Intramedullary nailing for irreducible spiral subtrochanteric fractures: A comparison of cerclage and non-cerclage wiring

PURPOSE

Intramedullary nailing is the preferred internal fixation technique for the treatment of subtrochanteric fractures because of its biomechanical advantages. However, no definitive conclusion has been reached regarding whether combined cable cerclage is required during intramedullary nailing treatment. This study was performed to compare the clinical effects of intramedullary nailing with cerclage and non-cerclage wiring in the treatment of irreducible spiral subtrochanteric fractures.

METHODS

Patients with subtrochanteric fractures admitted to our center from January 2013 to December 2021 were retrospectively analyzed. The patients were enrolled in the case-control study according to the inclusion and exclusion criteria and divided into the non-cerclage group and the cerclage group. The patients' clinical data, including the operative time, intraoperative blood loss, hospital stay, reoperation rate, fracture union time, and Harris hip score, were compared between these 2 groups. Categorical variables were compared using Chi-square or Fisher's exact test. Continuous variables with normal distribution were presented as mean ± standard deviation and analyzed with Student's t-test. Non-normally distributed variables were expressed as median (Q1, Q3) and assessed using the Mann-Whitney test. A p value < 0.05 was considered significant.

RESULTS

In total, 69 patients were included in the study (35 patients in the non-cerclage group and 34 patients in the cerclage group). The baseline data of the 2 groups were comparable. There were no significant difference in the length of hospital stay (z = -0.391, p = 0.696), operative time (z = -1.289, p = 0.197), or intraoperative blood loss (z = -1.321, p = 0.186). However, compared with non-cerclage group, the fracture union time was shorter (z = -5.587, p < 0.001), the rate of nonunion was lower (χ2 = 6.030, p = 0.03), the anatomical reduction rate was higher (χ2 = 5.449, p = 0.03), and the Harris hip score was higher (z = -2.99, p = 0.003) in the cerclage group, all with statistically significant differences.

CONCLUSIONS

Intramedullary nailing combined with cable cerclage wiring is a safe and reliable technique for the treatment of irreducible subtrochanteric fractures. This technique can improve the reduction effect, increase the stability of fracture fixation, shorten the fracture union time, reduce the occurrence of nonunion, and contribute to the recovery of hip joint function.

[Clinical characteristics and prognosis of 28 cases of infant acute lymphoblastic leukemia]

Objective: To analyze the clinical characteristics and prognosis of patients with infant acute lymphoblastic leukemia (IALL). Methods: A retrospective cohort study.Clinical data, treatment and prognosis of 28 cases of IALL who have been treated at Beijing Children's Hospital, Capital Medical University and Baoding Children's Hospital from October 2013 to May 2023 were analyzed retrospectively. Based on the results of fluorescence in situ hybridization (FISH), all patients were divided into KMT2A gene rearrangement (KMT2A-R) positive group and KMT2A-R negative group. The prognosis of two groups were compared. Kaplan-Meier method and Log-Rank test were used to analyze the survival of the patients. Results: Among 28 cases of IALL, there were 10 males and 18 females, with the onset age of 10.9 (9.4,11.8) months. In terms of immune classification, 25 cases were B-ALL (89%), while the remaining 3 cases were T-ALL (11%). Most infant B-ALL showed pro-B lymphocyte phenotype (16/25,64%). A total of 22 cases (79%) obtained chromosome karyotype results, of which 7 were normal karyotypes, no complex karyotypes and 15 were abnormal karyotypes were found. Among abnormal karyotypes, there were 4 cases of t (9; 11), 2 cases of t (4; 11), 2 cases of t (11; 19), 1 case of t (1; 11) and 6 cases of other abnormal karyotypes. A total of 19 cases (68%) were positive for KMT2A-R detected by FISH. The KMT2A fusion gene was detected by real-time PCR in 16 cases (57%). A total of 24 patients completed standardized induction chemotherapy and were able to undergo efficacy evaluation, 23 cases (96%) achieved complete remission through induction chemotherapy, 4 cases (17%) died of relapse. The 5-year event free survival rate (EFS) was (46±13)%, and the 5-year overall survival rate (OS) was (73±10)%.The survival time was 31.3 (3.3, 62.5) months. There was no significant statistical difference in 5-year EFS ((46±14)% vs. (61±18)%) and 5-year OS ((64±13)% vs. (86±13)%) between the KMT2A-R positive group (15 cases) and the KMT2A-R negative group (9 cases) (χ2=1.88, 1.47, P=0.170, 0.224). Conclusions: Most IALL patients were accompanied by KMT2A-R. They had poor tolerance to traditional chemotherapy, the relapse rate during treatment was high and the prognosis was poor.

[Ultrasound-guided continuous fascia iliaca compartment block for perioperative pain management in elderly patients undergoing hip fracture surgery]

OBJECTIVE

To study the effect of ultrasound-guided fascia iliaca compartment block on perioperative analgesia and postoperative complications in geriatric patients with hip fractures.

METHODS

A total of 127 elderly patients undergoing hip fracture surgery from January 2021 to September 2021 were randomized to receive ultrasound-guided continuous fascia iliaca compartment block(group F) either intravenous analgesia control group(group C). There were 62 cases in group F, including 19 males and 43 females with an average age of (82.4±7.2) years old ranging from 66 to 95 years old, involving 25 femoral neck fractures and 37 femoral intertrochanteric fractures. There were 65 cases in control group, including 18 males and 47 females, with an average age of (81.4±8.7) years old ranging from 65 to 94 years old, involving 29 femoral neck fractures and 36 femoral intertrochanteric fractures. The visual analogue scale(VAS), minimental state examination (MMSE), observer's assessment of alertness/sedation(OAA/S) scale, modified Bromage score, postoperative complications and general conditions during hospitalization in two groups were observed.

RESULTS

The resting and exercise VAS at 30 min after block, anesthesia placement and 6, 24 and 48 h after surgery were lower than those in group C(P<0.05). In group F, MMSE scores at 12 h before surgery, and 1, 3 d after surgery and OAA/S scores at 3 d after surgery were higher than those in group C(P<0.05). The incidence of adverse effects and the number requiring additional analgesia were lower than those in group C(P<0.05). Group F had better perioperative analgesia satisfaction and hospital stay than group C(P<0.05). But there was no significant difference regarding Bromage score and 30-day mortality between two group(P>0.05).

CONCLUSION

Ultrasound-guided continuous fascia iliacus space block was safe and effective for elderly patients with hip fracture, and could significantly reduce perioperative pain, improve postoperative cognitive function, and reduce postoperative complications, thereby shortening hospital stay and improving the quality of life during hospitalization.

[Evaluation of the effect of comprehensive prevention and management of diabetes mellitus of two cross-sectional surveys based on community population]

To investigate the prevalence of diabetes mellitus (DM) among residents in Chongchuan district, Nantong city in 2012 and 2018, and evaluate the effectiveness of community comprehensive management of DM. Based on the data of 17 780 and 13 382 residents in the cross-sectional surveys of the " National Demonstration Area for Comprehensive Prevention and Control of Chronic Diseases " project in Chongchuan District of Nantong City, Jiangsu Province in 2012 and 2018, 4 583 and 3 996 DM-related information were obtained. The population of Jiangsu Province in 2012 and 2018 was used as the reference for standardization. The rates of prevalence and management (including awareness, treatment, treatment of patients who knew their diabetic situation, control and control of patients under treatment) of DM in the two surveys were compared using chi-square test. The results showed that in 2012 and 2018, the prevalence rates of DM were 12.0% and 15.7% (χ²=24.25, P<0.05), and the standardized rates were 10.1% and 10.8% (χ²=1.05, P=0.306). The incidence rates were 5.7% and 2.3%, respectively (χ²=55.60, P<0.05). The standardized prevalence rates in the two surveys were 9.7% and 11.6% for males (χ²=3.66, P=0.056) and 10.5% and 9.9% for females (χ²=0.50, P=0.481), 7.2% and 6.5% (χ²=0.85, P=0.357) for people aged 18-59 years old and 20.6% and 21.9% (χ²=0.91, P=0.339) for people aged 60 years and over, respectively. The standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, control, and control of patients under treatment in 2018 were 84.4%, 80.3%, 95.2%, 58.4%, and 70.2%, respectively, higher than 47.2%, 23.4%, 44.8%, 30.4% and 59.4% in 2012 (χ²=183.33, χ²=380.65, χ²=282.99, χ²=93.24, χ²=6.22, all P<0.05). Among men, the standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, and control in 2018 were 85.8%, 78.8%, 91.8% and 62.7%, higher than 50.5%, 37.5%, 72.3% and 32.6% in 2012 (χ²=78.40, χ²=96.17, χ²=27.55, χ²=48.96, all P<0.05). Similarly, the standardized management rates in 2018 were 83.0%, 81.7%, 98.5%, 54.1% and 65.1%, higher than 44.0%, 10.0%, 18.3%, 28.2% and 48.8% in 2012 among women (χ²=105.52, χ²=326.36, χ²=317.22, χ²=43.34, χ²=3.87, all P<0.05). The standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, and control of people aged 18-59 and 60 years and over were 82.9%, 79.7%, 96.1%, 55.0% and 88.0%, 81.8%, 93.0% and 67.2%, higher than 42.6%, 19.8%, 42.2%, 27.5% and 63.9%, 36.8%, 53.9%, 40.8% in 2012 (χ²=44.51, χ²=102.17, χ²=57.78, χ²=21.65, all P<0.05; χ²=71.18, χ²=181.55, χ²=146.26, χ²=59.23, all P<0.05). The comprehensive prevention and control system of chronic diseases, which comprehensively covered the life of community residents, had good management effect on DM, and effectively promoted health education and health promotion.

[Clinical application of LASEREO endoscopic system in early gastric cancer]

Objective: To evaluate the clinical application of LASEREO endoscopic system in early gastric cancer (EGC). Methods: A total of 68 patients diagnosed with EGC were retrospectively analyzed between August 2017 to December 2020 in Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine. There were 50 males and 18 females finally enrolled with a median age of 64 years. EGCs were analyzed from subjective and objective aspect, as well as from magnification and non-magnification status. Six endoscopists evaluated the visibility of the EGC (RSC) and calculated the color difference (ΔEC) between EGC and the surrounding mucosa in white light imaging (WLI), blue light imaging-bright (BLI-Bri) and linked color imaging (LCI) modes. In the case of magnification (×80), the visibility of the microstructures and microvessels (RSV) was analyzed and the color difference (ΔEV) between microvessels and non-vessels areas were calculated in WLI, BLI and LCI modes. The visibility was evaluated using visibility ranking scale(RS) and the color difference (ΔE) was calculated using L*a*b* color space. Results: In WLI, BLI-Bri, and LCI modes, the mean (±SD) RSC were 2.56±0.68, 2.63±0.59 and 3.17±0.50, and the mean(±SD) ΔEC were 15.71±5.58, 12.04±3.73, and 22.84±8.46, respectively, which in LCI were higher than those in WLI and BLI-Bri modes (P<0.001).Regarding the data evaluated by senior endoscopists, the RSC was higher in BLI-Bri than that in WLI mode (2.98±0.58 vs. 2.79±0.73, P<0.001), but as to those evaluated by junior endoscopists, there were no significant differences between the WLI and BLI-Bri modes(2.29±0.72 vs. 2.23±0.72,P =0.218).In magnifying endoscopy with WLI, BLI, and LCI modes, the mean(±SD) RSV were 2.95±0.28, 3.46±0.40, and 3.38±0.33, and the mean (±SD) ΔEV were 21.68±7.52, 44.29±10.94, and 45.38±14.29, respectively.The RSV and ΔEV in LCI and BLI were higher than that in WLI mode (P<0.001). Conclusions: LCI improves the visibility of EGC by increasing ΔEC, especially in junior endoscopists. Both BLI and LCI improve the visibility of microstructures and microvessels under magnification.

[Exploring the teaching mode about clinical laboratory diagnostic pathway for chronic hepatitis B]

Exploring a new teaching mode of CHB laboratory diagnostics to improve the teaching quality through establishment a teaching model covered the whole process of CHB disease diagnosis and differential diagnosis, treatment, drug selection, the toxicity and side effects prediction, effect monitoring, and prognosis evaluation. According to the CHB clinical diagnosis and treatment guidelines, formulated the laboratory examination and detection strategies related to different stages of CHB, and established CHB clinical laboratory diagnostic pathway. Compared the classroom teaching effect by the questionnaire between the 2016 and 2017 eight-year undergraduates from the First Clinical College of Wuhan University. In this study,the CHB clinical laboratory diagnostic pathway was established and approved by clinicians, which covered the whole process of CHB disease diagnosis and differential diagnosis, treatment, drug selection, the toxicity and side effects prediction, effect monitoring, and prognosis evaluation. The teaching quality evaluation indicators and the scores on the class test had been greatly improved with the clinical diagnostic pathway teaching mode in the classroom teaching of 2017 clinical medicine undergraduates compared with the traditional teaching mode in the 2016 clinical medicine undergraduates. In summary, the medical students not only could realize the organic integration of laboratory diagnostics and clinical medicine, but also improves overall understanding of various laboratory tests in CHB diagnosis and treatment from the teaching model of laboratory diagnostics based on the CHB clinical laboratory diagnostic pathway,and the quality of teaching for CHB has been significantly improved.

A rapid detection of tomato yellow leaf curl virus using recombinase polymerase amplification-lateral flow dipstick assay

Tomato yellow leaf curl disease which is caused by Tomato yellow leaf curl virus (TYLCV) is economically important and a widely spread tomato disease in China. Rapid and accurate detection methods are important in the control TYLCV. Here, a rapid method was developed to identify TYLCV on the basis of recombinase polymerase amplification (RPA) that can be visualized in 5 min using lateral flow dipsticks. The sensitivity and the specificity of this method were evaluated. This method can detect 0·5 pg DNA after 30 min at 37°C without any expensive instrumentation. In addition, it showed higher sensitivity than a PCR method when purified DNA was used. Moreover, the TYLCV was specifically detected, whereas other viruses infecting tomato produced negative results. The crude tomato extracts used in this assay has potential application in minimally equipped plant clinic laboratories. This method will facilitate the early and rapid detection of TYLCV for the timely application of control measures.

[Clinical characteristics and gene expression profiles in children with ETV6-RUNX1 acute lymphoblastic leukemia]

目的

通过基因表达谱研究儿童ETV6-RUNX1阳性急性淋巴细胞白血病（ALL）异质性，探索不同聚类分组临床特征，为临床个性化诊疗及利用测序技术探索预后相对不良组预测模型提供可行性参考。

方法

应用改进的基因片段分析技术对2016年8月至2019年6月北京儿童医院收治的264例初诊ALL患儿的骨髓标本进行57个分型基因检测和聚类分析，重点分析56例ETV6-RUNX1阳性患者的基因表达谱与临床特点、免疫表型和早期化疗反应的关系。

结果

基因分型聚类显示ETV6-RUNX1阳性ALL被分为两组：E/R-1组（45例，80.4%）和E/R-2组（11例，19.6%）。E/R-2聚类离散度大于E/R-1，spearman相关系数分别为0.788、0.901；E/R-2、E/R-1组初诊PLT中位数分别为104（27～644）×10⁹/L、50（8～390）×10⁹/L（P<0.01），初诊骨髓原始幼稚细胞比例分别为0.830（0.270～0.975）、0.935（0.445～0.990）（P<0.05）；CD22⁺CD34⁺CD20⁻CD117⁻CD56⁻免疫组合在E/R-2组占比更高（P<0.001）；E/R-2和E/R-1组化疗第33天流式细胞术检测的微小残留病（MRD）转阴例数分别为5例（55.6%）和32例（88.9%）（P＝0.064），去除临界值病例敏感性分析转阴例数分别为5例（55.6%）和32例（91.4%）（P＝0.035）；第33天PCR检测的MRD转阴例数分别为7例（77.8%）和36例（100.0%）（P＝0.047）。

结论

ETV6-RUNX1阳性ALL患儿在基因表达谱层面存在异质性，符合E/R-2表达特征的患儿可能初诊时血小板减少倾向小但早期化疗反应相对不良。

[Study on the correlation between dietary N-glycolylneuraminic acid intake and chronic inflammation state of body]

Objective: To explore the correlation between dietary N-glycolylneuraminic acid (Neu5Gc) intake and chronic inflammation state of body. Methods: A total of 306 samples of 102 types of food were purchased from a supermarket in Xiamen in September 2019, including grains, meat, poultry, seafood, eggs, beans, dairy products, vegetables and fruits. The content of Neu5Gc in food was determined by liquid chromatography-mass spectrometry. A total of 500 healthy freshmen from Xiamen University were selected by using a simple random sampling method. The food frequency questionnaire was used to investigate the food intake in the past year. The food intake was corrected by 3 consecutive 24-hour recalls, and the amount of Neu5Gc intake was calculated. The concentration of anti-Neu5Gc antibody, C-reactive protein (CRP) and interleukin-6 (IL-6) in serum was detected. Spearman correlation analysis was used to explore the correlation between Neu5Gc intake and anti-Neu5Gc antibody, CRP and IL-6 levels. Results: Neu5Gc was mainly found in red meat and liquid dairy products. The contents of Neu5Gc in beef, lamb and pork were (30.32±2.84), (20.39±4.73) and (5.58±1.04) mg/kg, respectively, and in liquid milk and yogurt were (10.87±1.54) and (6.91±0.24) mg/L, respectively. The M (P₂₅, P₇₅) intake of Neu5Gc for all participants was 4.62 (2.20, 8.60) mg/d. The M(P₂₅, P₇₅) intake of Neu5Gc for males about 6.60(2.83, 10.20) was higher than that for females about [3.84 (1.84, 6.35) mg/d] (P<0.001). The M (P₂₅, P₇₅) of serum anti-Neu5Gc, CRP and IL-6 levels were 3.07 (2.17, 4.14) μg/ml, 0.37 (0.22, 0.87) mg/ml and 61.82 (12.23, 315.30) pg/ml, respectively. Spearman correlation analysis showed that the intake level of Neu5Gc was positively correlated with serum anti-Neu5Gc antibody, CRP and IL-6 levels, with r_s values about 0.222, 0.102 and 0.126, respectively (all P values <0.05). Conclusion: Dietary Neu5Gc intake is mainly from red meat and liquid dairy products, and its intake level is positively correlated with chronic inflammatory state of body.

[Preliminary study on the elimination of artifacts of five kinds of dental prosthetic materials by energy spectrum CT multi-material artifact reduction technology]

Objective: To investigate the effect of the multi-material artifact reduction (MMAR) algorithm of spectral CT in reducing the beam hardening artifacts in dental restoration material. Methods: Three-unit fixed bridge restorations were fabricated on the first to third molars in pig jaw. Gold alloy, zirconia, cobalt chromium alloy, nickel chromium alloy and pure titanium were used as materials for these fixed bridges. After restoration delivery, the pig jaw was scaned using energy spectrum CT machines. Images in regular 120 kVp scan mode were used as conventional group, and reconstructed single-energy horizontal images of 80, 90, 100, 110, 120, 130 and 140 keV in energy spectrum scanning mode were used as energy spectrum group, and reconstructed images applied MMAR technology in energy spectrum scanning mode were used as energy spectrum MMAR group. Each group was scanned 10 times to measure CT value and noise of muscles around dental prosthetic materials and adjacent non-artifact layers. Artifact index was calculated. Two radiologists scored the image quality of each group subjectively. Kruskal Wallis rank sum test was used to compare the difference of image noise, artifact index and subjective score among the control group and the best keV condition in the energy spectrum group and the energy spectrum MMAR group. Results: The image noise of energy spectrum group and energy spectrum MMAR group decreased gradually with the increase of single energy level. The artifact index of pure titanium restorations in conventional group, energy spectrum group and energy spectrum MMAR group were 71.0±8.0, 21.4±2.7 and 14.7±2.7 respectively, and these values were significantly lower than those of other materials in the same group (P<0.05). The subjective image quality scores in energy spectrum MMAR group were as follows: 3.0±0.2 for gold alloy, 4.3±0.5 for zirconia, 3.0±0.4 for cobalt chromium alloy, 3.1±0.4 for cobalt chromium alloy, and 4.6±0.5 for pure titanium. These scores were significantly smaller than those in the conventional group (P<0.05). There was no significant difference in noise between energy spectrum group and energy spectrum MMAR group (P>0.05), and the noise values in energy spectrum group and energy spectrum MMAR group were significantly lower than that in the conventional group (P<0.05). Conclusions: Artifacts of pure titanium is minimal. Energy spectrum CT combined with MMAR technology can effectively reduce the artifacts of gold, zirconia, cobalt-chromium alloy, nickel-titanium alloy and pure titanium. This technique can be used as an effective method to remove artifacts of dental prosthesis.

Local dermal application of a compound lidocaine cream in pain management of cancer wounds

The aim of this study was to explore the analgesic effect of local application of compound lidocaine/prilocaine cream on cancer wounds during wound care in order to reduce the amount of morphine intake or completely replace the systemic morphine administration and optimize the protocol for cancer wound pain management. All patients were enrolled with a visual analog scale (VAS) pain score ≥4. Before wound care, 60 patients were randomly divided into 2 groups of 30 each: morphine group (10 mg tablet); topical 5% compound lidocaine cream group (0.2 g/cm²). VAS scores, heart rate, and Kolcaba comfort level were recorded for the two groups 10 min before and 10, 15, 20, and 25 min after wound care and data were analyzed statistically. The means for the pain score and heart rate of the topical lidocaine/prilocaine cream group were lower than those of the morphine group (P<0.01) and the Kolcaba comfort level was higher (P<0.01). Local dermal application of the compound lidocaine cream can be used as an alternative to the systemic morphine administration in cancer wound care for its safety and effectiveness. In addition, it can improve the patients' comfort and quality of life.

PM2.5 stimulated the release of cytokines from BEAS-2B cells through activation of IKK/NF-κB pathway

Previous studies indicated that exposure to fine particulate matter (PM_2.5) was related to pulmonary inflammatory diseases through activation of nuclear factor kappa B (NF-κB) signaling pathway to trigger cytokine secretions in human lung carcinoma cells. To investigate the potential mechanisms underlying expression of cytokines via activated NF-κB by PM_2.5, human bronchial epithelial cells (BEAS-2B cells) were treated with PM_2.5 extracts at different concentrations (6, 13, 25, 50, 100, 200, and 400 µg mL^-1) for 6 and 24 h. We found that 100 µg mL^-1 PM_2.5 increased interleukin 6 (IL-6) and IL-8 expression at 24 h (p < 0.05 or p < 0.01). Moreover, 100 µg mL^-1 PM_2.5 upregulated phosphorylated IκB kinase (IKK), p65, and IκBα at 6 h, which could be reversed by the IKK inhibitor Bay11-7082 (p < 0.05 or p < 0.01). The p65 subunit of NF-κB was translocated into the nucleus of the cells treated with 100 µg mL^-1 PM_2.5 at 6 and 24 h. Bay11-7082 partly inhibited PM_2.5-induced increases of IL-6 and IL-8 secretion. The results indicated that PM_2.5 extract increased IL-6 and IL-8 levels in BEAS-2B cells through activation of IKK/NF-κB pathway. Our study will contribute to better understanding of the mechanism of PM_2.5-induced pulmonary inflammatory diseases.

[Effects of casein phosphopeptide-amorphic calcium phosphate on enamel erosion: an in situ study]

Objective: To evaluate the effects of casein phosphopeptide-amorphic calcium phosphate (CPP-ACP) on enamel erosion using an improved in situ experimental protocol. Methods: Forty-eight enamel blocks were prepared from fresh-extracted human premolars and further embedded in the acrylic resins. The present study was divided into 2 parts. In part 1 of the study, two volunteers were recruited to test the availability and safety of the in situ erosion protocol. Customized intraoral appliance was made with 4 reservoirs containing the specimens for each volunteer. For each intraoral applicance, 2 reservoirs were made with the openings and the other 2 remained intact. All volunteers were instructed to drink 150 ml cola within 5 min using the gargling method after placing appliances intraorally for 2 h. After erosion, the appliances were remained undisturbed intraorally for 1 h until the next erosive attack. The in situ erosion cycles were performed 4 times daily over 7 d. In part 2 of the study, forty specimens were randomly divided into 2 groups (n=20): CPP-ACP group and control group. The surfaces of specimens in CPP-ACP group were pretreated with CPP-ACP for 3 min before in situ erosion, whereas the specimens in control group were pretreated with deionized water for 3 min. For each intraoral applicance, 4 reservoirs were made with openings. Ten healthy volunteers were recruited and the above-mentioned in situ erosion protocol was applied to test the effects of CPP-ACP on enamel erosion. The surface microhardness and surface microstructure of the samples were examined before and after erosion in both parts of the study. The data were statistically analyzed using ANOVA and LSD tests. Data were considered statistically significant at a level of P<0.05. Results: Significant surface softening was observed in all specimens after erosion (P<0.001). The surface microhardness in the CPP-ACP group and control group were (198.8±23.2) and (152.4±42.1) HV, respectively (P=0.040). The specimens in the CPP-ACP group showed significantly fewer changes in surface microstructure compared with those in the control group. Conclusions: Based on this in situ experimental protocol, short-time consuming of acid beverages would produce significant effects on the surface microhardness of the human enamel, whereas the application of CPP-ACP can increase the erosion resistance of the enamel.

[Characterization analysis of gM, gL genes of varicella zoster virus in six provinces of China]

Objective: To analyze the genetic characterization of glycoprotein M(gM.),glycoprotein L(gL) of varicella zoster virus. Methods: According to the program of "Ministry of Science and Technology of China" , Based on the 12 suspected VZV patients monitored in Beijing (1 case), Shanghai (5 cases), Jilin (2 cases), Qinghai (1 case), Guangdong (2 case) and Sichuan (case) in 2007-2015. A total of 12 Vesicle fluid and throat swab samples were collected. Positive samples were identified by Agarose gel electrophoresis and two glycoprotein genes were amplified by polymerase chain reaction (PCR). Nucleotide sequences were determined and analyzed by PCR amplification of VZV positive specimens V-OKA-BK of the domestic varicella attenuated live vaccine and the Varilrix-1 of the imported attenuated live vaccine. Nucleotide sequences of VZV positive specimens, vaccine strains (V-OKA-BK, varilrix-1) and GenBank foreign wild strains (41 strains), parent strains (P-oka), vaccine strains (V-oka, Varilrix, Varivax) were compared using BioEdit and MEGA 5.0. Results: 12 specimens were VZV positive. Compared with the vaccine strains and the parent strains, the GM gene of 1 positive specimen had radical mutation at 86686 sites, which resulted in amino acid mutation, 5 positive specimens had base mutation at 87844 sites, and 30 strains of foreign wild strains had the same variation at 87 844 sites. 1 positive specimens of gL gene in 101245 sites had base mutation, and led to amino acid mutation, 6 positive specimens at 101624, 101625, 101626 sites had base of loss and the foreign wild strains in these 3 sites had the same variation. Compared with the vaccine strains, the nucleotide and amino acid homology of gM of 12 VZV positive specimens were 99.2%-100% and 98.2%-100%, respectively, and gL of those were 99.3%-100% and 98.6%-100%, respectively. Compared with 41 strains of foreign wild strains, homology of gM's nucleotides and amino acid were 99.3%-100% and 98.5%-100%, respectively; 99.1%-100% and 98.6%-100% for gL. The results of phylogenetic analysis showed that 7 VZV positive samples were on the same branch with 4 vaccine strains and p-oka strain. Based on gL, 12 VZV positive samples were on the same branch as the vaccine strains and p-oka strain. Conclusion: This study demonstrates that the genes of gM, gL are highly conserved and remain stable immunogen, which may be involved in the attenuation of VZV and need to be further researched.

[Epidemiological characteristics of Coxsackie virus A16 caused hand foot and mouth disease cases in Guangdong province, 2012-2016]

Objective: To analyze the epidemiological characteristics of hand foot and mouth disease (HFMD) cases caused by Coxsackie virus A16 (Cox A16) in Guangdong province from 2012 to 2016. Methods: The data of mild HFMD cases caused by Cox A16 were collected from 8 sentinel hospitals in 8 prefecture-level cities in Guangdong to estimate Cox A16 infection status and its population and time distribution characteristics. Results: (1) The highest estimated incidence of Cox A16 infection was in 2014 (113.0/100 000), followed by 2016 (86.4/100 000) and 2012 (79.1/100 000), while the estimated incidence was lower in 2015 (29.0/100 000) and 2013 (28.8/100 000). (2) Cox A16 was confirmed to be the predominant pathogen causing HFMD outbreaks (54.6%, 89/163). The number of outbreaks in the year with high incidence (28 outbreaks) was 11.2 times higher than that in the year with low incidence (2.5 outbreaks). (3) Across all age groups, the annual estimated incidence of Cox A16 infection decreased with age (trend χ(2)=853 905.63, P<0.01). The incidence was highest in age group 1 year (1 449.2/100 000), followed by that in age group 3 years (1 097.0/100 000), in age group 2 years (1 083.5/100 000), in age group 4 years (687.8/100 000) and in age group 0 year (604.9/100 000). Among the age groups <12 months, the estimated incidence increased with age (trend χ(2)=5 541.77, P<0.01), which was highest in age group 11-months (2 105.1/100 000), followed by that in age groups 10-months (1 448.6/100 000), 9-months (938.3/100 000), 8-months (703.3/100 000) and 6-months (664.6/100 000). (4) The annual incidence peak was during May (143.9/100 000)-June (131.5/100 000). Conclusion: The prevalence of Cox A16 infection differed with year in Guangdong during 2012-2016. When the incidence of Cox A16 infection was high, more outbreaks occurred. The prevalence occurred mainly in nurseries and kindergartens from May to June each year. Children aged 0-4 years were the high risk group for Cox A16 infection, children aged 6-11 months were at high risk for Cox A16 infection.

[The incidence and risk factors of catheter-related-thrombosis during induction chemotherapy in acute lymphocytic leukemia children]

目的

分析初诊急性淋巴细胞白血病（ALL）诱导化疗期外周静脉穿刺中心静脉置管（PICC）患儿导管相关性血栓（CRT）的危险因素。

方法

收集2014年3月1日至2014年12月31日首都医科大学附属北京儿童医院血液肿瘤中心白血病病房行PICC置管的116例初诊ALL患儿临床资料。

结果

①PICC置管后第15天33例（28.4%）患儿发生CRT（CRT组），83例患儿未发生CRT（非CRT组）。②两组在性别、年龄分布、ALL危险度、免疫表型以及置管时两组血常规、凝血功能、是否合并感染、置管静脉方面差异无统计学意义，CRT组右侧置管比例高于非CRT组[75.8%（25/33）对55.4%（46/83），P=0.043]。③CRT组患者均无临床症状，置管第15天D-二聚体高于非CRT组[0.18（0.05~2.45）mg/L对0.11（0.01~5.34）mg/L，P=0.001]。④观察期中出现3例导管相关性并发症，均为导管相关性感染，其中2例并发CRT。⑤置管第33天CRT组26例患者复查B超，19例（73.1%）血栓缩小，6例（23.1%）无明显变化，1例（3.8%）增大。

结论

CRT是初诊ALL患儿诱导化疗期PICC置管的常见导管相关并发症，但症状出现较少，大部分血栓可自行缩小，右侧置管为CRT发生的危险因素；检测D-二聚体水平以及定期进行导管部位B超检查有助于及时发现CRT。

[Clinical characteristics and prognosis in 12 patients with adult T cell leukemia/lymphoma confirmed by HTLV-1 provirus gene detection]

Objective: To analyze the clinical characteristics and prognosis of adult T cell leukemia/lymphoma (ATLL). Methods: Peripheral blood samples from patients who were suspected as ATLL from March, 2013 to July, 2015, were collected for HTLV-1 provirus genes detection in genomic DNA extraction by PCR. Cases showing positive results were confirmed as ATLL. Clinical and laboratory characteristics, therapeutic outcomes and survival evaluation were collected. Results: 12 out of 23 suspected patients were confirmedly diagnosed as ATLL through HTLV-1 provirus genes detection by PCR. Eight patients were male and four patients were female. Median age was 51 (range 28-66) years old. All of those patients came from coastal cities of Fujian province where a HTLV-1 epidemic area locates. In the subtype classification of these 12 ATLL, 11 patients were classified as acute type and one case as lymphoma type ATLL. As one of the clinical characteristics of ATLL, ' flower cells ', with typical or atypical morphology had been observed in a high rate (81.8%). Clinical symptom such as hepatomegaly, splenomegaly and lymphadenectasis were detected in most of patients, and hypercalcemia and elevated LDH were also noted commonly. The ATLL cells immunophenotype were typical, and the major subtype was CD4+ CD8- type. Confection of hepatitis B virus was detected in a high rate (54.5%). Ten patients received chemotherapy, and 2 cases in complete remission after chemotherapy received allogeneic hematopoietic stem cell transplantation. At the end of the follow-up, 7 cases died, 4 cases survived, 1 case was lost, and the median survival was 2.8 (0.9-10.8) months. We found a case had HTLV-1 provirus negative after transplantation. Conclusion: In the coastal area of Fujian Province, ATLL is not rare. Characteristics of those ATLL are typical. But prognosis is still unsatisfactory.

Fabrication of Laser-reduced Graphene Oxide in Liquid Nitrogen Environment

Porous structure of reduced graphene oxide (rGO) plays an important role in developing flexible graphene-based devices. In this work, we report a novel methodology for reduction of freestanding graphite oxide (GO) sheet by picosecond pulse laser direct writing in liquid nitrogen. Non-agglomerate and porous structure of rGO is fabricated successfully due to frozen effect during laser processing. Compared with laser-irradiated rGO developed in N₂ gas at ambient environment, the frozen rGO developed in liquid N₂ shows better ordered structure with less defects, crack-free morphology as well as better electron supercapacitor performance including 50–60 Ω/sq in sheet electrical resistance. Mechanism of cryotemperature photoreduction GO is also discussed.

Correlation between serum IL-16 and atopic dermatitis

This study aims to investigate the correlation between allergic sensitization of atopic dermatitis (AD) patients and their serum interleukin (IL)-16 levels. AD patients, healthy volunteers, and patients with psoriasis (N = 80, 35, 20, respectively) were tested for serum IL-16 and total and specific IgE levels by enzyme-linked immunosorbent assay, along with eosinophil counts. Serum allergen-specific IgE levels were determined, and skin-prick testing conducted in a subgroup of 45 AD patients. Based on specific IgE levels, AD patients were categorized into non-sensitized group 1 and sensitized group 2. Furthermore, they were sorted as non-sensitized group A and sensitized group B based on skin-prick results. Next, the serum IL-16 and total IgE levels in these subgroups were determined. Compared to levels in healthy volunteers and psoriasis patients, the serum IL-16 levels in AD patients were significantly higher (P < 0.001). Additionally, total serum IgE levels were significantly correlated with serum IL-16 levels and eosinophil counts. However, no correlation was observed between serum IL-16 levels and eosinophil counts. The serum IL-16 and total IgE levels in group 2 were also significantly elevated (P < 0.001) in contrast to those in group 1. Although we did not observe any significant difference between serum IL-16 levels in groups A and B, the total serum IgE level in group B was significantly higher than that in group A (P < 0.001). Thus, allergic sensitivity in AD patients correlates with total serum IgE as well as serum IL-16; the correlation with IL-6 is weaker.

The Treatment of Mid-shaft Clavicle Fractures

OBJECTIVE

Through reviewing the relevant literature from the past decades, to summarize the assessment and management of fractures of the clavicle, and provide an overview of the clinical results of a range of treatment options.

DATA SOURCES

The data analyzed in this review are mainly from articles included in PubMed and EMBASE, published from 1960 to 2015.

STUDY SELECTION

Studies involving assessment of fractures of the clavicle were reviewed. Further literatures were gathered regarding the conservative and surgical treatment of these fractures, including the methods of fixation and the surgical approaches used. Both conservative and surgical treatments were then compared and contrasted.

RESULTS

Through retrieving and reading the abstract, a total of 42 representative articles were selected, which covered all aspects of the conservative treatment and surgical treatment, and compared the advantages and disadvantages of different treatment options.

CONCLUSIONS

Although the majority of recent data suggest that surgery may be more appropriate as it improves functional outcome and reduces the risk of complications, we recommend that the treatment should be individually assessed.

Theoretical study of pre-formed hole geometries on femtosecond pulse energy distribution in laser drilling

Maxwell's wave equation was solved for fs laser drilling of silicon. The pre-formed hole wall's influence on the propagation behavior of subsequent laser pulses was investigated. The laser intensity at hole bottom shows distinct profile as compared with that at hole entrance. The multi-peaks and ring structure of the laser intensity were found at hole bottom. The position of maximum laser intensity (MLI) in relation to the wall taper angle was studied. It was found that the position of the MLI point would be closer to the hole entrance with increasing taper angle. This observation provides valuable information in predicting the position of plasma plume which is a key factor influencing laser drilling process. The elliptical entrance hole shape and zonal structure at the hole bottom reported in the literatures have been reasonably explained using the laser intensity distribution obtained in the present model.

Tunable dual-band perfect absorbers based on extraordinary optical transmission and Fabry-Perot cavity resonance

Magnetic resonance is considered to be a necessary condition for metamaterial perfect absorbers, and dual-band absorbers can be composed of a pair of metallic layers with anti-parallel surface currents. We designed and fabricated a tunable dual-band perfect absorber based on extraordinary-optical-transmission (EOT) effect and Fabry-Perot cavity resonance. The idea and the mechanism are completely different from the absorber based on the near-field interaction. The important advantage of our structure is that we can switch a single-band absorber to a dual-band absorber by changing the distance between two metallic layers and/or incident angle. The peak originating from the EOT effect becomes significantly narrower, resulting in an increase of the Q-factor from 16.88 to 49. The dual-band absorber can be optimized to be insensitive to the polarization of the incident electromagnetic wave by slightly modifying the absorber structure.

Influence of the material removal mechanisms on hole integrity in ultrasonic machining of structural ceramics

Micro-chipping via micro-cracks, due to rapid mechanical indentations by abrasive grits, is the fundamental mechanism of material removal during ultrasonic machining (USM) of hard-brittle materials like ceramics and glass. This study aims mainly to investigate the adverse effects of this inherent removal phenomena on the hole integrity such as entrance chipping, wall roughness and subsurface damage. It also presents the material removal mechanism happens in the gap between the tool periphery and the hole wall (called 'lateral gap'). To do so, experiments were conducted for drilling holes on three advanced structural ceramics, namely, silicon carbide, zirconia, and alumina. Earlier published basic studies on the initiation of different crack modes and their growth characteristics are employed to explain the experimental findings in this USM study. It is realized that the radial and the lateral cracks formed due to adjacent abrasives, which are under the tool face, extends towards radial direction of the hole resulting in entrance chipping. Additionally, the angle penetration and the rolling actions of the abrasives, which are at the periphery of the tool, contribute to the entrance chipping. Later on, in the 'lateral gap', the sliding (or abrasion) and the rolling mechanisms by the larger abrasives take part to material removal. However, they unfavorably produce micro-cracks in the radial direction resulting in surface and subsurface damages, which are ultimately responsible for higher wall-surface roughness. Since the size of micro-cracks in brittle materials is grit size dependent according to the earlier studied physics, it is realized that such nature of the hole integrity during USM can only be minimized by employing smaller grit size, but cannot fully be eliminated.

Investigation on CO(2) laser irradiation inducing glass strip peeling for microchannel formation

The study investigates the use of CO(2) laser to induce glass strip peeling off to form microchannels on soda lime gass substrate. The strip peeling exhibits a strong dependence on the energy deposition rate on the glass surface. In spite of the vast difference in the combination of laser power and scanning speed, when the ratio of the two makes the energy deposition rate in the range 3.0-6.0 J/(cm(2) s), the temperature rising inside glass will be above the strain point and reach the softening region of the glass. As a result, glass strip peeling is able to occur and form microchannels with dimensions of 20-40 μm in depth and 200-280 μm in width on the glass surface. Beyond this range, higher energy depsotion rate would lead to surface melting associated with solidification cracks and lower energy deposition rate causes the generation of fragment cracks.

Detection of the Treponema pallidum gene and variation of treponemal DNA load before and after therapy

We explored a genetic detection method for Treponema pallidum (TP) in the peripheral blood of infected patients to compare the loads of treponemal DNA before and after therapy and to see if this new technique enabled assessment of therapeutic effect and detection of serum resistance. Polymerase chain reaction was used for a qualitative detection of TP DNA in peripheral blood and then a semiquantitative method was adopted to estimate the load of TP DNA in blood, both before and after treatment of syphilis. Among 30 untreated patients, three cases were TP DNA-positive. Among 42 treated patients with demonstrated serum resistance, three cases were TP DNA-positive. Five cases in which the rapid plasma reagin had become negative had no detectable TP DNA in their peripheral blood. The TP DNA load in blood after treatment was significantly lower than that before therapy. We conclude that the detection of TP DNA in peripheral blood of TP-infected patients is not yet sufficiently sensitive, but we observed that TP DNA load declines significantly after treatment.

An inter-subspecies cloned buffalo (Bubalus bubalis) obtained by transferring of cryopreserved embryos via somatic cell nuclear transfer

The aim of this study was to explore the feasibility of cryopreservation of inter-subspecies cloned embryos in buffalo. In our experiment, river buffalo ear fibroblast nucleus was fused into swamp buffalo oocyte cytoplasm. The blastocyst formation rate for nuclear transfer of freshly thawed cells was not different from those of growing cells, confluent or serum-starved cells. A total of 122 cloned blastocysts derived from cryopreserved fibroblasts were cryopreserved and thawed, 37 were survived, the cryosurvival rate was 30.3%. The survived blastocysts were transferred into 15 recipient buffalos. Five of the recipients established pregnancy, but four of them aborted on day 53, 59, 145 and 179 of gestation respectively. One cross-bred buffalo (Murrah × Swamp buffalo (2n = 49) received three embryos delivered a 40.5 kg female calf by natural delivery on day 320 of gestation. Up to now (13-month old), the cloned calf has been growing well with no abnormity observed. These results demonstrated that cryopreservation of inter-subspecies cloned embryos is feasible to produce buffalo offspring.

RAPD-based genetic diversities and correlation with morphological traits in Camellia (Theaceae) cultivars in China

Camellia is an economically important ornamental plant that has many uses, such as in beverages, foods and medicines. We examined 15 Camellia cultivars in Wenzhou, China, using RAPD markers and measurements of three traits (petal color, flower diameter, blooming period). PCR amplification with 15 random primers produced 1935 bands, observed at 88 amplification loci; 77% of the amplified loci were polymorphic, with a mean of 4.5 polymorphic loci per primer. The similarity coefficient ranged from 0.5419 to 0.7933 among the 15 samples; the lowest value was between Manao (C. reticulata) and Feibai FR (C. japonica), and the largest value was between Chidan (C. japonica) and Yuanyang FG (C. japonica). Cluster analysis divided the 15 cultivars into two groups at the similarity coefficient of 0.65. A correlation was found between RAPD markers and petal color in the first group. No correlation was found between RAPD markers and the other traits (flower diameter, blooming period). This study provides information useful for the identification, classification, phylogenesis, and breeding of Camellia cultivars.

Femtosecond laser induced surface nanostructuring and simultaneous crystallization of amorphous thin silicon film

Ultrafast pulsed laser irradiation is demonstrated to be able to produce surface nano-structuring and simultaneous crystallization of amorphous silicon thin film in one step laser processing. After fs laser irradiation on 80 nm-thick a-Si deposited on Corning 1737 glass substrate, the color change from light yellow to dark brown was observed on the sample surface. AFM images show that the surface nano-spike pattern was produced on amorphous-Si:H film by fs laser irradiation. Furthermore, micro-Raman results indicate that the a-Si has been crystallized into nanocrystalline Si. Also, the absorptance of the fs laser treated Si thin film was found to increase in the spectrum range of below bandgap compared to original untreated a-Si. The developed process has a potential application in fabrication of high efficiency Si thin film solar cells.

Direct patterning in sub-surface of stainless steel using laser pulses

This paper reports for the first time on the direct creating microcavities in sub-surface of stainless steel using a single Nd:YAG laser pulse. The low peak power density is used in the process, which is in the order of 1 MW/cm(2). The formation of the microcavities in the sub-surface of stainless steel is an evidence of volume expulsion during laser-metal interaction. Direct patterning in the sub-surface of stainless steel is demonstrated by realizing a series of microcavities to form a pre-designed pattern. Potential applications of sub-surface patterning in metal, such as security marking, micro-heater, micro-insulator and micro-sensor, are discussed.

Study on the inter-subspecies nuclear transfer of river buffalo somatic cell nuclei into swamp buffalo oocyte cytoplasm

The objective of this study was to explore the feasibility of inter-subspecies somatic cell nuclear transfer (SCNT) of river buffalo (50 chromosomes) somatic cell nuclei into swamp buffalo (48 chromosomes) oocyte cytoplasm. The enucleated swamp buffalo oocytes were fused with four different types of river buffalo cells: freshly thawed ear fibroblasts, serum-starved ear fibroblasts, cumulus cells and ear fibroblasts from a cloned buffalo calf. As a result, the developmental competence of embryos reconstructed with freshly thawed ear fibroblasts was the poorest (P<0.01), while those of the other three types were not different from each other. Furthermore, the efficiency of swamp-swamp buffalo, swamp-river buffalo and bovine-buffalo SCNT were also compared. The results showed that the blastocyst rate of swamp-river reconstructed embryos was not different from swamp-swamp embryos, while significantly higher than that of bovine-buffalo embryos (P<0.01). A total of thirty cloned blastocysts derived from freshly thawed ear fibroblasts were transferred into thirteen recipient buffaloes, four recipients established pregnancy, while three of them aborted on Days 65, 75 and 90 of gestation, respectively. One cross-bred buffalo (Murrah x swamp, 49 chromosomes) receiving three embryos delivered a 39 kg female calf on Day 335 of gestation. These results indicate that the inter-subspecies SCNT is feasible to produce swamp-river buffalo embryos, and these can develop to full term and result in live buffalo calves.

Cloning the swamp buffalo SRY gene for embryo sexing with multiplex-nested PCR

The polymerase chain reaction (PCR) is an efficient method for sexing embryos. The objective of this study was to develop an accurate and reliable method for sexing swamp buffalo (Bubalus bubalis) embryos. The SRY gene from swamp buffalo genomic DNA was amplified by PCR, using primers based on the sequence of the Holstein SRY gene. This fragment was sequenced based on a BLAST search; the SRY gene was highly conserved. Using a Southern blot, there was a strong signal in genomic DNA only from male swamp buffalo. Two pairs of nested primers, targeted to amplify the swamp buffalo SRY conserved region, were designed for sex identification. Simultaneously, the G3PDH gene was co-amplified to serve as an internal control. A multiplex-nested PCR system was optimized by varying the following individually: concentrations of Mg(2+) and dNTPs, ratio of concentrations of primers and numbers of cycles. Biopsies of 27 IVF-derived embryos and 24 embryos fertilized with Y-chromosome-bearing sperm were examined. Using optimized procedures, clear signals following PCR amplification were obtained from all embryo samples; PCR amplification accuracy was further verified by comparing PCR and dot blots. We concluded that this PCR technique was highly reliable for sexing swamp buffalo embryos.

Effect of femtosecond laser irradiation on structure of UV grade fused silica

A p-polarized femtosecond laser beam was used to irradiate a UV grade fused silica to create microchannels, which are useful for producing optical gratings or micro fluidics devices. The laser irradiated surface was characterized using optical microscope, stylus profiler, SEM, XRD and TEM. A special technique was used to protect the laser irradiated surfaces in preparing cross-sectional TEM samples. The XRD spectra and TEM observation reveal that structure of the fused silica remain amorphous after the femtosecond laser irradiation.

Quantification of thermal energy deposited in silicon by multiple femtosecond laser pulses

We report our study of deposited thermal energy in silicon induced by multiple-pulse femtosecond laser irradiation. Using infrared thermography, we quantified through in situ direct measurement of temperature fields that a significant portion of laser power (two-thirds or more) was deposited into the silicon substrate instead of being reflected or carried away with the ablated material. This is believed to be the first reported study of direct in situ measurement of temperature fields as the result of deposited thermal energy from multiple femtosecond laser pulses. Our simulation results support the measured data.

Enhanced human osteoblast cell adhesion and proliferation on 316 LS stainless steel by means of CO2 laser surface treatment

An effective and novel technique for improving the biocompatibility of a biograde 316 LS stainless steel through the application of CO(2) laser treatment to modify the surface properties of the material is described herein. Different surface properties, such as surface roughness, surface oxygen content, and surface energy for CO(2) laser-treated 316 LS stainless steel, untreated, and mechanically roughened samples were analyzed, and their effects on the wettability characteristics of the material were studied. It was found that modification of the wettability characteristics of the 316 LS stainless steel following CO(2) laser treatment was achieved. This improvement was identified as being mainly due to the change in the polar component of the surface energy. One-day cell adhesion tests showed that cells not only adhered and spread better, but also grew faster on the CO(2) laser-treated sample than on either the untreated or mechanically roughened sample. Further, compared with the untreated sample, MTT cell proliferation analysis revealed that the mechanically roughed surface resulted in a slight enhancement, and CO(2) laser treatment brought about a significant increase in cell proliferation. An increase in the wettability of the 316 LS stainless steel was observed to positively correlate with the cell proliferation.

The formation of a hydroxyl bond and the effects thereof on bone-like apatite formation on a magnesia partially stabilized zirconia (MgO-PSZ) bioceramic following CO2 laser irradiation

For the purpose of improving the bioactivity of a magnesia partially stabilized zirconia (MgO-PSZ) and to explore a new technique for inducing OH group and apatite formation, a CO(2) laser has been used to modified the surface properties. The bioactivity of the CO(2) laser modified MgO-PSZ has been investigated in stimulated human fluids (SBF) with ion concentrations almost equal to those in human blood plasma. Some hydroxyl groups were found on the MgO-PSZ following CO(2) laser treatment with selected power densities. The surface melting on the MgO-PSZ induced by CO(2) laser processing provides the Zr(4+) ion and OH(-) ion, in turn, the incorporation of the Zr(4+) ion and the OH(-) ion creates the Zr-OH group on the surface. After 14 days of SBF soaking, the apatites formed on the MgO-PSZ with relatively high amount of hydroxyl groups generated by the CO(2) laser treatment, while no apatite was observed on the untreated with few hydroxyl groups. It exhibits that the Zr-OH groups on the MgO-PSZ surface is the functional groups to facilitate the apatite formation. The increased surface roughness provides more active sites, meantime, increased surface energy benefits to the adsorption and reaction on the surface.

Characterisation of a potyvirus and a potexvirus from Chinese scallion

Molecular analyses of viruses infecting Chinese scallion (Allium chinense G. Don) showed that the plants did not contain any of the poty-, carla- or allexiviruses that are common in garlic plants in China. The complete sequences of a potyvirus and a potexvirus were determined and these were shown to represent different viruses from any in the databases. They could be transmitted mechanically to scallion but not to other Allium species (including garlic) or to Narcissus. The potyvirus, tentatively named Scallion mosaic virus, has a distant relationship (c. 62% nucleotide identity over the entire genome) to Turnip mosaic virus and Japanese yam mosaic virus, with which it grouped in phylogenetic analyses. Its genome is 9324 nts long, encoding a 341.3 kDa polyprotein of 3001 amino acids. The potexvirus, tentatively named Scallion virus X, has a genome 6987 nts long and its organisation was similar to that of the other potexviruses but with only 46.3-63.2% nucleotides identical to them. It is most closely related to Narcissus mosaic virus but phylogenetic analyses indicate that it should be considered a distinct species. Neither of the viruses have been detected in garlic, although the two host plants are closely related.

Asian domains of four major genotypes of JC virus, Af2, B1-b, CY and SC

JC virus (JCV) strains worldwide can be classified into various genotypes based on DNA sequence variations. To define the domains of the four major JCV genotypes in Asia, we collected urine samples at six unstudied sites: three in southeastern Asia, two in the central highlands and one in central Asia. DNA was extracted from urine samples, and used to amplify a 610-bp region of the viral genome. For each geographical site, we determined 16 to 31 sequences, from which a phylogenetic tree was constructed to unambiguously classify detected JCV isolates into distinct genotypes. From JCV genotype profiles at the sites studied here and elsewhere, the following conclusions were drawn. Although Af2 is the major genotype in Africa, this genotype also occurs in western and central Asia. B1-b mainly occurs in western and central Asia, including the central highlands. CY occurs in northeastern Asia with the southern boundary between China and southeast Asian countries. Although SC predominates in southeastern Asia, it also occurs in northern and central Asia at lower frequencies. In addition, a few minor JCV genotypes (B1-a, B2 and B3) occur at many sites. We discuss here the anthropological and medical significance of the present findings.

Intermittent phase synchronization of coupled spatiotemporal chaotic systems

Phase synchronization is studied with a discrete system formed by two coupled map lattices, in which phases are measured in two-dimensional vectors. Simulation results show that by imposing external coupling between the two lattices, phase synchronization can be found in all two-dimensional phase planes between them. When the system is approaching the phase synchronizing state, unstable phase synchronization is observed. This is referred to as intermittent phase synchronization that appears when the trajectories on two interacting phase planes have opposite directions of rotation but with only a small phase difference. The intermittent phase synchronization could also be observed in coupled autonomous systems with diffusive attractors although their phase concepts are inconsistent. Our results show that the intermittent phase synchronization of both discrete and autonomous systems relates to the diffusion or the complexity of the attractors.

Phase signal coupling induced n:m phase synchronization in drive-response oscillators

We have studied phase synchronization between two identical Rössler oscillators connected in the drive-response configuration by a single phase signal. Before the transition to phase synchronization, the distribution of the time interval between consecutive 2pi jumps shows several sharp peaks. With a strong phase signal coupling, the n:m phase synchronization between the oscillators can be achieved. For the n (not equal) m phase synchronizing state, some values of coupling strength result in a phenomenon characterized by a reduction in the mean amplitude of the response termed amplitude reduction. In these regions, the mean rotation speed of the response remains approximately constant while the locking ratio n:m varies.

Lack of disease-specific amino acid changes in the viral proteins of JC virus isolates from the brain with progressive multifocal leukoencephalopathy

Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating disease of the central nervous system caused by a ubiquitous human polyomavirus designated as JC virus (JCV). JCVs in the brain of PML patients (PML-type JCVs) contain various regulatory regions generated from the archetypal regulatory region during persistence in the patients. We determined the complete DNA sequences of 2 PML-type isolates and 5 archetype isolates. Amino acid sequences of individual viral proteins were deduced from complete DNA sequences, and were compared among 16 isolates (6 PML types and 10 archetypes). From the data obtained, we concluded that PML-associated amino acid changes did not occur in the viral proteins of PML-type JCVs.

Recurrent herpes zoster myelitis

Recurrent zoster myelitis is quite rare. We present a previously healthy 27-year-old woman who developed recurrent attacks of myelopathy shortly after the characteristic skin rashes of herpes zoster. Magnetic resonance imaging studies demonstrated each lesion in the spinal cord at the same segments as the skin lesions. She had two attacks at opposite sites at the same spinal cord level and complete recovery after being treated with intravenous acyclovir. We suspect that direct invasion of varicella zoster virus was the cause of recurrent myelopathy in our patient.

[Immune interference of enteroviruses to immune response of TOPV in subtroptical areas]

To study whether enteroviruses interfere with the immunoeffect of TOPV in subtroptical areas, a total number of 188 children were investigated 82 in summer, 106 in winter in two townships of Hui Dong County from 1992 to 1993. The carrier rates of enteroviruses and serum nutralization antibody titres of polio were tested before and after the children were vaccinated with TOPV. Data showed that the GMTs of poliovirus type I, II, III in winter were 2 to 7.1 times as much as those in summer after administration of one and three doses TOPV. Enterovirus carrier rates were 75.6% and 38.8% respectively in summer and winter before vaccination in health children. The GMTs of polio serum antibody in children without enteroviruses was 1.5 to 1.7 times as much as the GMTs of those with enteroviruses, and the difference was statistically significant. Overall, the results demonstrated that enterovirus infection interfered the immune response of vaccinates to TOPV to some extent. It was also suggested that supplemental immunization was the key measure in polio eradication program and should be conducted in winter or spring seasons.

Effects of H2O2-producing lactobacilli on Neisseria gonorrhoeae growth and catalase activity

In the vagina and endocervix, Neisseria gonorrhoeae must interact with complex microflora. Among these are lactobacilli, which may inhibit the growth of gonococci. Lactobacillus acidophilus, which produce H2O2 (LB+), and L. acidophilus and Lactobacillus casei, which do not produce H2O2 (LB-), were coincubated with catalase-positive and -deficient strains of N. gonorrhoeae. When the incubation medium was maintained at pH 7.3, neither LB+ nor LB- affected gonococcal growth. However, LB+ caused a significant increase in expression of gonococcal catalase, which could be offset by exposure of the bacteria to exogenous catalase. When coincubation medium was at lower pH (4.8-5.0), there was a significant decrease in gonococcal survival and catalase activity, which was only partly reversed by exogenous catalase. Lysates of LB+ also effectively inhibited gonococcal catalase. This inhibition was retained upon heating of the lysate to 100 degrees C for 15 min but was lost with proteinase K treatment. Thus, LB+ may inhibit growth of gonococci by acidification of the environment, secretion of H2O2, and production of protein inhibitors.

Variation in hydrogen peroxide sensitivity between different strains of Neisseria gonorrhoeae is dependent on factors in addition to catalase activity

Catalase, which catalyzes the reduction of hydrogen peroxide to oxygen and water, is considered the primary defense of Neisseria gonorrhoeae against exogenous hydrogen peroxide. Recent reports have demonstrated drastically different sensitivities of the organism to hydrogen peroxide ranging from greater than 80% survival after challenge with 30 mM hydrogen peroxide to less than 0.001% survival after challenge with 10 mM hydrogen peroxide. In this study, we have examined the hydrogen peroxide sensitivities of six clinical gonococcal isolates. The study demonstrates that the variations in gonococcal hydrogen peroxide sensitivities previously reported can be attributed to (i) differences in experimental methods employed or (ii) variation among different gonococcal strains. All of the gonococcal isolates examined generated similar concentrations of catalase, implying that the differences in the H2O2 sensitivity observed may depend on factors in addition to catalase.

Regulation of catalase in Neisseria gonorrhoeae. Effects of oxidant stress and exposure to human neutrophils

We studied the effects of oxidant stress on the catalase activity and hydrogen peroxide sensitivity of Neisseria gonorrhoeae. N. gonorrhoeae is an obligate pathogen of man that evokes a remarkable but ineffective neutrophil response. Gonococci make no superoxide dismutase but express high catalase activity. Gonococcal catalase activity increased threefold when organisms were subjected to 1.0 mM hydrogen peroxide. This increase in catalase activity was marked by a parallel increase in protein concentration recognized by a rabbit polyclonal antibody raised against the purified gonococcal enzyme. Catalase was primarily localized to the gonococcal cytoplasm in the presence or absence of stress; only a single isoenzyme of catalase could be identified. Exposure of gonococci to neutrophil-derived oxidants was accomplished by stimulating neutrophils with phorbol myristate acetate or by using gonococcal Opa variants that interacted with neutrophils with different degrees of efficiency. Gonococci exposed to neutrophils demonstrated a twofold increase in catalase activity in spite of some reduction in viability. Exposure of gonococci to 1.0 mM hydrogen peroxide made the organisms significantly more resistant to higher concentrations of hydrogen peroxide and to neutrophils than control organisms. These results suggest that catalase is an important defense for N. gonorrhoeae during attack by human neutrophils. The rapid response of this enzyme to hydrogen peroxide should be taken into consideration in studies designed to evaluate the interaction between neutrophils and gonococci.