Computational investigations of mechanical failures of internal plate fixation

This paper investigated the biomechanics of two clinical cases of bone fracture treatments. Both fractures were treated with the same locking compression plate but with different numbers of screws as well as different plate materials. The fracture treated with 12 screws (rigid fixation) failed at 7 weeks with the plate breaking; the fracture with six screws (flexible fixation) endured the entire healing process. It was hypothesized that the plate failure in the unsuccessful case was due to the material fatigue induced by stress concentration in the plate. As the two clinical cases had different fracture locations and different plate materials, finite element simulations were undertaken for each fractured bone fixed by both a rigid and a flexible method. This enabled comparisons to be made between the rigid and flexible fixation methods. The fatigue life was assessed for each fixation method. The results showed that the stress in the rigid fixation methods could be significantly higher than that in flexible fixation methods. The fatigue analyses showed that, with the stress level in flexible fixation (i.e. with fewer screws), the plate was able to endure 2000 days, and that the plate in rigid fixation could fail by fatigue fracture in 20 days. The paper concludes that the rigid fixation method resulted in serious stress concentrations in the plate, which induced fatigue failure. The flexible fixation gave sufficient stability and was better for fracture healing.

Meta-analysis: clinicopathological and prognostic significance of cyclooxygenase-2 expression on oesophageal squamous cell carcinoma

BACKGROUND

Cyclooxygenase-2 (COX-2) is involved in oesophageal carcinogenesis, but the clinical and prognostic significance of COX-2 expression in oesophageal squamous cell carcinoma (ESCC) remains controversial.

AIM

To evaluate the clinicopathological and prognostic role of COX-2 expression in ESCC.

METHODS

Studies assessing clinical or prognostic significance of COX-2 expression in ESCC published until December 2008 were selected. A meta-analysis was performed to clarify the impact of COX-2 expression on clinicopathological parameters or overall survival (OS) in ESCC.

RESULTS

A total of 19 studies met the inclusion criteria, among which 17 studies were about the clinicopathological significance of COX-2 expression in ESCC, 12 studies were dealing with prognostic role of COX-2 expression in ESCC and 10 studies evaluated both of them. Overexpression of COX-2 was significantly correlated with not only the depth of invasion and TNM stage, with a combined odds ratio (OR) of 0.55 (95%CI: 0.34-0.90, Z = 2.41, P = 0.02) and 0.55 (95%CI: 0.32-0.95, Z = 2.13, P = 0.03) respectively but also the reduced OS with relative risk (RR) 1.42, 95% CI: 1.07-1.90, Z = 2.43, P = 0.02).

CONCLUSIONS

COX-2 might play an important role in the progress of ESCC, overexpression of COX-2 correlates with not only the depth of invasion and TNM stage but also the reduced OS. COX-2 might be a potential therapy target for ESCC and work as a prognostic factor for ESCC patients, yet the clinicopathological and prognostic role of COX-2 in ESCC still needs further confirmation by well-designed prospective studies.

Thermoelectric properties and efficiency measurements under large temperature differences

The maximum efficiency of a thermoelectric generator is determined by the material's dimensionless figure of merit ZT. Real thermoelectric material properties are highly temperature dependent and are often measured individually using multiple measurement tools on different samples. As a result, reported ZT values have large uncertainties. In this work we present an experimental technique that eliminates some of these uncertainties. We measure the Seebeck coefficient, electrical conductivity, and thermal conductivity of a single element or leg, as well as the conversion efficiency, under a large temperature difference of 2-160 degrees C. The advantages of this technique include (1) the thermoelectric leg is mounted only once and all measurements are in the same direction and (2) the measured properties are corroborated by efficiency measurements. The directly measured power and efficiency are compared to the values calculated from the measured properties and agree within 0.4% and 2%, respectively. The realistic testing conditions of this technique make it ideal for material characterization prior to implementation in a real thermoelectric generator.

Simulation of the nutrient supply in fracture healing

The healing process for bone fractures is sensitive to mechanical stability and blood supply at the fracture site. Most currently available mechanobiological algorithms of bone healing are based solely on mechanical stimuli, while the explicit analysis of revascularization and its influences on the healing process have not been thoroughly investigated in the literature. In this paper, revascularization was described by two separate processes: angiogenesis and nutrition supply. The mathematical models for angiogenesis and nutrition supply have been proposed and integrated into an existing fuzzy algorithm of fracture healing. The computational algorithm of fracture healing, consisting of stress analysis, analyses of angiogenesis and nutrient supply, and tissue differentiation, has been tested on and compared with animal experimental results published previously. The simulation results showed that, for a small and medium-sized fracture gap, the nutrient supply is sufficient for bone healing, for a large fracture gap, non-union may be induced either by deficient nutrient supply or inadequate mechanical conditions. The comparisons with experimental results demonstrated that the improved computational algorithm is able to simulate a broad spectrum of fracture healing cases and to predict and explain delayed unions and non-union induced by large gap sizes and different mechanical conditions. The new algorithm will allow the simulation of more realistic clinical fracture healing cases with various fracture gaps and geometries and may be helpful to optimise implants and methods for fracture fixation.

As(V) adsorption on maghemite nanoparticles

In this study a novel adsorbent, maghemite nanoparticles (gamma-Fe(2)O(3)), is used for As(V) removal. Maghemite nanoparticles are an exceptional adsorbent material due to its magnetic properties and a good adsorption capacity. The aims of the study were to investigate the suitability of maghemite nanoparticles for As(V) adsorption and to compare properties of different maghemites and their As(V) adsorption efficiency. Maghemite nanoparticles were characterized by XRD, XPS, TEM, VSM, BET and Zeta potential analyzers. Size of the particles varied from 3.8 to 18.4 nm. Adsorption experiments were carried out with three different kinds of maghemite nanoparticles: (i) commercially available, (ii) homemade with mechanochemical method and (iii) homemade with sol-gel process. All three different kinds of maghemite nanoparticles were successful in removing As(V) from water, one of them reached as high adsorption capacity as 50mg/g.

Farm work-related injury among middle school students in rural China

Farm work-related injuries are considered an important issue facing rural area adolescents. However, little research has been done in developing countries, including China. This study evaluated agricultural work-related injuries among Chinese middle school adolescents, focusing on the potential association between farm work hours, sleep patterns, school-related stress, and farm work-related injuries. This cross-sectional study surveyed 1,551 middle school students in Hunan Province who reported working on farms. The surveys assessed their involvement in farm work, sleep patterns, school activities, and farm work-related injuries during a three-month recall period. The cumulative incidence of farm work-related injury was 15.6% among the 1187 students who reported working on a farm. Average days per month farming, number of pesticide applications per month, sleep disturbances, and school-related stress were significantly associated with farm work-related injuries (p < 0.05). Multivariable logistic regression analysis revealed that after adjusting for possible confounding effects of age, gender, and farm work days per month, sleep disturbance (less than 7 hours of sleep: OR = 2.36, 95% CI = 1.07-5.22; awakening at night and having trouble falling back to sleep: OR = 2.70, 95% CI = 1.36-5.37; having nightmares: OR = 2.24, 95% CI = 1.18-4.24) and school-related stress (difficult homework: OR = 2.45, 95% CI = 1.21-4.99; extra homework assigned often by parents: OR = 3.62, 95% CI = 1.88-6.97; and scolded/chastised by parents for poor school performance: OR = 2.53, 95% CI = 1.75-3.65) were statistically significant risk factors for farm work-related injuries (p < 0.05).

Diabetes, pre-diabetes and associated risks on Minnesota code-indicated major electrocardiogram abnormality among Chinese: a cross-sectional diabetic study in Fujian province, southeast China

The goal of this study was to determine the prevalence of diabetes mellitus (DM), impaired glucose regulation (IGR) and related metabolic disorders (overweight, obesity and hypertension) in a Chinese population (20-74 years old). An additional goal was to investigate the relationship between glucose metabolism and the Minnesota code-indicated major abnormal electrocardiogram (MA-ECG). There were 3960 individuals selected from urban and rural areas of Fujian, China from July 2007 to May 2008 by multistage-stratified sampling. Ultimately, data from 3208 subjects (20-74 years old) were analysed (including physical measurements, blood biochemical analysis, oral glucose tolerance test and 12-lead resting ECG). According to World Health Organization diagnostic criteria, the prevalence rates of DM and IGR were 9.51% (male, 10.08%; female, 9.14%) and 14.40% (male, 14.48%; female, 14.35%) respectively. Newly diagnosed DM was found in 53.44% of the diabetic subjects. Based on the 2000 China census, the age-standardized prevalence rates of DM and IGR were 7.19% (male, 7.74%; female, 6.61%) and 11.96 % (male, 12.35%; female, 11.56%) respectively. The age-standardized prevalence rates of DM and IGR in urban areas (7.74% and 12.97% respectively) were slightly but no significantly higher than in rural areas (6.67%, 10.86%). The prevalence rates of overweight, obesity and hypertension were 25.50%, 3.52% and 28.52% respectively (age- and sex- standardized rates: 23.69%, 3.02 % and 22.45 %). After adjusting for other confounding risk factors, multiple logistic regression analysis showed that DM and impaired glucose tolerance were independent risk factors for MA-ECG. Non-diabetic subjects with increased 30-min plasma glucose (PG) after an oral glucose load had a higher risk of MA-ECG after adjusting for other risk factors, especially in those with normal glucose tolerance but with 30-min PG >or= 7.8 mmol L(-1) (odds ratio = 1.371 [1.055-1.780]). The prevalence rates of DM and IGR as well as other metabolic disorders have increased dramatically in the last decade in China, especially in rural areas, with many undiagnosed cases of DM. Even slightly elevated PG levels may predict early cardiovascular events.

Sulfation of dietary flavonoids by human sulfotransferases

Dietary flavonoids catechin, epicatechin, eriodictyol, and hesperetin were investigated as substrates and inhibitors of human sulfotransferases (hSULTs). Purified recombinant proteins and human intestine cytosol were used as enzyme sources. hSULT1A1 and hSULT1A3 as well as human intestine cytosol can catalyse the sulfation of the investigated flavonoids. Sulfation of catechin, epicatechin, eriodictyol, and hesperetin by recombinant hSULTs showed substrate inhibition at high flavonoid concentrations. Hesperetin and eriodictyol are potent inhibitors of purified hSULT1A1, hSULT1A3, hSULT1E1, and hSULT2A1. Catechin and epicatechin inhibited hSULT1A1 and hSULT1A3, but not hSULT1E1 and hSULT2A1. The sulfation efficacy and potency of inhibition is related to the C-ring structure of flavonoids. These results suggest that dietary flavonoids may regulate human SULT activity and, therefore, affect the regulation of hormones and neurotransmitters, detoxification of drugs, and the bioactivation of pro- carcinogens and pro-mutagens.

Involved-field radiotherapy for patients with limited small cell lung cancer: Patterns of local-regional failure and feasibility

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Background: To investigate the feasibility of the involved-field radiotherapy in patients with limited-stage small cell lung cancer (LSCLC) according to the patterns of local failure, focused on the first local-regional failure. Methods: Two clinical phase II studies for patients with LSCLC treated at our institute between 1997 and 2007 were reviewed. All patients received combined chemotherapy (CHT) with cisplatin and etoposide, and thoracic RT (TRT) was generally delivered sequentially following one to three cycles of CHT and consisted of either 56 Gy in 40 fractions for 4 weeks or 55 Gy in 22 fractions for 4–5 weeks. TRT fields encompassed primary tumor volume (post-CHT) and the involved nodal areas (pre- and post-CHT) without elective node irradiation. The local-regional failure was defined as failure within thoracic cavity and supraclavicular fossa except for pleural effusion, which was then divided into two subtypes: in-field and out-field failure according to the first occurred site in the planning target volume or not. Results: There were 89 patients completed the planed regimen and eligible for evaluating patterns of failure, 54 patients (57%) in 56 Gy cohort and 35 patients(43%) in 55 Gy cohort. The media cycles of CHT were 6 (4–8). The overall survival and local progression-free survival rates for 89 patients at 2 years were 56% and 71%, respectively, with a median survival of 25.6 months. 56 patients (63%) developed distant metastases and 21 patients (24%) developed local-regional failures: 12 in-field and 9 out-field. 8 out of 9 out-field failures occurred in the ipsilateral supraclavicular fossa, and the media duration to the end of TRT was 6 mouths (5–14). Comparing the 56 Gy and 55 Gy cohorts, the rates of any thoracic, in-field and out-field failures were no difference significantly. Conclusions: Thoracic radiotherapy using involved-field technique in patients with LSCLC resulted in a high failure rate of the supraclavicular fossa. Whether improving accuracy for the initial evaluation of clinical stage could reduce out-field failure in supraclavicular fossa need to be investigated.

No significant financial relationships to disclose.