[Real-world data analysis of 3012 patients undergoing laparoscopic radical gastrectomy in a single center over the past 12 years]

Objective: To Summarize the safety, clinical outcome and technical evolution of laparoscopic gastric cancer surgery. Methods: A retrospective cohort study was carried out. Clinical data of 3012 patients who underwent laparoscopic radical gastrectomy for gastric cancer from January 2010 to March 2022 at Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University were retrospectively collected and analyzed. Case inclusion criteria were gastric malignancies confirmed by pathology, without distant metastasis by examination before operation and exploration during operation, patients undergoing laparoscopic radical gastrectomy, intact function of important organs and with complete data. Exclusion criteria were patients who underwent emergency gastric cancer resection due to gastric bleeding, perforation or obstruction, etc., tumor found to invade adjacent organs such as pancreas or transverse colon during the operation, conversion to open surgery during the operation, those who had other malignant tumors (except thyroid cancer) within 5 years, and those had severe cardiopulmonary, liver, or kidney insufficiency before surgery. Outcomes included: (1) baseline information of patients; (2) trend of the quantity of laparoscopic radical gastrectomy year by year; (3) evolution of the mode of digestive tract reconstruction; (4) periopertive outcome short-term complication was defined as complication occurring within 30 days after operation and classified accordiny to the clavien-Dindo criteria; and (5) 5-year overall survival. SPSS software was used for statistical analysis. Continuous variables that obeyed the normal distribution were expressed in the form of Mean±SD. Days of hospital stay that did not follow a normal distribution were expressed as median (Q₁,Q₃), and the Mann-Whiney U test was used for comparison. Discrete variables were expressed as cases (%), and chi-square test or rank sum test was used for comparison between groups. Linear regression analysis was used to analyze the relationship between the amount of surgery and the year of surgery. Kaplan-Meier method and log-rank test were used for survival analysis. Two-tailed P<0.05 was considered as statistically significant. Results: Among the 3012 cases, 2114 were male and 898 were female. The patients' average age at surgery was (61.1±10.7) years old. According to the number of cumulative cases, the patients were divided into three groups: early, intermediate and late, with 1004 patients in each group. The early group consisted of patients undergoing operation from January 2010 to October 2018, the intermediate group consisted of patients undergoing operation from October 2018 to January 2021, and the late group consisted of patients undergoing operation from January 2021 to March 2022. (1) General information: There were 691 (68.8%), 699 (69.6%) and 724 (72.1%) male patients in early, intermediate and late groups respectively; the average age increased from 56.6 years in 2010 to 62.8 years in March 2022. As for the tumor stage T1, T2, T3, T4, there were 49.0%, 14.4%, 23.9% and 12.6% in the early group; 47.5%, 12.9%, 26.9% and 12.6% in the intermediate group; 39.7%, 14.6%, 30.0%, and 15.6% in the late group, respectively. Patients with N0, N1, N2, N3a, N3b stage were 56.8%, 13.7%, 13.4%, 11.0%, and 5.0% in the early group; 55.7%, 12.9%, 12.8%, 11.6%, and 6.9% in the intermediate group; 51.0%, 16.1%, 12.8%, 12.5%, and 7.5% in the late group, respectively. (2) Year-by-year change in the number of gastric cancer operations: From 19 cases per year in 2010 to 786 per year in 2021, the annual number of gastric cancer operations was proportional to the year of operation (y=47.505x, R²=0.67). The proportion of patients with stage I disease showed a fluctuating downward trend over time, while the proportion of patients with stage III disease increased slightly, accounting for 34% until March 2022. (3) Evolution of digestive tract reconstruction methods: Except in 2010, the digestive tract reconstruction method of distal gastrectomy focused on Billroth-II+Braun anastomosis among patients undergoing laparoscopic gastric cancer surgery in other years, whose proportion had gradually increased from less than 20% in 2016 to about 70% after 2021; the gastrointestinal reconstruction methods after total gastrectomy had gradually increased in π anastomosis and overlap anastomosis since 2016, of which π anastomosis reached about 65% in 2019, and overlap anastomosis reached almost 30% in 2020; the anastomosis methods after proximal gastrectomy had been mainly double-channel anastomosis (54%) and esophagogastric anastomosis (30%) since 2016, and double-channel anastomosis accounted for up to 70% in 2019. (4) Operation time: The operation time of early, intermediate and late group was (193.3±49.8) min, (186.9±44.3) min and (206.7±51.4) min respectively. Intermediate group was significantly shorter than early group (t=3.005, P=0.003), while late group was significantly longer than early group (t=5.875, P<0.001) and intermediate group (t=9.180, P<0.001). (5) Postoperative hospital stay: The median length of hospital stay for gastric cancer patients in early, intermediate and late groups was 9 (8, 11) d, 8 (7, 10) d, and 8 (7.5, 10) d respectively. The postoperative hospital stay of intermediate group and late group was significantly shorter than that of early group (Z=-12.467, Z=-5.981, both P<0.001), but there was no significant difference between intermediate group and late group (Z=0.415,P=0.678). (6) Postoperative complication: The morbidity of short-term complication in early, intermediate and late group was 20.4% (205/1004), 16.2% (163/1004), and 16.2% (162/1004) respectively, and above morbidity of intermediate group and late group was significantly lower than that of early group (χ²=5.869, P=0.015; χ²=6.165, P=0.013), while there was no significant difference between intermediate group and late group (χ²=0.004,P=0.952). The morbidity of short-term complication of grade IIIor higher was 8.0% (80/1004), 7.6% (76/1004), and 4.9% (49/1004) in early, intermediate and late group respectively, and above morbidity of late group was significantly lower than that of early and intermediate group (χ²=7.965, P=0.005; χ²=6.219,P=0.013), while there was no significant difference between intermediate group and early group (χ²=0.111,P=0.739). (7) Survival analysis: The follow-up deadline for survival data was December 31, 2021, and the median follow-up time was 29.5 months. The overall 5-year survival rate of all the patients was 74.7%. The 5-year survival rates of stage I, II and III patients were 92.0%, 77.2%, and 40.3% respectively and 5-year survival rates of patients with stage IA, IB, IIA, IIB, IIIA, IIIB and IIIC were 93.2%, 87.8%, 81.1%, 72.7%, 46.2%, 37.1%, and 34.0% respectively. Conclusions: The number of laparoscopic gastric cancer operation in our center is increasing year by year. With the maturity of laparoscopic technology, the morbidity of complication in laparoscopic gastric cancer surgery is decreasing.

An Empirical Approach to Identifying Subject Matter Experts for the Development of Situational Judgment Tests

Abstract. The development of a scoring key for the situational judgment test often requires subject matter experts (SMEs) to identify the best responses for a hypothetical situation. And yet, there is no gold standard for identifying the SMEs. This paper describes an empirical and context-free approach: the Cochran–Weiss–Shanteau (CWS) method, which does not rely on external criteria such as tenure or credential. We first describe the theory behind the empirical approach of expertise. We also outline the CWS method and provide an R script for calculating the CWS index. Next, we demonstrate how the CWS index can be used for improving interrater agreement and the efficiency of SME selection. Finally, we examined the nomological network of the CWS index. We found that the CWS index was associated with reflective thinking and intuition avoidance.

Personality Profile of Risk-Takers

Abstract. Risk-taking is a long-standing area of inquiry among psychologists and economists. In this paper, we examine the personality profile of risk-takers in two independent samples. Specifically, we examined the association between the Big Five facets and risk-taking propensity across two measures: The Domain-Specific Risk-Taking Scale (DOSPERT) and the General Risk Propensity Scale (GRiPS). At the Big Five domain level, we found that extraversion and agreeableness were the primary predictors of risk-taking. However, facet-level analyses revealed that responsibility, a facet of conscientiousness, explained most of the total variance accounted for by the Big Five in both risk-taking measures. Based on our findings across two samples ( n = 764), we find that the personality profile of a risk-taker is extraverted, open to experiences, disagreeable, emotionally stable, and irresponsible. Implications for the risk measurement are discussed.

Malleability of Statistical Perception: Impact of Validity Presentation on College Admission Test Policy Preferences

Research evidence in the social sciences often relies on effect size statistics, which are hard to understand for the public and do not always provide clear information for decision-makers. One area where interpretation of research evidence has profound effects on policy is college admission testing. In this paper, we conducted two experiments testing how different effect size presentations affect validity perception and policy preferences toward standardized admission tests (e.g., ACT, SAT). We found that compared to traditional effect size statistics (e.g., correlation coefficient), participants perceived admission tests to be more predictively valid when the same evidence was presented using an alternative effect size presentation. The perceived validity of the admission test was also positively associated with admission test policies (e.g., test-optional policy) preferences. Our findings show that policy preferences toward admission tests depend on the perception of statistical evidence, which is malleable and depends on how evidence is presented.

[Qualitative study on unprotected sexual behaviors among male students who have sex with men in Beijing]

Objective: To investigate the related factors of unprotected sexual behaviors among male students who have sex with men in Beijing. Methods: Male students who have sex with men were recruited from May 2018 to July 2018 at two voluntary counseling and testing (VCT) clinics in Beijing by convenient sampling method. Information being collected during in-depth personal interviews with a semi-structured outline included ways to seek sexual partners, sexual partners characteristics, attitude of condom use, incidence and causes of unprotected sexual behaviors, rush poppers and alcohol use. The text information was summarized and analyzed by Nvivo 11.0 software. Results: A total of 35 male students who have sex with men were recruited and interviewed, the median of age was 22 years old (P(25)-P(75): 21-24 years old). We found that incomprehensive knowledge of condom use, low risk perception of non-anal sexual behaviors, rush poppers and alcohol use were risk factors of unprotected sexual behaviors on individual level. Besides, sex with regular sex partners, partners who were much older or not from campus, and insertive partners are more likely to be unprotected. Furthermore, refusal of condom use by sexual partners and low self-efficacy of decision-making on condom use were the main reasons for unprotected sexual behaviors among male student who have sex with men. Conclusion: Lack of condom use knowledge, low risk perception of non-anal sexual behaviors and insufficient ability to refuse non-condom requirements for regular sex partners, partners who were much older or not from campus, and insertive partners are related factors of unprotected sexual behaviors among male students who have sex with men.

[Effects of ICAT silencing in Wnt signaling pathway and NSC67657 induced cell differentiation of HL-60 cells]

目的

探讨β-catenin相关蛋白1（ICAT）沉默对Wnt信号通路及甾醇类新药NSC67657诱导HL-60细胞单核系分化的影响。

方法

NSC67657诱导HL-60细胞分化，流式细胞术检测细胞表面分化抗原CD14的表达，检测细胞分化程度；构建慢病毒LV-ICAT-RNAi载体，感染HL-60细胞，采用荧光实时定量PCR和Western blot技术检测感染前后ICAT基因和蛋白表达情况，判断干扰效果；采用免疫共沉淀技术检测β-catenin与ICAT蛋白在细胞内的相互作用；采用Western blot技术分析NSC67657诱导非感染HL-60细胞（HL-60v组）和LV-ICAT-RNAi载体感染HL-60细胞（HL-60i组）前后Wnt/β-catenin通路下游靶点Cyclin D1、TCF-1和c-Jun的表达情况；NSC67657分别作用HL-60v组和HL-60i组细胞24 h，采用瑞氏染色、透射电子显微镜、流式细胞术观察细胞分化情况。

结果

10 µmol/L NSC67657可以诱导HL-60细胞向单核系分化，连续诱导5 d后，CD14⁺细胞比例为（92.30±5.14）%；HL-60i细胞ICAT mRNA表达（0.07±0.01）明显低于HL-60v组（1.00±0.08）（P=0.002）（平均敲减效率为93.2%），Western blot结果与PCR结果一致（P=0.001）；免疫共沉淀结果显示，ICAT与β-catenin蛋白在细胞分化前后都存在相互作用，药物诱导细胞分化后两者相互作用条带吸光度明显增加。药物作用HL-60i细胞Wnt信号通路下游靶蛋白Cyclin D1、TCF-1和c-Jun表达明显高于HL-60v组，但低于非药物处理组。NSC67657作用HL-60i细胞CD14⁺细胞比例为（8.33±3.14）%，明显低于HL-60v组的（19.08±4.73）%，但仍高于非药物处理非感染HL-60细胞组（0.60±0.03）%（F=119.24，P=0.010），细胞形态和超微结果符合细胞表面分化抗原检测结论。

结论

ICAT蛋白参与了NSC67657诱导HL-60细胞的单核系分化，Wnt/β-catenin信号通路可能起到桥梁作用。

Utility of Alternative Effect Size Statistics and the Development of a Web-Based Calculator: Shiny-AESC

Alternative displays of effect size statistics can enhance the understandability and impact of validity evidence in a variety of applied settings. Arguably, the proliferation of alternative effect size statistics has been limited due to the lack of user-friendly tools to create them. Common statistical packages do not readily produce these alternative effect sizes and existing tools are outdated and inaccessible. In this paper, I introduce a free-to-use web-based calculator (https://dczhang.shinyapps.io/expectancyApp/) for generating alternative effect size displays from empirical data. This calculator requires no mathematical or programming expertise, and therefore, is ideal for academics and practitioners. I also present results from an empirical study that demonstrates the benefits of alternative effect size displays for enhancing lay people's perceived understandability of validity information and attitudes toward the use of standardized testing for college admissions.

Simple method for liquid analysis by laser-induced breakdown spectroscopy (LIBS)

As a fast-developing technique for in situ multi-element analysis method, laser induced breakdown spectroscopy - LIBS is, however, developing slowly on liquid analysis due to some technical difficulties. We propose a new method, namely capillary mode, to quantify the concentrations of the elements in solution using LIBS. A Nd:YAG laser with repetition of 10 Hz were used to analyze the solution of Na₂CrO₄ and no any sample preparation in measurements. The experimental results show that the splashing of liquid induced by laser pulses is decreased significantly and the pollution of mirrors is avoided effectively using liquid capillary mode. The results of quantitative analysis for liquid are also improved than other method. The calibration curves of Cr and Na are well characterized by straight lines and the regression coefficient values of the linear fit are better than 0.998. The limits of detection (LODs) of Cr and Na are determined to be 28.9 mg/L and 1.0 mg/L in this work, respectively. The experimental results show that the liquid capillary mode provides a more practical and very simple approach to improve accuracy of quantitative element analysis in liquids by LIBS technique.

Microstructures and mechanical properties of in situ TiC-β-Ti-Nb composites with ultrafine grains fabricated by high-pressure sintering

In this study, an in situ β–Ti–Nb composites reinforced with TiC particles with an ultrafine grain size were fabricated using a powder metallurgical (PM) method. The microstructures and mechanical properties of the composites were characterized using X-ray diffraction (XRD) analysis, scanning electron microscopy (SEM), transmission electron microscopy (TEM) and compression tests. TiC particles were formed in the ball-milled powders after annealing at 600 °C due to a chemical reaction between stearic acid and titanium. Using high-pressure sintering (HPS) on an apparatus with six tungsten carbide anvils, a fully dense β–Ti–Nb composite reinforced with fine in situ TiC particles was obtained. The TiC particles exhibit particle sizes of ~500 nm, uniformly distributed in the composite matrix, which had grain sizes of ~600 nm. Thus, the TiC–β–Ti–Nb composite show very high compression yield strength and relatively high plasticity contributed by grain refinement and TiC particles strengthening. The composite with 45 vol.% TiC exhibited excellent mechanical properties, with a yield compressive strength of 1990 MPa and plastic strain of 9.12%. More over, a modified rule-of-mixture (ROM) was presented to describe the combined strengthening effect of grain refinement and TiC particles.

[Effects of hemoglobin J-Bangkok traits on measurements of glycated hemoglobin by five methods]

OBJECTIVE

To evaluate the interference of hemoglobin variants J-Bangkok on glycated hemoglobin (HbA(1)c) detected by five measurement systems.

METHODS

Seventy cases of blood samples were collected at Zhongshan Hospital of Sun Yat-sen University from July 2012 to January 2014, the blood samples were divided into the normal control group (40 cases) and Hb J-Bangkok variant group (30 cases), and the normal control group was divided into healthy control group (20 cases) and diabetic group (20 cases). HbA(1)c measurement systems were Primus Ultra2, Variant Ⅱ, Variant Ⅱ Turbo, Modular P and Leadman. Based on the standard of the American National Glycosylated Hemoglobin Standardization Program (NGSP), Primus Ultra2 was used as comparative system, and the other 4 systems were test systems. Comparative analysis and bias evaluation were conducted on the results from five detection systems in different groups, statistical analysis were used for evaluating the differences. The estimated average glucose (eAG) was calculated by HbA(1)c values and fasting plasma glucose (FPG) of Hb J-Bangkok variant group with the different detection systems. Deming regression analysis was used to determinate whether Hb J-Bangkok produced significant clinical effect on HbA(1)c results. HbA(1)c ± 10% and relative bias at 6% and 9% HbA1c were evaluation limits.

RESULTS

The differences of the 95% confidence interval (95%CI) between the test systems and the comparative system in control group were within ±0.7% HbA(1)c, bias were less than 6%, there were no statistically significant difference (P>0.05). In Hb J-Bangkok group, the eAG calculated from HbA(1)c measured by using Primus Ultra2, Modular P and Leadman were (8.14±2.99), (8.10±3.06) and (8.23±3.00)mmol/L, which had no statistically significant difference compared with FPG ((8.21±3.12)mmol/L, t=0.996, 1.091, 1.479, all P>0.05), and the differences of 95%CI between the results measured by Modular P and the comparative system were all within ±0.7% HbA(1)c, bias were -4.3%-0.4% and -5.2%-4.9%, there were no statistically significant difference (P>0.05). At 6% and 9% HbA(1)c concentrations, the mean differences of the results from the three detection systems were less than the clinically acceptable range. These results showed that the systems of Primus Ultra2, Modular P and Leadman were not affected by Hb J-Bangkok. However, the eAG values calculated from HbA(1)c of Variant Ⅱ and Variant Ⅱ Turbo were (5.58±2.12) and(5.00±2.13)mmol/L, which showed statistically significant lower results compared with FPG level (t=12.29, 13.23 , all P<0.001). Compared with Primus Ultra2, the differences of 95%CI were outside of ± 0.7% HbA1c, bias were -31.9%--12.0% and -42.0%- -17.6% , greater than 6%, showed a negative bias.At 6% and 9% HbA(1)c concentrations, the mean differences of the results were all greater than the clinical acceptable range. These results indicated that Hb J-Bangkok had significantly clinical interference on Variant Ⅱ and Variant Ⅱ Turbo systems.

CONCLUSION

Hb J-Bangkok has different interference on different HbA(1)c measurement systems, when performs the HbA(1)c test, clinical laboratory should pay attention to identify Hb variants, and select the appropriate methods to measure the HbA(1)c values in order to prevent the occurrence of interference by Hb variants.

CLOSED FEMORAL NAILING WITH THE TECHNIQUE OF USING A NEW FEMORAL DISTRACTOR: A PRELIMINARY REPORT

This study introduces the application of a new femoral distractor in the treatment of femoral fracture restoration with internal fixation of intramedullary nail. Sixty-three patients with femoral fracture from the Affiliated Hospital of Binzhou Medical University underwent femoral facture restoration with the new femoral distractor in combination with internal fixation of an intramedullary nail from June 2011 to March 2014. There were 18 cases of proximal femur fractures, 44 cases of middle femoral shaft fractures and 1 case of distal femur fracture. Follow-up was on the 4th, 6th, 8th, 12th, 16th and 24th week after operation. All 63 patients successfully underwent the surgery and the steel needles used did not cause injury to the adjacent vessels or nerves. Five cases had to have steel needles reinserted, as they had failed in the distraction reduction due to being unsteadily fixed because of an improper position. Patients were followed up for 10~24 months (mean 16 months), and the total healing rate was 100%. Operative time was 93.5 minutes averagely. Average time of patients’ exposure to X-ray was 26.8 seconds. Bleeding volume was averagely 219.1 ml. There were no complications either during the operations or after them. All cases healed within 12 weeks (average 7.6 weeks). This study proves that, the new femoral distractor can help the closed reduction of fractures in treating femoral fractures with intramedullary nails to avoid the inconvenience of applying traction tables and the occurrence of potential complications.

New insight into power-law behavior of fragment size distributions in the C₆₀ multifragmentation regime

Previous experimental work has shown that a phase transition in C60 multifragmentation induced by nanosecond laser occurs at almost constant temperature covering a wide range of laser fluency. Here the relative yields of ionic fragments (IFs) C(n)(+) (n = 1-20) resulting from the multifragmentation are measured within the phase transition region. By excluding two small IFs and magic IFs due to their abnormal behavior, the data for residual IFs are used to estimate the size distributions of primary intermediate-mass IFs in the multifragmentation regime. The distributions are found to obey power laws n(-τ). Furthermore, the exponent τ values have sensitive dependence on lower laser fluency and converge to a constant of about 2.4 ± 0.2 for larger fluencies. These observations are in good agreement with an explanation based on the Fisher droplet model, offering the tantalizing possibility of a liquid-to-gas phase transition in C60 systems.

Effect of thermomechanical treatment on the superelasticity of Ti-7.5Nb-4Mo-2Sn biomedical alloy

Effects of thermomechanical treatment on the microstructure and superelasticity of Ti-7.5Nb-4Mo-2Sn biomedical alloy were investigated by using XRD measurement, optical microscope (OM), transmission electron microscope (TEM) and tensile tests. The titanium alloy samples were prepared by annealing at a temperature in the range of 600 to 1000°C after severe cold rolling; and the samples that were annealed at 800°C were further aged at 600 and 700°C. The volume fraction of α phases decreased while that of ω phases increase with increasing annealing temperature. The α→β transformation temperature of the alloy was determined to be between 700 and 800°C. The alloy that was annealed at 700°C exhibited a high level of superelasticity with relatively high first yield stress (σSIM) at room temperature because it contained a fine α phase. A certain amount of ω phases also resulted in an increase in σSIM, leading to an improvement in the superelasticity of the alloys that were annealed at 900 and 1000°C. Aging treatment led to the precipitations of α and ω phases in the alloy after annealing at 800°C; and the volume fraction of α phases decreased while that of ω phases increased with increasing aging temperature. Excellent superelasticity with high recovered strain (εrecoverable) and strain recovery rate (η) were obtained in the aged alloy due to the reinforcement of α and ω phases induced by aging treatment. The alloy annealed at 700°C for 0.5h exhibited the best superelasticity in all the thermomechanically treated alloys due to the strengthening from the subgrain refining and the precipitating of fine α phases.

Enhancing flow boiling heat transfer in microchannels for thermal management with monolithically-integrated silicon nanowires

Thermal management has become a critical issue for high heat flux electronics and energy systems. Integrated two-phase microchannel liquid-cooling technology has been envisioned as a promising solution, but with great challenges in flow instability. In this work, silicon nanowires were synthesized in situ in parallel silicon microchannel arrays for the first time to suppress the flow instability and to augment flow boiling heat transfer. Significant enhancement in flow boiling heat transfer performance was demonstrated for the nanowire-coated microchannel heat sink, such as an early onset of nucleate boiling, a delayed onset of flow oscillation, suppressed oscillating amplitudes of temperature and pressure drop, and an increased heat transfer coefficient.

cDNA cloning and mRNA expression of a tandem-repeat galectin (PoGal2) from the pearl oyster, Pinctada fucata

Galectins can recognize and specifically bind to β-galactoside residues, playing crucial roles in innate immune responses of vertebrates and invertebrates. We cloned the cDNA of a tandem-repeat galectin from the pearl oyster Pinctada fucata (designated as PoGal2). PoGal2 cDNA is 1347 bp long and consists of a 5'-untranslated region (UTR) of 3 bp, a 3'-UTR of 297 bp with one cytokine RNA instability motif (ATTTA), and an open reading frame of 1047 bp, encoding a polypeptide of 349 amino acids, with an estimated molecular mass of 38.1 kDa and a theoretical isoelectric point of 8.5. PoGal2 contains two carbohydrate recognition domains (CRDs); both have the conserved carbohydrate-binding motifs H-NPR and WG-EE. PoGal2 shares 50.6 and 50.9% identity with those of abalone (Haliotis discus) and the Manila clam (Venerupis philippinarum), respectively. Phylogenetic analysis revealed that the tandem-repeat galectins formed two clades for the different species. Molluscan tandem-repeat galectins were clustered into a single clade, and nematode tandem-repeat galectins were clustered into another single clade. In both clades, CRD-N and CRD-C were divided into different groups. PoGal2 mRNA was constitutively expressed in all tissues analyzed, and the expression level of PoGal2 mRNA was found to be significantly up-regulated in digestive glands, gills and hemocytes after Vibrio alginolyticus stimulation/infection. Expression profile analysis showed that the expression level of PoGal2 mRNA was significantly up-regulated at 8, 12 and 24 h after V. alginolyticus infection. These results suggest that PoGal2 is a constitutive and inducible acute-phase protein involved in the innate immune response of pearl oysters.

Pharmacokinetics, tissue distribution, and metabolism of novel DNA topoisomerase I inhibitor yuanhuacine in rabbit

A liquid chromatography/tandem mass spectrometry method was developed and validated for the quantitative determination of yuanhuacine (YHC), a daphne diterpene ortho-ester anticancer agent, and identification of its metabolites. Pharmacokinetic behaviour, tissue distribution, and metabolism were investigated in rabbit. YHC plasma data best fitted to a two-compartment model and were characterized by an elimination half-life t(1/2)(beta) of 11.1 h following intravenous administration. Tissue distribution studies did not identify any tissues having a high affinity for YHC. The main metabolites are proposed to be M392I, M392II, and M390, resulting from the ortho-ester group and aromatic ester bond being cleaved off simultaneously during Phase I metabolism. This investigation contributes to an understanding of the metabolism of daphne diterpene ortho-esters.

Determination of microstickies in recycled whitewater by headspace gas chromatography

This study proposed a novel headspace gas chromatographic (HS-GC) method for determination of adhesive contaminants (microstickies) in recycled whitewater, a fiber containing process stream, in the paper mill. It is based on the adsorption behavior of toluene (as a tracer) on the hydrophobic surface of microstickies, which affects the apparent vapor-liquid equilibration partitioning of toluene. It was found that the equilibrium concentration of toluene in the vapor phase is inversely proportional to the apparent effective surface area of microstickies that remain in the corresponding solution. Thus, the amount of microsticky materials in the recycled whitewater can be quantified by HS-GC via indirect measurement of the toluene content in the vapor phase of the sample without any pretreatment. The presented method is simple, rapid and automated.

Dantaxusins A and B, two new taxoids from Taxus yunnanensis

Two new taxane diterpenes, dantaxusin A [5 alpha-cinnamoyloxy-2 alpha,7 beta,13 alpha-triacetoxy-2(3-->20)abeo-taxa-4(20),11-diene-9,10-dione (1)] and dantaxusin B [5 alpha-cinnamoyloxy-9 alpha-hydroxy-10 beta,13 alpha-diacetoxytaxa-4(20),11-diene (2)], were isolated from an ethanol extract of the aerial parts of Taxus yunnanensis along with taxuspine B, 2-deacetoxytaxinine J, taxuyunnanine C, taxinine B, taxuspine C, and taxinine NN-4. The structures of 1 and 2 were established on the basis of 1D and 2D NMR and HRMS spectroscopic methods.

Cytotoxity of non-alkaloidal taxane diterpenes from Taxus chinensis against a paclitaxel-resistant cell line

Seven taxane diterpenes were isolated from the EtOH extract of the aerial parts of Taxus chinensis, and evaluated for cytotoxicity against nine human cell lines, including a beta-tublin mutant resistant to paclitaxel. Compound 2, a non-alkaloid-type taxane diterpene, showed significant cytotoxicity in most cell lines, and notably, equipotent against both parental and beta-tublin mutant tumor cell lines.

[Surgical treatment for mitral valve prolapse]

OBJECTIVE

To determine the excellent operative procedure to treat mitral valve prolapse (MVP).

METHODS

Fifty seven patients with MVP were divided into three groups: Group I received traditional chordal reconstruction; Group II underwent chordal replacement using expanded polytetrafluorethylene(e-PTFE) sutures and artificial ring valvuloplasty reconstruction; Group III submitted mitral valve replacement.

RESULTS

Mitral regurgitation volume was reduced significantly in Group II [(1.3 +/- 3.8) ml] and Group III [(1.2 +/- 3.4) ml] than that in Group I [(4.7 +/- 7.7) ml] (P < 0.05).

CONCLUSION

The utilization of e-PTFE sutures as artificial chordae and artificial ring valvuloplasty for MVP is a more reliable and safe procedure than traditional mitral valve reconstruction, and can avoid the complications of long term anticoagulant therapy after mechanical valve replacement.

A new taxoid, 19-acetoxytaxagifine, from Taxus chinensis

A new taxane diterpene, 19-acetoxytaxagifine (1), was isolated from an ethanol extract of the aerial parts of Taxus chinensis. Its structure was determined on the basis of spectral evidence.

Novel cytokine release inhibitors. Part I: Triterpenes

Tripterine and closely related triterpenoid derivatives as IL-1 beta release inhibitors are discussed.

[Studies on sultamicillin hydrolysis]

Sultamicillin is an oral mutual pro-drug composed of double esters of formaldehyde hydrate in which one of the hydroxyl groups is esterified with ampicillin and the other with sulbactam. It is hydrolyzed fast in neutral or weakly alkaline condition. When hydrolyzed, it forms ampicillin and hydroxylmethyl sulbactam or sulbactam and hydroxylmethyl ampicillin by different routes. Usually, the former has priority as the two ester bonds have different activities. The ratio of ampicillin to sulbactam in the products is about 3:1. Both the hydroxylmethyl sulbactam and the hydroxylmethyl ampicillin can be further catalyzed by esterase to produce formaldehyde.

The isolation and structural elucidation of three new neolignans, piperulins [corrected] A, B, and C, as platelet activating factor receptor antagonists from Piper puberulum

Three new neolignans, piperulins [corrected] A [1], B [2], and C [3], were isolated from Piper puberulum. Their structures and relative stereochemistries were determined from spectral data and the X-ray crystallographic analysis of 1. Compounds 1 and 3 inhibit specific platelet activating factor receptor binding with IC50 values of 7.3 and 5.7 microM, respectively.

Yunantaxusin A, a new 11(15-->1)-abeo-taxane from Taxus yunnanensis

Yunantaxusin A [2], an 11(15-->1)abeo-taxane-type diterpene with an opened oxetane ring, has been isolated from the leaves and stems of Taxus yunnanensis. Its structure was established from its spectral data.

Inhibition of IL-1 release from human monocytes and suppression of streptococcal cell wall and adjuvant-induced arthritis in rats by an extract of Tripterygium wilfordii Hook

1. It was investigated whether an extract of Tripterygium wilfordii Hook f (TW) inhibits IL-1 production by monocytes and suppresses the development of IL-1-dependent arthritis induced in rats with streptococcal cell wall and adjuvant. 2. TW preferentially inhibited IL-1 alpha and IL-1 beta production by bacterial lipopolysaccharide (LPS)-stimulated human monocytes with IC50 of approximately 1 microgram/ml. 3. Oral administration of TW dose-dependently suppressed joint swelling and structural damage in streptococcal cell wall-induced arthritis (ED50 = 20 mg/kg/day) and in adjuvant-induced arthritis (ED50 = 46 mg/kg/day for developing and 8 mg/kg/day for established arthritis).

Antitumor agents--CLI. Bis(helenalinyl)glutarate and bis(isoalantodiol-B)glutarate, potent inhibitors of human DNA topoisomerase II

Evaluation of a number of cytotoxic antitumor sesquiterpene lactones and their derivatives has led to the discovery of bis(helenalinyl)glutarate (4) and bis(isoalantodiol-B)glutarate (10) as potent inhibitors of human-derived topoisomerase II. Unlike etoposide, which inhibits by preventing the DNA rejoining process, compounds 4 and 10 inhibit topoisomerase II without causing DNA breakage. The structure-activity relationships of 4, 10, and related compounds are discussed.

The sartorius myocutaneous island flap

The vascular supply to the distal part of sartorius m. was studied in 37 limbs by dissection under magnification and after black ink and latex injections. The muscle or myocutaneous island flap pedicled on the saphenous artery (SA) is supplied by a retrograde circulation through anastomoses of the SA with the perforating branches of the posterior tibial artery and the medial inferior genicular artery. Three different vascular patterns were defined. Retrograde injection also showed good perfusion of the SA. The flap is useful for covering around the knee, the proximal and middle thirds of the lower leg, and the end of the amputation stump. Raising of the flap has not resulted in any functional or cosmetic defect. Eighteen operations have so far been performed, six using the muscle island flap and twelve using the myocutaneous island flap, and all survived completely.

Antitumor agents, 145. Cytotoxic asprellic acids A and C and asprellic acid B. new p-coumaroyl triterpenes, from Ilex asprella

Three new p-coumaroyl triterpenes, asprellic acids A [1], B [2], and C [3], were isolated from the EtOH extract of dried leaves of Ilex asprella. The structures for 1-3 have been established as 3,27-di-O-trans-p-coumaroyl [1], 3-O-trans-p-coumaroyl-27-O-cis-p-coumaroyl- [2], and 3-O-cis-p-coumaroyl-27-O-trans-p-coumaroyl- [3] 3 beta,27-dihydroxyolean-12-en-28-oic acid, respectively, by spectral and chemical examinations. Asprellic acid A [1] exhibited potent cytotoxicity against the RPMI-7951 cell line with an ED50 value of 0.62 micrograms/ml, while the cytotoxicity of asprellic acid C [3] against RPMI-7951 was marginal (ED50 5.5 micrograms/ml). Compounds 1 and 3 also showed cytotoxicity against KB cells with ED50 values of 3.75 and 2.86 micrograms/ml, respectively. Asprellic acid B [2] did not show cytotoxicity (> 10 micrograms/ml) against KB or RPMI-7951 cell lines.

Yuanhuacin A is a selective antagonist of phorbol ester receptor in protein kinase C

Protein kinase C with a molecular weight of 82 kD has been purified to electrophoresis homogeneous from rat brain through a series of chromatography columns including DE-52, Sepharose G-200 and phenyl-Sepharose. The enzyme possessed autophosphorylation activity. Yuanhuacin A inhibited the 3H-phorbol-12, 13-dibutyrate (3H-PdBu) binding of PKC with an IC50 value of 1.48 +/- 0.28 x 10(-8) mol/L when the concentration of 3H-PdBu was 1.5 x 10(-9) mol/L (Ki = 1.2 x 10(-8) mol/L). Yuanhuacin A inhibited the PdBu-stimulated PKC activity in the catalysis of the phosphorylation of Histone III-S with an IC50 of 2.82 +/- 0.37 x 10(-9) mol/L (PdBu = 10(-6) mol/L), while it had no effect on the basal and Ca(2+)-stimulated PKC activity in the same assay system. This result suggests that Yuanhuacin A is a selective antagonist of the phorbol ester receptor in protein kinase C.

Anti-AIDS agents, 4. Tripterifordin, a novel anti-HIV principle from Tripterygium wilfordii: isolation and structural elucidation

A new kaurane-type diterpene lactone, tripterifordin [1], has been isolated from the roots of Tripterygium wilfordii. The structure of 1 was elucidated by spectroscopic methods, including the concerted application of a number of 2D nmr techniques that involved the 1H-1H COSY, heteronucleus-detected variants of the heteronuclear chemical shift correlation (HETCOR), phase-sensitive NOESY, and long-range HETCOR. Compound 1 shows anti-HIV replication activity in H9 lymphocyte cells with an EC50 of 1 microgram/ml.

[Hassab's procedure with or without lower esophageal transection in the treatment of portal hypertension. A prospective controlled study]

Seventy-three patients of portal hypertension were treated with Hassab's procedure or the procedure combined with lower esophageal transection during 1982-1986. All were followed up to 25-74 months (average of 48.8 months). The results revealed that Hassab's procedure was effective in maintaining hepatic function, no encephalopathy, good quality of life (excellent and fair in 83.3%). low incidence of upper GI rebleeding within two years after operation (3.1%), and easy manipulation. However, the accumulated late rebleeding rate was rather high (18.8%). The long-term results of combined procedure, including rebleeding rate, was no significantly difference from those of the simple Hassab's procedure, and the early postoperative serious complications were more frequently seen in patients receiving combined procedure than in those receiving Hassab's procedure.

[Early treatment of third degree burns of the entire hand]

Treatment and result of burned total hand was reported here in 4 hands (4 cases). According to the treatment and anatomical characteristics, burned hand was divided into 4 areas: dorsum of hand, dorsum of finger, thenar-wrist area and volar-digit area. The treatment of total hand in third degree burns included emergency escharotomy of hand and digits, early escharotomy and immediate skin grafting on the dorsum of hand, thenar-wrist and volar-digit area. But on the dorsum of digit area this sort of hand was often deepen to the phalangeal bones and joints. After healing of early graft, the exposed bones and joints were decorticated with immediate grafting on the fresh bone marrow surface and with the finger tip repair so as to preserve the length of digits. When the bone marrow surface grafting healed metallic finger splints were bent sequentially to functional position for 8 weeks in order to ankylosis of interphalangeal joints. Followed up 4 hands with good results. And only 5 distal phalanges were loss in 20 digits. But in previous cases this kinds of digits were often amputated with poor results.

Impedance cardiography-dipyridamole test in detecting coronary artery disease

Thallium-201 dipyridamole test (Tl-201DT) has high sensitivity and specificity in the assessment of coronary disease (CAD), but is not always available. We proposed impedance cardiography DT (IDT)instead. To determine the characteristic changes of impedance cardiogram (ICG) in patients with typical angina and to compare with those in normal subjects, 37 subjects undergoing IDT were divided into 3 groups: typical angina (15), suspected chest pain (11) and normals (11). Dipyridamole (DP) was infused intravenously for over 10 minutes at a total dose of 0.75 mg/kg. Simultaneous recording of ECG, PCG, and ICG were repeated immediately 2 minutes and 4 minutes after infusion of DP, and immediately and 5 minutes after intravenous infusion of aminophylline. Eleven parameters, HR, SPRP, QZ/ZA2, HI, SV, CO, A wave, A/C, O wave, O/C, A + O/C were observed. Only in O/C and A + O/C there were changes of significant differences (P less than 0.01) between groups. Specificity was 100% (0/11 positive) in normals. Sensitivity was 80% (12/15 positive) in the angina group, but only 46.7% (7/15) with ECG. The characteristic changes in CAD patients during IDT were angina induced by DP, abnormal O wave on ICG and change from deep A wave to abnormal O wave. No serious complication occurred after IDT. Our results indicate that IDT is a simple, practical and valuable method for detecting CAD.

Morphopathologic observations on high-velocity steel bullet wounds at various intervals after wounding

Soft-tissue wounds of both hind legs in 15 dogs were inflicted by spherical steel bullets. Histologic and ultrastructural changes were observed in the contusion zone and the concussion zone at 6, 12, and 24 hr after wounding. Histologically, it was shown that at 6 hr after wounding, there were degeneration and necrosis of myofibers and interstitial hemorrhage and edema in the contusion zone, while some fibers still appeared to have normal structure in the outer layers. In the inner layers of the concussion zone close to the entrance, there was focal necrosis of myofibers. Histologic changes at 12 and 24 hr after wounding were similar to those at 6 hr but there were more inflammatory reactions. A considerable number of ultrastructural changes were seen in the contusion zone at 6 hr after wounding, such as loss of sarcomeres, vacuolization and pyknosis of mitochondria, swelling of sarcoplasmic reticulum, irregular arrangement of Z-lines, breaking of some capillary endothelial cells, etc. However, in the concussion zone, the changes were much less than those above mentioned, although karyons and karyomeres of some monocytes appeared to be gathering to the side of cytoblast. On the whole, the ultrastructural changes were not so severe at 12 and 24 hr as those at 6 hr after wounding. Also, the characteristic features of the wound caused by high-velocity steel bullets were not similar to those caused by 5.56-mm high-velocity missiles. The severity of damage at the entrance of wound track caused by steel bullet was more marked than that at the exit.

[Evaluation of CT scan for carcinoma of the gastric cardia]

CT scans of 50 cases with carcinoma of gastric cardia were analyzed. 45 cases were operated but 12 were explored only. The causes of unresectability were: bulky primary tumor, regional lymph node involvement, infiltration of the adjacent structures, e.g. liver, pancreas, spleen and diaphragm, intragastric extension and ascites. By CT scan, the detection rate of the visceral organ involvement was: diaphragm 4/7, pancreas 3/10, liver 4/6 and spleen 5/6. Therefore, it is very important to have a preoperative CT scan for carcinoma of gastric cardia.