[Electromyographic signals and the starting threshold voltage of orbicularis oris muscle in healthy rhesus monkeys]

Objective: To investigate the characteristics of electromyography (EMG) signals and the starting threshold voltages of the orbicularis oris muscles (OOM) in healthy rhesus monkeys under different muscle movement conditions. Methods: The EMG signals and the starting threshold voltages at different time points in 4 healthy rhesus monkeys were acquired and recorded with EMG device and evoked potentiometer. The voltage amplitude variation of EMG signals was analyzed, and the voltage amplitude range of EMG signals at the beginning of OOM contraction was established. The data were statistically analyzed by one-way ANOVA. Results: The EMG of OOM in healthy monkeys in the quiet, natural and continuous mouth-closed state was linear and relatively stable, and the absolute value fluctuated between 15 and 50 μV. The EMG waveform increased rapidly during the natural lip contraction movement, and its amplitude fluctuated greatly, with the highest absolute value of the peak value reaching hundreds of microvolts. The amplitude of EMG induced by continuous mouth closure was more than thousands of microvolts. There was no significant difference in EMG amplitudes of OOM in the healthy rhesus monkey under quiet and continuous lip closure at different time points (P>0.05). There was no significant difference in threshold voltages in the state of natural lip contraction of bilateral OOM at different time points (average range: 57.17-57.47 μV) in the healthy rhesus monkeys (P>0.05). There was no significant difference in threshold voltages of OOM induced by bilateral OOM at different time points(average range: 55.38-55.99 μV) in the healthy rhesus monkeys(P>0.05). There were significant differences in the absolute values of EMG amplitudes of OOM between the three lip movement modes: (30.67±8.72) μV in quiet and natural continuous lip closure (475.12±54.72) μV in natural lip contraction, and (921.22±312.79) μV in the induced persistent lip closure, with t values of -8.48, -9.35 and -5.01 respectively, all P<0.001. Conclusions: The EMG signals of OOM show different characteristics under different muscle movement conditions, which can be used as a basis for computer to judge and recognize the movement conditions of OOM. The upper limits of the EMG threshold voltage values of OOM under different motion states are 55-60 μV.

[Self-reported quality of life in patients with coronary heart disease and analysis of the associated factors]

Objective: To investigate the quality of life and associated factors in patients with coronary heart disease (CHD) in China. Methods: A cross-sectional study of 25 provinces and cities in China was performed from June to September 2020. A questionnaire was used to collect the socio-demographic and clinical information of patients with CHD, while the European Five-dimensional Quality of Life Scale (EQ-5D) was used to assess the quality of life. Multiple linear regression model was performed to analyze the associated factors. Results: The median age of the 1 075 responders was 60 (52, 67) years, and 797 (74.1%) were men. The EQ-5D and EQ-VAS indices were 0.7 (0.5, 0.8) and 60.0 (40.0, 80.0). Among the five dimensions in the quality of life scale, the frequency of anxiety/depression was the highest (59.8%), while problems in self-care was the lowest (35.8%). In the multiple linear regression model, female, increasing age, obesity, comorbidity(ies), anxiety/depression, social media channels, and receiving the CABG therapy were associated with the lower EQ-5D index (all P<0.05). In addition, increasing age, obesity, comorbidity (ies), depression, anxiety and depression, social media channels, and receiving the CABG therapy were associated with lower EQ-VAS index (all P<0.05). Conclusion: Over half of the patients with CHD in China have a low quality of life, which is related to gender, age, obesity, treatment pathway, the presence or absence of comorbidity (ies), and psychological state. In addition to managing the adverse effects of traditional socio-demographic factors on the quality of life, clinical practices should pay attention to the psychological state of patients. Moreover, establishing a WeChat group for doctor-patient communication could improve the quality of life of CHD patients.

In-Vitro Comparison of Single Limb and Dual Limb Circuit for Aerosol Delivery via Noninvasive Ventilation

BACKGROUND

The effect of single- and dual-limb circuits on aerosol delivery during noninvasive ventilation (NIV) in adult models is unclear.

METHODS

A noninvasive ventilator equipped with a single-limb circuit or an ICU ventilator equipped with a dual-limb circuit was connected to a simulated lung. Ventilator parameters were adjusted to maintain a tidal volume at ∼500 mL. Aerosol deposition with different placements of a vibrating mesh nebulizer and humidification conditions were compared. Additional experiments by using a non-vented mask or a vented mask were compared in the single-limb circuit only. Aerosol was collected by a disposable filter placed between the simulated lung and the head model (n = 3), and measured by ultraviolet spectrophotometry (276 nm).

RESULTS

The aerosol deposition varied between 4.12 ± 0.22% and 20.75 ± 0.95%. The greatest aerosol delivery during NIV when using a non-vented mask was found when a vibrating mesh nebulizer was placed between the mask and 15 cm from the exhalation port in the humidified single-limb circuit, and 15 cm from the Y-piece in the inspiratory limb of the humidified dual-limb circuit, and no significant difference of aerosol deposition was found between the two optimal positions (20.03 ± 1.48% vs 18.04 ± 0.93%, respectively; P =.042). There was no difference of aerosol delivery in dry versus humidified circuits, except when a vibrating mesh nebulizer was placed at the humidifier inlet in a dual-limb circuit. When using a vented mask, the aerosol deposition was poor (6.56 ± 0.41 ∼ 8.02 ± 0.39%), regardless of vibrating mesh nebulizer positions and humidification types.

CONCLUSIONS

During NIV, the aerosol delivery was optimal when a vibrating mesh nebulizer was placed between the non-vented mask and 15 cm from the exhalation port in the single-limb circuit or 15 cm from the Y-piece in the inspiratory limb of the dual-limb circuit; no significant difference was found between the two optimal placements. Humidification had little effect on aerosol delivery. Aerosol delivery was poor in the single-limb circuit with a vented mask.

Effectiveness of the use of a high-flow nasal cannula to treat COVID-19 patients and risk factors for failure: a meta-analysis

Background:

Coronavirus disease 2019 (COVID-19) has spread globally, and many patients with severe cases have received oxygen therapy through a high-flow nasal cannula (HFNC).

Objectives:

We assessed the efficacy of HFNC for treating patients with COVID-19 and risk factors for HFNC failure.

Methods:

We searched PubMed, Embase, and the Cochrane Central Register of randomized controlled trials (RCTs) and observational studies of HFNC in patients with COVID-19 published in English from January 1st, 2020 to August 15th, 2021. The primary aim was to assess intubation, mortality, and failure rates in COVID-19 patients supported by HFNC. Secondary aims were to compare HFNC success and failure groups and to describe the risk factors for HFNC failure.

Results:

A total of 25 studies fulfilled selection criteria and included 2851 patients. The intubation, mortality, and failure rates were 0.44 (95% confidence interval (CI): 0.38–0.51, I² = 84%), 0.23 (95% CI: 0.19–0.29, I² = 88%), and 0.47 (95% CI: 0.42–0.51, I² = 56%), respectively. Compared to the success group, age, body mass index (BMI), Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score, D-dimer, lactate, heart rate, and respiratory rate were higher and PaO₂, PaO₂/FiO₂, ROX index (the ratio of SpO₂/FiO₂ to respiratory rate), ROX index after the initiation of HFNC, and duration of HFNC were lower in the failure group (all Ps < 0.05). There were also more smokers and more comorbidities in the failure group (all Ps < 0.05). Pooled odds ratios (ORs) revealed that older age (OR: 1.04, 95% CI: 1.01–1.07, P = 0.02, I² = 88%), a higher white blood cell (WBC) count (OR: 1.06, 95% CI: 1.01–1.12, P = 0.02, I² = 0%), a higher heart rate (OR: 1.42, 95% CI: 1.15–1.76, P < 0.01, I² = 0%), and a lower ROX index(OR: 0.61, 95% CI: 0.39–0.95, P = 0.03, I² = 93%) after the initiation of HFNC were all significant risk factors for HFNC failure.

Conclusions:

HFNC is an effective way of providing respiratory support in the treatment of COVID-19 patients. Older age, a higher WBC count, a higher heart rate, and a lower ROX index after the initiation of HFNC are associated with an increased risk of HFNC failure.

The efficacy and tolerance of prone positioning in non-intubation patients with acute hypoxemic respiratory failure and ARDS: a meta-analysis

Background and aims:

The application of prone positioning with acute hypoxemic respiratory failure (AHRF) or acute respiratory distress syndrome (ARDS) in non-intubation patients is increasing gradually, applying prone positioning for more high-flow nasal oxygen therapy (HFNC) and non-invasive ventilation (NIV) patients. This meta-analysis evaluates the efficacy and tolerance of prone positioning combined with non-invasive respiratory support in patients with AHRF or ARDS.

Methods:

We searched randomized controlled trials (RCTs) (prospective or retrospective cohort studies, RCTs and case series) published in PubMed, EMBASE and the Cochrane Central Register of Controlled Trials from 1 January 2000 to 1 July 2020. We included studies that compared prone and supine positioning with non-invasive respiratory support in awake patients with AHRF or ARDS. The meta-analyses used random effects models. The methodological quality of the RCTs was evaluated using the Newcastle–Ottawa quality assessment scale.

Results:

A total of 16 studies fulfilled selection criteria and included 243 patients. The aggregated intubation rate and mortality rate were 33% [95% confidence interval (CI): 0.26–0.42, I² = 25%], 4% (95% CI: 0.01–0.07, I² = 0%), respectively, and the intolerance rate was 7% (95% CI: 0.01–0.12, I² = 5%). Prone positioning increased PaO₂/FiO₂ [mean difference (MD) = 47.89, 95% CI: 28.12–67.66; p < 0.00001, I² = 67%] and SpO₂ (MD = 4.58, 95% CI: 1.35–7.80, p = 0.005, I² = 97%), whereas it reduced respiratory rate (MD = −5.01, 95% CI: −8.49 to −1.52, p = 0.005, I² = 85%). Subgroup analyses demonstrated that the intubation rate of shorter duration prone (⩽5 h/day) and longer duration prone (>5 h/day) were 34% and 21%, respectively; and the mortality rate of shorter duration prone (⩽5 h/day) and longer duration prone (>5 h/day) were 6% and 0%, respectively. PaO₂/FiO₂ and SpO₂ were significantly improved in COVID-19 patients and non-COVID-19 patients.

Conclusion:

Prone positioning could improve the oxygenation and reduce respiratory rate in both COVID-19 patients and non-COVID-19 patients with non-intubated AHRF or ARDS.

The reviews of this paper are available via the supplemental material section.

[The variation of serum uric acid levels among patients with myocardial infarction treated with ticagrelor and the association between serum uric acid and platelet reactivity]

Objectives: To compare the impact of ticagrelor or clopidogrel on serum uric acid levels among patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) and further evaluate the effects of variation of serum uric acid levels on platelet reactivity. Methods: STEMI patients who admitted to Fuwai Hospital from April 2017 to January 2020, and underwent primary PCI and discharged alive with aspirin and ticagrelor or clopidogrel were included in this study. Patients were divided into ticagrelor group and clopidogrel group. The baseline clinical data were collected. Serum uric acid and creatinine levels at baseline and 30 days post-PCI were measured. Light transmittance aggregometry was used to assess maximum aggregation rate induced by adenosine diphosphate and arachidonic acid. The changes of serum uric acid and creatinine were compared between the two groups. Multivariate logistic regression was performed to evaluate independent related factors for rise in the uric acid levels, and the effect of variation of serum uric acid level on platelet reactivity was analyzed. Results: A total of 967 patients were included, the age was (59.4±12.1) years, and 163 case were female. There were 550 cases in ticagrelor group (56.9%) and 417 cases in clopidogrel group (43.1%). Baseline serum uric acid and creatinine levels were similar between the 2 groups. At 30 days, the serum uric acid level [(347.2±96.5) mmol/L vs. (341.2±105.3) mmol/L, P=0.009] and absolute [46.4 (-2.4, 88.1) mmol/L vs. 25.0 (-21.9, 73.0) mmol/L, P=0.001] and percentage [13.2 (-0.01, 29.0) % vs. 7.9 (-5.7, 25.0) %, P=0.007] increase in the serum uric acid levels were significantly higher in ticagrelor group than in clopidogrel group. The level of serum creatinine at 30 days was significantly lower in ticagrelor group than in clopidogrel group [(89.7±21.3) μmol/L vs. (94.4±43.9) μmol/L, P<0.05], whereas there were no differences in absolute [8.0 (-1.4, 16.6) μmol/L vs. 7.8 (-2.0, 16.6) μmol/L] and percentage [10.5 (-1.7%, 22.6%) vs. 9.8 (-2.4%, 22.1%)] change in the serum creatinine between the 2 groups (all P>0.05). Logistic regression analysis showed that, after adjusting for confounding factors, ticagrelor therapy was an independent related factor of serum uric acid elevation (OR=1.582, 95% CI:1.023-2.447, P=0.039). The variation of the serum uric acid levels did not affect platelet aggregation and the percentage of high platelet reactivity in both groups. Conclusions: Ticagrelor use is related to a significant increase in the serum uric acid levels at 30 days post-PCI in this patient cohort. The variations in the uric acid levels do not increase the percentage of high platelet reactivity in STEMI patients treated with ticagrelor or clopidogrel.

[One case of atypical septic shock with acute pulmonary edema in a patient with extensive burn]

A 25-year-old man with extensive burn due to industrial dust explosion was admitted to the First Affiliated Hospital of Naval Medical University on 16th October, 2018. Four days after the first skin grafting and vacuum sealing drainage surgery, the patient developed signs of uncontrolled severe inflammation and shock. However, several atypical manifestations interfered the diagnosis of septic shock. After giving emergency treatment including fluid resuscitation, broad-spectrum antibiotics, and administration of vasopressor agents, the patient's condition was alleviated, but quickly relapsed and deteriorated, with acute pulmonary edema appeared in the evening of the same day. Finally, the condition was reversed by completely removing the negative pressure devices on upper limbs and thorough dressing change. This case suggests that the diagnosis and treatment of infection in patients with extensive burn need comprehensive analysis. Timely intervention of the wound is the key to control the exacerbation of sepsis. In addition, the possibility of pulmonary edema in patients with sepsis should be on high alert.

[Comparison of heart failure and COVID-19 in chest CT features and clinical characteristics]

Objective: To identify the characteristics including clinical features and pulmonary computed tomography (CT) features of heart failure and COVID-19. Methods: This study was a retrospective study. A total of 7 patients with heart failure and 12 patients with COVID-19 in the Second Xiangya Hospital of Central South University between December 1, 2019 and February 15, 2020 were enrolled. The baseline clinical and imaging features of the two groups were statistically analyzed. Results: There was no significant difference in age and sex between the two groups(both P>0.05), but the incidence of epidemiological contact history, fever or respiratory symptoms in the COVID-19 group was significantly higher than that in the heart failure group (12/12 vs. 0, P<0.001; 12/12 vs. 4/7, P=0.013). While the proportion of cardiovascular diseases and impaired cardiac function was significantly less than that of the heart failure group(2/12 vs.7/7, P<0.001；0 vs.7/7, P<0.001). For imaging features, both groups had ground-glass opacity and thickening of interlobular septum, but the ratio of central and gradient distribution was higher in patients with heart failure than that in patients with COVID-19 (4/7 vs. 1/12, P=0.04). In heart failure group, the ratio of the expansion of pulmonary veins was also higher (3/7 vs. 0，P=0.013), and the lung lesions can be significantly improved after effective anti-heart failure treatment. Besides, there were more cases with rounded morphology in COVID-19 group（9/12 vs. 2/7, P=0.048）. Conclusions: More patients with COVID-19 have epidemiological history and fever or respiratory symptoms. There are significant differences in chest CT features, such as enlargement of pulmonary veins, lesions distribution and morphology between heart failure and COVID-19.

[Study on the matching feature of current parameters for inducing contraction of orbicularis oris muscle by artificial facial nerve in rabbit with peripheral facial paralysis]

Objective: To explore the optimal matching of the current parameters about artificial facial nerve (AFN) for inducing contraction of the orbicularis oris muscle (OOM) in rabbit with peripheral facial paralysis. Methods: According to the combinations of different stimulus parameters, at different time points, we used AFN to induce contraction of the affected side OOM of the paralyzed rabbit in waking state. We recorded the current amplitudes of the threshold stimulation and peak stimulation under each combination, then compared the total charge of the stimulus consumption under different combinations. Results: Compared the total stimulus charge consumption of the AFN threshold stimulation and that in the peak stimulation respectively under different stimulus frequency and pulse width matching combinations, we found that the frequency, the pulse width and the interaction of the frequency and pulse width among different groups could affect the total charge, the differences were statistically significant (P<0.05). Conclusions: When AFN stimulus frequency is 60 Hz and the stimulus pulse width is 100 μs, the output current intensity is relatively lowest and the total consumed charge is the lowest under the premise of effectively inducing the paralytic side OOM contraction. Thus we recommend this stimulus parametric combination as the optimal combination for meeting the low power consumption of AFN.

[Study on the method of microelectrodes implantation of artificial facial nerve prosthesis in closed mouth of orbicularis oris muscle in monkeys with facial nerve paralysis]

Objective: To explore the optimal method of microelectrode implantation that can produce efficient mouth closure with microelectrode for orbicularis oris muscle (OOM) in rhesus monkeys with unilateral peripheral facial paralysis (UPFP) in order to provide basis for the research and development of artificial facial nerve prosthesis (AFNP). Methods: Right lateral peripheral facial paralysis model on four healthy rhesus monkeys (two males and two femles, aged 5-6 years, weighed 2.0-3.0 kg) were prepared. AFNP electric stimulation was used to induce closed-mouth reaction of the affected OOM with a one-way rectangular pulse, 50 Hz frequency and 0.2 ms pulse width in vitro. Around the affected lateral OOM, four stimulus electrodes implantation positions were selected at the upper lip (position A), the lower lip (position B), the connection with the corner of the mouth to the ipsilateral tragus (position C), and the horizontal line of the mouth angle (position D). According to the different implantation positions of three stimulation electrodes on the stimulation side of AFNP and the results of our previous study, six groups of microelectrode implantation methods were designed. In Group A, two microelectrodes were implanted at position A and one microelectrode was implanted at position B; in Group B, one microelectrode was implanted at position A, B and C respectively; in Group C, one microelectrode was implanted at position A and two microelectrodes were implanted at position B; in Group D, one microelectrode was implanted at position A, B and D respectively; in Group E, one microelectrode was implanted at position A, C and D respectively; in Group F, one microelectrode was implanted at position B, C and D respectively. The minimum stimulating current (threshold current) required for effective mouth closure were recorded. The threshold and peak current values were compared using one-way ANOVA and LSD-t multiple comparisons. Results: The microelectrodes of the AFNP stimulating side in Group E and F failed to induce a smooth mouth closure. The microelectrodes in A, B, C and D group induced smooth mouth closure. The threshold current value of OOM contraction on affected side in the Group A, B, C, and D were (1.35±0.05), (1.02±0.04), (1.40±0.04) and (1.10±0.02) mA, respectively (F=295.302, P<0.001), with the lowest value in Group B and there was significant difference between the current value in Group B and those in the other groups (all P<0.05). The peak current value of OOM contraction on affected side in the four groups were (3.95±0.02), (2.95±0.03), (3.99±0.05) and (3.51±0.01) mA, respectively (F=1 014.985, P<0.001). Group B showed the best lip-closure morphology observed with naked eyes. Conclusions: When three output microelectrode of the AFNP stimulated side are separately imbedded into the upper lip, the lower lip and the connection with the corner of the mouth to the ipsilateral tragus, AFNP can sufficiently induce closed-mouth reaction. These positions are suitable as priority options microelectrodes implantation positions for the microelectrodes of the AFNP stimulated side.

[Comparison of machine learning method and logistic regression model in prediction of acute kidney injury in severely burned patients]

Objective: To build risk prediction models for acute kidney injury (AKI) in severely burned patients, and to compare the prediction performance of machine learning method and logistic regression model. Methods: The clinical data of 157 severely burned patients in August 2nd Kunshan factory aluminum dust explosion accident conforming to the inclusion criteria were collected. Patients suffering AKI within 90 days after admission were enrolled in group AKI, while the others were enrolled in non-AKI group. Single factor analysis was used to choose independent factors associated with AKI, including sex, age, admission time, features of basic injuries, initial score on admission, treatment condition, and mortality on post injury days 30, 60, and 90. Data were processed with Mann-Whitney U test, chi-square test, and Fisher's exact test. Variables with P<0.1 in single factor analysis and those with possible clinical significance were brought into the establishment of prediction model. Logistic regression and XGBoost machine learning algorithm were used to build the prediction model of AKI. The area under receiver operating characteristic curve (AUC) was calculated, and the sensitivity and specificity for optimal threshold value were also calculated for each model. Nonparametric resampling test was used to compare the significance of difference of AUC of the two models. Results: (1) Eighty-nine (56.7%) patients developed AKI within 90 days from admission. Compared with 68 patients in non-AKI group, 89 patients in group AKI were older (Z=-2.203, P<0.05), with larger total burn area and full-thickness burn area (Z=-5.200, -6.297, P<0.01), worse acute physical and chronic health evaluation (APACHE) Ⅱ score, abbreviated burn severity index score, and sequential organ failure assessment (SOFA) score on admission (Z=-7.485, -4.739, -4.590, P<0.01), higher occurrence rate of sepsis (χ(2)=33.087, P<0.01), higher rates of accepting tracheotomy, mechanical ventilation, and continuous renal replacement therapy (χ(2)=12.373, 17.201, 43.763, P<0.01), larger first excision area (Z=-2.191, P<0.05), and higher mortality on post injury days 30, 60, and 90 (χ(2)=7.483, 37.259, 45.533, P<0.01). There were no statistically significant differences in sex, open decompression, admission time, 24-hour fluid volume after admission, 48-hour fluid volume after admission, the first 24-hour urine volume, the second 24 hour urine volume, the first excision time, and inhalation injury (χ(2)=0.529, 3.318, Z=-1.746, -0.016, -1.199, -1.824, -0.625, -1.747, P>0.05). The rates of deep vein catheterization of patients in the two groups were both 100%. (2) There were twenty possible prediction variables for preliminary establishment of model according to the difference results of single factor analysis and clinical significance of variables. (3) The logistic regression prediction model had three variables: APACHE Ⅱ score [odds ratio (OR)=1.36, 95% confidence interval (CI)=1.20-1.53, P<0.001], sepsis (OR=2.63, 95% CI=0.90-7.66, P>0.05), and the first 24-hour urine volume (OR=0.71, 95% CI=0.50-1.01, P>0.05). The AUC of the logistic regression prediction model was 0.875 (95% CI=0.821-0.930), with the specificity and sensitivity of optimal threshold value 84.4% and 77.7%, respectively. (4) XGBoost machine learning model had seven main predictive variables: APACHE Ⅱ score, full-thickness burn area, 24-hour fluid volume after admission, sepsis, the first 24-hour urine volume, SOFA score, and 48-hour fluid volume after admission. The AUC of machine learning model was 0.920 (95% CI=0.879-0.962), higher than that of logistic regression model (P<0.001), with the specificity and sensitivity of optimal threshold value 89.7% and 82.0%, respectively. Conclusions: Sepsis and fluid resuscitation are two important predictive variables that can be intervened for AKI in severely burned patients. Machine learning method has a better performance and can provide more accurate prediction for individuals than logistic regression prediction model, and therefore has good clinical application prospect.

Bioinformatics analysis of aberrantly methylated-differentially expressed genes and pathways in hepatocellular carcinoma

AIM

To discover methylated-differentially expressed genes (MDEGs) in hepatocellular carcinoma (HCC) and to explore relevant hub genes and potential pathways.

METHODS

The data of expression profiling GSE25097 and methylation profiling GSE57956 were gained from GEO Datasets. We analyzed the differentially methylated genes and differentially expressed genes online using GEO2R. Functional and enrichment analyses of MDEGs were conducted using the DAVID database. A protein-protein interaction (PPI) network was performed by STRING and then visualized in Cytoscape. Hub genes were ranked by cytoHubba, and a module analysis of the PPI network was conducted by MCODE in Cytoscape software.

RESULTS

In total, we categorized 266 genes as hypermethylated, lowly expressed genes (Hyper-LGs) referring to endogenous and hormone stimulus, cell surface receptor linked signal transduction and behavior. In addition, 161 genes were labelled as hypomethylated, highly expressed genes (Hypo-HGs) referring to DNA replication and metabolic process, cell cycle and division. Pathway analysis illustrated that Hyper-LGs were enriched in cancer, Wnt, and chemokine signalling pathways, while Hypo-HGs were related to cell cycle and steroid hormone biosynthesis pathways. Based on PPI networks, PTGS2, PIK3CD, CXCL1, ESR1, and MMP2 were identified as hub genes for Hyper-LGs, and CDC45, DTL, AURKB, CDKN3, MCM2, and MCM10 were hub genes for Hypo-HGs by combining six ranked methods of cytoHubba.

CONCLUSION

In the study, we disclose numerous novel genetic and epigenetic regulations and offer a vital molecular groundwork to understand the pathogenesis of HCC. Hub genes, including PTGS2, PIK3CD, CXCL1, ESR1, MMP2, CDC45, DTL, AURKB, CDKN3, MCM2, and MCM10, can be used as biomarkers based on aberrant methylation for the accurate diagnosis and treatment of HCC.

[The clinical significance of EBV DNA analysis in nasopharyngeal carcinoma screening]

Objective:The aim of this study is to explore the value of EBV DNA monitor in high risk population of nasopharyngeal carcinoma (NPC). Method:A total of 366 cases of NPC at high risk were screened for 15 864 cases by ELISA, and 262 cases were randomly selected from low-risk groups. Fifty-eight nasopharyngeal carcinoma patients were also involved. EBV DNA was detected by PCR in 366 NPC high risk patients and followed up for 1 year. The clinical significance of EBV-DNA in screening NPC was compared. Result:The positive rate of EBV-DNA test was 12.0% in primary screening, EBV-DNA test in primary screening was 3.4% in low-risk population, and EBV-DNA in nasopharyngeal carcinoma was 91.4%, The positive rate of the three groups was statistically significant (P<0.01); After one year follow-up, a total of 267 cases returned visit. Positive rate of group A with continuous high risk was significantly higher than group B who was high risk at the first time of visit and non high risk at returned visit (P＜0.05). Conclusion:Quantitative analysis of plasma EBV DNA in high risk population can supply serological risk assessment. It can elevate the efficiency of screening and has significant application value for NPC high risk population.

CHD1 loss sensitizes prostate cancer to DNA damaging therapy by promoting error-prone double-strand break repair

Background

Deletion of the chromatin remodeler chromodomain helicase DNA-binding protein 1 (CHD1) is a common genomic alteration found in human prostate cancers (PCas). CHD1 loss represents a distinct PCa subtype characterized by SPOP mutation and higher genomic instability. However, the role of CHD1 in PCa development in vivo and its clinical utility remain unclear.

Patients and methods

To study the role of CHD1 in PCa development and its loss in clinical management, we generated a genetically engineered mouse model with prostate-specific deletion of murine Chd1 as well as isogenic CHD1 wild-type and homozygous deleted human benign and PCa lines. We also developed patient-derived organoid cultures and screened patients with metastatic PCa for CHD1 loss.

Results

We demonstrate that CHD1 loss sensitizes cells to DNA damage and causes a synthetic lethal response to DNA damaging therapy in vitro, in vivo, ex vivo, in patient-derived organoid cultures and in a patient with metastatic PCa. Mechanistically, CHD1 regulates 53BP1 stability and CHD1 loss leads to decreased error-free homologous recombination (HR) repair, which is compensated by increased error-prone non-homologous end joining (NHEJ) repair for DNA double-strand break (DSB) repair.

Conclusions

Our study provides the first in vivo and in patient evidence supporting the role of CHD1 in DSB repair and in response to DNA damaging therapy. We uncover mechanistic insights that CHD1 modulates the choice between HR and NHEJ DSB repair and suggest that CHD1 loss may contribute to the genomic instability seen in this subset of PCas.

Morin enhances hepatic Nrf2 expression in a liver fibrosis rat model

AIM

To investigate whether morin can reduce hepatic fibrosis by activating the NF-E2-related factor 2 (Nrf2) signaling pathway.

METHODS

Twenty male Sprague-Dawley rats were randomly divided into four groups: control group, morin group, carbon tetrachloride (CCl₄) group, and morin + CCl₄ group. Rats in both the CCl₄ and morin + CCl₄ groups were injected intraperitoneally with CCl₄ at a dose of 2 mL/kg twice a week. Rats in both the morin and morin + CCl₄ groups were treated orally with morin at a dose of 50 mg/kg twice a week. Control rats were treated with vehicle only twice a week. At the end-point of the 8 wk of the experimental period, serum AST, ALT, and ALP were measured, and the liver specimens were obtained for pathological assessment. Real-time PCR and Western blot methods were used to analyze the expression of α-smooth muscle actin (α-SMA), collagen I, collagen III, Nrf2, heme oxygenase (HO-1), and quinone oxidoreductase 1 (NQO1) using frozen liver specimens.

RESULTS

Morin-treated rats in the morin + CCl₄ group had less hyperplasia of fiber tissue, minimal inflammatory cells, and less body weight loss with favorable liver enzyme measurements compared to rats treated with CCl₄ only. Additionally, morin-treated rats had significantly lower mRNA and protein expression of α-SMA, collagen I, and collagen III, but significantly higher mRNA and protein expression of Nrf2, HO-1, and NQO1 compared to rats treated with CCl₄ only (P < 0.05).

CONCLUSION

Morin could play a protective role by inducing the expression of Nrf2 and its downstream antioxidant factors (HO-1 and NQO1) and reducing the expression of α-SMA, collagen I, and collagen III in CCl₄-induced liver fibrosis rats.

[Positions of the implanted stimulating electrodes for artificial facial nerve for inducing contraction of the orbicularis oris muscle in rabbit with peripheral facial paralysis]

Objective: To explore the optimal positions of the implanted stimulating eletrodes for artificial facial nerve (AFN) for inducing contraction of the orbicularis oris muscle (OOM) in rabbit with peripheral facial paralysis. Methods: According to the four microelectrodes of the AFN stimulating side, four modes of the implanted positions were divided. In line with different modes, the electrodes were implanted into the affected OOM of the rabbits with unilateral peripheral facial paralysis. AFN output electric stimulation to induce contraction of the affected OOM with uniform stimulating frequency and pulse length in vitro. Then compared the stimulus threshold amplitude and the peak amplitude separately among different modes by SAS 9.3 version statistical software. Results: The differences of the stimulus threshold amplitude and the peak amplitude had no statistically significant separately between the first mode and the second mode (P>0.05), but there were statistically significant differences between the third mode and the fourth mode (P<0.05). Both kinds of the amplitudes were approximated between the first mode and the second mode respectively, and higher than those in the third mode or the fourth mode. Furthermore, both kinds of the amplitudes in the fourth mode were higher than those in the third mode. Conclusions: The microelectrodes of the AFN stimulating lateral are implanted into the upper lip with a public microelectrode and an output microelectrode, into the lower lip with an output microelectrode, and into the way, which is located to the angle 40° to 45° about the line joining between the midpoint of the ipsilateral auricle root and the corner of the mouth with an output microelectrode. This is the third positional mode which requires lowest effective stimulus current intensity. Thus the mode is suitable as the optimal placement programme.

Significance of Ebp1 and p53 protein expression in cervical cancer

In this study, the ErbB3-binding protein (Ebp1) and p53 protein expression in cervical cancer tissues, and its significance in the prognosis of the disease was investigated. Ebp1 and p53 protein expression was detected by immunohistochemical analysis in cervical cancer tissues (N = 60) and normal tissues adjacent to the cancer tissues (N = 60). The rates of positive Ebp1 and p53 protein expression were 35.0 and 60.0%, respectively. Ebp1 and p53 were overexpressed in cervical cancer tissues, compared to normal tissues (P < 0.05). Ebp1 and p53 protein expression was not correlated with age, tumor size, or family tumor history (P > 0.05). However, high levels of expression of Ebp1 and p53 were positively correlated with the TNM stage and lymphatic metastasis in cervical cancer patients (P < 0.05). The combined determination of Ebp1 and p53 expression levels in cervical cancer patients could support the effective prediction of metastatic potential and patient prognosis.

Ebp1 protein expression in cervical cancer tissue and its significance

The objectives of this study were to observe the changes in expression of ErbB-3 binding protein (Ebp1) in cervical cancer and to investigate their clinic significance. We detected the expression level of Ebp1 in cancerous and adjacent tissues from 56 patients with cervical cancer. We identified 21 Ebp1 positive samples (37.5%) from among the 56 cervical cancer tissue samples and 5 Ebp1 positive samples (8.9%) in the corresponding adjacent tissues; the difference was statistically significant (P < 0.05). No statistically significant (P > 0.05) differences in the rates of positive Ebp1 expression were found between patients under 60 years of age and those equal to or over this age. No statistically significant differences (P > 0.05) were found between patients whose tumor diameters were under 5 cm and those with tumor diameters over 5 cm. No statistically significant differences (P > 0.05) in the Ebp1 positive rates were found among the cervical cancer samples when stratified by grade (I, II, or III). Together, these results demonstrate that Ebp1 protein expression is upregulated in cervical cancer tissues but is not related to clinical pathologic factors such as patient age or tumor size or differentiation level, suggesting that Ebp1 plays an important role in the genesis and growth process of cervical cancer.

Study on the ERCC1 gene polymorphism response to chemotherapy and prognosis of gastric cancer

We conducted a cohort study to investigate the role of 2 single-nucleotide polymorphisms of the excision repair cross-complimentary group 1 (ERCC1) gene polymorphism in response to chemotherapy and clinical outcomes of gastric cancer. A total of 231 patients with newly diagnosed and histopathologically confirmed primary gastric cancer participated in the study. ERCC1 rs11615 and rs3212986 were genotyped. Individuals with the ERCC1 rs11615 TT genotype and the T allele showed a significant poorer response to chemotherapy compared to the wild-type genotype. Patients carrying the rs11615 TT genotype (22.8 months) and the T allele (24.2 months) showed a significantly shorter median survival time when compared with the GG genotype (33.7 months). Cox proportional hazard regression analysis showed that adjusted hazard ratios of overall survival in those carrying the rs11615 TT genotype and the T allele were 2.79 (1.15-7.26) and 1.84 (1.19-2.87) when using the wild-type genotype as a reference variable. In conclusion, this study reports that the ERCC1 rs11615 TT polymorphism can be used as a prognostic marker to determine the clinical outcome of gastric cancer patients treated with 5-fluorouracil-based chemotherapy.

Maslinic acid induces apoptosis in salivary gland adenoid cystic carcinoma cells by Ca2+-evoked p38 signaling pathway

Maslinic acid (MA) is a triterpenoid with a high concentration that exists in olives. This natural compound, which has shown multiple biological activities, was proved to be an anti-tumoral agent more recently. We have investigated the mechanisms of MA with regard to its inhibitory effects on the growth of salivary gland adenoid cystic carcinoma (ACC). We demonstrated that MA at 10-100 μM reduced cell viability in a dose-dependent manner, IC(50) of 43.68 μM, and 45.76 μM, respectively in cultured ACC-2 and ACC-M cells. Fifty micromolars of MA efficiently induced apoptosis as indicated by AO/EB staining, electronic microscopy, flow cytometry, and activation of caspase-3 activity. MA induced an elevation of [Ca(2+)](i) in a dose-dependent manner, and cell viability inhibition and cell apoptosis induced by MA were blocked by an intracellular Ca(2+) chelator, BAPTA-AM. The elevation of [Ca(2+)](i) induced by MA was blocked by EGTA or TRPV channel inhibitor suggesting TRPV channel involved in calcium influx induced by MA. MA also activated ERK and p38 MAPK in a time-dependent manner. MA induced cell apoptosis and activation of caspase-3 activity were reversed by SB203580, but not by PD98059, suggesting that the apoptosis induction of MA was via p38 MAPK, but not via ERK. Chelation of intracellular Ca(2+) with BAPTA reversed MA induced p38 MAPK phosphorylation, but SB203580 did not block MA-evoked elevation of [Ca(2+)](i), suggesting a Ca(2+)-evoked p38 MAPK signaling involved in MA-induced apoptosis in ACC cells. Taken together, in ACC cells, maslinic acid induced an increase in [Ca(2+)](i), which evoked p38 MAPK phosphorylation, subsequently activated caspase-3 leading to apoptosis.

Sulforaphane induces G2-M arrest and apoptosis in high metastasis cell line of salivary gland adenoid cystic carcinoma

New chemotherapeutic strategy should be investigated to enhance clinical management in salivary gland adenoid cystic carcinoma (ACC). Recently, sulforaphane (SFN), as a natural compound from cruciferous vegetables exhibits a potent anti-cancer activity in various tumor cells, but remains uncertain in ACC cells. The present study examined whether SFN suppresses proliferation and in ACC cells, if so, the possible molecular targets would be further investigated. Cell survives, apoptosis, cell cycle progression and molecular targets were identified by multiple detecting techniques, including trypan blue dye exclusion assay, electron microscopy, AO/EB staining, flow cytometry and immunoblotting in human lung high metastasis cell line of salivary gland adenoid cystic carcinoma (ACC-M). The results showed that 5-20 microM SFN suppressed proliferation and induced apoptosis of ACC-M cells in dose- and time-dependent manners. Cell cycle analysis demonstrated treatment of ACC-M cells with 20 microM SFN resulted in G(2)/M cell cycle arrest, which was associated with a marked decline in protein levels of G(2)/M regulatory proteins including cyclin B1 and cyclin-dependent kinase 1 (Cdk1). In terms of apoptosis, SFN increased the expression of Bax and decreased the level of Bcl-2 and subsequently triggered release of cytochrome c from mitochondria and activation of caspase-3, but Fas level and caspase-8 activity remained unchanged at all time points. Furthermore, levels of nuclear factor-kappaB (NF-kappaB) p65 in both of the cytoplasm and the nucleus have also been markedly suppressed by SFN in a time-dependent manner. Taken together, these results suggest SFN inhibits cell growth via inducing G(2)/M cell arrest and apoptosis in ACC-M cells. These events have been associated with SFN-regulated multiple targets involved in ACC-M cell proliferation. The present study provides an evidence for testing SFN efficacy in vivo and warranting future investigations to exam the clinical potential of SFN in ACC chemotherapy.

Vaginal paraganglioma presenting as a gynecologic mass: case report

Paragangliomas in the vagina are extremely rare. Unwitting surgical excision of a functional paraganglioma may precipitate life-threatening complications. We present a case of a 38-year-old woman with a vaginal mass 3.0 cm in diameter who experienced a hypertensive crisis during an unwitting attempted surgical excision of the vaginal mass. The diagnosis of a vaginal functional paraganglioma was then made based on to her 16-year history of paroxysmal headaches, chest distress, palpitation and elevated levels of urinary vannillylmandelic acid (VMA). Consequently, after thorough presurgical preparation, the patient again underwent excision of the vaginal mass uneventfully. She has been followed-up for three years since surgery without any evidence of recurrence. The clinical features and perioperative management of functional vaginal paraganglioma are described.

[5-HT3 receptors in amygdala mediate neuroimmunomodulation in rats]

The present study was to explore the possible immunomodulatory role of 5-HT3 receptors in the amygdala in rats. Concanovalin A (Con A)- and lipopolysaccharide (LPS)-stimulated splenocyte proliferation response (SPR), production of IL-2, activity of natural killer (NK) cells and serum cortisol were measured by 3H-TdR incorporating method, MTT method and RIA, respectively. The Con A- and LPS-stimulated SPR was enhanced in a dose-dependent manner by 5-HT3 receptor antagonist granisetron (GNT) (0.1-0.4 mg/kg, i.p.). SPR was also enhanced by intracerebroventricular (icv) administration of 1-phenylbiguanide (PBG, 10 micrograms/d). Con A-stimulated SPR and production of IL-2 were increased either by bilateral or by unilateral central amygdala (CeA) microinfusion of PBG (0.5 microgram/side), but LPS-induced SPR and NK cell activity were not affected. On the contrary, the LPS-induced SPR was increased by either bilateral or unilateral basomedial amygdala (BmA) microinfusion of PBG (0.5 microgram/side). The plasma cortisol level was significantly raised by CeA or BmA PBG microinfusion, but the effect induced by PBG intra-CeA was greater than that induced by PBG intra-BmA (P < 0.01). The effects of icv PBG and intra-amygdala infusion were antagonized by granisetron. Asymmetrical modulation of immune reactivity by 5-HT3 receptors in CeA or BmA was not observed in these experiments. It is suggested that 5-HT3 receptors within the amygdala may modulate rat mitogen-stimulated SPR in different manners.

Oxidized lipoprotein(a) enhanced the expression of P-selectin in cultured human umbilical vein endothelial cells

Lipoprotein(a) [Lp(a)] has been demonstrated to be an independent risk factor for coronary heart disease. However, the precise mechanism by which it contributes to the development of atherosclerosis remains unclear. P-selectin is one of the major adhesion molecules to mediate the interaction between monocytes, platelets and endothelial cells. Increased expression of P-selectin has been frequently found in atherosclerotic lesions. The present study assessed the effects of native and oxidized LDL (n-LDL and ox-LDL) and Lp(a) (n-Lp(a) and ox-Lp(a)) on the expression of P-selectin in cultured human umbilical vein endothelial cells (HUVECs). Cell ELISA was used to measure the expression of P-selectin in HUVECs and monocyte adhesion assay was used to detect whether the P-selectin expressed in HUVECs was functional. P-selectin mRNA expression in HUVECs was determined by Northern blot. Results showed that P-selectin protein expression was not influenced by n-LDL, but was moderately increased by ox-LDL and n-Lp(a). ox-Lp(a) was the most potent stimulus for P-selectin expression, increasing it in HUVECs by 144 +/- 10% at 10 nmol/l and 202 +/- 22% at 20 nmol/l. In addition, it showed that dose dependency induced monocyte adherence to endothelial cells after incubation of HUVECs with ox-Lp(a). Northern blot analysis demonstrated that the amount of P-selectin mRNA was markedly increased after treatment with ox-Lp(a) but not with n-LDL, ox-LDL and n-Lp(a). These results demonstrate that ox-Lp(a) can induce P-selectin expression in HUVECs, which may thereby influence the pathogenesis of athersclerosis.

Oxidized lipoprotein(a) increases the expression of platelet-derived growth factor-B in human umbilical vein endothelial cells

Lipoprotein(a) ¿Lp(a) has been demonstrated to be an independent risk factor for atherosclerosis and restenosis after angioplasty. However, the precise mechanism by which it contributes to the development of both remains unclear. Platelet-derived growth factor (PDGF) is one of the key factors that induce the proliferation and migration of vascular smooth muscle cells. The present study investigated the effects of native and oxidized LDL ¿n-LDL and ox-LDL and Lp(a) ¿n-Lp(a) and ox-Lp(a) on the expression of PDGF-B in cultured human umbilical vein endothelial cells (HUVECs). Results showed that PDGF-B expression was not influenced by n-LDL, but was moderately increased by ox-LDL and n-Lp(a). Ox-Lp(a) was the most potent stimulus for PDGF-B expression, increasing it in HUVECs by 156%+/-18% at 5 nmol/l and 219%+/-42% at 20 nmol/l. Northern Blot analysis demonstrated that the amount of PDGF-B mRNA was markedly increased after treatment with ox-Lp(a) but not n-LDL, ox-LDL and n-Lp(a). These results demonstrate that ox-Lp(a) can elicit PDGF-B expression in HUVECs, which may thereby influence the pathogenesis of atherosclerosis and restenosis after angioplasty.

The effect of stevioside on blood pressure and plasma catecholamines in spontaneously hypertensive rats

Stevioside is a sweet-tasting glycoside, composed of stevia, a diterpenic carboxylic alcohol with three glucose molecules, mainly used as a substitute for non-alcoholic sweetener. It has previously been shown to reduce blood pressure in studies in animals and human. The effect of intravenous stevioside on the blood pressure was studied in spontaneously hypertensive rats (SHR). The hypotensive effect on both systolic and diastolic blood pressure was dose-dependent for intravenous doses of 50, 100 and 200 mg/kg in conscious SHR. The maximum reductions in systolic and diastolic blood pressure were 31.4 +/- 4.2% and 40.8 +/- 5.6% (mean +/- SEM) respectively and the hypotensive effect lasted for more than 60 min with a dose of 200 mg/kg. Serum dopamine, norepinephrine and epinephrine levels were not changed significantly 60 min after intravenous injection of stevioside 100 mg/kg in anesthetized SHR. The present data show that stevioside given intravenously to conscious SHR was effective in blood pressure reduction and there was no change in serum catecholamines in anaesthetized animals with this natural compound.

Elevated plasma levels of soluble P-selectin in patients with acute myocardial infarction and unstable angina. An inverse link to lipoprotein(a)

P-selectin in platelets and endothelial cells mediates adhesive interactions between platelet, leukocyte and endothelium to form thrombi. The purpose of the present study was to investigate the plasma level of soluble P-selectin (sP-selectin) in patients with coronary heart disease and the relationship between sP-selectin and plasma concentration of lipoprotein(a) [Lp(a)]. Levels of sP-selectin and Lp(a) were determined by enzyme-linked immunoabsorbent assay on plasma taken from patients with acute myocardial infarction (AMI), old myocardial infarction (OMI), unstable angina (UA), stable angina (SA) and the controls. In patients with AMI and UA, sP-selectin levels (79.62+/-3.82 ng/ml, 43.75+/-2.97 ng/ml, respectively) were significantly higher (P<0.01) than those in patients with OMI (15.92+/-1.34 ng/ml), SA (15.31+/-1.51 ng/ml), and the controls (14.93+/-1.33 ng/ml), but there was no difference between AMI and UA groups. Among all subjects studied, there was an inverse correlation between Lp(a) and sP-selectin (r=-0.315 P<0.001). These findings indicate that plasma levels of sP-selectin are increased in patients with AMI and UA, and high levels of soluble P-selectin may play a role in the pathogenesis of acute coronary events.

Pinacidil suppression on 5-HT3 receptor-mediated contraction of guinea pig ileum in vitro

AIM

To study the effects of the K+ channel opener pinacidil on 5-HT3 receptor-mediated contractions of the isolated guinea pig ileum (GPI) longitudinal muscle-myenteric plexus strip preparations.

METHODS

GPI contractions were recorded with a chart recorder through isometric transducers. The effect of pinacidil on binding properties of 5-HT3 receptors was assessed using [3H]GR65630 binding assay in membrane preparations of rat entorhinal cortex.

RESULTS

(1) A selective 5-HT3 receptor agonist 2-methyl-5-HT 0.1-300 mumol.L-1 and 5-HT 0.001-50 mumol.L-1 elicited GPI contractile responses in concentration-dependent manners, the EC50 values (and 95% confidence limits) for 2-methyl-5-HT and 5-HT were 10.0 (8.9-11.2) mumol.L-1 and 1.6 (1.3-1.9) mumol.L-1, respectively. Selective 5-HT3 receptor antagonist tropisetron 0.1 mumol.L-1 competitively inhibited the responses to 2-methyl-5-HT and 5-HT. (2) Pinacidil 0.5-5 mumol.L-1 inhibited 5-HT3 receptor-mediated contractions. (3) Pinacidil 1 mumol.L-1 enhanced the inhibitory effects of tropisetron 0.1 mumol.L-1 or another selective 5-HT3 receptor antagonist benesetron 1 mumol.L-1 on 5-HT-induced GPI contractile responses. (4) Pinacidil 1-5 mumol.L-1 did not affect GPI contractile responses evoked by a selective M-ACh receptor agonist carbachol 1 mumol.L-1. (5) Pinacidil 1-5 mumol.L-1 had no effect on binding properties of 5-HT3 receptors with selective 5-HT3 receptor radioligand [3H]GR65630 in the entorhinal cortex of rat brain.

CONCLUSION

The inhibition by pinacidil of 5-HT3 receptor-mediated GPI contractile responses may be mediated through activation of ATP-sensitive K+ channels located in prejunctional myenteric neurons.

Systemic fibrous dysplasia involving multiple bones in human body. Report of 4 cases

Four cases of systemic fibrous dysplasia were selected from 356 cases of fibrous dysplasia. All of them were verified pathologically. In these 4 cases, the long, short, flat and irregular bones were involved. Some of the changes were characteristic in comparison with those of the monostotics or regional types. This disorder was often seen clinically in females, started in early childhood and exacerbated during puberty. Its main symptoms were primary or secondary deformities. Radiologically, the main changes were diffuse and uniform expansion and developmental disturbances of the bones and joints.

Neuroarthropathy. Clinico-radiologic analysis of 115 cases

115 patients (163 joints) with neuroarthropathy (Charcot joint) were observed clinically and radiologically. In Charcot joint of the shoulder, the entire scapula was disintegrated. After debridement and arthrodesis, fragmentation of bone reappeared at both ends of the affected long bone and even on the lateral surface of diaphysis. Fragmentation of the articular surface and the subchondral bone was seen in the non-weight-bearing surface. 32 patients in this series sustained spontaneous fractures without a history of trauma or undue strain. Follow-up for short periods (2 to 6 weeks) showed rapid progressive destruction. These results indicated that neurotrophic theory seems to furnish an explanation for the pathogenesis of the Charcot joint, and that bone resorption should be the primary change while bone hypertrophy and proliferation, the secondary.

Extraskeletal chondrosarcoma. Report of 8 cases

Eight cases of surgically and pathologically verified extraskeletal (soft tissue) chondrosarcoma were analyzed with regard to clinical and X-ray features. Their cardinal clinical aspects included presence of a local soft tissue mass and gradual enlargement of the mass accompanied by increasing pain. The X-ray signs were formation of a soft tissue mass, various forms of calcification in the central area of the tumor presence of saucer-like defect on the cortical surface of neighbouring bone in some cases, and bending deformity of the affected bone. The incidence and sites of predilection, the main X-ray findings, radiological diagnosis and differential diagnosis of the tumor were discussed.

[Studies on the classification of thermophilic actinomycetes. IV. Determination of thermophilic Streptomyces hygroscopicus group]

The thermophilic streptomyces hygroscopicus is one of the pathogens of farmer's lung disease. The identified 60 strains of thermophilic streptomyces hygroscopicus coming from the isolates from the haystack, moldy hay and sputa collected from Jiangsu, Hubei province and Shanghai in China. These strains are grown around 50 degrees C and have moist patches on the surface of colonies. It is proved that protease can be extracted from cultured H9-4 strain. This protease is provided with antigen, the farmer's lung disease of rabbit can be induced in animals experiments. On clinical diagnosis the farmer's lung disease can be detected by sera test. From the identification of the 60 thermophilic streptomyces hygroscopicus strains, we found the morphological cultural, physiological characteristics and cell wall composition of H9-4 and T562 well different from description hitherto. So two of them are identified as new species. H9-4 is named as Streptomyces thermoendus sp. nov. and T562 is named as Streptomyces thermobicorno-hygroscopicus sp. nov.

[Neuroarthropathy (a clinico-radiologic analysis of 115 cases)]

The clinical and radiological observations of 115 patients (163 joints) with neuroarthropathy (Charcot joint) were presented. The main clinical and typical X-ray findings as well as the radiologic features of different joints were described: (1) In Charcot joint of the shoulder, the entire scapula bone may be disintegrated; (2) After cleaning and arthrodesis, fragmentation of bone may reappear at both ends of the affected long bone and even the lateral surface of diaphysis; (3) Fragmentation of articular surface and subchondral bone may be seen in non-weight bearing surface; (4) 32 cases in our series had spontaneous fractures without history of trauma or undue strain; (5) Follow-up observation in short period (two to six weeks) showed rapid progressive destruction. The authors were of the opinion that neurotrophic theory seems to be the important pathogenesis of Charcot joint. While bone resorption should be the primary change. Bone hypertrophy and proliferation are secondary changes.

[Chondrosarcoma: clinical and radiological analysis of 206 cases]

206 cases of chondrosarcoma including central type 159 cases and peripheral type 47 all proved by surgery and pathology were analysed. The important aggressive X-ray signs of central (primary) chondrosarcoma include: Infiltrating, notching and scalloping of the endosteal cortical surface; irregular and ill-defined margin between tumor and bone, transition zone widened or 'moth-eaten' in appearance; soft tissue tumor mass may grow eccentrically or concentrically around the bone; various patterns of calcification within the tumor and localized laminated periosteal reaction. The radiologic features of the secondary peripheral chondrosarcoma are: fuzzy and indistinct surface in the region of the cartilaginous cap which becomes irregular and thickened (more than 1 cm); formation of a soft tissue mass containing faint flocculent or ring-like calcifications; the "bursting" and scattering of old calcifications in the depth of the cartilage cap and destruction of adjacent bone.

HPLC separation and characterization of chlorin derivatives with intact ring V from acid degradation products of silkworm excrement crude chlorophyll mixture

A reversed-phase HPLC system with 88% methanol in 1 M ammonium acetate buffer pH 5.35 as the mobile phase on an ODS column was used to analyse pheophorbides a, a', b, b' and pyropheophorbides a and b. Pyropheophorbides a and b were found in samples obtained from silkworm excrement but not from spinach leaves though the preparation methods used were the same. This difference suggests that chlorophylls undergo metabolism in the body of silkworm to give pyrochlorophyll derivatives.