[Predictive factors of poor prognosis in children with acute kidney injury treated with renal replacement therapy]

Objective: To investigate the predictive factors of poor prognosis in children with acute kidney injury (AKI) treated with renal replacement therapy (RRT). Methods: In this retrospective case-control study, the clinical data were collected from 134 pediatric patients (82 male, 52 female) with AKI treated with RRT in six tertiary hospitals from May 2015 to June 2018. According to the serum creatinine level at discharge, the patients were divided into the favorable outcome group and unfavorable outcome group. The data of sex, age, primary diseases, AKI stage, time from diagnosis of AKI to start of RRT (h) and whether to start RRT within 24 hours, urine volume and complications between the two groups were compared. Continuous variables were compared by t test and Mann-Whitney U test, and percentage or proportions were compared by Chi square test. The predictive factors of adverse prognosis were analyzed by using univariate and unconditional binary logistic regression analysis. Results: The average age of the 134 AKI patients was (6±4) years. There were 114 patients (85.0%) in the favorable outcome group and 20 patients (15.0%) in the unfavorable outcome group. No statistically significant differences were found between the two groups in terms of sex (χ(2)=2.596, P=0.107), age (t=0.718, P=0.474), primary disease (χ(2)=2.076, P=0.722), AKI stage (χ(2)=0.004, P=0.998), time from diagnosis of AKI to start RRT (h) (P=0.745), whether to start RRT within 24 hours (χ(2)=0.016, P=0.899), urine volume (χ(2)=3.118, P=0.374), fluid overload (χ(2)=0.014, P=0.905), multiple organ dysfunction syndrome (MODS) (χ(2)=2.972, P=0.085), acidosis (χ(2)=3.204, P=0.073), hyperkalemia (χ(2)=2.829, P=0.093), the level of blood urea nitrogen (t=1.351, P=0.179) and serum creatinine (P=0.901) at the beginning of RRT. In the unfavorable outcome group, the proportion of patients with mechanical ventilation (45.0% (9/20) vs. 12.3% (14/114), χ(2)=12.811, P<0.01) and the incidence of extra organ injury (≥3) (30.0% (6/20) vs. 10.5% (12/114), χ(2)=6.365, P=0.041) were higher than those in the favorable outcome group. Logistic regression analysis showed that mechanical ventilation (OR=12.540, 95%CI: 3.376-46.577, P<0.01) and hyperkalemia (OR=4.611, 95%CI: 1.265-16.805, P=0.021) were the predictive factors of poor prognosis in patients with AKI treated with RRT. Conclusion: Mechanical ventilation and hyperkalemia may predict a poor prognosis in AKI patients treated with RRT.

Correction of facial asymmetry associated with vertical maxillary excess and mandibular prognathism by combined orthognathic surgery and guiding templates and splints fabricated by rapid prototyping technique

The facial asymmetry associated with vertical maxillary excess and mandibular prognathism is one of the more complicated types in the field of oral and maxillofacial surgery. The purpose of this study was to investigate the efficacy of combined orthognathic surgeries, together with guiding templates and splints fabricated by rapid prototyping technique, for the correction of facial asymmetry. Fourteen patients with facial asymmetry associated with vertical maxillary excess and mandibular prognathism were included. A maxillary Le Fort I osteotomy, a sagittal split ramus osteotomy on the shorter side of the face, and an intraoral vertical ramus osteotomy on the longer side of the face were performed with the aid of guiding templates and splints fabricated by rapid prototyping technique. Parameters reflecting maxillary canting, ramal inclination, mandibular deviation, and chin inclination were measured before surgery, 7 days after surgery, and 1 year after surgery, and compared. Significant differences in these parameters were found between the two sides preoperatively, whereas no differences were observed postoperatively. Facial asymmetry was corrected in all patients with satisfactory outcomes. In conclusion, combined orthognathic surgery and guiding templates and splints can offer improvements in accuracy, complexity, and duration over traditional procedures for the correction of facial asymmetry associated with vertical maxillary excess and mandibular prognathism.

The effects of radiation on antitumor efficacy of an oncolytic adenovirus vector in the Syrian hamster model

We report that radiation enhances the antitumor efficacy of the oncolytic adenovirus vector VRX-007 in Syrian hamster tumors. We used tumor-specific irradiation of subcutaneous tumors and compared treatment options of radiation alone or combined with VRX-007 and cyclophosphamide (CP). Radiation therapy further augmented the VRX-007-mediated inhibition of tumor growth, in both CP-treated and non-CP-treated hamsters, even though radiation did not lead to increased viral replication in tumors when compared to those treated with VRX-007 alone. Moreover, tumor growth inhibition was similar in tumors irradiated either one week before or after injection with VRX-007, which suggests that radiation exerts its antitumor effect independently from vector therapy. Thus, our results demonstrate that these two therapies do not have to be provided simultaneously to enhance their combined effectiveness against subcutaneous hamster tumors.

Tongue musculomucosal flap for soft palate reconstruction in patients with OSAHS - clinical experience in technical strategy

BACKGROUND

With the idea of "replacing lost tissure with similar tissure in kind", vessel-pedicled palate mucosal flap, pedicled buccal musculomucosal flap and adjacent tongue musculomucosal flap could be the ideal approaches to soft palate reconstruction.

AIM

To assess the adjacent tongue musculomucosal flap for soft palate reconstruction.

PATIENTS AND METHODS

From August 2010 to July 2011, we applied tongue musculomucosal flap for soft palate reconstruction in three patients with Obstructive Sleep Apnoea/Hypopnoes Syndrome (OSAHS) in order to release OSAHS symptom by glossal volume reduction.

RESULTS

All patients recovered from intraoral operations with good objective as subjective speech and swallowing. Suffice it to say that OSAHS symptom was released for these patients.

CONCLUSIONS

Here we provide a case to deal with problems related to OSAHS symptom when one works on oral surgery or reconstructing oral structure.

Association of polymorphisms in interleukin-18 and interleukin-28B with hepatitis B recurrence after liver transplantation in Chinese Han population

Interleukin-18 (IL-18) is a potent proinflammatory cytokine, which can promote hepatitis B virus clearance. The latest studies find that genetic polymorphisms near the IL-28B gene are strongly associated with sustained viral response and spontaneous viral clearance in patients with chronically infected hepatitis C and hepatitis B. We investigated the effect of rs187238 and rs1946518 in IL-18 gene and rs8099917 in IL-28B gene on HBV recurrence in liver transplant patients. A total of 200 liver transplant recipients and relevant donors were enrolled in this study. The patients' mean follow-up was 39 month (range 10-65 month). All liver transplant recipients were in a stable stage. The total recipients (n = 200) were divided into end-stage liver disease secondary to hepatitis B (n = 140) and end-stage liver disease secondary to other diseases (n = 60) before transplantation. Recipients (n = 140) with hepatitis B before transplantation were defined to nonHBV recurrence group (n = 119) or HBV recurrence group (n = 21), which was positive for HBsAg or elevatory in HBV DNA (>2.0 × 10(2) IU mL(-1)) after transplantation. For the recipients (n = 140) had hepatitis B before transplantation, we studied the single-nucleotide polymorphisms (SNPs) of IL-18 gene (rs187238 and rs1946518) and IL-28B gene (rs8099917) by high-resolution melting (HRM) curve analysis. The serum levels of IL-18 and IFN-γ were tested by ELISA. The serums levels of IFN-γ were lower in HBV recurrence group than that in nonHBV recurrence group (P < 0.01). The genotype of IL-28B gene rs8099917 was associated with alanine aminotransferase (ALT) levels and aspartate aminotransferase (AST) levels in HBV-related liver transplant recipients (n = 140). The recipients with allele G (GG+GT) had higher ALT and AST levels (P < 0.05). No association was found between IL-18 gene and IL-28B gene polymorphisms with HBV recurrence in the liver transplant recipients or the donors. We identified that the IFN-γ was a protective factor of HBV recurrence after liver transplantation. The allele G of rs8099917 was associated with hepatitis B-related hepatocytes injury. The rs8099917 G allele subgroup should reinforce antiviral therapy.

INGN 007, an oncolytic adenovirus vector, replicates in Syrian hamsters but not mice: comparison of biodistribution studies

Preclinical biodistribution studies with INGN 007, an oncolytic adenovirus (Ad) vector, supporting an early stage clinical trial were conducted in Syrian hamsters, which are permissive for Ad replication, and mice, which are a standard model for assessing toxicity and biodistribution of replication-defective (RD) Ad vectors. Vector dissemination and pharmacokinetics following intravenous administration were examined by real-time PCR in nine tissues and blood at five time points spanning 1 year. Select organs were also examined for the presence of infectious vector/virus. INGN 007 (VRX-007), wild-type Ad5 and AdCMVpA (an RD vector) were compared in the hamster model, whereas only INGN 007 was examined in mice. DNA of all vectors was widely disseminated early after injection, but decayed rapidly in most organs. In the hamster model, DNA of INGN 007 and Ad5 was more abundant than that of the RD vector AdCMVpA at early times after injection, but similar levels were seen later. An increased level of INGN 007 and Ad5 DNA but not AdCMVpA DNA in certain organs early after injection, and the presence of infectious INGN 007 and Ad5 in lung and liver samples at early times after injection, strongly suggests that replication of INGN 007 and Ad5 occurred in several Syrian hamster organs. There was no evidence of INGN 007 replication in mice. In addition to providing important information about INGN 007, the results underscore the utility of the Syrian hamster as a permissive immunocompetent model for Ad5 pathogenesis and oncolytic Ad vectors.

Reconstruction of mandibular symphyseal defects by trifocal distraction osteogenesis: an experimental study in Rhesus

Mandibular symphyseal defects caused by tumor surgery, trauma, or congenital misshape can produce maxillofacial deformity and functional handicap. Recently, the technique of distraction osteogenesis has become a valuable reconstructive method for craniofacial bone defects. Four adult rhesus monkeys were used in this study. The anterior mandibulectomy (ranged from canine to canine) was performed, and bilateral transport segments (ranged from first premolar to first molar) were created. Custom-made multiplanar distractors were applied for the reconstruction of the monkeys' artificial mandibular symphyseal defects by trifocal distraction osteogenesis. After a delay period of 7 days, the bilateral transport discs were distracted forward and inward simultaneously. Serial X-ray and three-dimensional CT films were taken within the experimental period. Two monkeys were sacrificed at 8 and 16 weeks, respectively, after the completion of distraction. The distracted calluses and united areas between bilateral transport discs were harvested and processed for histological examination. The mandibular symphyseal defects in all animals were repaired successfully and the anterior mandibular contours were similar to the normal ones. Perfect bone regeneration in the distraction gaps was found, and fibro-bony union between the bilateral transport segments was observed in the midline region at 16 weeks after the end of distraction. The success of distraction osteogenesis for repair of mandibular symphseal defects in monkeys by this distractor may provide an alternative method to reconstruct the anterior part of mandible.

[No arresting aorta undergoing open heart surgery with CPB through a right anterolateral thoracotomy]

We performed operation of CPB without arresting aorta on 57 cardiac patients through a right anterolateral thoracotomy. Results showed: except that one case of ASD required a 2nd time thoracotomy to hemostasis for a lot of drainage, another case of residual shunt postoperation of TOF was not satisfactory in repair, the others are perfect. There were no operative or hospitalized mortality, no incision infection. It has also solve the psychological distress of female patients provoking by midline showy scar of median sternotomy, so it has acquire a good surgical cosmetic effect.

[Study on the defluoridation of drinking water with synthetic hydroxyapatite]

Synthetic hydroxyapatite was used as a material for the defluoridation of drinking water. The defluoridation capacity, regeneration the capability of defluoridator and the corresponding parameters of defluoridation and regeneration have been studied with batch and column test. The results showed that the defluoridation capacity of synthetic hydroxyapatite on F- was 3.7-4.3 mg/g in batch test, 5.6 mg/g for break through (1.0 mg/L is considered as the break through point) in column test, and 10.7 mg/g for saturation in column test. The efficiency of regeneration was 46%-64% for saturated hydroxyapatite with surface-coating method.

[Optimizing the synthesis of hydroxyapatite as a method for the defluoridation of drinking water]

As the cheaper raw materials for the synthesis of hydroxyapatite as a defluoridator, calcium hydroxide and phosphoric acid are used. Hydroxyapatite is made by a hydro-synthesis method, and optimum conditions are determined by batch test for defluoridation with respect to the consumption of phosphoric acid, reaction time and acid-washed product. The results showed that the defluoridation capacity of the synthetic hydroxyapatite for break through (F- 1.0 mg/L is considered as the break through point) was F- 5.6 mg/g in column test, and F- 10.7 mg/g for saturation in column test. After optimization of the synthesis method, the defluoridation capacity of hydroxyapatite is much higher than activated alumina and bone charcoal, which are used currently.

[Evaluation on the effect of synthetic hydroxyapatite for drinking water defluoridation in field study]

In order to evaluate the effect of synthetic hydroxyapatite on drinking water defluoridation, a coagulative precipitation method and a flow column system was tested in the fields. The defluoridation capacity of coagulative precipitation method was 4.19 mg/g, and the method was simple on operation, but more reagents were needed with high cost for operation. The defluoridation capacity of flow column system was 6 mg/g and the saturated hydroxyapatite could be reused after regeneration. The operation of household defluoridator based on flow column system is simple, with low cost and high capacity in defloridation. The system will be applied in the fluorosis areas.

Three novel TBX5 mutations in Chinese patients with Holt-Oram syndrome

Holt-Oram syndrome (HOS) is an autosomal dominant syndrome that comprises upper limb and cardiac defects. The gene responsible for HOS, TBX5, was isolated and many mutations have been identified in HOS patients. We analyzed 11 Chinese HOS patients (7 from three families and 4 sporadic cases) for TBX5 mutation by single strand conformation polymorphisms (SSCPs). Three SSCP changes were detected in two of the three familial cases and one sporadic case. Sequence analysis identified three novel, heterozygous mutations in TBX5: a frameshift mutation caused by one base deletion [C416del] in one family, a mis-sense mutation (Gln49Lys) induced by a base substitution (C145A) in another family, and the other mis-sense mutation (Ile54Thr) by T161C in one sporadic case. The patients with the frameshift mutations had severer clinical manifestations that involved aplasia/hypoplasia of the arm and thumbs, while those with the mis-sense mutations presented with milder anomalies such as absent or hypoplastic thumbs but without arm abnormalities. These observations may support a genotype-phenotype correlation in HOS patients with TBX5 mutation.

Molecular cloning and mapping of a novel ADAM gene (ADAM29) to human chromosome 4

Members of the ADAM family (type I integral membrane protein with a disintegrin and metalloprotease domain) have been implicated in many important biological processes involving cell-cell and cell-matrix interactions, such as fertilization and myoblast fusion. We report here the cDNA sequence of a novel human ADAM gene (ADAM29) that contains a putative fusion peptide. Northern blot analysis revealed that the mRNA of ADAM29 is highly expressed in the testis. By radiation hybrid panel mapping, the ADAM29 gene was assigned to human chromosome 4q34.2-qter.

[Study on the oxidation of N-alkylacridans and 10,10'-dialkyl-9,9'-biacridens by spectrophotometer]

The oxidation of N-alkylacridans and 10,10'-dialkyl-9,9'-biacridens with pi-acceptors TCNQ, DDQ, TCNE and CA were studied by UV, IR, ESR and fluorescent spectra, the oxidation mechanism for N-alkylacridans and 10,10'-dialkyl-9,9'-biacridens was presented respectively.

Mouse adenovirus type 1 early region 1A is dispensable for growth in cultured fibroblasts

Mouse adenovirus type 1 (MAV-1) mutants with deletions of conserved regions of early region 1A (E1A) or with point mutations that eliminate translation of E1A were used to determine the role of E1A in MAV-1 replication. MAV-1 E1A mutants expressing no E1A protein grew to titers comparable to wild-type MAV-1 titers on mouse fibroblasts (3T6 fibroblasts and fibroblasts derived from Rb+/+, Rb+/-, and Rb-/- transgenic embryos). To test the hypothesis that E1A could induce a quiescent cell to reenter the cell cycle, fibroblasts were serum starved to stop DNA replication and cellular replication and then infected with the E1A mutant and wild-type viruses. All grew to equivalent titers. Steady-state levels of MAV-1 early mRNAs (E1A, E1B, E2, E3, and E4) from 3T6 cells infected with wild-type or E1A mutant virus were examined by Northern analysis. Steady-state levels of mRNAs from the mutant-infected cells were comparable to or greater than the levels found in wild-type virus infections for most of the early regions and for two late genes. The E2 mRNA levels were slightly reduced in all mutant infections relative to wild-type infections. E1A mRNA was not detected from infections with the MAV-1 E1A null mutant, pmE109, or from infections with similar MAV-1 E1A null mutants, pmE112 and pmE113. The implications for the lack of a requirement of E1A in cell culture are discussed.

Construction and identification of a recombinant adenovirus which expresses human interferon-gamma

An E1-deleted adenoviral vector, pAdl2/RSV-IFN-bpA, harboring human IFN-gamma cDNA, and plasmid pJM17 were cotransfected into a human embryo kidney cell line 293 by the calcium-phosphate precipitation method. Six strains of recombinant adenovirus (rAd) were obtained after 11-day incubation. PCR analysis indicated that all six rAds contained human IFN-gamma cDNA. The biological activity of IFN-gamma was detected in the supernatant of the cultured 293 cells following rAd infection, and it could be blocked by the antibody against IFN-gamma. The B16F10 cells infected with the purified rAd (RSV/IFN-01) didn't show cytopathic effect (CPE), and more biological activity of IFN-gamma was detected in the supernatant of the infected B16F10 cells with increased MOI (multiple of infection) values. Therefore, the recombinant adenovirus constructed in this study can express and secrete human IFN-gamma.

Interaction of mouse adenovirus type 1 early region 1A protein with cellular proteins pRb and p107

We demonstrated functional associations between mouse adenovirus type 1 (MAV-1) early region 1A (E1A) protein and both the mouse retinoblastoma protein (pRb) and the mouse pRb-related protein, p107. Interactions between MAV-1 E1A and mouse pRb or mouse p107 proteins were examined in infected cell lysates using a mouse embryonic fibroblast cell line infected with wild-type and mutant MAV-1 viruses. Using a polyclonal antibody to MAV-1 E1A, exogenously added mouse pRb or mouse p107 was coimmunoprecipitated from wild-type, dIE105 (CR1 delta)-, and dIE106 (CR3 delta)-infected cell lysates. No coimmunoprecipitation was seen with cell lysates from dIE102 (CR2 delta) or pmE109, a mutant virus that produces no detectable E1A protein due to an ATG to TTG point mutation in the initiator methionine. Introduction of mouse pRb into SAOS-2 cells resulted in a flat and enlarged cell phenotype, whereas cotransfection of mouse pRb and MAV-1 E1A resulted in a significant reduction of flat cells, presumably due to E1A binding pRb. CR1 delta and CR2 delta E1A proteins were less effective at reducing the number of flat, enlarged cells induced by pRb expression than were the CR3 delta or wild-type E1A proteins. The reduced ability of these mutants to inactivate pRb relative to wild-type E1A correlated with their reduced ability to bind pRb in the in vitro coimmunoprecipitation experiments. As a measure of p107/MAV-1 E1A complex formation in MAV-1-infected cells, we used mobility shift assays to examine cell extracts for the presence of p107-containing E2F protein-DNA complexes. Mock-, dIE102-, and pmE109-infected cell extracts formed a p107-containing complex, whereas wild-type-infected cell extracts did not. Thus the formation of a p107-E2F complex in wild-type- or these mutant-infected extracts inversely correlated with the presence of E1A-p107 complexes identified in the vitro coimmunoprecipitation experiments. This is consistent with E1A-p107 complexes forming in wild-type MAV-1-infected cells.

Different malignant phenotypes induced in a stable, subdiploid, benign epithelial clone by DNA transfection

Progression to malignancy in carcinomas has been studied in a stable, benign, subdiploid, cloned epithelial cell line (A5P/B10) sensitive to Geneticin at 100 micrograms/ml. A total of 28 cell lines were selected for Geneticin - resistance and inoculated into the footpads of syngeneic animals following co-transfection with pSV2neo and genomic DNA, or transfection with plasmid constructs containing neo and the activated Ha-ras oncogene. The behavior of 12 cell lines cotransfected with normal genomic DNA and inoculated into 146 footpads was the same as the A5P/B10 cells. Low grade primary tumors were produced in 122 footpads by 13 cell lines transfected with Ha-ras, and a proportion (61/122) produced well-differentiated lymph node metastases. One of 3 cell lines cotransfected with genomic DNA from a malignant cell line (BC1) produced 8 anaplastic primary tumors with anaplastic metastases. Cell lines from lymph nodes involved by these anaplastic tumors were sensitive to Geneticin, and genomic DNA from 2 clones of these cells failed to produce a malignant phenotype when co-transfected into the A5P/B10 cells. These results indicated that the progression to a malignant phenotype induced in benign cells from a spontaneous epithelial tumor by co-transfection with genomic DNA from malignant cells was different from that induced by the ras oncogene.