[Multiple pulmonary nodules with cavity formation]

A 64-year-old female patient was admitted to Beijing Chao-Yang Hospital on February 21, 2023 because of right-sided chest pain for more than 4 years and left-sided chest pain for more than 9 months. She had a past medical history of previous tuberculosis and rheumatoid arthritis. A chest CT in October 2018 revealed multiple pulmonary nodules. A CT-guided biopsy showed no tumors, and adenosine deaminase levels in the pleural effusion were elevated, suggesting a high likelihood of tuberculosis. As a result, anti-tuberculosis treatment was initiated in March 2019. In December 2019, she underwent a right lower lobe resection due to localized hydropneumothorax on the right side. Postoperative pathology unveiled granulomatous inflammation with necrosis. A chest CT in May 2020 showed a significant increase in nodules and cavities. In January 2023, a diagnosis of cryptococcal pneumonia was considered, and she was prescribed oral fluconazole. Finally, the diagnosis of pulmonary rheumatoid nodules was confirmed after a pathological consultation of the postoperative specimen. After one month of treatment with oral prednisone and mycophenolate mofetil, a follow-up chest CT showed improvement. It was recommended that she continue with her current treatment and undergo regular chest CT scans.

[Secondary non-tuberculous mycobacterium infection in patients with bronchiectasis caused by Marfan syndrome]

In this article, we reported a 28-year-old female patient who presented with intermittent hemoptysis, cough, and sputum production. Laboratory tests showed no abnormalities in the blood counts or inflammatory markers, and the sputum cultures were negative. A chest computed tomography scan showed bronchiectasis associated with infection in the middle and lower lobes of the right lung and right pleural thickening. We performed bronchoalveolar lavage by bronchoscopy in the dorsal segment of the right lower lobe and found Mycobacterium avium intracellulare complex (MAC) by Next Generation Sequencing (NGS) of bronchoalveolar lavage fluid (BALF). The patient's symptoms improved significantly after anti-mycobacterium treatment and the extent of infection was reduced on imaging. To further identify the cause of bronchiectasis, the patient is tall and thin, with slender limbs. Cardiac color ultrasound showed the widening of aortic sinus. Her genetic testing of blood samples revealed the gene mutation in the FBN1 gene (c.4349G>A). Based on these results, she was diagnosed with Marfan syndrome.

Durability of neutralization against Omicron subvariants after vaccination and breakthrough infection

Booster immunizations and breakthrough infections can elicit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron subvariant neutralizing activity. However, the durability of the neutralization response is unknown. We characterize the sensitivity of BA.1, BA.2, BA.2.75, BA.4/BA.5, BF.7, BQ.1.1, and XBB against neutralizing antibodies from vaccination, hybrid immunity, and breakthrough infections 4-6 months after vaccination and infection. We show that a two-dose CoronaVac or a third-dose ZF2001 booster elicits limited neutralization against Omicron subvariants 6 months after vaccination. Hybrid immunity as well as Delta, BA.1, and BA.2 breakthrough infections induce long-term persistence of the antibody response, and over 70% of sera neutralize BA.1, BA.2, BA.4/BA.5, and BF.7. However, BQ.1.1 and XBB, followed by BA.2.75, are more resistant to neutralization, with neutralizing titer reductions of ∼9- to 41-fold, ∼16- to 63-fold, and ∼4- to 25-fold, respectively. These data highlight additional vaccination in CoronaVac- or ZF2001-vaccinated individuals and provide insight into the durability of neutralization against Omicron subvariants.

[Epidemiological characteristics of notifiable infectious diseases in Beijing, 2021]

Objective: To understand the epidemiological characteristics of notifiable infectious diseases reported in Beijing in 2021 under the influence of the novel coronavirus pneumonia epidemic prevention and control policy, and provide reference evidence for the prevention and control of notifiable infectious diseases. Methods: Descriptive epidemiological methods were used to analyze the morbidity of notifiable infectious diseases reported in Beijing in 2021, with software R 4.1.2 for data process and ArcGIS 10.8 for visualization. Results: The morbidity of notifiable infectious diseases in Beijing in 2021 was 290.51/100 000, a decrease of 43.29% compared with 2020 and a decrease of 71.45% compared with the average during 2017-2019. The top 5 reported diseases with high morbidity were other infectious diarrhea, influenza, hand foot and mouth disease, pulmonary tuberculosis and syphilis. From the perspective of transmission route, intestinal infectious diseases were the main diseases, accounting for 50.15% (31 898/63 601) of the total cases. From the perspective of pathogens, viral infectious diseases were the main diseases, accounting for 59.63% (25 259/42 356) of the total cases. The laboratory diagnosis rate of notifiable infectious diseases reported in Beijing increased from the average of 16.47% (36 289/220 371) during 2017-2019 to 35.36% (22 490/63 601) in 2021. The laboratory diagnosis rate of parasitic infectious diseases was 83.33%. The districts with high incidence of intestinal infectious diseases were Pinggu, Miyun and Fengtai; Natural foci and insect borne infectious diseases were mainly reported in Yanqing, Mentougou, Fangshan and Daxing. Conclusion: The morbidity of notifiable infectious diseases in Beijing in 2021 showed a decrease trend. The laboratory confirmation rate of reported notifiable infectious disease cases increased, and there were great differences in the laboratory confirmation rate among different diseases. It is very necessary to improve the laboratory confirmation rate of the cases. The diseases with different transmission routes showed different geographical distributions. It is necessary to conduct the targeted prevention and control of infectious diseases in different areas.

[Study of transmissibility of 2019-nCoV Omicron variant in Beijing]

Objective: To evaluate the transmissibility of 2019-nCoV Omicron variant under the current prevention and control strategy in Beijing, and provide evidence for the prevention and control of COVID-19. Methods: The information of 78 Omicron variant infection cases involved in clear transmission chains in Beijing during 7-25 March, 2022 were collected, the incubation period and serial interval of the disease were fitted by using Gamma and Weibull distribution. Markov Chain Monte Carlo approach was used to estimate the time-varying reproduction number (R_t). Results: The median of the incubation period (Q₁, Q₃) of Omicron variant infection was 4.0 (3.0, 6.0) days, and the serial interval was 3.0 (2.0, 5.0) days. The median of the serial interval (Q₁, Q₃) was 2.0 (1.0, 4.0) days in unvaccinated cases and 4.0 (2.0, 6.0) days in vaccinated cases (Z=-2.12, P=0.034), and 2.0 (1.5, 3.0) days in children and 4.0 (2.0, 6.0) days in adults, respectively (Z=-2.02,P=0.044), the differences were significant. The mean of R_t was estimated to be 4.98 (95%CI: 2.22-9.04) for Omicron variant in this epidemic. Conclusion: Omicron variant has stronger transmissibility compared with Delta variant. It is necessary to strengthen the routine prevention and control COVID-19, promote the vaccination and pay close attention to susceptible population, such as children.

[Multiple pulmonary nodules with interstitial changes]

A 53-year-old female patient with pulmonary nodules for more than 3 years was admitted to Beijing Chao-Yang Hospital because of cough and sputum with shortness of breath after exercise for 4 months. In the first two and a half years, her pulmonary nodules remained stable, after that the nodules increased obviously with interstitial changes. After admission, a venous thromboembolic (VTE) event was quickly detected with a marked increase in D-dimer. Then, based on the clues of VTE examination, bronchoscopy, gastroscope, positron emission tomography-CT, head magnetic resonance and other examinations were performed. The final pathological diagnosis was lung adenocarcinoma, mainly solid with mucus secretion, with mediastinal hilar lymph node metastasis, intrapulmonary metastasis and gastric metastasis. Gene detection of lung and stomach histopathological tissues showed positive EML4-ALK fusion gene. The patient received therapies with crizotinib, alectinib in sequence and anticoagulation. After 20-month treatment, a telephone follow-up showed that there was no significant limitation in her daily activities.

Oviposition Deterrents in Larval Frass of Potato Tuberworm Moth, Phthorimaea operculella (Lepidoptera: Gelechiidae)

The potato tuberworm moth (PTM) Phthorimaea operculella (Zeller) (Lepidoptera: Gelechiidae) is one of the most damaging pests of potato Solanum tuberosum L. in warm temperate and subtropical areas. Our previous experiment showed that extracts of larval frass of PTM deterred oviposition of conspecific females. In this study, we investigated the identification of chemicals in larval frass that were influencing the oviposition of PTM by behavioral bioassays and electroantennography analysis in the laboratory. Frass was collected from third and fourth instar larvae and combined analysis of gas chromatography coupled with electroantennography (GC-EAD) of dichloromethane extracts showed that eight compounds from larval frass extracts elicited repeatable antennal responses from mated females. Seven EAD-active compounds in frass volatile extract were identified by gas chromatography-mass spectrometry (GC-MS) as linoleic acid, octadecanoic acid, tricosane, pentacosane, heptacosane, nonacosane, and cholesterol. Oviposition bioassays indicated that frass extracts had a deterrent effect on egg laying, the deterrent activity increased with the concentration of frass extracts, and the threshold value for statistical significance in oviposition deterrence was in the range of 20-200 mg frass per cage. Linoleic acid, pentacosane, heptacosane, nonacosane, and cholesterol in larval frass volatiles were found to play a key role in repelling oviposition in a dose-dependent manner. We suggest that the bioactive compounds in larval frass are responsible for repelling oviposition of PTM, and n-alkanes, especially pentacosane, strongly deter oviposition and may be considered as a potential oviposition deterrent for potential applications.

[Design of cross-sectional anatomical model focused on drainage pathways of paranasal sinuses]

Objective:To design and produce cross-sectional anatomical models of paranasal sinuses for the purpose of demonstrating drainage pathways of each nasal sinus for the young doctors. Method:We reconstructed the three-dimensional model of sinuses area based on CT scan data, and divided it into 5 thick cross-sectional anatomy models by 4 coronal plane，which cross middle points of agger nasi cell, ethmoid bulla, posterior ethmoid sinuses and sphenoid sinus respectively. Then a 3D printerwas used to make anatomical cross-sectional anatomical models.Result:Successfully produced a digital 3D printing cross-sectional models of paranasal sinuses. Sinus drainage pathways were observed on the models. Conclusion:The cross-sectional anatomical models made by us can exactly and intuitively demonstrate the ostia of each sinus cell and they can help the young doctors to understand and master the key anatomies and relationships which are important to the endoscopic sinus surgery.

[Probability of premature mortality caused by non-communicable diseases in Beijing, 2010-2015]

Objective: To understand the probability of premature mortality caused by non-communicable diseases (NCD) in Beijing from 2010 to 2015. Methods: The data of deaths from Beijing vital registration system were used to analyze age-standardized NCD mortality rates, proportion of NCD deaths in age group <70 years and premature NCD mortality. Results: NCD deaths accounted for 90% of the total deaths in Beijing. Age-standardized NCD death rate decreased from 332.43/100 000 in 2010 to 280.02/100 000 in 2015. Meanwhile, the probability of deaths from four NCDs between in age group 30-70 years (premature NCD mortality) decreased from 12.81% to 11.11% in Beijing. The premature mortality of four NCDs in men was 14.63%, and compared with 2015 baseline, it would decrease by 16.4% to reach 2025 goal (12.23%), and the probability of premature mortality four NCDs in women was 7.54%, and compared with 2015 baseline, it would decrease by 6.8% to reach the 2025 goal (7.03%). People living in suburb areas had a higher probability of premature NCD mortality (13.67%) than those living in urban areas (9.72%) in Beijing in 2015. Conclusions: The premature NCD mortality was much higher in men than in women in Beijing. More attention should be paid to the control of risk factors for NCD premature deaths, especially in men and in suburb residents, to reach the 25×25 goal.

[Comparison of Criminal Characteristics in Depression Patients and Schizophrenics with Homicide Behavior]

OBJECTIVES

To explore the criminal characteristics of forensic psychiatry expertise in depression patients and schizophrenics with homicide behavior.

METHODS

A total of 40 depression （depressive episode） patients and 50 schizophrenics with homicide behavior were randomly assigned into the study group and control group, respectively. Data of demographic and criminal characteristic of the two groups were collected by a self-designed questionnaire, and then were compared.

RESULTS

There were no statistical differences in age, education level and career between study and control groups （P>0.05）. Compared with the control group, the victims in the study group were mainly the patient's children and parents, and most offenders had suicidal behavior after homicide （70%）. In study group, the motives of crime were mainly extended suicide and indirect suicide, and most offenders had attempted suicide （85%） and diminished capacity of criminal responsibility （70%）, which in control group had no capacity of criminal responsibility （56%）. Except for criminal site, there were statistical differences in other criminal characteristics between two groups （P<0.05）.

CONCLUSIONS

There are different criminal characteristics between depression patients and schizophrenics with homicide behavior in forensic psychiatry, and these characteristics should be considered when these two diagnoses are distinguished in forensic psychiatry expertise.

Ultraviolet saturable absorption and ultrafast carrier dynamics in ultrasmall black phosphorus quantum dots

Understanding the photoexcited carrier-relaxation actions in ultrasmall black phosphorus quantum dots (BPQDs) will play a crucial role in the fields of electronics and optoelectronics. Herein, we report the ultraviolet (UV) saturable absorption and ultrafast photoexcited carrier-relaxation dynamics of BPQDs. The ultrasmall BPQDs are synthesized using a facile liquid-exfoliation method and possess a diameter of 3.8 ± 0.6 nm and a thickness of 1.5 ± 0.4 nm. Femtosecond open-aperture (OA) Z-scan measurements showed typical saturable absorption properties in the UV band. A negative nonlinear optical (NLO) absorption coefficient of -(1.4 ± 0.3) × 10^-3 cm GW^-1 and a saturable intensity of 6.6 ± 1.3 GW cm^-2 were determined. Using a degenerate pump-probe technique, an ultrafast photoexcited carrier-recombination time was observed in the range of 216-305 fs, which was 3 orders of magnitude faster than that of BP nanosheets. Such an ultrafast relaxation component may be attributable to the edge- and step-mediated recombination and was confirmed by our density functional theory (DFT) calculations. This work provides fundamental insight into the underlying mechanism of the photoexcited carrier relaxation dynamic action in BPQDs which can enable UV photonic devices.

[Analysis on causes of death of residents in Beijing, 1965-1974]

OBJECTIVE

To fill up the absence of data on causes of death of urban residents in Beijing during 1965-1974 and provide evidence for the similar study in other areas.

METHODS

All possible sources for death data during 1965-1974 were identified through expert consultations and record search. Stratified sampling was conducted to collect the death data of urban residents during this period in Beijing. The mortality rate, death cause constituent and rank of death causes were used in this descriptive analysis.

RESULTS

A total of 11 668 records of deaths from 1965 to 1974 were collected from 10 local police stations in urban area of Beijing. The top 10 death causes in the urban residents were heart disease, tumor, cerebrovascular disease, accidental injury, respiratory system disease, digestive system disease, communicable disease and parasitic disease, nervous system disease, urogenital and reproductive system disease, endocrine and nutrition metabolic diseases. The deaths caused by these diseases accounted for 84.19% of the total deaths. Accidental injury accounted for 13.22% of the total deaths, which was significantly higher than that in either 1964 or 1975, two years before and after this period(P<0.01). Suicide accounted for 54.47% of the total accidental injury deaths. For men, accidental injury was the leading death cause, followed by cancer and heart disease; for women, heart disease, cancer and cerebrovascular disease were the top three death causes.

CONCLUSION

The major death cause in urban residents changed from infectious diseases to chronic and non-communicable diseases during 1965-1974. A remarkable high proportion of deaths caused by accidental injury was due to the historical background during that period in Beijing, China.

Development of a valid Simplified Chinese version of the International Hip Outcome Tool (SC-iHOT-33) in young patients having total hip arthroplasty

OBJECTIVE

The International Hip Outcome Tool (iHOT-33) is a questionnaire designed for young, active patients with hip disorders. It has proven to be a highly reliable and valid questionnaire. The main purpose of our study was to adapt the iHOT-33 questionnaire into simplified Chinese and to assess its psychometric properties in Chinese patients.

METHOD

The iHOT-33 was cross culturally adapted into Chinese and 138 patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the EuroQol-5D (EQ-5D), and the Chinese version of the iHOT-33(SC-iHOT-33) pre- or postoperatively within 6 months' follow-up. The Cronbach's alpha, intraclass correlation coefficient (ICC), Pearson's correlation coefficient (r), effect size (ES), and standardized response mean (SRM) were calculated to assess the reliability, validity, and responsiveness of the SC-iHOT-33, respectively.

RESULTS

Total Cronbach's alpha was 0.965, which represented excellent internal consistency of the SC-iHOT-33. The ICC ranges from 0.866 to 0.929, which shows excellent test-retest reliability. The subscales of SC-iHOT-33 had the highest correlation coefficient (r = 0.812) with the physical function subscales of the WOMAC, as well as good correlation between the social/emotional subscale of the SC-iHOT-33 and the EQ-5D (r = 0.740, r = 0.743). No floor or ceiling effects were found. The ES and SRM values indicated good responsiveness of 2.44 and 2.67, respectively.

CONCLUSION

The SC-iHOT-33 questionnaire is reliable, valid, and responsive for the evaluation of young, Chinese, active patients with hip disorders.

NtBRC1 suppresses axillary branching in tobacco after decapitation

Axillary branching is controlled by a very complex mechanism involving various endogenous and environmental factors. Previous studies have shown that Tb1/BRC1 is the point of integration in the network of molecular mechanisms regulating axillary branching in plants. In this study, we cloned the Tb1/BRC1 ortholog, NtBRC1, from Nicotiana tabacum and functionally analyzed its role in the control of axillary branching in tobacco. Overexpression of NtBRC1 resulted in significant retardation of axillary branching, and downregulation of this gene resulted in significant acceleration of axillary branching after decapitation. This indicates a negative role for this gene in the regulation of axillary branching. In-line with previous reports, NtBRC1 was found to be expressed predominantly in axillary buds. Additionally, as expected, expression was decreased 8 h following decapitation, which further confirms its role in the suppression of axillary branching. Furthermore, the expression of NtBRC1 was significantly downregulated by cytokinin, but was not affected by GR24, a synthetic strigolactone. Based on the data collected in the present study, we demonstrate that NtBRC1 negatively regulates axillary branching in tobacco after decapitation and functions downstream of the cytokinin signaling pathway inside axillary buds.

[Influencing factors on healthy life expectancy in adults in Beijing]

OBJECTIVE

To understand the main influencing factors related to healthy life expectancy (HALE) among adults in Beijing.

METHODS

The calculation on health-adjusted life expectancy was performed by Sullivan METHODS. Data from the self-reported health survey program on adults in Beijing 2012 was gathered. Hierarchical ordered probit model was used to estimate the severity-weighted prevalence of disability and then combined with the period life table to obtain the HALE. Factors associated with the severity-adjusted prevalence of the disabled were analyzed under the generalized additive models (GAM).

RESULTS

The main influencing factors of HALE would include age (t=40.351, P<0.001), sex (t=9.689, P<0.001), levels of education (t=5.021, P< 0.001), exercise (t=5.487, P<0.001) and alcohol intake (t=-2.380, P=0.017) etc. The influence of per capita monthly income (χ(2) =3.949, P=0.044) showed as non-linear.

CONCLUSIONS

Levels of income would directly influence the severity-weighted prevalence of the disability, which also affecting the HALE. Programs on improving healthy life style and health care in women should be promoted.

Cloning, characterization, expression, and feeding response of thyrotropin receptor in largemouth bass (Micropterus salmoides)

Thyrotropin receptor (TSHR) is a G-protein-coupled receptor that regulates the synthesis, storage, and secretion of thyroid hormones in the thyroid tissue. The aims of the present study were to characterize the full-length TSHR cDNA in largemouth bass (Micropterus salmoides), and to determine the TSHR gene transcription levels in different tissues. In addition, the response of TSHR transcription levels to daily feeding in thyroid tissue was investigated. The results showed that the full-length cDNA sequence was 2743 bp with an open reading frame of 2340 bp encoding a 779-amino acid peptide. BLAST analysis indicated that the amino acid sequence displayed 58.4-90.2% identity and 5.6-125.8 divergence, compared with other known fish species. The most abundant TSHR transcription levels were found in the spleen, head kidney, and kidney. Feeding did not affect the transcription level of TSHR in thyroid tissue over the course of the day. Thus, the current study suggests that there was no relationship between daily nutritional status and TSHR transcription level in the thyroid tissue of largemouth bass. The spleen, head kidney, and kidney exhibited the most abundant TSHR transcription levels.

The expression of osteopontin in breast cancer tissue and its relationship with p21ras and CD44V6 expression

OBJECTIVE

This study aimed to investigate the expression of osteopontin (OPN), p2lras, and CD44V6 in breast cancer tissues, and to analyze the relationships between their expression and a patient's clinicopathological characteristics and five-year survival rate.

MATERIALS AND METHODS

Streptavidin-peroxidase immunohistochemistry was used to detect the expression of OPN, p2lras, and CD44V6 in tissue samples from 96 breast cancer patients, and the multivariate Cox proportional hazards model (mCOX-PHM) was used to analyze the factors that affect prognosis.

RESULTS

Among the 96 breast cancer patients studied, positive staining for OPN, CD44V6, and p21ras was observed in 54.2%, 58.3%, and 43.8% of samples, respectively. The expression of OPN and CD44V6 were positively correlated (r = 0.58), and the expression of OPN and p21ras were also positively correlated (r = 0.25). Coexpression OPN, CD44V6, and p21ras was negatively correlated with a patient's five-year survival rate (p < 0.05). Kaplan-Meier analysis indicated that a patient without OPN, CD44V6, or p21ras expression had an improved survival (p < 0.05). Results from the mCOX-PHM analysis indicated that CD44V6 expression, the degree of tumor differentiation, and lymph node metastasis were all independent factors that indicate prognosis. The combined detection of OPN, CD44V6, and p21ras could contribute to a more accurate assessment of the biological behavior of breast cancers, and could help to indicate the prognosis of breast cancer patients.

Quality of life of Chinese urologists: a cross-sectional study using WHOQOL-BREF

OBJECTIVES

In recent years, Chinese hospital settings are under violent threats. The exact status of quality of life of Chinese doctors under these disastrous situations remains obscure. The aim of this study was to assess the quality of life of Chinese urologists and analyse its potential affecting factors.

DESIGN

Cross-sectional survey.

SETTING

Beijing, China.

PARTICIPANTS

Overall, 1000 participants from more than 30 areas of China, who participated in the 20th National Urology Conference in Beijing in 2013, were surveyed. The brief version of the World Health Organization Quality of Life (WHOQOL-BREF) Chinese version was used to assess the quality of life among these urologists. The relationship between quality of life and the affecting factors was analysed.

RESULTS

Of the 1000 questionnaires, 856 were completed and returned, and 708 questionnaires were valid for analysis. Approximately 46% of the respondents came from provincial capitals, 54.2% of them felt stress from medical environment, while 76.0% felt stress from research work, and 85.3% from promotion. Cronbach's α coefficient of the instrument was 0.825, Kaiser-Meyer-Olkin measure was 0.841, and P value of Bartlett's sphericity was <0.001. The results of binary logistic regression indicated gender, work years, and medical environment as potential affecting factors of quality of life only influenced one domain. In contrast, research work and promotion influenced three domains of the WHOQOL-BREF.

CONCLUSIONS

The study indicated that the WHOQOL-BREF may be a reliable and valid tool to assess quality of life of Chinese urologists. In China it is true that the deteriorative medical environment negatively affects medical practice according to previous studies, and policies are recommended to improve the situation. Nevertheless, we should not be too pessimistic about it, as in today's context research work and promotion may be the most extensive and significant affecting factors on doctors' quality of life.

Initial experiences with laparoscopy and flexible ureteroscopy combination pyeloplasty in management of ectopic pelvic kidney with stone and ureter-pelvic junction obstruction

To demonstrate the safety and efficacy of combine laparoscopy and flexible ureteroscopy to treat ectopic pelvic kidneys with ureteropelvic junction obstruction (UPJO) and stones. 16 patients of ectopic pelvic kidneys with ureteropelvic junction obstruction and stones were treated with laparoscopy and flexible ureteroscopy (FURS). The operative time, required dose of tramadol, visual analog pain scale (VAPS), postoperative day, stone-free rates (SFRs), perioperative complications, and serum creatinine were evaluated. The SFRs were evaluated with noncontrasted renal computed tomography (CT). Intravenous pyelography (IVP) and CT scan were used to evaluate the UPJO. Stone-free status was defined as absence of stone fragments in kidney or the size of that is less than 3 mm. Operation time from 118 to 225 min, average time (171 ± 28) min; lithotomy time from 16 to 45 min, average time (32 ± 6) min. Average tramadol required at the first day postoperation was (118 ± 49.6) mg; at the second day was (78 ± 24.8) mg. VAPS score at 24 h (5.0 ± 0.7), VAPS score at 48 h (2.5 ± 0.8). Postoperative day (3.9 ± 0.6) days. Stone-free rate was 100%. Average serum creatinine was (88.7 ± 24.3) mol/L before surgery and (92.8 ± 21.6) mol/L after surgery. No major complication. No stone and obstruction recurrence in the follow-up of average 29.3 months. Combined FUR and LC is a good option for patient of ectopic pelvic kidney with renal stone and UPJO. From our initial experience, the SFRs and the effect of pyeloplasty are satisfactory and without major complication, the operative time is acceptable.

Ischemia-reperfusion injury in an aortic dissection patient

Aortic dissection is a life-threatening emergency. Well-established risk factors include systemic hypertension, hereditary connective tissue diseases (Marfan syndrome and Ehlers-Danlos syndrome), coarctation of the aorta, bicuspid aortic valve, aortitis, and arch hypoplasia. Ischemia of the viscera, the kidneys, the spinal cord, or the lower extremities due to malperfusion constitutes life-threatening complications that have to be considered in the treatment strategy.We report a rare case of symptomatic ischemia of the lower extremities due to aortic dissection. This case demonstrates that the treating physician needs to be vigilant for ischemia reperfusion injuries such as osteofascial compartment syndrome and acute renal failure in aortic dissection.

Correlation between atomic structure evolution and strength in a bulk metallic glass at cryogenic temperature

A model Zr_41.25Ti_13.75Ni₁₀Cu_12.5Be_22.5 (at.%) bulk metallic glass (BMG) is selected to explore the structural evolution on the atomic scale with decreasing temperature down to cryogenic level using high energy X-ray synchrotron radiation. We discover a close correlation between the atomic structure evolution and the strength of the BMG and find out that the activation energy increment of the concordantly atomic shifting at lower temperature is the main factor influencing the strength. Our results might provide a fundamental understanding of the atomic-scale structure evolution and may bridge the gap between the atomic-scale physics and the macro-scale fracture strength for BMGs.

Transmission of Babesia sp to sheep with field-collected Haemaphysalis qinghaiensis

Haemaphysalis qinghaiensis ticks collected in the Gannan Tibet Autonomous Region were infested onto a sheep from a Babesia-free area. A strain of small Babesia (1.8-2.1 microm in length) was isolated from the sheep. Most of the Babesia in erythrocytes were round, oval, single pyriform, double pyriform, budding or elongated in form. Measurements were made of 100 single sides of the double-pyriform Babesia and compared with those for B. motasi and B. ovis from Holland, using Student's t-test. The Gannan small Babesia was similar to the B. ovis from Holland, but differed significantly from the Dutch B. motasi.

Development of an enzyme-linked immunosorbent assay for the diagnosis of Theileria sp. infection in sheep

A rapid, sensitive and specific diagnostic method, an enzyme-linked immunosorbent assay (ELISA), was developed for the diagnosis of Theileria sp. infection in sheep; and optimal conditions were established, such as antigen concentration, serum dilution, coating time, Tween-20 concentration and conjugate. The results were analyzed by measuring the coefficient of variation (CV). Three sera titers (high, middle, low) were analyzed over the measurement range, resulting in a CV of around 10%, whereas a 30% variation is the maximum acceptable. The cut-off value was determined by the mean of a negative control plus three standard deviations. Cross-reaction was found only with Babesia ovis. However, this result may be questionable, because it cannot be excluded that these sheep were already infected with both Theileria sp. and B. ovis. The ELISA described in the present study proved to be a useful tool for studying the epidemiology of Theileria sp.

A field test on the treatment of ovine theileriosis with an injection of Kangjiaoming

A compound effective for the treatment of ovine theileriosis was selected and a slow-release preparation (named Kangjiaoming) was prepared. A total of 1,172 sheep and goats in Zhangjiachuan, Lintan and Yuzhong Counties, Gansu Province, where small ruminants are seriously affected by theileriosis, were injected with this preparation at a dosage of 5 mg/kg body weight. The infection rate of the control group in each of the above-mentioned counties was 98.5%, 85% and 80%, respectively. None of the treated animals became sick due to theileriosis. This drug proved to be useful for the treatment of carrier cases, although its effect was apparently slower than in acute theileriosis. The effect of the preparation on some weak animals was not satisfactory.

gammadelta T cells express activation markers in the central nervous system of mice with chronic-relapsing experimental autoimmune encephalomyelitis

In this study, we assessed the expression of activation markers on gammadelta T cells in central nervous system (CNS) lesions of SJL mice adoptively sensitized to develop experimental autoimmune encephalomyelitis (EAE) using myelin basic protein-reactive T cells. Although disease expression is known to be dependent upon T cells that express the alphabeta T cell receptor (TCR), a role for gammadelta T cells has been implicated in some studies but not in others. Using three-color flow cytometric analysis of both total and gammadelta T cells in spleen and CNS, the data showed that expression of CD69 (early activation marker), CD62L (lymphocyte homing receptor), CD25 (IL-2Ralpha), CD122 (IL-2Rbeta) and CD95/CD95L (Fas/FasL), fluctuated on gammadelta T cells in EAE lesions in a disease-related fashion. Furthermore, the pattern of expression for these markers on gammadelta T cells was distinct from that found on the total lymphocyte population. Cytokine analysis of gammadelta T cells in the CNS demonstrated a bias towards a Th1-like cytokine profile. From these data, we conclude that gammadelta T cells in EAE lesions display an activated phenotype and form a dynamic component of the total lymphocyte population in the CNS, supporting a contributory role for these cells.

A comparison of calcitonin gene-related peptide effects on coronary flow and cardiac conduction system in the guinea pig

The purpose of this study was to examine the effects of calcitonin gene-related peptide (CGRP) on coronary flow and various parts of cardiac conduction system (CCS) in the isolated guinea pig heart by recording the cardiac electrogram and His bundle activity simultaneously. The coronary flow (CF) was measured and the right atrium was paced at incremental frequencies periodically. Perfusing heart with CGRP at the concentrations of 3 30 nmol/L increased CF strikingly and dose-dependently. CGRP (30 nmol/L) caused a moderate and significant increase in the spontaneous heart rate, but failed to influence the atrioventricular nodal and His bundle-Purkinje fiber conduction time and the longest atrial pacing cycle length inducing 3 2 Wenckebach and 2 1 AV nodal conduction. The results indicate that CGRP in the guinea pig heart might act mainly on coronary vessels and then the sinus node, but did not affect the conductivity and refractoriness of the AV conduction system.

Neuregulin in neuron/glial interactions in the central nervous system. GGF2 diminishes autoimmune demyelination, promotes oligodendrocyte progenitor expansion, and enhances remyelination

Glial growth factor 2 (GGF2) is a neuronal signal that promotes the proliferation and survival of the oligodendrocyte, the myelinating cell of the central nervous system (CNS). This study has focused on recombinant human GGF2 (rhGGF2) and it's potential to affect clinical recovery and repair to damaged myelin in chronic relapsing experimental autoimmune encephalomyelitis (EAE) in the mouse, a major animal model for the human demyelinating disease, multiple sclerosis (MS). Mice with EAE were treated with rhGGF2 during both the acute and relapsing phases, and GGF2 treatment led to delayed signs, decreased severity and resulted in statistically significant reductions in relapse rate. Further, rhGGF2-treated groups displayed CNS lesions with more remyelination than in controls. This correlated with increased expression of myelin basic protein exon 2, a marker for remyelination, and with an increase of the regulatory cytokine, IL-10. Thus, a beneficial effect of a neurotrophic growth factor has been demonstrated upon the clinical, pathologic and molecular manifestations of autoimmune demyelination, an effect that was associated with increased expression of a Th2 cytokine. rhGGF2 treatment may represent a novel approach to the treatment of MS (Cannella et al., 1998).

Evidence for gammadelta T cells with a restricted Vgamma6 junctional region in the normal mouse central nervous system

In this study we present evidence that gammadelta T cells are present in the normal mouse central nervous system (CNS). Compared with matching spleen gammadelta T cells, CNS gammadelta T cells expressed only the CD45RBlow phenotype, suggesting that CNS gammadelta T cells belong to the memory cell population. Approximately 20% expressed exclusively the CD8alphabeta heterodimer, consistent with a thymic origin. Gammadelta T cells in both spleen and CNS expressed higher levels of the IL-2rbeta (CD122), as well as Fas and FasL, than alphabeta T cells, suggesting that these cells function as immunoregulatory T cells. RT-PCR analysis showed almost exclusive use of Vdelta6 in the CNS whereas more Vdelta genes were expressed in the spleen. Sequencing of Vdelta6 RT-PCR products demonstrated a polyclonal population of T cells in the spleen but a more clonal population within the CNS. The predominant CNS sequence was found in all animals studied and was also detected in the spleen. From these data we conclude that a selective component of circulating gammadelta T cells traffics through the CNS. Thus, all major populations of lymphocytes can be detected in the normal CNS and as such may play specific roles in the immunological surveillance of that organ.

Heat shock proteins and experimental autoimmune encephalomyelitis. II: environmental infection and extra-neuraxial inflammation alter the course of chronic relapsing encephalomyelitis

We wished to study how infections might trigger relapses of autoimmune diseases such as multiple sclerosis (MS) and encephalomyelitis (EAE). We hypothesized that immune responses to heat shock proteins (hsp) induced by an infection could modulate responses to autoantigens. We induced extra-neuraxial inflammation in SJL mice housed either in specific-pathogen free (SPF) or conventional facilities. Mice in conventional housing are continuously exposed to large numbers of infectious agents. Spleen cell proliferative responses to human HSP60 and bacterial HSP65 were measured as were numbers of cells secreting IFN-gamma or IL-5. Proliferative responses to HSP60 were increased in conventionally housed mice compared to SPF mice and this was associated with skewing of secreted cytokines toward a Th2 pattern. Skewing toward a Th1 pattern was noted in SPF mice. Acute and relapsing EAE was induced in both groups of mice. Acute EAE was, in general, equivalent in all groups. However, SPF mice had more severe relapses than did conventionally housed animals and these differences were amplified by extra-neuraxial inflammation. Immunocytochemical analyses of brains from mice with relapsing EAE showed that increased numbers of brain gamma/delta cells were associated with disease remission. Our data suggest that frequent exposure to infectious agents leads to a relative Th2 skewing of immune responses to hsp and that this is associated with milder, less frequent relapses of EAE. They also support the concept that immune responses to hsp are of potential importance in exacerbating and perpetuating organ-restricted autoimmune diseases.

The neuregulin, glial growth factor 2, diminishes autoimmune demyelination and enhances remyelination in a chronic relapsing model for multiple sclerosis

Glial growth factor 2 (GGF2) is a neuronal signal that promotes the proliferation and survival of the oligodendrocyte, the myelinating cell of the central nervous system (CNS). The present study examined whether recombinant human GGF2 (rhGGF2) could effect clinical recovery and repair to damaged myelin in chronic relapsing experimental autoimmune encephalomyelitis (EAE) in the mouse, a major animal model for the human demyelinating disease, multiple sclerosis. Mice with EAE were treated with rhGGF2 during both the acute and relapsing phases. Clinically, GGF2 treatment delayed signs, decreased severity, and resulted in statistically significant reductions in relapse rate. rhGGF2-treated groups displayed CNS lesions with more remyelination than in controls. This correlated with increased mRNA expression of myelin basic protein exon 2, a marker for remyelination, and with an increase in the CNS of the regulatory cytokine, interleukin 10, at both the RNA and protein levels. Thus, a beneficial effect of a neurotrophic growth factor has been demonstrated on the clinical, pathologic, and molecular manifestations of autoimmune demyelination, an effect that was associated with increased expression of a T helper 2 cytokine. rhGGF2 treatment may represent a novel approach to the treatment of multiple sclerosis.

Cell death during autoimmune demyelination: effector but not target cells are eliminated by apoptosis

The Fas and FasL apoptotic pathway was investigated by protein immunohistochemistry, flow cytometry, and reverse transcriptase-PCR analysis to assess whether it is involved in the elimination of target and/or effector cells from the central nervous system (CNS) during adoptively transferred chronic relapsing experimental autoimmune encephalomyelitis (EAE), a model for multiple sclerosis. In addition to Fas and FasL, we studied Bax, an intracellular protein of the apoptotic cascade, the Bax antagonist and anti-apoptotic molecule Bcl-2, and DNA fragmentation, the final step in the apoptotic pathway. Infiltrating CD4+ T cells and parenchymal microglia expressed Fas, FasL, and Bax, and about half of these cells showed DNA fragmentation, a combination indicative of ongoing apoptosis. Using flow cytometry and reverse transcriptase-PCR, a positive correlation was seen between disease activity and up-regulation of the Fas system; in fact, Fas and FasL were expressed at low levels at the onset of EAE and increased at the height of disease to involve about one-third of all infiltrating lymphocytes. In the normal CNS, Fas immunoreactivity was constitutively present at low levels on oligodendrocytes and was up-regulated in the CNS during the course of EAE. However, oligodendrocytes showed no Bax reactivity or DNA fragmentation and expressed high levels of Bcl-2, as did the majority of infiltrating CD3+ cells, a pattern inconsistent with apoptosis. Thus, while molecules of the apoptotic cascade are well represented in the CNS during EAE, their expression correlates with elimination of infiltrating cells and microglia, not the myelinating cell, the oligodendrocyte.

Cell death during autoimmune demyelination: effector but not target cells are eliminated by apoptosis

The Fas and FasL apoptotic pathway was investigated by protein immunohistochemistry, flow cytometry, and reverse transcriptase-PCR analysis to assess whether it is involved in the elimination of target and/or effector cells from the central nervous system (CNS) during adoptively transferred chronic relapsing experimental autoimmune encephalomyelitis (EAE), a model for multiple sclerosis. In addition to Fas and FasL, we studied Bax, an intracellular protein of the apoptotic cascade, the Bax antagonist and anti-apoptotic molecule Bcl-2, and DNA fragmentation, the final step in the apoptotic pathway. Infiltrating CD4+ T cells and parenchymal microglia expressed Fas, FasL, and Bax, and about half of these cells showed DNA fragmentation, a combination indicative of ongoing apoptosis. Using flow cytometry and reverse transcriptase-PCR, a positive correlation was seen between disease activity and up-regulation of the Fas system; in fact, Fas and FasL were expressed at low levels at the onset of EAE and increased at the height of disease to involve about one-third of all infiltrating lymphocytes. In the normal CNS, Fas immunoreactivity was constitutively present at low levels on oligodendrocytes and was up-regulated in the CNS during the course of EAE. However, oligodendrocytes showed no Bax reactivity or DNA fragmentation and expressed high levels of Bcl-2, as did the majority of infiltrating CD3+ cells, a pattern inconsistent with apoptosis. Thus, while molecules of the apoptotic cascade are well represented in the CNS during EAE, their expression correlates with elimination of infiltrating cells and microglia, not the myelinating cell, the oligodendrocyte.

IL-10 fails to abrogate experimental autoimmune encephalomyelitis

Mice adoptively-sensitized to develop chronic relapsing experimental autoimmune encephalomyelitis (EAE), a model for the human demyelinating condition, multiple sclerosis (MS), were given injections of recombinant human IL-10 at various timepoints post-sensitization in an attempt to abrogate disease development. IL-10 is a Th2 immunomodulatory cytokine with known down-regulatory effects upon Th1 responses and macrophages. Contrary to a previous report on EAE and the predicted outcome, after repeated experiments, IL-10 was found to elicit a worsening or no effect upon EAE in the mouse. Animals were studied clinically, histopathologically and immunocytochemically. On no occasion was disease ameliorated by IL-10. Pretreatment with IL-10 of lymph node cells used to transfer EAE had no effect upon disease outcome, indicating that the cells were already committed effectors. Administration of anti-IL-10 monoclonal antibody before onset of signs had no effect when given early post-sensitization and caused marked worsening when given immediately before onset of signs. In the context of this autoimmune demyelinating model, these results suggest that IL-10 alone is insufficient to reverse the effector response and indeed may serve to enhance the cascade of events in EAE.

A pathogenic role for gamma delta T cells in relapsing-remitting experimental allergic encephalomyelitis in the SJL mouse

Previous studies have detected gamma delta T cells in multiple sclerosis and experimental allergic encephalomyelitis (EAE) lesions but their role remains obscure. In the present study, we assessed gamma delta T cell dynamics and distribution in spleen and central nervous system (CNS) from mice with relapsing-remitting EAE, and studied the effect of depleting these cells on clinical and pathologic expression of disease using the mAb GL3. By immunohistochemistry and FACS analysis, striking disease-related changes were observed in the gamma delta T cell population in the CNS. FACS analysis showed that while gamma delta T cells remained low in the spleen (approximately 2% total CD3+ T cells) at all stages, in the CNS they increased to approximately 12% at the height of the acute attack, fell to approximately 5% during the recovery phase, but rose again to approximately 12% during the chronic phase. In animals in which gamma delta T cells were depleted immediately before the onset of acute disease, or during the chronic stage, a striking and significant reduction in the severity of the clinical signs was observed that was associated with a decrease in the percentage of CD3+/gamma delta T cells in the CNS. In depleted animals a statistically significant reduction in inflammation and demyelination was noted during the acute stage, but only marginal effects on these disease parameters were found in the chronic phase. Taken together, the data support the conclusion that gamma delta T cells play an important role in the pathogenesis of EAE in mice during both acute and chronic/progressive phases of the disease process.

A pathogenic role for gamma delta T cells in relapsing-remitting experimental allergic encephalomyelitis in the SJL mouse

Previous studies have detected gamma delta T cells in multiple sclerosis and experimental allergic encephalomyelitis (EAE) lesions but their role remains obscure. In the present study, we assessed gamma delta T cell dynamics and distribution in spleen and central nervous system (CNS) from mice with relapsing-remitting EAE, and studied the effect of depleting these cells on clinical and pathologic expression of disease using the mAb GL3. By immunohistochemistry and FACS analysis, striking disease-related changes were observed in the gamma delta T cell population in the CNS. FACS analysis showed that while gamma delta T cells remained low in the spleen (approximately 2% total CD3+ T cells) at all stages, in the CNS they increased to approximately 12% at the height of the acute attack, fell to approximately 5% during the recovery phase, but rose again to approximately 12% during the chronic phase. In animals in which gamma delta T cells were depleted immediately before the onset of acute disease, or during the chronic stage, a striking and significant reduction in the severity of the clinical signs was observed that was associated with a decrease in the percentage of CD3+/gamma delta T cells in the CNS. In depleted animals a statistically significant reduction in inflammation and demyelination was noted during the acute stage, but only marginal effects on these disease parameters were found in the chronic phase. Taken together, the data support the conclusion that gamma delta T cells play an important role in the pathogenesis of EAE in mice during both acute and chronic/progressive phases of the disease process.

Experimental autoimmune encephalomyelitis. Qualitative and semiquantitative differences in heat shock protein 60 expression in the central nervous system

The factors that contribute to disease progression in multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE), are not known. In this study, we have tested the hypothesis that inflammation in the central nervous system (CNS) is associated with altered expression of heat shock proteins (hsp) that may function as a target in the development of chronic disease. In normal mouse spinal cord, hsp 60 immunoreactivity was localized exclusively to its constitutive site in mitochondria. In animals with acute EAE, lesions were accentuated by increased expression of hsp 60, primarily by infiltrating cells. In chronic EAE, hsp 60 was found predominantly on CNS components, particularly oligodendrocytes, and astrocytes. In both acute and chronic lesions, hsp 60 was located in the cytoplasm of cells, but in non-lesion areas, it was mitochondrial. By semiquantitative Western blotting, hsp 60 in normal mouse spinal cord (n = 6) was 0.99 +/- 0.09% of total protein. In acute EAE (n = 6), the value was 1.08 +/- 0.1%, and in chronic EAE (n = 8), 1.39 +/- 0.39%. FACS analysis showed that a subpopulation of CD3+ cells expressed hsp 60 on the cell surface, an observation confirmed by cell surface labeling and immunoprecipitation. In chronic EAE lesions, gamma delta T cells colocalized with areas of increased hsp 60 immunoreactivity. The results support the conclusion that development of autoimmune-directed inflammation in the CNS is associated with differences in hsp 60 expression that may act as an additional target and/or modulator of the immune response.

Experimental autoimmune encephalomyelitis. Qualitative and semiquantitative differences in heat shock protein 60 expression in the central nervous system

The factors that contribute to disease progression in multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE), are not known. In this study, we have tested the hypothesis that inflammation in the central nervous system (CNS) is associated with altered expression of heat shock proteins (hsp) that may function as a target in the development of chronic disease. In normal mouse spinal cord, hsp 60 immunoreactivity was localized exclusively to its constitutive site in mitochondria. In animals with acute EAE, lesions were accentuated by increased expression of hsp 60, primarily by infiltrating cells. In chronic EAE, hsp 60 was found predominantly on CNS components, particularly oligodendrocytes, and astrocytes. In both acute and chronic lesions, hsp 60 was located in the cytoplasm of cells, but in non-lesion areas, it was mitochondrial. By semiquantitative Western blotting, hsp 60 in normal mouse spinal cord (n = 6) was 0.99 +/- 0.09% of total protein. In acute EAE (n = 6), the value was 1.08 +/- 0.1%, and in chronic EAE (n = 8), 1.39 +/- 0.39%. FACS analysis showed that a subpopulation of CD3+ cells expressed hsp 60 on the cell surface, an observation confirmed by cell surface labeling and immunoprecipitation. In chronic EAE lesions, gamma delta T cells colocalized with areas of increased hsp 60 immunoreactivity. The results support the conclusion that development of autoimmune-directed inflammation in the CNS is associated with differences in hsp 60 expression that may act as an additional target and/or modulator of the immune response.

The relationship between PGE2 level in mothers' milk and physiological diarrhea of the baby and the treatment

Physiological diarrhea of baby during the period of breastfeeding often occurs. To investigate the relationship between mother's milk and the physiological diarrhea of baby, we measured the PGE2 levels in milk of 320 lactating women within 4 months of postpartum with radioimmunoassay and the mean value of PGE2 level was 216.8 +/- 145.2 ng/L. The PGE2 levels in mother's milk in the group with diarrhea were 286.5 +/- 142.2 ng/L, that of control group 130.4 +/- 76.3 ng/L. The difference was obviously significant (P < 0.001). The physiological diarrhea of baby was positively related to the PGE2 level in mother's milk (r = 0.75, P < 0.01) i.e., the high PGE2 level in mother's milk may be an important cause of diseases. The observation on 102 cases of baby with severe physiological diarrhea showed a higher level of PGE2 in the mother's milk. 52 cases of lactating women in the treated group were given indomethacin, and after treatment the PGE2 level in mother's milk decreased obviously, and the diarrhea of baby disappeared. The effective rate was 96.15%. No side effects were found in both mother and baby.

[The antimetastatic effects of BJA-II on nude mice with highly metastatic human ovarian carcinoma]

Nude mice with highly metastatic human ovarian carcinoma were treated with BJA-II. This new agent was made in our institute. Twenty-four experimental mice were divided into 4 groups with 6 mice each. The mice, according to the treatment given them, were designated as: the BJA-II group, the cisplatin group, the group with combination therapy and the control group. Treatment began on the 2nd day after tumor transplantation. For BJA-II, a dose of 16 mg per mouse per day was administered orally. The total dose each mouse received by the 53rd day was 848mg. The tumor growth inhibition rate was found to be 63.7% in the BJA-II group; the transplanted tumors disappeared in 2 mice. No significant difference in average tumor weight was found between the BJA-II group and the control group (P < 0.05). The antimetastatic effect of BJA-II (1 mouse with metastasis) was higher than that of the control group (4 mice with metastasis). The influences on the immunofunction of the host were observed: the increase of the peripheral WBC count, the increase of NK cell activity, the increase in the ratio of spleen weight to body weight, and the histiocyte increase in the lymph node sinuses, etc. All of these findings were better demonstrated in the BJA-II group than in the cisplatin group. The results indicate that BJA-II is provided with the effectiveness of inhibiting tumor growth, is antimetastatic and is capable of increasing the immunofunction of the host.

Humoral response to hsp 65 in multiple sclerosis and other neurologic conditions

The expression of heat shock proteins (hsp) within the target organ is implicated in the pathogenesis of a number of diseases of suspected autoimmune etiology, including MS. To pursue the potential role of a humoral response to the hsp 60/65 kd family in MS, we studied serum and CSF by Western blotting using recombinant Mycobacterium bovis hsp 65 and human hsp 60 as antigens and compared the findings with samples from patients with other neurologic diseases (OND). Analysis of the IgG response in CSF from 18 patients with MS indicated moderate reactivity in 10 cases and no reactivity in eight. In the OND group, reactivity was found in the CSF from one of two patients with Parkinson's disease, four of four Alzheimer's disease patients, and two of two patients with amyotrophic lateral sclerosis. CSF samples from seven of seven patients with subacute sclerosing panencephalitis were negative, as were samples from two normal subjects. There was no reactivity in CSF from two Huntington's disease patients. We conclude that antibodies reactive with hsp 60/65 are present in CSF of some MS patients but are also present in a number of chronic neurodegenerative conditions. The findings indicate that a humoral response to hsp 60/65 in the CSF is not specific for MS.

Pelvic lymphadenectomy with stripping technique in 43 cases

Pelvic lymphadenectomy with stripping technique--Gao's stripping pelvic lymphadenectomy (GSPL) was introduced. From January to December 1989, this operation was performed on 43 patients (36 patients with cervical carcinoma, 5 endometrial carcinoma and 2 ovarian carcinoma). The mean time of the operation was 12.56 minutes for the left side, and 13.33 minutes for the right side. No severe complications were found. The bleeding during operation was minimal. The main advantages of GSPL include high-speed operation, clean and integral lymphnodes stripped, less bleeding and complications, and easy performance of operation.

[Stripping technique in radical pelvic lymphadenectomy]

An improved pelvic lymphadenectomy technique by stripping of the lymphatic tissue was introduced. From January to December, 1989, this technique was performed in 43 patients, consisting of 36 cases of cervical carcinoma, 5 cases of endometrial carcinoma and 2 cases of ovarian carcinoma. The mean operative time was 12.6 minutes for the left pelvic lymphadenectomy and 13.3 minutes for the right side. The bleeding during operation was insignificant and no severe complication was observed.

[Research on the need to perform a second curettage of hydatidiform mole: analysis of 152 cases]

Curettage, for the second time, has been performed almost routinely for patients after the first curettage for hydatidiform mole. Is it necessary? The histopathologic results of the second curettage specimens were investigated. It showed that residual molar tissue was found in only 3.3% of the second curettage specimens. So in our opinion, a second curettage, which will not only add to patients' suffering but also would prolong hospitalization time, should be performed only in cases strongly indicated.

A two-year study of acceptability, side effects, and effectiveness of Norplant and Norplant-2 implants in the People's Republic of China

A large scale, phased investigation of NORPLANT contraceptive systems was conducted in the People's Republic of China. The first phase comprehended 1,200 women in four cities. Expanded trials included 11,918 women at 12 major centers and at sub-centers by 31 May 1987. At that date 4,676 NORPLANT capsule subjects and 1,089 rod subjects had completed one year of use, 1,381 capsule acceptors had completed two years as had 197 rod users. Gross pregnancy rates were less than 0.1 per 100 for each implant type both at one and at two years. Continuation rates were 94 per 100 for each implant type at one year, and were 82.0 and 83.6 per 100 among users of NORPLANT capsule and rod implants, respectively, at two years. Disruption of menstrual function was the dominant reason for termination, but mean hemoglobin levels increased in each of the nine centers reporting values at admission and at one year. First year gross cumulative termination rates for medical reasons were 1.2 to 1.3 per 100, reaching 3.8 and 5.6 per 100 for capsule and rod implants, respectively, at two years. Microdose contraception with these levonorgestrel-releasing implants appears to be a highly acceptable and effective modality suitable for Chinese women. NORPLANT implants are now approved by the national drug regulatory agency for general use in China.

Chlamydial infection in a Chinese gynecologic outpatient clinic

In an attempt to detect the presence, if any, of cervical chlamydial infection, we obtained endocervical smears from 1000 female patients attending the outpatient gynecologic and family planning clinics at Women's Hospital, Zheijiang Medical University, Hangzhou, People's Republic of China. Using direct immunofluorescent monoclonal antibody staining technique, we identified elementary bodies typical of the Chlamydia trachomatis organism in ten of the 1000 slides (1%). The only characteristic of statistical significance in this small group of infected women was the complaint of infertility for more than two years' duration, noted in six of the ten cases.