of HSPA12B in sepsis-induced ALI and its potential mechanisms of action remain unclear.

METHODS

For in vivo experiments, C57BL/6 mice were randomly divided into four groups (n=15): a sham operation group, a cecal ligation and puncture (CLP) group, a HSPA12B siRNA-CLP group and a negative control (NC) siRNA-CLP group. The mice were treated by nasal inhalation of 2-OMe-modified HSPA12B siRNA or NC siRNA. Sepsis was induced by CLP. Samples were harvested 24 and 48 hours post-CLP surgery. Pathological changes and scoring of lung tissue samples were monitored using hematoxylin and eosin staining. Levels of pro-inflammatory cytokines (e.g., interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and IL-6) and myeloperoxidase activity in bronchoalveolar lavage fluid were analyzed by ELISA. Pulmonary edema was assessed using a wet-to-dry weight ratio. Neutrophils and alveolar macrophages were counted using flow cytometry. Pulmonary endothelial cell apoptosis was detected by TUNEL staining. Expression levels of MAPK family signaling molecules and caspase-3 were measured by Western blot analysis. In addition, 7-day survival was recorded. For in vitro experiments, human umbilical vein endothelial cells were pre-transfected with HSPA12B siRNA or pIRES2-EGFP-HSPA12B-Flag plasmid and treated with lipopolysaccharide; subsequently, the expression levels of MAPK family signaling molecules and caspase-3 were measured by Western blotting.

RESULTS

Nasal inhalation of nano-polymer-encapsulated HSPA12B siRNA specifically downregulated mRNA and protein expression levels of HSPA12B in lung tissues. The administration of HSPA12B siRNA aggravated lung pathological injury, upregulated pro-inflammatory cytokine (e.g., IL-1β, TNF-α, and IL-6) expression, and increased myeloperoxidase activity, neutrophil infiltration, pulmonary edema, and pulmonary endothelial cell apoptosis. Additionally, HSPA12B knockdown worsened survival after CLP surgery. The potential protective mechanisms of HSPA12B may involve the inhibition of ERK phosphorylation and caspase-3 activation in vivo and in vitro.

CONCLUSION

HSPA12B protected against sepsis-induced ALI. The potential mechanism may be partly due to the inhibition of ERK phosphorylation and caspase-3 activation. These findings provide a potential therapeutic target for treating sepsis.

Collaborating to Compete: Blood Profiling Atlas in Cancer (BloodPAC) Consortium

The cancer community understands the value of blood profiling measurements in assessing and monitoring cancer. We describe an effort among academic, government, biotechnology, diagnostic, and pharmaceutical companies called the Blood Profiling Atlas in Cancer (BloodPAC) Project. BloodPAC will aggregate, make freely available, and harmonize for further analyses, raw datasets, relevant associated clinical data (e.g., clinical diagnosis, treatment history, and outcomes), and sample preparation and handling protocols to accelerate the development of blood profiling assays.

Intra-articular corrective osteotomies combined with the Ilizarov technique for the treatment of deformities of the knee

Aims

To present our experience of using a combination of intra-articular osteotomy and external fixation to treat different deformities of the knee.

Patients and Methods

A total of six patients with a mean age of 26.5 years (15 to 50) with an abnormal hemi-joint line convergence angle (HJLCA) and mechanical axis deviation (MAD) were included. Elevation of a tibial hemiplateau or femoral condylar advancement was performed and limb lengthening with correction of residual deformity using a circular or monolateral Ilizarov frame.

Results

At a mean follow-up of 2.8 years (1.5 to 4.1), the mean HJLCA improved from 15.6° (10° to 23°) pre-operatively to 0.4° (0° to 2°). The mean MAD improved from 70.0 mm (20.1 to 118.5) pre-operatively to 9.1 mm (3 to 15). The mean tibiofemoral angle improved from 31.0° (8° to 54°) pre-operatively to 4.9° (2° to 8°). The mean limb-length discrepancy decreased from 6.3 cm (2.9 to 13.6) pre-operatively to 1.1 cm (0 to 5). All osteotomies and distraction zones healed without complications.

Conclusion

The use of intra-articular corrective osteotomies combined with the Ilizarov technique allowed correction of deformities of the knee joint with satisfactory HJLCA and overall mechanical axis in six patients with a good functional and cosmetic outcome in the short term. Cite this article: Bone Joint J 2017;99-B:204–10.

Raman-shifted wavelength-selectable pulsed fiber laser with high repetition rate and high pulse energy in the visible

A high-pulse-energy, diffraction-limited, wavelength-selectable, visible source, based on Raman frequency shifting of a frequency-doubled Yb-doped fiber laser, has been studied. The relative length-scaling laws of Raman gain and self-phase modulation push the design towards short fiber lengths with large core size. It is experimentally demonstrated that the Raman clean-up effect in a graded-index multi-mode fiber is not sufficient to obtain diffraction-limited beam quality in the short fiber length. Thus, a large-core photonic crystal fiber is used to maintain diffraction-limited performance and output pulse energies of ~1 μJ, at a 1-MHz repetition rate and 1.3-ns pulse-width are successfully achieved. This step-tunable visible source should find applications in photoacoustic microscopy.

Understanding hydraulic fracturing: a multi-scale problem

Despite the impact that hydraulic fracturing has had on the energy sector, the physical mechanisms that control its efficiency and environmental impacts remain poorly understood in part because the length scales involved range from nanometres to kilometres. We characterize flow and transport in shale formations across and between these scales using integrated computational, theoretical and experimental efforts/methods. At the field scale, we use discrete fracture network modelling to simulate production of a hydraulically fractured well from a fracture network that is based on the site characterization of a shale gas reservoir. At the core scale, we use triaxial fracture experiments and a finite-discrete element model to study dynamic fracture/crack propagation in low permeability shale. We use lattice Boltzmann pore-scale simulations and microfluidic experiments in both synthetic and shale rock micromodels to study pore-scale flow and transport phenomena, including multi-phase flow and fluids mixing. A mechanistic description and integration of these multiple scales is required for accurate predictions of production and the eventual optimization of hydrocarbon extraction from unconventional reservoirs. Finally, we discuss the potential of CO2 as an alternative working fluid, both in fracturing and re-stimulating activities, beyond its environmental advantages.This article is part of the themed issue 'Energy and the subsurface'.

Heat shock protein A12B protects against sepsis-induced impairment in vascular endothelial permeability

BACKGROUND

As a common and life-threatening infectious syndrome, sepsis contributes significantly to morbidity and mortality in clinical settings. Vascular endothelial injury and hyperpermeability play an important role in the development of sepsis-induced organ dysfunction. Heat shock protein A12B (HSPA12B) is one of the HSP70 superfamily members and is mainly expressed in vascular endothelial cells. The present study was performed to investigate the role of HSPA12B in endothelial barrier dysfunction during sepsis.

METHODS

Human umbilical vein endothelial cells (HUVECs) were stimulated with 1 μg/mL of lipopolysaccharide (LPS) and harvested at 0, 3, 6, 9, 12, and 24 h. The messenger RNA and protein levels of HSPA12B were detected by Real Time-polymerase chain reaction and Western blot. Upregulation of HSPA12B was induced by transfection of pIRES2-EGFP plasmid carrying the HSPA12B complementary DNA. The in vitro effect of HSPA12B overexpression on endothelial permeability was manifested by the transendothelial electrical resistance value, expression of the adhesion molecules VE-cadherin, and the level of permeability-related kinase myosin light chain, SRC, and CDC42. Mice received cecal ligation and puncture surgery followed by nasal inhalation of nano-polymer-mediated siRNA. Lung endothelial permeability was assessed via intrajugular vein injection of Evans Blue 30 h after cecal ligation and puncture.

RESULTS

After LPS induction, the messenger RNA and protein level of HSPA12B in HUVECs increased and peaked at 12 h, whereas they returned to the baseline level at 24 h. Overexpression of HSPA12B can reduce the permeability of HUVEC stimulated by LPS in vitro, while increasing the expression of VE-Cadherin, myosin light chain, and CDC42. On the other hand, downregulating the expression of HSPA12B can significantly increase lung permeability in mice with sepsis-induced vascular injury.

CONCLUSIONS

HSPA12B plays a protective role in vascular endothelial barrier dysfunction by preserving the endothelial permeability during sepsis.

Tandem overexpression of five human factors renders murine hepatocytes susceptible to hepatitis C virus

Development of mouse model of hepatitis C virus (HCV) infection has great significance in drug screening and vaccine research. The barriers of interspecies transmission of HCV are increasingly better understood. Human factors, namely low-density lipoprotein receptor (hLDLR), CD81 (hCD81), scavenger receptor class B type I (hSCARB1), occludin (hOCLN) and claudin 1 (hCLDN1) are all required for rendering mouse hepatocytes permissive to HCV. With the aim to humanize mouse hepatocytes we constructed two recombinant vectors tandemly expressing the first three and the last two HCV entry factors mentioned above, respectively. Cotransfection of mouse hepatocytes with these vectors made them permissive to HCV binding and entry. Tandem overexpression of hLDLR, hSCARB1, hCD81, hCLDN1 and hOCLN is a novel approach to tailoring mouse hepatocytes to HCV binding and entry which can be further used to establish a mouse model of HCV infection as a basis for developing antiviral drugs and vaccines.

Cladding pumped few-mode EDFA for mode division multiplexed transmission

We experimentally demonstrate a few-mode erbium doped fiber amplifier (FM-EDFA) supporting 6 spatial modes with a cladding pumped architecture. Average modal gains are measured to be >20dB between 1534nm-1565nm with a differential modal gain of ~3dB among the mode groups and noise figures of 6-7dB. The cladding pumped FM-EDFA offers a cost effective alternative to core-pumped variant as low cost, high power multimode pumps can be used, and offers performance, scalability and simplicity to FM-EDFA design.

Effect of high-fructose corn syrup on the acidogenicity, adherence and biofilm formation of Streptococcus mutans

BACKGROUND

Although high-fructose corn syrup (HFCS) as a kind of sugar has been widely used in manufactured foods recently, there is little information available regarding its cariogenicity. The aim of this study was to evaluate the cariogenic potential of HFCS.

METHODS

Streptococcus mutans UA159 was inoculated into HFCS media and cultivated. The pH of each culture was measured to assess acidogenicity. Spectrophotometric turbidity was measured to determine the percentage of adherence. Confocal laser scanning microscopy and SYTO-9 staining were employed to observe biofilm formation. Sucrose media was used as a positive control.

RESULTS

The ΔpH in HFCS media was significantly larger than that in sucrose media and the pH in HFCS media decreased faster (p < 0.05). The percentage of adherence of S. mutans in HFCS media was significantly lower than that in sucrose media (p < 0.05). The biofilm formed in sucrose media was significantly thicker than that in HFCS media (p < 0.05).

CONCLUSIONS

The results of this study suggest that the cariogenicity of S. mutans in the presence of HFCS may differ compared to its cariogenicity in the presence of sucrose. Further in vivo studies need to be undertaken to resolve this uncertainty.

Three mode Er3+ ring-doped fiber amplifier for mode-division multiplexed transmission

We successfully fabricate three-mode erbium doped fiber with a confined Er(3+) doped ring structure and experimentally characterize the amplifier performance with a view to mode-division multiplexed (MDM) transmission. The differential modal gain was effectively mitigated by controlling the relative thickness of the ring-doped layer in the active fiber and pump launch conditions. A detailed study of the modal gain properties, amplifier performance in a MDM transmission system and inter-modal cross-gain modulation and associated transient effects is presented.

Multicomponent interparticle-potential lattice Boltzmann model for fluids with large viscosity ratios

This work focuses on an improved multicomponent interparticle-potential lattice Boltzmann model. The model results in viscosity-independent equilibrium densities and is capable of simulating kinematic viscosity ratios greater than 1000. External forces are incorporated into the discrete Boltzmann equation, rather than through an equilibrium velocity shift as in the original Shan and Chen (hereafter, SC) model. The model also requires the derivation of a momentum conserving effective velocity, which is substituted into the equilibrium distribution function and applies to both the single- and multiple-relaxation-time formulations. Additionally, higher-order isotropy is used in the calculation of the fluid-fluid interaction forces to reduce the magnitude of spurious currents (i.e., numerical errors) in the vicinity of interfaces. First, we compare the model to the SC model for static bubble simulations. We demonstrate that the model results in viscosity-independent equilibrium bubble densities for a wide range of kinematic viscosities, which is not the case for the SC model. Furthermore, we show that the model is capable of simulating stable bubbles for kinematic viscosity ratios greater than 1000 (when higher-order isotropy is used), whereas the SC model is known to be limited to kinematic viscosity ratios on the order of 10. Next we verify the model for surface tension via Laplace's law and show that the model results in the same surface tension values for a range of kinematic viscosities and kinematic viscosity ratios of 10, 100, and 1000. The model is also verified for layered cocurrent flow though parallel plates. We show that the simulated velocity profiles preserve continuity at the interface for kinematic viscosity ratios ranging from 0.001 to 1000 and that the model accurately predicts nonwetting and wetting phase relative permeability for kinematic viscosity ratios of 0.01 to 100.

Human neural stem cell transplantation attenuates apoptosis and improves neurological functions after cerebral ischemia in rats

BACKGROUND

Neuroprotection is a major therapeutic approach for ischemic brain injury. We investigated the neuroprotective effects induced by transplantation of human embryonic neural stem cells (NSCs) into the cortical penumbra 24 h after focal cerebral ischemia.

METHODS

NSCs were prepared from human embryonic brains obtained at 8 weeks of gestation. Focal cerebral ischemia was induced in adult rats by permanent occlusion of the middle cerebral artery. Animals were randomly divided into two groups: NSCs-grafted group and medium-grafted group (control). Infarct size was assessed 28 days after transplantation by hematoxylin and eosin staining. Neurological severity scores were evaluated before ischemia and at 1, 7, 14, and 28 days after transplantation. The terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay and immunohistochemical analysis of Bcl-2 and Bax were performed at 7, 14, and 28 days after transplantation.

RESULTS

Physiological parameters of the two groups were comparable, but not significantly different. NSC transplantation significantly improved neurological function (P<0.05) but did not reduce the infarct size significantly (P>0.05). Compared with the control, NSC transplantation significantly reduced the number of TUNEL- and Bax-positive cells in the penumbra at 7 days. Interestingly, the number of Bcl-2-positive cells in the penumbra after NSC transplantation was significantly higher than that after medium transplantation (P<0.05).

CONCLUSIONS

The results indicate that NSC transplantation has anti-apoptotic activity and can improve the neurological function; these effects are mediated by the up-regulation of Bcl-2 expression in the penumbra.

Effects of sterilization on implant mechanical property and biocompatibility

This article concisely reviews the effects of sterilization on the mechanical properties and surface chemistries of implantable biomaterials. This article also summarizes the biological effects of the sterilization-related changes in the implant. Because there are so many different types of implant materials currently in use (including metals, polymers, and diverse biological materials), the response of tissue to these different materials varies dramatically. This review further discusses the effects of sterilization on in vivo and in vitro tissue response specifically to implantable metals and polyethylene, with the possibility of future biocompatibility testing of the implants sterilized with supercritical phase carbon dioxide sterilization.

Characterization of the distinct orthotopic bone-forming activity of 14 BMPs using recombinant adenovirus-mediated gene delivery

Efficacious bone regeneration could revolutionize the clinical management of bone and musculoskeletal disorders. Although several bone morphogenetic proteins (BMPs) (mostly BMP-2 and BMP-7) have been shown to induce bone formation, it is unclear whether the currently used BMPs represent the most osteogenic ones. Until recently, comprehensive analysis of osteogenic activity of all BMPs has been hampered by the fact that recombinant proteins are either not biologically active or not available for all BMPs. In this study, we used recombinant adenoviruses expressing the 14 types of BMPs (AdBMPs), and demonstrated that, in addition to currently used BMP-2 and BMP-7, BMP-6 and BMP-9 effectively induced orthotopic ossification when either AdBMP-transduced osteoblast progenitors or the viral vectors were injected into the quadriceps of athymic mice. Radiographic and histological evaluation demonstrated that BMP-6 and BMP-9 induced the most robust and mature ossification at multiple time points. BMP-3, a negative regulator of bone formation, was shown to effectively inhibit orthotopic ossification induced by BMP-2, BMP-6, and BMP-7. However, BMP-3 exerted no inhibitory effect on BMP-9-induced bone formation, suggesting that BMP-9 may transduce osteogenic signaling differently. Our findings suggest that BMP-6 and BMP-9 may represent more effective osteogenic factors for bone regeneration.

The mass transfer process and the growth rate of protein crystals

In this paper, protein crystal growth is studied by a Mach-Zehnder interferometer and an image process system. The interference fringe images are recorded during the crystallization of tetragonal hen egg white lysozyme crystal. Concentration distributions of the protein solution are given from the interference fringe images recorded by the Mach-Zehnder interferometer with a real time servo system of a four-step phase shift. The mass transfer flux and the crystal growth rates are obtained from the concentration distribution. The results show that the observed rates are in accordance with those demonstrated by measurements of the experimental images; therefore the method for determining growth rate by the diffusion process is reasonable.

Metalloprotease-disintegrin ADAM 12 interacts with alpha-actinin-1

ADAM 12, a member of the ADAM family of proteins (containing A Disintegrin And Metalloprotease domain), has been implicated in differentiation and fusion of myoblasts. While the extracellular domain of ADAM 12 contains an active metalloprotease and a region involved in cell adhesion, the function of the cytoplasmic tail of ADAM 12 has been less clear. Here we show that the cytoplasmic domain of ADAM 12 interacts in vitro and in vivo with alpha-actinin-1, an actin-binding and cross-linking protein. Green fluorescent protein fused to ADAM 12 cytoplasmic domain co-localizes with alpha-actinin-1-containing actin stress fibres in C2C12 cells. The interaction between ADAM 12 and alpha-actinin-1 is direct and involves the 58-amino acid C-terminal fragment of ADAM 12 and the 27 kDa N-terminal domain of alpha-actinin-1. Consistently, expression of the 27 kDa fragment of alpha-actinin-1 in C2C12 cells using a mitochondrial targeting system results in recruitment of the co-expressed ADAM 12 cytoplasmic domain to the mitochondrial surface. Moreover, alpha-actinin-1 co-purifies with a transmembrane, His6-tagged form of ADAM 12 expressed in C2C12 myoblasts, indicating that the transmembrane ADAM 12 forms a complex with alpha-actinin-1 in vivo. These results indicate that the actin cytoskeleton may play a critical role in ADAM 12-mediated cell-cell adhesion or cell signalling during myoblast differentiation and fusion.

Direct interaction between the cytoplasmic tail of ADAM 12 and the Src homology 3 domain of p85alpha activates phosphatidylinositol 3-kinase in C2C12 cells

ADAM 12, a member of the ADAM family of transmembrane metalloprotease-disintegrins, has been implicated previously in the differentiation of skeletal myoblasts. In the present study, we show that the cytoplasmic tail of mouse ADAM 12 interacts in vitro and in vivo with the Src homology 3 domain of the p85alpha regulatory subunit of phosphatidylinositol (PI) 3-kinase. By site-directed mutagenesis, we have identified three p85alpha-binding sites in ADAM 12 involving PXXP motifs located at amino acids 825-828, 833-836, and 884-887. Using green fluorescent protein (GFP)-pleckstrin homology (PH) domain fusion protein as a probe for PI 3-kinase lipid products, we have further demonstrated that expression of ADAM 12 in C2C12 cells resulted in translocation of GFP-PH to the plasma membrane. This suggests that transmembrane ADAM 12, by providing docking sites for the Src homology 3 domain of p85alpha, activates PI 3-kinase by mediating its recruitment to the membrane. Because PI 3-kinase is critical for terminal differentiation of myoblasts, and because expression of ADAM 12 is up-regulated at the onset of the differentiation process, ADAM 12-mediated activation may constitute one of the regulatory mechanisms for PI 3-kinase during myoblast differentiation.

Interarticular bone tunnel healing

PURPOSE

To evaluate the healing behavior of an interarticular bone tunnel exposed continuously to a synovial environment.

TYPE OF STUDY

Experimental in vivo animal model.

METHODS

Twenty-six adult rabbits had 3.2-mm diameter tunnels drilled in the femur and tibia of both hind-limb stifle joints parallel to but without violation of the native anterior cruciate ligament (ACL). The animals were euthanized at 1, 2, 4, and 12 weeks postoperatively. Decalcified sections were made of the bone tunnels and new bone formation was computer quantified using histomorphometric methods at each time interval.

RESULTS

In this model, bone tunnel healing velocity was most rapid between 1 and 2 weeks after surgery. Both femoral and tibial interosseous tunnels showed substantial bone ingrowth (71% of bone tunnel volume) by 2 weeks postoperatively. The peripheral tunnel segment, that third of the tunnel furthest from the joint surface, healed rapidly and was 99% occluded with bone (99% confidence interval, 93.7% to 100%) at 2 weeks. Tunnel ingrowth was delayed and incomplete in the articular third of the tunnel, especially the femoral side. At 12 weeks, by volume, only 69.1% (99% confidence interval, 52.3% to 85.7%) of the interarticular third of the femoral tunnel was ingrown with new bone. Peripheral third bone tunnel healing was significantly greater than articular third tunnel healing at all time intervals; P <. 005 for the femoral and P <. 05 for the tibial tunnel.

CONCLUSIONS

Interarticular bone tunnels heal from the outside in. At 12 weeks, bone healing was slower and incomplete in the articular segment of the tunnel, closest to the joint surface. The same biologic factors that impede intersubstance ACL healing may interfere with bone tunnel healing and be another cause of bone tunnel enlargement after ACL reconstruction.

Metalloprotease-disintegrin ADAM 12 binds to the SH3 domain of Src and activates Src tyrosine kinase in C2C12 cells

ADAM 12, a member of the ADAM (protein containing a disintegrin and metalloprotease) family of metalloprotease-disintegrins, has been implicated in the differentiation and fusion of skeletal myoblasts, and its expression is dramatically up-regulated in many cancer cells. While the extracellular portion of ADAM 12 contains an active metalloprotease and a cell-adhesion domain, the function of the cytoplasmic portion is much less clear. In this paper, we show that the cytoplasmic tail of ADAM 12 mediates interactions with the non-receptor protein tyrosine kinase Src. The interaction is direct, specific, and involves the N-terminal proline-rich region in the cytoplasmic tail of ADAM 12 and the Src homology 3 (SH3) domain of Src. ADAM 12 and Src co-immunoprecipitate from transfected C2C12 cells, suggesting that the two proteins form a complex in vivo. Co-expression of Src and ADAM 12, but not ADAM 9, in C2C12 cells results in activation of the recombinant Src. Moreover, endogenous ADAM 12 associates with and activates endogenous Src in differentiating C2C12 cells. These results indicate that ADAM 12 may mediate adhesion-induced signalling during myoblast differentiation.

Generation of an adenovirus vector lacking E1, e2a, E3, and all of E4 except open reading frame 3

Toxicity and immunity associated with adenovirus backbone gene expression is an important hurdle to overcome for successful gene therapy. Recent efforts to improve adenovirus vectors for in vivo use have focused on the sequential deletion of essential early genes. Adenovirus vectors have been constructed with the E1 gene deleted and with this deletion in combination with an E2a, E2b, or E4 deletion. We report here a novel vector (Av4orf3nBg) lacking E1, E2a, and all of E4 except open reading frame 3 (ORF3) and expressing a beta-galactosidase reporter gene. This vector was generated by transfection of a plasmid carrying the full-length vector sequence into A30.S8 cells that express E1 and E2a but not E4. Production was subsequently performed in an E1-, E2a-, and E4-complementing cell line. We demonstrated with C57BL/6 mice that the Av4orf3nBg vector effected gene transfer with an efficiency comparable to that of the Av3nBg (wild-type E4) vector but that the former exhibited a higher level of beta-galactosidase expression. This observation suggests that E4 ORF3 alone is able to enhance RNA levels from the beta-galactosidase gene when the Rous sarcoma virus promoter is used to drive transgene expression in the mouse liver. In addition, we observed less liver toxicity in mice injected with the Av4orf3nBg vector than those injected with the Av3nBg vector at a comparable DNA copy number per cell. This study suggests that the additional deletion of E4 in an E1 and E2a deletion background may be beneficial in decreasing immunogenicity and improving safety and toxicity profiles, as well as increasing transgene capacity and expression for liver-directed gene therapy.

Morphological and mechanical study on the effects of experimentally induced inflammatory knee arthritis in rabbit long bones

Inflammatory knee arthritis was induced by intraarticular injection of carrageenan twice a week for a total of 6 weeks in New Zealand White rabbits and the effects of the arthritis on the morphological and mechanical properties of the adjacent femur and tibia were evaluated 8 weeks after the first injection. Carrageenan-induced knee arthritis resulted in severe osteopenic changes and a dramatic decrease in bone strength of the entire ipsilateral femur and tibia, including the femoral head and distal tibia, but not the contralateral femur and tibia and the remote humerus. The osteoporotic changes of the adjacent bones of the inflammatory arthritic knee are the basis for the reduced mechanical strength of these bones. These findings may have clinical significance with regard to the mechanisms and consequences of osteoporotic changes in patients with rheumatoid arthritis.

Mechanical properties and bone densities of canine trabecular bone

The purposes of this study were (1) to evaluate the mechanical properties of canine epiphyseal cancellous bones from adult canine femoral heads, femoral condyles, tibial plateau, and humeral heads, using indentation and compression tests, and (2) to measure bone densities (apparent density and ash density) of these cancellous bones so as to develop a normal data base of mechanical strength and bone density. The correlations between the two mechanical tests and between these tests and bone densities were also considered. The results showed all of the three mechanical parameters, ultimate load, stiffness, and ultimate strength, measured by the indentation test were higher than those measured by the compression test. Correlation analysis showed that the two sets of mechanical values correlated well (r=0.823-0.952, p<0.01). The apparent density and ash density correlated well with the mechanical parameters determined by the two types of mechanical tests (r=0.737-0.966, p<0.05).

Effects of multiple freezing-thawing cycles on ultimate indentation load and stiffness of bovine cancellous bone

OBJECTIVE

To assess the effects of multiple freezing-thawing cycles on ultimate indentation load and stiffness of bovine tibial cancellous bone with regard to freezing conditions (saline solution or air) or methods of thawing (saline solution or air).

SAMPLES

4 tibias from 4 adult cows.

PROCEDURE

The proximal portions of the tibias were sectioned to produce 20-mm-thick bone slices. Slices were subjected to 5 freezing-thawing cycles under 4 conditions: freezing with and without saline solution, then thawing in saline solution or exposed to the air. The mechanical properties of the bone slices before and after the treatments were measured, using an indentation test for comparison. Indentation testing was performed before and after freezing-thawing cycles to measure differences in mechanical parameters.

RESULTS

Significant differences in mechanical parameters were not found for bone specimens frozen in saline solution and thawed in saline solution; frozen without saline solution and thawed in air; frozen in saline solution and thawed in air; or frozen without saline solution and thawed in saline solution.

CONCLUSIONS

Multiple thawing-freezing cycles do not significantly affect the ultimate indentation load and stiffness of bovine tibial cancellous bone.

Mechanical properties of rat epiphyseal cancellous bones studied by indentation testing

Twenty-six pairs of rat femoral heads, distal femurs, proximal tibiae, and humeral heads were tested using an indentation test with a flat-ended cylindrical indentor. A useful mechanical data set including ultimate load, stiffness, and ultimate strength has been generated. Differences were found between the cancellous bones at different locations. Good correlations have been obtained between indentation depth (at 50 N load) and ultimate strength (R=-0.937, p<0.05), which means that with an increase of ultimate strength the indentation depth or deformation decreased proportionally. Based on the experimental results and the comparison with other methods in the literature, the simplicity and usefulness of this indentation test to evaluate compressive mechanical properties of rat epiphyseal cancellous bone are apparent.

Mechanical symmetry of rabbit bones studied by bending and indentation testing

OBJECTIVE

To determine whether mechanical parameters of rabbit long bones are bilaterally symmetric.

ANIMALS

Adult male New Zealand White rabbits.

PROCEDURE

17 pairs of femurs, tibias, and humeri were mechanically tested with 3-point bending (for diaphyseal bone) and indentation (for epiphyseal bone).

RESULTS

Significant differences were not found between the right and left femur, tibia, or humerus for all bending parameters. Significant differences were not found between the right and left femoral, tibial, or humeral epiphyses for all indentation parameters.

CONCLUSIONS

The results indicate mechanical symmetry of rabbit long bones in terms of mean value. The study also developed a normal comparable database for bending and indentation parameters of the rabbit femur, tibia, and humerus.

Prevention of bacterial adherence to implant surfaces with a crosslinked albumin coating in vitro

Titanium surfaces were coated with bovine serum albumin using carbodiimide, a crosslinking agent. The durability of the coated surfaces and the inhibitory effect of the albumin coating on bacterial adherence were tested in vitro for 20 consecutive days at 37 degrees C in phosphate buffered saline, with intermittent agitation. The results showed that only 10% of the coated bovine serum albumin decayed off the surface during the 20-day incubation period. The inhibition rate of the albumin coating on bacterial adherence remained high (greater than 8.5%) throughout the experiment. The results suggested potential use of this crosslinked albumin coating to reduce bacterial adherence and thus the subsequent possibility of prosthetic or implant infection in vivo.

Radiographic sizing for meniscal transplantation

Allograft or synthetic meniscal replacement has the potential to delay the arthritic sequelae of the meniscectomized knee. Meniscal implants must, however, be side and size specific. A cadaveric study was performed in which medial and lateral menisci were painted with a radiopaque tantalum powder-cyanoacrylic mixture. Radiographs of this preparation demonstrated reproducible relationships between each meniscus and established bony landmarks. When corrected for magnification, meniscal size could be derived from plain films. Meniscal width equaled the distance (coronal) from the peak of the tibial eminence to the periphery of the tibial metaphysis on anteroposterior films. Meniscal length was measured from lateral radiographs. Medial meniscal length was 80%, and lateral meniscal length was 70% of the measured sagittal length of the tibial plateau. Measurement error averaged 7.8% by these parameters.

[Nationwide survey of the distribution of human parasites in China--infection with parasite species in human population]

The infection rate of main species of parasites and their character by first nationwide survey of human parasites was made. The overall infection rate of human intestinal parasite and the infection rate of most species of parasites were higher in females than that in males. The infection rate according to the age group, the highest infection rate was found in the group aged 5-14 years. With regard to the relation between parasitic infections and occupations of the infected persons, the highest infection rates of Ascaris lumbricoides were exhibited in school children, of hookworm and Clonorchis sinensis were in halfpeasants and halfmerchant and vegetable grower; of Trichuris trichiura were in fishers, of Giardia lamblia, Entamoeba histolytica and Taenia were in herdsmen and halfherdsmen and halfpeasants. In this survey it is also shown that each nationality has their main species of parasites. The family clustering of some main parasites were proved by some province/autonomous region/municipality.

Ten families of ankylosing spondylitis

Twenty-two patients with ankylosing spondylitis (AS) from 10 families were studied with special attention to their clinical findings, HLA-B27 examinations and family histories. Results showed that HLA-B27 was positive in 19 and negative in 3. The hereditary relationship between ankylosing spondylitis and HLA-B27 in Chinese was similar to that in westerners. We consider that subjective symptoms and clinical findings are essential to early diagnosis of AS, but HLA-B27 examination and family history are supportive.