A case of acute lung injury in a peripheral blood stem cell donor mobilized with pegylated recombinant human granulocyte colony-stimulating factor

Pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) has been introduced for the mobilization of peripheral blood stem cells (PBSCs). However, no cases of acute lung injury (ALI) in healthy donors have been reported, and the underlying mechanisms remain poorly understood. We first reported a case of ALI caused by PEG-rhG-CSF in a healthy Chinese donor, characterized by hemoptysis, hypoxemia, and patchy shadows. Ultimately, hormone administration, planned PBSC collection, leukocyte debridement, and planned PBSC collection resulted in active control of the donor's ALI. The donor's symptoms improved without any adverse effects, and the PBSC collection proceeded without incident. Over time, the lung lesion was gradually absorbed and eventually returned to normal. PEG-rhG-CSF may contribute to ALI in healthy donors via mechanisms involving neutrophil aggregation, adhesion, and the release of inflammatory mediators in the lung. This case report examines the clinical manifestations, treatment, and mechanism of lung injury induced by PEG-rhG-CSF-mobilized PBSCs.

[Clinical study of the efficacies of ruxolitinib plus low-dose PTCY for acute GVHD prevention after haploidentical transplantation in malignant hematological diseases]

Objective: To investigate and verify a novel acute graft versus host disease (aGVHD) prevention protocol in the context of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) . Methods: Patients who underwent haplo-HSCT in our center between January 2022 and December 2022 were included. All patients received reduced doses of cyclophosphamide, Rabbit anti-human tymoglobulin, ruxolitinib, methotrexate, cyclosporine, and MMF to prevent aGVHD. The transplantation outcomes, complications, and survival rate of all patients were investigated. Results: A total of 52 patients with haplo-HSCT were enrolled, 29 (55.8%) male and 23 (44.2%) female, with a median age of 28 (5-59) years. There were 25 cases of acute myeloid leukemia, 17 cases of acute lymphocyte leukemia, 6 cases of myelodysplastic syndrome, 2 cases of chronic myeloid leukemia and 2 cases of myeloproliferative neoplasms. 98.1% of patients had successful engraftment. The incidence of Ⅱ-Ⅳ aGVHD and Ⅲ-Ⅳ aGVHD was 19.2% (95% CI 8.2% -30.3% ) and 7.7% (95% CI 0.2% -15.2% ), respectively. No patients experienced severe gastrointestinal mucositis. The Epstein-Barr virus and CMV reactivation rates were 40.4% and 21.3%, respectively. 9.6% of patients relapsed during followup, with 1-year overall survival, progression-free survival, and non-relapse mortality rates of 86.5% (95% CI 76.9% -96.1% ), 78.8% (95% CI 67.4% -90.3% ) and 11.5% (95% CI 2.6% -20.5% ), respectively. Conclusion: Ruxolitinib combined with a low dose of PTCY is a safe and effective first-line aGVHD prevention strategy.

[Intervention effects of drugs on GSH and SOD enzyme activity of rats kidney acutely poisoned by nickel carbonyl]

Objective: To evaluate the intervention effect of various drugs on glutathione (GSH) and superoxide dismutase (SOD) enzyme activity of rats kidney with acute nickel carbonyl poisoning. Methods: In January 2019, The 250 SPF male SD rats were randomly divided into normal control group (n=10) , poisoned group (n=40) and treatment groups (n=200) according to the random number table method. And the treatment groups were divided into methylprednisolone group (20 mg/kg) , DDC group (100 mg/kg) , sodium selenite group (10 μmol/kg) , Shenfu huiyang decoction group (0.25 ml) and methylprednisolone combined with DDC group (100 mg/kg) , with 40 mice in each group. Except for the normal control group, rats in the other groups were exposed to nickel carbonyl for 30 min, at 4 h and 30 h after exposure, the rats in each treatment group were intraperitoneally injected with corresponding drugs, and kidney tissues were collected 3 d and 7 d after administration, with 10 mice in each group. The activities of GSH and SOD in kidney were measured by enzyme-linked immunosorbent assay, and using electron microscopy observe ultrastructure changes. Results: Compared to the control group, the activities of GSH and SOD enzyme of poisoned group were significantly decreased at 3 d or 7 d after 4 h or 30 h exposure, and the difference was statistically significant (P=0.000, 0.031, 0.001, 0.033) , the epithelial nuclei of proximal convoluted tubules were pyknosis and lysosome hyperplasia in the cytoplasm. And compared to poisoned group, the activities of GSH and SOD enzyme of methylprednisolone+DDC group were significantly increased at treatment with 7 d after 4 h exposure, the difference was statistically significant (P=0.022, 0.000) , and the activities of GSH and SOD enzyme of methylprednisolone and enzyme of methylprednisolone+DDC group were significantly higher at 7 days than at 3 days, the difference was statistically significant (P=0.020, 0.017, 0.018, 0.033) . The results of electron microscopy showed that the cell nuclei and cytoplasmic organelles of proximal convolute tubule were almost restored to normal tissue level of both methylprednisolone group and methylprednisolone+DDC group. Conclusion: The methylprednisolone and methylprednisolone+DDC have obvious repair effect on renal enzyme activity level of rats with acute nickel carbonyl poisoning, and the treatment effect is better for a long time of medication.

[A nested case-control study on relationship of traditional and combined lipid metabolism indexes with incidence of diabetes]

Objective: To explore the relationship between lipid indicators and the incidence of diabetes, and to compare the diabetes prediction and identification power of traditional lipid combined lipid indicators, in order to explore the best alternative indicators for identifying and predicting diabetes. Methods: Based on the Jinchang cohort, a nested case-control study was conducted in 1 025 new cases of diabetes after excluding patients with malignant tumor and related endocrine, circulatory system disease, then an age (±2 years), gender matched 1∶1 control group of 1 025 cases was set to analyze the relationship between the incidence of diabetes and lipid parameters. Results: Among the traditional lipid parameters, the fourth quartile of TG, TC, and LDL-C indicated higher risks of developing diabetes, which was 14.00 times (95%CI: 9.73-20.15), 2.15 times (95%CI: 1.65-2.79) and 1.66 times (95%CI: 1.29-2.14) than that of the first quartile, respectively. The risk of developing diabetes indicated by the fourth quartile of HDL-C was 0.21 times than that indicated by the first quartile (95%CI: 0.15-0.28). In the combined lipid parameters, the fourth quartile of TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C indicated higher risks of developing diabetes, which was 14.86 times (95%CI: 10.35-21.34), 8.12 times (95%CI: 5.94-11.01), 5.85 times (95%CI:4.34-7.88) and 5.20 times (95%CI: 3.85-7.03) than that indicated by the first quartile, respectively. The areas under the ROC curve of TG, TC, HDL-C, LDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C were 0.76 (95%CI: 0.74-0.78), 0.59 (95%CI: 0.57-0.61), 0.67 (95%CI: 0.65-0.69), 0.57 (95%CI: 0.55-0.59), 0.77 (95%CI: 0.75-0.78), 0.73 (95%CI: 0.71-0.75), 0.69 (95%CI: 0.67-0.71) and 0.66 (95%CI: 0.64-0.68), respectively. The optimal diabetes predicting point cuts of TG, TC, HDL-C, LDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C were 1.40, 4.70, 1.28, 3.25, 1.17, 3.43, 2.46, and 3.58 mmol/L, respectively. Conclusions: Lipid metabolic disorder is a risk factor for diabetes. TG and TG/HDL-C are the good lipid metabolism indicators for the prediction of diabetic.

[Relationship of body mass index and blood pressure with diabetes: a nested case-control study]

Objective: To explore the relationship of body mass index and blood pressure with the incidence of diabetes in Jinchang cohort. Methods: We designed a nested case-control study, a total of 29 572 workers who had no history of diabetes in baseline survey in Jinchang cohort were selected as the study cohort from June 2011 to December 2013. After 2 year follow-up, 1 021 workers with first diagnosed diabetes were selected as the case group, after 1∶1 matching according to the same gender and age ±2 years among those without diabetes, circulatory system, or endocrine system diseases during the same follow-up period, 1 021 controls was selected and 2 042 subjects were finally included. We used multivariate conditional logistic regression model, additive interaction model and multiplicative interaction model to explore the relationship of body mass index and blood pressure with the incidence of diabetes. Results: After adjusting for factors such as occupation, alcohol use, family history of diabetes, hyperuricemia, hypercholesterolemia, hypertriglyceridemia, low-HDL cholesterolemia and high-LDL cholesterolemia, multivariate conditional logistic regression analysis showed that the risk of diabetes increased with body mass index and blood pressure. Hypertension and overweight/obesity had a multiplicative interaction on the incidence of diabetes. The risks of diabetes in men and women with hypertension and overweight/obese were 2.04 times (95%CI: 1.54-2.69) and 3.88 times (95%CI: 2.55-5.91) higher than those in men and women with normal body weight and blood pressure, respectively. In the combination of BMI and blood pressure, obese individuals with SBP≥160 mmHg were 4.57 times (95%CI: 2.50-8.34) more likely to have diabetes than those with normal BMI and SBP, obese individuals with DBP≥90 mmHg were 3.40 times (95%CI: 2.19-5.28) more likely to have diabetes than those with normal BMI and DBP. Conclusions: Overweight/obesity and hypertension can increase the risk of diabetes. Health education about body weight and blood pressure controls should be strengthened to reduce the risk of diabetes.

[Effect of HBV infection pattern on prevalence of fatty liver disease in Jinchang cohort]

Objective: To investigate the influence of HBV infection on the prevalence of fatty liver disease in Jinchang cohort and provide theoretical evidence for the prevention and treatment of fatty liver disease. Methods: Epidemiological investigation, laboratory examination and abdominal ultrasound were conducted in the baseline population of Jinchang cohort to collect the basic data, the differences in the prevalence of fatty liver disease under different HBV infection patterns were described and compared and the influence of different HBV infection patterns on the prevalence of fatty liver disease were evaluated by using logistic regression analysis. Results: The baseline Jinchang cohort population totaled 45 605, including 27 917 males and 17 688 females. The male to female ratio was 1.6∶1. The mean age of the overall population was 46.49 years. Among the 8 common HBV infection modes in the Jinchang cohort, the prevalence of fatty liver was low in HBsAg, HBeAg and HBcAb positive, HBsAg and HBcAb positive, and HBsAg, HBeAb and HBcAb positive groups. For 4 serum markers of HBV infection, the prevalence of fatty liver disease in HBsAg and HBeAg positive groups was lower than that in HBsAg and HBeAg negative groups. Logistic regression analysis showed that being HBsAg and HBcAb positive (OR=0.61, 95%CI: 0.39-0.98) and HBsAg, HBeAg and HBcAb positive (OR=0.52, 95%CI: 0.30-0.89) could reduce the risk for fatty liver disease. Conclusion: Acute HBV infection reduces the prevalence of fatty liver disease, and the reason may be related to the disturbance of the body's fat metabolism by active HBV replication.

[Prospective cohort study of relationship of triglyceride, fasting blood-glucose and triglyceride glucose product index with risk of hypertension]

Objective: To investigate the relationship of triglyceride (TG), fasting blood glucose (FPG) and triglyceride glucose product index (TyG) with the incidence of hypertension, and provide basic data for the prevention and treatment of hypertension in the population. Methods: A total of 23 581 individuals who met the research criteria in Jinchang cohort were selected as the research subjects, the Cox proportional hazard model was used to analyze the relationship of TG, FPG, and TyG with the risk of hypertension. A stratified analysis was conducted by sex. Results: After adjusting for confounding factors, compared with the normal TG group, the HR(95%CI) of the elevated TG margin group and the elevated group were 1.16 (1.01-1.34) and 1.49 (1.30-1.70), respectively in the total population. Among men, they were 1.13 (1.01-1.27) and 1.17 (1.06-1.30), and among women, they were 1.05 (0.88-1.26) and 1.06 (0.88-1.28). Compared with the normal FPG group, the HR (95%CI) of the FPG-impaired group were 1.29 (1.13-1.48) in the total population, 1.26 (1.08-1.48) in men and 1.59 (1.14-2.21) in women. Taking the lowest quartile array as a reference, the HR (95%CI) of the highest quartile array of TyG was 1.73 (1.45-2.07) in the total population, 1.32 (1.14-1.53) in men and 1.87 (1.37-2.54) in women. TG, FPG had a nonlinear dose-response relationship with the risk of hypertension, while TyG had a linear correlation with the risk of hypertension. Conclusions: Higher TG, FPG, and TyG levels are independent risk factors for the incidence of hypertension. People with higher TG, FPG and TyG are at high risk for hypertension, to which close attention should be paid in the prevention and treatment of hypertension.

[Analysis on influencing factors for nonalcoholic fatty liver disease in Jinchang cohort]

Objective: To explore the influencing factors for non-alcoholic fatty liver disease (NAFLD) in Jinchang cohort, and provide scientific basis for the prevention and control of NAFLD. Methods: A total of 20 051 patients without fatty liver at baseline survey and met the inclusion criteria in Jinchang cohort were selected as study subjects. Prospective cohort study and Cox regression analysis were used to investigate the influencing factors for NAFLD, and the dose-response relationship between related biochemical indicators and NAFLD risk was studied by restricted cubic spline method. Results: The incidence of NAFLD was 42.37/1 000 person years. Multivariate Cox regression analysis showed that being worker and technical personnel (being worker:HR=0.84,95%CI:0.70-0.99;being technical personnel:HR=0.73,95%CI:0.56-0.95), tea drinking (current drinking:HR=0.86,95%CI:0.78-0.94;previous drinking: HR=0.52,95%CI: 0.31-0.86), exercise (occasionally: HR=0.79, 95%CI: 0.68-0.91;frequently:HR=0.60,95%CI:0.52-0.69), low body weight (HR=0.10, 95%CI: 0.05-0.22), daily intake of dairy products >300 ml/day (HR=0.78, 95%CI: 0.71-0.87) and HBV infection (HR=0.77, 95%CI: 0.60-0.99) were the protective factors for NAFLD, while being internal or office workers (HR=1.84, 95%CI: 1.46-2.31), income ≥2 000 yuan (2 000- yuan: HR=1.32, 95%CI: 1.04-1.66; ≥5 000 yuan: HR=1.72, 95%CI:1.11-2.66), bachelor degree or above (HR=1.35,95%CI:1.03-1.76), overweight (HR=2.31, 95%CI:2.08-2.55), obesity (HR=3.95, 95%CI: 3.42-4.56), impaired fasting blood glucose (HR=1.31, 95%CI:1.17-1.47), diabetes (HR=1.53, 95%CI: 1.30-1.80), increased TC (HR=1.37,95%CI:1.24-1.52), increased TG (HR=1.79,95%CI: 1.62-1.98), decreased HDL-C (HR=1.29, 95%CI: 1.14-1.45), increased ALT (HR=1.13, 95%CI: 1.01-1.26) and high-fat diet (HR=1.24, 95%CI: 1.11-1.40) were the risk factors for NAFLD. Moreover, TC, TG, HDL-C, ALT and FPG all showed good dose-response relationship with the incidence of NAFLD. Conclusion: Occupation, education level, income level, tea drinking, exercise, BMI, FPG, blood lipid, ALT, HBV infection and diet were related to the incidence of NAFLD.

[Effect of Dendrobium nobile Lindl. alkaloids on myocardial lipid metabolism during cardiopulmonary bypass ischemia-reperfusion in dogs]

Objective: To explore the effects and mechanisms of Dendrobium nobile Lindl. alkaloids (DNLA) on myocardial lipid metabolism during ischemia-reperfusion in dogs undergoing cardiopulmonary bypass (CPB). Methods: Twenty-four healthy hybrid dogs, half male and half female, were randomly divided into sham group, model group, solvent control group and treatment group (DNLA, 6 mg/kg) (n=6), all of which were established with CPB. Except for the sham group, the aorta of the other groups was occluded for 60 min and then reopened. The uptake rate of free fatty acids, the concentration of long-chain acyl coenzyme A (LCACoA), mRNA and protein expression of fatty acid translocase enzyme/CD36 (FAT/CD36) in myocardial tissue and the cardiac function indexes were measured at 4 time points: before cardiopulmonary bypass (T1), 15 min (T2), 60 min (T3), and 90 min (T4) after reperfusion in each group. Results: Before CPB, there were no statistically significant differences in the uptake rate of free fatty acids, the concentration of LCACoA and mRNA expression of FAT/CD36 in myocardial tissue in each group (P>0.05). After the opening of the aorta, the above indexes in model group [(35.8±4.7)%, (8.55±1.51) nmol/g, 3.23±0.68] and treatment group [(27.4±2.7)%, (6.10±1.38) nmol/g, 2.20±0.56] were higher than those in sham group [(19.6±3.9)%, (4.16±0.81)nmol/g, 1.19±0.52], which were the highest at T2, and then gradually decreased (all P<0.05). Compared with the model group, the increase of above indicators in the treatment group was significantly lower at T2 (all P<0.05). Before CPB, there was no statistically significant differences in cardiac function indexes [left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP) and±dp/dtmax] among the groups (P>0.05). After the aorta was opened, the above indexes in model group [(76.5±9.1) mmHg, (31.1±2.9) mmHg, (1.2±0.4) mmHg/ms, (-0.9±0.1) mmHg/ms] and treatment group [(92.9±8.7) mmHg, (25.3±3.6) mmHg, (1.8±0.4) mmHg/ms, (-1.3±0.1) mmHg/ms] were lower than those in sham group [(165.5±12.9) mmHg, (6.5±0.5) mmHg, (3.3±0.6) mmHg/ms, (-2.9±0.3) mmHg/ms] (all P<0.05), but the impairment degree of cardiac function indicators in treatment group was significantly lower than that those in model group (all P<0.05). Conclusion: During CPB in dogs, DNLA can inhibit the abnormal expression of FAT/CD36, decrease the uptake of free fatty acids, and reduce the abnormal accumulation of LCACoA in myocardium,thereby alleviating the myocardial injury after ischemia-reperfusion.

[Retrospective investigation of patients receiving additional surgery after endoscopic non-curative resection for early colorectal cancer]

Objective: To investigate the clinical application of additional surgery after non-curative endoscopic resection for early colorectal cancer. Methods: A retrospectively descriptive cohort study was conducted. Inclusion criteria: (1) pathologically confirmed primary colorectal adenocarcinoma;(2) receiving additional surgery after endoscopic resection; (3) semi-elective operation. Exclusion criteria: familial adenomatous polyposis, appendiceal neoplasms, anal canal neoplasms, neuroendocrine tumors, and surgery because of perforation or bleeding after endoscopic resection. Indications of additional surgery: (1) pathologically positive lateral or basal resection margin; (2) submucosal invasion depth ≥ 1000 μm; (3) lymphovascular invasion; (4) poorly differentiated, undifferentiated or mucinous adenocarcinoma; (5) more than grade G2 in tumor budding; (6) incomplete resection or piecemeal specimen with margin impossible to evaluate; (7) patient's consent due to undetermined pathology. According to the above criteria, clinical data of 92 patients at the Colorectal Surgery Department, the First Affiliated Hospital of Nanjing Medical University between January 2013 and December 2018 were collected. Demographic data, pathological examinations, operative methods and outcomes were analyzed. Results: There were 61 (66.3%) male and 31 female (33.7%) patients with an average age of (58.2±10.7) years. The average BMI was (23.8±3.5) kg/m(2). The lesions located in the right-sided colon, left-sided colon and rectum in 19, 37 and 36 patients respectively. Sixteen patients received endoscopic snare resection, 45 received endoscopic mucosal resection and 31 received endoscopic submucosal dissection. Reasons for additional surgery included endoscopic specimen with pathologically positive margin (n=22, 23.9%), submucosal invasion depth ≥ 1000 μm (n=9, 9.8%), lymphovascular invasion (n=4, 4.3%), poorly differentiated, undifferentiated or mucinous adenocarcinoma (n=5, 5.4%), piecemeal resection (n=13, 14.1%), undetermined pathology (n=52, 56.5%). The median duration from endoscopic resection to additional surgery was 16 days. Thirty-four patients (37.0%) received preoperative endoscopic localization with carbon nanoparticles suspension injection and 5 (5.4%) were marked with titanium clip. Seventy-four patients (80.4%) received laparoscopic surgery, 17 (18.5%) received open surgery, while 1 patient (1.1%) was converted to open surgery due to missing titanium clip. Three patients (3.3%) were treated with transanal excision, 2 (2.2%) with bowel resection, and 87 (94.6%) with radical excision. After additional surgery, histopathological examination of surgical specimens revealed the presence of residual tumor in 5 patients (5.4%), lymph node metastasis in 8 (8.7%), lymphovascular invasion in 1 (1.1%) and tumor deposit in 1 (1.1%). Twelve patients (13.0%) developed postoperative complications, including 4 mid-low rectal cancer patients (4.3%) with anastomostic leakage or bleeding. After surgery, according to the TNM staging system, 83 patients (90.2%) were classified as TNM stage 0-I, 9 (9.8%) as TNM stage II-IV. One patient of stage IV with liver metastasis underwent concomitant hepatectomy. One patient of stage II received regular follow-up after operation. Seven cases of stage III and 1 of stage IV received postoperative chemotherapy. Eighty-five patients (92.4%) were followed up with a median time of 12.8 (IQR: 8.1, 24.3) months. No recurrence or metastasis was observed. Conclusions: Surgery is an effective salvage measure for non-curative endoscopic resection of early colorectal cancer. Since surgery may have complications, indications of the additional surgery should be considered carefully. Preoperative endoscopic localization should be performed in order to ensure the safety and efficacy of surgery.

[Incidence of chronic obstructive pulmonary disease and pneumoconiosis in different occupational positions among populations from jinchang cohort]

Objective: To investigate the incidence and rank of chronic obstructive pulmonary disease and pneumoconiosis to the workers in different occupational positions in Jinchang Cohort. Methods: In January 2014, a cohort of follow-up population in jinchang city was taken as the research object, 17843 individuals among follow-up populations in Jinchang Cohort Study, removed the individuals with chronic obstructive pulmonary disease and pneumoconiosis before 2013, and counted the new incidence individuals diagnosed by the A-Class hospital in Grade III in Jinchang City, Gansu Province, as the investigation objects to investigate the incidence rate & rank of chronic obstructive pulmonary disease and pneumoconiosis. The statistical significance was tested by chi-square test. Results: The 2-year incidence rate of Chronic Obstructive Pulmonary Disease and Pneumoconiosis in the population of Jinchang Cohort Study were 11.60‰, 13.51‰ for male and 8.46‰ for female. the ranks of 2-year incidence rates of chronic bronchitis, emphysema, pneumoconiosis and other phenotypes of chronic obstructive pulmonary disease were 7.06‰、3.42‰、0.84‰、0.34‰, respectively. Incidence rate of chronic bronchitis among administrators and executive staffs were 10.45‰; incidence rate of chronic bronchitis among service staffs were 10.45‰; incidence rate of pneumoconiosis among mining staffs were 3.44‰. Conclusion: The first incidence rank of chronic obstructive pulmonary disease and pneumoconiosis in Jinchang cohort is chronic bronchitis, and the risk factors are smoking and occupational exposure.

[Prospective study of relationship between metabolic diseases and stroke in Jinchang Cohort]

Objective: To understand the incidence of stroke in the population of Jinchang Cohort and the relationship between metabolic diseases and stroke, and provide scientific evidence for the prevention and treatment of stroke in the population. Methods: The epidemiological investigation data and physical examination data of the 33 042 follow-up participants in Jinchang Cohort were collected for a prospective cohort study. Restricted cubic splines functions was used to analyze the dose-response relationship between metabolic indexes and the risk of stroke incidence. Results: 1) The incidence rate of stroke in Jinchang Cohort was 1.59%, and the standardized incidence rate was 3.99%. 2) Hypertension (male HR=2.20, female HR=4.45) and dyslipidemia (male HR=1.49, female HR=1.79) were the risk factors of stroke incidence in the population and diabetes had influence on the incidence of stroke only in the males (HR=1.79), while obesity had influence only in the females (HR=1.64). The more kinds of metabolic diseases, the higher risk of stroke incidence was. 3) Systolic blood pressure had a non-linear dose-response correlation with the risk of stroke incidence, while diastolic blood pressure had a positive linear correlation with the risk of stroke incidence. Conclusions: The incidence of stroke in Jinchang Cohort population was high compared with both domestic level and oversea level. The patients with metabolic diseases were the population at high-risk for stroke, and more attention should be paid to them in the prevention and treatment of stroke. Diastolic blood pressure might be more closely related to stroke.

[Association between fatty liver and type 2 diabetes in the baseline population of Jinchang Cohort]

Objective: To explore the association between fatty liver and type 2 diabetes mellitus (T2DM) in the baseline-population of Jinchang cohort study. Methods: Data from all the participants involved in the baseline-population of Jinchang cohort study was used, to compare the risks of T2DM in fatty liver and non fatty liver groups and to explore the interaction between family history or fatty liver of diabetes and the prevalence of T2DM. Results: Among all the 46 861 participants, 10 574 were diagnosed as having fatty liver (22.56%), with the standardized rate as 20.66%. Another 3 818 participants were diagnosed as having T2DM (8.15%) with standardized rate as 6.90%. The prevalence of T2DM increased in parallel with the increase of age (trend χ(2)=2 833.671, trend P<0.001). The prevalence of T2DM in the fatty liver group was significantly higher than that in the non-fatty liver group, both in men or women and in the overall population. Compared with the group of non-fatty liver, the risks of T2DM in fatty liver group were seen 1.78 times higher in males, 2.33 times in women and 2.10 times in the overall population, after adjustment for factors as age, levels of education, smoking, drinking, physical exercise, BMI, family history of diabetes and some metabolic indicators (pressure, TC, TG, uric acid, ALT, AST, gamma-glutamyl transferase). Date from the interaction model showed that fatty liver and family history of diabetes present a positive additive interaction on T2DM (RERI=1.18, 95%CI: 0.59-1.78; AP=0.24, 95%CI: 0.14-0.34; S=1.43, 95%CI: 1.21-1.69). Conclusions: Fatty liver could significantly increase the risk of T2DM and a positive additive interaction was also observed between fatty liver and family history of diabetes on T2DM. It was important to strengthen the prevention program on T2DM, in order to effectively control the development of fatty liver.

Effects of fluoride on proliferation and mineralization in periodontal ligament cells in vitro

Fluoride, which is often added to toothpaste or mouthwash in order to protect teeth from decay, may be a novel therapeutic approach for acceleration of periodontal regeneration. Therefore, we investigated the effects of fluoride on proliferation and mineralization in human periodontal ligament cells in vitro. The periodontal ligament cells were stimulated with various concentrations of NaF added into osteogenic inductive medium. Immunohistochemistry of cell identification, cell proliferation, alkaline phosphatase (ALP) activity assay, Alizarin red S staining and quantitative real-time-polymerase chain reaction (RT-PCR) were performed. Moderate concentrations of NaF (50-500 μmol/L) had pro-proliferation effects, while 500 μmol/L had the best effects. ALP activity and calcium content were significantly enhanced by 10 μmol/L NaF with osteogenic inductive medium. Quantitative RT-PCR data varied in genes as a result of different NaF concentrations and treatment periods. We conclude that moderate concentrations of NaF can stimulate proliferation and mineralization in periodontal ligament cells. These in vitro findings may provide a novel therapeutic approach for acceleration of periodontal regeneration by addition of suitable concentrations of NaF into the medication for periodontitis treatment, i.e., into periodontal packs and tissue patches.

Single-agent capecitabine as maintenance therapy after induction of XELOX (or FOLFOX) in first-line treatment of metastatic colorectal cancer: randomized clinical trial of efficacy and safety

BACKGROUND

The optimal strategy of maintenance therapy for patients with mCRC is controversial. This study was to evaluate the efficacy and safety of maintenance therapy with capecitabine versus observation following inductive chemotherapy in patients with metastatic colorectal cancer.

PATIENTS AND METHODS

In this randomized, open-label, multicenter, phase III trial, patients who received 18-24 weeks of induction chemotherapy with XELOX or FOLFOX and achieved disease control were randomly assigned centrally (1:1) to receive maintenance therapy of capecitabine or only observation until disease progression. The primary end point was progression-free survival (PFS) from randomization; the secondary end points included overall survival (OS), PFS from induction treatment (PFS2) and safety. Analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02027363.

RESULTS

Between 30 July 2010 and 15 September 2013, 274 patients were enrolled in the study from 11 sites in China and randomly assigned to maintenance group (n = 136) or observation group (n = 138). Clinicopathological characteristics were balanced in two groups. The median follow-up time from randomization was 29.0 months [interquartile range (IQR) 21-36 months]. The primary end point of PFS was statistically significantly longer in capecitabine maintenance group than in observation group {6.43 [95% confidence interval (CI) 5.26-7.71] versus 3.43 (2.83-4.16) months, HR 0.54 (0.42-0.70), P < 0.001}. The median OS of capecitabine maintenance group was longer than that of observation group, but not statistically significant [25.63 (22.46-27.80) versus 23.30 (19.68-26.92) months; HR 0.85 (0.64-1.11), P = 0.2247]. Similar safety profiles were observed in both arms. The most common grade 3 or 4 toxicities in capecitabine maintenance group versus observation group were neutropenia, hand-foot syndrome, and mucositis.

CONCLUSIONS

Maintenance therapy with a single agent of capecitabine can be considered an appropriate option following the induction of XELOX or FOLFOX in mCRC patients with acceptable toxicities.

CLINICAL TRIALS NUMBER

NCT02027363.

[Correlation analysis between 18F-FDG uptake features and the prognosis in patients with pathologic stage Ⅰ lung adenocarcinoma]

OBJECTIVE

To analyze the (18)F-FDG uptake features and the correlation between (18)F-FDG uptake and the prognosis in patients with pathologic stageⅠlung adenocarcinoma.

METHODS

One hundred and seventeen patients with stageⅠlung adenocarcinoma proved by surgery, who underwent a preoperative (18)F-FDG PET-CT, were studied retrospectively. The tumors' SUVmax in different groups of clinicopathologic factors were compared. The correlations between the SUVmax and clinicopathologic factors were analyzed using Spearman rank correlation. The ROC was plotted to estimate the most discriminative cut-off point for SUVmax in predicting the recurrence or progression of tumor. The progression-free survival (PFS) in different clinicopathologic groups were estimated using the Kaplan-Meier method and Log-rank test.

RESULTS

The SUVmax of pathologic stageⅠlung adenocarcinomas were significantly different in different groups of gender, tumor size, density, tumor differentiation grade and T staging, respectively (P<0.05 for all). Patients with a larger tumor size, a higher proportion of solid component, poorer grade of tumor differentiation had a higher SUVmax. The T1b group had a higher SUVmax than T1a and T2a groups. The male group had a higher SUVmax than the female group. The SUVmax was positively correlated with the size of the adenocarcinomas (P<0.01), and was negatively correlated with both the density and tumor differentiation grade (P<0.01). But there was no correlation between SUVmax and the T stage (P>0.05). The patients with an SUVmax of <3.0 had a much better PFS (75.1±3.0 month)than those with an SUVmax of ≥3.0 (52.7±5.9 month)(P<0.01). The tumor with a poorer differentiation grade was associated with reduced PFS (45.7±5.4 months) compared with those with well differentiated tumor (76.7±4.2 month)(P<0.05). The PFS showed no statistically significant differences in different gender, age, smoking history, tumor size, density and T staging groups (P>0.05).

CONCLUSIONS

(18)F-FDG uptake is correlated with the tumor size, density, and differentiation grade, and has a prognostic value for predicting the PFS in the patients with pathologic stageⅠ lung-adenocarcinoma. Patients with an SUVmax of <3.0 have a much better PFS than those with an SUVmax of ≥3.0.

Effects of 5-aza-2'deoxycytidine on RECK gene expression and tumor invasion in salivary adenoid cystic carcinoma

Reversion-inducing cysteine-rich protein with kazal motifs (RECK), a novel tumor suppressor gene that negatively regulates matrix metalloproteinases (MMPs), is expressed in various normal human tissues but downregulated in several types of human tumors. The molecular mechanism for this downregulation and its biological significance in salivary adenoid cystic carcinoma (SACC) are unclear. In the present study, we investigated the effects of a DNA methyltransferase (DNMT) inhibitor, 5-aza-2′deoxycytidine (5-aza-dC), on the methylation status of the RECK gene and tumor invasion in SACC cell lines. Methylation-specific PCR (MSP), Western blot analysis, and quantitative real-time PCR were used to investigate the methylation status of the RECK gene and expression of RECK mRNA and protein in SACC cell lines. The invasive ability of SACC cells was examined by the Transwell migration assay. Promoter methylation was only found in the ACC-M cell line. Treatment of ACC-M cells with 5-aza-dC partially reversed the hypermethylation status of the RECK gene and significantly enhanced the expression of mRNA and protein, and 5-aza-dC significantly suppressed ACC-M cell invasive ability. Our findings showed that 5-aza-dC inhibited cancer cell invasion through the reversal of RECK gene hypermethylation, which might be a promising chemotherapy approach in SACC treatment.

Expression of beclin 1 in primary salivary adenoid cystic carcinoma and its relation to Bcl-2 and p53 and prognosis

Beclin 1 plays a critical role in autophagy and functions as a haploinsufficient tumor suppressor. The expression and prognostic significance of beclin 1 in head and neck adenoid cystic carcinoma (ACC) are largely unexplored. Therefore, we investigated the expression of beclin 1, Bcl-2, and p53 in head and neck ACC tissue. Tissue samples from 35 cases (15 females, 20 males) of head and neck ACC were utilized for immunohistochemistry. Beclin 1 expression was observed in 32 cases (91.4%) and considered to be high in 15 cases (42.9%) and low in 20 cases (57.1%). Beclin 1 expression was significantly correlated with a histological growth pattern (P=0.046) and histological grade (P=0.037). Beclin 1 expression was inversely correlated with Bcl-2 expression (P=0.013) and significantly associated with overall survival (P=0.006). Bcl-2 and p53 expression were observed in 21 cases (60.0%) and 16 cases (45.7%). Bcl-2 expression was significantly correlated with perineural invasion (P=0.041) and not associated with overall survival (P=0.053). p53 expression was directly correlated with beclin 1 expression (P=0.044). Our results indicated that beclin 1 may be a novel, promising prognostic factor for clinical outcome in head and neck ACC patients and may play a part in the development of head and neck ACC by interacting with Bcl-2 and p53.

Sulfite (SPORL) pretreatment of switchgrass for enzymatic saccharification

SPORL (Sulfite Pretreatment to Overcome Recalcitrance of Lignocellulose) pretreatment was applied to switchgrass and optimized through an experimental design using Response Surface Methodology within the range of temperature (163-197 °C), time (3-37 min), sulfuric acid dosage (0.8-4.2% on switchgrass), and sodium sulfite dosage (0.6-7.4% on switchgrass). Performance of SPORL was compared with that of dilute acid (DA) and alkali (AL) in switchgrass pretreatment. Results indicated that SPORL pretreatment improved the digestibility of switchgrass through sufficiently removing hemicellulose, partially dissolving lignin, and reducing hydrophobicity of lignin by sulfonation. The removal of hemicellulose was more critical to substrate digestibility than the removal of lignin during SPORL pretreatment. SPORL pretreated switchgrass had better enzymatic digestibility than DA and AL pretreated ones. The SPORL pretreated switchgrass could be hydrolyzed by 83% within 48 h with 15 FPU (filter paper unit) cellulase and 30 CBU (cellobiose unit) β-glucosidase/g cellulose.

Potential location of a bladder tumor suppressor gene on chromosome 9q at 9q13 to 9q22.1

Allelic losses involving chromosome 9q occur in a significant percentage of bladder tumors. Experimental evidence suggests that a putative tumor suppressor gene located on this chromosome may play a role in the development of bladder cancer. The precise location of this potential tumor suppressor gene is not clear. Previous studies have targeted a large region between 9p12-13 and 9q22 or 9p12 and 9q34.1 as the likely site. To further delineate the location of this gene, we examined 49 tumors by loss of heterozygosity (LOH) analysis, using seven microsatellite polymorhpic loci spanning from 9p21 to 9q34 of the chromosome. LOH was found in at least one of the loci in 20 (41%) of the tumors examined, and the majority (12 of 17; 71%) of the losses on 9q involved large segments or the entire chromosome arm. Although many of the tumors with large losses on 9q also involved 9p21, several tumors with small losses did not involve the 9p marker. Conversely, there were tumors with 9p21 losses that did not involve the q-arm. These data agree with recent findings that distinct tumor suppressor genes associated with bladder cancer are located on separate arms of chromosome 9. Among tumors with single locus LOHs, the most common deletion was located in 9q 13-21.2, which was detected by probe D9S15. This also is the smallest area of critical loss when LOH patterns of tumors with partial or interstitial losses were examined. Results of the study therefore suggest that a potential tumor suppressor gene may reside within or near the region of 9q13-22.1.

Nano-structured TiO(2) film fabricated at room temperature and its acoustic properties

Nano-structured TiO(2) thin film has been successfully fabricated at room temperature. Using a quarter wavelength characterization method, we have measured the acoustic impedance of this porous film, which can be adjusted from 5.3 to 7.19 Mrayl by curing it at different temperatures. The uniform microstructure and easy fabrication at room temperature make this material an excellent candidate for matching layers of ultra-high frequency ultrasonic imaging transducers.

Characterization and mapping of Rpi1, a gene that confers dominant resistance to stalk rot in maize

The maize inbred lines 1145 (resistant) and Y331 (susceptible), and the F(1), F(2) and BC(1)F(1) populations derived from them were inoculated with the pathogen Pythium inflatum Matthews, which causes stalk rot in Zea mays. Field data revealed that the ratio of resistant to susceptible plants was 3:1 in the F(2) population, and 1:1 in the BC(1)F(1)population, indicating that the resistance to P. inflatum Matthews was controlled by a single dominant gene in the 1145xY331 cross. The gene that confers resistance to P. inflatum Matthews was designated Rpi1 for resistance to P. inflatum) according to the standard nomenclature for plant disease resistance genes. Fifty SSR markers from 10 chromosomes were first screened in the F(2) population to find markers linked to the Rpi1 gene. The results indicated that umc1702 and mmc0371 were both linked to Rpi1, placing the resistance gene on chromosome 4. RAPD (randomly amplified polymorphic DNA) markers were then tested in the F(2)population using bulked segregant analysis (BSA). Four RAPD products were found to show linkage to the Rpi1 gene. Then 27 SSR markers and 8 RFLP markers in the region encompassing Rpi1 were used for fine-scale mapping of the resistance gene. Two SSR markers and four RFLP markers were linked to the Rpi1 gene. Finally, the Rpi1 gene was mapped between the SSR markers bnlg1937 and agrr286 on chromosome 4, 1.6 cM away from the former and 4.1 cM distant from the latter. This is the first time that a dominant gene for resistance to maize stalk rot caused by P. inflatum Matthews has been mapped with molecular marker techniques.

A chromosome bin map of 16,000 expressed sequence tag loci and distribution of genes among the three genomes of polyploid wheat

Because of the huge size of the common wheat (Triticum aestivum L., 2n = 6x = 42, AABBDD) genome of 17,300 Mb, sequencing and mapping of the expressed portion is a logical first step for gene discovery. Here we report mapping of 7104 expressed sequence tag (EST) unigenes by Southern hybridization into a chromosome bin map using a set of wheat aneuploids and deletion stocks. Each EST detected a mean of 4.8 restriction fragments and 2.8 loci. More loci were mapped in the B genome (5774) than in the A (5173) or D (5146) genomes. The EST density was significantly higher for the D genome than for the A or B. In general, EST density increased relative to the physical distance from the centromere. The majority of EST-dense regions are in the distal parts of chromosomes. Most of the agronomically important genes are located in EST-dense regions. The chromosome bin map of ESTs is a unique resource for SNP analysis, comparative mapping, structural and functional analysis, and polyploid evolution, as well as providing a framework for constructing a sequence-ready, BAC-contig map of the wheat genome.

Genetic analysis and molecular mapping of maize (Zea mays L.) stalk rot resistant gene Rfg1

One single pathogen Fusarium graminearum Schw. was inoculated to maize inbred lines 1,145 (Resistant) and Y331 (Susceptive), and their progenies of F(1), F(2) and BC(1)F(1) populations. Field statistical data revealed that all of the F(1) individuals were resistant to the disease and that the ratio of resistant plants to susceptive plants was 3:1 in the F(2) population, and 1:1 in the BC(1)F(1 )population. The results revealed that a single dominant gene controls the resistance to F. graminearum Schw. The resistant gene to F. graminearum Schw. was denominated as Rfg1 according to the standard principle of the nomenclature of the plant disease resistant genes. RAPD (randomly amplified polymorphic DNA) combined with BSA (bulked segregant analysis) analysis was carried out in the developed F(2) and BC(1)F(1 )populations, respectively. Three RAPD products screened from the RAPD analysis with 820 Operon 10-mer primers showed the linkage relation with the resistant gene Rfg1. The three RAPD amplification products (OPD-20(1000), OPA-04(1100) and OPY-04(900)) were cloned and their copy numbers were determined. The results indicated that only OPY-04(900) was a single-copy sequence. Then, OPY-04(900) was used as a probe to map the Rfg1 gene with a RIL F(7) mapping population provided by Henry Nguyen, which was developed from the cross "S3xMo17". Rfg1 was primarily mapped on chromosome 6 between the two linked markers OPY-04(900) and umc21 (Bin 6.04-6.05). In order to confirm the primary mapping result, 25 SSR (simple sequence repeat) markers and six RFLP (restriction fragment length polymorphism) markers in the Rfg1 gene-encompassing region were selected, and their linkage relation with Rfg1 was analyzed in our F(2) population. Results indicated that SSR marker mmc0241 and RFLP marker bnl3.03 are flanking the Rfg1 gene with a genetic distance of 3.0 cM and 2.0 cM, respectively. This is the first time to name and to map a single resistant gene of maize stalk rot through a single pathogen inoculation and molecular marker analysis.

Processing dewatered sewage sludge using electrokinetic technology

High content of heavy metals and presence of pathogens in the dewatered sewage sludge have been the main obstacles for land application of sewage sludge-made fertilizer. The aim of this study was to examine the effects of the innovative electrokinetic (EK) technology on removal of heavy metals from sewage sludge, on the reduction of pathogens, and on sludge chemical characteristics. The results showed that the removal efficiencies for Zn, Cu, Ni, Cr, As and Pb were 94.9%, 95.4%, 89.7%, 67.8%, 31.2% and 18.7%, respectively. Acidification pretreatment of the dewatered sludge for 29 h decreased the content of heterotrophic bacteria from 1.5 x 10(8) c.f.u./g of wet sludge to 1.1 x 10(4) c.f.u./g of wet sludge. Although the initial content of total coliforms and fecal coliforms in sewage sludge were 5.8 x 10(5) c.f.u./g of wet sludge and 4.0 x 10(5) c.f.u./g of wet sludge, respectively, no viable cells were detected. Minor losses of K and N were detected, but the loss of P was found to be significant in EK treated sewage sludge. The treated sludge was technically considered as very stable based on the carbon dioxide evolution rate.

Myosin-VIIb, a novel unconventional myosin, is a constituent of microvilli in transporting epithelia

Mouse myosin-VIIb, a novel unconventional myosin, was cloned from the inner ear and kidney. The human myosin-VIIb (HGMW-approved symbol MYO7B) sequence and exon structure were then deduced from a human BAC clone. The mouse gene was mapped to chromosome 18, approximately 0.5 cM proximal to D18Mit12. The human gene location at 2q21.1 was deduced from the map location of the BAC and confirmed by fluorescence in situ hybridization. Myosin-VIIb has a conserved myosin head domain, five IQ domains, two MyTH4 domains coupled to two FERM domains, and an SH3 domain. A phylogenetic analysis based on the MyTH4 domains suggests that the coupled MyTH and FERM domains were duplicated in myosin evolution before separation into different classes. Myosin-VIIb is expressed primarily in kidney and intestine, as shown by Northern and immunoblot analyses. An antibody to myosin-VIIb labeled proximal tubule cells of the kidney and enterocytes of the intestine, specifically the distal tips of apical microvilli on these transporting epithelial cells.

[The imaging principles and the structure of the low-dose digital radiographic device]

This article introduced A new type of X-ray radiographic device, which uses MWPC as the low-dose detector with the machinery and computer to reconstruct the X-ray digital images. In this paper, the advantages and the disadvantages of the device are analysed, thus much improvement has been made to make it better and more efficient.

[Functional evaluation of electrical-injury nerve using somatosensory evoked potential technique]

OBJECTIVE

To investigate the characteristics and the pathologic classification of electrical-injury nerve using somatosensory evoked potential(SEP) technique.

METHODS

SEP were detected and evaluated in 12 cases with electrical-injury nerve during operation, electrical stimulation was commenced from distal side of nerve where the structure of nerve looks normal under operating microscope, up to proximal side until evoking out a stable SEP predeterminate virtual value. Pathological examination and the following functional evaluation were compared with the values of SEP.

RESULTS

At the site of nerve looking normal under operating microscope, perineurium appears normal or slightly thicken. But there are obvious fibrosis and fibrotic proliferation between fascicular and intrafascicular. Vessel plexus is not seen. At SEP stabilizely evoked site, nervous construction is normal, there are visible interfascicular vessel plexus and connective tissue appears loose. Comparing SEP values with pathological section, amplitude and latency of SEP is positively correlative with the quality of nerve. Eight cases repaired with SEP technique to select the anastomosis site for nerve transplantation were followed up, two-point discrimination reached grade III (America hand surgery association criterion) within 62.5% cases.

CONCLUSION

SEP technique is valuable method for functional evaluation of electrical- injury nerve which has a complicated pathology. The pathology of electrical-injury nerve can be classified into 4 types, type A: fibrosis of nerve; type B: nerve looking normal under operation microscope, perineurium appears thicken, and there are obvious fibrosis and fibrotic proliferation between fascicular and intrafascicular, vessel plexus is rarely to see; type C: nerve looks normal, lymphocyte infiltration exists and it is obvious that there are many physalis-like, retrogressive construction in the section; type D: nervous construction is normal, there are visible interfascicular vessel plexus, and connective tissue appears loose, SEP always can be stably evoked.

[Establishment of the animal models of mandibular distraction osteogenesis]

OBJECTIVE

To establish the animal models of mandibular distraction osteogenesis in rabbits and study its osteogenetic mechanism.

METHODS

The right mandibles just anterior to the first molars of 12 rabbits were performed osteotomies, and the mandibles were positioned with distractors. The left mandibles were control group without operation. After 1 week, the distractors were stretched 0.9 mm every day for 10 days progressively. One day, 2, 4, 8 weeks after distraction, the mandibles were studied with gross measurement, X-ray, and histological examination.

RESULTS

The right mandible were lengthened 8.3 mm on average without bone nonunion and deformity healing. It was observed that the gaps between the distracted bone edges were first occupied by fibrous tissue. Two weeks after distraction, it was found that the gaps were bridged by callus in X-ray, the new bone and the normal bone could not be differentiated clearly after 8 weeks. In histological sections, there were collagen bundles in early distraction, then those collagen bundles were calcificated and become trabeculaes. No Cartilage was found during distraction.

CONCLUSION

It suggests that the rabbit mandible can be lengthened by distraction osteogenesis, and the new bone is formed by intramembranous ossification.

HLA typing in patients with ocular manifestations of Stevens-Johnson syndrome

BACKGROUND

Stevens-Johnson syndrome (SJS) is an acute, self-limited, inflammatory disorder of the skin and mucous membranes. With ocular involvement, SJS has been associated with the class I human leukocyte antigen (HLA)-Bw44. This study examined HLA class II associations in patients with SJS with ocular involvement to help identify possible molecular genetic mechanisms underlying disease susceptibility/resistance.

METHODS

Twenty-three white patients with ocular complications secondary to SJS had HLA class II typing performed using polymerase chain reaction-based molecular techniques. Genotype frequency was compared with results obtained from 175 control subjects.

RESULTS

HLA-DQB1*0601 was present in four (17%) patients with SJS and in five (3%) control subjects (P < 0.05; relative risk = 7.2). There was no association with HLA-DQB1*0301, which previously has been been strongly associated with recurrent erythema multiforme. None of the class II antigens tested appeared to offer a protective effect against the development of disease.

CONCLUSION

HLA-DQB1*0601 was found in a significantly disproportionate number of white patients with SJS and ocular complications. The presence of this allele may confer an increased risk for the development of SJS with ocular complications and provides further evidence for an underlying immunogenetic susceptibility to the development of this disease.

Detection in human blood platelets of sialyl Lewis X gangliosides, potential ligands for CD62 and other selectins

Activated platelets are known to express P-selectin, a lectin-like adhesion receptor (CD62), through which they bind to sialyl Lewis X (sLex) ligands displayed on the membranes of leukocytes. To determine whether direct platelet-platelet interactions via P-selectin/sLex interactions are also possible, we have examined the ganglioside extract of human blood platelets for the presence of sLex ligands. Using the sensitive method of high-performance thin-layer chromatography (HPTLC)-immunostaining with the monoclonal antibody (mAb) CSLEX or with sialidase followed by mAbs MC480 or PM81, eight sLex bands were demonstrated at Rf 0.01, 0.03, 0.05, 0.06, 0.08, 0.10, 0.14 and 0.21 in the solvent 45:55:10 chloroform-methanol-aqueous 0.02% CaCl2. The sensitivity of all eight bands to sialidase or endoglycoceramidase confirmed that they were gangliosides. Comparison of the HPTLC mobilities and densities of platelet bands with those from five other human tissues (granulocytes, monoblasts, kidney, aortic endothelium and erythrocytes) in three different solvents revealed three major bands associated with platelets: 3 (Rf0.03), 6 (0.08) and 14 (0.21). Platelet bands were demonstrated not to have resulted from granulocyte contamination. Partial purification of platelet sLex gangliosides by high-performance liquid chromatography and their reaction with 14 oligosaccharide-specific mAbs (FH4, FH5, LM112-161, LM119-181, A5, 1B2, BR55-2, BE2, ES4, MC631, MH04, SH34, P001 and MC813-70) revealed that band 6 is a multifucosylated neolacto ganglioside and band 14 is a branched, disialo neolacto fucoganglioside. Platelet band 3 combined the features of both bands 6 and 14, and reacted differently than granulocyte band 3. These partial structures resemble gangliosides associated with adhesion in other cell systems. It is concluded that platelets express tissue-specific sLex gangliosides (sLex ligands). Thus, it is possible that platelet-platelet binding may be mediated at least partially through P-selectin/sLex interactions, especially after platelet activation.

[Percutaneous catheter drainage for post-traumatic perinephric urinoma]

From June 1989 to April 1992, 5 patients with post-traumatic perinephric urinoma were treated by using percutaneous catheter drainage. The urinoma disappeared and the renal function restored in all the 5 patients 18-27 days (average 21.8 days) after continual drainage. Follow-up for 1-4 (averaging 2-6 years) years showed non-recurrence of the urinoma in all the 5 patients. The procedure is characterized by less distress and economical to the patients. It can keep the kidneys intact. The pathogenesis, pathology, diagnosis and treatment are discussed along with a review of the literature.

Surgical correction of hypertelorism. Report of 40 cases

Forty patients with hypertelorism seen in the past 16 years were reviewed retrospectively. Combined intra- and extracranial surgical approach was used for 37 severe and moderate cases and subcranial approach (U-osteotomy) for 3 moderate cases. Gratifying results were obtained in patients with different types of hypertelorism by a multidisciplinary team. Complications were also reviewed. Of the 37 cases of intra- and extracranial corrections, 1 died, 4 had cerebrospinal fluid leakage and 4 had keratitis. No seizure, cerebral edema, meningitis, blindness, and ptosis occurred in this series. The average age was 13 years and two months. Operating time averaged 6 hours and 50 minutes. Hypertelorism was mostly attributable to craniofacial cleft, craniosynostosis, frontoethmoidal meningoencephalocele, frontonasal fibrous dysplasia, and trauma. Satisfactory esthetic appearance was achieved in most of the cases.

[Surgical correction of 34 patients with hypertelorism]

In 34 patients with hypertelorism aged on the average 12.6 years, 24 underwent intracranial surgery (combined intra- and extracranial approach), 2 (moderate) U-osteotomy (subcranial approach), and 8 (mild) canthoplasties. Improved results were obtained in the patients with various types of hypertelorism. The complications were reviewed. Of the 24 patients undergone intracranial surgery, one died, 4 had cerebrospinal fluid leakage, and 4 had keratitis. No seizure, cerebral edema, meningitis, blindness, and ptosis were observed in these patients. Average blood loss was 72% of blood volume. Average duration of surgery was 7.5 hours. The causes of hypertelorism such as craniofacial cleft, craniosynostosis, frontoethmoidal meningoencephalocele, frontonasal fibrous dysplasia, and trauma were also discussed. Satisfactory appearance was seen in most of the patients.

Purification and partial characterization of a new group of gastric cancer associated antigens

The corresponding antigens of MG series monoclonal antibodies (MG5, MG9, MGd1 and MGe1) against gastric cancer were purified and partially characterized. Each of these monoclonal antibodies was purified by passing through a DEAE-52 cellulose columns and covalently coupled with CNBr-activated sepharose 4B successively. By means of concanavalin A and antibody affinity chromatography, the corresponding antigens of MG series McAb were extracted from gastric cancer tissue respectively. Immunological and biochemical studies confirmed that the corresponding antigens of MG series McAb were a new group of gastric cancer associated neutral glycolipid and glycoprotein antigens.

Indirect lymphography with Isovist-300 in various forms of lymphedema

Twenty patients with various forms of lymphedema were studied by indirect lymphography. Isovist, a new non-ionic, water-soluble, dimeric contrast media, was used for intradermal infusion. Simultaneous indirect lymphography showed characteristic patterns of lymphatics. The initial lymphatics were visualized by intradermal infusion of the newly developed isovist. However, they were not opacified with direct lymphography unless in the presence of valvular insufficiency. No systemic side-effects were observed except for a feeling of discomfort at the injection site. The results showed that indirect lymphography with intradermal infusion of Isovist is useful for demonstrating dermal lymph vessels and for the diagnosis of lymphedema.

Detection of exfoliated bladder cancer cells by monoclonal antibodies to tumor-associated cell surface antigens

Monoclonal antibodies (Mabs) to human tumor antigens have potential for tumor detection and treatment. For bladder carcinoma, the detection of exfoliated tumor cells in urinary specimens may be accomplished with Mabs reacting to tumor cell-surface components. This method may be useful for screening and monitoring carcinogen-exposed workers. A Mab generated by our laboratory, 3G2-C6, reacts with high affinity to a cell-surface component expressed by bladder tumor cells. The potential utility of this Mab in detecting exfoliated tumor cells was evaluated in bladder wash specimens. The Mab method detected positive cells in 87% (56/64) of specimens from patients with bladder cancer, including a great majority with grade 1 tumor and carcinoma in situ, superior to the routine cytology done on the same specimens. Cells in specimens from patients with urinary calculi, chronic cystitis, and history of bladder cancer also reacted with the Mab, suggesting that other stimuli can induce antigen expression. The Mab method can also be performed on urine samples, thus allowing evaluation of the ability of the Mab to identify premalignant, malignant, and other abnormal exfoliated cells in urine. The Mab method represents a unique opportunity to develop noninvasive detection of bladder cancer and to monitor and screen bladder cancer high-risk groups.

A study of the immunofunction in patients of coronary heart disease with the fundamental deficiency and outward excess syndrome

The fundamental deficiency and outward excess syndrome of coronary heart disease can be classified into Qi Yang deficiency with blood stasis (QYD) and Yin deficiency with blood stasis (YD). The patients showed disturbances in immunofunction manifested as marked increase of serum IgG, CIC, IC-IgG and IC-C3 levels and the percentage of B cells in the peripheral blood, while the percentages of OKT3+, OKT4+ and OKT8+ cells markedly decreased, especially the percentage of OKT8+ cells, resulting in an increase of the ratio of T4/8 and imbalance between TS and TH. The authors deem that the fundamental deficiency of coronary heart disease is related to the low cellular immunity, especially the imbalance between TS and TH cells, while outward excess of coronary heart disease is related to hyperactivity of humoral immunity.

Immunochemical and biochemical characterizations of two monoclonal antibody-reacting antigens associated with human bladder carcinoma

Two murine monoclonal antibodies (Mabs), 3G2-C6 and C3, which react to surface components on human bladder carcinoma cells, were produced using cultured human bladder tumor cells as immunogens. The expression of these antigens is highly restricted to malignant cells, and as such these Mabs are potentially useful for cancer diagnosis and treatment. We report here the immunochemical characterizations and molecular size determinations of these two Mab-reacting bladder tumor-associated antigens. The 3G2-C6 antigen has a molecular weight of 92,000, while the C3 antigen is a macromolecule with a molecular weight of about 600,000, consisting of 4 subunits of identical size, as determined by high pressure liquid chromatography gel filtration and sodium dodecyl sulfate and gradient-gel electrophoresis. The apparent affinity constants for the binding of these two Mabs and the number of antigenic determinants per cell were determined in 4 human bladder tumor cell lines (MGH-U1 through MGH-U4) with different degrees of malignancy. The apparent affinity constants for 3G2-C6 ranged from 1.8 x 10(-10) to 1.7 x 10(-8) M, while those for C3 ranged from 1.9 x 10(-9) to 4.4 x 10(-8) M. The number of antigenic determinants per cell ranged from 3 x 10(5) to 2.9 x 10(3) for 3G2-C6 and from 2 x 10(6) to 1.2 x 10(5) for C3. This coincides with our earlier observation that bladder tumor cells of higher malignancy tend to express higher numbers of determinants of these antigens, particularly of 3G2-C6. Very low levels of both of the antigens were released from the cells; less than 10% of the antigens could be detected in 3-day spent culture medium. Radioactively labeled Mabs were used to assess the stability of the antibody bound to MGH-U1 cells. More than 70% of 3G2-C6 remained bound to the cell after 24 h, whereas more than 60% of C3 was lost from the cell and recovered in the culture medium as small fragments. This information may be useful for the clinical applications of these Mabs, including the improvement of in vitro detection of bladder cancer through identification of exfoliated tumor cells and determining the potential utilities of these Mabs in in vivo localization of in situ and metastatic bladder tumors.

[Postabortion complications and recovery of ovarian function in nulliparous women]

Induced abortions performed in 481 cases of nulliparous women were carefully investigated. The incidence of complications during operation was 2.1%, of which the majority was the induced abortion syndrome. The early postabortal complication rate was 6.4% and the majority was mild pelvic inflammatory disease. The late complication rate was 10.2% and manifested mainly by menstrual disturbance. Ovulation occurred in 67.4% of the first postabortal cycles. It is suggested that the induced abortion is not a safe procedure for nulliparous women.

[Effects of kuo guan powder on immunologic functions in patients with ben-xu biao-shi syndrome in ischemic heart disease]

Ischemic heart disease (IHD) is correlated with the Immunodisturbances. In this study, the immunological effects of Kuo Guan No 1, a powder for aiding Qi and activating the blood, in 17 cases of Qi Yang Xu Xue Yu (QYXXY, ) syndrome, Kuo Guan No 2, powder for nourishing the Yin and activating the blood, in 14 cases of Yin-Xu Xue-Yu (YXXY, ) syndrome had been observed in one month treatment. After treatment with both powder of Kuo Guan No 1 and Kuo Guan No 2, the increased levels of IgG, CIC, IC-IgG and IC-C3 in serum and the numbers of B cells in peripheral blood lymphocyte (PBL) of the patients with Ben-Xu Biao-Shi (BXBS, ) syndrome of IHD angina were markedly decreased and showed no significant difference while compared with the normal controls (P greater than 0.05); the numbers of OKT+3, OKT+4 and OKT+8 cells in PBL, which were lower before treatment in both groups, were obviously increased and showed no marked difference with the controls (P greater than 0.05); the higher ratio of T4/T8 was lowered in group of YXXY syndrome, and showed no difference while compared with the controls (P greater than 0.05), but the ratio in QYXXY syndrome group was lowered than that in the controls (P less than 0.05). After the treatment with Kuo Guan No 1, the increased level of C3 in serum in QYXXY group was lowered down to that of the controls (P greater than 0.05). The results indicated that it is reasonable to consider that "Kuo Guan" powder is an immunoregulative preparation for patients with BXBS syndrome of IHD angina.

[Scrotopenile inversion: a report of 4 cases]

From Sep. 1980 to July 1987, 4 cases of scrotopenile inversion were treated surgically. There were complete and partial scrotopenile inversion in 2 cases respectively. A pedicle skin tube of scrotum was used to prolongate the urethra and correct the curved penis. The operation was performed at a time in 3 cases and satisfactory results were obtained in all 4 cases.

[Effects of cerebral GABA level on learning and memory]

In step-down tests, icv GABA 0.1 micrograms (3 min before training) or ip amino-oxyacetic acid 20 mg/kg (1.5 h before training) both significantly impaired memory acquisition in mice. But semicarbazide (ip 110 mg/kg 3.5 h before training), an inhibitor of GABA synthesis, improved the anisodine-induced impairments of learning. The effects of GABA was also enhanced by aminooxyacetic acid. The results suggest that the increase of cerebral GABA contents is unfavourable to learning and memory.