[Effectiveness evaluation between enhanced recovery after surgery and traditional treatment in unilateral total knee arthroplasty]

Objective: To investigate the clinical effect of enhanced recovery after surgery (ERAS) in unilateral total knee arthroplasty (TKA). Methods: Retrospective analysis of 98 patients received unilateral TKA from September 2015 to September 2016 in the Orthopaedic Departmentof Affiliated Hospital of Logistics University of Chinese People's Armed Police Forces.Of the patients, 52 cases were treated by traditional operation (routine group) and the other 46 cases were treated with ERAS concept (ERAS group). The following data were gathered and statistically analyzed between the groups: gender, age, body mass index, preoperative hemoglobin, preoperative visual analogue scale (VAS) score, postoperative visible blood loss, postoperative hemoglobin at 24 hour after operation, blood transfusion rate, postoperative VAS score, length of hospital stay, the satisfaction rate, preoperative and 1 and 6 months postoperative evaluation with hospital for special surgery knee score (HSS), postoperative range of motion (ROM) of knees after 2 weeks, 1 month and 6 months of surgery, incidence rate of complications after surgery.Data between groups were analyzed with one-factor analysis of variance or chi-square test. Results: There was no significant difference in preoperative data between two groups.Postoperative visible blood loss of ERAS group was significantly lower than that in routine group[(224±59) vs (361±70) ml, t=4.723, P<0.01]; postoperative hemoglobin after 24 hours in ERAS group was significantly higher than that in routine group[(109±8) vs (96±10) g/L, t=-3.297, P=0.004]; blood transfusion rate of ERAS group was significantly lower than that in routine group[6.5 %(3/46) vs 46.2%(24/52), χ(2)=19.207, P<0.01]; the 12-hour and 48-hour postoperative VAS scores in ERAS groups were both significantly lower than those in routine group (t=3.708, 3.894, both P<0.05); length of hospital stay in ERAS group was significantly shorter than that in routine group[(6.8±1.2) vs (13.1±2.6) d, t=6.924, P<0.01]; HSS scores of ERAS groups at 1 month and 6 months after surgery were both significantly higher than those in routine group (t=-3.677, -3.594, both P<0.05); knees ROM in ERAS group at 2 weeks and 1 month after surgery were both significantly higher than those in routine group (t=-4.628, -4.442, both P<0.05); the rate of postoperative nausea vomiting in ERAS group was significantly lower than that in routine group[13.0%(6/46) vs 48.1%(25/52), χ(2)=13.852, P=0.002]. VAS score at 1 month after surgery, knees ROM at 6 months after surgery and the satisfaction rate were all comparable between the two groups (t=0.412, -1.026, χ(2)=3.695, all P>0.05). Conclusions: Condition of patients treated by unilateral TKA under ERAS model improves effectively during perioperative period when compared with routine treatment, patients have earlier rehabilitation and better experience in hospital and operation.

[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.

Low-protein diet improves meat quality of growing and finishing pigs through changing lipid metabolism, fiber characteristics, and free amino acid profile of the muscle

The objective of the study was to investigate the effect of feeding reduced CP, AA-supplemented diets on meat quality in growing and finishing pigs as well as the related mechanism. In experiment 1, 18 growing pigs (36.5 kg BW) were assigned randomly and fed 1 of 3 corn-soybean meal diets containing either 18% CP (normal protein, NP), 15% CP (low protein, LP), or 12% CP (very low protein, VLP). In experiment 2, 18 finishing pigs (62.3 kg BW) were allotted randomly into 1 of the following diets: 16% CP (NP), 13% CP (LP), or 10% CP (VLP). In both experiments, the LP and VLP diets were supplemented with crystalline AA to achieve equal content of standardized ileal digestible lysine, methionine, threonine, and tryptophan. At the end of each experiment, all pigs were slaughtered to collect longissimus dorsi muscle (LM) samples. Samples were used for determining meat quality, intramuscular fat (IMF) content, fatty acid composition, free AA profile, and expression of genes for myosin heavy chain isoforms. Results showed that growing and finishing pigs fed the LP diets increased (P < 0.05) redness value of LM, while finishing pigs fed the LP and VLP diets decreased (P < 0.05) the shear force values. Compared with the NP diet, growing and finishing pigs fed lower CP diets had higher (P < 0.05) contents of IMF and MUFA, and lower (P < 0.05) contents of PUFA. Besides, higher (P < 0.05) expression levels of type I and/or IIa muscle fibers were observed in LP diet-fed growing and finishing pigs, and greater concentrations of taurine and tasty AA in VLP diet-fed growing and finishing pigs. Taken together, our results indicate that low-protein diets could positively affect meat quality of growing and finishing pigs, and likely through regulation of IMF content and fatty acid composition, fiber characteristics, and free AA profile in the muscle.

The characteristics and risk factors for cisplatin-induced acute kidney injury in the elderly

Objectives

The most serious adverse reaction of cisplatin is acute kidney injury (AKI). Cisplatin-induced acute kidney injury (CIA) has no specific preventive measures. This study aims to explore the characteristics and risk factors for CIA in the elderly and to identify potential methods to reduce CIA.

Materials and methods

Patients ≥18 years old, with primary tumors, who received initial cisplatin chemotherapy and whose serum creatinine (SCr) values were measured within 2 weeks pre- and postcisplatin treatment and who had complete medical records, were selected from a single center from January 1, 2013 to December 31, 2015. The exclusion criteria included radiotherapy or surgery, recurrent tumors, previous cisplatin treatment, lack of any SCr values before or after cisplatin therapy, and incomplete medical records.

Results

Out of a total of 527 patients, 349 were elderly. Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) use (9.2%) was more prevalent in the elderly than in younger patients (2.8%, p = 0.007). The dosage of cisplatin treatment was lower in the elderly, but the incidence of CIA (9.46%) was higher in the elderly than in younger patients (3.37%). There were significant differences in the SCr levels, estimated glomerular filtration rate, ACEI/ARB use, and whether a single application of cisplatin was administered, between the elderly AKI group and the non-AKI group. Multivariable analysis showed that administration of a single application of cisplatin (OR 2.853, 95% CI: 1.229, 6.621, p = 0.015) and ACEI/ARB use (OR 3.398, 95% CI: 1.352, 8.545, p = 0.009) were predictive factors for developing CIA in the elderly.

Conclusion

The incidence of CIA in the elderly was higher than in younger patients. ACEI/ ARB usage and administration of a single application of cisplatin were independent risk factors for CIA in the elderly.

Anti-colorectal cancer effects of tripolinolate A from Tripolium vulgare

Tripolinolate A (TLA) is recently identified as a new compound from a halophyte plant Tripolium vulgare and has been shown to have significant in vitro activity against the proliferation of colorectal cancer and glioma cells. This study was designed to further investigate the effects of TLA on the proliferation of human normal cells, and the apoptosis and cell cycle in colorectal cancer cells, and the growth of tumors in the colorectal cancer-bearing animals. The data obtained from this study demonstrated that: 1) TLA had much less cytotoxicity in the human normal cells than the colorectal cancer cells; 2) TLA remarkably induced apoptosis in the human colorectal cancer cells and blocked cell cycle at G₂/M phase, and 3) TLA had significant anti-colorectal cancer activity in the tumor-bearing animals.

Abstract 4018: Mutations of HER2 at L755 residue results in HER2 nuclear accumulation and enhances breast cancer stem cell activity

Background: HER2 plays a critical role in tumor progression and cancer stemness in breast cancer cells. Somatic mutations in HER2 gene have been observed in low HER2-expressing cancer cells and are correlated with insensitization to tyrosine kinase inhibitors. One of the most frequently altered residue is L755, which is located at kinase domain and near a putative nuclear export signal sequence, increasing kinase activity and is associated with lapatinib resistance. Moreover, the correlation between HER2 nuclear localization and drug-resistance and poor clinical outcome has been demonstrated in cancer patients. However, the roles of HER2 mutations in its nuclear distribution and its ability to enhance cancer stemness remain unknown.

Methods: We hypothesized that activation of HER2 mutations on amino acid L755 might affect HER2 cellular localization. To investigate the cellular localization of HER2 and the role of L755 mutations in expansion of cancer stem cells, T47D cell line clones expressing wile-type (WT) and mutant HER2 (L755P and L755S) were established. The cellular fractionation, immunofluorescence staining, and western blot analysis were employed to verify the cellular distribution of HER2 L755 mutations. Biochemical strategies were further performed to examine the interaction of HER2 L755 mutant and cellular transporters nuclear importers or exporters.

Results: Our results showed that ectopically expressed HER2 L755P and L755S mutants exhibited a higher nuclear retention via interrupting nuclear exporting complex formation. HER2 L755P and HER2 L755S showed higher abilities to associate with CRM1 and RanBP3 but reduced the binding capacity with Ran. The increases in tyrosine phosphorylation of CRM1 and RanBP3 were found by HER2 mutants and cause the defect in the formation of nuclear exporting complex. Additionally, the HER2 L755P and HER2 L755S-expressing cell lines showed higher levels of cancer stem cell markers, CD44 and ALDH1 and increased mammosphere formation.

Conclusion: HER2 L755P and L755S mutations enhance the HER2 nuclear localization and breast cancer stemness. This study provided new insight into the role of HER2 mutation in cancer stemness, and was helpful to develop novel prognostic markers for the therapeutic efficacy in breast cancer patients.

Citation Format: Wen-Ling Wang, Lei Nie, Kieu-Thanh Huynh, Jhen-Yu Chen, Jing-Han Yao, Mien-Chie Hung, Wei-Chien Huang. Mutations of HER2 at L755 residue results in HER2 nuclear accumulation and enhances breast cancer stem cell activity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4018.

A clinical analysis of systemic chemotherapy combined with radiotherapy for advanced gastric cancer

This study aims to investigate the clinical efficacy of systemic chemotherapy combined with radiotherapy for advanced gastric cancer.A total of 194 advanced gastric cancer patients who were treated from 2006 to 2016 were included in this study. These patients were divided into 2 groups: chemotherapy group (n = 92) and combined chemoradiotherapy group (n = 102). The clinical efficacy of these 2 groups was compared and analyzed to explore the advantageous population and duration of radiotherapy.The remission rates in the chemotherapy group and combined chemoradiotherapy group were 73.5% and 90.6%, respectively, and median survival time was 6.7 versus 10.6 months. Furthermore, the 6-month, 1-year, and 2-year survival rates were 62% versus 83.3%, 22.8% versus 38.2%, and 7.6% versus 13.7%, respectively. All the differences were statistically significant (P < .05). In patients with distant lymph node metastasis, local advanced cancer and organ metastasis, who underwent chemotherapy + radiotherapy, the median survival time was 12.6, 11.1, and 9.8 months, respectively; and the differences were statistically significant compared with the chemotherapy group (P < .05). The median survival time in patients who received concurrent chemoradiotherapy and sequential chemoradiotherapy was 11 and 9.5 months, respectively, and the difference was not statistically significant (P > .05).Combined chemoradiotherapy significantly improved the clinical remission rate, median survival time, and the 6-month, 1-year, and 2-year survival rates in patients with advanced gastric cancer. Furthermore, the survival rate of patients with simple distant lymph node metastasis was better. Concurrent chemoradiotherapy did not significantly improve survival rate compared with sequential chemoradiotherapy.

Positioning error and expanding margins of planning target volume with kilovoltage cone beam computed tomography for prostate cancer radiotherapy

Objective

In this study, prostate cancer patients were treated with image-guided radiotherapy (IGRT). The translational positioning errors were discussed to provide the basis for determining margins of the planning target volume (PTV).

Methods

Thirty prostate cancer patients were treated with radical radiotherapy using the IGRT system. Patients were placed in the supine position and underwent kilovoltage cone beam computed tomography (KVCBCT) scans before radiotherapy. A total of 447 images were acquired. The translational positioning errors were obtained in three linear directions which were X (left-to-right), Y (superior-to-inferior) and Z (anterior-to-posterior) axes (denoted as Lx, Ly and Lz) through the contrast between images adjusted with gray and manual registrations and the planning CT images. Rotational errors were denoted as Rx, Ry and Rz.

Results

Uncorrected translational errors Lx, Ly and Lz in the 251 positioning images were all higher than those after correction, and the differences were all statistically significant (P=0.000, 0.037 and 0.004, respectively). For rotational errors Rx, Ry and Rz, only Rx had a significant difference before and after correction (P=0.044). Before correction, PTV margins in the X, Y and Z directions were 0.61, 0.78 and 0.41 cm, respectively; after correction, these were 0.17, 0.12 and 0.17 cm, respectively.

Conclusion

KVCBCT can be applied to measure positioning errors in prostate cancer radiotherapy and correct these errors in real time through the 6° robotic patient positioning system, in order to improve patient positioning accuracy. The application of IGRT with KVCBCT may reduce PTV margins.

Characteristics of and risk factors for death in elderly patients with acute kidney injury: a multicentre retrospective study in China

Purpose of the study

The incidence of acute kidney injury (AKI) with a poor prognosis in the elderly has been increasing each year. This study aimed to investigate the clinical characteristics of and risk factors for death from AKI in the elderly and help improve prognosis.

Study design

This study was a retrospective cohort study based on data from adult patients (≥18 years old) admitted to 15 hospitals in China between 1 January 2009 and 31 December 2011. The characteristics of AKI in the elderly were compared with those in younger patients.

Results

In elderly patients with AKI, rates of hypertension, cardiovascular disease and multiple organ dysfunction syndrome (MODS) were higher than in younger patients (44.2% vs 31.2%, 16.1% vs 4.6% and 20.9% vs 16.9%, respectively), the length of ICU stay was longer (3.8 days vs 2.7 days, P=0.019) and renal biopsy (1.0% vs 7.13%, P<0.001) and dialysis (9.6% vs 19.2%, P<0.001) were performed less. Hospital-acquired (HA) AKI was more common than community-acquired (CA) AKI (60.3% vs 39.7%), while the most common cause of AKI was pre-renal (53.5%). Multiple logistic regression analysis showed that age (OR 1.041, 95% CI 1.023 to 1.059), cardiovascular disease (OR 1.980, 95% CI 1.402 to 2.797), cancer (OR 2.302, 95% CI 1.654 to 3.203), MODS (OR 3.023, 95% CI 1.627 to 5.620) and mechanical ventilation (OR 2.408, 95% CI 1.187 to 4.887) were significant risk factors for death.

Conclusions

HA-AKI and pre-renal AKI were more common in the elderly. Age, cardiovascular disease, cancer, MODS and mechanical ventilation were independent risk factors for death in the elderly with AKI.

Chinese observational prospective study of ageing population with chronic kidney disease (C-OPTION): a study protocol

INTRODUCTION

The proportion of elderly people is steadily rising worldwide, especially in low-income and middle-income countries, including China. Chronic kidney disease (CKD) is a common disorder in older people. However, little is known about the epidemiology of CKD and its consequences among the elderly. Improvements on clinical guidelines and healthcare policies for this population are required. This study aims to examine the risk factors for progression of CKD among the elderly and develop models to identify subgroups who are at high risk.

METHODS AND ANALYSIS

This is a prospective, multicentre, cohort study. The study population comprises ~3000 patients with predialysis CKD, aged ≥65 years, recruited between March 2016 and December 2017. After the baseline assessments, these patients will be followed for 5 years or until the occurrence of primary outcomes. Assessments that include anthropomorphic measures, laboratory tests, questionnaires, and blood and urine specimen collection will be performed at baseline and at follow-ups. Data on demographic information, cognitive function, depression, risk of malnutrition, physical activity and quality of life will be collected. The primary outcomes are incidence of end-stage renal disease, loss of renal function (≥40% decline in glomerular filtration rate from baseline), and death. The secondary outcomes are acute coronary syndrome, hospitalisation for heart failure or unstable angina, cerebrovascular events, and peripheral arterial disease.

ETHICS AND DISSEMINATION

This study protocol has been approved by the ethics committees of the Chinese People's Liberation Army General Hospital and the participating centres. All the participants gave written informed consent before data collection. The findings of the study will be published in peer-reviewed journals and will be presented at national or international conferences.

TRIAL REGISTRATION NUMBER

NCT03246204; Pre-results.

[Impacts of EGFR 19 exon mutations on brain metastases in treatment-naïve patients with lung adenocarcinoma]

Objective: To investigate the relationship between the status of epidermal growth factor receptor (EGFR) mutations and brain metastases in patients with lung adenocarcinoma. Methods: From August 2010 to May 2015, a total of 1 063 lung adenocarcinoma patients with identified status of EGFR mutations in Shanxi Cancer Hospital were enrolled, of which 456 patients had EGFR mutations. Multivariate Logistic regression model was used to analyze the correlation between EGFR mutation status and brain metastases in patients with lung adenocarcinoma. Results: In 125 patients with brain metastases before initial treatment, 65 patients had EGFR mutations, including 36 patients with deletion mutations in exon 19. The frequency of EGFR 19 exon mutation was 28.8% (36/125). Among 456 patients with EGFR mutations, 65(14.3%) patients were with brain metastases, in which 36(55.0%) had deletion mutations in exon 19. The multivariate analysis showed that age, Eastern Cooperative Oncology Group (ECOG) score, EGFR mutations and N staging were associated with brain metastases(P<0.05). Further subgroup multivariate analyses showed that age, ECOG score, mutation status in exon 19 and N staging were associated with brain metastases (P<0.05). Conclusions: EGFR mutation status is related to brain metastases. Mutations in EGFR exon 19 is an independent risk factor for brain metastases.

Dynamics of levitated objects in acoustic vortex fields

Acoustic levitation in gaseous media provides a tool to process solid and liquid materials without the presence of surfaces such as container walls and hence has been used widely in chemical analysis, high-temperature processing, drop dynamics and bioreactors. To date high-density objects can only be acoustically levitated in simple standing-wave fields. Here we demonstrate the ability of a small number of peripherally placed sources to generate acoustic vortex fields and stably levitate a wide range of liquid and solid objects. The forces exerted by these acoustic vortex fields on a levitated water droplet are observed to cause a controllable deformation of the droplet and/or oscillation along the vortex axis. Orbital angular momentum transfer is also shown to rotate a levitated object rapidly and the rate of rotation can be controlled by the source amplitude. We expect this research can increase the diversity of acoustic levitation and expand the application of acoustic vortices.

Experimental investigations and phase-field simulations of triple-phase-separation kinetics within liquid ternary Co-Cu-Pb immiscible alloys

The phase-separation kinetics and microstructure evolution mechanisms of liquid ternary Co_{43}Cu_{40}Pb_{17} immiscible alloys are investigated by both the drop tube technique and phase-field method. Two successive phase separations take place during droplet falling and lead to the formation of a three-phase three-layer core-shell structure composed of a Co-rich core, a Cu-rich middle layer, and a Pb-rich shell. The Pb-rich shell becomes more and more conspicuous as droplet diameter decreases. Meanwhile, the Co-rich core center gradually moves away from the core-shell center. Theoretical analyses show that a larger temperature gradient inside a smaller alloy droplet induces the accelerated growth of the surface segregation shell during triple-phase separation. The residual Stokes motion and the asymmetric Marangoni convection result in the appearance of an eccentric Co-rich core and the core deviation degree is closely related to the droplet size and initial velocity. A three-dimensional phase-field model of ternary immiscible alloys, which considers the successive phase separations under the combined effects of Marangoni convection and surface segregation, is proposed to explore the formation mechanisms of three-phase core-shell structures. The simulated core-shell morphologies are consistent with the experimental observations, which verifies the model's validity in reproducing the core-shell dynamic evolution. Numerical results reveal that the development of three-phase three-layer core-shell structures can be attributed to the primary and then secondary phase separations dominated simultaneously by Marangoni convection and surface segregation. Furthermore, the effects of droplet temperature gradient on the growth kinetics of the surface segregation shell are analyzed in the light of phase-field theory.

Liquid Supercoolability and Synthesis Kinetics of Quinary Refractory High-entropy Alloy

The high-entropy configuration of equiatomic multicomponent alloys opens an effective access to the development of advanced materials. Here we report the synthesis of a new quinary refractory WMoTaNbZr high-entropy alloy under electrostatic levitation condition. It showed a high liquidus temperature of 2686 K and achieved a maximum supercooling of 640 K (0.24 T_L) at molten state. The containerless measurements revealed a linear increasing tendency for both its liquid state density and the specific heat to emissivity ratio versus alloy supercooling. A high-entropy body-centered cubic (HEB) phase dominated its phase constitution despite the formation of a negligible amount of solid solution (Zr) phase. The dendritic growth of HEB phase always governed the crystallization process, attained a fastest growth velocity of 13.5 m/s and displayed a power function relation to alloy supercooling. The high speed videographic research of recalescence phenomenon indicated Johnson-Mehl-Avrami type transition kinetics for its rapid solidification process. As supercooling increases, the microstructures of primary HEB phase were refined conspicuously and exhibited an obvious solute trapping effect of the segregative Zr component. Meanwhile, the Vickers hardness of HEB phase displayed the rising tendency with supercooling.

Ultrafast charge-transfer in organic photovoltaic interfaces: geometrical and functionalization effects

Understanding the microscopic mechanisms of electronic excitation in organic photovoltaic cells is a challenging problem in the design of efficient devices capable of performing sunlight harvesting. Here we develop and apply an ab initio approach based on time-dependent density functional theory and Ehrenfest dynamics to investigate photoinduced charge transfer in small organic molecules. Our calculations include mixed quantum-classical dynamics with ions moving classically and electrons quantum mechanically, where no experimental external parameter other than the material geometry is required. We show that the behavior of photocarriers in zinc phthalocyanine (ZnPc) and C60 systems, an effective prototype system for organic solar cells, is sensitive to the atomic orientation of the donor and the acceptor units as well as the functionalization of covalent molecules at the interface. In particular, configurations with the ZnPc molecules facing on C60 facilitate charge transfer between substrate and molecules that occurs within 200 fs. In contrast, configurations where ZnPc is tilted above C60 present extremely low carrier injection efficiency even at longer times as an effect of the larger interfacial potential level offset and higher energetic barrier between the donor and acceptor molecules. An enhancement of charge injection into C60 at shorter times is observed as binding groups connect ZnPc and C60 in a dyad system. Our results demonstrate a promising way of designing and controlling photoinduced charge transfer on the atomic level in organic devices that would lead to efficient carrier separation and maximize device performance.

A convenient synthesis of 1-aralkyl-4-benzylpiperazine derivatives

An efficient two-step route was developed for the synthesis of 1-aralkyl-4-benzylpiperazine derivatives by a Blanc reaction and alkylation. The key intermediate, N-benzylpiperazine, was prepared in an excellent yield by direct benzylation of commercially available piperazine under metal-free conditions.

[Effect of hyperbaric oxygen therapy on antioxidant capacity in brains of rats after acute carbon monoxide poisoning]

OBJECTIVE

This study was designed to observe the antioxidant effects of hyperbaric oxygen (HBO) on brains of rats after acute carbon monoxide (CO) poisoning.

METHODS

Sixty-six Sprague-Dawley (SD) male rats were divided into three groups including control group, CO group and HBO group.Morris water maze experiments were used for monitoring cognitive function.Antioxidant capacities were evaluated by detecting T-AOC, GSH-PX, GR and CAT activities in the brain.

RESULTS

Compared with the control group (45±17, 43±14, 35±12, 34±11, 29±13) s and the HBO group (40±10, 39±6, 35±9, 31±11, 21±10) s, the CO group (57±5, 54±8, 52±8, 52±10, 46±8) s had the longer escape latency (P<0.05). Compared with the control group (51±6) s and the HBO group(40±10) s, the CO group (8±5) s had the shorter swimming time in I quadrant (P<0.05). Compared with the control group (1.25±0.40) U/mg and the HBO group(0.97±0.31, 0.97±0.39, 1.45±0.15, 1.40±0.25, 1.20±0.20) U/mg, the CO group (0.68±0.09, 0.45±0.17, 0.71±0.18, 0.69±0.29, 0.48±0.29) U/mg had the lower T-AOC activity of brain tissue.The GSH-PX activity (42±13, 106±46, 197±49, 173±42, 429±58) U/mg in the CO group decreased compared with the control group (182±53) U/mg and the HBO group (203±63, 325±86, 389±29, 385±100, 453±32) U/mg.GR activity (4.3±0.7, 2.6±0.5, 3.0±1.2, 1.8±0.8, 3.2±1.9) U/mg in the CO group decreased compared with the control group(14.5±3.0) U/mg and the HBO group (13.9±3.3, 4.3±1.0, 3.9±0.7, 4.8±0.9, 4.6±0.9) U/mg.CAT activity (1.6±0.8, 4.3±1.6, 3.9±1.0, 8.5±2.6, 5.4±1.7) U/mg in the CO group decreased compared with the control group(5.2±1.3) U/mg and the HBO group (5.2±2.2, 8.8±2.8, 5.3±1.0, 9.2±2.1, 14.1±3.8) U/mg.

CONCLUSIONS

HBO can improve the behavior of rats after acute CO poisoning.The antioxidant capacity in rat brain tissue after acute CO poisoning decreases, while after the HBO therapy, the antioxidant capacity in rat brain tissue can increase.

[Clinical outcome of mid-term follow-up of anterior cervical non-fusion surgery versus anterior cervical discectomy and fusion for cervical spondylosis]

OBJECTIVE

To evaluate the clinical and radiological outcomes of artificial cervical disc replacement (Prodisc-C), dynamic cervical implant and anterior cervical discectomy and fusion (ACDF) in the treatment of cervical spondylosis.

METHOD

From May 2011 to May 2013, a total of 44 cervical spondylosis patients that received cervical disc arthroplasty (Prodisc-C), dynamic cervical implant (DCI) or ACDF were retrospectively reviewed in Orthopedics Department, Beijing Chaoyang Hospital, Capital Medical University.The patients were divided into three groups by surgical methods.Parameters as gender, age, the operation time, blood loss and average hospital stay of three groups were compared.The patients were followed 3 months, 6 months, 12 months and 24 months postoperatively.Neck disability index (NDI), Japanese Orthopaedic Association (JOA) Score and Visual Analogue Scale (VAS) were used to evaluate the clinical outcomes of the three groups.We also measured the cervical lordosis, range of motion of surgical segment and adjacent segment and height of disc at pre-op and post-op.

RESULT

All the patients were got at least 24 months follow-up.The differences between postoperative JOA, NDI and VAS scores and preoperative scores were of statistical significance (P<0.05). There was no statistical difference in average hospital stay, JOA, NDI and VAS recovery rate (P>0.05) among three groups.But the operative time and intraoperative blood loss were statistically different (P<0.05). Compared the pre-and postoperative ROM of C2-7, operative, upper and lower levels of each group respectively, the difference between pre-and postoperative ROM of ACDF group were of statistically significant [(16.6±3.6)°, (22.3±4.6)°, (18.1±3.1)°, P<0.05], while was no statistically significant of non-fusion group(P>0.05). There was no statistically significant difference between pre-and postoperative ROM of upper and lower levels among three groups (P>0.05), but had statistically difference in operative levels [(7.0±1.0) mm, (9.2±1.5) mm, (6.8±1.4) mm, P<0.05]. And there are no serious postoperative complications.

CONCLUSION

Two cervical non-fusion surgery and ACDF have received good clinical effects in the treatment of spondylotic myelopathy or radicular spondylosis.The artificial cervical disc replacement and dynamic cervical implant can not only recover cervical lordosis and keep the range of motion and stability of the surgical segment, but also reduce the incidence of compensatory motion at adjacent segments and will prevent from adjacent segment degeneration.

Challenges and Strategies of Instrument Translation

The often-cited back translation procedure used for the translation of research instruments has not been consistently described in cross-cultural literature. Translation errors resulting in conceptually dissimilar instruments can compromise comparisons of cross-cultural health initiatives. This report describes a five-step translation procedure and equivalence and reliability testing process used to develop the High School Questionnaire: Profile of Experiences (HSQ) in Mandarin. Each step of the translation process provided additional information and detected discrepancies between the English and Mandarin versions of the HSQ. Issues related to grammatical translation, cultural usage and experience, syntax, and concept interpretation were exposed by the translation process. The procedures used in this 18-month study were rigorous enough to create an instrument that was both linguistically appropriate and culturally relevant.

Phytochemicals from Tradescantia albiflora Kunth Extracts Reduce Serum Uric Acid Levels in Oxonate-induced Rats

Background:

Tradescantia albiflora (TA) Kunth (Commelinaceae) has been used for treating gout and hyperuricemia as folklore remedies in Taiwan. Therefore, it is worthwhile to study the effect of TA extracts on lowering uric acid activity. The hypouricemic effects of TA extracts on potassium oxonate (PO)-induced acute hyperuricemia were investigated for the first time.

Materials and Methods:

All treatments at the same volume (1 ml) were orally administered to the abdominal cavity of PO-induced hyperuricemic rats. One milliliter of TA extract in n-hexane (HE), ethyl acetate (EA), n-butanol (BuOH), and water fractions has 0.28, 0.21, 0.28, and 1.03 mg TA, respectively; and the plasma uric acid (P_UA) level was measured for a consecutive 4 h after administration.

Results:

All four fractions' extracts derived from TA were observed to significantly reduce P_UA compared with the PO group. The EA-soluble fraction (TA-EA) exhibited the best xanthine oxidase (XO) inhibitory activity. Following column chromatography, 12 phytochemicals were isolated and identified from the EA fraction. The IC₅₀ values of isolated phytochemicals indicated that bracteanolide A (AR11) showed the remarkable XO inhibitory effect (IC₅₀ value of 76.4 μg/ml). These findings showed that the in vivo hypouricemic effect in hyperuricemic rats was consistent with in vitro XO inhibitory activity, indicating that TA extracts and derived phytochemicals could be potential candidates as hypouricemic agents.

SUMMARY

Tradescantia albiflora extracts possess in vivo hypouricemic action in hyperuricemic rats

T. albiflora extracts exhibited strong inhibitory activity against xanthine oxidase (XO)

Butenolide may play an important role in XO inhibition

The extract bracteanolide A was demonstrated potent XO inhibitory activity in vitro.

Abbreviations used: TA: Tradescantia albiflora, PO: potassium oxonate, HE: n-hexane, EA: ethyl acetate, BuOH: n-butanol, P_UA: plasma uric acid, XO: xanthine oxidase, MeOH: methanol, IP: intraperitoneal

Dynamic evolution process of multilayer core-shell microstructures within containerlessly solidifying Fe(50)Sn(50) immiscible alloy

Multilayer core-shell structures are frequently formed in polymers and alloys when temperature and concentration fields are well symmetrical spatially. Here we report that two- to five-layer core-shell microstructures were the dominant structural morphology of a binary Fe(50)Sn(50) immiscible alloy solidified under the containerless and microgravity states within a drop tube. Three dimensional phase field simulation reveals that both the uniformly dispersive structure and the multilayer core-shells are the various metastable and transitional states of the liquid phase separation process. Only the two-layer core-shell is the most stable microstructure with the lowest chemical potential. Because of the suppression of Stokes motion, solutal Marangoni migration becomes important to drive the evolution of core-shell structures.

IL-18-induced interaction between IMP3 and HuR contributes to COX-2 mRNA stabilization in acute myeloid leukemia

Acute myeloid leukemia is the majority type presented in leukemia patients. Forcing malignant cells to undergo differentiation is 1 strategy for acute myeloid leukemia therapy. However, the failure of acute myeloid leukemia patients to achieve remission as a result of drug resistance remains a challenge. In this study, we found that the abundances of the proinflammatory cytokine IL-18 and its receptor (IL-18R) correlated with the occurrence of drug resistance in AML patients during standard treatment. Cyclooxygenase 2 (COX-2) has been suggested to have an antiapoptotic role in chemoresistant cancer cells. IL-18 treatment resulted in an increase in COX-2 expression through the post-transcriptional regulation of COX-2 mRNA in differentiated U937 cells and showed antiapoptotic activity in U937 and THP-1 cells. Two RNA-binding proteins, human antigen R and insulin-like growth factor mRNA-binding protein 3, mediated the stabilization of COX-2 mRNA. IL-18 induced the shuttling of human antigen R and insulin-like growth factor mRNA-binding protein 3 from the nucleus to the cytoplasm and facilitated their interaction; subsequently, this complex bound to the 3' untranslated region of COX-2 mRNA and affected its stability. We demonstrated further that JNK and/or ERK1/2 regulated human antigen R nucleocytoplasmic shuttling, mediating IL-18 stabilization of cyclooxygenase 2 mRNA.