[Efficacy of inverted door flap combined with transcanal approach to the tympanic antrum technique for the treatment of middle ear cholesteatoma under endoscope]

This study aimed to investigate the efficacy of inverted door flap (IDF) combined with transcanal approach to the tympanic antrum (TCAA) technique under the endoscope for treatment of middle ear cholesteatoma. Outcomes of patients treated with combined techniques at the First People's Hospital of Foshan City between March 2021 and March 2023 were evaluated. A total of 31 patients (33 ears, 16 males and 15 females) aged (42.9±15.9) years were included. The patients were divided into three groups based on the extent of cholesteatoma involvement: the lateral ossicular chain (LOC) group (8 ears), the internal ossicular chain (IOC) group (11 ears), and the mastoid antrum and mastoid process (MA/MP) group (14 ears). No complications occurred postoperatively, such as cholesteatoma recurrence, facial paralysis and infection. The median (Q1, Q3) follow-up duration was 12 (7, 18) months. The results showed a median (Q1, Q3) dry ear duration of 1.5 (1.5, 2.0) months, and a dry ear rate of 97.0% (32/33) at six months postoperatively. Specifically, 7 out of 8 patients in the LOC group had dry ears, while all patients in the IOC group and the MA/MP group had dry ears 6 months after surgery. The current study demonstrates that IDF combined with TCAA techniques are safe and effective in the treatment of middle ear cholesteatoma, with rapid achievement of dry ear.

Refined crystal structure of Cd, Zn metallothionein at 2.0 A resolution

The crystal structure of Cd5,Zn2-metallothionein from rat liver has been refined at 2.0 A resolution of a R-value of 0.176 for all observed data. The five Cd positions in the asymmetric unit of the crystal create a pseudo-centrosymmetric constellation about a crystallographic 2-fold axis. Consequently, the distribution of anomalous differences is almost ideally centrosymmetric. Therefore, the previously reported metal positions and the protein model derived therefrom are incorrect. Direct methods were applied to the protein amplitudes to locate the Cd positions. The new positions were used to calculate a new electron density map based on the Cd anomalous scattering and partial structure to model the metal clusters and the protein. Phases calculated from this model predict the positions of three sites in a (NH4)2WS4 derivative. Single isomorphous replacement phases calculated with these tungsten sites confirm the positions of the Cd sites from the new direct methods calculations. The refined metallothionein structure has a root-mean-square deviation of 0.016 A from ideality of bonds and normal stereochemistry of phi, phi and chi torsion angles. The metallothionein crystal structure is in agreement with the structures for the alpha and beta domains in solution derived by nuclear magnetic resonance methods. The overall chain folds and all metal to cysteine bonds are the same in the two structure determinations. The handedness of a short helix in the alpha-domain (residues 41 to 45) is the same in both structures. The crystal structure provides information concerning the metal cluster geometry and cysteine solvent accessibility and side-chain stereochemistry. Short cysteine peptide sequences repeated in the structure adopt restricted conformations which favor the formation of amide to sulfur hydrogen bonds. The crystal packing reveals intimate association of molecules about the diagonal 2-fold axes and trapped ions of crystallization (modeled as phosphate and sodium). Variation in the chemical and structural environments of the metal sites is in accord with data for metal exchange reactions in metallothioneins.

Carcinoma induction following direct in situ transfer of v-Ha-ras into rat mammary epithelial cells using replication-defective retrovirus vectors

Chemically induced mammary carcinomas often contain the activated Ha-ras oncogene. The role of this oncogene in the multistage process of carcinogenesis remains undefined. In order to model the role of ras in mammary carcinogenesis, gene transfer into adult rat mammary epithelial cells was accomplished by infusing helper-free, replication-defective retrovirus vectors into the central duct of each gland. In the initial experiments, the beta-galactosidase reporter gene was used to optimize the efficiency of this in situ gene transfer method. Stable infection of greater than 0.1% of mammary cells could be achieved following exposure to the beta-galactosidase gene-expressing vector. v-Ha-ras was then introduced into in situ adult rat mammary epithelial cells using this method. Cellular infection frequencies of less than 1% resulted in the frequent and rapid appearance of mammary carcinomas without any further treatment. Tumors arising following v-Ha-ras oncogene transfer resembled those induced by chemical carcinogens in both the kinetics of their development and histopathological spectrum. These observations support the hypothesis that ras activation can act as an initiation event in chemically induced mammary carcinogenesis. However, only a small percentage of v-Ha-ras infected cells, even with hormonal promotion, were neoplastically transformed, suggesting that ras-driven transformation is not a one-step event.

Pharmacology study of the neutral myocardial imaging agent technetium-99m-N(NOEt)2

OBJECTIVE

The biological properties of a new neutral myocardial imaging agent 99mTcN(NOEt)2 were evaluated.

METHODS

Blood clearance in rabbits, biodistribution in rats, and initial myocardial imaging in dogs were performed.

RESULTS

Radiochemical purity of 99mTcN(NOEt)2 was more than 90% and stable for 6 h at room temperature. Blood disappearance was analyzed with a biexponential model and T1/2(alpha) = 2.53 min, T1/2(beta) = 330 min and CI = 378 ml/h were obtained. Biodistribution studies demonstrated that 99mTcN(NOEt)2 localized selectively in the rat myocardium. Cardiac uptakes were 4.69, 4.20, 3.95 and 3.43% ID/g at 5, 30, 60 and 90 min postinjection, respectively. The mean heart-to-lung activity ratios were 1.69, 2.40 and 2.55 at 10 min, 30 min and 60 min postinjection, respectively.

CONCLUSION

Technetium-99m-N(NOEt)2 exhibited favorable stability and biological properties. Further study in humans is required.

[Retrospective analysis of curative effect of total pelvic organ resection and anal preservation in 20 patients with recurrence of cervical cancer after radical radiotherapy]

Objective: To explore the surgical method and effect of en bloc pelvic resection and anal preservation after radical radiotherapy for cervical cancer. Methods: Clinical data of 20 cervical cancer patients with central recurrence after radical radiotherapy underwent en bloc pelvic resection in the Tumor Hospital of Zhengzhou University and Hainan Provincial People's Hospital from January 2013 to December 2017 were retrospectively analyzed. The operative time, intraoperative blood loss, length of stay, postoperative anal function and postoperative complications were evaluated. Results: The median operation time of 20 patients with anal preservation after en bloc pelvic resection was 135.2 min, the median intraoperative blood loss was 680 ml, and the median hospitalization time was 16.5 days. Among them, 18 patients had good postoperative healing, and the anal function gradually returned to normal within 6 months after surgery, defecated 1~2 times per day.One patient showed incomplete adhesion between the external colon and the anus. One patient presented with pre-sacral infection. Postoperative pathology confirmed the recurrences in 20 patients, of which 11 cases were squamous cell carcinoma, 7 cases were adenocarcinoma, 2 cases were adenosquamous cell carcinoma. Conclusions: It is safe and reliable to preserve anus after en bloc pelvic resection for cervical cancer patients with radical radiotherapy. The anus function is good enough to improve the postoperative life quality of patients significantly.

[Research advances of relationship between non-alcoholic fatty liver disease and biliary tract diseases]

Recent studies have found that non-alcoholic fatty liver disease(NAFLD) has great impact on the development of biliary tract diseases. Here in this review, we summarized the relationship between NAFLD and the occurrence and development, risk factors and severity of cholestasis, gallstones, intrahepatic cholangiocarcinoma, primary biliary cirrhosis and bile microbiota, so as to further illuminate the pathogenesis of NAFLD and biliary tract diseases, obtain better diagnostic and therapeutic outcomes on NAFLD and biliary tract diseases.

Clinical analysis of four Chinese hemophiliacs with human immunodeficiency virus infection

Human immunodeficiency virus (HIV) is now considered as the causative agent of acquired immunodeficiency syndrome (AIDS). A high risk of AIDS has been reported among patients with hemophilia who received lyophilized commercial factor VIII and IX concentrates of American origin. At a prevalent survey from September to December 1985, HIV antibodies were found in all four patients with hemophilia treated with the batch number W87307, 955 I.U. of American commercial factor VIII concentrate supplied by Armour Pharmaceutical Company, USA. One of the sero-positive patients developed AIDS-related complex (ARC) and died of cerebral hemorrhage. The other three sero-positive patients had abnormalities in cell-mediated immunity. Of them two developed left lumbosacral radiculopathy and hemorrhagic herpes zoster and one remained well so far.

Effect of dipivalyl derivatives of catecholamines on cardiovascular function in the conscious dog

Dipivalyl derivatives of epinephrine, norepinephrine and isoproterenol were injected intravenously into conscious dogs while cardiovascular variables were monitored. The dipivalyl compounds produced cardiovascular effects that were comparable to those produced by their respective parent catecholamines except that the responses had a delayed onset and a prolonged duration. The catecholamines were more potent than their derivatives; norepinephrine was 28 times, epinephrine 15 times and isoproterenol 1.7 times as effective as their respective dipivalyl derivatives. Alpha or beta adrenergic responses to the dipivalyl compounds were attenuated or abolished after alpha adrenergic blockade (phenoxybenzamine or phentolamine), or beta adrenergic blockade (propranolol), respectively, or combined alpha and beta blockade. Since other evidence indicates that the dipivalyl derivatives themselves are inactive, our results suggest that these compounds act as prodrugs that exert their cardiovascular effects only after they are biotransformed to catecholamines.

Single crystals of a chimeric T7/T3 RNA polymerase with T3 promoter specificity and a nonprocessive T7 RNAP mutant

Two RNA polymerases homologous to bacteriophage T7 RNA polymerase, bacteriophage Sp6 and T3 RNA polymerases, were screened for crystallization under conditions identical or similar to those reported for the growth of large single crystals of T7 RNA polymerase (Sousa, R., Rose, J. P., Chung, Y. J., Lafer, E. M., and Wang, B.-C. (1989) Proteins 5, 266; Sousa, R., Lafer, E. M., and Wang, B.-C. (1990) J. Crystal Growth, in press; Sousa, R., and Lafer, E. M. (1990) Methods 1, in press). A number of mutant T7 RNAPs were also screened under these conditions as were three chimeric RNA polymerases consisting of T7 RNAP N-terminal and T3 RNAP C-terminal sequences. One chimeric polymerase and two mutant polymerases crystallized readily under T7 RNAP crystallization conditions. The chimeric polymerase crystallized in a space group different from T7 RNA polymerase: orthorombic with unit cell parameters a = 75 A, b = 98 A, c = 159 A; space group P2(1)2(1)2(1) and 4 molecules/unit cell. This chimeric enzyme exhibits T3 promoter specificity and will make it possible to investigate how structural differences between the T3 and T7 RNA polymerase promoter recognition domains determine their different promoter specificities. One of the mutant polymerases successfully crystallized was an enzyme which can carry out promoter recognition and abortive transcription but cannot carry out processive transcription. Its structure may provide information on the nature of the conformational changes undergone by T7 RNAP in the abortive-processive switch. Crystals of the second mutant T7 RNA polymerase were unsuitable for x-ray analysis.

Comparison of human menopausal gonadotropin and follicle-stimulating hormone with gonadotropin-releasing hormone agonist desensitization for controlled ovarian hyperstimulation in in vitro fertilization

BACKGROUND

A pregnancy in patients treated with gonadotropin-releasing hormone agonists (GnRHa) using follicle-stimulating hormone (FSH) alone was first reported by Shaw et al. in 1991. Recently, several comparative trials have shown that FSH is as effective as human menopausal gonadotropin (hMG) in this indication. In other words, the residual endogenous levels of luteinizing hormone (LH) in GnRHa treated cycles may be generally sufficient to support FSH-induced follicular development to exempt from the co-administration of exogenous LH.

METHODS

A total of 42 consecutive candidates for in vitro fertilization (IVF) participated in a prospective randomized study. In this study, the efficacy of two different gonadotropins (Pergonal and Metrodin, Serono, Italy) in inducing ovulation was investigated. All treated women were less than 40 years of age and had received a long desensitized protocol by a GnRHa (Leuprolide acetate, Takeda or Decapeptyl, Ferring). Ovarian inactivity was monitored by plasma estradiol and LH concentration. After the pituitary gland was down-regulated, all patients were given either hMG (n = 25) or FSH (n = 17) for controlled ovarian hyperstimulation (COH).

RESULTS

The mean number of gonadotropin ampoules and the peak estradiol level were significantly higher in hMG group than in the FSH group. No significant differences were found between both groups in the incidence of cancelled cycles, failed oocyte recovery, mean number of oocytes recovered per patient, the fertilization and embryo cleavage-rate. However, the hMG group demonstrated a higher pregnancy and abortion rate.

CONCLUSIONS

There is no significant difference between hMG and FSH stimulation when used following GnRHa desensitization for COH, so the cost should be considered.

[Clinical and experimental study on treatment of infantile mycotic enteritis by jiechang mixture]

OBJECTIVE

To evaluate the therapeutic effect and mechanism of Jiechang Mixture (JCM) in treating infantile mycotic enteritis.

METHODS

The children patients confirmed to be suffered from mycotic enteritis were divided randomly into two groups: the 40 cases in the treated group treated with JCM and the 20 cases in the control group treated with fungicidin. The time of stool forming, diarrhea relieving and fungi vanishing were observed. The promoting effect of JCM on small intestine motility and the inhibition of JCM on Candida albicans in stool culture were studied experimentally.

RESULTS

The time of stool forming, diarrhea relieving and fungi vanishing in the treated group were significantly shorter than those in the control group (P < 0.01), and JCM also showed a better effect in improving clinical symptoms and signs of patients than the control. Results of experimental study showed that JCM could abate the ink evacuation of small intestine in mice. The fungi inhibitory test suggested that Candida albicans was susceptible to JCM.

CONCLUSION

JCM is an effective herbal medicine in treating infantile mycotic enteritis.

[Determination of ibandronate by high performance ion exchange chromatography]

A method for the determination of Ibandronate by high performance ion exchange chromatography is reported. Ibandronate can form a complex compound with the copper ion added in the mobile phase. The complex can be detected at UV 240 nm. The effects of pH of mobile phase and concentration of methanol to the retention time were studied. Concentration of 10% methanol and pH 2.5 were suitable for the detection in less than 5 min. The flow rate was 1.0 mL/min. The relative standard deviation of peak area was 0.8%. The linear correlation was observed from 300 mg/L to 1,500 mg/L of Ibandronate (r = 0.9989). The lowest detectable concentration of Ibandronate was 6 mg/L. The method is simple, rapid and reproducible.

Effect of surgery treatment on hypersplenism caused by cirrhotic portal hypertension

AIM

Aim of the study was to summarize the types and quantities of peripheral hematocytopenia in the patients of hypersplenism caused by cirrhotic portal hypertension and investigate the effect of surgery, including splenectomy on the patient's peripheral blood cells and liver function.

METHODS

The quantities of peripheral blood cells in the 322 patients of hypersplenism, caused by cirrhotic portal hypertension, were retrospectively studied. Then, the preoperative and postoperative values of peripheral blood cells and liver function were compared in 266 patients who were followed up. The liver function was scored and graded according to Child-Pugh scoring system.

RESULTS

The study enrolled 322 patients who showed hematocytopenia, including multi-hemocyte decrease in 206 patients (64%) and simple hemocyte decrease in 116 patients (36%). After surgical treatment in the 226 patients who were followed up, the quantities of peripheral blood cells significantly increased (P<0.01), Child-Pugh grade A increased by 32 patients (14.2%), while Child-Pugh grade C increased only by 2 patients (0.9%), the liver function scores decreased (P<0.05).

CONCLUSION

Hypersplenism caused by cirrhotic portal hypertension mainly manifests as a multi-hemocyte decrease and rarely shows single types of hematocytopenia. Surgical intervention including splenectomy can increase the reduction of hemocytes and promote the recovery of liver function.

Radio frequency measurement and tuning of a 13 MeV Alvarez-type drift tube linac for a compact pulsed hadron source

This paper describes the radio frequency (RF) measurement and tuning result of a 13 MeV Alvarez-type drift tube linac (DTL) for a compact pulsed hadron source (CPHS) at Tsinghua University. The design, machining, assembly, and alignment of the DTL are presented for integrity. The CPHS project consists of a high-current proton linac (13 MeV, 16 kW, peak current of 50 mA, 0.5 ms pulse width at 50 Hz), a neutron target station, a small-angle neutron scattering instrument, and a neutron imaging/radiology station. The linac contains an electron cyclotron resonance ion source, a low energy beam transport line, a four-vane radio frequency quadrupole (RFQ) accelerator, an Alvarez-type DTL, a high energy beam transport line, and a RF power supply and distributor. Construction on the CPHS started in June 2009, and the CPHS has provided 2000 h since 2013 to users with the neutrons produced by the 3 MeV proton beam from the radio frequency quadrupole bombarding on the beryllium target as an achievement of its mid-term objective. Presently, the tuning of the assembled DTL cavity has been completed successfully. The 4.3-m-long DTL consists of 40 accelerating cells, among which 39 full-length drift tubes (DTs) are suspended inside the cavity, and two half-length DTs are mounted inside the two end flanges of the cavity. Each DT contains a permanent magnet quadrupole. Thirteen post couplers and nine tuners are available for the tuning of the field. The relative error of the field after tuning is within ±1.6%, with a tilt sensitivity within ±33%/MHz in all cells. The beam energy will reach its designed value of 13 MeV after the DTL is installed in the beam line downstream the 3 MeV RFQ accelerator.

A new crystal form of ricin-OR

Ricin-OR, an antitumor toxin, has been crystallized in space group P2 with cell parameters a = 8.77 nm, b = 4.64 nm, c = 7.64 nm and beta = 101 degrees. There is one molecule in the asymmetric unit and the solvent content is estimated to be 48% by volume. The crystals diffract to 0.25 nm resolution which is higher than that of the previously reported C2 crystal form which had a solvent content of 65%.

A follow-up study of 100 patients with acute brucellosis for its prognosis and prevention

Objective

To prevent chronic brucellosis, this study analysed the changes in patient antibody titers, and the trajectories of biochemical indicators at different stages of brucellosis, identified relevant biomarkers, and explored risk factors affecting the prognosis of brucellosis patients.

Methods

A prospective cohort study was conducted to follow 100 patients with acute brucellosis. Laboratory serological test results [taken with a serum (tube) agglutination test (SAT)] and biochemical parameters (liver function, renal function, and hematological system) were measured repeatedly at four-time points: 0 weeks-baseline survey, 6 weeks after the first treatment, 12 weeks after the second treatment, and 3 months after the third treatment. The changes in the antibody titres and biochemical parameters at each time point were analysed for trend changes.

Results

One hundred patients with acute brucellosis were enrolled in this follow-up study, with 100% retention in follow-up. By the third follow-up, 21 patients had turned subacute and 11 had turned chronic. One-way repeated measures analysis of variance results showed statistically significant differences (p < 0.01) across the time points for the following five indicators: alanine aminotransferase, aspartate aminotransferase, total bilirubin, serum creatinine (SCr) and platelet count. The clinical symptoms of patients in the acute stage were mainly joint pain, fatigue, and fever, while those in the chronic stage complained primarily of joint pain and fatigue. The results of multivariate logistic analysis showed that joint pain [odds ratio (OR) = 3.652, 95% confidence interval (CI) =1.379-9.672], monoarticular pain (OR = 6.356, 95% CI = 4.660-8.669), elevated SCr (OR = 15.804, 95% CI = 1.644-151.966) and elevated haemoglobin (Hb) (OR = 1.219, 95% CI = 1.065-1.736) were risk factors for poor prognosis (not cured or chronic) in patients with brucellosis.

Conclusion

The trajectory of changes in patient SAT posirates and antibody titers can be used to distinguish patients with chronic brucellosis. The brucellosis is preventable and treatable, and the standard treatment can be effective in reducing the clinical symptoms of affected patients. If patients are not treated in a timely manner, joint pain, monoarticular pain, and elevated SCr are risk factors for patients who are not cured. Therefore, the treatment cycle for these patients should be extended.

Enhancement of (-)-stepholidine on protein phosphorylation of a dopamine- and cAMP-regulated phosphoprotein in denervated striatum of oxidopamine-lesioned rats

AIM

To study effects of (-)-stepholidine (SPD) on the phosphorylation of a dopamine- and cAMP-regulated phosphoprotein (DARPP-32) in the striatum of oxidopamine-lesioned rats.

METHODS

The amount of dephospho-DARPP-32 was measured by a back-phosphorylation assay.

RESULTS

In the striatum of control rats, SPD per se had no effect on the phosphorylation of DARPP-32, but it antagonized the decrease by 28% of dephospho-DARPP-32 induced by the D1 agonist SK&F-38393. In the denervated striatum of oxidopamine-lesioned rats, SPD decreased the amount of dephospho-DARPP-32 by 44%. The effect of SPD was completely counteracted by the concomitant administration of the D1 antagonist Sch-23390.

CONCLUSION

SPD exhibits D1 agonistic action on DARPP-32 phosphorylation in the denervated striatum of oxidopamine-lesioned rats, but it acts as a D1 antagonist in normal striatum.

Atriopeptin alters the vasopressin and renin responses elicited by hemorrhage

This study was designed to investigate whether an infusion of atrial peptide is capable of modulating the hormonal and hemodynamic responses elicited by acute hemorrhage. Conscious dogs were bled at a rate of 0.8 ml.kg-1.min-1 until 20 ml of blood/kg body wt had been removed. Two experiments were performed on each dog; in one experiment the animal was given alpha-human atrial natriuretic peptide (alpha-hANP) (50 ng.kg-1.min-1) dissolved in saline; in the other only the saline vehicle was given. Right and left atrial pressures decreased during hemorrhage in all experiments; the absolute decreases were greater when the animals received atriopeptin, but the differences between treatments were statistically significant only for right atrial pressure. Cardiac output decreased (P less than 0.05) and total peripheral resistance increased (P less than 0.05) during hemorrhage when atriopeptin was infused; although these variables showed similar trends when vehicle alone was infused during hemorrhage, no significant changes occurred. Infusion of atrial peptide did not affect the decrease in arterial blood pressure that occurred during hemorrhage. The increase in plasma vasopressin induced by hemorrhage was potentiated, but the increase in plasma renin activity was attenuated when alpha-hANP was infused. Hemorrhage increased circulating aldosterone levels in each experiment, but the response was less pronounced when alpha-hANP was given during the experiment. Intravenous administration of alpha-hANP modulates the hemodynamic responses elicited by hemorrhage, potentiates the rise in plasma vasopressin, and attenuates the rise in plasma renin activity induced by acute blood loss in conscious dogs.