[Recurrence pattern of pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer]

Patients with locally advanced rectal cancer who undergo neoadjuvant chemoradiotherapy may achieve pathological complete response (pCR). The incidence of recurrence is low among patients with pCR, there is still a lack of consensus on postoperative treatment and follow-up strategy. This review summarizes the recurrence patterns of patients with pCR, including distant metastasis rate, characteristics of distant metastasis time and location, local recurrence rate, and local recurrence time. The aim is to provide reference for the postoperative treatment and follow-up strategy of patients with pCR. Patients with pCR have a low recurrence rate, with infrequent local recurrence. Distant metastasis is the most common recurrence pattern, primarily in the lung and secondly in the regional lymph node. The time of recurrence is delayed which suggests the need for appropriate adjustments to follow-up strategy, extending the follow-up period, and placing emphasis on monitoring sites prone to recurrence.

Meta-analysis and systematic review of the relationship between sex and the risk or incidence of poststroke aphasia and its types

OBJECTIVE

To analyse and discuss the association of gender differences with the risk and incidence of poststroke aphasia (PSA) and its types, and to provide evidence-based guidance for the prevention and treatment of poststroke aphasia in clinical practice.

DATA SOURCES

Embase, PubMed, Cochrane Library and Web of Science were searched from January 1, 2002, to December 1, 2023.

STUDY SELECTION

Including the total number of strokes, aphasia, the number of different sexes or the number of PSA corresponding to different sex.

DATA EXTRACTION

Studies with missing data, aphasia caused by nonstroke and noncompliance with the requirements of literature types were excluded.

DATA SYNTHESIS

36 papers were included, from 19 countries. The analysis of 168,259 patients with stroke and 31,058 patients with PSA showed that the risk of PSA was 1.23 times higher in female than in male (OR = 1.23, 95% CI = 1.19-1.29, P < 0.001), with a prevalence of PSA of 31% in men and 36% in women, and an overall prevalence of 34% (P < 0.001). Analysis of the risk of the different types of aphasia in 1,048 patients with PSA showed a high risk in females for global, broca and Wenicke aphasia, and a high risk in males for anomic, conductive and transcortical aphasia, which was not statistically significant by meta-analysis. The incidence of global aphasia (males vs. females, 29% vs. 32%) and broca aphasia (17% vs 19%) were higher in females, and anomic aphasia (19% vs 14%) was higher in males, which was statistically significant (P < 0.05).

CONCLUSIONS

There are gender differences in the incidence and types of PSA. The risk of PSA in female is higher than that in male.

[Clinical efficacy of single/double 125I-seed strands combined with biliary stents in the treatment of malignant obstructive jaundice]

Objective: To compare the clinical efficacy of single/double 125I-seed strands combined with biliary stents in the treatment of malignant obstructive jaundice. Methods: Totally 67 cases of patients with malignant obstructive jaundice who received single/double125I-seed strands combined with biliary stents implantation from September 2018 to December 2021 were analyzed retrospectively. Among them, 36 patients received single 125I-seed strands combined with biliary stents (single strand group) and 31 patients received double 125I-seed strands combined with biliary stents(double strands group). The technical success rate, clinical success rate, complications, biochemical and tumor indexes at 8 weeks after operation [total bilirubin (TB), direct bilirubin (DB), alanine transaminase (ALT), aspartate transaminase (AST), carbohydrate antigen 19-9 (CA19-9)], stent patency time (SP), median progression-free survival time (mPFS) and median survival time (mOS) were analyzed. Results: There was no significant difference (P>0.05) in technical success rate (100% vs 100%), clinical success rate (97.2% vs 96.8%) and major complications (5.6% vs 6.5%) between single strand group and double strands group. There were significant differences in TB, DB, ALT, AST and CA19-9 indicators between the two groups before and 8 weeks after operation (all P<0.05), but there was no significant difference in the difference value of preoperative and postoperative 8-week indicators between the two groups (all P>0.05).The SP and mPFS of double-stranded stents were longer than those of single-stranded stents.[8.6 months (95%CI:6.9-10.4) vs 6.2 months (95%CI:5.8-6.6), 3.2 months (95%CI:3.0-3.4) vs 3.0 months (95%CI:2.9-3.1), all P<0.05]. The mOS of single and double strands groups was 11.2 months (95%CI:8.3-14.1) and 13.4 months (95%CI:9.9-16.9) respectively, with no statistical difference (P=0.137). Conclusion: Compared with single 125I-seed strands, double 125I-seed strands can prolong biliary SP and mPFS, but the long-term survival index still needs further observation.

[Study on the recurrence pattern of rectal cancer patients undergoing radical surgery after neoadjuvant chemoradiotherapy]

Objective: To analyze the recurrence pattern of rectal cancer patients with radical surgery after neoadjuvant chemoradiotherapy. Methods: The clinicopathological characteristics and follow-up information of rectal cancer patients with radical surgery after neoadjuvant chemoradiotherapy in the Cancer Hospital of the Chinese Academy of Medical Sciences from June 2004 to December 2017 were retrospectively collected. The recurrence pattern including the time and site was investigated. Results: The age of 537 patients was (55.5±11.7) years, of whom 361 were male (67.2%). The median follow-up time [M(Q₁,Q₃)] was 77.9 (64.5, 95.6) months. Moreover, 30.7% (165/537) of patients had distant metastasis or local recurrence; 26.8% (144/537) of patients had distant metastasis; 5.6% (30/537) of patients had local recurrence; 1.7% (9/537) of patients had both distant metastasis and local recurrence. In all the recurrent patients, 23.6% (39/165) were in the first year after surgery, followed by 27.3% (45/165) in the second year, 17.0% (28/165) in the third year, and 15.8% (26/165) after five years. According to the risk curve drawn by the life table, the highest metastasis risk of patients occurred in the second year after surgery, and the metastasis risk peak occurred again after more than five years. The lung was the most common metastatic organ, accounting for 47.9% (69/144), followed by the liver (18.8%, 27/144). The ratios of the recurrent patients in each ypTNM stage were 9.5% (8/84), 12.0% (12/100), 26.5% (41/155), 52.5% (104/198), respectively. The proportion of recurrent patients in tumor regression grade (TRG) 1-2 and TRG 3-5 patients were 19.2% (38/198) and 37.5% (127/339), respectively. Conclusions: The recurrence pattern of patients undergoing radical surgery after neoadjuvant chemoradiotherapy is mainly distant metastasis. The lung is the primary metastatic organ. The risk of distant metastasis and local recurrence is high in the first three years after surgery, and there is still high risk of recurrence after five years. For patients with ypTNM stage 2, 3 and TRG3-5, the postoperative adjuvant chemotherapy and long-term follow-up should be strengthened.

[A long-term follow-up study on recurrence and benefit of standardized postoperative chemotherapy of rectal cancer patients with complete pathological response after neoadjuvant chemoradiotherapy]

Objective: To analyze the clinicopathological factors affecting long-term disease-free survival and the characteristics of local recurrence or distance metastasis of rectal cancer patients with complete pathological response after neoadjuvant chemoradiotherapy. Methods: The clinicopathological data and follow-up information of patients with a complete pathological response of rectal cancer after neoadjuvant chemoradiotherapy in the Cancer Hospital of Chinese Academy of Medical Sciences from June 2004 to December 2019 were retrospectively collected. The clinicopathological factors affecting the long-term disease-free survival of patients were analyzed to build a prediction model of local recurrence and distant metastasis and to evaluate the benefits of postoperative chemotherapy. Results: The age of 108 patients was(56.3±11.6) years, of which 68 were males (63.0%); The median follow-up time was 79.9 (61.8, 112.6) months. There were 12 patients (11.1%) who had a local recurrence or distant metastasis. The 5-year disease-free survival rate was 91.1% with 9 patients who experienced recurrence. Multivariate Cox proportional hazards regression analysis showed that the maximum diameter of the residual tumor or scar (HR=8.41, 95%CI: 1.08-65.22, P=0.042) and the distance from the lower edge of the tumor to the anal margin before treatment (HR=4.54, 95%CI: 1.23-16.81, P=0.023) were independent risk factors affecting the prognosis. The prognosis of patients was stratified based on relevant factors. The 5-year cumulative disease-free survival rate of those patients receiving postoperative standardized chemotherapy was 92.0%, while for patients who did not receive or complete standardized chemotherapy, the 5-year cumulative disease-free survival rate was 82.3%. Conclusions: The maximum diameter of the residual tumor or scar and the distance from the lower edge of the tumor to the anal margin before treatment were independent risk factors affecting the prognosis of patients with a complete pathological response. Patients with independent risk factors could benefit from the standardized postoperative chemotherapy.

[The diagnostic performance of 2020 Chinese Ultrasound Thyroid Imaging Reporting and Data System in thyroid nodules]

Objective: To evaluate the diagnostic performance of the Chinese Ultrasound Thyroid Imaging Reporting and Data System (C-TIRADS) in thyroid nodules,and to compare it with the TIRADS proposed by Kwak et al. (K-TIRADS) and the TIRADS proposed by the American College of Radiology (ACR-TIRADS). Methods: The data of 1 750 patients with 2 029 thyroid nodules in the Department of Thyroid Surgery, the Affiliated Hospital of Jining Medical University from January 2018 to November 2020 was retrospectively collected. Among them, there were 328 males and 1 422 females,aged from 6 to 86 with an average of (47±12) years. The nodules were divided into≤1.0 cm group(n=997) and>1.0 cm group(n=1 032)based on the size of the nodules. The stratification for malignant risk and the determination of benign or malignancy of the nodules was evaluated using the C-TIRADS, K-TIRADS and ACR-TIRADS, respectively. The receiver operating characteristic (ROC)curve analysis was performed to compare the diagnostic performance of the aforementioned three kinds of TIRADS using pathological results as the referent standard. Results: The optimal diagnosis points in the determination of malignant nodules of C-TIRADS, K-TIRADS and ACR-TIRADS in the two groups were 4A, 4b and 4 respectively according to ROC curve analysis. For the diagnosis of the malignant nodules, the C-TIRADS achieved with an AUC value of 0.772 and 0.892 in the ≤1.0 cm group and>1.0 cm group, respectively, which was significantly higher than K-TIRADS (AUC= 0.762 and 0.869, respectively) and ACR-TIRADS (AUC= 0.735 and 0.832, respectively) (P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of C-TIRADS were 94.99%, 59.41%, 86.46%, 88.13%, 78.89% (≤1.0 cm group)and 88.34%, 90.05%, 89.34%, 86.33%, 91.57%(>1.0 cm group), respectively. C-TIRADS had the highest sensitivity, accuracy, and negative predictive value in the determination of malignant nodules in both groups compared to the other two kinds of TIRADS. Conclusions: The three kinds of TIRADS all have high diagnostic performance for the determination of the malignant nodules, and the C-TIRADS has the best overall efficacy, which can effectively assist clinicians for medical decision, and is worth to be popularized and applied in the clinical setting.

[Diagnostic value of diffusion-weighted imaging and conventional magnetic resonance imaging in testicular tumor]

Apparent diffusion coefficient(ADC) of magnetic resonance imaging≤0.90×10^-3 mm²/s and T2-hypointensity, intratuminal septa, and peritumoral infiltration could achieve best diagnostic efficiency. ADC values and cyst or necrosis were independent predictors for the differential diagnosis of nonseminomatous germ cell tumor versus seminoma and nonseminomatous germ cell tumor versus lymphoma. ADC value and intratuminal septa were independent predictors for the differential of seminoma versus lymphoma.

AMPKα2 Deficiency Does Not Affect the Exercise-Induced Improvements in Glucose Tolerance and Metabolic Disorders in Mice Fed a High-Fat Diet

Exercise can improve obesity and metabolic disorders in mice fed a high-fat diet (HFD), but the role of AMPKα2 in the process remains unclear. The aim of this study was to investigate the role of AMPKα2 in the exercise-induced improvements in glucose tolerance and metabolic turnover in obesity mice. Male wild-type mice (n=12) and AMPKα2 knockout (AMPKα2 KO) mice (n=12) were fed a HFD for 16 wk and were then randomly divided into four groups: WT HFD group (WT HF), AMPKα2 KO HFD group (AMPKα2 KO HF), WT HFD exercise group (WT HE), and AMPK HFD exercise group (AMPKα2 KO HE). The HF groups continue to be fed a HFD from 16 wk to 24 wk, and the HE groups were fed a HFD and performed exercise training. After 8 wk of exercise, all mice were placed in an energy metabolism chamber to test their metabolic turnover, include locomotor activity, food intake, oxygen consumption (VO₂), carbon dioxide production (VCO₂), energy expenditure (EE) and respiratory exchange ratio (RER), over a period of 3 d. Exercise improved glucose tolerance, VO₂, VCO₂ and EE in mice fed a HFD (p<0.05). The VO₂, VCO₂ and EE in AMPKα2 KO HE group were lower than these in WT HE group (p<0.05). Our findings revealed exercise improved glucose tolerance and metabolic disorders in C57 and AMPKα2 KO mice fed a HFD. AMPKα2 is not essential for exercise-induced improvements in glucose tolerance and metabolic disorders.

Effect of acupuncture at ST36 on motor cortical excitation and inhibition

BACKGROUND

Acupuncture at Zusanli (ST36) is often used to facilitate motor recovery after stroke. However, the effect of acupuncture at ST36 on motor cortical excitation and inhibition remains unclear. This study aimed to explore the effect of acupuncture at ST36 on motor cortical excitation and inhibition.

METHODS

Twenty healthy volunteers were recruited to receive acupuncture treatment. We selected the acupoint ST36 and its respective sham point as the experimental acupoint. Transcranial magnetic stimulation (TMS) was used to measure motor-evoked potentials (MEP) at 7 time points-before acupuncture (Pre), acupuncture (T0), 4 and 8 min after acupuncture (T4; T8), needle removal (T12), 4 and 8 min after needle removal (T16; T20). Simultaneously, paired TMS (pTMS) was employed to measure short- and long-interval intracortical inhibition (SICI [short latency intracortical inhibition]; LICI [long latency intracortical inhibition]), respectively, at three time points-before acupuncture (Pre), acupuncture (T0), needle removal (T12). After removing the acupuncture needle, all subjects were asked to quantify their Deqi sensation using a Gas table.

RESULTS

The average Deqi sensation score of all subjects during acupuncture at ST36 was higher than that observed at the sham point. With acupuncture at ST36, the MEP amplitude was higher at three time points (T0, T4, T8) than at Pre, although the MEP amplitude tended toward Pre after needle removal. The MEP amplitude was also higher at the same time points (T0, T4, T8) than at the sham point. Furthermore, the Deqi sensation score was correlated with MEP amplitude. With acupuncture at ST36, SICI and LICI at T0 were higher than those at Pre, and SICI and LICI at T0 were higher than those at the sham point.

CONCLUSION

Acupuncture at ST36 increased motor cortical excitation and had an effect on the remaining needle phase. Deqi sensation was correlated with MEP amplitude. Acupuncture at ST36 also decreased motor cortical inhibition.

Whole-transcriptome sequencing of knee joint cartilage from osteoarthritis patients

Objectives

The aim of this study was to provide a comprehensive understanding of alterations in messenger RNAs (mRNAs), long noncoding RNAs (lncRNAs), and circular RNAs (circRNAs) in cartilage affected by osteoarthritis (OA).

Methods

The expression profiles of mRNAs, lncRNAs, and circRNAs in OA cartilage were assessed using whole-transcriptome sequencing. Bioinformatics analyses included prediction and reannotation of novel lncRNAs and circRNAs, their classification, and their placement into subgroups. Gene ontology and pathway analysis were performed to identify differentially expressed genes (DEGs), differentially expressed lncRNAs (DELs), and differentially expressed circRNAs (DECs). We focused on the overlap of DEGs and targets of DELs previously identified in seven high-throughput studies. The top ten DELs were verified by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) in articular chondrocytes, both in vitro and in vivo.

Results

In total, 739 mRNAs, 1152 lncRNAs, and 42 circRNAs were found to be differentially expressed in OA cartilage tissue. Among these, we identified 18 overlapping DEGs and targets of DELs, and the top ten DELs were screened by expression profile analysis as candidate OA-related genes. WISP2, ATF3, and CHI3L1 were significantly increased in both normal versus OA tissues and normal versus interleukin (IL)-1β-induced OA-like cell models, while ADAM12, PRELP, and ASPN were shown to be significantly decreased. Among the identified DELs, we observed higher expression of ENST00000453554 and MSTRG.99593.3, and lower expression of MSTRG.44186.2 and NONHSAT186094.1 in normal versus OA cells and tissues.

Conclusion

This study revealed expression patterns of coding and noncoding RNAs in OA cartilage, which added sets of genes and noncoding RNAs to the list of candidate diagnostic biomarkers and therapeutic agents for OA patients.

Cite this article: H. Li, H. H. Yang, Z. G. Sun, H. B. Tang, J. K. Min. Whole-transcriptome sequencing of knee joint cartilage from osteoarthritis patients. Bone Joint Res 2019;8:290–303. DOI: 10.1302/2046-3758.87.BJR-2018-0297.R1.

[Relationship between the weight of hospitalized patients with pulmonary tuberculosis and the oral dose of isoniazid]

Objective: To study the relationship between the weight change trend of initial treatment patients with pulmonary tuberculosis and the dose change trend of isoniazid, and therefore to analyze the appropriate dose of isoniazid. Methods: Data of initial treatment inpatients with pulmonary tuberculosis from May 1955 to December 2012 were retrospectively analyzed. Elderly patients with pulmonary tuberculosis, patients with drug-resistant tuberculosis, extrapulmonary tuberculosis and those with complications were excluded from the study. The time period was separated as 20th century 1950s to 1960s, 1970s, 1980s, 1990s, 21th century 2000s and 2010s. Samples were selected in each year and month between 1950s to 1960s and 1970s. After 1980s, samples of 1 year were taken from each 5 years. The sex, age and weight for every patient were collected, as well as the dose of isoniazid of every inpatient on a day in therapeutic regimen. Meanwhile, the weight change trend of the patients in different ages and the dose change trend of isoniazid were compared. The total number of cases was 1 398, with 924 males and 474 females, averaging (36.7±14.4) years old. Results: The weight of the patients increased when it was compared between that in 1950s to 1960s, 1970s or 1980s and that in 2000s, with a increasing weight of 3 kg, 3.5 kg and 3 kg respectively. The difference showed statistical significance (P<0.003). The difference was also significant when the weight in 70s was compared with that in 2010s (P=0.002). The therapeutic dose of isoniazid remained invariable regardless of the weight change. At 1990s, 2000s and 2010s, the dose of isoniazid per kilogram of body weight would reduce to 0.005 4 g, 0.005 2 g and 0.0054 g relative to patients' weight increase, and the difference was statistically significant (P<0.001). Conclusions: The weight of pulmonary tuberculosis inpatients increased in recent 60 years. The weight has a close relation with the dose of isoniazid. A fixed dose of isoniazid (0.3 g/d) regardless of the weight change could result in low blood drug concentration . To avoid tolerance of isoniazid and increase the cure rates of pulmonary tuberculosis, the dosage of isoniazid should be increased based on the weight increase of patients.

[Efficacy of 3D print guide technique in one stage posterior approach for the treatment of cervical and thoracic tuberculosis with kyphosis]

Objective: To investigate the application of 3D printing technology in the treatment of patients with cervical kyphosis and paraplegia in different segments of the cervical spine after one-stage debridement, bone graft fusion and pedicle screw fixation. Methods: From January 2008 to January 2017, a total of 31 patients with thoracolumbar tuberculosis were treated in the Department of Orthopaedics, the Xinjiang Uygur Autonomous Region people's Hospital.Lesions of the thoracic spine (T1-T4) in 8 cases, (C5-C7) in 10 cases, cervical and thoracic segment in 13 cases, involving a total of 2 cases of vertebral body in 7 cases, 3 cases of vertebral body in 14 cases, 4 cases of vertebral body. 3D printing group (group A) 12 cases, non 3D printing group (group B) of 19 cases.All cases were treated with a posterior approach to the treatment of the cervical spinal cord around the spinal cord.After taking regular anti tuberculosis drugs in 6-12 months, follow-up observation of correction of kyphosis and paraplegia recovery, blood sedimentation rate (ESR), C-reactive protein (CRP) changes. Results: All cases were followed up for at least 6 months. Twelve patients were treated with 3D printing technique before operation, and the operation was performed according to the preoperative plan.The diameter and length of pedicle screws, the direction of insertion, and the distance between the insertion point and the posterior midline of the pedicle screw were similar to those in the 3D.Three days after the operation, the effect of fracture reduction was satisfactory, and the position of pedicle screws was good.After 6 months of follow-up, the X-ray showed that the pedicle screws were in good position, and there was no loosening and fracture.All the patients were healed, and there was no segmental instability.3D printing group during surgery bleeding, operation time, postoperative drainage volume, compared with the non 3D print group of surgical results, 3D printing group significantly reduce the surgical trauma[(131±18) min vs (162±23), P<0.01; (528±34) ml vs (615±41) ml, P<0.01; (257±46) vs (327±56), P<0.01; (not grouping, before after operation), (64±42) mm/1 h vs (6±7) mm/1 h, P<0.01; CRP (not packet): (72±41) μg/L, (13±6) mm/1 h, P<0.01]. There was significant difference between two groups.The JOA scores of patients in the 3D group were better than those in the non 3D group after the operation in 1, 2 week and in 1, 3, and month.There was no significant difference between the two groups after the operation.Two groups of patients before and after correction of Cobb angle were satisfied, and no significant difference between the two groups.Cobb lost an average of 1 degrees angle correction.The spinal tuberculosis in this group were cured without serious complications. Conclusions: According to the cervical and thoracic tuberculous kyphosis and paraplegia severity, choose a posterior surgery can achieve effective cure, feasible thorough debridement with fixed spinal stability before and after the party obtained bone fusion and deformity correction in 3D technology to increase the accuracy and safety of operation, and can be provide more detailed preoperative, intuitive, three-dimensional, realistic personalized operation scheme.It can reduce the operation trauma, and achieve rapid recovery after operation.

[Effect of nicorandil on ventricular arrhythmia in patients with acute ST-segment elevation myocardial infarction underwent emergent percutaneous coronary intervention treatment]

Objective: To investigate the effect of nicorandil on ventricular arrhythmia in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with emergent percutaneous coronary intervention (PCI). Methods: A total of 120 acute STEMI patients treated with emergent PCI in our hospital from January 2015 to June 2016 were randomly divided into control group and experiment group (n=60 each). Patients in both groups received conventional therapy.Patients in experiment group took 10 mg nicorandil orally before PCI and received oral nicorandil treatment (15 mg/d, three times daily) for 3 days.QT disperse(QTd), correct QTd(QTcd) and the occurrence rate of ventricular arrhythmia were compared between two groups. Results: QTd at 6, 24, 48 and 72 hours((70.6±4.4), (67.2±5.3), (55.7±8.5), (48.2±8.2) ms, respectively) after PCI was significantly lower in the experiment group than those of control group ((77.1±7.1), (71.3±6.5), (65.1±8.1), (57.2±5.4) ms, all P<0.05). The level of QTd was also significantly lower in the experiment group at 6, 24, 48 and 72 hours((77.5±7.7), (67.7±8.6), (61.2±7.5), (52.9±8.4) ms, respectively) after PCI comared to those of control group ((88.6±8.1), (79.2±7.8), (74.4±7.4), (69.6±8.6) ms, all P<0.05). There was no significant difference in the incidence of reperfusion arrhythmia during PCI procedure between the two groups.The prevalence of the ventricular premature beat in the experiment group (25/60, 41.7%) was significantly lower than in the control group(45/60, 75.0%) within 3 days after PCI(P<0.01), the prevalence of the no sustained ventricular tachycardia and ventricular fibrillation in the experiment group(6/60, 10.0%) was also significantly lower than in the control group (18/60, 30.0%, P<0.01) within 3 days after PCI. Conclusions: Nicorandil use prior and post PCI could decrease the occurrence rate of ventricular arrhythmia in STEMI patients undergoing emergent PCI, and this effect might be related with reduced QTd and QTcd post medication.

[Discriminatory power of variable number on tandem repeats loci for genotyping Mycobacterium tuberculosis strains in China]

Objective: Using the standard genotype method, variable number of tandem repeats (VNTR), we constructed a VNTR database to cover all provinces and proposed a set of optimized VNTR loci combinations for each province, in order to improve the preventive and control programs on tuberculosis, in China. Methods: A total of 15 loci VNTR was used to analyze 4 116 Mycobacterium tuberculosis strains, isolated from national survey of Drug Resistant Tuberculosis, in 2007. Hunter-Gaston Index (HGI) was also used to analyze the discriminatory power of each VNTR site. A set combination of 12-VNTR, 10-VNTR, 8-VNTR and 5-VNTR was respectively constructed for each province, based on 1) epidemic characteristics of M. tuberculosis lineages in China, with high discriminatory power and genetic stability. Results: Through the completed 15 loci VNTR patterns of 3 966 strains under 96.36% (3 966/4 116) coverage, we found seven high HGI loci (including QUB11b and MIRU26) as well as low stable loci (including QUB26, MIRU16, Mtub21 and QUB11b) in several areas. In all the 31 provinces, we found an optimization VNTR combination as 10-VNTR loci in Inner Mongolia, Chongqing and Heilongjiang, but with 8-VNTR combination shared in other provinces. Conclusions: It is necessary to not only use the VNTR database for tracing the source of infection and cluster of M. tuberculosis in the nation but also using the set of optimized VNTR combinations in monitoring those local epidemics and M. tuberculosis (genetics in local) population.

Gradual electroforming and memristive switching in Pt/CuO(x)/Si/Pt systems

We report a memristive switching effect in Pt/CuOx/Si/Pt devices prepared by the rf sputtering technique at room temperature. Differently from other Cu-based metal filament switching systems, a gradual electroforming process, marked by a gradual increase of the device resistance and a gradual decrease of the device capacitance, was observed in the current-voltage and capacitance characteristics. After the gradual electroforming, the devices show a uniform memristive switching behavior. By Auger electron spectroscopy analysis, a model based on the thickness change of the SiOx layer at the CuOx/Si interface and Cu ion migration is proposed for the gradual electroforming and uniform memristive switching, respectively. This work should be meaningful for the preparation of forming-free and homogeneous memristive devices.

Tumor necrosis factor-α pathway plays a critical role in regulating interferon-γ induced protein-10 production in initial allogeneic human monocyte-endothelial cell interactions

T-cell infiltration of allografts is a major pathologic component defining acute rejection episodes (ARE). We have shown that monocytes interact with allogeneic endothelial cells (ECs) for costimulation to achieve T-cell allorecognition. However, the production of T-cell interferon-γ induced protein-10 (IP-10) and regulation of this chemokine during the initial monocyte-EC interaction are unclear. We hypothesized that the tumor necrosis factor (TNF)-α pathway plays a key role to regulate IP-10 production during the initial monocyte-EC interaction. Cytokine-activated ECs were analyzed for IP-10 production and adhesion molecule expression. Established, monocyte-EC cocultures were analyzed using real-time polymerase chain reaction and a chemokine assay for IP-10 and activation factors. Anti-TNF-α antibody was used to neutralize TNF-α release during monocyte-EC interactions. TNF-α-activated ECs upregulated CD62E and CD54 as determined by flow cytometry, releasing high levels of IP-10 and interleukin (IL)-6. Interferon-γ-stimulated ECs also produced high levels of IP-10 and IL-6. Monocyte-EC interactions demonstrated upregulation of gene transcripts for TNF-α, IL-6, and IP-10. The cytokine/chemokine assay detected high levels of TNF-α, IL-6, and IP-10 in coculture supernates in a time-dependent manner. Anti-TNF-α antibody dramatically reduced IP-10 production by monocyte-ECs interactions. However, anti-TNF-α antibody did not prevent the release of IL-6 by monocytes in EC cocultures. Our results showed that ECs activated by TNF-α are an important source of IP-10. The monocyte-EC interaction produces high levels of IP-10. The TNF-α pathway plays a key role to regulate IP-10 production during monocyte-EC interactions. We thus proposed that the initial monocyte-EC interaction with increased expression of IP-10 may play a critical role to initiate and augment T-cell-mediated ARE.

Monocyte-derived CD40 expression is regulated by interferon-γ/interferon-γ receptor-1 pathway when acting as a bridge during their interaction with T cells and allogeneic endothelial cells

Previous studies have showed the lack of CD40 expression on monocytes during monocyte and endothelial cell (EC) interaction in the absence of T cells indicating that the interaction between T cells, monocytes, and ECs is required for monocyte-derived CD40 expression. We investigated the role of monocytes acting as a bridge between ECs and T cells and the possible mechanisms for monocyte-derived CD40 up-regulation in allogeneic immune responses. A coculture system with tanswell was established between purified monocytes, T cells, and ECs, and the cells were analyzed by flow cytometry to detect monocyte-derived CD40 expression. Purified monocytes stimulated by ECs did not show up-regulation of CD40 expression. Ec-stimulated monocytes up-regulated interferon (IFN)-γ receptor-1 expression. Monocytes, stimulated by ECs, up-regulated CD40 expression in the presence of T cells. However, when T cells were separated from monocyte-EC interaction, these monocytes did not show CD40 up-regulation. Furthermore, IFN-γ receptor-1 blockade but not IFN-γ receptor-2 blockade inhibited monocyte-derived CD40 expression during monocyte-EC-T cell interaction. Neutralizing antibody directed to IFN-γ inhibited up-regulation of monocyte-derived CD40. We showed here that the interaction between T cells and EC-stimulated monocytes and up-regulation of monocyte-derived CD40 expression are contact-dependent, suggesting that monocytes act as bridge between ECs and T cells. The IFN-γ receptor-1 blockade inhibited the monocyte-derived CD40 up-regulation. These data suggest that the Th1 lymphocytes provide help for monocytes via IFN-γ and IFN-γ receptor-1 pathway following their interaction.

ATP-mediated protein kinase B Akt/mammalian target of rapamycin mTOR/p70 ribosomal S6 protein p70S6 kinase signaling pathway activation promotes improvement of locomotor function after spinal cord injury in rats

The protein kinase B (Akt)/mammalian target of rapamycin (mTOR)/p70 ribosomal S6 protein kinase (p70S6K) signaling pathway, as a central controller of cell growth, proliferation, survival, and differentiation in response to extracellular signals, growth factors, nutrient availability, energy status of the cell, and stress, has recently gained attention in neuroscience. The effects of this signaling pathway on repair of spinal cord injury (SCI), however, have not been well elucidated. ATP is increasingly recognized as an important regulator of signal transduction pathways, and plays important roles in functional recovery after nervous system injury. In the present study, we examined the ATP-induced changes of the Akt/mTOR/p70S6K signaling pathway in injured spinal cord of adult rats and potential therapeutic effects of this pathway on SCI-induced locomotor dysfunction. SCI was produced by extradural weight-drop using modified Allen's stall with damage energy of 50 g-cm force. The rats were divided into four groups: SCI plus ATP, SCI plus saline, SCI plus ATP and rapamycin, and sham-operated. Using immunostaining studies, Western blot analyses and real-time qualitative RT-PCR analyses, we demonstrated that the Akt/mTOR/p70S6K signaling pathway is present in the injured spinal cord and the expression of its components at the protein and mRNA levels is significantly elevated by exogenous administration of ATP following SCI. We observed the effectiveness of the activated Akt/mTOR/p70S6K signaling pathway in improving locomotor recovery, significantly increasing the expression of nestin, neuronal nuclei (NeuN), neuron specific enolase (NSE), and neurofilament 200 (NF200), and relatively inhibiting excessive reactive astrogliosis after SCI in a rapamycin-sensitive manner. We concluded that ATP injection produced a significant activation of the Akt/mTOR/p70S6K signaling pathway in the injured spinal cord and that enhancement of rapamycin-sensitive signaling produces beneficial effects on SCI-induced motor function defects and repair potential. We suggest that modulation of this protein kinase signaling pathway activity should be considered as a potential therapeutic strategy for SCI.

[Experimental study on closing the firearm injured soft tissue defect by skin stretch]

OBJECTIVE

To investigate the availability and effect of skin stretch in closing the firearm injured soft tissue defect.

METHODS

Eight white pigs with firearm injured soft tissue defect were divided into 3 groups. Each group I and group II had 3 pigs which were performed skin stretch. The control group had 2 pigs without stretch. The average diameter of the defect in three groups was (7.3 +/- 0.2) cm, (9.1 +/- 0.3) cm, (7.3 +/- 0.2) cm respectively, and the site of defect was on the lateral thigh and buttock.

RESULTS

Skin stretch could make a visible reduction of the wound. It was possible to close the wound by direct traction when the diameter of the buttock wound was less than 7 cm, and when the diameter of the lateral thigh wound was less than the radius of thigh. The skin stretch should not last more than 7 days and the best effect appeared in 4 to 5 days after performing the skin stretch.

CONCLUSION

The skin stretch can be applied in the repair of the firearm injured soft tissue defect. It has many advantage compared with the tradtional treatment.

[Effect of storage methods on breaking seed dormancy of Trollius chinensis Bge]

OBJECTIVE

Exploring the best seed storage method for Trollius chinensis.

METHOD

Different temperatures were applied to the seed storage in wet sand and dry sand, and the embryo-endosperm ratio and germination rate were inspected.

RESULT

The dormancy of T. chinensis seeds could only be broken in lower temperatures. The newly collected seeds set out to germinate after 75 days of storage at 5-6 degrees C when the embryo-endosperm ratio reached 47%, and the time of seed germination varied with the length of storage time before low-temperature treatment.

CONCLUSION

The best storage method for the seed of T. chinensis is keeping it in dry for 6-8 months with an additional 1 month of low-temperature treatment to follow.

Construction and characterization of a human chromosome 2-specific BAC library

We have constructed a human chromosome 2-specific bacterial artificial chromosome (BAC) library using DNA from the somatic cell hybrid GM10826. The average size of the clones is about 63 kb. The coverage and distribution of the library were estimated by screening with known polymorphic genetic markers and fluorescence in situ hybridization (FISH). Twenty-one markers tested positive when DNA pools prepared from approximately one-sixth of the library were screened with 33 known markers. This is consistent with the theoretical calculation of 63% coverage at one genomic equivalent. This suggested that the coverage of the library is approximately 5-6x. FISH analysis with 54 BACs revealed single site hybridization to chromosome 2, and the clones were distributed randomly on the chromosome. We have also performed direct sequencing of the BAC insert ends to generate sequence-tagged sites suitable for mapping and chromosome walking. This is the first reported human chromosome 2-specific BAC library and should provide a resource for physical mapping and disease searching for this chromosome.

[Clinical significance of cerebrospinal fluid beta 2-microglobulin determination in central nervous system leukemia]

Cerebrospinal fluid (CSF) beta 2-microglobulin (beta 2-MG) level was measured in 72 healthy subjects and the value (means +/- S means) was found to be 1.26 +/- 0.06 mg/L. The CSF beta 2-MG level in 33 patients who had simple acute leukemia without CNS involvement was 1.46 +/- 0.13 mg/L, which was not significantly different from that in the normal controls (P greater than 0.05). In 25 patients who had leukemia with involvement of CNS, the CSF beta 2-MG level (mean +/- S mean) was 3.94 +/- 0.30 mg/L, which was statistically different from that in the healthy controls (P less than 0.01). It is found that beta 2-MG level in CSF was one of the reliable criteria for diagnosis and indication of intrathecal chemotherapy in CNS leukemia.