Treatment response assessment to chemotherapy with bevacizumab for colorectal liver metastasis by contrast-enhanced ultrasound

Background

Though contrast-enhanced ultrasound (CEUS) perfusion parameters have been approved to be potential indicators for response to chemotherapy in solid tumors, their ability in assessment of colorectal liver metastasis (CRLM) to chemotherapy with bevacizumab (Bev) has rarely been investigated.

Methods

From March 2021 to May 2022, 115 consecutive CRLM patients with CEUS pre- and post-2 months' chemotherapy with Bev were prospectively enrolled. One target lesion per patient underwent CEUS quantitative analysis with SonoLiver software. Rise time, time-to-peak, mean transit time, maximal intensity (IMAX), and area under the time-intensity curve (AUC) were assessed with region of interest (ROI) selected on whole lesion, lesion periphery, and internal lesion, respectively. The reduction and ratio of post- to pre-treatment in parameters were investigated in development cohort (n=89) and validated in internal validation cohort (n=26) according to the chronological order.

Results

With modified Response Evaluation Criteria in Solid Tumor as reference, 48, 14 responders and 41, 12 non-responders were included in development and validation cohort, respectively. Significantly smaller values of IMAX and AUC on ROIwhole, ROIperipheral, and ROIinternal, were observed post-treatment in development cohort (all P<0.05). In predicting treatment response, the influence of ROI selection was observed when using ∆IMAX and ∆AUC, while no influence was observed using ratios. Areas under the receiver operating characteristic curve (AUROCs) for ∆IMAX and ∆AUC on ROIperipheral were 0.939 (0.867-0.979), 0.951 (0.883-0.985), and 0.917 (0.740-0.988), 0.923 (0.748-0.990) in development and validation cohort, respectively. For ratios of IMAX and AUC, AUROCs were 0.976 (0.919-0.997), 0.938 (0.865-0.978), and 0.899 (0.717-0.982), 0.982 (0.836-1.000) in development and validation cohort, respectively.

Conclusions

IMAX and AUC showed significant reductions in responders, and different analyses ROIs influence the performance of ∆IMAX and ∆AUC in response assessment. Parameters derived from ROI peripheral exhibited the most promising results in predicting treatment response.

[Effects of rapid drug sensitivity testing for multidrug-resistant bacteria on the prognosis of patients with severe intra-abdominal infection]

Objective: To examine the clinical value of rapid detection of drug-resistant bacteria by immunochromatography and the effects of rapid detection on the prognosis of patients with severe intra-abdominal infection complicated by carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infection. Methods: This was a retrospective cohort study. We analyzed clinical data of 73 patients with severe abdominal infections with sepsis or septic shock complicated by CRE bloodstream infection admitted to the general surgery department of Jinling Hospital between February 2022 and February 2023. Patients were divided into a colloidal gold immunochromatographic assay (GICA) group (17 patients) and conventional testing group (56 patients) based on whether a GICA for CRE had been performed on the patients' first blood culture sample during the diagnosis and treatment process. There were no statistically significant differences between the GICA and conventional testing groups in age ([55.9±17.3] vs. [47.6±16.4] years), sex ([16 men vs. one woman ] vs. [41 men vs. 15 women]), median Charlson comorbidity index (3.0[2.0,4.0] vs. 3.0[2.0, 4.8]), septic shock (10 vs. 39), or acute kidney injury (8 vs. 40) (all P>0.05). Both groups routinely underwent traditional bacterial identification and drug susceptibility testing. Additionally, patients in the GICA group were tested directly for positive blood cultures using a GICA carbapenemase test kit. The main outcomes were mortality rates on Days 28 and 90 after the first identification of CRE bloodstream infection in both groups. We also compared the microbial clearance rate, duration of hospitalization and intensive care unit stay, and time from onset of CRE bloodstream infection to initiation of targeted and appropriate antibiotics between the two groups. Results: The rate of microbial clearance of bloodstream infection was significantly greater in the GICA group than in the conventional testing group (15/17 vs. 34/56 [60.7%], χ2=4.476, P=0.034), whereas the 28-day mortality tended to be lower in the GICA than conventional testing group [5/17 vs. 44.6% [25/56], χ2=1.250, P=0.264). The 90-day mortality (8/17 vs. 53.6% [30/56], χ2=0.222, P=0.638), median duration of hospitalization (37.0 [18.0, 46.5] days vs. 45.5 [32.2, 64.8] days, Z=-1.867, P=0.062), and median duration of intensive care unit stay (18.0 [6.5, 35.0] days vs. 32.0 [5.0, 51.8] days, Z=-1.251, P=0.209). The median time between the onset of bloodstream infection and administration of antibiotics was 49.0 (38.0, 69.0) hours in the GICA group, which is significantly shorter than the 163.0 (111.8, 190.0) hours in the conventional testing group (Z=-5.731, P<0.001). The median time between the onset of bloodstream infection and administration of appropriate antibiotics was 40.0 (34.0, 80.0) hours in the GICA group, which is shorter than in the conventional testing group (68.0 [38.2, 118.8]) hours; however, this difference is not statistically significant (Z=-1.686, P=0.093). Conclusions: GICA can provide information on carbapenemase- producing pathogens faster than traditional drug sensitivity testing, enabling early administration of the optimal antibiotics. The strategy of 'carbapenemase detection first' for managing bacterial infection has the potential to improve prognosis of patients and reduce mortality rate.

Assessing artificial intelligence enabled liquid-based cytology for triaging HPV-positive women: a population-based cross-sectional study

INTRODUCTION

Cytology-based triaging is commonly used to manage the care of women with positive human papillomavirus (HPV) results, but it suffers from subjectivity and a lack of sensitivity and reproducibility. The diagnostic performance of an artificial intelligence-enabled liquid-based cytology (AI-LBC) triage approach remains unclear. Here, we compared the clinical performance of AI-LBC, human cytologists and HPV16/18 genotyping at triaging HPV-positive women.

MATERIAL AND METHODS

HPV-positive women were triaged using AI-LBC, human cytologists and HPV16/18 genotyping. Histologically confirmed cervical intraepithelial neoplasia grade 2/3 or higher (CIN2+/CIN3+) were accepted as thresholds for clinical performance assessments.

RESULTS

Of the 3514 women included, 13.9% (n = 489) were HPV-positive. The sensitivity of AI-LBC was comparable to that of cytologists (86.49% vs 83.78%, P = 0.744) but substantially higher than HPV16/18 typing at detecting CIN2+ (86.49% vs 54.05%, P = 0.002). While the specificity of AI-LBC was significantly lower than HPV16/18 typing (51.33% vs 87.17%, P < 0.001), it was significantly higher than cytologists at detecting CIN2+ (51.33% vs 40.93%, P < 0.001). AI-LBC reduced referrals to colposcopy by approximately 10%, compared with cytologists (51.53% vs 60.94%, P = 0.003). Similar patterns were also observed for CIN3+.

CONCLUSIONS

AI-LBC has equivalent sensitivity and higher specificity compared with cytologists, with more efficient colposcopy referrals for HPV-positive women. AI-LBC could be particularly useful in regions where experienced cytologists are few in number. Further investigations are needed to determine triaging performance through prospective designs.

[Cholera Prevention and Control in China in 1919 from the Perspective of Ta Kung Pao]

The cholera epidemic in 1919 started from coastal cities in the south of China and the cities near Russia in the north. It centered on those cities with relatively developed economies with well-developed transportation, and spread along railway lines and coastal lines in both directions to the North and the South, based on the reports in Ta Kung Pao. It covered 14 provinces, the municipalities under the Central Government and the special administrative regions. To prevent and control the 1919 cholera epidemic, the Republic of China government took some effective measures, such as reminding people of prevention, providing medical assistance, controlling the flow of people and cutting off transmission routes. It was found that some serious issues were exposed in the process of preventing and controlling the 1919 cholera epidemic, such as corrupt government, the ignorance of part of the population and poor medical services and technology. Analysing the historical materials of the 1919 cholera epidemic and summarising its experience and lessons in Ta Kung Pao can provide references for future epidemic prevention and control.

[The 1918 influenza from the perspective of the Hongkong Chinese Daily (Xiang Gang Hua Zi Ri Bao)]

The 1918 outbreak of influenza in Hongkong was reported in the Hongkong Chinese Daily (Xiang Gang Hua Zi Ri Bao). It was said that the influenza began in June 1918 with mild symptoms, but spread wildly in November with strong momentum as a second wave. It killed about 3,000 people in Hongkong that year. It subsided in Hongkong, Guangdong and other places after February 1920. The reports and news on the 1918 influenza in the Hongkong Chinese Daily mostly came from medicine-related business rather than official news, in particular, the news of influenza treatment. Many influenza treatments were reported in the newspaper, such as Tui Shao tablets and Qing Bu Wan in Watson's pharmacy, Bai Sheng Tea and Bai Sheng Oil in Cheng De Tang, and Bai Sheng Tea in Xin Yu Xian Tang. The reports and news about the 1918 influenza in the Hongkong Chinese Daily have their historical value for the research of epidemic influenza in Hongkong, Guangdong and other places.

[Association between pulse pressure and new-onset diabetes in hypertensive patients]

Objective: To determine the association between pulse pressure and the risk of new-onset diabetes in hypertensive patients. Methods: In this prospective cohort study, hypertensive patients from the Kailuan Study, who were diagnosed in 2006-2007 check-up, were screened for enrollment. Participants who finished the biennial follow-up until December 31, 2017 were finally included in this analysis. The primary outcome was incident diabetes development. The pulse pressure variables were divided into quartiles (Q1-Q4), and the Kaplan-Meier curve was used to examine and estimate the cumulative incidence of new-onset diabetes among quartiles. Cox proportional hazards regression model was performed to explore the association between pulse pressure and the risk of new-onset diabetes in hypertensive patients. Results: During an average follow-up of 8.17 years, 6 617 new-onset diabetes were identified out of the 32 917 hypertensive patients with no history or evidence of diabetes in 2006-2007 check-up. Participants were classified into quartiles according to pulse pressure levels as follows: Q1 group(<41 mmHg (1mmHg=0.133kPa))(n=7 995); Q2 group(41-<51 mmHg) (n=8 196); Q3 group (51-<61 mmHg) (n= 8 270); Q4 group (≥61 mmHg) (n=8 456). The cumulative incidences of new-onset diabetes across the quartiles were 16.94%, 19.61%, 21.07%, and 22.33%, respectively, with the incidence density was 20.27, 23.20, 24.92, and 26.10 per 1 000 person-years, respectively. The cumulative incidence of new-onset diabetes increased in proportion with increasing pulse pressure levels (P<0.01 by the Log-rank test). After multivariate adjustment, compared with the first quartile, the hazard ratios for new-onset diabetes in the third and fourth quartiles were 1.13 (95%CI 1.04-1.22, P<0.01) and 1.14 (95%CI 1.05-1.24, P<0.01), respectively. The risk of new-onset diabetes increased 5%(HR=1.05, 95%CI 1.02-1.08, P<0.01) with the fractional pulse pressure increased per 1 SD (0.13). Findings from the three sensitivity analyses were consistent with the main results in this cohort. Conclusions: Pulse pressure at baseline is positively associated with the incidence of new-onset diabetes among hypertensive individuals, and pulse pressure is an independent risk factor for the development of diabetes in hypertensive patients.

[The epidemic and prevention of the 1918 influenza in China from the perspective of Ta Kung Pao]

Based on the pandemic influenza data collected by the Ta Kung Pao, the pandemic of 1918 spread to at least 16 provinces (autonomous regions), including Beijing, Tianjin, Shanghai, Hebei, Henan, Hubei, Hunan, Jilin, Liaoning, Shanxi, Inner Mongolia, Sichuan, Zhejiang, Jiangsu, and Yunnan. The first wave of the pandemic between spring and summer in 1918 was relatively mild, with symptoms of dizziness, headache, body heat, bone pain, cough, and mental fatigue. Symptoms of the infection in the second wave between October and November were more serious than in the first wave. Sufferers experienced more symptoms and the number of deaths reported in newspapers increased. The proposed causes of the pandemic, based on the Ta Kung Pao, were mainly focused on season changes, unclean diet, and air pollution. It was also reported from the point of view of traditional Chinese medicine theories, such as Fu Xie (hidden pathogen), Qiu Zao (autumn dryness), and winter pestilence. For the prevention and treatment of the pandemic in 1918, the data in Ta Kung Pao suggested keeping away from the patients, having clean food, being careful about living, paying attention to hygiene and medicine prevention and control. According to the data in Ta Kung Pao, traditional Chinese medicine played an important role in the prevention and treatment of the 1918 pandemic.

Clinical Manifestations, Fluid Changes and Neuroimaging Alterations in Patients with General Paresis of the Insane

PURPOSE

We aim to study the clinical manifestations, fluid changes and neuroimaging alterations in patients with general paresis of the insane (GPI).

METHODS

A total of 119 patients suffering from GPI recruited in Beijing Ditan Hospital, Capital Medical University from 2010 to 2020 were retrospectively analyzed.

RESULTS

In 119 GPI patients, 103 cases (86.6%) were male. Misdiagnosed rate was up to 83.2%, schizophrenia and mood disorders were the most common misdiagnosed diseases. Duration from symptom onset to the final confirmed diagnosis was 10.4±12.9 months. The main clinical manifestations included cognitive impairment (114 cases, 95.8%) and neuropsychiatric symptoms (107 cases, 90.0%). The cognitive domains including the delayed recall, visuospatial/executive function and language ability indicated by MoCA score were damaged severely. Rapid plasma regain (RPR) of all GPI patients was 100% positive in serum and 89.9% positive in cerebral spinal fluid (CSF). The white blood cell (WBC) number in CSF was between 6 and 50/μL in 73 GPI patients (61.3%). The protein level was between 45.1 and 70mg/dL in 47 cases (39.5%). In the 110 cases, 96 cases (87.3%) were abnormal indicated by cerebral atrophy mostly located in the anterior brain and abnormal signals distributed in various regions of the brain mostly in the frontal lobe and temporal lobe.

CONCLUSION

The symptoms of GPI were complex and easy to misdiagnose. The clinicians were still short of vigilance for neurosyphilis. We should expand serologic testing for syphilis especially in patients with cognitive impairment and neuropsychiatric symptoms. We suggest syphilis curricula in the training program of the clinicians especially for neurologist and psychiatrist.

[The historical data of pandemic influenza in China from 1918 to 1920 in the Shun Pao]

China was not been isolated from the Spanish flu which begun in 1918. According to the reports on the influenza epidemic in China from 1918 to 1920 in the Shun Pao(, Shanghai Daily), the plague was rampant in China three times, involving at least three cities including Beijing, Tianjin and Shanghai, and more than 14 provinces including Heilongjiang, Jilin, Jiangsu, Zhejiang, Anhui and Guangdong. Among them, the first wave of epidemic reports were mainly in June and July 1918, the disease was relatively mild. The second wave outbroke on October to November, with aggravating symptoms and a significant increase in the number of patients and deaths, Ningbo, Shaoxing, Jiaxing in Zhejiang Province were the worst, and Beijing, Anhui, Henan, Hunan, Shanghai and other places were also serious. The third wave occurred in the spring of 1919, Shanghai, with more reports. In previous works on the 1918 pandemic, there are few descriptions about the epidemic in China, therefore, the reports on the 1918-1920 pandemic in Shun Pao are important historical data supplement to the most deadly natural disaster in human history.

Integrated network analysis to identify the key genes, transcription factors, and microRNAs involved in hepatocellular carcinoma

HCC (hepatocellular carcinoma), which can be induced by cirrhosis and viral hepatitis infection, is the most frequent form of liver cancer. This study is performed to investigate the mechanisms of HCC. GSE57957 was obtained from Gene Expression Omnibus database, including 39 HCC samples and 39 adjacent non-tumorous samples. The DEGs (differentially expressed genes) were screened using the limma package in R, and then were conducted with enrichment analysis using "BioCloud" platform. Using STRING database, WebGestalt tool, as well as ITFP and TRANSFAC databases, PPI (protein-protein interaction) pairs, miRNA (microRNA)-target pairs, and TF (transcription factor)-target pairs separately were predicted. Followed by integrated network was constructed by Cytoscape software and module analysis was performed using the MCODE plugin of Cytoscape software. There were 518 DEGs identified from the HCC samples, among which 17 up-regulated genes (including MCM2, MCM6, and CDC20) and 5 down-regulated genes could also function as TFs. In the integrated network for the down-regulated genes, FOS and ESR1 had higher degrees, and both of them were targeted by miR-221 and miR-222. Additionally, MCM2 had interaction with MCM6 in the up-regulated module with the highest score. MCM2, MCM6, CDC20, FOS, ESR1, miR-221 and miR-222 might affect the pathogenesis of HCC.

Analysis of EEG Lemple-Ziv complexity and correlative aspects before and after treatment of anti-syphilis therapy for neurosyphilis

Objective To investigate the diagnostic value of electroencephalogram (EEG) complexity in patients with neurosyphilis by comparing the changes of electroencephalogram Lempel-Ziv complexity (EEG-LZC) before and after anti-syphilis treatment. Methods The EEG complexity of neurosyphilis patients diagnosed in our hospital from July in 2015 to June in 2017 was analyzed and compared with other diagnostic results such as serology examination and cerebrospinal fluid examination. Results A total of 27 patients were diagnosed, including 19 males and 8 females, of which 6 were mesenchymal(cerebrospinal membrane and meningeal vascular), 16 were parenchymal(paralytic dementia, spinal cord tuberculosis and optic neuropathy), and 5 were asymptomatic. After intensive anti-syphilis therapy, the LZC increased significantly in all patients while the trend and degree of change were consistent with other diagnostic results. Conclusion The LZC can be used as one of the diagnostic indexes meanwhile the trend and degree of its change can be used as the reference index of curative effect to neurosyphilis.

[The prenatal genetic diagnosis of a family with complete androgen insensitivity syndrome]

Objective: To identify the Androgen Receptor (AR) gene mutation of one family with complete androgen insensitivity syndrome (CAIS) and to establish the methods of prenatal genetic diagnosis for CAIS. Methods: The AR gene exons of the family were amplified by PCR and sequenced directly. Linkage analysis was performed by using the CAG repeats in the exon1 of AR gene to assure accuracy of the prenatal diagnosis. Results: We found a frameshift mutation c. 2546del A (p. Asn849Ile fsX34) in the exon7 of AR gene in the proband.The mutation had not been reported before.The mother of the proband went through two times prenatal genetic diagnosis for her next pregnancies, both fetuses were male and did not get the mutation.The results of the linkage analysis were consistent with the sequencing results. Conclusion: A novel AR mutations in a CAIS family have been confirmed. The method of prenatal genetic diagnosis was established, and worked effectively in the CAIS family.

Association between XRCC1 polymorphisms and laryngeal cancer susceptibility in a Chinese sample population

Laryngeal cancer is the major malignant tumor affecting the upper respiratory tract. Previous studies have reported on the association between XRCC1 genetic polymorphisms and risk of laryngeal cancer, but with conflicting results. In this study, we attempted to assess the association between XRCC1 Arg194Trp, Arg280His and Arg399Gln polymorphisms and risk of laryngeal cancer in a Chinese population. A total of 126 laryngeal cancer patients and 254 control subjects were recruited to this study from the Second Medical College of Jinan University between December 2013 and May 2015. The XRCC1 Arg194Trp, Arg280His, and Arg399Gln polymorphic sites were genotyped by polymerase chain reaction-restriction fragment length polymorphism. Our results revealed a significant association between the AA genotype of XRCC1 Arg280His [odds ratio (OR) = 2.51, 95% confidence interval (CI) = 1.29-4.87, P = 0.01] and an increased risk of laryngeal cancer susceptibility compared to the GG genotype. Moreover, the A allele showed a higher risk of laryngeal cancer susceptibility compared to the G allele (OR = 1.63, 95%CI = 1.19-2.50, P = 0.002). In conclusion, the results of our study suggest that the AA genotype and A allele of the XRCC1 Arg280His polymorphism are associated with an increased laryngeal cancer risk in a Chinese population.

[Modulatory Effect of Mouse Compact Bone-derived Suspending MSC on T Cells and It's Related Mechanisms]

OBJECTIVE

To investigate the modulatory effect of the MSC derived from low attaching culture systems (suspending MSC) on T lymphocytes and the related mechanisms.

METHODS

The suspending MSC were generated from mouse compact bones by using low attaching plates and adherent cell culture flasks, respectively. The morphology of suspending MSC was observed under the inverted microscope and the cells were induced to differentiate into osteoblasts and adipocytes. Further, the surface antigen profile of MSC was analyzed with flow cytometry. In addition, the culture medium (CM) of suspending MSC and adherent MSC was collected and added into the activated T cell cultures before detection of the proliferation by CFSE assay. Moreover, the modulaory effects of the CM on the T cell-derived cytokines were detected by quantitative PCR. Also, the mRNA expression of cytokines of MSC was detected.

RESULTS

The suspending MSC grew in floating cell spheres and differentiated into osteoblasts and adipocytes in the induction medium. Furthermore, the suspending MSC shared the typical immuno-phenotype with their adherent counterparts. In addition, the results of CFSE assay demonstrated that suspending MSC derived CM suppressed ConA induced T cell proliferation. The results of quantitative PCR revealed that suspending MSC expressed transforming factor β1 and interleukin-6 at a higher level and suppressed the T cell expressing interferon γ and interleukine-17A.

CONCLUSION

The suspending MSC exerted an unique modulatoy effect on T cells, which is quite different to adherent MSC.

[Effects of wheat planted adjacent to rape on the major pests and their natural enemies in wheat field]

Based on the dynamic analysis of insect community structure characteristics, an investigation was conducted on the composition, abundance, and stability of wheat aphids and their major natural enemies in the wheat field adjacent to rape field in Handan City, Hebei Province in 2008-2009. The wheat and rape fields had the similar composition of insect communities. The main pests were aphids, their predatory natural enemies included ladybirds, green lacewings, spiders, and hover flies, and their parasitic natural enemies were wasps. In 2008-2009, the composition of insect communities in the wheat and rape fields had definite changes, but the common features were the lowest abundance of aphids and the highest abundance of predatory and parasitic natural enemies in wheat field adjacent to rape field. The insect community, aphid sub-community, and predatory natural enemy' s sub-community had a high stability in the wheat field adjacent to rape field and a low stability far from the rape field, suggesting that planting wheat adjacent to rape could effectively protect and make use of the natural enemies and promote their control ability on wheat aphids in wheat field.

[Literature study of Dongpo Yangshengji]

Dongpo Yangshengji is compositions on health preservation in SU Dongpo's works. The health preserving philosophy centered on 'an' (peaceful mind) and 'he' (harmony) is embodied in the book. It can be certain that the book was compiled by WANG Ruxi in the 8th year of the Ming Emperor Chongzhen. There are 3 editions and 2 series existing. One is the Ming edition series represented by the Chongzhen edition, and the other is the Qing edition series which is represented by the CHEN Daosheng edition. The notes in the Chongzhen edition were made by WANG Ruxi, and QIU Xiangsheng revised the comments then formed the Qing edition. The preface of Kangxi could be the key point to differentiate between the two editions.

Blocking effects of siRNA on VEGF expression in human colorectal cancer cells

AIM: To investigate the expression of vascular endothelial cell growth factor (VEGF) and its receptors Fms-like tyrosine kinase 1 (FLT-1) and fetal liver kinase 1 (FLK-1) in colorectal carcinoma (CRC), and the blocking effects of small interfering RNAs (siRNAs) on VEGF expression in human colorectal cancer HCT116 cells.

METHODS: Immunohistochemical staining for VEGF, FLT-1 and FLK-1 proteins was performed in 82 cases of CRC and 14 normal colorectal mucosae. A siRNA targeting VEGF was synthesized and transfected into HCT116 cells using lipofectamine 2000. Immunocytochemical staining and Western blotting analyses were performed to detect the expression of VEGF protein. The suppressive effect of the siRNA on cell proliferation was detected using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltertrazolium bromide (MTT) assay. Cellular apoptosis was detected using flow cytometry (FCM).

RESULTS: The expression of VEGF, FLT-1 and FLK-1 in tumor tissues was significantly higher than that in normal tissues (P = 0.008, P = 0.000, P = 0.000). The expression of VEGF was positively correlated with both lymph node metastasis and clinical stage (P = 0.009 and P = 0.025, respectively). Immunocytochemistry showed that the expression of VEGF was weakly positive and Western blotting indicated a significant reduction in VEGF-siRNA cell protein levels. VEGF-siRNA cell growth inhibition was assessed by the MTT assay, and the tumor cell proliferation rate was significantly different at 24, 48, and 72 h after transfection. FCM results showed that the VEGF-siRNA group had an apparent aneuploid peak.

CONCLUSION: VEGF, FLT-1 and FLK-1 are associated with colorectal carcinogenesis. siRNA silencing of the VEGF gene suppresses proliferation, and induces apoptosis in HCT116 cells. The results suggest that VEGF may be a new gene therapy target for colorectal cancer.

[The recognition and denomination of drastic cholera in modern Traditional Chinese medicine]

This article mainly expounds on the recognition and denomination of drastic cholera in modern Traditional Chinese medicine. After cholera spread into China, some doctors found that this disease was different from "Huoluan" recorded in ancient Chinese medical books. They began to do research on the subject and invented new disease terminology such as Diaojiaosha, Bieluosha, Fuyin, Shiyihuoluan etc. Thereafter, more and more doctors of TCM began to accept the nomenclature and connotation of cholera in western medicine. Huoluan, the ancient TCM terminology has been given a new connotation which has been used until now, becoming the formally recognized name of the drastic epidemic disease.

[Exploration on the academic achievements of YAN Cangshan's Yi jingjia ting zi liao ji (self-treatment for pestilent convulsion)]

OBJECTIVE

In 1929, yi jing (pestilent convulsion) was prevalent in Shanghai, Yan Cangshan, a noted modern physician, was active in treating and rescuing the patients. Yi jingjia ting zi liao ji is a book of the summary on his clinical experience in the treatment of yi jing (pestilent convulsion). It is the first monograph on epidemic diseases carrying the title of yi jing (pestilent convulsion). There were many creative ideas about the name of disease, prescriptions, and medication, etc, embodying Yan's academic thought and achievements. It is of great reference value up to now.

[Study of chromosome pellicle by indirect immunoflourescence method and antigen analysis in Vicia faba]

The autoimmune antiserum specific to pellicle of human metaphasic chromosomes from a lupus patient was used to stain metaphasic chromosome Vicia faba by means of indirect immunoflourescence method. It was found that the pellicles of vicia metaphasic chromosomes was positively stained. The antigen of Vicia faba recognized by the antiserum was also examined by PAGE of total cell lysate and western blotting.

Inter-ocular interference and circadian regulation of the chick electroretinogram

Illumination of a chick's eye allows light to pass through to the retina of the contralateral eye. Electroretinographic (ERG) recording employing the scalp or comb as a reference results in shorter implicit time, higher amplitude and lower sensitivity during the day than during the night in a light:dark (LD) cycle and in constant darkness (DD). ERG recordings employing the contralateral eye as reference abolishes rhythmicity or reverses the phase angle (higher amplitudes at night). This is probably due to light transmission through the eyes to elicit visual responses in the reference. The contralateral eye is a poor choice for reference in birds and obscures physiological analyses of clock control of vision.

[Stereociliary cross-links on the guinea pig utricle hair cells]

OBJECTIVE

To observe the cross-links between stereocilia on guinea pig utricle hair cells.

METHOD

Twenty-four utricles from pigmented guinea pigs were examined using high resolution scanning (SEM) and transmission electron microscopy (TEM).

RESULT

An extensive network of cross-links occurs between stereocilia of utricle hair cells. These links fall into three categories. Upward-pointing links: from the tips of shorter stereocilia to the side of the adjacent taller stereocilia; Side-to-side links: between stereocilia of the same row; Row-to-row links: between adjacent rows.

CONCLUSION

The existence of the stereociliary cross-links binds the hair bundles together and may be associated with the transduction process.

Circadian regulation of visually evoked potentials in the domestic pigeon, Columba livia

The avian circadian and visual systems are integrally related and together influence many aspects of birds' behavior and physiology. Certainly, light cycles and their visual perception are the major zeitgebers for circadian rhythms, but do circadian rhythms affect vision? To assess whether visual function is regulated on a circadian basis, flash-evoked electroretinograms (ERGs) and vision-evoked potentials (VEPs) from the optic tectum (TeO) were recorded simultaneously in domestic pigeons at different circadian phases in a light-dark regime (LD) and in constant darkness (DD), while feeding activity was measured to determine circadian phase. In both LD and DD, the amplitudes of ERG b-waves were higher during the day than at night and latencies of a- and b-waves were longer at night. The median effective intensity for ERG a-wave was marginally higher during the day than during the night, indicating greater sensitivity at night, but this rhythm did not persist in DD. The amplitudes of TeO VEPs were also greater during the day, and latencies were greater at night in LD and DD. Together, the data indicate that a circadian clock regulates pigeon visual function at several integrative levels.

[The foundation of the injury model on cultured human fetal lung fibroblasts and its immunohistochemistry research]

Cultured human fetal lung Fbs was first used to study the relationship between wound age and the change of cFn synthesized by Fbs in Vitro. A sterilized injector was applied to scrap the cultured confluent Fbs and a "wound" was obtained. Fbs around the wound was seen to change from a stationary stage to an active stage. Using the method of immunochemistry and image analysis system (IAS), cFn synthesized by Fbs around the wound was observed at once, 30 min, 1 h, 3 h and 6 h after injury. It was found that cFn began to change 1 h after injury and increased continually within 6 h. It suggests that the change of cFn synthesized by Fbs is time-dependent after injury and this approach breaks a new path in the study on estimation of wound age.

Human chromosome pellicle antibody recognizing centromere protein-C (CENP-C), the main component of the kinetochore

Recently the antichromosome antisera from several scleroderma patients have been found to recognize the pellicle of metaphase and anaphase chromosomes. In order to identify the pellicle components, we used these antichromosome antisera to screen a human embryonic cDNA library. The sequences of the positive clones are identical to the cDNA gene sequence of CENP-C (centromere protein C), a human centromere autoantigen. This result suggests that CENP-C is a component of the pellicle of human metaphase and anaphase chromosomes.

Protein kinase C and calcium/calmodulin-dependent protein kinase II phosphorylate three-repeat and four-repeat tau isoforms at different rates

All six isoforms of the microtubule-associated protein tau are present in hyperphosphorylated states in the brains of patients with Alzheimer's disease (AD). It is presently unclear how such hyperphosphorylation of tau is controlled. In a previous study (Singh et al. Arch Biochem Biophys 328: 43-50, 1996) we have shown that three-repeat taus containing two N-terminal inserts were phosphorylated to higher levels and at different sites compared to those either lacking or containing only one such insert. We have extended these observations in this study by comparing the phosphorylation of tau isoforms containing three-repeats (tau 3, tau 3 L) and four-repeats (tau 4, tau 4 L). In the absence of N-terminal inserts in tau structure (tau 3, tau 4) both CaM kinase II and C-kinase phosphorylated four-repeat tau (tau 4) to a higher extent than three-repeat tau (tau 3). When two N-terminal inserts are present in tau structure (tau 3 L, tau 4 L), then three-repeat tau (tau 3 L) is phosphorylated to a higher extent than four-repeat tau (tau 4 L) by these kinases. CK-1 and GSK-3 phosphorylated each of the above pairs of three-repeat and four-repeat taus to the same extents. However, after an initial prephosphorylation of the taus by CaM kinase II, GSK-3 differentially phosphorylated three-repeat and four-repeat taus. Under these conditions thr 231, ser 235, ser 396, and ser 404 were phosphorylated to greater extents in four-repeat tau (tau 4) compared to three-repeat tau (tau 3) in the absence of N-terminal inserts. In the presence of such inserts these sites were phosphorylated to greater extents in three-repeat (tau 3 L) compared to four-repeat (tau 4 L) tau. Our results indicate that the extents to which tau isoforms are phosphorylated in normal and AD brain depends on (a) the number of repeats (3 or 4), (b) the number of N-terminal inserts (0, 1, or 2), and (c) the initial phosphorylation state of tau.

[Hemodynamic studies of pulmonary heart diseases and the effects of nifedipine]

Swan-Ganz catheterization, blood gas analysis, pulmonary function tests and two-dimensional echocardiography were performed in 10 patients with pulmonary heart disease and the effects of nifedipine were then observed. Mean pulmonary artery pressure (mPAP) correlated significantly to PaO2. PaO2 may be a useful parameter for predicting mPAP. Continuous oxygen breathing can correct hypoxemia, prevent and alleviate pulmonary artery hypertension (PAH). After using nifedipine, PaO2 and blood pressure of systemic circulation decreased significantly, while pulmonary physiological shunt increased and pulmonary artery pressure did not decrease. As a consequence, the use of nifedipine to treat pulmonary heart disease and PAH is not advocated.

[Measurement of right and left heart function of COPD and cor pulmonale by radionuclide ventriculography]

Non-invasive measurements of right and left ventricular ejection fraction (RVEF, LVEF) by multiple-gated equilibrium radionuclide ventriculography were performed in 19 control subjects, 55 patients with COPD and cor pulmonale, simultaneous right heart catheterizations were performed in 10 patients with cor pulmonale to determine the mean pulmonary artery pressure (mPAP), and then, the acute hemodynamic and functional effects of nifedipine were evaluated. The mean RVEFs are different significantly among the various groups. With the development of the diseases, the RVEFs reduce gradually. The mean LVEF reduces significantly in cor pulmonale patients with heart failure. The RVEF correlated negatively to mPAP (r = -0.7047, P < 0.01). After nifedipine (20mg), the RVEF and mPAP do not change significantly (P > 0.05), but the artery blood pressure reduces significantly. We conclude that the equilibrium radionuclide ventriculography may be a useful and accurate method in diagnosing early cor pulmonale and cor pulmonale with right heart failure, and nifedipine may not be a good vasodilator for pulmonary hypertension.

[Enzyme linked counter reference electrophoresis assay and reverse passive hemagglutination assay in general survey of liver cancer]

The AFP content in sera of 11735 persons was tested by the new method-enzyme linked counter reference electrophoresis assay and the conventional method-reverse passive hemagglutination assay (RPHA). AFP level in 15 out of 11735 persons, determined by the former technique, was over the normal range, quite similar to those by radiorocket electrophoresis. A good correlation was noted between the two techniques. But by RPHA, AFP was positive only in 7/15 and gave a false positive up to 4.53% (532/11735). It is indicated that the new method is more specific and sensitive than RPHA, and more suitable for general survey of liver cancer.

Delayed effects from retained foreign bodies in the spine and spinal cord

Gunshot injuries to the spine and spinal cord were covered adequately in the literature shortly after World War II. Similar injuries in the civilian population have been reported in the literature with regard to surgical and nonsurgical treatment. However, the two cases reported here concern intraspinally retained foreign bodies (one bullet and one glass fragment), their effects on the neural elements, and their management.

Echocardiographic abnormalities following cardiac radiation

Five years or more after receiving cardiac radiation, 41 patients with Hodgkin's disease and seminoma in remission were subjected to echocardiography. The abnormalities detected included pericardial thickening in 70%, thickening of the aortic and/or mitral valves in 28%, right ventricular dilatation or hypokinesis in 39%, and left ventricular dysfunction in 39%. In the 23 patients treated by an upper mantle technique with shielding, the incidence of right ventricular abnormalities and valvular thickening was significantly lower than in patients treated with modified techniques. Although no symptoms were attributable to the observed abnormalities, longer follow-up time may reveal important functional implications.

Injuries of the cervical spine in high school wrestling

Severe injuries to the cervical spine and spinal cord have been widely reported from many causes: automobile accidents, diving mishaps, falls, and contact sports. This paper concerns three young men who sustained severe trauma to the cervical spine and spinal cord during high school wrestling. Certain head-holds are prone to cause such injuries. Their tetraparesis and tetraplegia were reversed by reducing the fracture-dislocation and internal stabilization, in one case by decompressive laminectomy when no bony disruption was encountered. Their recoveries were satisfactory, but prevention of these cervical injuries may be accomplished by elimination of the more dangerous holds in wrestling.

Management of two giant neurilemomas of the cauda equina

This report concerns two giant neurilemomas, each involving the entire cauda equina. Only subtotal excision of the tumors was accomplished, and postoperative irradiation seems to account for the long-term good results.

Botryomycosis: first report of human brain involvement

A 57-year-old man, previously well except for dental caries and a history of Wolff-Parkinson-White syndrome, presented with marching right-sided motor seizures of sudden onset. Cerebral arteriography and scan demonstrated an avascular left frontal lobe mass. At operation, it was identified as an abscess and was totally excised. Histologically, granules resembling those seen in actinomycosis were demonstrated in the abscess wall, but special stains revealed gram-positive cocci in chains within and outside the granules. Fungal spores, mycelia, or branching filamentous structures were absent. Acid-fast stains were negative, and alpha-hemolytic streptococcus was recovered in pure culture from the abscess. While the patient was convalescing with penicillin therapy, a dental survey revealed the presence of periodontal abscesses which were drained by exodontia. Culture of the tooth sockets showed alpha-hemolytic streptococcus and Staphylococcus aureus. The literature on this relatively rare bacterial disease which histologically resembles actinomycosis is reviewed.

Metastasis of carcinoma of cervix uteri to convexity meningioma

A cerebral collision tumor in which a convexity meningioma was invaded by a metastatic squamous cell carcinoma of the cervix uteri is described. This is the first time such a lesion has been reported to invade a cerebral meningioma. The patient lived three active years postoperatively until the lesion recurred. Her status then deteriorated, and she died five years after the operation. This was a longer follow-up than any among the other 17 cases of carcinomatous metastases to meningiomas found in the literature.

Subluxation of cervical spine in major epileptic seizure due to cerebral schistosomiasis

Subluxation of the cervical spine either with or without neurologic involvement as a result of epileptic seizure is a rare occurrence. Most of the literature reviewed deals with compression fractures of the spine effected by metrazol-induced convulsions or electroshock therapy for major psychosis. Of further interest in this case is the presumptive diagnosis of a cerebral lesion due to schistosomiasis as the cause of the seizure which produced the cervical subluxation with neurologic changes. The subluxation was reduced and stabilized by inter-body fusion.

Cranio-cerebral injuries from nail-gun used in the construction industry

The nail-gun has been used in the construction industry world-wide. An increasing number of injuries to the cranium and other parts of the body has been reported due to its careless use or mishandling. Some of these are reviewed with emphasis on craniocerebral and spinal cord involvement. Two cases are reported here. Both of these patients survived and have returned to gainful employment.

Primary non-skeletal intracranial cartilaginous neoplasms: report of a chondroma and a mesenchymal chondrosarcoma

The clinical and pathological features of two rare, primary non-skeletal intracranial cartilaginous tumours, a chondroma and a mesenchymal chondrosarcoma, are presented. The literature with respect to clinical, pathological, and possible pathogenetic features is reviewed. The chondroma was successfully resected and the patient has had no recurrence since the operation in 1956. The clinical course of the mesenchymal chondrosarcoma was characterized by rapidly recurring tumour, slowed somewhat by cobalt therapy and frequent surgical interventions. Death occurred some 16 months after the initial resection. There were no metastases.