[Introduction and development of modern western medicine into Chaoshan (Chaozhou-Shantou)area]

Shantou was opened officially in 1861. Willian Gauld, a doctor of British Presbyterian arrived in Shantou in 1863 topractisemedicine and missionary work, and set up the Medical Missionary Hospital. Since then, western medicine began to enter the Chaoshan area. Hereafter, the American Baptists, the Japanese Hakuai Society and the French Catholic Church also entered successively into the Chaoshan area, and the hospitals of western medicine were founded. At the same time, local organizations and individuals of the Chaoshan area also established western medical institutions. Chaoshan people had certain resistance to the transmission of Western medicine, which was obviously less than other places of the mainland. The reasons included not only the church hospital taking some measures to win the people's support, providing human health services, as well as the superiority of western medicine itself, but also the shortage of doctors and medicine in the Chaoshan area and thepeople's tolerance for foreign things. In addition to the provision of medical services in the hospital, the church hospital also set up medical education and trained a group of local medical talents. Although western medicine served as the pioneer of western religion into the Chaoshan area, it also brought advanced medical ideals, technology, equipment, and medical system, laying down the foundation for the development of western medicine in Chaoshan area.

[Mechanism of Heat-reinforcing Needling for Rheumatoid Arthritis Rabbits with Cold Syndrome Based on Metabonomics]

OBJECTIVE

To explore the specific mechanism of heat-reinforcing needling (HRN) for rheumatoid arthritis (RA) rabbits with cold syndrome based on metabolomics.

METHODS

A total of 40 healthy rabbits were randomly divided into a normal group, a model group, a reinforcing-reducing needling(RRN) group, a twirling-reinforcing needling (TRN) group and a HRN group (n=8 rabbits/group). The RA model with cold syndrome was established with ovalbumin and freezing. Except the normal and model groups, RRN, TRN and HRN were given at "Zusanli" (ST 36) in the corresponding acupuncture groups for 30 min, once a day for 7 days. After the interventions, the pain threshold and the local skin temperature of each group were observed. The endogenous metabolites in the serum were analyzed by the gas chromatography mass spectrometry (GC-MS) technology combined with the pattern-recognition method.

RESULTS

The pain threshold and the local skin temperature in the model group were lower than those in the normal group (P<0.05). The pain thresholds and the local skin temperatures in the three acupuncture groups were higher than those in the model group after interventions (P<0.05), and those in the HRN group were obviously higher than those in the RRN and TRN groups (P<0.05). The serum metabolites of leucine, valine, isoleucine, and arachidonic acid in the model group were increased compared with those in the normal group (P<0.05), and the metabolites of α-ketoglutaric acid, citric acid, succinic acid, glucose, inositol, palmitic acid, stearic acid, lactose, d-ribose, and D-mannose were decreased (P<0.05). The above-mentioned metabolites in the three acupuncture groups were significantly reversed relevant to the model group (P<0.05), and the effect of HRN group was significantly superior to those of the RRN and TRN groups in regulating α-ketoglutaric acid, citric acid, succinic acid, glucose, inositol, d-ribose, and D-mannose (P<0.05).

CONCLUSIONS

HRN for RA with cold syndrome is effective, which may be related to the specific regulation for the krebs cycle and glycometabolism.

[Effects of seawater immersion on the inflammatory response and oxygen free radical injury of rats with superficial partial-thickness scald at early stage]

Objective: To study the effects of seawater immersion on the inflammatory response and oxygen free radical injury of rats with superficial-thickness scald at early stage. Methods: Seventy Wistar rats were divided into healthy control group (HC, n=7), pure scald group (PS, n=21), scald+ fresh water immersion group (SF, n=21), and scald+ seawater immersion group (SS, n=21) according to the random number table. Rats in group HC did not receive any treatment, while 5% total body surface area superficial partial-thickness scald was made on the back of rats in the latter three groups. Rats in group PS lived freely immediately post burn, while wounds on the back of rats in groups SF and SS were immersed into fresh water and seawater, respectively. Serum and full-thickness skin tissue in the center of wounds on the back of 7 rats in groups PS, SF, and SS at post immersion (injury) hour (PIH) 2, 4, and 6 were collected, respectively, while serum and full-thickness skin tissue at the same position of the 7 rats in group HC were collected at PIH 6 of rats in other groups. Morphology of skin tissue was observed with HE staining; tumor necrosis factor-alpha (TNF-α) content in serum and skin tissue was determined by enzyme-linked immunosorbent assay; superoxide dismutase (SOD) content in serum and skin tissue was determined by hydroxylamine method; malondialdehyde content in serum and skin tissue was determined by thiobarbituric acid method. Data were processed with analysis of variance of factorial design, one-way analysis of variance, Welch test, LSD test, and Tamhane test. Results: (1) Epidermal cells of skin tissue of rats in group HC arranged in order and continuously, and the dermis tissue and accessory structures were clear and complete. The skin layer and epidermis of wounds of rats in group PS had no significant change, but the edema of epidermis and dermis and infiltration of inflammatory cells enhanced over time at PIH 2, 4, and 6. The horny layer of epidermis of wounds of rats in group SF reduced, and the edema of epidermis and dermis and infiltration of inflammatory cells enhanced over time at PIH 2, 4, and 6; some epidermal cells disintegrated at PIH 6. The horny layer of epidermis of wounds of rats in group SS significantly reduced, along with the increase in disintegration of epidermal cells, the significant enhancement of edema of epidermis and dermis, and infiltration of a large number of inflammatory cells over time at PIH 2, 4, and 6. (2) Compared with (247±27) pg/mL in group HC, the serum content of TNF-α of rats in group PS significantly increased at PIH 2 and 4 [respectively (675±122) and (367±54) pg/mL, P<0.05 or P<0.01] but significantly decreased at PIH 6 [(147±27) pg/mL, P<0.01]; the serum content of TNF-α of rats in group SF significantly decreased at PIH 6 [(90±24) pg/mL, P<0.01]; the serum content of TNF-α of rats in group SS significantly increased at PIH 2, 4, and 6 [respectively (1 646±58), (2 086±114), and (2 951±58) pg/mL, with P values below 0.01]. Compared with (364±123) U/mL in group HC, the serum content of SOD of rats in group PS significantly increased at PIH 2 and 4 [respectively (489±13) and (447±14) U/mL, with P values below 0.05]; the serum content of SOD of rats in group SF significantly decreased at PIH 6 [(282±13) U/mL, P<0.05]; the serum content of SOD of rats in group SS significantly increased at PIH 2 [(461±23) U/mL, P<0.05] but significantly decreased at PIH 4 and 6 [respectively (226±8) and (205±10) U/mL, with P values below 0.01]. Compared with that in group HC, the serum content of malondialdehyde of rats in groups PS, SF, and SS significantly increased at PIH 2, 4, and 6 (with P values below 0.01). (3) Compared with that in group HC, the TNF-α content in wound tissue of rats in groups PS and SS significantly increased at PIH 2, 4, and 6 (P<0.05 or P<0.01), and the TNF-α content in wound tissue of rats in group SF significantly increased at PIH 2 and 4 (with P values below 0.01). Compared with that in group HC, the SOD content in wound tissue of rats in groups PS and SF significantly increased at PIH 2, 4, and 6 (P<0.05 or P<0.01), and the SOD content in wound tissue of rats in group SS significantly increased at PIH 2 and 4 (with P values below 0.01). Compared with that in group HC, the malondialdehyde content in wound tissue of rats in groups PS, SF, and SS significantly increased at PIH 2, 4, and 6 (with P values below 0.01). Conclusions: Seawater immersion can enhance the inflammatory response and oxygen free radical injury of wounds and the whole body of rats with superficial partial-thickness scald at early stage.

Tumor-associated autoantibodies are useful biomarkers in immunodiagnosis of α-fetoprotein-negative hepatocellular carcinoma

AIM

To determine the prevalence and diagnostic value of autoantibodies in α-fetoprotein (AFP)-negative hepatocellular carcinoma (HCC).

METHODS

Fifty-six serum samples from AFP-negative HCC cases, 86 from AFP-positive HCC cases, 168 from chronic liver disease cases, and 59 from normal human controls were included in this study. Autoantibodies to nucleophosmin (NPM)1, 14-3-3zeta and mouse double minute 2 homolog (MDM2) proteins in AFP-negative HCC serum were evaluated by enzyme-linked immunosorbent assay. Partially positive sera were further evaluated by western blotting. Immunohistochemistry was used to detect the expression of three tumor-associated antigens (TAAs) in AFP-negative HCC and normal control tissues.

RESULTS

The frequency of autoantibodies to the three TAAs in AFP-negative HCC sera was 21.4%, 19.6% and 19.6%, which was significantly higher than in the chronic liver disease cases and normal human controls (P < 0.01) as well as AFP-positive HCC cases. The sensitivity of the three autoantibodies for diagnosis of AFP-negative HCC ranged from 19.6% to 21.4%, and the specificity was approximately 95%. When the three autoantibodies were combined, the sensitivity reached 30.4% and the specificity reached 91.6%.

CONCLUSION

Autoantibodies to NPM1, 14-3-3zeta and MDM2 may be useful biomarkers for immunodiagnosis of AFP-negative HCC.

[A correlation analysis of the ankle CT and ankle fracture classification]

OBJECTIVE

To summarize the CT features of ankle fracture and to analyze the relationship between the CT images and the most commonly used ankle fracture classification.

METHODS

With 369 cases of adult ankle fractures analyzed retrospectively, the CT images 1 cm above the ankle joint and its characteristics, the Danis-Weber classification of ankle fracture were studied, and so was the relationship between CT images and the fracture classification.

RESULTS

There were 8 forms of CT images. With a, b, and c referred to the fibular fracture, posterior malleolar fracture and interosseous tibiofibular ligament (IOL) rupture respectively. 369 CT imges had 40 cases of 0 degree injury (fibula, posterior malleolus, IOL all intact); 60 cases of Ia degree injury (fibular fracture, posterior malleolus and IOL intact), 3 cases of Ib degree injury (fibula intact, posterior malleolus fracture, IOL intact), 26 cases of Ic degree injury (fibula and posterior malleolus intact, IOL rupture); 163 cases of IIab degree injury (fibula and posterior malleolus fractures, IOL intact), 6 cases of IIac degree injury (fibular fracture, posterior malleolus intact, IOL rupture), 61 cases of IIbc degree injury (fibula intact, posterior malleollar fracture, IOL rupture); 10 cases of III degree injury (fibular fracture, posterior malleollar fracture and IOL rupture). According to the Danis-Weber classification, there were 18 cases of type A, 238 cases of type B, 94 cases of type C, and 19 cases without fibular fracture. The prevalence of IOL rupture were 0, 5.9%, and 88.3% in types A, B, and C respectively. There was a correlation between the CT image and Danis-Weber classification, the incidence of IOL rupture was changed with the severity of Danis-Weber classification, and the difference was statistically significant after the rank correlation test (Spearman R=0.781, P<0.001). IOL rupture not determined by the fracture classification was found with the CT images and the incidence was 5.9%.

CONCLUSION

Cross-sectional CT images 1 cm above the ankle joint can clearly determine the IOL injury preoperatively with a good correlation with the Danis-Weber fracture classification, IOL rupture unrecognized with the fracture classification can also be noticed with the CT image.

[Research advances in diagnosis of non-alcoholic fatty liver disease]

Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in clinical practice, and the spectrum of NAFLD includes nonalcoholic simple fatty liver, nonalcoholic steatohepatitis, and liver cirrhosis. Some patients may even progress to hepatocellular carcinoma. At present, the gold standard for the diagnosis of NAFLD is liver biopsy, but since this is an invasive examination and has high costs, its application is limited in clinical practice. More and more studies have focused on noninvasive diagnostic methods for NAFLD, including serological markers, fatty liver predictive model, and imaging examinations. Emerging diagnostic techniques, including genomics, proteomics, glycomics, and metabolomics, also play an important role in the diagnosis of NAFLD.

Complete mesocolic excision in right hemicolectomy: comparison between hand-assisted laparoscopic and open approaches

Purpose

To demonstrate the feasibility, safety, and technical strategies of hand-assisted laparoscopic complete mesocolic excision (HAL-CME) and to compare oncological outcomes between HAL-CME and the open approach (O-CME) for right colon cancers.

Methods

Patients who were scheduled to undergo a right hemicolectomy were divided into HAL-CME and O-CME groups. Measured outcomes included demographic variables, perioperative parameters, and follow-up data. Demographic variables included age, sex distribution, body mass index (BMI), American Society of Anesthesiologists (ASA) physical status classification, previous abdominal surgery, tumor localization, and potential comorbidities. Perioperative parameters included incision length, operative time, blood loss, conversion rate, postoperative pain score, postoperative first passage of flatus, duration of hospital stay, total cost, number of lymph nodes retrieved, TNM classification, and postoperative complications. Follow-up data included follow-up time, use of chemotherapy, local recurrence rate, distant metastasis rate, and short-term survival rate.

Results

In total, 150 patients (HAL-CME, 78; O-CME, 72) were included. The groups were similar in age, sex distribution, BMI, ASA classification, history of previous abdominal surgeries, tumor localization, and potential comorbidities. Patients in the HAL-CME group had shorter incision lengths, longer operative times, less operative blood loss, lower pain scores, earlier first passage of flatus, shorter hospital stay, higher total costs, similar numbers of lymph nodes retrieved, similar TNM classifications, and a comparable incidence of postoperative complications. The 2 groups were also similar in local recurrence rate, distant metastasis rate, and short-term survival rate.

Conclusion

The results demonstrate that the HAL-CME procedure is a safe, valid, and feasible surgical method for right hemicolon cancers.

[Tetracycline-inducible replications of wild-type and an adefovir-dipivoxil-resistant hepatitis B virus in human liver cells]

OBJECTIVE

To establish cell lines with inducible replications of wild-type or rtE218G, an adefovir-dipivoxil-resistant HBV mutant.

METHODS

Tetracycline transactivator (tTA) was stably transfected into human liver cell line HepG2.1.2 folds of full-length of wild-type or rtE218G-mutated HBV genomes were cloned into the pTRE vector and cotransfected into the tTA-expressing cells with a linear selection marker for hygromycin, respectively. After hygromycin screening, clones with the highest levels of tetracycline-inducible HBV replications were selected. The obtained cell lines were further used to evaluate the in vitro sensitivity of rtE218G mutant to adefovir-dipivoxil.

RESULTS

HepG2-off23, a HepG2-derived cell line with stable tTA expression was established. PTRE-based plasmids carrying wild-type HBV (pTRE-HBV-WT) or rtE218G mutant (pTRE-HBV-E218GHBV) were constructed. After stable transfection of the HBV constructs into HepG2-off23 cells, cell lines with robust and tetracycline-inducible replications of wild-type HBV (HepG2-tetHBV-WT) and rtE218G-mutated HBV (HepG2-tetHBV-E218G) were selected. In the two cell lines, high levels of viral core protein and DNA replication could be detected after 144 hours of culture, which could be potently inhibited when tetracycline was added into the medium. At the presence of 1 000 ng/ml of tetracycline, HBV replication intermediates were hardly detected by Southern blotting experiments. HBV mutant with rtE218G could independently confer resistance to adefovir in vitro. IC50 for HBV rtE218G mutant of adefovir was (6.49±0.09) μmol/L, which was significantly higher than that for wild type virus (2.49±0.05) μmol/L.

CONCLUSION

Wild-type and the rtE218G HBV mutant could be expressed and efficiently regulated by tetracycline in the established new cell lines. These cell lines could be useful tools for the HBV virology and anti-HBV drug screening studies.

Hybrid Pixel-Waveform (HPWF) Enabled CdTe Detectors for Small Animal Gamma-Ray Imaging Applications

This paper presents the design and preliminary evaluation of small-pixel CdTe gamma ray detectors equipped with a hybrid pixel-waveform (HPWF) readout system for gamma ray imaging applications with additional discussion on CZT due to its similarity. The HPWF readout system utilizes a pixelated anode readout circuitry which is designed to only provide the pixel address. This readout circuitry works in coincidence with a high-speed digitizer to sample the cathode waveform which provides the energy, timing, and depth-of-interaction (DOI) information. This work focuses on the developed and experimentally evaluated prototype HPWF-CdTe detectors with a custom CMOS pixel-ASIC to readout small anode pixels of 350 μm in size, and a discrete waveform sampling circuitry to digitize the signal waveform induced on the large cathode. The intrinsic timing, energy, and spatial resolution were experimentally evaluated in this paper in conjunction with methods for depth of interaction (DOI) partitioning of the CdTe crystal. While the experimental studies discussed in this paper are primarily for evaluating HPWF detectors for small animal PET imaging, these detectors could find their applications for ultrahigh-resolution SPECT and other imaging modalities.

[A systematic review and Meta-analysis on influencing factors related to the quality of sleep among community population aged 60 and older, in China]

Objective: To systematically evaluate the influencing factors on quality of sleep among community elderly population aged ≥60 years in China. Methods: Literature review was conducted using databases of PubMed, EMbase, CBM, CNKI and Wanfang to collect data regarding influencing factors on quality of sleep. Both qualitative and quantitative analysis were performed to pool the eligible studies. Results: Sixteen cross-sectional studies were included. Data from both qualitative and quantitative analysis showed that the elderly population who had ever married (OR=0.72, 95%CI: 0.52-0.98) or lived with other people (OR=0.78, 95%CI: 0.70-0.87) had better quality of sleep but it was worse when with chronic diseases (OR=2.24, 95%CI: 1.39-3.61). The effects of age and sex on the quality of sleep in the elderly was not yet conclusive. Studies on life style, social support and psychological factors appeared scarce. Conclusion: The protective factors on quality of sleep among community elderly population aged ≥60 years in China appeared as: ever had married or lived with others while chronic diseases were risk factors in reducing the quality of sleep.

[Effect of Scalp-acupuncture Stimulation on Neurological Function and Expression of ASIC 1 a and ASIC 2 b of Hippocampal CA 1 Region in Cerebral Ischemia Rats]

OBJECTIVE

To observe the influence of scalp-acupuncture on the expression of acid-sensing ion channels (ASICs) 1 a and 2 b of hippocampal CA 1 region in cerebral ischemia (CI) rats, so as to investigate its mechanism underlying improvement of ischemic stroke.

METHODS

Thirty-two male SD rats were randomly allocated to normal control, model, scalp-acupuncture and Amiloride group (n=8 in each group). The model of focal CI was established by middle cerebral artery occlusion (MCAO). Scalp acupuncture stimulation was applied to bilateral Dingnieqianxiexian (MS 6) and Dingniehouxiexian (MS 7), once daily for 7 days. Rats of the Amiloride group were fed with Amiloride solution, twice a day for 7 days, and those of the normal control and model groups were grabbled and fixed in the same way with the acupuncture and Amiloride groups. The neurological deficit score was given according to Longa's method. The expression of hippocampal ASIC 1 a and ASIC 2 b was detected by immunohistochemistry, and the Ca²⁺ concentration in the hippocampal tissue assayed using flowing cytometry.

RESULTS

After the intervention, the neurological deficit score of both the scalp-acupuncture and Amiloride groups were significantly decreased in comparison with pre-treatment (P<0.01), and the effect of scalp-acupuncture was markedly superior to that of Amiloride in reducing neurological deficit score (P<0.05). The expression of ASIC 1 a and ASIC 2 b in the hippocampal CA 1 region and hip-pocampal Ca²⁺ concentration were significantly up-regulated in the model group compared with the normal control group (P<0.01), and obviously down-regulated in both scalp-acupuncture and Amiloride groups (P<0.01, P<0.05),without significant differences between the two treatment groups in the ASIC 1 a and ASIC 2 b expression and Ca²⁺ concentration (P>0.05).

CONCLUSIONS

Scalp-acupuncture stimulation can improve neurological function in CI rats, which may be related to its effects in suppressing the increased expression of hippocampal ASIC 1 a and ASIC 2 b proteins and in reducing calcium overload in hip-pocampal neurocytes.

[Influence of Heat-reinforcing Needling on Expression of Plasma Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA in Patients with Rheumatoid Arthritis of Wind-cold-damp Retention Type]

OBJECTIVE

To observe influences of heat-reinforcing needling (HRN) on scores of traditional Chinese medicine (TCM) symptoms and expression of plasma ATP synthase subunit O (Atp 5 O) mRNA and lysosomal V 1 subunit B 2 (Atp 6 V 1 B 2) mRNA in patients with wind-cold-damp retention type rheumatoid arthritis (RA), so as to investigate its biological mechanisms in "heat production".

METHODS

Sixty wind-cold-damp retention type RA patients were randomly allocated to HRN group (n=30) and control group (n=30). Guanyuan (CV 4), Qihai (CV 6), bilateral Zusanli (ST 36), and local acupoints near the knee-joint were selected for needling stimulation. Patients of the HRN group were treated by manipulating the acupuncture needle with HRN, and those of the control group treated by manipulating the needle with uniform reinforcing-reducing method. The treatments were performed once daily, 5 days a week, and two weeks altogether. The other 30 healthy volunteers were recruited as the normal control group. The TCM symptom scoring system (0-31 points, 11 items as the severities of pain, swelling and tenderness of the knee-joint) was used to evaluate the status of RA, and quantitative real-time PCR (RT-PCR) was used to detect the expression of plasma Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA following removal of red blood cells.

RESULTS

After the treatment, the TCM scores of both the HRN and control groups were significantly decreased (P<0.05), and that of the HRN group was significantly lower than that of the control group (P<0.05). Before the treatment, the expression levels of plasma Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA in RA patients were significantly lower than those of the normal group (P<0.05), and after the treatment, the expression levels of plasma Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA were significantly increased in both HRN and control groups compared to pre-treatment in the same one group (P<0.05), and the up-regulated Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA levels were remarkably higher in the control group than in the HRN group (P<0.05).

CONCLUSIONS

Both heat-producing needling and uniform reinforcing-reducing needling can improve RA patients' clinical symptoms, which may be associated with their actions in up-regulating expressions of plasma Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA.

[Clinicopathological features and differential diagnosis of metanephric adenoma: a report of sixteen cases]

OBJECTIVE

To study the clinicopathological features and differential diagnosis of metanephric adenoma (MA).

METHODS

The clinicopathological data of 16 cases with MA diagnosed and treated in Peking University First Hospital from 2004 to 2016 were retrospectively analyzed, and the clinical characteristics, pathologic parameters, differential diagnosis, treatment options and prognosis of MA were analyzed with literature review.

RESULTS

The patients included 10 females and 6 males. The age of patients ranged from 14 to 83 years (mean=33.7 years). The partial nephrectomy was carried out for most patients. All cases were located in renal codex with 3 growing into the renal sinus. Histologically, the tumor was composed of tubules, papillary or glomeruloid structures and psammoma bodies were focally seen. Immunohistochemical study showed that all the cases expressed vimentin, and 94% cases expressed CD57, 63% WT1, 75% AE1/AE3, 19% cytokeratin 7 (CK7) and 13%α-methylacyl-CoA racemase (AMACR), and negative expressions for MA included CD10, neuron-specific enolase (NSE) and CD56. Follow-up information from 1 to 125 months was available in all the patients; and none of the patients showed any evidence of recurrence and metastasis.

CONCLUSION

The benign tumor characteristics of MA are not obvious for preoperative imaging diagnosis, and the diagnosis of MA should be based on the unique pathological features. Positive immunostain of CD57 is a useful indicator for MA diagnosis and differential diagnosis. The partial nephrectomy surgical treatment can achieve good clinical cure with good prognosis.

[Reliability and validity of a newly developed tool to be used for the comprehensive geriatric assessment on community elderly]

OBJECTIVE

To evaluate the reliability and validity of a comprehensive geriatric assessment tool set for community elderly.

METHODS

A sample of 574 community elderly (231 males, 343 females) aged 60 to 94 years, were included in the study. Split-half reliability and Chronbach' s α coefficient were used to test the reliability, with Face validity tested by Delphi method. Construct validity was tested, using the Factor Reliability.

RESULTS

The split-half reliability coefficient appeared as 0.706. The Chronbach' s α coefficient was 0.652 for the whole questionnaire. The authority coefficient was 0.876, and the Kendall coefficient was 0.408 (P<0.001). Six factors were identified through factor analysis and the factor loading matrix showed that the construct validity was good.

CONCLUSION

The tool was recognized as a reliable and validated measure for the comprehensive assessment on community elderly.

[Clinical analysis of the character and prognostic factors of 23 cases of mantle cell lymphoma]

OBJECTIVE

To investigate the clinical characteristics and prognostic factors of mantle cell lymphoma (MCL) patients.

METHODS

The clinical data of 23 MCL patients were retrospectively analyzed. Immunohistochemical stain was performed to detect the protein expressions of Mcl-1, pNF-κB p65 and 14-3-3ζ of MCL patients to analyze its prognostic factors.

RESULTS

Among 23 MCL patients, there were 17(73.9%) patients with IPI 0-2 (low risk group) and 6(26.1%) patients with IPI 3-4. Only the rate of 2y-progression-free survival (PFS) of group IPI 0-2 was superior to that of group IPI 3-4 patients (47.1% vs 0, P=0.049); There were 16 (69.5%) patients with MIPI < 5.7, whose rates of overall response rate (ORR), 2y overall survival (OS) and PFS were better than those of the ones with MIPI ≥ 5.7(ORR: 81.3% vs 33.3% P=0.032; OS: 68.8% vs 16.7% P=0.041; PFS: 50% vs 0, P=0.040 respectively). The rates of ORR, 2y-OS and 2y-PFS (100.0%, 80.0% and 70.0%) of patienets received regimen R+CHOP(E) were all superior to those (38.5%, 30.8% and 7.7%) of ones received regimen CHOP(E) (P=0.002, P= 0.024, P=0.003, respectively). Among 12 patients, 2 out of 6 cases with Mcl-1 positive expression achieved good response (CR+PR) and 2y-OS, 1 case 2y-PFS; All 6 cases with Mcl-1 negative expression achieved good response (CR+PR) and 2y-OS, 5 cases 2y-PFS. 3 out of 6 cases with pNF-κB p65 positive expression achieved good response (CR+PR) and 2y-OS, 1 case 2y-PFS; 5 out of 6 cases with pNF-κB p65 negative expression achieved good response (CR+ PR) and 2y-OS/PFS. 5 out of 8 cases with 14-3-3ζ positive expression achieved good response (CR+PR), 4 cases 2y-OS, and 3 cases 2y-PFS. 3 out of 4 cases with 14-3-3ζ negative expression achieved CR, 4 cases 2y-OS, and 3 cases 2y-PFS.

CONCLUSION

MCL patients had high heterogeneity. MIPI has better prognostic significance than IPI. R+CHOP(E) as first line treatment improved the rates of OS/PFS. The expressions of Mcl-1, pNF-κB p65 and 14-3-3ζ proteins in MCL might be related to prognosis.

Correlation between reproductive factors and pancreatic cancer in northwest China

AIM: To assess the correlation between reproductive factors and pancreatic cancer in Chinese female Hans from northwest China, in order to find a new strategy for the prevention and treatment of pancreatic cancer.

METHODS: A total of 154 female pancreatic cancer patients treated at the Second Affiliated Hospital of Xi'an Jiaotong University from 2008 to 2014 were included in a case group, and 251 gender and age matched hospitalized patients without gynecological and endocrine disease were included in a control group. A case-control study was carried out, and odds ratio (OR) and its 95% confidence interval (95%CI) estimating the relative risk of each factor (including parity, age at menarche and age at menopause) to pancreatic cancer were calculated to assess their correlation.

RESULTS: In the female Han population, compared with the hospitalized patients without gynecological and endocrine disease, multiple births (≥3) was a risk factor for pancreatic cancer (OR = 2.42, 95%CI: 1.43-4.10). In univariate analysis, compared with non-menopausal women, menopausal woman had a higher risk to develop pancreatic cancer (OR = 4.65), and menarche at age less than or equal to 14 years was associated with a lower risk to develop pancreatic cancer. In multivariate analysis, age at menarche and age at menopause were not associated with the incidence of pancreatic cancer. When distribution characteristics of parity in patients with pancreatic cancer were studied, compared with the control group of patients, patients with pancreatic cancer had a significantly higher proportion of multiple births (≥3) compared with the control group (P < 0.05).

CONCLUSION: In the female Han population, multiple births may be a risk factor for pancreatic cancer. Age at menarche and age at menopause are not significantly associated with the incidence of pancreatic cancer. Compared with hospitalized patients without gynecological and endocrine disease, patients with pancreatic cancer have a higher proportion of multiple births.

[Study on incidence and risk factors of fall in the elderly in a rural community in Beijing]

OBJECTIVE

To investigate the incidence of fall in the old farmers of Miyun county in Beijing.

METHODS

The old farmers who lived in Jugezhuang and Fengjiayu townships of Miyun county were selected for a questionnaire survey to collect the information about the incidence of fall and their health status.

RESULTS

A total of 2 397 old farmers, including 967 males and 1 430 females, were surveyed. Fall occurred in 347 old farmers(14.5%). The difference in the incidence of fall was significant between males(9.6%)and females(17.8%). A total of 282 falls occurred in courtyards, 45 falls occurred in field/hilly areas. Among the falls occurred, 216(27.2%)led to injuries. The most common site of injuries was hip(45 falls). Logistic regression analysis showed that physical exercise and high income were protective factors, but difficult standing up and walking, visual problem and stroke were the risk factors. In the males, the special risk factor was mid cognitive impairment, and in the females, the special risk factor was urinary incontinence, but afternoon nap was a protective factor.

CONCLUSION

The incidence of fall in the rural community was relatively high with distinct area distribution, which has caused serious influence on the mental and physical health of the elderly.

Correlation between metabolic factors and pancreatic cancer in northwest China

AIM: To investigate the correlation between metabolic factors and pancreatic cancer in Chinese Hans in northwest China, in order to find new strategies for the prevention and treatment of pancreatic cancer.

METHODS: Three hundred and eighty-four pancreatic cancer patients treated at the Second Affiliated Hospital of Xi'an Jiaotong University from 2008 to 2014 were included in a case group, and 744 gender- and age-matched hospitalized patients without carcinoma or metabolic disease were included in a control group. A case-control study was carried out, and odds ratio (OR) and 95% confidence interval (95%CI) estimating the relative risk of each of the four aspects of metabolic syndrome (hypertension, hyperglycemia, hyperlipidemia and obesity) for pancreatic cancer were calculated to assess the correlation between them.

RESULTS: In the Han population, compared with the hospitalized patients without carcinoma or metabolic disease, hyperglycemia was a risk factor for pancreatic cancer (OR = 1.74, 95%CI: 1.49-2.03). Hypertension decreased the risk of pancreatic cancer, but there was no statistical significance (P > 0.05). In univariate analysis, obesity and hyperlipidemia were risk factors for pancreatic cancer (P < 0.05), and the OR values were 1.49 and 1.99, respectively. The association between hyperlipidemia and pancreatic cancer was not statistically significant (P > 0.05). When distribution characteristics of the factors of metabolic syndrome in patients with pancreatic cancer were studied, compared with the control group, there was a higher proportion of three or more kinds of metabolic disorders at the same time in patients with pancreatic cancer, and the difference was statistically significant (P < 0.05).

CONCLUSION: In the Han population in northwest China, hyperglycemia can increase the risk of pancreatic cancer. Hypertension has no significant impact on the incidence of pancreatic cancer. Although hyperlipidemia and obesity were associated with the risk of pancreatic cancer in univariate analysis, more studies are needed to confirm such correlation. There is a higher proportion of three or more kinds of metabolic disorders at the same time in patients with pancreatic cancer.

Isolation, identification, and optimal cultivation of a marine bacterium antagonistic to Magnaporthe grisea

In this paper, a plate confrontation method was used to isolate bacteria antagonistic to the rice blast fungus Magnaporthe grisea from samples collected from China's Dalian Bay. The antagonist strain LM-031 was obtained. We studied this strain's morphological, physiological and biochemical characteristics and analyzed its 16S rDNA sequence. We compared the effects of different culture conditions (type of media, carbon and nitrogen source, incubation temperature and time, and initial pH value) on the inhibitory effect against M. grisea. Strain LM-031 was preliminarily identified as Bacillus pumilus and was found to strongly inhibit M. grisea, especially when grown on BPY medium at an initial pH 7 for 72 h at 30°C. The optimum carbon and nitrogen sources for growth were lactose and peptone, respectively. The most suitable carbon and nitrogen sources for production of active substances were glucose and NH4Cl, respectively. Our results show that development and utilization of B. pumilus LM-031 has great potential for biological control of M. grisea.

[Children's intelligence quotient following general anesthesia for dental care: a clinical observation by Chinese Wechsler young children scale of intelligence]

OBJECTIVE

It has been demonstrated that anesthetics exposure may lead to neurocognitive impairment in developing brain of animal models. However, for the limitation that the animal models cannot fully mimic the dose and duration in clinical settings especially for dental general anesthesia, the clinical significance of anesthetics exposure on developing central nervous system remains undetermined. Therefore, we conducted the current study in order to observe the fluctuation of intelligence quotient (IQ) after the administration of dental general anesthesia comparing to that before surgery. We conducted the current study in order to observe the fluctuation of intelligence quotient (IQ) after the administration of dental general anesthesia compared with that before surgery.

METHODS

Thirty two patients, ASA I, who were exposed to dental general anesthesia in Department of Pediatric Dentistry Peking University School and Hospital of Stomatology, aged 4 to 6.5 years, were enrolled in this prospective study. Patients with severe learning difficulties or communication disorders were excluded. Written and informed consent was obtained from each patients' family which was fully explained of the purpose and method of study. Their intelligence quotients were evaluated with the Chinese Wechsler young children scale of intelligence (Urban version) before and 2 weeks after dental anesthesia. They were treated by experienced pediatric dentists and the sevoflurane, propofol and nitrous oxide were used for general anesthesia by anesthetist. Articaine hydrochloride and epinephrine tartrate injections were used for their pulp treatment or extraction. The examiners and scorers for IQ had technical training in the test administration. All the patients were tested by the same examiner and with standardized guide language. Each subtest was scored according to the tool review. Verbal IQ and performance IQ consisted of relevant 5 subtests and full scale IQ. Statistical analyses were performed by SPSS 18.0. All the scores of subtests and 3 types of IQ were expressed as mean±standard deviation. Paired two-tailed t test was applied and P<0.05 was accepted as statistically significant.

RESULTS

The results of intelligent assessment from 28 subjects were collected. The anesthetic time was (163.4±32.6) min and the number of treated teeth was 12.1±2.3, mean age (4.60±0.41) years; age range=4.04 to 5.44 years. Among the patients, there were 13 girls and 15 boys. There was no significant difference in gender distribution. The postoperative full IQ (128.46±10.85) was higher than that before surgery (124.64±11.46, P= 0.017). We found that the elevation of performance IQ, to a large extent, contributed to this change in full IQ (P= 0.007). Correspondingly, there was no statistical difference in the verbal IQ, which was 119.68±11.74 to 120.21±15.61 (P=0.854).

CONCLUSION

Dental general anesthesia has no negative effect on the intelligence of preschool children, who were treated under general anesthesia by sevoflurane, propofol and nitrous oxide for 2 to 4 hours. The full IQ and performance IQ were slightly enhanced after treatment which can be explained by the memory effect.

Multicenter study of autoverification methods of hematology analysis

This study was designed to establish and validate a set of autoverification methods for hematology analysis. One thousand and twenty-four samples were selected from Shanghai Ruijin Hospital and 999 from Beijing Hospital, China. False positive, false negative and autoverification pass rates were verified and the rules were then adjusted and confirmed according to the verification results. After confirmation, at least 10,000 sample cases were selected from Shanghai Ruijin Hospital, Beijing Hospital and China Armed Police General Hospital and checked automatically. The differences in the autoverification pass rate and average report delivery time before and after the application of the autoverification methods were compared between the three hospitals. Preliminary validation results showed that the false negative rates of the Shanghai Ruijin Hospital and Beijing Hospital were less than 2%. The false positive rates of these two hospitals were high, close to 18%. After rule adjustment, the false negative rate was basically the same as before adjustment, but the false positive rate declined obviously while the pass rate of autoverification improved significantly. The autoverification pass rates of the three hospitals were 76.4%, 85.1% and 84.2%, respectively. The turnover time (TAT, time from receipt of sample to report of the result) of the three hospitals decreased by 4.1 min, 8.8 min and 10.2 min, respectively. Autoverification systems using a Mindray BC-6800 auto hematology analyzer and labXpert were confirmed as being effective in reducing TAT and enhancing working efficiency on the premise of ensuring low false negative rate.

Multidisciplinary expert consensus on clinical features and prognosis of drug-induced liver injury

AIM: To analyze the clinical features of drug-induced liver injury (DILI), and discuss the risk factors affecting its prognosis.

METHODS: Clinical data for 572 patients with DILI hospitalized at the First Affiliated Hospital of Xi'an Jiaotong University, the Second Affiliated Hospital of Xi'an Jiaotong University and Xijing Hospital from 2010 to 2014 were retrospectively analyzed. Gender, age, underlying disease, medication time, clinical manifestation, clinical classification, type of drugs, laboratory tests, ways of medication, treatments and prognosis were analyzed to explore the risk factors affecting the prognosis.

RESULTS: A total of 572 patients were involved, including 280 (48.95%) males and 292 (51.05%) females, and their average age was 45.56 ± 15.11 years. Most cases of DILI occurred in less than 8 weeks of medication. Main clinical manifestations were jaundice (59.44%), fatigue (57.52%), and poor appetite (55.54%). Four hundred and two (70.28%) cases were classified as hepatocellular type, 62 (10.84%) cases as cholestasis type and 53 (9.27%) as mixed type. The top three most common types of drugs that induced DILI were Chinese herbs, antituberculotics and antimicrobials. As for the prognosis, 194 cases were cured, 323 cases improved well, 39 cases showed no significant improvement, and 16 cases died. Factors influencing prognosis of DILI were medication time, clinical classification, type of drugs and index of total bilirubin, with total bilirubin being an independent risk factor for DILI.

CONCLUSION: Clinical manifestations of drug-induced liver injury are non-specific. The most common cause is Chinese medicine. There are many factors influencing DILI, with total bilirubin being the independent risk factor.