[Diagnosis and treatment of strabismus caused by nasal endoscopic surgery]

Objective: Strabismus with diplopia is the main orbital complication of functional endoscopic sinus surgery (FESS). This study was to analyze clinical findings, treatment and outcomes of such cases. Methods: Retrospective case series. Twenty-three cases were divided into 3 groups based on the disease severity: group A, partial transection of the medial rectus muscle, group B, complete transection of the medical rectus, group C, transection of the medial rectus combined with the other orbital injuries. Complete ophthalmology examinations, including eye alignment, eye motility, force duction test, force generation test, general eye exam, and medical imaging (orbital CT or MRI), were performed for each case. The treatment included botulinum toxin (Botox) injection to the lateral rectus muscle, transposition of the vertical rectus muscle, and orbital surgery if needed. Results: In group A with Botox injection, all the cases achieved single vision in primary position, but still remained some adduction weakness. In group B treated by vertical transposition surgery combined with Botox, 22% of the cases got single vision in primary gaze. In group C, even with more efforts of treatment, the cases with orbital injury can only get cosmetic improvement, and diplopia and adduction dysfunction were found in most cases. Conclusions: Due to the variety of the complications of FESS, force duction test is a crucial exam to detect the direction and severity of synechia in the orbit, which will give solid information to surgery approach as well as prognosis. Botox injection at early stage will minimize the contraction of antagonist lateral rectus, helping to postpone the transposition surgery which may cause anterior segment ischemia when performed right after the medial rectus transection injury. Botox may even reduce the synechia by minimizing the scarring process. Partial vertical rectus transposition combined with muscle resection may effectively correct the eye misalignment in primary gaze and improve eye motility. The prognosis of FESS induced orbital complications is quite related with the severity of the injury. Botox combined with surgery may help medial rectus transection cases to achieve single vision in primary gaze, but when there is any other orbital injury, treatment may only improve cosmetic appearance. (Chin J Ophthalmol, 2017, 53: 917-923).

[Association of plasma albumin and hypersensitive C-reactive protein with 5-year all-cause mortality among Chinese older adults aged 65 and older from 8 longevity areas in China]

Objective: To investigate the relationship of plasma albumin and hypersensitive C-reactive protein (Hs-CRP) with 5-year all-cause mortality among Chinese older adults aged 65 and older. Method: Data was collected in 8 longevity areas of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) study conducted by Chinese Center for Disease Control and Prevention and Peking University at baseline survey in 2012 and 2014, the participants enrolled in 2012 was followed-up in 2014 and 2017, the participants enrolled in 2014 was followed-up in 2017 only. Finally, 3 118 older adults aged 65 and older with complete information on albumin, Hs-CRP and body mass index (BMI) were included in this study. Plasma samples of older adults were collected for the detection of albumin and Hs-CRP at baseline survey. Survival status and follow-up time was recorded for all participants. All older adults were divided into 4 groups according to the levels of plasma albumin and Hs-CRP, and Cox proportional hazard models were constructed to assess their influence on the risk of all-cause mortality. Results: Among 3 118 older adults included, the prevalence of hypoalbuminemia was 10.1% (316/3 118), and was 22.8% (711/3 118) for elevated Hs-CRP. During 10 132 person-years of follow-up, 1 212 participants died. Participants with hypoalbuminemia had increased risk of all-cause mortality, with an hazard ratio (HR) and 95% confidential interval (CI) of 1.18 (1.01-1.38), compared to participants with normal plasma albuminemia; participants with elevated Hs-CRP had increased risk of all-cause mortality, with an HR (95%CI) of 1.18 (1.04-1.35), compared to participants with normal plasma Hs-CRP. Participants with normal plasma albumin and elevated Hs-CRP, with hypoalbuminemia and normal Hs-CRP, with hypoalbuminemia and elevated Hs-CRP also had increased risk of all-cause mortality when compared to those with normal plasma albumin and normal Hs-CRP, the HR (95%CI) were 1.16 (1.01-1.34), 1.11 (0.91-1.37) and 1.43 (1.11-1.83), respectively. Conclusion: Hypoalbuminemia and elevated Hs-CRP were responsible for increased risk of 5-year all-cause mortality among Chinese older adults from 8 longevity areas.

[Feasibility and toxicity of EC-T dose-dense adjuvant chemotherapy: A real world study in Chinese early-stage breast cancer patients with high recurrence risk]

Objective: We aimed to examine the feasibility and toxicity of EC-T dose-dense regimen and to demonstrate the suitable dose of epirubicin in a Chinese early-stage breast cancer population with high recurrence risk. Methods: 370 patients with early-stage breast cancer at high risk of recurrence were treated with EC-T dose-dense adjuvant chemotherapy and prophylactic administration of recombinant human granulocyte stimulating factor (G-CSF). The incidence of delayed chemotherapy, drug reduction and adverse reactions were retrospectively analyzed. Results: 370 patients completed the planned eight cycles of chemotherapy, 50 patients experienced chemotherapy delay, and 90 had chemotherapy dose reductions. Overall, 61.1% of the patients experienced grade 3 or 4 hematology toxicities, 4.1% of the patients experienced grade 3 gastrointestinal toxicity, 16.3% experienced grade 3 or 4 liver malfunction, and 1.9% experienced grade 3 alopecia. In the multivariate analysis, pretreatment epirubicin levels were associated with comprehensive and hematology toxicity risk (OR=1.268, P=0.046; OR=1.244, P=0.036). With G-CSF support, the probability of grade 3-4 dose limiting toxicity, i. e. neutropenia, abnormal liver function, and gastrointestinal adverse effects did not increase as the epirubicin dose level increased(P>0.05). However, there were no statistically significant associations between epirubicin grade and treatment delay (P=0.814) or dose reduction (P=0.282). Conclusions: EC-T dose-dense chemotherapy shows tolerable toxicity. High dose level is not a limiting factor for this regimen. With G-CSF support, epirubicin 85-90 mg/m(2) is appropriate tolerance dose for Chinese early breast cancer patients with high recurrence risk.

[Influence of low dose perfluorooctanoate acid exposure to the cell proliferation, migration and invasion of the human muscle rhabdomyosarcoma cell line]

Objective: This study aimed to explore the effect of perfluorooctanoate acid (PFOA) on the proliferation, migration and invasion of the human muscle rhabdomyosarcoma RD cell line and its related mechanisms. Methods: RD cells were cultured and exposed to PFOA of different concentrations with 6-72 hours. The cell viability was assessed by cell counting kit-8 (CCK-8) assay. Wound healing and transwell filter assay were used to evaluated the migration and invasion ability of the RD cells respectively. The cell cycles were detected by Flow cytometry. Quantitative real-time PCR and Western blot were used to quantify the mRNA and protein expression difference of related genes, respectively. Results: CCK-8 assay showed that, after treated the RD cell with different dose of PFOA for 72 h, low dose PFOA (1,10,50, 100 μmol/L) promotes the proliferation of RD cells while high dose PFOA (250, 500 mol/L) inhibits the proliferation (P<0.001). Flow cytometry showed that compared with the control group, there was no significant difference in G0/G1 phase, while cells in S phase deceased and G2/M phase cells increased after treated with PFOA (50 μmol/L) for 72 h. The relative proportions of S and G2/M were significantly different between the two groups (P<0.01). The results of qPCR showed that the mRNA relative expression of CDK2 of the control group and the PFOA (50 μmol/L) group were 0.97±0.07 and 2.64±0.11 respectively, and there was a significant difference (t=12.60, P<0.001); The mRNA relative expression of cyclin E2 of the control group and the PFOA (50 μmol/L) group were 1.33±0.17 and 3.35±0.22 respectively, and there was a significant difference (t=7.42, P<0.001); The results of Western blot showed that the protein relative expression of CDK2 of the control group and the PFOA (50 μmol/L) group were 0.35±0.01 and 0.84±0.03 respectively, and there was a significant difference (t=14.60, P<0.001); The protein relative expression of cyclin E2 of the control group and the PFOA (50 μmol/L) group were 0.67±0.04 and 0.86±0.01 respectively, and there was a significant difference (t=4.88, P<0.01); There was no significant difference in the mRNA and protein expression of p21 and p53 between the PFOA and control group (P>0.05). The wound healing rate of the PFOA (50 μmol/L) group was faster than that of the control group, and the relative migration area of the PFOA group was larger accordingly (P<0.001). After PFOA (50 μmol/L) treated, the number of the cell through the membranes was much more than the control group (t=54.40, P<0.001), which means PFOA significantly stimulated the invasion ability of the RD cells. The results of qPCR showed that the mRNA relative expression of vimentin of the control group and the PFOA (50 μmol/L) group were 0.71±0.03 and 2.53±0.16 respectively, and there was a significant difference (t=11.00, P<0.001); The mRNA relative expression of MMP2 of the control group and the PFOA (50 μmol/L) group were 1.09±0.04 and 10.73±1.20 respectively, and there was a significant difference (t=8.04, P<0.001). The results of Western blot showed that the protein relative expression of vimentin of the control group and the PFOA (50 μmol/L) group were 0.55±0.06 and 0.81±0.01 respectively, and there was a significant difference (t=4.50, P<0.05). The protein relative expression of cyclin E2 of the control group and the PFOA (50 μmol/L) group were 0.64±0.04 and 1.03±0.13 respectively, and there was a significant difference (t=2.94, P<0.05). Conclusions: Low dose PFOA (50 μmol/L) exposure promotes cell proliferation, migration and invasion in the human muscle rhabdomyosarcoma cell line through inducing the expressions of MMP2, vimentin and cell cycle related genes.

Methylation-Based Age Estimation Model Construction and Its Effectiveness Evaluation

OBJECTIVES

To screen the DNA methylation loci associated with the age of Han males in northern China and to construct an age estimation model.

METHODS

Twenty-one candidate methylation loci were screened. The DNA methylation levels of 476 blood samples from Chinese Han males were detected for 21 amplicons using EpiTYPER technology platform, and data on 153 DNA methylation loci were obtained.

RESULTS

After correlation analysis, 8 age-related DNA methylation loci were finally screened. CpG1, CpG2, CpG4, CpG7, CpG8 were located on TRIM59, RASSF5, Clorf132, CSNK1D, ELOVL2,CpG5, CpG6 on PDE4C, and CpG3 on chr17:21452808. Based on the 8 loci, 352 samples were used for model construction. A multivariate linear regression age estimation model was constructed （R²=0.93）, with mean absolute deviation （MAD） of 2.69 years old. When 109 samples were used for model validation, the MAD was 3.80 years old. The test was repeated 3 times in 15 new samples, with MADs of 4.08, 4.68 and 3.93 years old, respectively.

CONCLUSIONS

The age estimation model on Han males in northern China constructed in this study can be used to estimate the age of victims and suspects and to narrow the scope of investigation, and therefore has practical application value.

[Expression of anaplastic lymphoma kinase fusion gene in patients with lung sarcomatoid carcinoma and treatment analysis]

Objective: To investigate the expression status of anaplastic lymphoma kinase (ALK) fusion gene in lung sarcomatoid carcinoma (LSC) and the role of ALK inhibitors for treatment. Methods: Total of 84 cases of LSC confirmed by histopathology were detected for ALK fusion gene from January 2011 to December 2014 in the Cancer Hospital of Chinese Academy of Medical Science&Peking Union Medical College and Shandong Zibo Wanjie Cancer Hospital. All patients were primarily treated by the multi-disciplinary mode in combination with chemotherapy or targeted therapy based on surgery. Postoperative adjuvant chemotherapy was given on platinum based two-drug combination regimen. In ALK fusion gene (+ ) patients with recurrence or metastasis, crizotinib target therapy was prefered. Chi-square test was applied for the comparison of 1, 3, 5-year survival rates between the two groups. Results: Eighty-two cases completed the follow-up. ALK fusion gene was found in 9(10.7%) patients. After application of crizotinib, 1 case was evaluated as complete remission, 6 cases as partial response, 2 cases as stable disease; the 1, 3, 5-year survival rate was 100% (9/9), 100% (9/9) and 88.9% (8/9) for the patients with ALK fusion gene, and it was 65.8% (48/73), 15.1% (11/73) and 6.8% (5/73) respectively for patients without ALK fusion gene. There was significant difference in the survival rate between the two groups (χ(2)=1.56, 1.56, 0.83, all P<0.05). Conclusion: ALK fusion gene maybe expressed in LSC patients. Compared with conventional chemotherapy, crizotinib can significantly prolong the survival time of patients with ALK fusion gene.

[Clinical significance of S100A6 and Notch1 in multiple myeloma patients]

目的

探讨S100A6、Notch1在多发性骨髓瘤（MM）患者中的表达及其临床意义。

方法

以28例MM患者为研究对象，以20例白细胞、血小板略低但骨髓检查未见异常者为对照，采用real time PCR法检测骨髓单个核细胞S100A6、Notch1的表达；采用免疫组化染色法检测S100A6、Notch1蛋白在MM患者骨髓和髓外浸润组织活检病理切片中的表达；采用real time PCR法和Western blot法检测siRNA沉默骨髓瘤U266细胞S100A6基因后对Notch1 mRNA和蛋白水平的影响。并结合临床进行相关分析。

结果

①S100A6、Notch1 mRNA表达水平：初发MM患者组分别为2.19±1.25、2.98±0.64，均高于对照组（0.71±0.20、0.58±0.39）和稳定期患者组（0.85±0.26、0.72±0.40）（P值均<0.05）；伴髓外转移组（8例）分别为3.36±1.23、5.71±3.96，均高于无髓外转移组（20例）（1.40±0.25、1.16±1.00）。②S100A6与Notch1 mRNA表达呈正相关（r=0.505，P=0.007）。③MM患者骨髓和髓外浸润组织活检病理切片均可见浆细胞S100A6、Notch1阳性表达。④siRNA转染U266细胞48 h后S100A6基因表达沉默，Notch1 mRNA及蛋白水平明显下降。

结论

S100A6、Notch1表达与MM疾病发生、进展、髓外转移相关，二者具有显著相关性，可作为MM诊断及预后的指标。

[Advances in epidemiology and serum markers for the noninvasive diagnosis of nonalcoholic fatty liver disease]

The global prevalence rate of nonalcoholic fatty liver disease (NAFLD) has increased year by year, and it has become the number one cause for chronic liver disease in China. In addition, the trend of NAFLD has become more pronounced and evident in female gender and younger age group. The long-term persistence of fatty liver disease may cause serious consequences. There are no accepted diagnostic criteria for diagnosing noninvasive diagnosis of NAFLD. Alpha-ketoglutarate is a newly discovered serological marker of high diagnostic value and considered the most valuable potential biomarker along with cytokeratine-18 (CK-18).

[Association between air pollution and cognitive function in the elderly]

Cognition disorders is one of the most important factors affecting the elderly. Impaired cognitive function caused by the elderly daily self-care ability decreased, the elderly in China cause serious social, psychological and economic burden. The purpose of this review is to summarize the current evidence on main air pollutants(SO(2), NO(2), CO, PM(2.5) and PM(10), black carbon)and cognitive function in elderly. The study found that exposure to air pollution, especially particulate matter, is associated with cognitive disorders n in the elderly. However, the existence of such correlations requires reasonable physiological mechanisms. Future studies also require a large number of longitudinal cohorts to investigate air pollution in association with cognitive impairment . There is a need for parallel toxicological and epidemiological studies to elucidate mechanisms and pathways of action.

[Occupational mental health and job satisfaction in university teachers in Shenyang, China]

Objective: To investigate the current status of occupational mental health and job satisfaction in university teachers in Shenyang, China and related influencing factors. Methods: A total of 1500 teachers from 6 universities in Shenyang were randomly selected as study subjects from November 2013 to January 2014. Self-administered questionnaires were used to investigate mental health, including effort-reward imbalance questionnaire, Minnesota Satisfaction Questionnaire, Center for Epidemiological Survey-Depression Scale, and Psychological Capital Questionnaire. Results: Of all teachers, 58.9% had depressive symptoms. Depressive symptoms in university teachers were negatively correlated with the scores of psychological capital, supervisory commitment, and perceived organizational support (r=-0.461, -0.306, and -0.366, all P<0.01) and were positively correlated with the score of occupational stress (r=0.414, P<0.01) . Job satisfaction was positively correlated with psychological capital, perceived organizational support, and supervisory commitment (r=0.650, 0.715, and 0.636, all P<0.01) and negatively correlated with occupational stress (r=-0.475, P<0.01) . The direct effects of occupational stress, perceived organizational support, and supervisory commitment on job satisfaction were -0.30, 0.26, and 0.14, respectively, and their indirect effects were -0.0176, 0.0656, and 0.0368, respectively. The direct effects of occupational stress, perceived organizational support, and supervisory commitment on depressive symptoms were 0.20, -0.08, and -0.05, respectively, and their indirect effects was 0.033, -0.123, and -0.069, respectively. Conclusion: Occupational mental health is closely associated with job satisfaction in university teachers in Shenyang, and psychological capital has a mediating effect on perceived organizational support, supervisory commitment, occupational stress, job satisfaction, and depressive symptoms.

[Analysis of treatment and prognosis in post-operative patients with urachal carcinoma]

OBJECTIVE

Urachal carcinoma is a kind of urogenital tract malignancy with a very low incidence. The objective of this study was to observe the clinical presentation, pathological condition, treatment method and outcome of patients with urachal carcinoma.

METHODS

A retrospective analysis of thirty-six cases of urachal carcinoma diagnosed over a period of 10 years from 2003 to 2013 was carried out. All pathologic specimens were reviewed by two separate pathologists. Clinical and histological features, treatment condition, patient follow-up and survival outcome was reviewed and calculated.

RESULTS

The mean age at diagnosis was 53 years. Of the thirty-six patients, twenty-five were male. All patients underwent partial cystectomy with bilateral pelvic lymph node dissection. All cases were adenocarcinoma, including 20 mucinous adenocarcinoma, 7 moderately differentiated adenocarcinoma, 5 poorly differentiated adenocarcinoma, 1 signet ring cell carcinoma, 3 hybrid adenocarcinoma. The Sheldon pathologic stage was stage Ⅱ in 11, Ⅲ in 16 and Ⅳa in 9 cases. All patients received medical oncological therapy. The median follow-up period was 27 months. The median overall survival was 36 months. One-year survival rate was 70% and five-year survival rate was 28%.

CONCLUSIONS

Urachal carcinomas are rare and usually at locally advanced stage at diagnosis with a high tendency of metastases. Surgery is a key method of primary treatment and medical oncological therapy may play a role in decreasing the chances of recurrence which still needs to be explained by prospective clinical trials.

Prognostic and Predictive Model for Stage II Colon Cancer Patients With Nonemergent Surgery: Who Should Receive Adjuvant Chemotherapy?

No ideal prognostic model has been applied to clearly identify which suitable high-risk stage II colon cancer patients with negative margins undergoing nonemergent surgery should receive adjuvant chemotherapy routinely. Clinicopathologic and prognostic data of 333 stage II colon cancer patients who underwent D2 or D3 lymphadenectomy during nonemergent surgery were retrospectively analyzed. Four pathologically determined factors, including adjacent organ involvement (RR 2.831, P = 0.001), histologic differentiation (RR 2.151, P = 0.009), lymphovascular invasion (RR 4.043, P < 0.001), and number of lymph nodes retrieved (RR 2.161, P = 0.011), were identified as independent prognostic factors on multivariate analysis. Importantly, a simple cumulative scoring system clearly categorizing prognostic risk groups was generated: risk score = ∑ coefficient' × status (AOI + histological differentiated + lymphovascular invasion + LNs retrieved). Our new prognostic model may provide valuable information on the impact of lymphovascular invasion, as well as powerfully and reliably predicting prognosis and recurrence for this particular cohort of patients. This model may identify suitable patients with an R0 resection who should receive routine postoperative adjuvant therapy and may help clinicians to facilitate individualized treatment. In this study, we aim to provide an ideal and quantifiable method for clinical decision making in the nonemergent surgical treatment of stage II colon cancer. Our prognostic and predictive model should be applied in multicenter, prospective studies with large sample sizes, in order to obtain a more reliable clinical recommendation.

Enhanced ultraviolet emission from Au/Ag-nanoparticles@MgO/ZnO heterostructure light-emitting diodes: A combined effect of exciton- and photon- localized surface plasmon couplings

Localized surface plasmon (LSP)-enhanced ultraviolet light-emitting diodes (LEDs) based on a Au/MgO/ZnO metal/insulator/semi- conductor heterostructure were fabricated by embedding Ag nanoparticles (Ag-NPs) into MgO dielectric layer. A ~6-fold electroluminescence (EL) enhancement was achieved from the Ag-NPs decorated device. Time-resolved spectroscopy studies, as well as analogue simulation and theoretical estimation based on experimental data, reveal that the internal quantum efficiency and light extraction efficiency of the heterojunction LED are increased ~3-fold and ~2-fold, respectively, as a result of the introduction of Ag LSPs. This result indicates that the observed EL enhancement originates from a combined effect of both exciton-LSP coupling and photon-LSP coupling.

Giant negative magnetoresistance in Manganese-substituted Zinc Oxide

We report a large negative magnetoresistance in Manganese-substituted Zinc Oxide thin films. This anomalous effect was found to appear in oxygen-deficient films and to increase with the concentration of Manganese. By combining magnetoresistive measurements with magneto-photoluminescence, we demonstrate that the effect can be explained as the result of a magnetically induced transition from hopping to band conduction where the activation energy is caused by the sp-d exchange interaction.

Strengthening of a Pd-free high gold dental alloy for porcelain bonding by a pre-firing heat treatment

OBJECTIVES

The purpose of the present investigation was to report a Pd-free high gold alloy for porcelain bonding based on the ternary system of Au-Pt-Zn with a nominal composition of 86Au-11Pt-1.5Zn-0.5In-0.7Rh-0.2Fe-0.1Ir (wt.%). Emphasis was put on the effect of a pre-firing heat treatment on the mechanical properties of the alloy.

METHODS

The strengthening effect of the pre-firing heat treatment was investigated by means of hardness measurement, tensile testing, X-ray diffraction, optical microscopy and scanning electron microscopy.

RESULTS

Experimental results showed that both the hardness and tensile strength of the alloy can be significantly improved after heat treatment at the temperature of 980 degrees C for 15 min. The strengthening could be attributed to homogenization of microstructure and alloying elements and precipitation of new fine particles.

SIGNIFICANCE

The cast framework of the present new Pd-free alloy could be heat treated before actual firing, and this would improve the processing properties of the alloy during firing.

Age-hardening behavior of a low-gold dental alloy

The age-hardening behaviors of a low gold dental alloy were studied by means of differential scanning calorimetry, hardness testing, X-ray diffraction, optical microscopy and transmission election microscopy. Two distinct hardening behaviors were found at two different aging temperatures. Age-hardening at 290 degrees C was attributed to the formation of the metastable AuCuI' ordered phase, and the gradual softening in the overaging stage resulted from the slow growth of this phase. The rapid increase in hardness in the early stage at 495 degrees C was due to the precipitation of the metastable AuCuI' or/and AuCuII' ordered phases, and the rapid decrease in hardness in the overaging stage was a consequence of the growth of these phases and the loss of the coherency strain at the interface between the spindal-like AuCuI platelets and the matrix.

Spectral dependence of spin photocurrent and current-induced spin polarization in an InGaAs/InAlAs two-dimensional electron gas

The converse effects of spin photocurrent and current induced spin polarization are experimentally demonstrated in a two-dimensional electron gas system with Rashba spin splitting. Their consistency with the strength of the Rashba coupling as measured for the same system from beating of the Shubnikov-de Haas oscillations reveals a unified picture for the spin photocurrent, current-induced spin-polarization, and spin-orbit coupling. In addition, the observed spectral inversion of the spin photocurrent indicates a system with dominating structure inversion asymmetry.

Effective dose evaluation for chest and abdomen X-ray tests

The radiation doses resulting from diagnostic X-ray examinations are routinely measured in terms of entrance skin exposure (ESE). In this study, for the purpose of radiation protection, the radiation doses received from chest and abdomen X-ray tests were evaluated in terms of equivalent dose and effective dose. The dose calculations were conducted by using the MCNP Monte Carlo code and an adult hermaphrodite mathematical phantom. The effects of both operating high voltage and projection geometry on the effective dose were investigated. The absolute values of the effective doses may be provided from the national average ESE.

Low energy electron irradiation induced deep level defects in 6H-SiC: the implication for the microstructure of the deep levels E1/E2

N-type 6H-SiC samples irradiated with electrons having energies of E(e)=0.2, 0.3, 0.5, and 1.7 were studied by deep level transient technique. No deep level was detected at below 0.2 MeV irradiation energy while for E(e)>/=0.3 MeV, deep levels ED1, E(1)/E(2), and E(i) appeared. By considering the minimum energy required to displace the C atom or the Si atom in the SiC lattice, it is concluded that generation of the deep levels E(1)/E(2), as well as ED1 and E(i), involves the displacement of the C atom in the SiC lattice.

Structural analysis of the epitopes on erbB2 interacted with inhibitory or non-inhibitory monoclonal antibodies

erbB2 oncogene encodes a growth factor receptor. The overexpression of erbB2 was correlated with more aggressive tumors and a poorer prognosis. Some antibodies directed to this molecule have an antitumor effect in vivo, but some antibodies do not. In an attempt to understand the molecular basis of the anti-erbB2 antibody interaction with erbB2 ectodomain (ECD), we analyzed binding epitopes on erbB2 for inhibitory and non-inhibitory antibodies, Herceptin and HF by computer-guided protein engineering and site-directed mutagenesis. Two different interaction domains were identified by molecular docking, computer graphics and distance geometry method and confirmed through studies on a series of mutants of erbB2 ECD. Non-inhibitory antibody HF only recognized N-terminal portion of erbB2 ECD, but inhibitory antibody Herceptin bound to C-terminal portion of it exclusively. The region interacted with inhibitory antibody Herceptin can be an important target for anticancer therapies.

Age-dependent protection quantities for external neutron irradiation

Based on the recommendations issued by the International Commission on Radiological Protection (ICRP), equivalent doses and effective doses for different ages are obtained for external neutron sources. The calculations at 28 neutron energies from 1 x 10(-9) MeV to 20 MeV are carried out for six irradiation geometries: AP, PA, RLAT, LLAT, ROT and ISO. An age-dependent anthropomorphic mathematical phantom series of six age groups: newborn, 1, 5, 10, 15 years old and adult is used with the Monte Carlo computer code MCNP for the dose evaluations. The results for adults are compared with those in ICRP Publication 74 and are in good agreement. At low energies the effective doses increase as the phantom age increases, but at high energics they decrease with increasing age for the AP, PA, ROT and ISO irradiation geometries. In the whole energy region the effective doses decrease as the phantom age increases for the RLAT and LLAT irradiation geometries. The age-dependent equivalent doses behave similarly to the effective doses, with some exceptions caused by the influence of the organ position.

Validity of the updated pediatric risk of mortality score (PRISM III) in predicting the probability of mortality in a pediatric intensive care unit

This study assessed the validity of the PRISM III scoring system in accurately predicting the probability of mortality in a pediatric intensive care unit (PICU) in Taiwan. We collected data from consecutive patients admitted to our PICU during a one-year period from November 1999 through October 2000. Our PICU had 412 admissions including 385 patients (202 boys and 183 girls) with an average age of 53.9 +/- 58.2 months (range: 1 month to 18 years). The most common reason for admission was respiratory failure (26.2%). Almost 60% of the patients had at least one underlying chronic disease. The average duration of stay was 4.52 +/- 8.43 days (range 1 day to 81 days). The average PRISM III score was 5.06 +/- 6.95 (range 0-44). The overall mortality rate in the PICU was 8.17%. The mortality rate was not significantly different from the predicted rate (7.56%) (p=0.65). The efficiency of care was 32.5% and the standardized PICU length of stay ratio (SLOSR) was 1.33. The SLOSR ratio was significantly higher than the predicted rate (p value < 0.001). The PRISM III score was validfor assessing mortality risk of PICU patients in this hospital in Taiwan. However, the SLOSR ratio obtained in this study was higher than predicted. Differences in the patterns of practicing medicine may play an important role in observed PICU length of stay. Special caution is needed in adopting a severity of illness scoring system to assess performance of care, particularly in contexts different from the ones in which the instrument was originally developed. Further study including more pediatric intensive care units and other regions would enable greater generalization of the validity of this instrument.