[Efficacy of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei]

Objective: To evaluate the efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of pseudomyxoma peritonei (PMP). Methods: In this descriptive case series study, we retrospective analyzed the records of PMP patients treated with CRS and HIPEC between January 2013 and June 2023 at Affiliated Cancer Hospital and Institute of Guangzhou Medical University. The inclusion criteria were as follows: (1) Aged 18 to 75 years and nonpregnant women. (2) Histologically confirmed diagnosis of pseudomyxoma peritonei. (3) Karnofsky Performance Scale (KPS)>70. (4) The functions of major organs such as the heart, liver, lungs, and kidneys can tolerate major surgery for long periods of time. (5) No evidence of extra-abdominal metastasis. Patients with extensive intra-abdominal adhesions or severe infectious diseases were excluded. The main outcomes were overall survival (OS) and postoperative major complications. The postoperative major complications were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0). We used the peritoneal cancer index (PCI) score to quantitatively assess the peritoneal metastases and the completeness of cytoreduction (CCR) score at the end of surgery (CCR-0 and CCR-1 considered to be complete CRS). Results: A total of the 186 PMP patients with a median age of 56 (interquartile range extremes (IQRE), 48-64) years were included, 65 (34.9%) males and 121 (65.1%) females. The median peritoneal cancer index (PCI) score was 28 (20-34). Appendiceal origin accounted for 91.4%. Histological types were low grade in 99 patients (53.2%), high grade in 57 patients (30.6%), and 55 patients (29.6%) received complete cytoreduction (CCR-0/1). The median operative duration was 300 (211-430) minutes for all patients. Treatment-related 30-day mortality was 2.7%; 90-day mortality 4.3%; reoperation 1.6%; and severe morbidity 43.0%. Within the entire series, anemia(27.4%), electrolyte disturbance(11.6%), and hypoalbuminemia(7.5%) were the most frequent major complications (grade 3-4). The incidences of gastrointestinal anastomotic leakage, abdominal bleeding, and abdominal infection were 2.2%, 2.2%, and 4.3%, respectively. After a median follow-up of 38.1 (95%CI:31.2-45.1) months, the 5-year OS was 50.3% (95%CI: 40.7%-59.9%) with a median survival time of 66.1 (95%CI: 43.1-89.1) months. The survival analysis showed that patients with pathological low grade, low PCI, and low CCR score had better survival with statistically significant differences (all P<0.05). Further stratified into complete and incomplete CRS subgroups, the 5-year OS of the CCR-0 and CCR-1 subgroups was 88.9% (95%CI: 68.3%-100.0%) and 77.6% (95%CI: 62.7%-92.5%), respectively; and 42.0% (95%CI: 29.5%-54.5%) in the CCR-2/3 subgroup. Conclusions: CRS and HIPEC may result in a long-term survival benefit for PMP patients with acceptable perioperative morbidity and mortality. This strategy, when complete CRS is possible, could significantly prolong survival for strictly selected patients at experienced centers.

[Prevalence and risk factors of medication non-adherence in children with inflammatory bowel disease]

Objective: To investigate the prevalence and risk factors of medication non-adherence in children with inflammatory bowel disease (IBD). Methods: A cross-sectional study was conducted in Children's Hospital, Zhejiang University School of Medicine from September 2020 to March 2022 and 112 children with IBD were enrolled. Their general information, medication adherence, and parental disease-related knowledge were collected by questionnaires. According to the medication adherence score, the children were divided into the adherence group (score of 6 to 8) and the non-adherence group (score of <6), then the demographic and clinical characteristics of the two groups were compared. Subsequently, a multivariate binary Logistic regression analysis was performed to determine the risk factors of medication non-adherence. Results: Of the 112 children, 76 were males and 36 females, with the age of 12.9 (9.5, 14.0) years. There were 50 (44.6%) in the non-adherence group and 62 (55.4%) in the adherence group. Regarding the demographic and clinical characteristics, the results showed that the dosage frequency and the parental disease related knowledge were associated with medication non-adherence (both P<0.05). Multivariate binary Logistic regression analysis showed that compared with 0-6 years old children, the risk of medication non-adherence was significantly increased in children aged 7-12 years (OR=9.30, 95%CI 1.58-54.87, P=0.014) and 13-18 years (OR=8.26, 95%CI 1.49-45.85, P=0.016); and the risk was also significantly increased in children who took medication twice or more per day (OR=12.88, 95%CI 2.77-59.80, P=0.001) compared with children who took medication once per day. Meanwhile, the parental score of the questionnaire on Crohn's disease and ulcerative colitis related knowledge (OR=0.76, 95%CI 0.66-0.89, P=0.001) was also a significant risk factor. Conclusions: Medication non-adherence is common in children with IBD. Children older than 7 years, a dosage frequency of twice or more per day, and parental poor disease-related knowledge are the independent risk factors for medication non-adherence in children with IBD. Clinicians should pay attention to promoting patients' adherence to improve clinical outcomes.

[Advice on the rationalized layout of outpatient clinics in a wound repair department]

According to a document issued by the General Office of National Health Commission, "one person, one diagnosis, and one room" is required in the process of outpatient consultation. However, the patient will need to go to another room for dressing change after the doctor checks the wound if sticking to the conventional layout of current wound repair specialist outpatient clinic in hospitals and following the regulation of "separation of diagnosis and treatment". To allow a patient walking back and forth with the exposed wounds to different clinics or going to another clinic for dressing change with the original dressing reapplied to the wound is against the regulation of nosocomial infection control and the principle of sterility. To ensure that the layout of the outpatient clinic in the wound repair outpatient department not only conforms to the principle of "one person, one diagnosis, and one room", but also meets the characteristics of the diagnosis and treatment process of chronic wounds, this paper proposes the layout of "large space and small partition" in the wound repair clinic.

[Comparison of epidemic characteristics between severe acute respiratory syndrome and coronavirus disease 2019]

Objective: To compare epidemic characteristics between severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19). Methods: The general information, including epidemiological and clinical data of the confirmed cases during the epidemic period of the two infectious diseases was collected. The data of SARS in Guangzhou was derived from the technical files of Guangzhou Center for Disease Control and Prevention (GZCDC), including the statistical report and brief report of the epidemic situation (from January 2 to May 11, 2003);The data of COVID-19 in Wuhan was derived from the epidemic data published by Wuhan health and Health Committee's official website and other publicly reported documents (from December 9, 2019 to March 11, 2020). Descriptive analysis was used for a comparativeanalysis of the time and age characteristics, the number of cases, basic reproduction number (R0), proportion of medical staff in confirmed cases (%), crude mortality, etc. Results: A total of 1 072 cases of SARS in Guangzhou were included in the study. The incidence ratio of male to female was 1∶1.26. 43 cases of death were reported with a mortality rate of 4.01%. The median age was 36 years old. The proportion of medical staff in the early stage of the epidemic was 29.04% (88 cases). As to COVID-19 in Wuhan, a total of 49 978 cases were included, The incidence ratio of male to female was 1.04∶1. The 2 423 cases of death were reported with a mortality rate of 4.85%. The median age was 56 years old. The proportion of medical staff in the early stage of the epidemic was 30.43% (42 cases). Conclusion: The COVID-19 in Wuhan has the characteristics of high incidence and wide population. However, the epidemic situation is falling rapidly, and the prevention and control strategy needs to be adjusted timely. The prevention and control of nosocomial infection should be addressed in future.

[Pay attention to the exposure risk of patients with chronic wounds on the way to hospital during coronavirus disease 2019 epidemic prevention and control]

Statistics show that 76.74% (4 688) of 6 109 patients with chronic wounds are over 50 years of age; the proportion of patients with underlying diseases in all age groups above 50 years ranges from 78.25% to 100.00%. Among the underlying diseases of chronic wound patients, the top four diseases are diabetes mellitus, cardiovascular and cerebrovascular diseases, hypertension, and respiratory diseases. The above underlying diseases and ages of patients are the susceptibility factors of coronavirus disease 2019 released by National Health Commission of China. It is an unavoidable fact that the patients with chronic wounds have to go to the hospital for treatment prescribed by the physician. At the same time, we found that quite a few patients preferred going far afield in choosing hospital for treatment due to various reasons. During the prevention and control of coronavirus epidemic, this " go far afield" style of seeking medical treatment may increase the exposure risk during travelling. Accordingly, we convened 36 wound care clinics in different regions in Shanghai to implement the " Five Measures" encouraging the patients with chronic wounds to seek medical treatment nearby. The principle of this operation is that when seeking medical treatment, patients with chronic wounds should try their best to reduce the travel distance as much as possible to minimize the exposure risk during the epidemic period, which will in turn support the campaign of epidemic prevention and control.

[Comparison of epidemic characteristics between SARS in 2003 and COVID-19 in 2020 in Guangzhou]

Objective: By analyzing the epidemic characteristics and related indicators of SARS and COVID-19, to explore the reasons for the similarities and differences of the two epidemics, so as to provide reference for epidemic prevention and control. Methods: The general situation, clinical classification, activity history, contact history, family members' contact and incidence of the two infectious diseases in Guangzhou were collected and used to analyze the time characteristics, occupational characteristics, age characteristics and other key indicators of the two diseases, including the number of cases, composition ratio (%), mean, median, crude mortality, etc. Results: A total of 1 072 cases of SARS were included in the study. Three hundred and fifty three were severe cases with the incidence of 30.13%. Forty three cases of death were reported with a mortality rate of 4.01%. The average age was 46 years old, and 26.31% of the cases were medical staff. The interval time between first report to continuous zero reports was 129 days. As to COVID-19, a total of 346 cases were included. 58 of which were severe cases with the incidence of 16.67%. One case of death was reported with a mortality rate of 0.29%. The average age was 38 years old, and no hospital infection among medical staff was reported. The interval time between first report to continuous zero reports was 35 days. Conclusions: The prevention and control strategies for COVID-19 were more effective compared to that of SARS, and the emergency response procedures were worth to be evaluated and summarized.

Dose-related histopathology and bone remodeling characteristics of the knee articular cartilage and subchondral bone induced by glucocorticoids in rats

The aim of the current study was to investigate histopathological changes and bone remodeling in the knee articular cartilage and subchondral bone in rats following treatment with glucocorticoids. A total of 30 3-month-old female Sprague-Dawley rats were randomly divided into either a vehicle control group or one of three experimental groups wherein dexamethasone (Dex) was administered at a dose of 1.0, 2.5 or 5.0 mg/kg (Dex1.0, Dex2.5 and Dex5.0, respectively), for 8 weeks. Articular cartilage and the epiphyseal subchondral bone of the proximal tibias were evaluated by histopathology or for bone remodeling using histomorphometry. No histological changes were identified in the knee articular cartilage but the bone formation rate of the subchondral bone was lower in the Dex1.0 group compared with that of the control group. Compared with the control and the Dex1.0 group, the width of the articular cartilage and the subchondral plate were larger, with abnormal morphology and increased apoptosis of chondrocytes, decreased cell/matrix volume ratio in the cartilage and fewer blood vessels in the subchondral plate in the Dex2.5 and Dex5.0 groups. A higher Dex dose resulted in more severe inhibition of bone formation, a greater number of apoptotic osteocytes and constrained bone resorption. All microstructure parameters indicated no significant changes in the Dex2.5 group but exhibited deterioration in the Dex5.0 group compared with the normal and Dex1.0 group. There were no significant differences in morphological changes, or in static and dynamic bone indices between the Dex2.5 and Dex5.0 groups. In conclusion, long-term glucocorticoid use induced dose-related histopathological changes in the knee articular cartilage, along with unbalanced bone remodeling and osteopenia in the subchondral bone. The degree of damage to the articular cartilage was milder and transformed from compensation to degeneration at higher doses.

[Thoughts and principles of diagnosis and treatment of chronic refractory wounds in China]

The correct thoughts and principles of diagnosis and treatment of chronic refractory wounds need to be formulated. Through the relevant domestic and international consensus and based on clinical experience, the Thoughts and principles of diagnosis and treatment of chronic refractory wounds in China is proposed. It is considered that in the diagnosis and treatment of chronic refractory wounds, in the case of fully understanding the patient's medical history, the following thoughts and principles should be complied in order. (1) Pay attention to the cleanliness of the wound after being cleaned. (2) Reasonably perform debridement to avoid being " excessive" or " not thorough". (3) Reasonably perform examination, diagnosis, and differential diagnosis of pathogenic factors. (4) Treat according to etiology. (5) Find comorbidities and prevent adverse outcomes. (6) Select the correct wound treatment method reasonably and timely. When the conservative wound care treatment is considered, pay attention to embodying the concept of etiological treatment, treat the wound according to the principles of safety, phase, selectivity, and effectiveness, and make a reasonable choice of continuing conservative treatment or surgical treatment in time after completing the preparation of the wound bed. When surgical treatment is considered, pay attention to the selection of reasonable surgical method and donor site, pay attention to the healing rate of surgical wound site and the outcome of donor site, and give reasonable protection to the wound site after surgery. (7) Carry out rehabilitation treatment after wound healing and related health education.

[Epidemiological and pathogenic characteristics of mumps in Fujian province, 2005-2017]

Objective: To understand the epidemiological and etiological characteristics of mumps in Fujian province, 2005-2017. Methods: All the reported mumps cases were collected through the National Notifiable Disease Information Management System, 2005-2017. Active search and interviews were conducted to collect the information on vaccination of mumps. Throat swab specimens were collected for cells culture, genotyping and gene sequence analysis on mumps virus (MuV). Results: A total of 83 959 cases of mumps were reported in Fujian province from 2005 to 2017, with an average annual incidence of 17.6 per 100 000. Since 2007, the incidence appeared increasing but then decreasing, reaching the lowest level (7.5 per 100 000), after the setup of a monitoring program. Annually, the onset time of mumps showed an obvious two seasonal peaks, one from April to July, with a weakening trend, and the other from October to January with a rising trend. Most of the mumps cases occurred among students, kindergarten and scattered children (89.2%, 5 814/6 517), children aged 5-9 years (38.8%, 2 527/6 517), with cases reported from every region. Program from the pathogen surveillance showed that the transmission chain of G genotype mumps virus did exist in Fujian. Data from the sequence analysis revealed that mutations in the nucleotide of G genotype strain in 2015 had led to mutation of 6 amino acid sites in the SH gene coding region, resulting in the differences appearing in both nucleotide and amino acid homology with type A vaccine strain. Conclusions: The incidence of mumps decreased annually, in Fujian. Prevention programs should focus on primary and secondary school students. In Fujian province, we also noticed the transmission chain of mumps G genotype with some amino acid mutations in the SH gene coding region. Monitor programs on both epidemiologic and etiology, should be strengthened.

WISP1 silencing confers protection against epithelial-mesenchymal transition of renal tubular epithelial cells in rats via inactivation of the wnt/β-catenin signaling pathway in uremia

Uremia can affect hepatic metabolism of drugs by regulating the clearance of drugs, but it has not been clarified whether gene silencing could modulate the epithelial-mesenchymal transition (EMT) process in uremia. Hence, we investigated the effect of WISP1 gene silencing on the renal tubular EMT in uremia through the wnt/β-catenin signaling pathway. Initially, microarray-based gene expression profiling of uremia was used to identify differentially expressed genes. Following the establishment of uremia rat model, serum creatinine, and urea nitrogen of rats were detected. Renal tubular epithelial cells (TECs) were transfected with shRNA-WISP1 lentivirus interference vectors and LiCI (the wnt/β-catenin signaling pathway activator) to explore the regulatory mechanism of WISP1 in uremia in relation to the wnt/β-catenin signaling pathway. Then, expression of WISP1, wnt2b, E-cadherin, α-SMA, c-myc, Cyclin D1, MMP-2, and MMP-9 was determined. Furthermore, TEC migration and invasion were evaluated. Results suggested that WISP1 and the wnt/β-catenin signaling pathway were associated with uremia. Uremic rats exhibited increased serum creatinine and urea nitrogen levels, upregulated WISPl, and activated wnt/β-catenin signaling pathway. Subsequently, WISP1 silencing decreased wnt2b, c-myc, Cyclin D1, α-SMA, MMP-2, and MMP-9 expression but increased E-cadherin expression, whereas LiCI treatment exhibited the opposite trends. In addition, WISP1 silencing suppressed TEC migration and invasion, whereas LiCI treatment promoted TEC migration and invasion. The findings indicate that WISP1 gene silencing suppresses the activation of the wnt/β-catenin signaling pathway, thus reducing EMT of renal TECs in uremic rats.

[Application value of endoscope in probing chronic wound with sinus tract in clinic]

Objective: To explore the application value of endoscope in probing the chronic wound with sinus tract in clinic. Methods: Twenty-eight chronic wounds with sinus tracts from 27 patients conforming to the inclusion criteria admitted to Outpatient Department of Wound Healing Center of Ruijin Hospital from December 2017 to March 2018 were investigated in a prospective and self-controlled trial. After being cleaned, the diameter of the opening of sinus tract was measured with a rule. A probe was used to measure the depth of a sinus tract according to the touch from the probe extremity in operation, and to measure the depth of a sinus tract that could be observed with naked eyes with the help of a pair of hemostatic forceps. Five minutes later, a probe was inserted deeply into the sinus tract to measure the depth under the endoscopic view combined with touch from the probe extremity in operation. Afterwards, the sinus tract was observed with endoscope, and the depth of the tract which could be observed under the endoscopic view was measured using a probe inserted deeply into the sinus tract. After completion of the above exploration, the sinus tract was infused with contrast agent Omnipaque 350 and scanned by computed tomography (CT) later to obtain its depth. The following indicators were calculated: the ratio of the depth of the sinus tract measured by CT to the diameter of the opening of the sinus tract (hereinafter referred to as the depth/diameter ratio of the sinus tract), the deviation rate comparing the depth of the sinus tract measured by conventional method (measured by probe only) and by endoscope (measured by probe under the endoscope view) with the depth of the sinus tract measured by CT (hereinafter referred to as the deviation rate of the measured depth of the sinus tract), the deviation rate comparing the depth of the sinus tract that could be observed measured by conventional method and by endoscope with the depth of the sinus tract measured by CT (hereinafter referred to as the deviation rate of the depth of the sinus tract that could be observed). Data were processed with paired t test. Pearson correlation analysis was applied to analyze the correlation between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method and by endoscope. Results: The depth/diameter ratio of the sinus tract of this group of wounds was 1-32 (8±7). The deviation rate of the measured depth of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method were (19±14)% and (79±18)%, respectively, both obviously larger than (9±9)% and (25±25)% by endoscope (t=3.837, 13.626, P<0.01). Positive correlation existed between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract by conventional method, and between the depth/diameter ratio of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method and by endoscope (r=0.514, 0.585, 0.651, P<0.01). However, there was no obvious correlation between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract by endoscope (r=0.113, P>0.05). Conclusions: Compared with the conventional method, application of endoscope is able to get more accurate data of chronic wounds with sinus tracts and observe the wounds with wider range.

[A large scale cohort study on the immunization effect of hepatitis B vaccine in Fujian province]

Objective: To evaluate the effectiveness of hepatitis B vaccination in Fujian province. Methods: Based on the hepatitis B immunization strategy of China, a cohort study was designed, involving the population in Fujian province. The population under study was divided into natural exposure birth cohort before 1992 and the immunization birth cohort after 1992 (including voluntary vaccination cohort and standardized vaccination cohort). By cleaning the database of hepatitis B cases which directly reported through network and looked into the incidence and related death outcomes of acute hepatitis B from 2004 to 2017, the incidence levels of hepatitis B and immunization effects were analyzed and evaluated among different birth cohorts. Results: During the observation period, the overall prevalence of hepatitis B in Fujian province was 44.594 per 100 000, with mortality rate as 0.010 per 100 000. The incidence of natural exposure cohort of birth was 56.885 per 100 000. The incidence of voluntary vaccination cohort of birth was 14.502 per 100 000. Compared with the voluntary vaccination cohort, the risk of hepatitis B increased significantly in the natural exposed cohort (RR=3.923), and the difference was statistically significant (P=0.000 7), with attributable risk as 42.383 per 100 000. The attributable risk ratio was 74.507. The population attributable risk ratio was 70.967%. The population attributable risk was 35.448 per 100 000. The attributable rate in standardized vaccination cohorts born after 2002 was 2.336 per 100 000. Compared with the cohorts born before 1992, the RR was 24.347 (P=0.000 0), the attributable risk was 54.549 per 100 000, and the attributable risk ratio was 95.893%, the population attributable risk ratio was 95.300%, the population attributable risk was 47.371 per 100 000, comparing to the natural exposed population. Conclusions: The effectiveness of hepatitis B immunization program had been remarkable in Fujian province since 1992. However, further studies on the persistency of hepatitis B vaccine immunization and its public health significance still needed to be carried out.

The development of bone microstructure, metabolism and biomechanics in lumbar vertebra under short-term glucocorticoid exposure

Abstracts Objective: This study investigated the characteristics of bone microstructure, metabolism, and biomechanics in rat's lumbar vertebra undergoing short-term glucocorticoid administration. Methods: Forty 4-month-old female Sprague-Dawley rats were treated with either vehicle (Cont) or prednisone acetate (Pre) at 3.5 mg/kg/day, respectively for periods of 7 days and 21 days. The lumbar vertebras were processed for MicroCT scan, histomorphometry analysis, mechanical compression test, in addition to Dual-Energy X-ray absorptiometry scan, respectively. Results: The connective density (Conn. D) along with trabecular connection nodes decreased while trabecular termini increased in Pre at day 21 when compared to Cont at day 21 as well as Pre at day 0. The mineralizing surface (MS/BS), mineral apposition rate (MAR), bone formation rate (BFR), osteoblast surfaces (Ob.S/BS) were lower in Pre at day 21 than that in Cont at day 21, Pre at day 0 and Pre at day 7. Only the bending stiffness of compression test decreased in Pre group at day 21 compared to age-matched control. Conclusion: The results suggested that excess prednisone significantly inhibited bone formation and slightly depressed bone resorption in the lumbar vertebra of intact rats for the duration of 21 days. Accordingly, the trabecular spatial microstructure made an adjustment yet failed to maintain the anti-compression mechanical property.

[Clinical analysis of idiopathic sudden sensorineural hearing loss with vertigo and without vertigo]

Objective:To explore the clinical characteristics and treatments of patients with idiopathic sudden sensorineural hearing loss（ISSHL） with or without vertigo. Method:One hundred and twenty ISSHL cases were divided into vertigo group (n=36) , without vertigo group (n=84) , and with benign paroxysmal positional vertigo group (n=15). All patients were in regular treatment. Besides, according to the types of BPPV, patients do the Epley maneuver or Barbecue roll maneuver. We summarized the result and treatment of the patients. Result:The audiometric curve of ISSHL with vertigo were mainly at flat type. After treatment of the ISSHL patients were better than the patients with vertigo in the degrees of hearing loss . Furthermore, the rate of the patients of marked efficiency, efficiency and total efficiency of ISSHL was lower than the ones without.The patients with BPPV, including 12 cases of posterior semicircular canal and the 3 cases of lateral semicircular canal, were all ipsilateral. Conclusion:ISSHL with vertigo group lost hearing is severer than ISSHL without vertigo. Thus the hearing and the treatment effect were worse.The symptoms without vertigo in ISSHL were better than the patients with vertigo.

The epidemiology of hepatitis B virus infection in women of reproductive age in highly endemic areas in China

We describe the epidemiology of hepatitis B virus (HBV) infection among women of reproductive age residing in areas of China that are highly endemic for chronic HBV, and provide evidence useful for decision-makers to guide strategies for preventing mother-to-child transmission of HBV, and assess the impact of perinatal transmission PMTCT by projecting HBsAg prevalence trends without interventions. We conducted a cross-sectional HBV serological survey of women, 15-49 years of age, residing in Fujian, Guangdong, Guangxi and Hainan provinces. Demographic and other subject-level data were collected in face-to-face interviews, after which we obtain blood specimens. Specimens were tested for HBV sero-markers by ELISA (Beijing Wantai Biological Pharmacy), and HBV DNA was tested with PCR (Hunan Sansure Biotech). Weighted HBsAg and HBV (either HBsAg+ or anti-HBc+ indicating either present or past infection) prevalences were 11.82% and 57.16%, respectively. Among the HBsAg-positive women, 27% were also HBeAg positive. The proportion of individuals with HBV DNA loads >10⁵ IU/mL declined with increasing age. Among HBsAg-negative women, 0.9% had occult HBV infection. The prevalence of chronic HBV infection among reproductive women in these highly endemic provinces is high, posing a threat to maternal health and risk of mother-to-child transmission. Prevention of mother-to-child transmission remains critically important.

A Point-based Mortality Prediction System for Older Adults with Diabetes

The mortality prediction models for the general diabetic population have been well established, but the corresponding elderly-specific model is still lacking. This study aims to develop a mortality prediction model for the elderly with diabetes. The data used for model establishment were derived from the nationwide adult health screening program in Taiwan in 2007-2010, from which we applied a 10-fold cross-validation method for model construction and internal validation. The external validation was tested on the MJ health screening database collected in 2004-2007. Multivariable Cox proportional hazards models were used to predict five-year mortality for diabetic patients ≥65 years. A total of 220,832 older subjects with diabetes were selected for model construction, of whom 23,241 (10.5%) died by the end of follow-up (December 31, 2011). The significant predictors retained in the final model included age, gender, smoking status, body mass index (BMI), fasting glucose, systolic and diastolic blood pressure, leukocyte count, liver and renal function, total cholesterol, hemoglobin, albumin, and uric acid. The Harrell's C in the development, internal-, and external-validation datasets were 0.737, 0.746, and 0.685, respectively. We established an easy-to-use point-based model that could accurately predict five-year mortality risk in older adults with diabetes.

Construction of a cDNA library and preliminary analysis of expressed sequence tags in Piper hainanense

Black pepper is a perennial climbing vine. It is widely cultivated because its berries can be utilized not only as a spice in food but also for medicinal use. This study aimed to construct a standardized, high-quality cDNA library to facilitated identification of new Piper hainanense transcripts. For this, 262 unigenes were used to generate raw reads. The average length of these 262 unigenes was 774.8 bp. Of these, 94 genes (35.9%) were newly identified, according to the NCBI protein database. Thus, identification of new genes may broaden the molecular knowledge of P. hainanense on the basis of Clusters of Orthologous Groups and Gene Ontology categories. In addition, certain basic genes linked to physiological processes, which can contribute to disease resistance and thereby to the breeding of black pepper. A total of 26 unigenes were found to be SSR markers. Dinucleotide SSR was the main repeat motif, accounting for 61.54%, followed by trinucleotide SSR (23.07%). Eight primer pairs successfully amplified DNA fragments and detected significant amounts of polymorphism among twenty-one piper germplasm. These results present a novel sequence information of P. hainanense, which can serve as the foundation for further genetic research on this species.

Temperature- and Relative Humidity-Dependent Life History Traits of Phenacoccus solenopsis (Hemiptera: Pseudococcidae) on Hibiscus rosa-sinensis (Malvales: Malvaceae)

Phenacoccus solenopsis Tinsley (Hemiptera: Pseudococcidae), a worldwide distributive invasive pest, originated from the United States, and it was first reported in Guangdong province, China, in 2008. The effects of temperature and relative humidity (RH) on the life history traits of P. solenopsis on Hibiscus rosa-sinensis L. (Malvales: Malvaceae) were studied at seven constant temperatures (15, 20, 25, 27.5, 30, 32.5, and 35°C) and three RHs (45, 60, and 75%). The results showed that temperature, RH, and their interactions significantly influenced the life history traits of P. solenopsis. First instar was the most sensitive stage to extreme temperatures with very low survival rates at 15 and 35°C. At 25-32.5°C and the three RHs, the developmental periods of entire immature stage were shorter with values between 12.5-18.6 d. The minimum threshold temperature and the effective accumulative temperature for the pest to complete one generation were 13.2°C and 393.7 degree-days, respectively. The percentage and longevity of female adults significantly differed among different treatments. It failed to complete development at 15 or 35°C and the three RHs. Female fecundity reached the maximum value at 27.5°C and 45% RH. The intrinsic rate for increase (r), the net reproductive rate (R0), and the finite rate of increase (λ) reached the maximum values at 27.5°C and 45% RH (0.22 d(-1), 244.6 hatched eggs, and 1.25 d(-1), respectively). Therefore, we conclude that 27.5°C and 45% RH are the optimum conditions for the population development of the pest.

First Report of Bacterial Stem and Root Rot of Sweetpotato Caused by a Dickeya sp. (Erwinia chrysanthemi) in China

Since 2006, stem and root rot of sweetpotato has been observed in fields at a number of sweetpotato-production areas in Huidong, Haifeng, Puning, and Zhanjiang counties and Guangzhou City in Guangdong Province of China. Initially, the leaves turn yellow, and a black, water-soaked rot occurs on the bottom of the stems that gradually extends to the top of the stems. Finally, the entire plant collapses and dies. Bacteria were consistently isolated from stems of diseased seedlings by streaking on nutrient agar. Twelve representative isolates were chosen for further characterization. All strains grew at 37°C, were gram negative, facultatively anaerobic, and rod shaped with peritrichous flagella. The strains were negative for oxidase and positive for catalase and tryptophanase (indole production) They fermented glucose, reduced nitrates to nitrites, degraded pectate, produced phosphatase and lecithinase, and utilized citrate, tartrate, malonate, glucose, sucrose, fructose, and maltose, but not trehalose and lactose. These characteristics were similar to those of Erwinia chrysanthemi (Pectobacterium chrysanthemi) (1). PCR was performed on the 16S rDNA gene from isolate H12 (1,503 bp; GenBank Accession No. GU252371) with primers 27f (5'-GAGAGTTTGATCCTGGCTCAG-3') and reverse primer (5'-GGCTACCTTGTTACGACTTC-3'). Subsequently, PCR products were sequenced. Results of sequence analysis showed the sequence of isolated strain H12 was 99% identical to that of E. chrysanthemi, 99% identical to that of type strain CFBP 1269T of Dickeya dadantii (Accession No. AF520707), and 98% identical to that of type strain CFBP 1200T of D. dianthicola (Accession No. AF520708). Recently, E. chrysanthemi was transferred to Dickeya gen. nov., but it was difficult to identify the species within the genus Dickeya. Seedlings (20 to 30 cm) were planted in 10-cm-diameter plastic pots containing sterilized field soil at room temperature. Four days later, five stem tops of sweetpotato were injected with a bacteria suspension (10⁸ CFU/ml) of approximately 100 μl to fulfill Koch's postulates. Five control plants were inoculated with sterile distilled water. The experiment was conducted three times. All plants were incubated in a chamber at 30°C with high humidity. One to two days after inoculation, symptoms were observed in all inoculated plants and appeared to be identical to those observed in the field. No symptoms were noted on the control plants. The bacterium was reisolated from symptomatic stems of sweetpotato plants. This pathogen was previously reported on sweetpotato in the United States in 1974 (2). To our knowledge, this is the first report of a Dickeya sp. (E. chrysanthemi) causing bacterial stem and root rot of sweetpotato in China. References: (1) D. J. Brenner et al. Page 670 in: Bergey's Manual of Systematic Bacteriology. 2nd ed. Springer, New York, 2005. (2) N. W. Schaad et al. Phytopathology 67:302, 1977.

Analyses on mutation patterns, detection of population bottlenecks, and suggestion of deleterious-compensatory evolution among members of the genus Potyvirus

Viruses of the family Potyviridae exhibited a robust single-nucleotide polymorphism profile at the between-species level, conforming to the neutral theory rule. However, the ratios of nonsynonymous to synonymous mutations (Ka/Ks) were relatively greater between-species than within-species in viral cistrons examined from members of the genus Potyvirus, indicating a relaxation on constraint. Judged by the McDonald and Kreitman's test, the fixation frequencies for nonsynonymous mutations across the genomes of closely related potyviruses were greater than expected, suggesting population bottlenecks at speciation. These mutation patterns are best explained by a deleterious-compensatory model.

The complete genome sequence, organization and affinities of carrot red leaf virus

A sequence of 5723 nucleotides (GenBank accession number: AY695933) is reported for the RNA genome of an isolate of Carrot red leaf virus (CtRLV). The sequence is predicted to contain six large open reading frames and non coding sequences of 28 nucleotides at the 5' end, 110 nucleotides at the 3' end, and 215 nucleotides between the two main blocks of coding sequences. The 5' coding region encodes two polypeptides with calculated molecular masses (Mr) of 28.6 kDa (P0) and 68.2 kDa (P1) that overlap in different reading frames. Circumstantially, the third ORF in the 5' block is putatively translated by frameshift read-through to yield a polypeptide (P1 + P2) with a calculated Mr of 116.9 kDa. Frameshifting is predicted at a "shifty" sequence (GGGAAAC; nt 1523-1529) also found in most members of the genus Polerovirus. The C-terminal region of the 116.9 kDa polypeptide includes the consensus sequence for the viral RNA-directed RNA polymerase. The 3' block of coding sequence defines three putative polypeptides of: 23.0 kDa (P3), 21.3 kDa (P4, in a different reading frame) and 77.2 kDa (P3 + P5, by read-through of P3) respectively. From the genome structure of CtRLV, it is suggested that this virus belongs to the genus Polerovirus, rather than either the genus Luteovirus or the genus Enamovirus.

Effects of low doses of hydrochloride tetracycline on bone metabolism and uterus in ovariectomized rats

AIM

To study the effects of low doses of hydrochloride tetracycline (Tc) on bone metabolism and uterus in the ovariectomized (Ova) rats.

METHODS

Forty 3-month-old rats were randomly divided into 5 groups: sham group, Ova group, Tc1 group (1.2 mg/kg/d), Tc2 group (4.8 mg/kg/d), and estrone group (1.48 mg/kg/d), oral fed for 3 months. The proximal tibia metaphyses were processed undecalcified for quantitative bone histomorphometry and the soft tissues were processed in paraffin for pathological observation.

RESULTS

Placebo-treated (lactose) Ova rats were characterized by trabecular area (TA) decreasing and their architecture worsening compared with sham controls, and bone resorption was over formation with high bone turnover. The uteri were atrophy. (2) In estrone-treated group, TA and trabecular numbers were significantly increased and the trabecular separation decreased vs Ova group. Estrone slowed down Ova-inducing bone high turnover. But the size, weight, and the endometrium of the uteri in this group were increased vs Ova group. (3) TA was increased in both Tc1 and Tc2 groups compared with Ova rats. Tc maintained bone formation indices almost at Ova level, and only decreased mineral apposition rate (MAR) in Tc1 group, and declined bone resorption perimeter. The uteri and the cell of liver and kidney almost maintained at Ova level; Tc2 decreased labeling perimeter and increased MAR in comparison with Tc1 group. The uteri were atrophy, whose size maintained at Ova level; yellow labeling was not found in bone with these doses of Tc, while yellow labeling could be seen with the doses of 30 mg/kg/d of Tc for bone marker.

CONCLUSION

The two doses of Tc have similar effects on preventing bone loss in Ova rats while the bone formation and uterus are not affected. However, Tc2 does not have more effects on increasing bone mass, Tc2 causes less mild damages to the liver and kidneys.

Effect of intermittent injection of recombinant human parathyroid hormone on bone histomorphometry of ovariectomized rats

AIM

To observe the effect of intermittent parathyroid hormone (PTH) administration on bone histomorphology of relatively old ovariectomized rats.

METHODS

The 6-month-old female SD rats were randomly divided into 5 groups: (1) sham-operated for baseline (ShamB, n=5), (2)ovariectomized for baseline (OVXB, n=6), (3) Sham-operated for end point (ShamE, n=6), (4) ovariectomized for end point (OVXE, n=6), (5) ovariectomized for PTH treatment (OVXEP, n=6). ShamB and OVXB rats were sacrificed 3 months after operation, ShamE, OVXE and OVXEP rats were sacrificed 4.5 months after operation. During 3-4.5 months after operation, OVXEP rats received daily subcutaneous injection of rhPTH1-84, while ShamE and OVXE received vehicle injection. The proximal tibiae of all rats were processed without decalcification for quantitative bone histomorphometry.

RESULTS

The percent trabecular area (TbAr) of OVXEP was significantly greater than that of OVXE (P <0.05), and was similar to that of OVXB (P >0.05), but was smaller than that of ShamE (P <0.05); the trabecular thickness (TbTh) of OVXEP was thicker than any other group (all, P <0.05); the trabecular number (TbN) of OVXEP was only slightly higher than that of OVXE; the percent labeled perimeter (LPm), mineral apposition rate (MAR) and bone formation rate with bone area as referent (BFR/BV) of OVXEP were all higher than those of ShamE and OVXE respectively (P <0.01), whereas the osteoclast number (N of Oc) of OVXEP was similar to those of ShamE and OVXE (P >0.05).

CONCLUSION

Short-term intermittent injection of rhPTH1-84 can prevent further bone loss in 9-month-old rats 3 months after ovariectomy, the mechanisms of this therapy are that PTH could increase TbTh while not alter TbN, and promote bone-forming activity while not influence bone-resorptive activity.

In vitro morphogenesis of amphibian erythroblasts

Non-mammalian vertebrate erythrocytes are flattened nucleated ellipsoids containing marginal bands (MBs) of microtubules that assemble during cellular morphogenesis. Earlier work suggested that pointed erythroid cells containing pointed MBs were intermediate stages in terminal differentiation, rather than aberrant forms, but direct evidence was lacking. Here we report on morphogenesis in individual post-cytokinetic amphibian erythroblasts in culture. Daughter cells remained adjacent in pairs, and developed pointed morphology over 1-2 h in the following sequence: (a) ends opposite the cytokinetic furrow became pointed, producing a spheroidal singly-pointed stage; (b) furrow ends usually became pointed, yielding doubly-pointed cells; (c) furrow-end points disappeared, producing a second singly-pointed stage that was flattening. Over a longer term, the single points sometimes disappeared, yielding a flattened discoid. These observations support the hypothesis that pointed cells are normal intermediates in a biogenetic program in which post-mitotic centrosomes organize MBs while occupying the singly-pointed ends of differentiating erythroblasts.

[Experimental study in rabbit on repair of radial bone defect by bioactive degradable polymer]

OBJECTIVE

To investigate the availability of bone defect repair by degradable porous polycaprolactam (PCL) as the carrier of bone morphogenetic protein (BMP).

METHODS

Three different kinds of bone substitutes, including decalcified bone matrix, PCL-BMP compounds and simple PCL, were implanted into the radial bone defects in 36 rabbits, and in the other 12 rabbits the bone defects were left untreated as control. X-ray examination, X-ray morphometry, histological and electron microscopic observation were performed at different time after operation.

RESULTS

The quantity of new bone formation in PCL-BMP group was prior to that in simple PCL group. The pattern and speed of bone defect repair in PCL-BMP group were similar to those in decalcified bone matrix. Electron microscopic observation showed that the PCL-BMP group degraded faster than simple PCL group, which was more suitable for bone repair.

CONCLUSION

PCL is a good carrier of BMP with potential for clinical use.

Performance of CT in detection of bowel injury

OBJECTIVE

The objective of our study was to identify relevant and reliable CT signs of bowel injury, to determine the overall performance of CT in detection of bowel injuries, and to establish the effect of the training level of radiologists on this performance.

MATERIALS AND METHODS

Abdominal CT scans of 112 patients with blunt abdominal trauma were prospectively and retrospectively reviewed. Fifty patients had proven bowel injuries (with or without other visceral injuries), whereas 62 patients had no bowel injury and comprised the comparison or control group. Thirty-one of the 62 patients in the comparison group had surgical proof of abdominal but not bowel or mesenteric injuries. The retrospective review of the 112 CT scans was performed randomly and individually by nine radiologists unaware of the diagnosis, including three faculty abdominal radiologists, three senior residents in training, and three junior residents in training. Individual performance and group performance were evaluated by receiver operating characteristic analysis, and interobserver agreement was tested. Individual CT signs as relevant predictors of bowel injury were identified by logistic regression.

RESULTS

Relevant predictors of bowel injury included mesenteric infiltration, bowel wall thickening, extravasation of vascular or enteric contrast agent, and the presence free air. In the retrospective blinded review, CT showed good to excellent interobserver reliability for individual CT signs as well as for diagnosis of bowel and visceral injuries. Faculty radiologists tended to diagnose injuries with greater accuracy and confidence, but they showed significantly better performance than residents only in diagnosing duodenal perforation. For the prospective CT diagnosis of bowel injury, CT had a sensitivity of 64%, an accuracy of 82%, and a specificity of 97%.

CONCLUSION

Bowel injuries are challenging to diagnose on CT. Radiologists with various levels of experience and expertise can achieve accurate and reproducible results using a variety of CT criteria.

Traumatic neuroma after neck dissection: CT characteristics in four cases

BACKGROUND AND PURPOSE

Traumatic neuroma, an attempt by an injured nerve to regenerate, may present as a palpable nodule or an area sensitive to touch (trigger point) after neck dissection. The purpose of this study was to identify CT characteristics of traumatic neuroma in four patients after neck dissection.

METHODS

Between April 1995 and November 1998, the CT studies in three men and one woman (ages, 45-64 years) who had had a radical neck dissection and a nodule posterior to the carotid artery were reviewed retrospectively. CT was performed 1.5 to 6 years after neck dissection with clinical correlation and/or pathologic examination. Three patients had squamous cell carcinoma of the upper aerodigestive tract and one had a primary parotid adenocarcinoma.

RESULTS

Three patients with a traumatic neuroma had a centrally radiolucent nodule with peripherally dense rim and intact layer of overlying fat, which was stable on CT studies for 1 to 2 years. One of these had a clinical trigger point. The fourth patient with a pathologically proved traumatic neuroma mixed with tumor had intact overlying fat, but the nodule lacked a radiolucent center and was not close to the carotid artery.

CONCLUSION

The CT findings of a stable nodule that is posterior but close to the carotid artery with central radiolucency, a dense rim, and intact overlying fat, combined with the clinical features of a trigger point and a lack of interval growth, strongly suggest the diagnosis of traumatic neuroma.

Synthesis and opiate receptor binding properties of 17-methyl-6,7-dehydro-3,14-dihydroxy-4,5alpha-epoxy-6,7:4',5'-pyrimidin omorphinans

A class of opioid receptor active derivatives of oxymorphone has been synthesized using a common enaminone intermediate. The derivatives have heterocyclic groups fused to the 6,7-positions of the morphinan system and all were synthesized in high yield. A pyrazolo derivative is an agonist for the mu and delta receptors and an antagonist for the kappa receptor.

Synthesis and structure-activity relationships of potential anticancer agents: alkylcarbamates of 3-(9-acridinylamino)-5-hydroxymethylaniline

A series of potential 9-anilinoacridine antitumor agents, 3-(9-acridinylamino)-5-hydroxymethylaniline (AHMA) derivatives with monosubstituent at C4' and disubstituents at C4' and C5' of the acridine ring and their alkylcarbamates, were synthesized for evaluation of their antitumor activity. A structure-activity relationship (SAR) study showed that the AHMA-alkylcarbamates were more potent than their corresponding parent AHMA compounds. In addition, the cytotoxicity of the AHMA-alkylcarbamate decreased with increasing length and size of the alkyl function. Among these compounds, AHMA-ethylcarbamate (18) and 4'-methyl-5'-dimethylaminoethylcarboxamido-AHMA-ethylcarb amate (34) possess potent cytotoxicity on the inhibition of human leukemic HL-60 cell growth in culture. Further in vivo studies of these compounds displayed significant anticancer therapeutic effects in mice bearing sarcoma 180, Lewis lung carcinoma, and P388 leukemia.

[Guided bone regeneration by using biodegradable co-polymer membranes in rabbits]

OBJECTIVE

To repair long bone segmental defects using biodegradable poly epsilon-caprolactone (PCL) and polylactic acid(PLA) co-polymer membranes, and explore its role and mechanism in guided bone regeneration (GBR).

METHODS

Rabbit radial segmental defects (1.2 cm in length, retain the periosteum) were created in this study, 24 animals were divided into 2 groups. The membranes were used to enclose the defects in experimental group, and no treatment in control group. After 3, 6, and 12 weeks of operation, X-ray, gross and histological examinations were observed.

RESULTS

The bone regeneration of experimental group was better than that of control group. Three weeks after operation, obvious external callus along the membrane were found in experimental group, and bony linking composed of external callus bridge were found in 6 weeks after operation. After 12 weeks of operation, callus bridge outside the membrane and bony reunion inside the membrane were achieved in experimental group. While in control group, typical nonunion was observed after 6 weeks of operation.

CONCLUSION

Guided bone regeneration can be achieved by using biodegradable membrane. The defects are repaired by the means of outside membrane callus and relatively late inside membrane callus. The membrane can prevent the ingrowth of fibrous tissue into defect area, thus nonunion are avoid, and keep a high concentration of nutritive elements, also serve as a frame for osteocyte growth to enhance bone healing.

Greater tuberosity changes as revealed by radiography: lack of clinical usefulness in patients with rotator cuff disease

OBJECTIVE

Studies linking greater tuberosity findings on radiographs with rotator cuff disease have largely been uncontrolled and biased toward more severe disease. We correlated greater tuberosity changes seen on radiography with rotator cuff disease seen on MR images in a broadly symptomatic patient population.

MATERIALS AND METHODS

Both radiography and MR imaging were performed in 108 shoulders. Unaware of the MR imaging findings, three radiologists independently reviewed the radiographs for cortical thickening, subcortical sclerosis, and cystlike lesions in the humeral greater tuberosity. Interobserver agreement was analyzed using kappa statistics. We correlated the radiographic findings with MR imaging evidence of rotator cuff tears and tendonopathy. The positive predictive value of each finding for rotator cuff disease was also calculated.

RESULTS

Interobserver agreement for the three radiographic findings was poor to fair: Kappa values ranged from .06 to .41. Cortical thickening and subcortical sclerosis were not seen more frequently in shoulders with rotator cuff disease than in normal shoulders. Cystlike lesions were more prevalent in shoulders with rotator cuff disease, but the association reached statistical significance (p < .05) for one observer only. Positive predictive values for each finding were low (14-48% for predicting full-thickness rotator cuff tears).

CONCLUSION

Cortical thickening of the greater tuberosity and subcortical sclerosis are not associated with rotator cuff disease. For some observers, identifying cystlike lesions is associated with rotator cuff disease, but the clinical usefulness of the observation is limited by high interobserver variability and poor positive predictive value.

Skeletal effects of constant and terminated use of risedronate on cortical bone in ovariectomized rats

To study the skeletal effects of continual and terminated use of risedronate treatment on cortical bone in ovariectomized (Ovx) rats, we used risedronate (Ris), 5 microg x kg(-1), by subcutaneous injections, twice per week. The middle part of the tibial shafts (Tx) were processed undecalcified for quantitive bone histomorphometry. Cortical bone and the marrow areas of the tibial shaft did not change in either sham-Ovx or Ovx rats during the 150-day experimental period. Continued administration of Ris for 150 days decreased the marrow area and increased the percentage of cortical area compared with the matching sham and Ovx group. A decrease in bone formation indices in both periosteal and endocortical surfaces of Tx in sham-operated rats between the age of 5 and 8 months was seen. Ovariectomy increased the percentage of labeled perimeter in the periosteal area, and markedly increased the percentage of eroded perimeter in the endocortical surface compared with sham control groups in 81 and 150 days. Bone formation indices of Ris treatment were increased in periosteal surfaces, and percentages of eroded perimeter were decreased more in endocortical surfaces in 150 days than in the matching sham and Ovx groups. These data matched our static data, which showed a significantly increased percentage of cortical bone area and decreased percentage of marrow area. These bone gains were not maintained in the 90-day Ris withdrawal group. For cancellous bone, the 60-day Ris-treated high bone mass was maintained in the withdrawal group and not maintained in Ris continmuously treated group. These results indicate the effects of constant and terminated use of Ris in cortical bone were different from those in trabecular bone in the proximal tibial metaphysis.

Skeletal effects of constant and terminated use of sodium risedronate in ovariectomized rats

AIM

To study the skeletal effects of constant and terminated use of sodium risedronate (Ris) treatment in the ovariectomized (Ova) rats.

METHODS

Ris 5 micrograms.kg-1, s.c., twice a wk. The proximal tibial metaphysis (PTM) were processed undecalcified for quantitive bone histomorphometry.

RESULTS

(1) Placebo-treated (normal saline) Ova rats were characterized by decreased trabecular area (TA) on d 60, d 81, and d 150 compared with aging controls, and bone resorption was over formation with high bone turnover. (2) Ova rats were treated with Ris for 60, 81, and 150 d (Ris-on) increased. (TA 217%, 108%, and 101%) respectively, vs Ova rats and depressed bone turnover indices to aging control level, but bone mass did not maintain at high level in 150-d group as in the early stage. (3) Ova rats were pretreated with Ris for 60 d and then terminated (Ris-on/off), followed by sequential sacrifice of rats on 21 and 90 d. Withdrawal on 21 d showed the same results as the match-age Ris-on group. Withdrawal on 90 d still maintained cancellous bone mass at a high level vs 150 d Ris-on groups (+26%) and aging control group (+27%).

CONCLUSION

Regimen of Ris 60 d on then 90 d off prevented the development of osteoporosis in Ova rats.

Effects of total coumarins of Cnidium monnieri on bone density and biomechanics of glucocorticoids-induced osteoporosis in rats

AIM

To evaluate the effects of total coumarins from dried fruits of Cnidium monnieri (TCCM) on glucocorticoids (GC)-induced osteoporosis (OP) in rats.

METHODS

Single photon absorptiometric and biomechanical character measurements of femurs were used.

RESULTS

The bone density (BD) indices in proximal, middle, and distal segments in GC group were decreased by 12% (P < 0.05), 14% (P < 0.05), and 12% (P < 0.05), respectively vs control group. The BD on proximal, middle, and distal segments in GC-TCCM group were increased by 26% (P < 0.01), 34% (P < 0.01), and 31% (P < 0.01), respectively vs GC group. The biomechanical competence in femoral middle segments in GC group tended to decrease vs control group. In GC-TCCM group, the torsional strength, energy, maximal torsional angle, and rigidity were increased by 15% (P < 0.05), 32% (P < 0.05), 14% (P > 0.05), and 13% (P > 0.05), respectively vs the GC group.

CONCLUSION

TCCM not only prevented glucocorticoids-induced osteoporosis but also increased the torsional strength of femurs in rats.

Mouse clavicular development: analysis of wild-type and cleidocranial dysplasia mutant mice

Cleidocranial dysplasia (CCD) is an autosomal dominant disease characterized by hypoplasia or aplasia of clavicles, open fontanelles, and other skeletal anomalies. A mouse mutant, shown by clinical and radiographic analysis to be strikingly similar to the human disorder and designated Ccd, was used as a model for the human disorder. Since malformation of the clavicle is the hallmark of CCD, we studied clavicular development in wild-type and Ccd mice. Histology and in situ hybridization experiments were performed to compare the temporal and spatial expression of several genes in wild-type and Ccd mutant mouse embryos. Bone and cartilage specific markers--type I, II, and X collagens, Sox9, aggrecan, and osteopontin were used as probes. The analyses covered the development of the clavicle from the initial mesenchymal condensation at embryonic day 13 (E13) to the late mineralization stage at embryonic day 15.5. At day 13.5, cells in the center of the condensation differentiate into characteristic precursor cells that were not observed in other bone anlagen. In the medial part of the anlage these cells express markers of the early cartilage lineage (type II collagen and Sox9), whereas cells of the lateral part express markers of the osteoblast lineage (type I collagen). With further development the medial cells differentiate into chondrocytes and start to express chondrocyte-specific markers such as aggrecan. Cells of the lateral part differentiate into osteoblasts as indicated by the production of bone matrix and the expression of osteopontin. At day 14.5 a regular growth plate has developed between the two parts where type X collagen expression can be demonstrated in hypertrophic chondrocytes. The data indicate that the medial part of the clavicle develops by endochondral bone formation while the lateral part ossifies as a membranous bone. The clavicle of Ccd mice showed a smaller band of mesenchymal cell condensation than in wild-type mice. Cells of the condensation failed to express type I and type II collagen at E13.5. In the lateral part of the clavicle type I collagen expression was not detected until E14.5 and osteopontin expression only appeared at E15.5. At E15.5, a small ossification center appears in the lateral part which is, in contrast to the wild-type clavicular bone, solid and without primary spongiosa as well as bone marrow. In the medial portion, type II collagen expression and endochondral ossification never occurs in Ccd mice; this portion of the clavicle is therefore missing in Ccd.

[Effects of fructus cnidii coumarins compared with nilestriol on osteoporosis in ovariectomized rats]

AIM

To compare the total coumarins from dried fruits of Cnidium monnieri (TCCM) and nilestriol (Nil) against osteoporosis.

METHODS

SD rats (40, female, 3-month-old) were randomly divided into basal control, age control, ovariectomized (Ova), Ova + TCCM 67 mg.kg-1, Ova + TCCM 200 mg.kg-1, 6 times a week, and Ova + Nil 1 mg.kg-1, i.g. once a week. After 12 wk, sections (20 microns) of proximal tibiae were examined histologically.

RESULTS

Ova reduced markedly the trabecular bone mass due to bone resorption excessed bone formation (% Tb. Ar -59%). Treatment with TCCM 67 mg.kg-1 partly suppressed bone turnover, but did not inhibit bone loss in Ova rats (% Tb.Ar -43%). Treatment with TCCM 200 mg.kg-1 and Nil 1 mg.kg-1 increased the trabecular area (% Tb. Ar +100% and +274%).

CONCLUSION

Nil was more potent than TCCM in protecting against osteoporosis in Ova rats via supression of bone turnover.

Osteogenic potential of murine osteosarcoma cells: comparison of bone-specific gene expression in in vitro and in vivo conditions

Bone tissue formation and the expression of osteoblast-specific genes were compared in vitro and in vivo for two well characterized murine clonal osteosarcoma cell lines (K7 and K8). In vitro studies were carried out under conditions that promoted extracellular matrix morphogenesis and mineralization. The K8 cells showed 8-fold greater alkaline phosphatase activity and mineral accumulation than did K7 cells during 21 days of in vitro growth. The K8 cell line showed high levels of bone sialoprotein (BSP), collagen type I (COL I), and alkaline phosphatase (APase) mRNA expression throughout its growth in vitro. In contrast, K7 cells showed an almost complete absence of BSP and COL I and very low levels of APase throughout the culture period. In vitro, both cell lines expressed very low levels of osteocalcin (OC). For in vivo studies, we used a three-dimensional culture device that permitted analysis of tissue formation by the cells after their implantation into syngeneic mice. The K8 cells consistently generated extensive mineralized woven bone after their subcutaneous implantation. The striking features distinguishing the bone formed by the implanted cells from normal recipient bone were the complete absence of osteoclasts or matrix resorption, the absence of OC protein, and very low levels of OC mRNA expression in the tissues formed by these cell lines. BSP, APase, and COL I expressions were maintained at high levels in the K8-produced tissues. In contrast to their near absence in vitro, APase, BSP, and COL I were expressed by K7 cells and increased with time in vivo. These findings demonstrate that the K7 cells in vitro are less differentiated than K8 cells, but that K7 cells in vivo undergo osteogenic maturation. Thus, expression of bone-specific genes in these osteogenic cell lines was dependent on systemic or local factors in recipient animals and was distinct for these cell lines when grown under in vitro conditions. OC protein does not appear to be needed for the mineralization of the extracellular matrix but may be needed to provide the necessary signals for the resorption and remodeling of the tissue.

An epidemiological study of risk factors for lung cancer in Guangzhou, China

Lung cancer has been on a rapid rise worldwide during the last three or four decades, in part due to modern social habits and unhealthy lifestyles. Although smoking, air pollution, and certain types of occupational exposure have been recognized as the major risk factors for lung cancer, the significance of each of these factors appears to vary with sex, country, and with region within a given country. In the case of nonsmoking females, some risk factors for lung cancer remain to be identified. In the city of Guangzhou, lung cancer is one of the five leading tumors and the rate has been increasing steadily in both males and females since the 1970s. In this report, more than 6000 cases of lung cancer deaths, accumulated over the past 9 years, were analyzed. The severity of air pollution and cigarette smoking were positively correlated with the incidence of lung cancer deaths. Analysis of levels of SO2 and NOx suggests that the major source of indoor air pollution came from cooking. Two studies were performed in order to determine the relative contribution and importance of smoking, indoor air pollution and occupational exposure as risk factors for the rising incidence of lung cancer. The first was a population-based case-control study involving 849 subjects (566 males and 283 females). The second study was based on the data made available by the Third National Census survey, in which the standardized mortality rate (SMR) and population attributable risk (PAR) for lung cancer due to occupational exposure for the population in Guangzhou were analyzed. Results of these two studies show that: in females, indoor air pollution, derived primarily from burning coal, was found to be a highly significant risk factor for lung cancer. In males, however, cigarette smoking and occupational exposure were significantly associated with lung cancer. To further elucidate the contribution of indoor air pollution as a risk factor for lung cancer in nonsmoking females, two additional case-control studies were performed in 1985 and 1986. The 1985 study involved 120 nonsmokers (28 males, 92 females) in which the influence of such lifestyle factors as: personal history of nonmalignant respiratory diseases, fresh vegetable consumption, lifetime occupation and occupational exposure histories, exposure to environmental tobacco smoke (ETS), degree of indoor air pollution, general conditions of home residence, cooking practices and environments, and family history of cancer were first individually assessed and then collectively subjected to multiple conditional regression analysis for evaluation as risk factors for lung cancer. The 1986 study involved 75 cases of never-smoking females in which the aim was to investigate the influence of exposure to spousal smoke as a risk factor for lung cancer. These studies suggest that consumption of fresh vegetables was a "protective" factor for lung cancer in both males and females. In females, indoor air pollution and size of the kitchen were risk factors for lung cancer, whereas ETS exposure, respiratory disease history, family history of cancer, living conditions, use of cooking fuel, and participation in cooking, were not statistically associated with female lung cancer deaths. Occupational exposure was also correlated with the incidence of female lung cancer deaths. In males, chemists had the highest SMR, whereas in females, homemakers had the highest SMR. In males, the most common lung cancer cell type was squamous cell carcinoma, whereas in females adenocarcinoma was the most predominant type. The factors affecting the distribution of histologic lung cancer cell types were also investigated and discussed.

[Quantitative study on the effect of osthole on proximal tibiae in ovariectomized (OVX) rats]

Thirty-one 3-month-old Female Sprague-Dawley rats were randomly divided into 5 groups, basal control (group 1, killed at the begining), aging control (group 2), ovariectomized (OVX, group 3), OVX with nilestriol treatment group (group 4) and OVX with osthole treatment group (group 5). Group 2 and group 3 ig with water 5 ml.kg-1 and group 5 ig with osthole 6.7 mg.kg-1, all once a day for 6 d; group 4 ig with nilestriol 1 mg.kg-1, once a week. After 12 weeks, all rats were killed. The proximal tibiae of rats were processed to undecalcified sections at 20 microns thickness for histomorphometric analysis. OVX was shown to reduce markedly the trabecular bone mass (%Tb. Ar-59%) due to increase of bone turnover with the result that bone resorption exceeded bone formation, as compared with aging controls. In contrast, treatment of OVX rats with Osthole and nilestriol increased significantly the trabecular area (increased 68% and 27.1% compared with that of OVX respectively). Our results indicate that osthole and nilestriol treatment provides protection against osteoporosis in OVX rats. The protective mechanism of osthole and nilestriol involves supression of bone turnover, but the effects of osthole is lower than that of nilestriol (trabecular area decreased 55% more in osthole group than that with nilestriol treatment). Our finding may provide theoretical evidence for the clinical use of osthole or nilestriol for treatment and prevention of osteoporosis.

Risedronate pretreatment does not hamper the anabolic effects of prostaglandin E2 in ovx rats

Pretreatment of an anti-resorptive agent on the anabolic effects of prostaglandin E2 (PGE2) was studied on the proximal tibia and tibial shaft of ovariectomy (ovx) rats. Two days after ovx, rats were treated with either risedronate (Ris, 5 micrograms/kg twice weekly) or vehicle (V) for 60 days and then switched to 3 or 6 mg/kg/d PGE2 for 21 or 90 days. Bone area of both proximal tibial metaphysis (PTM) and tibial shaft (TX) were measured. Pretreatment with Ris increased the bone mass in PTM but not in TX of ovx rats. In the PTM, PGE2 produced the same percentage of new bone mass in both V- and Ris-pretreated ovx rats. The amount of new bone was almost the same after 3 weeks and 12 weeks of PGE2 treatment. There was no difference in the anabolic effects of 3 and 6 mg PGE2/kg/d in V-pretreated rats; however, the effects in Ris-pretreated groups were greater with 6 mg PGE2/kg/d than with 3 mg PGE2/kg/d. In TX, only the 6mg PGE2/kg/d administration added new bone on endocortical surfaces of both V- or Ris-pretreatment rats which leads to thickening the minimal cortical width, decreasing the marrow cavity and increasing total bone area. Both doses of PGE2 created new trabecular bone in the marrow cavity of tibial shaft in both vehicle- and Ris-pretreated ovx rats. These results suggest that Ris-pretreatment did not hamper the anabolic effects of PGE2 on either PTM or TX in ovx rats.

Simple method to fabricate a polarizer with a large aperture by the use of anodic alumina films

A simple method is proposed for the fabrication of an optical polarizer with a large aperture by the use of anodic alumina films. The aperture size of the polarizer is 10 × 10 mm(2), the extinction ratio is shown to be larger than 35 dB, and the insertion loss is less than 1 dB at a wavelength of 1.55 µm.

[Effect of total coumarins from dried fruits of Cnidium monnieri on glucocorticoid-induced osteoporosis in rats]

Twenty-four 3-month-old male SD rats were divided into 3 groups: Group 1--control (ig water). Group 2--ig prednisone 45 micrograms.kg-1 twice a week. Group 3--treated with total coumarins of dried fruits of Cnidium monnieri (L) Cuss (TCCM) and prednisone. TCCM was given ig 5 g.kg-1, 6 days per week. After 90 d, rats were killed. The proximal tibiae of rats were processed undecalcified for histomorphometric analysis. In comparison with control rats, the bone resorption was enhanced and bone formation decreased. The trabecular bone areas were characterized by reduction of 40% in rats which received prednisone. Trabecular bone areas of rats treated with TCCM increased 56% compared with rats receiving prednisone. All indices of bone histomorphometry were near to those in the control. The results showed that TCCM prevented glucocorticoid-induced osteoporosis.

Graded index profile of anodic alumina films that is induced by conical pores

The size and the shape of micropores in anodic alumina films are studied by electron microscope observation and mercury intrusion porosimetry. Pores have conical shapes with ~ 10-nm diameters and are widened at the rate of ~ 0.05 nm/min by immersion in a sulfuric acid solution. Such conical pores give rise to the refractive-index distribution and anisotropy in the alumina films. By analyzing interference fringes, we find that a graded-index profile, as well as birefringence, exists in the anodic alumina films. The experimental results are in good agreement with theoretical predictions.

The economic cost of senile dementia in the United States, 1985

Senile dementia is a progressive and irreversible decline of mental functions. The symptoms are mental confusion, memory loss, disorientation, cognitive decline, and inappropriate social behavior. It is one of the most common, costly, and distressful diseases among the elderly in the United States. Information on the economic costs of senile dementia is essential for determining research priorities and the allocation of resources to support aging and medical research. Economic consequences, such as direct medical and nonmedical expenditures by patients' families and the amount of time by third parties in caring for patients with senile dementia, are substantial. However, little systematic accounting to estimate these consequences has been undertaken. This paper attempts to estimate various costs associated with the care of senile dementia, based on available secondary data. We have used the direct cost and indirect cost approach and avoided double counting to identify the additional economic costs due to senile dementia. The total, direct national cost of senile dementia is $13.26 billion, which includes $6.36 billion of medical care costs, $2.56 billion of nursing home care costs, and $4.34 billion of social agency service costs. The indirect cost for community home care alone is $31.46 billion, more than twice the total direct costs. The costs of premature death and loss of productivity due to senile dementia are about $43.17 billion. Although most of the indirect costs were imputed from the value of housekeeping or productivity loss, the magnitude of indirect costs reflects the serious consequences and burden on society's resources of this disease.