[The effect of Ba Duan Jin on the balance of community-dwelling older adults: a cluster randomized control trial]

Objective: To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults. Methods: A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test. Results: A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95%CI: 2.23-3.88) points (P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95%CI: 4.03-5.37) points (P<0.001). Ba Duan Jin showed significant improvement (P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions: This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

[The expression and function of PD-L1 in CD133(+) human liver cancer stem-like cells]

Objective: To investigate the expression of programmed death protein-ligand 1 (PD-L1) in liver cancer stem-like cells (LCSLC) and its effect on the characteristics of tumor stem cells and tumor biological function, to explore the upstream signaling pathway regulating PD-L1 expression in LCSLC and the downstream molecular mechanism of PD-L1 regulating stem cell characteristics, also tumor biological functions. Methods: HepG2 was cultured by sphere-formating method to obtain LCSLC. The expressions of CD133 and other stemness markers were detected by flow cytometry, western blot and real-time quantitative polymerase chain reaction (RT-qPCR) were used to detect the expressions of stemness markers and PD-L1. The biological functions of the LCSLC were tested by cell function assays, to confirm that the LCSLC has the characteristics of tumor stem cells. LCSLC was treated with cell signaling pathway inhibitors to identify relevant upstream signaling pathways mediating PD-L1 expression changes. The expression of PD-L1 in LCSLC was down regulated by small interfering RNA (siRNA), the expression of stem cell markers, tumor biological functions of LCSLC, and the changes of cell signaling pathways were detected. Results: Compared with HepG2 cells, the expression rate of CD133 in LCSLC was upregulated [(92.78±6.91)% and (1.40±1.77)%, P<0.001], the expressions of CD133, Nanog, Oct4A and Snail in LCSLC were also higher than those in HepG2 cells (P<0.05), the number of sphere-formating cells increased on day 7 [(395.30±54.05) and (124.70±19.30), P=0.001], cell migration rate increased [(35.41±6.78)% and (10.89±4.34)%, P=0.006], the number of transmembrane cells increased [(75.77±10.85) and (20.00±7.94), P=0.002], the number of cloned cells increased [(120.00±29.51) and (62.67±16.77), P=0.043]. Cell cycle experiments showed that LCSLC had significantly more cells in the G(0)/G(1) phase than those in HepG2 [(54.89±3.27) and (32.36±1.50), P<0.001]. The tumor formation experiment of mice showed that the weight of transplanted tumor in LCSLC group was (1.32±0.17)g, the volume is (1 779.0±200.2) mm(3), were higher than those of HepG2 cell [(0.31±0.06)g and (645.6±154.9)mm(3), P<0.001]. The expression level of PD-L1 protein in LCSLC was 1.88±0.52 and mRNA expression level was 2.53±0.62, both of which were higher than those of HepG2 cells (P<0.05). The expression levels of phosphorylation signal transduction and transcription activation factor 3 (p-STAT3) and p-Akt in LCSLC were higher than those in HepG2 cells (P<0.05). After the expression of p-STAT3 and p-Akt was down-regulated by inhibitor treatment, the expression of PD-L1 was also down-regulated (P<0.05). In contrast, the expression level of phosphorylated extracellular signal-regulated protein kinase 1/2 (p-ERK1/2) in LCSLC was lower than that in HepG2 cells (P<0.01), there was no significant change in PD-L1 expression after down-regulated by inhibitor treatment (P>0.05). After the expression of PD-L1 was knockdown by siRNA, the expressions of CD133, Nanog, Oct4A and Snail in LCSLC were decreased compared with those of siRNA-negative control (NC) group (P<0.05). The number of sphere-formating cells decreased [(45.33±12.01) and (282.00±29.21), P<0.001], the cell migration rate was lower than that in siRNA-NC group [(20.86±2.74)% and (46.73±15.43)%, P=0.046], the number of transmembrane cells decreased [(39.67±1.53) and (102.70±11.59), P=0.001], the number of cloned cells decreased [(57.67±14.57) and (120.70±15.04), P=0.007], the number of cells in G(0)/G(1) phase decreased [(37.68±2.51) and (57.27±0.92), P<0.001], the number of cells in S phase was more than that in siRNA-NC group [(30.78±0.52) and (15.52±0.83), P<0.001]. Tumor formation in mice showed that the tumor weight of shRNA-PD-L1 group was (0.47±0.12)g, the volume is (761.3±221.4)mm(3), were lower than those of shRNA-NC group [(1.57±0.45)g and (1 829.0±218.3)mm(3), P<0.001]. Meanwhile, the expression levels of p-STAT3 and p-Akt in siRNA-PD-L1 group were decreased (P<0.05), while the expression levels of p-ERK1/2 and β-catenin did not change significantly (P>0.05). Conclusion: Elevated PD-L1 expression in CD133(+) LCSLC is crucial to maintain stemness and promotes the tumor biological function of LCSLC.

[Epidemiologic characteristics of fall in the elderly in urban and rural areas in Shanghai]

Objective: To understand the epidemiologic characteristics of fall in the elderly in Shanghai, as well as the differences between urban and rural areas, and provide evidence for targeted fall prevention and intervention. Methods: From January to March in 2017, a questionnaire survey was conducted in the elderly aged 60 or above selected from 7 urban communities and 6 rural communities in Shanghai to understand the epidemiologic characteristics of fall in the elderly and analyze the gender and urban-rural differences. Results: In urban area, a total of 3 386 elderly people were surveyed, in whom 441 (13.0%) had fall and 261 (7.7%) were injured after fall. In rural area, a total of 2 826 elderly people were surveyed, in whom 320 (11.3%) had fall and 169 (6.0%) were injured after fall. Fall risk in women were higher than that in men in both urban and rural areas with OR of 1.62 (95%CI: 1.42-1.86) and 1.16 (95%CI: 1.38-1.98) respectively, but the differences of fall related injury were not significant. Compared with urban areas, fall risk and fall related injury risk were both lower in rural areas with OR of 0.86 (95%CI: 0.73-0.99) and 0.74 (95%CI: 0.56-0.99). Compared with urban areas, men had lower risk for fall, and women had lower risk for fall related injury with OR of 0.68 (95%CI: 0.51-0.90) and 0.66 (95%CI: 0.47-0.93) respectively. Fall mainly occurred at home. Fall in urban area more frequently occurred on stairs, and fall in rural area more frequently occurred during farming. More than 60% of the falls had environmental risk factors. Slippery ground and uneven ground were main reasons. The incidence of fracture resulted from fall was high indicated by 89 fracture cases in urban areas (28.2%) and 64 fracture cases in rural areas (36.1%). Conclusions: The risk for fall in Shanghai had gender and urban-rural differences. Targeted intervention should be conducted according to the characteristics of fall in the elderly.

[Effects of preoperative secretions on dry ears after the surgery for chronic suppurative otitis media and cholesteatoma]

Objective: To investigate the influences of preoperative secretions of the patients with chronic suppurative otitis media and/or middle ear cholesteatoma on the time to have dry ears after the operations. Method: The study enrolled 228 patients with chronic suppurative otitis media and/or middle ear cholesteatoma who received modified radical mastoidectomies and tympanoplasty. The patients were divided into two groups based on whether there were secreions in the surgical ear before the operations. The time to have dry ears after surgeries were compared between the two groups. Result: The time to have dry-ear postoperatively was significantly different between patients with different preoperative microbial types of surgical ear secretions(P<0.05). The dry ear time was(2.24±1.83) months in the secretion-free group, (2.22±1.96) months in the normal bacteria group of oral cavity and skin,(3.00±2.51) months in the single non-resistant bacteria group, (3.82±2.78) months in the fungal group and (6.82±1.83) months in the compound or multi-drug resistant bacteria group. The dry ear time of compound bacteria group or multi-drug resistant bacteria group was significantly longer than that of the other groups(P<0.05). The time to have dry ears of the fungus group was longer than that of the non-drug resistant bacteria, the normal oral and skin flora and the secretion free group(P<0.05). Chi-square test results showed that there was a significant difference in postoperative dry ear rate among patients with different preoperative secretions classification(P<0.05). Conclusion: The presence of secretion and microorganism type in ear before operation is an important influencing factor of postoperative time to have dry ears. Microbiological culture and appropriate medication based on the drug sensitivity tests are beneficial for the postoperative recovery of patients with chronic suppurative otitis media and/or middle ear cholesteatoma.

[A multi-center cross-sectional survey of medicine application in patients with osteoarthritis in China]

OBJECTIVE

To investigate the clinical characteristics, the medicine application and to evaluate the disease activity in patients with osteoarthritis (OA) in China.

METHODS

This was a cross-sectional study. Totally 1 066 cases of OA from 40 hospitals in China from April to October 2017 were retrospectively enrolled. Demographic characteristics, clinical data, medicine application, and joint function were evaluated. All the data were analyzed by SPSS software 19.0. t test, Mann-Whitney U test and chi-square test were used for statistical analysis.

RESULTS

In the 1 066 cases, the male-to-female ratio was 1:3.6 and the average age was (61.9±11.0) years, with an age range from 36 to 94 years. The incidence of knee OA, hip OA, and hand OA were respectively 81.9% (873/1 066), 14.1% (150/1 066), and 36.3% (387/1 066). In the study, 242 (22.7%) cases had two kinds of joint areas involved and three joint areas were involved in 51 cases (4.8%), and 56.6% (603/1 066) of the patients used more than one kind of non-steroid anti-inflammatory drugs (NSAIDs) while 61.2% (652/1 066) used disease modifying osteoarthritis drugs (DMOADs), including glucosamine (37.5%, 400/1 066), chondroitin sulfate (2.0%, 21/1 066), diacetate (5.9%, 63/1 066), and the combination of these drugs (15.8%, 168/1 066). 8.6% (92/1 066) patients only took analgesics to relieve the pain, not using any kind of NSAIDs or DMOADs. And 232 patients (21.7%) had intra-articular injections, including 9.2% (98/1 066) sodium hyaluronate, 4.5%(48/1 066) glucocorticoid, and 8.1% (86/1 066) combination of the two drugs. The proportion of the patients taking topical drugs accounted for 26.5% (283/1 066) and physical therapy accounted for 15.8% (168/1 066). Compared with those who suffered from knee OA, the patients who suffered from hip OA had more severe disease assessment. Moreover, there were significant differences in pain (Z=-7.625, P<0.001), morning stiffness (Z=-6.229, P<0.001), and joint function (Z=-6.777, P<0.001) between the two groups of the patients who suffered from knee or hip OA with The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. Furthermore, patients with hip OA took more analgesics (χ²=24.838, P<0.001).

CONCLUSION

Oral NSAIDs and DMOADs are wildly used in patients with OA in China. However, the treatment of some patients still need to be improved. Patients with hip OA are more seriously ill and require aggressive treatment.

[Screening of hot-spot deafness gene mutations among 277 cochlear implantation patients in Sichuan province]

Objective:To investigate the spectrum and incidence of the hot-spot deafness gene mutations of 277 patients with cochlear implantation in Sichuan province, and to provide information of the prevention and treatment for clinical application. Method: The data of the hotspot deafness gene mutations screening of 277 patients with cochlear implantation was analyzed retrospectively. A deafness related gene mutations detection kit was used to detect 9 mutation sites in four deafness-associated genes,including GJB2(35delG,176del16,235delC,299delAT), GJB3(538C＞T),SLC26A4(2168A＞G, IVS7-2A＞G), Mitochondrial 12SrRNA(1494C＞T, 1555A＞G). Result: ① A total of 122 patients with hot-spot Deafness Gene Mutations were detected in 277 cochlear implantation patients(44.04%),among which there were 39 patients were GJB2235delC homozygous mutation(14.08%), 23 patients were GJB2 235delC heterozygous mutation(8.30%), 1 patient was GJB2 299delAT homozygous mutation(0.36%), 2 patients were GJB2 176del16& 235delC compound heterozygous mutation(0.72%), 13 patients were GJB2 235delC& 299delAT compound heterozygous mutation(4.69%), 2 patients were SLC26A4 2168A＞G heterozygous mutation(0.72%), 16 patients were SLC26A4 IVS7-2A＞G homozygous mutation(5.78%), 22 patient were SLC26A4 IVS7-2A＞G heterozygous mutation(7.94%), 1 patients was SLC26A4 2168A＞G& IVS7-2A＞G compound heterozygous mutation(0.36%), 2 patients were mitochondrial 12SrRNA gene 1555A＞G homogenous mutation(0.72%), 1 patient carried both GJB2 235delC homozygous mutation and SLC26A4 IVS7-2A＞G heterozygous mutation(0.36%). ②A total of 49 patients with LVAS were found in 277 cochlear implantation patients: including 15 patients with IVS7-2A＞G homozygous mutation(30.61%), 22 patients with IVS7-2A＞G heterozygous mutation(44.90%), 1 patient with 2168A＞G heterozygous mutation(2.04%), 1 patient with complex heterozygosis mutations of 2168A＞G and IVS7-2A＞G(2.04%), 1 patient with GJB2 235delC homozygous mutation(2.04%) and 1 patient with GJB2 235delC&299delAT compound heterozygous mutation(2.04%), and no hotspot deafness gene mutations were found in 8 patients. ③There were 40 out of 277 cochlear implantation patients with definite family history.There was no statistic difference of the detection rate of hot-spot deafness gene mutations between in patients with family deafness history (57.50%) and in patients without family deafness history (41.77%). ④A total of 273 patients with profound binaural deafness were found among 277 cochlear implantation patients. Three patients with profound deafness in right ear and severe deafness in left ear were found among 277 cochlear implantation patients.Two patients of three were SLC26A4 IVS7-2A＞G heterozygosis mutations, and one patient of three was GJB2 235delC heterozygosis mutations; 1 patient with profound deafness in left ear and severe deafness in right ear was found among 277 cochlear implantation patients,and was GJB2 235delC heterozygosis mutations. Conclusion:① The detection rate of hotspot deafness gene mutations in 277 cochlear implantation patients is 44.04%(122/277). GJB2 Mutation is the most common, SLC26A4 mutation takes the second place, mitochondrial 12SrRNAgene mutation is not common and GJB3 mutation is not found in this study.② SLC26A4 mutation may not be the sole pathogenic factor of LVAS. ③ The results of this study suggest that the genetic background of cochlear implants patients has little effect on the data of the hotspot deafness gene mutations screening.

[Research advances in diabetic retinopathy telescreening systems]

Diabetic retinopathy has become the main cause of the sight impairment and blindness among the adult population. Early detection of diabetic retinopathy helps to prevent and reduce the damage to eyesight. The development of diabetic retinopathy telescreening systems has been rapid. The operation modes, key technologies, economic benefits and new progression of diabetic retinopathy telescreening systems are reviewed. (Chin J Ophthalmol, 2016, 52: 868-871).

Expression of CD4+CD25+ regulatory T cells and Foxp3 in peripheral blood of patients with gastric carcinoma

The aim of this research was to study the clinical significance and expression of CD4+CD25+ regulatory T cells (Tregs) and p3Forkhead transcription factor-3 (Foxp3) in peripheral blood of patients with gastric carcinoma (GC) and to investigate the effects in the occurrence and development process of GC, to further comprehend their clinical values and provide a theoretical basis for the early diagnosis and immunotherapy of GC. The expression levels of CD4+CD25+Foxp3+Tregs in GC patients, at TNM staging, differentiated degree, lymphatic metastasis, cancer sites and cancer diameter of GC, were analyzed within the groups. The comparison of the expression levels of CD4+CD25+Foxp3+Tregs in peripheral blood between the GC group and the healthy control group showed a statistically significant difference. At TNM staging within the groups, pairwise comparisons of the expression levels of CD4+CD25+Foxp3+Tregs indicated that differences among the stage I+II group, stage III group and stage IV group were statistically significant. The expression levels of CD4+CD25+Foxp3+Tregs are closely relative to the occurrence and development of GC, providing theoretical bases and evidence for the early diagnosis, prognosis evaluation and immunotherapy of GC.

Tilt engineering of exchange coupling at G-type SrMnO3/(La,Sr)MnO3 interfaces

With the recent realization of hybrid improper ferroelectricity and room-temperature multiferroic by tilt engineering, "functional" octahedral tilting has become a novel concept in multifunctional perovskite oxides, showing great potential for property manipulation and device design. However, the control of magnetism by octahedral tilting has remained a challenging issue. Here a qualitative and quantitative tilt engineering of exchange coupling, one of the magnetic properties, is demonstrated at compensated G-type antiferromagnetic/ferromagnetic (SrMnO3/La2/3Sr1/3MnO3) interfaces. According to interfacial Hamiltonian, exchange bias (EB) in this system originates from an in-plane antiphase rotation (a(-)) in G-type antiferromagnetic layer. Based on first-principles calculation, tilt patterns in SrMnO3 are artificially designed in experiment with different epitaxial strain and a much stronger EB is attained in the tensile heterostructure than the compressive counterpart. By controlling the magnitude of octahedral tilting, the manipulation of exchange coupling is even performed in a quantitative manner, as expected in the theoretical estimation. This work realized the combination of tilt engineering and exchange coupling, which might be significant for the development of multifunctional materials and antiferromagnetic spintronics.

Genetic variations in microRNA genes and susceptibility to hepatocellular carcinoma

We conducted a hospital-based case-control study to investigate the effect of the miR-146aG>C and miR-499A>G polymorphisms on the risk of hepatocellular carcinoma (HCC) in a Chinese population. This study was 1:1 matched case-control study consisting of 184 HCC patients and 184 control subjects. miR-146aG>C and miR-499A>G polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism. Multivariate regression analyses showed that subjects carrying the miR-146a G allele and miR-499 G allele were associated with a non-significant increased risk of HCC compared with subjects with the homozygous allele, with adjusted odds ratios (95% confidence interval) of 1.38 (0.97-1.84) and 1.40 (0.99-2.08), respectively. Moreover, subjects carrying the miR-499 A allele showed a greatly increased risk of HCC in subjects infected with HBV compared with subjects carrying the miR-499 A allele, with an adjusted odds ratio (95% confidence interval) of 1.53 (1.34-2.41). In conclusion, the miR-146aG>C and miR-499A>G polymorphisms do not have a role in the genetic susceptibility to HCC.

Unconventional resistive switching behavior in ferroelectric tunnel junctions

An unconventional resistive switching behavior is observed in ferroelectric tunnel junctions, which builds a bridge between ferroelectric tunnel junctions and resistive random access memory devices.

Tuning the entanglement between orbital reconstruction and charge transfer at a film surface

The interplay between orbital, charge, spin, and lattice degrees of freedom is at the core of correlated oxides. This is extensively studied at the interface of heterostructures constituted of two-layer or multilayer oxide films. Here, we demonstrate the interactions between orbital reconstruction and charge transfer in the surface regime of ultrathin (La,Sr)MnO₃, which is a model system of correlated oxides. The interactions are manipulated in a quantitative manner by surface symmetry-breaking and epitaxial strain, both tensile and compressive. The established charge transfer, accompanied by the formation of oxygen vacancies, provides a conceptually novel vision for the long-term problem of manganites—the severe surface/interface magnetization and conductivity deterioration. The oxygen vacancies are then purposefully tuned by cooling oxygen pressure, markedly improving the performances of differently strained films. Our findings offer a broad opportunity to tailor and benefit from the entanglements between orbit, charge, spin, and lattice at the surface of oxide films.

First Report of Basella rugose mosaic virus Infecting Four O'Clock (Mirabilis jalapa) in China

Four o'clock (Mirabilis jalapa) and M. himalaica var. chinensis are members of the family Nyctaginaceae and are widely distributed weeds in Yunnan Province, China. In 2009, mosaic and malformation symptoms were observed on leaves of the four o'clock on the campus of Yunnan Agricultural University and in the Black Dragon Pool Park in Kunming City, China. More than 30% of the four o'clock plants showed symptoms of the disease. Sap from leaves of symptomatic four o'clock plants caused local chlorotic and necrotic lesions in inoculated Chenopodium amaranticolor after 7 to 10 days and systemic mosaic symptoms in C. quinoa and Nicotiana benthamiana after 10 to 12 days. No symptoms were observed following inoculation of sap from asymptomatic plants. A pure virus isolate (MJ) was obtained after three successive single-lesion transfers from C. amaranticolor. Following mechanical inoculation of the MJ isolate, seedlings of indicator plants, N. benthamiana, displayed mosaic symptoms. Moreover, back transmission to healthy four o'clock seedlings by leaf extracts from systemically infected N. benthamiana plants caused similar mosaic and malformation symptoms. Flexuous, filamentous particles (650 to 700 nm long and 13 nm wide) and cytoplasmic laminar aggregates and pinwheel inclusions typical of members of the genus Potyvirus were observed in infected four o'clock leaves by electron microscopy. No other virus particles were observed. Serological testing of 10 symptomatic and healthy plants using a monoclonal antibody specific for Potyvirus group members in an indirect ELISA (Agdia Inc., Elkhart, IN) also resulted in positive reactions in infected leaves, however, all healthy seedlings tested were negative. Total RNAs were extracted from infected four o'clock leaves with the RNeasy Plant Mini Kit (QIAGEN, Hilden, Germany) and the 3'-terminal portion of the viral genome (including part of the NIb polymerase, the entire coat protein (CP), and 3'-UTR) was then amplified by reverse transcription-PCR with a universal Potyviridae primer Sprimer/M4 and an M4T as the initial primer (2). A fragment of 1,720 nucleotides long were separated, purified, and cloned and three independent clones were sequenced (GenBank Accession No. JN250997). Nucleotide and amino acid sequence analysis of the putative CP gene, respectively, revealed 75.1 to 76.3% and 80.3 to 82.1% identity with the Basella rugose mosaic virus (BaRMV) (GenBank Accession Nos. DQ821938, DQ394891, and DQ821939), 77.4 and 81.0% identity with Peace lily mosaic virus (GenBank Accession No. DQ851494), and 76.0 and 81.7% identity with the Phalaenopsis chlorotic spot virus (GenBank Accession No. HM021142). However, on the basis of the CP gene sequence analyses, these three viruses shared high (>88.5 and >94.3%) CP nucleotide and amino acid identity and should be classified as the same Potyvirus species. According to the species demarcation criteria for the Potyviridae (1), the pathogen causing mosaic and malformation symptoms on four o'clock was BaRMV (3). To our knowledge, this is the first report of BaRMV in four o'clock. References: (1) M. J. Adams et al. Arch. Virol. 150:459, 2005. (2) J. Chen et al. Arch. Virol. 146:757, 2001. (3) C. H. Hung and Y. C. Chang. Plant Pathol. 55:819, 2006.

Interaction between synchronous bilateral prophylactic oophorectomy and adjuvant chemotherapy in female patients with locally advanced colorectal cancer

AIM

In this study we explored the prognostic impact of synchronous bilateral prophylactic oophorectomy in female patients with primary colorectal cancer undergoing radical surgery.

METHOD

From 1991 to 2000, 267 female patients with stage II or stage III colorectal cancer, who had undergone curative resection, were retrospectively reviewed. In 224 patients, the ovaries were preserved. The other 43 patients underwent synchronous bilateral prophylactic oophorectomy. Univariate and multivariate analyses (Kaplan-Meier and Cox regression, respectively) were used to evaluate the effect of prophylactic oophorectomy and other clinical factors on the prognosis of patients.

RESULTS

Both univariate and multivariate analyses showed that tumor stage and adjuvant chemotherapy were the only two significant clinical factors that affected the 5-year overall survival of patients (P < 0.01). There was no significant difference in the 5-year overall survival between patients who had, or had not, undergone prophylactic oophorectomy (75%vs 73%, P > 0.05). In the subgroup analysis by adjuvant chemotherapy, the 5-year overall survival in patients receiving adjuvant chemotherapy was similar between nonoophorectomy and oophorectomy groups. However, in patients without adjuvant chemotherapy, the oophorectomy group was shown to have a significantly better 5-year overall survival than the nonoophorectomy group (76%vs 51%, P = 0.047).

CONCLUSION

Prophylactic oophorectomy may improve the overall survival of female patients with locally advanced colorectal cancer without adjuvant chemotherapy, but its survival benefit vanished in patients receiving adjuvant chemotherapy. The role of prophylactic oophorectomy may be substituted by adjuvant chemotherapy, which makes prophylactic oophorectomy unnecessary during surgery for locally advanced colorectal cancer.

Effect of system of feeding and watering on performance of lactating sows

An experiment was conducted to determine the effects of ad libitum access to feed and water and the option to mix feed and water, all in the same feeder, on the performance of multiparous lactating sows. Feed and water were made available to sows using a self-fed wet/dry (SFWD) or a hand-fed (HF) feed-water system. In the SFWD system, feed and water were dropped into a common trough area of the feeder. The sow determined when and how much of each was dropped. With feed falling onto the flat area of the bottom of the SFWD feeder trough and water falling into the shallow bowl area, and with the 2 areas seamlessly connected, the sow also determined the wetness of the feed consumed. In the HF system, sows were given dry feed twice daily in a J-shaped feeder that was independent of the sow's water source. Sows (n = 114) were assigned to treatments based on parity and genotype. Total feed disappearance per sow during lactation (20 +/- 0.2 d) was greater (P < 0.01) with the SFWD system than with the HF system (120 vs. 110 +/- 4.1 kg, respectively). The SFWD sows had greater (P < 0.01) BW gains during lactation than HF sows (6.2 vs. 0.6 +/- 1.85 kg, respectively). Backfat depth change during lactation did not differ (P = 0.37) between treatments. Likewise, percentage of sows displaying estrus by d 11 post-weaning did not differ (P = 0.51). Piglet weaning BW was greater (P < 0.01) with the SFWD system than with the HF system (6.63 vs. 6.12 +/- 0.22 kg, respectively). Sow average daily water intake and total feed wastage during lactation did not differ (P > 0.66) between treatments. However, sows with the SFWD system wasted less water (P < 0.01) than those with the HF system (15 vs. 232 +/- 12 L, respectively). From a commercial swine production perspective, the difference in waste water volume would result in a significant variation in costs associated with manure storage and distribution. In conclusion, use of a SFWD feed-water system in lactation, which provides sows choices of when to eat, how much to eat, and if dry feed should be mixed with water during consumption, enhances sow appetite, improves litter growth performance, and wastes less water than a HF feed-water system.

[The application radionuclide bone imaging in the treatment of hallux valgus]

Radionuclide bone imaging (RNBI) was performed by means of 99mTc-MDP on both 20 health subjects (40 feet) and 20 patients with hallux valgus (26 feet). The results showed that radioactivity intake were increased in second (or third) metatarsal of 26 feet of hallux valgus. The ratio of radioactivity of the lesion and contralateral normal site (D/N) had statistical difference (P < 0.01). Both the patient and normal groups RNBI is a highly sensitive study and valuable for the classification of diagnosis. It help for selection of surgical treatment, as to evaluate the results of the treatment.

[Changes of plasma motilin concentration in pregnancy and early postpartum period]

Plasma motilin concentration were determined by radioimmunoaction from 180 women during pregnancy and early postpartum period as compared with 20 healthy non-pregnant women. The results showed that mean plasma motilin concentration (384.40 +/- 110.30 ng/L) was higher in the first trimester of pregnancy than that of healthy non-pregnant women (366.12 +/- 96.23 ng/L), however, this difference did not reach statistical significance (P > 0.05). The mean plasma motilin concentration (323.90 +/- 125.10 ng/L) was lower in the second trimester of pregnancy than in the first trimester of pregnancy (P < 0.05), while the mean plasma motilin concentration in the third trimester of pregnancy (121.04 +/- 27.00 ng/L) was significantly lower than in second (P < 0.01) and the mean plasma motilin concentration in 3-5 d after delivery (443.05 +/- 140.79 ng/L) reached an even higher value (P < 0.01). Our results suggests that pregnancy appears to have a profound inhibitory effect on plasma motilin and this may in part be responsible for the gastrointestinal hypomotility during pregnancy.

[30 years' experience of obstetric hysterectomy]

Sixty-eight cases of obstetric hysterectomy were performed in our hospital from 1960 to 1989, an incidence of 27.63/10,000. The maternal mortality was 8.82% (6/68). Forty-four hysterectomies were done at end of cesarean sections and twenty-four performed after vaginal deliveries. Uterine rupture (48.53%) was the chief indication for emergent hysterectomies and placental disorders came next in frequency. The most common indication for nonemergency hysterectomies was uterine leiomyoma. The emergence of placenta accreta as major indication for hysterectomy is an obvious change since the past decade. Twelve of these patients (17.65%) underwent total abdominal hysterectomy and fifty-six (82.35%) subtotal hysterectomy. The operative indications, conditions and problems are discussed.

[Anesthesia for the low body weight neonates]

58 newborns weighting under 2500 gm were collected, who received surgery in the past five years (1985-1989) in Chang Gung Memorial Hospital, Taipei, and followed up the survivors until April 1990. We classified these 58 cases by physical status that 31 cases (53%) were in ASA II, 26 (45%) in ASA III, 1 (2%) in ASA IV; by body weight that 9 cases (16%) were under 1500 gm, 17 (29%) between 1501 and 2000 gm, 32 (55%) over 2000 gm; by gestational age that 26 cases (45%) were in term pregnancy, 14 (24%) in borderline prematurity, 16 (28%) in moderate prematurity, 2 (3%) in extreme prematurity. All these 58 cases were under endotracheal general anesthesia, the majority of surgery (32 cases) were abdominal procedures. They were all sent to pediatric intensive care unit after operation. The mortality rate was 42% (25 cases), 4 cases of those were dead within the post-operative 24 hours. In this study, the change of temperature during operative procedures was significantly correlative to the neonatal mortality (p less than 0.005).

Radiologic evaluation of the liver in the alcoholic patient

It has been well documented that long-term abuse of alcohol leads to dysfunction of multiple organ systems of the body. The liver, which is the primary organ responsible for alcohol metabolism, is also a major target for damage. Cirrhosis of the liver is the seventh leading cause of death in the United States. The radiologist plays an important role in the evaluation and possibly in the treatment of the conditions which result from alcohol abuse. The advantages and limitations of various radiologic diagnostic modalities in the evaluation of alcoholic liver disease are presented and discussed.

The disposable umbrella catheter: an alternative to the standard balloon enema catheter

The authors describe the use of a new catheter for barium enema examination that eliminates the hazards of the straight and balloon type catheters.