[Comprehensive analysis of the effect of null zone shifting surgery treatment on patients with infantile nystagmus syndrome]

Objective: To characterize the postoperative change of eyes related parameters of patients with infantile nystagmus syndrome(INS), so as to provide a reference for the clinical evaluation of postoperative effect and the rational arrangement of patients' follow-up time after operation. Methods: A retrospective study. Clinical and follow-up data of 17 patients diagnosed with INS at Department of Ophthalmology in Xinhua Hospital, School of Medicine, Shanghai Jiaotong University from June 2014 to December 2016 were collected. All patients with abnormal head posture (AHP) underwent null zone shift surgery. The operative methods were Parks 5-6-7-8, Anderson, Kestenbum 5-5-6-4,null zone shift combined with strabismus correction and vertical null zone transposition. Ophthalmological examination and eye movement were recorded, including best corrected binocular visual acuity (BCBVA), position of the null zone, expanded nystagmus acuity function (NAFX) and foveation time. Single factor repeated analysis of variance, independent sample t test and rank sum test were used for statistical analysis. Results: Among the 17 children, 6 were females and 11 were males. The age at surgery of the patients was 5-11 years.The follow-up time was (14.8±6.0) months. Preoperative BCBVA was 0.382±0.147 (corrected posture), 0.300±0.056 (AHP); foveation time was (0.594±0.011)s;position of null zone was 23.570°±0.118°. The BCBVA at three months after operation was 0.318±0.044 (corrected posture), 0.260±0.045 (AHP); foveation time was (0.950±0.146)s; position of null zone was 5.360°±1.107°. The BCBVA at six months after operation was 0.264±0.039 (corrected posture), 0.230±0.037 (AHP);foveation time was (1.496±0.233) s; position of null zone was 6.070°±1.303°. The BCBVA at twelve months after operation was 0.309±0.039 (corrected posture), 0.250±0.045 (AHP);foveation time was (1.455±0.201) s; position of null zone was 9.290°±8.520°. There was statistical difference between the data of pre-operation and post-operation(all P<0.05). Change of null zone position was identified in six patients after six months.The preoperative NAFX of patients with presence of change of null zone positon was 0.308±0.063 (the primary position), 0.393±0.210 (null zone); BCBVA was 0.450±0.043 (corrected posture), 0.417±0.031 (AHP); foveation time was 0.122 (0.080-1.014)s. The postoperative NAFX of those patients was 0.430±0.090(the primary position), 0.471±0.140 (null zone); foveation time was 0.438(0.170-1.450) s. The data above were lower than that of patients with no regression of null zone[0.523±0.142,0.601±0.110,0.200±0.063,0.250±0.076,0.725(0.230-1.440)s,0.610±0.160,0.680±0.120,0.975(0.380-2.000)s]. The difference was statistically significant(all P<0.05). Conclusions: Null zone shifting surgery is an effective approach for treating INS. Reduction in the null zone position can be observed in some patients at 6 months after operation, which was related to NAFX, BCBVA and foveation time. It is recommended to extend the follow-up time to at least 6 months after the operation. (Chin J Ophthalmol, 2019, 55:13-19).

[Effect of silica dust on protein oxidative injury in lung tissue of mice]

Objective: To investigate the effect of silica dust on protein oxidative injury in the lung tissue of mice. Methods: A total of 60 mice were randomly divided into control group (not exposed to dust) , 2-hour group (inhalation of dust for 2 hours per day) , 4-hour group (inhalation of dust for 4 hours per day) , and 8-hour group (inhalation of dust for 8 hours per day) , with 15 mice in each group. During dust exposure, the mice were placed in a dust exposure cabinet; the dust was blown with an air blower and the concentration was maintained at 125 mg/m(3). All mice were exposed to silica dust for 3 weeks. The changes of the lung were observed after dust exposure ended, and spectrophotometry was performed to measure the activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) and protein carbonyl in the lung tissue. Results: The 2-, 4-, and 8-hour groups had marked edema, sporadic punctate hemorrhage, and nodular shadow in the lungs. Compared with the control group, the 2-, 4-, and 8-hour groups had a significant increase in lung coefficient (7.03±0.78 mg/g, 8.48±0.93 mg/g, and 8.99±0.85 mg/g vs 5.52±0.81 mg/g, P<0.05) . Compared with the control group, the 2-, 4-, and 8-hour groups had significant increases in the content of MDA (2.83±0.52, 3.94±0.65, and 4.56±0.77 nmol/mg prot vs 1.26±0.36 nmol/mg prot, P<0.05) and protein carbonyl (1.61±0.44, 1.96±0.47, and 2.20±0.58 nmol/mg prot vs 1.13±0.21 nmol/mg prot, P<0.05) in lung tissue. The 4- and 8-hour groups had a significantly lower activity of SOD than the control group (153.69±20.58 and 140.35±18.97 U/mg prot vs 186.00±25.46 U/mg prot, P<0.05) . Conclusions: Silica dust may lead to protein oxidative injury in the lung tissue of mice, which might play an important role in lung injury.

[Analyses of pathogenic factors and clinicopathological characteristics of vocal leukoplakia]

Objective: To investigate the pathogenic factors of vocal leukoplakia and its clinical and pathological features. Methods: Eighty-one patients with vocal cord leukoplakia who underwent surgery between February 2010 and December 2016 and 160 volunteers without pharyngeal symptoms designed as controls were included in this case control study. The clinicopathological characteristics of 81 patients were summarized and analyzed synthetically. Results: There was statistical significance in reflux symptom index(RSI), reflux finding score(RFS), smoking index, and drinking index between case group and control group(Z=-5.35, -4.82, -4.76, -2.44, P<0.05). The voice-using duration per day in case group was significantly longer than that of control group.There was no statistical significance in hospital anxiety and depression scale for anxiety(HADA) scores、hospital anxiety and depression scale for depression(HADD) scores between case group and control group(P>0.05). In 42 patients who received 24-hour dual probe pH monitoring the prevalence of pathologic LPR was 42.8%. In 81 patients, 39(48%)patients were pathologically diagnosed as squamous cell hyperplasia, 18(22%)patients as mild dysplasia, 12(15%)sides as moderate dysplasia , 10(12%)patients as severe dysplasia and 2(2%)patients as carcinoma in-situ. The average age of high-risk pathological vocal leukoplakia was significantly higher than that of low-risk leukoplakia(t=-2.73, P<0.01). The propotion of speckled leukoplakia in high-risk leukoplakia was significantly higher than that of low-risk leukoplakia(χ(2)=23.81, P<0.01). There was no statistical significance between high-risk leukoplakia and low-risk leukoplakia in the prevalence of pathologic LPR(P>0.05). The bilateral lesions, speckled leukoplakia were more likely to relapse(χ(2)=4.27, 12.17, P<0.05). The more serious the pathology, the more likely it was to relapse (Z=-2.168, P=0.03). There was no statistical significance between recurrence group and non-recurrence group in the prevalence of pathologic LPR(P>0.05). Conclusions: LPR, smoke constitute the risk factors of vocal cord leukoplakia. Drinking, voice abuse are related to vocal cord leukoplakia. Senile, speckled leukoplakia are more likely to be malignancy. A speckled leukoplakia, bilateral leukoplakia, severe pathological degree are important factors to predict recurrence.

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.

Management and Short-Term Follow-Up Study of Transient Ischaemic Attack Patients in a University Teaching Hospital

Objective

The aim of this study was to describe the management of patients admitted to a university teaching hospital in China who were diagnosed of having transient ischaemic attack (TIA) and to determine the outcome within a 7-day and 90-day period.

Methods

A retrospective, hospital-based study included consecutive patients having TIA from July 2009 to February 2013 was performed. Demographic data, risk factors, symptoms, clinical management, ABCD2 scores were analysed. The main outcome variable was the occurrence of TIA and ischaemic stroke during the 7 and 90 days follow up periods.

Results

A total of 157 patients were evaluated. After excluding 3 patients (1.9%) because they were lost to follow-up, 154 patients were included in the study. All patients underwent a cranial computed tomogram (CT) to exclude intracranial haemorrhage. If the cranial CT scan result was negative for bleeding or other diagnoses, further comprehensive tests would be initiated following a standardised clinical assessment protocol at the time of hospitalisation. Totally 148 (96%) patients received antiplatelet therapy and 6 (4%) patients received anticoagulation therapy. Eight (5.2%) patients received stenting therapy. Only 3 (1.9%) and 6 (3.8%) TIA patients developed subsequent TIA within 7 days and 90 days respectively. Twelve (7.8%) TIA patients developed ischaemic stroke within 7 days and 19 (12.3%) within 90 days. All the 6 patients who had recurrence of TIA within 90 days proceeded to develop ischaemic stroke. The ABCD2 scores of patients experienced subsequent TIA and ischaemic stroke (4.94±1.39, n=19) were significantly higher than those of patients without recurrence (3.91±1.37, n=135; p<0.05). None of the patients who received stenting therapy developed subsequent TIA or ischaemic stroke during the follow up period.

Conclusions

Our findings suggest that in-patient evaluation and management of TIA may be a safe and effective strategy. Rapid diagnosis and implementation of treatments for TIA patients are crucial to reduce stroke risk. (Hong Kong j.emerg.med. 2014;21:92-97)

Prevalence, associated risk factors, and phylogenetic analysis of Echinococcus granulosus isolated from freerange Tibetan pigs in Tibet, China

The current study was performed to investigate the prevalence, associated risk factors exploration and phylogenetic analysis of Echinococcus granulosus (E. granulosus) genotypes isolated from Tibetan pigs. A total 373 Tibetan pigs were examined during 2014 and 2015, and the variables potentially associated with E. granulosus infection were explored with a multivariable logistic regression model. E. granulosus cysts (n=37) were collected from Tibetan pigs (lungs or livers). Fragments amplification of mitochondrial (mt) DNA of cox1 (shorter and longer) and atp6 were employed. The genotype of E. granulosus were identified by sequence and phylogenetic analysis. Results showed the prevalence of E. granulosus in Tibetan pigs was 9.9%. The prevalence of E. granulosus in male and female Tibetan pigs was 6.8% and 13.3%, with a significant difference in the two genders (P<0.05). In different seasons, the infection rate of E. granulosus in Tibetan pigs were ranged from 5.8% to 12.3%. E. granulosus infection rates in different growing stages of Tibetan pigs were ranged from 4.4% to 15.9%, with a statistical difference in the three stages (P<0.01). The prevalence of E. granulosus in Tibetan pigs were 7.9% in 2014 and 13.0% in 2015. Genders and growing stages were demonstrated to be risk factors to influence the prevalence significantly through multivariable logistic regression model. All the three fragments were successfully amplified from each of the 37 cysts. E. granulosus genotypes of G4 and G6 were identified by comparing with reference sequences of E. genotypes available at NCBI database and phylogenetic analysis by using MEGA software.

[Association between miR-146a single nucleotide polymorphism and genetic susceptibility to hepatocellular carcinoma: a meta-analysis]

Objective: To investigate the association between miR-146a single nucleotide polymorphism and genetic susceptibility to hepatocellular carcinoma (HCC). Methods: PubMed, Web of Science, Cochrane Library, Wanfang Data, and Google Scholar were searched for case-control studies on the association between miR-146a single nucleotide polymorphism and genetic susceptibility to HCC published up to October, 2016 in Chinese or English. The Q-statistics test was used to evaluate the heterogeneity of these articles. Results: A total of 18 articles with 5 610 cases and 7 531 controls were included for the meta-analysis. There was no significant association between miR-146a single nucleotide polymorphism and genetic susceptibility to HCC. The odds ratio (OR), 95% confidence interval (95% CI), and P values for the five genetic models were as follows: the allele model C/G (OR = 0.99, 95% CI 0.88-1.06, P = 0.440); the heterozygous model CG/GG (OR = 0.99, 95% CI 0.90-1.10, P = 0.898); the homozygous model CC/GG (OR = 0.91, 95% CI 0.75-1.10, P = 0.314); the dominant model CC+CG/GG (OR = 0.97, 95% CI 0.79-1.19, P = 0.759); the recessive model CG+GG/CC (OR = 1.05, 95% CI 0.94-1.18, P = 0.405). A subgroup analysis of race, source of control population, and Hardy-Weinberg equilibrium were performed in these five genetic models, and miR-146a single nucleotide polymorphism increased the susceptibility to HCC only in the control population-based subgroups of the recessive model CG+GG/CC (OR = 1.20, 95% CI 1.02-1.40, P = 0.024). There was no association between miR-146a rs2910164 polymorphism and susceptibility to HCC in all the other subgroups. A stratified analysis of HBV infection revealed that miR-146a rs2910164 polymorphism increased the risk of HBV-positive HCC (OR = 1.26, 95% CI 1.10-1.49, P = 0.001). Conclusion: There is no significant association between miR-146a rs2910164 polymorphism and the risk of HCC, but miR-146a rs2910164 polymorphism may increase the risk of HBV-positive HCC.

Imaging Appearances and Pathologic Characteristics of Spinal Epidural Meningioma

BACKGROUND AND PURPOSE

Spinal epidural meningioma is an uncommon tumor. This study aimed to analyze the imaging and pathologic characteristics of this rare tumor.

MATERIALS AND METHODS

Fourteen confirmed cases of epidural meningioma were retrospectively reviewed, and imaging characteristics and pathologic findings were analyzed to identify the typical features.

RESULTS

The mean age of the patients (4 men, 10 women) was 44.9 years. Twelve tumors were in the cervical spinal canal, and 2, in the thoracic spinal canal. There were 9 en plaque meningiomas, 4 dumbbell-shaped meningiomas, and 1 fusiform/ovoid meningioma. The epidural meningiomas extended over 2-5 spinal segments (mean, 3.2 spinal segments). A soft epidural mass was seen in 12/14 (86%) patients. Dural calcification was seen in 8/14 (57%) tumors. Tumor caused intervertebral foramen enlargement in 10/14 (71%) patients and adhered to the nerve roots in 11/14 (79%) patients. Intradural invasion was seen in 8/14 (57%) patients. The dural tail sign was present in 13/14 (93%) tumors on contrast-enhanced T1WI. Regarding pathologic type, 10 of 14 (71%) were psammomatous, 2 of 14 (14%) were meningothelial, 1 of 14 (7%) was angiomatous, and 1 of 14 (7%) was transitional. During follow-up (mean follow-up, 73.4 months; range, 4-192 months), 7 patients had recurrence. Recurrences were between 4 and 192 months after the operation.

CONCLUSIONS

Epidural meningioma has 3 different growth patterns. Dural thickening, calcification, invasion, and epidural mass formation are characteristic features of epidural meningioma. Regular follow-up imaging is required to detect recurrence.

Berberine containing quadruple therapy for initial Helicobacter pylori eradication: An open-label randomized phase IV trial

BACKGROUND

Due to increasing antimicrobial resistance, a bismuth-based quadruple regimen has been recommended as an alternative first-line therapy for Helicobacter pylori (H pylori) eradication. However, different results are varied greatly and the availability of bismuth was limited in some countries. We assessed the efficacy and safety of 14-day berberine-containing quadruple therapy as an alternative regimen for H pylori eradication.

METHODS

In a randomized, open-label, non-inferiority, phase IV trial between November 25, 2014, and October 15, 2015, 612 treatment-naive patients were randomly assigned to 14-day berberine-containing (n = 308) or 14-day bismuth-containing (n = 304) quadruple therapy. The primary outcomes were eradication rates determined by the C urea breath test (C-UBT) 28 days after the end of treatment. The secondary outcomes were adverse events and compliance.

RESULTS

The baseline demographic data including age, gender, body mass index (BMI), general condition and severity score were not statistically different in both groups. The eradication rates in bismuth and berberine groups were 86.4% (266/308) and 90.1% (274/304) in intention-to-treat (ITT) analysis (P = .149), and 89.6% (266/297) and 91.3% (273/299) in per-protocol (PP) analysis (P = .470), respectively. No statistically significant difference was found in the overall incidence of adverse events between both groups (35.7% vs 28.6%, P = .060).

CONCLUSIONS

Both regimens achieved the recommended efficacy for H pylori eradication. The berberine-containing quadruple regimen was not inferior to bismuth-containing quadruple regimen and can be recommended as an alternative regimen for H pylori eradication in the local region.

[The diagnostic value of plasma fibrin related markers in perioperation of femoral fracture]

Objective: To investigate potential value of fibrin related markers in patients with femoral fracture during perioperative period. Methods: Ninety-five patients were enrolled, including 39 males with (53±24) years old and 56 females with (73±13) years old, of which 44 fracture on caput femoris, 34 collum femoris and 17 shaft of femur. Sampling on the day before operation and 1(st,) 3(rd,) 5(th) days after operation, fibrin monomer (FM), D-dimer(DD), fibrinogen degradation product (FDP) and other coagulation assays were detected by reagents from Stago. Difference in day-to-day and between surgical sites were analyzed with general linear model (repeated measures). Results: FDP level on pre-operation, 1(st,) 3(rd,) 5(th) day after operation were 7.88(5.19, 12.12), 15.68(9.84, 29.48), 8.44 (6.27, 12.49) and 10.28 (7.56, 14.00) mg/L, the value of fibrin monomer were 5.00 (5.00, 6.03), 9.89(5.04, 30.12), 5.00 (5.00, 6.04) and 5.02(5.00, 5.76) mg/L. The value of D-Dimer were 2.24(1.41, 3.60), 4.78(2.74, 9.18), 2.60(1.79, 3.88) and 2.91(2.20, 3.85) mg/L, respectively, each parameter changs statistically during observation (Z=4.758, 6.027, 3.238 respectively, P<0.05). On the 5th day after surgery, fibrin monomer in patients with venous thrombus embolism (VTE) were higher than that in patients without VTE, 10.18(7.24, 28.11) mg/L vs 5.10(5.00, 6.73) mg/L (Z=-1.580, P<0.05), which showed potential value evaluating of post-operative VTE. No statistical changes were found in prothrombin time or thrombin time (TT) (P>0.05), but activated partial thromboplastin time (APTT) varied from day to day in (38.1±4.9), (40.8±5.2), (45.1±6.2) and (41.9±6.3)s with statistically difference (F=7.127, P<0.05). Similarly, fibrinogen changed statistically in (5.01±0.94), (4.99±1.35), (6.00±1.75), (5.81±1.38)g/L (F=8.927, P<0.05). Conclusion: Fibrin monomer, additional to markers as D-dimer, shows its value on activated coagulation associated to post-operative thromboembolism for patients receiving femoral surgery.

[Detection and screen of pulmonary metastasis-related signature genes in nasopharyngeal carcinoma]

Objective: To establish an animal model of pulmonary metastasis from nasopharyngeal carcinoma (NPC) and to investigate differential genes associated with pulmonary metastasis. Methods: CNE cell line was used to construct the stable metastasis CNE/Luc cell line which steadily expresses the fluorescent enzyme genes. The CNE/Luc cells were injected into immunodeficiency mice through tail vein, and with the in vivo imaging technology, the mice with pulmonary metastasis were filtered out. The pulmonary metastasis cells, were separated and injected into the tail vein of other nude mice to obtain the tissue-specificity metastasis cells confirmed by fluorescent imaging system. Based on the gene chip, the differential genes associated with pulmonary metastasis for NPC were found. Results: The gene expression profiles of nasopharyngeal carcinoma cell line CNE/Luc and their lung metastasis-associated subpopulation CNE/Luc-2 were constructed by gene chip technology. Ten metastasis-related genes were screened by software analysis, namely as TP53, PIK3CA, MET, KRAS, VEGFA, EDNRB, GSK3B, FOXO3, SOD2, and BIRC3. Conclusions: Some genes including TP53, PIK3CA, MET, KRAS, VEGFA, EDNRB, GSK3B, FOXO3, SOD2, and BIRC3 are indicated to have important roles in the lung metastasis of nasopharyngeal carcinoma.

Contributions of polymorphisms in miR146a, miR196a, and miR499 to the development of hepatocellular carcinoma

Hepatocellular carcinoma is one of the most common malignant tumors worldwide; it is estimated that there were 782,000 new cases in 2012. MicroRNAs (miRNAs) play an important role in carcinogenesis by regulating oncogenes and tumor suppressors. We investigated the role of miR-146a, miR-196a2, and miR-499 polymorphisms in the risk of hepatocellular carcinoma in a Chinese population. Hepatocellular carcinoma patients (175) and healthy controls (302) were recruited between April 2013 and March 2015. Genotype analysis of miR-146a, miR-196a2, and miR-499 polymorphisms was carried out by polymerase chain reaction-restriction fragment length polymorphism. There was a significant difference between the genotype distribution of miR-196a2 in hepatocellular carcinoma patients and controls (X² = 17.23, P < 0.001). CG and GG miR-146a genotypes significantly elevated the risk of hepatocellular carcinoma compared with the CC genotype, with adjusted ORs (95%CI) of 3.05 (1.07-8.70) and 4.96 (1.64-14.97), respectively. In the recessive model, the CG + GG genotype had a 3.75-fold risk of hepatocellular carcinoma compared with the CC genotype, with an adjusted OR (95%CI) of 3.75 (1.39-10.11). However, no significant association was observed between miR-196a2 and miR-499 variants and risk of hepatocellular carcinoma in the co-dominant, dominant, and recessive models. The miR-146a polymorphism is a G to C substitution that causes a mismatch in the stem-loop of miRNA, which influences how the expression and transcriptional regulation of miRNA affects its target genes. Our study revealed that the GG and CG genotypes of miR-146a increased the risk of hepatocellular carcinoma in the Chinese population.

Preparation of core-shell Ag@CeO2 nanocomposite by LSPR photothermal induced interface reaction

The core-shell structure of Ag@CeO2 was prepared by a novel and facile method, which was based on the photothermal effect of localized surface plasmon resonance (LSPR). Nanoparticles (NPs) of Ag were dispersed in a solution containing citric acid, ethylene glycol and cerium nitrate, then under irradiation, Ag NPs generated heat from LSPR and the heat-induced polymerization reaction in the interface between Ag and the sol resulted in cerium gel formation only on the surface of the Ag NPs. After calcination, Ag@CeO2 was successfully obtained, then Ag@CeO2/SiO2 was prepared by loading Ag@CeO2 on SiO2. The resultant catalyst exhibited favorable activity and stability for CO oxidation. The preparation method proposed here should be extendable to other composites with metallic cores and oxide shells in which the metallic nanoparticle possesses LSPR properties.

Association between polymorphisms in insulin-like growth factor-1 and risk of osteoporosis

We conducted a case-control study to assess the relation-ship between rs35767, rs2288377, and rs5742612 insulin-like growth factor-1 (IGF-1) and osteoporosis risk in a Chinese female population. The genotypes of rs35767, rs2288377, and rs5742612 of IGF-1 were determined by polymerase chain reaction-restriction fragment length polymorphism. Patients with osteoporosis were more likely to have drinking and smoking habits and have lower bone mineral density in the L2-L4 vertebrae, femoral neck, and total hip. According to conditional regression analysis, individuals carrying the TT genotype of rs35767 had an increased risk of osteoporosis, with an adjusted odds ratio (95% confidence interval) of 2.29 (1.35-4.97). In conclusion, our results sug-gest that the TT genotype of IGF-I rs35767 was associated with an in-creased risk of osteoporosis, suggesting that this polymorphism can be used as a predictive factor for osteoporosis risk.

[Radiographic analysis of treatment of inter-trochanteric fractures using proximal femoral nails]

OBJECTIVE

To establish a reliable approach for measuring proximal femoral 3 dimensional anatomy, and to compare post-operative differences of proximal femoralanatomy in the inter-trochanter fractures with two kinds of antegrade nailings.

METHODS

Some computer assisted design (CAD) softwares, e.g. Mimics, were used to establish a reliable approach for measuring proximal femoral 3 dimensional (3D) anatomy. Intra-class correlation coefficient (ICC) was used to test the reliability of intra- and inter-observers. The post-operative pelvic CT data of 19 cases of inter-trochanter fracture patients treated with InterTAN nailing and 21 cases of inter-trochanter fracture patients treated with proximal femoral nail anti-rotation (PFNA) were retrospectively analysed and used to measure bilateral proximal femoral anatomical parameters, including 2D and 3D femoral neck-shaft (NS) angle and femoral neck anteversion (NA) angle, and 2D and 3D anteversion angles of the intramedullary (IM) nailings. ICC was used to test the consistency of the NA angles in the different groups, and the paired student T-test was used to test the differences of the paired quantitative data.

RESULTS

The established measurement method hasdexcellent consistency within the intra- and inter-observers, with all the ICCs higher than 0.9. The paired student T-test showed no significant difference between the post-operative bilateral 2D or 3D NA angles. The ICCs results showed that there were no consistency between the post-operative bilateral 2D or 3D NA angles (P values were 0.099 and 0.055, respectively), but the excellent consistency between the 2D injured side NA angle and 2D IM nailing's NA angle, or between the 3D injured side NA angle and 3D IM nailing's NA angle (the ICCs were 0.81 and 0.8, respectively, P values < 0.001). In PFNA group, 57% of the differences between the 2D post-operative injured side's and intact side's NA angles were higher than 15°, which was more than 15.78% in InterTAN group. The paired student T-test showed no significant difference between the post-operative injured side's 2D or 3D NS angles and the intact side's respective 2D or 3D angles in PFNA group (P values were 0.925 and 0.367, respectively), but in InterTAN group, the post-operative injured side's 2D or 3D NS angles were significantly smaller than the intact side's respective angles (P values were 0.033 and 0.009, respectively).

CONCLUSION

By analyzing and comparing bilateral proximal femoral anatomical parameters after two kinds of IM nailings procedures, the differences between the bilateral post-operative NA angles in PFNA group were significantly larger than those in InterTAN group. There was significant correlation between the NA angles of the injured sides and NA angles of IM nailings in both the groups.

Safety culture in a pharmacy setting using a pharmacy survey on patient safety culture: a cross-sectional study in China

OBJECTIVE

To explore the attitudes and perceptions of patient safety culture for pharmacy workers in China by using a Pharmacy Survey on Patient Safety Culture (PSOPSC), and to assess the psychometric properties of the translated Chinese language version of the PSOPSC.

DESIGN

Cross-sectional study.

PARTICIPANTS

Data were obtained from 20 hospital pharmacies in the southwest part of China.

METHODS

We performed χ(2) test to explore the differences on pharmacy staff in different hospital and qualification levels and countries towards patient safety culture. We also computed descriptive statistics, internal consistency coefficients and intersubscale correlation analysis, and then conducted an exploratory factor analysis. A test-retest was performed to assess reproducibility of the items.

RESULTS

A total of 630 questionnaires were distributed of which 527 were responded to validly (response rate 84%). The positive response rate for each item ranged from 37% to 90%. The positive response rate on three dimensions ('Teamwork', 'Staff Training and Skills' and 'Staffing, Work Pressure and Pace') was higher than that of Agency for Healthcare Research and Quality (AHRQ) data (p<0.05). There was a statistical difference in the perception of patient safety culture at different hospital and qualification levels. The internal consistency of the total survey was comparatively satisfied (Cronbach's α=0.89).

CONCLUSIONS

The results demonstrated that among the pharmacy staffs surveyed in China, there was a positive attitude towards patient safety culture in their organisations. Identifying perspectives of patient safety culture from pharmacists in different hospital and qualification levels are important, since this can help support decisions about action to improve safety culture in pharmacy settings. The Chinese translation of the PSOPSC questionnaire (V.2012) applied in our study is acceptable.

Proposal of a new degradation mechanism of enalapril maleate and improvement of enalapril maleate stability in tablet formulation with different stabilizers

Enalapril maleate (EM) is unstable in poorly designed tablet formulations. To improve the stability of EM, the degradation mechanism should be elucidated. In this study, we found that several commonly used excipients promoted the degradants of EM, particularly a diketopiperazine derivative (DKP). We propose two degradation pathways in which both acid and alkali can promote the formation of DKP, although previous reports suggested that DKP is produced mainly in acidic media. Based on the degradation pathways, we believe that subtle control of the microenvironmental pH can inhibit the formation of DKP. This was confirmed by the observation that the degradation rate became slower when certain organic acids were added to the binary mixtures of EM and excipient. The data showed that the stability of EM in the ternary mixtures was much higher than that in binary mixtures. It was further proved that tablets containing these organic acids produced less DKP after the accelerated test. We also found that the formation of DKP in tablets varied with different ratios of tartaric acid, which was used as a model organic acid. This illustrated that an optimum ratio of tartaric acid is required. These results indicated that the stability of EM in tablet formulation is closely associated with microenvironmental pH and the addition of a suitable organic acid based on the reaction mechanism is an effective strategy for improving the stability of EM.

The prognostic value of P-cadherin in non-muscle-invasive bladder cancer

OBJECTIVES

This research aims to specify the prognostic value of P-cadherin on recurrence and progression in non-muscle-invasive bladder cancers (NMIBC).

METHODS

A total of 110 NMIBC cases were collected and P-cadherin protein was assessed by immunohistochemical test in these samples. Correlations between P-cadherin expression and clinicopathologic features were analyzed. For recurrence-free and progression-free survival, Kaplan-Meier log-rank test was used. Then Cox univariate and multivariate analyses were further performed.

RESULTS

P-cadherin high expression correlated with tumor progression (P = 0.031). Kaplan-Meier results showed that patients with high P-cadherin expression had worse progression-free survival (P = 0.034) but not recurrence-free survival (P = 0.133) than low-expression patients. Cox regression results showed P-cadherin expression was an independent predictor for progression (P = 0.042) but not recurrence (P = 0.139) in NMIBC.

CONCLUSIONS

Our results demonstrated that P-cadherin expression correlated with tumor progression and could be taken as an independent predictor for progression in NMIBC.

First Report of Bipolaris papendorfii Causing Corn Leaf Spot in China

Corn is the most important cereal crop in China, with over 34.94 million ha being cultivated in the country annually. However, fungal diseases are a major limiting factor in corn production. In August 2012, 20 ha of corn fields in Anhui Province were found to be heavily infected by fungi. The margin of the lesion was achlorotic, and the middle was yellowish white or off-white, which was similar to the corn Curvalaria leaf spot. The oval lesions were approximately 5 to 7 mm. Lesion tissue was removed from the border between symptomatic and healthy tissue. The surface was sterilized in 75% ethanol for 30 s and 0.1% HgCl₂ for 1 min, after which the sample was washed three times in sterile distilled water. The isolate was purified and subcultured on potato dextrose agar (PDA) at 25 ± 2°C. The initial color of the colony was light brown, turning dark brown after being cultured for 7 days. The conidia were boat-shaped or inverted pear-shaped and were clearly bent to one side. The cells of both ends were slightly lighter and respectively ranged from 34.5 to 44.0 μm and 12.0 to 21.0 μm away from the base, with the second cell as the widest. The majority conidia had three or four false septates; isolates produced light brown to medium brown conidiophore, scattered or clustered, often branching, and exhibited bending. These morphological characteristics matched with the description of Bipolaris papendorfii reported by Zhang (3). A pathogenicity test was conducted with the two isolates on each of the 36 corns by spraying 2 ml spore suspension (10⁶ conidia/ml). For the control treatment, 36 corns were inoculated with an equal volume of sterilized water. Inoculated plants were placed in a greenhouse from 29 to 33°C and 95% relative humidity. The typical 5 to 7 mm oval lesions were observed 7 days after inoculation, except on the control samples. Three replications of 36 corns were used for each treatment. The isolate was consistently 100% reisolated from the diseased tissue according to Koch's postulate. The isolate was found to be morphologically similar to B. papendorfii. Preliminary morphological identification of the fungus was confirmed by PCR assay using genomic DNA extracted from the mycelium of a 7-day-old culture on PDA at 25 ± 2°C. A 550-bp amplified region of the internal transcribed spacer (ITS) of rDNA was generated using ITS1 (5'-TCCGTAGGTGAACCTGCGG-3') and ITS4 (5'-TCCTCCGCTTATTGATATGC-3') universal primers (1). The ITS region (GenBank Accession No. KC592365) was then sequenced by Sangon Biotech (Shanghai, China), and displayed 99% nucleotide similarity with the rDNA-ITS of B. papendorfii (JQ753972.1) separately after BLASTn research in GenBank. Based on the symptoms, fungal morphology, ITS sequence, and pathogenicity testing, this fungus was identified as B. papendorfii. The pathogen could reportedly infect tobacco and cotton (2). To our knowledge, this is the first study to report that B. papendorfii can infect corn in China. This report will establish a foundation for the further study of B. papendorfii to address the disease effectively. Further studies will be conducted to determine the incidence of the disease and the severity of damage caused by B. papendorfii as well as determine a possible mode for controlling the spread of the disease. References: (1) Y. J. Cao et al. Chin. J. Trop. Crops 31:1098, 2010. (2) H. Deng et al. Mycosystema 21:327, 2002. (3) T. Y. Zhang. Chin. Fungi Chi. 30:21, 2010.

Cardiovascular protection and antioxidant activity of the extracts from the mycelia of Cordyceps sinensis act partially via adenosine receptors

Mycelia of cultured Cordyceps sinensis (CS) is one of the most common substitutes for natural CS and was approved for arrhythmia in China. However, the role of CS in ameliorating injury during ischemia-reperfusion (I/R) is still unclear. We examined effects of extracts from CS on I/R and investigated the possible mechanisms. Post-ischemic coronary perfusion pressure, ventricular function, and coronary flow were measured using the Langendorff mouse heart model. Oxidative stress of cardiac homogenates was performed using an ELISA. Our results indicate that CS affords cardioprotection possibly through enhanced adenosine receptor activation. Cardioprotection was demonstrated by reduced post-ischemic diastolic dysfunction and improved recovery of pressure development and coronary flow. Treatment with CS largely abrogates oxidative stress and damage in glucose- or pyruvate-perfused hearts. Importantly, observed reductions in oxidative stress [glutathione disulfide (GSSG)]/[GSSG + glutathione] and [malondialdehyde (MDA)]/[superoxide dismutase + MDA] ratios as well as the resultant damage upon CS treatment correlate with functional markers of post-ischemic myocardial outcome. These effects of CS were partially blocked by 8-ρ-sulfophenyltheophylline, an adenosine receptor antagonist. Our results demonstrate a suppressive role of CS in ischemic contracture. Meanwhile, the results also suggest pre-ischemic adenosine receptor activation may be involved in reducing contracture in hearts pretreated with CS.

Apple polyphenol protects against cigarette smoke-induced acute lung injury

OBJECTIVE

Chronic obstructive pulmonary disease (COPD) is a complex chronic inflammatory disease involving oxidative stress as well as a wide variety of cells activated from smoking cigarettes. There have been disappointingly few therapeutic advances in drug therapy for COPD. Plant polyphenols have been the topic of much research regarding their antioxidant activities and antiinflammatory and immunomodulatory effects. In the present study, we ask whether apple polyphenol provides protection against cigarette smoke (CS)-induced acute lung injury.

METHODS

ICR mice were exposed to CS for 4 d with increasing exposure time for up to 6 h per day to elicit epithelial cells injury. One hour before smoke exposure, mice were treated with apple polyphenol (APP) by gavage; all examinations were performed 18 h after the last CS exposure.

RESULTS

APP at 30, 100, or 300 mg not only significantly dose-dependently reduced the CS-induced accumulation of inflammatory cells and gene/protein expression of proinflammatory factors both in the lung and in bronchoalveolar lavage fluid, but also significantly reversed oxidative stress in the lungs. Additionally, treatment with APP also significantly regulated the CS-induced imbalance of matrix metalloproteinases-9/tissue inhibitor of metalloproteinase-1 expression in the lungs. To investigate further the possible signaling pathway of APP effects, we examined protein expression of p-P38 MAPK by immunohistochemistry that found treatment with APP significantly decreased the CS-induced increases of p-P38 expression in the lungs.

CONCLUSION

Taken together, APP may be a potential dietary nutrient supplement agent to improve quality of life of COPD patients by inhibiting CS-exposed acute lung injury via P38 MAPK signaling pathway.

Cyptoporus polysaccharide prevents lipopolysaccharide-induced acute lung injury associated with down-regulating Toll-like receptor 2 expression

AIM OF THE STUDY

To evaluate the effects and the possible mechanism of Cryptoporus polysaccharides (CP) extracted from fruiting body of Cryptoporus volvatus in lipopolysaccharide (LPS)-induced acute lung injury (ALI) in rats and mice.

MATERIALS AND METHODS

Acute lung injury was induced by intratracheally instillation of LPS into lung in either rats or mice, assessing leukocyte numbers and myeloperoxidase activity in bronchoalveolar lavage fluid, as well as evaluating cytokines mRNA and protein expressions, and Toll-like receptor 2 (TLR(2)) and nuclear factor (NF)-κB mRNA levels in the lung tissues of mice. Vascular permeability and edema of lung in mice, and arterial blood gas in rats were also performed.

RESULTS

In ALI, CP-treated mice and rats exhibited significantly reduced leukocyte invasion, myeloperoxidase activity, vascular permeability, edema of lung, as well as tumor necrosis factor-α and Interleukin-1β mRNA and protein expressions in the lung tissues compared with vehicle-treated mice. TLR(2) and NF-κB mRNA levels of the lung tissues were decreased in CP-treated mice in response to LPS. And decline in arterial blood gas was recovered in CP-treated rats.

CONCLUSIONS

Our results supported a protective role of CP in ALI and suggested that the reduction of the activation of TLR(2) and NF-κB signal pathway in lung injury may be relavant to the pretreatment of CP.

A novel membrane-permeant cADPR antagonist modified in the pyrophosphate bridge

A concise method for the formation of cyclopyrophosphate of cIDPRE as well as sulfur and selenium-substituted pyrophosphate cIDPRE analogues (P(1)(S)-cIDPRE, P(1)(Se)-cIDPRE, P(2)(S)-cIDPRE and P(2)(Se)-cIDPRE) was reported and one of the P(S)-diastereoisomers, P(1)(S)-cIDPRE-1, is a novel membrane-permeant cADPR antagonist.