The dual mTORC1/2 inhibitor AZD2014 inhibits acute graft rejection in a rat liver transplantation model / 南方医科大学学报

OBJECTIVE@#To investigate the inhibitory effect of AZD2014, a dual mTORC1/2 inhibitor, against acute graft rejection in a rat model of allogeneic liver transplantation.@*METHODS@#Liver transplantation from Lewis rat to recipient BN rat (a donor-recipient combination that was prone to induce acute graft rejection) was performed using Kamada's two-cuff technique. The recipient BN rats were randomized into 2 groups for treatment with daily intraperitoneal injection of AZD2014 (5 mg/kg, n=4) or vehicle (2.5 mL/kg, n=4) for 14 consecutive days, starting from the first day after the transplantation. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) levels of the rats were measured 3 days before and at 1, 3, 5, 7, 10, and 14 days after the transplantation, and the survival time of the rats within 14 days were recorded. Immunohistochemical staining was used to examine the expressions of CD3 and Foxp3 in the liver graft, and acute graft rejection was assessed using HE staining based on the Banff schema.@*RESULTS@#Three rats in the control group died within 14 days after the surgery, while no death occurred in the AZD2014 group, demonstrating a significantly longer survival time of the rats in AZD2014 group (χ2=4.213, P=0.04). Serum ALT, AST and TBIL levels in the control group increased progressively after the surgery and were all significantly higher than those in AZD2014 group at the same time point (P < 0.05). Pathological examination revealed significantly worse liver graft rejection in the control group than in AZD2014 group based on assessment of the rejection index (P < 0.01); the rats in the control group showed more serious T lymphocyte infiltration and significantly fewer Treg cells in the liver graft than those in AZD2014 group (P < 0.01).@*CONCLUSIONS@#AZD2014 can effectively inhibit acute graft rejection in rats with allogeneic liver transplantation.

Guidelines for diagnosis and management of aneurysmal subarachnoid hemorrhage: top issues and prospective / 浙江大学学报·医学版

Aneurysmal subarachnoid hemorrhage (aSAH) is a kind of hemorrhagic stroke with high mortality and morbidity. Although the preoperative diagnosis, surgical clipping, endovascular treatment, and intensive care have progressed in recent years, the overall prognosis of aSAH patients remains poor. In 2011, the Neurocritical Care Society organized an international, multidisciplinary consensus conference addressed the critical care management of SAH. In 2012, the American Stroke Association (AHA) updated the guidelines of diagnosis and treatment of aSAH published in 2009. In 2013, European Stroke Organization established the guideline for management of intracranial aneurysms and SAH. In 2014, the Korean Society of Interventional Neuroradiology (KSIN) published clinical practice guideline for the management of ruptured and unruptured aneurysms. The guideline for diagnosis and management of aSAH for Chinese patients has been drafted in this year. Thus, the diagnosis and management of aSAH is a hot topic in neurosurgery. This editorial summarizes the above mentioned guidelines and focuses on the progress and update of these guidelines. In this article we discuss the advantage and disadvantage of those imaging techniques, the pros and cons of surgical clipping and endovascular treatment.

Prevention and treatment of drug-related stroke / 浙江大学学报·医学版

Stroke classified into ischemic and hemorrhagic subtypes, is among the most devastating diseases for human being. Certain drugs could increase the blood viscosity, thereby increasing the potential risk of ischemia. Anti-platelet and anti-coagulation drugs, as the treatment of first choice, increase the risk of intracranial hemorrhage and death. Here, we are the first to propose the concept of drug-related stroke, and discuss the treatment strategy for patients who are complicated with intracranial hemorrhage or plan to receive neurosurgical operation during either anti-platelet or anti-coagulation medication. We hope to arouse the attention for drug related stroke among the clinicians and offer recommendation for clinical intervention.

Pterional keyhole approach in surgical treatment of ruptured anterior circulation intracranial aneurysm: a report of 313 cases / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To review the surgical modality with pterional keyhole approach in treatment of anterior circulation aneurysm.</p><p><b>METHODS</b>Three hundred and thirteen patients with ruptured anterior circulation intracranial aneurysm treated surgically with pterional keyhole approach between January 2009 and June 2014 in Department of Neurosurgery, the Second Affiliated Hospital of Zhejiang University School of Medicine, were included in the analysis. Complete occlusion rate of aneurysms and incidence of major complications including delayed cerebral ischemia and chronic hydrocephalus were documented. Surgical outcomes at 6-month follow up were assessed by modified Rankin Scale.</p><p><b>RESULTS</b>Totally 348 aneurysms were treated with pterional keyhole approach, 326 aneurysms were completely clipped, 16 aneurysms were partly clipped, and 6 aneurysms were wrapped with gauze material. Among 313 patients, 15 patients (4.79%) suffered from delayed cerebral ischemia, and 10 patients (3.19%) suffered from hydrocephalus. At the 6-month follow up, the rate of good outcome was 66.77% (209/313).</p><p><b>CONCLUSIONS</b>The pterional keyhole approach can be used to clip most of anterior circulation aneurysms, and it seems to have advantages over the traditional approaches with lower incidence of complications and similar outcomes.</p>

Brainstem cavernous malformation and its surgical treatment / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To analyze the clinical characteristics and surgery approach for patients with brainstem cavernous malformation (BSCM).</p><p><b>METHODS</b>The clinical data of 23 BSCM patients (5 cases at midbrain, 16 cases at pons, and 2 cases at medulla) treated in the Second Affiliated Hospital Zhejiang University School of Medicine from July 2003 to June 2014 were retrospectively reviewed. The medical history, radiological findings, operation records, postoperative course and follow-up results were analyzed.</p><p><b>RESULTS</b>Suboccipital approach, retrosigmoid approach, subtentorial supracerebella approach, Poppen approach, pterional approach, Kawase approach, interhemispheric transcallosal third ventrical approach were applied for the surgery of BSCM patients. Among them, Kawase approach and interhemispheric transcallosal third ventrical approach were firstly reported in treatment of BSCM. Total resection was achieved in 22 cases. Neurological function was improved in 15 cases, unchanged in 7 cases and deteriorated in 1 case. Fifteen cases were followed up for a mean period of 3.5 years and signs of recurrence was found.</p><p><b>CONCLUSION</b>Proper selection of surgical approach is important to assure total resection of the lesions, to protect surrounding normal vital structures and to avoid post-surgical complications.</p>

Evacuation of spontaneous supratentorial intracerebral hematoma with double targets-single channel and multiaxial stereotaxis / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of evacuation of spontaneous supratentorial hemorrhage with double targets-single channel and multiaxial stereotaxis.</p><p><b>METHODS</b>Thirty-four patients with supratentorial intracerebral hemorrhage, who underwent hematoma evacuation with the method of double targets-single channel between January 2014 and November 2014 in the Second Affiliated Hospital, Zhejiang University School of Medicine, were included in the study. We classified the hematoma into four types based on the principle of double targets-single channel calculation method (DTSC). And the appropriate stereotactic surgery path and operation opportunity were designed individually according to the hematoma volume and mass effect. Twenty-seven patients with supratentorial hemorrhage who underwent hematoma evacuation with the method of single targets-single channel between January 2013 and November 2014 were selected as single target group.</p><p><b>RESULTS</b>Volumes of initial hematoma in DTSC and single target groups were(38.6 ± 19.2)mL and(40.1 ± 18.1)mL, respectively. Initial Glasgow Coma Scale were 9.6 ± 3.2 (3~15) and 9.1 ± 2.9(3~13) (all P >0.05). Residual volume of hematoma and clearance ratio were (11.1 ± 4.2) mL and(73.1 ± 5.4)% in DTSC group and (18.5 ± 5.3) mL and(55.1 ± 5.1)% in single target group by CT scan 24 h after operation(all P <0.05). There was no significant difference in Glasgow Outcome Scale between two groups in one-month follow-up. Average length of postoperative stay of two groups were(12.6 ± 9.8)d and (14.2 ± 7.1)d, respectively.</p><p><b>CONCLUSION</b>Evacuation of spontaneous supratentorial intracerebral hematoma with DTSC and multi-axial stereotaxis can increase clearance ratio remarkably and decrease average length of stay.</p>

Surgical treatment of anterior circulation aneurysms via lateral supraorbital approach / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the efficacy of the surgery with lateral supraorbital approach for clipping anterior circulation aneurysms.</p><p><b>METHODS</b>The clinical data of 99 patients with anterior circulation aneurysms who underwent a clipping via lateral supraorbital approach from October 2012 to September 2014 and 75 patients, who underwent a clipping via pterional approach from January 2010 to December 2011 in the second Affiliated Hospital, Zhejiang University School of Medicine were reviewed. The operative duration, prognosis, residual rate and rupture rate during surgery were compared between two groups.</p><p><b>RESULTS</b>The patients by lateral supraorbital approach had a shorter operative duration, namely 37~61 min less than that in the patients by pterional approach. No difference were found in residual rate and rupture rate between two groups. The Glasgow Outcome Scale (GOS) at 3 months after surgery showed no significant difference between two groups.</p><p><b>CONCLUSION</b>The lateral supraorbital approach can be used safely and effectively with shorter operative duration and less tissue damage for treatment of patients with anterior circulation aneurysms.</p>

Does Early Postsurgical Temozolomide Plus Concomitant Radiochemotherapy Regimen Have Any Benefit in Newly-diagnosed Glioblastoma Patients? A Multi-center, Randomized, Parallel, Open-label, Phase II Clinical Trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The radiochemotherapy regimen concomitantly employing temozolomide (TMZ) chemotherapy and radiotherapy (RT) 4 weeks after surgery, followed by 6 cycles of TMZ is a common treatment for glioblastoma (GBM). However, its median overall survival (OS) is only 14.6 months. This study was to explore the effectiveness and safety of early TMZ chemotherapy between surgery and chemoradiotherapy plus the standard concomitant radiochemotherapy regimen.</p><p><b>METHODS</b>A randomized, parallel group, open-label study of 99 newly diagnosed GBM patients was conducted at 10 independent Chinese neurosurgical departments from June 2008 to June 2012. Patients were treated with concomitant radiochemotherapy regimen plus early postsurgical temozolomide (early TMZ group) or standard concomitant radiochemotherapy regimen (control group). Overall response was assessed based on objective tumor assessments, administration of corticosteroid and neurological status test. Hematological, biochemical, laboratory, adverse event (AE), and neurological condition were measured for 24 months of follow-up. The primary efficacy endpoint of this study was overall survival (OS). The secondary endpoint was progression free survival (PFS).</p><p><b>RESULTS</b>The median OS time in the early TMZ group was 17.6 months, compared with 13.2 months in the control group (log-rank test P = 0.021). In addition, the OS rate in the early TMZ group was higher at 6, 12, and 18 months than in the control group, respectively (P < 0.05). The median PFS time was 8.7 months in the early TMZ group and 10.4 months in the control group (log-rank test P = 0.695). AEs occurred in 29 (55.8%) and 31(73.8%) patients respectively in early and control groups, including nausea (15.4% vs. 33.3%), vomiting (7.7% vs. 28.6%), fever (7.7% vs. 11.9%), and headache (3.8% vs. 23.8%). Only 30.8% and 33.3% were drug-related, respectively.</p><p><b>CONCLUSIONS</b>Addition of TMZ chemotherapy in the early break of the standard concomitant radiochemotherapy regimen was well tolerated and significantly improved the OS of the GBM patients, compared with standard concomitant radiochemotherapy regimen. However, a larger randomized trial is warranted to verify these results.</p>

PDGFRα Participates in Basic Fibroblast Growth Factor-mediated Recovery of Human Bone Marrow Mesenchymal Stem Cell Proliferation and Osteogenic Differentiation after Irradiation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the effects of basic fibroblast growth factor (bFGF) on human bone marrow mesenchymal stem cell (hBMMSC) damaged by irradiation and its underlying mechanisms.</p><p><b>METHODS</b>hBMMSC was irradiated with 0, 6, 12 Gy X ray, then flow cytometry, cell counting kit-8 (CCK-8), Western blot and alizarin red staining were used to detect the effects of X ray on apoptosis, proliferation and osteogenic differentiation of hBMMSC; 0, 1, 5, 10, 20 ng/ml bFGF was added to hBMMSC irradiated with X ray for selecting the suitable bFGF reaction concentration; then the Western blot was used to detect the expression of PDGFRα so as to evaluate whether the expression of PDGFRα participated in bFGF-mediated recovery of hBMMSC proliferation and osteogenic differentiation after irradiation.</p><p><b>RESULTS</b>The proliferation and osteogenic differentiation of hBMMSC decreased remarkably after irradiation. bFGF promoted the recovery of proliferation and osteogenic differentiation of irradiated hBMMSC compared with untreated irradiated hBMMSC (P < 0.05); 5 ng/ml bFGF was identified as the optimal concentration. A significant difference in the number of apoptotic cells could be detected only between the 0 Gy group and 12 Gy group at the 24 h time point, while no differences were detected at later time points. Irradiated hBMMSC showed remarkable decrease of PDGFRα expression, while the PDGFRα expression increased after bFGF was added.</p><p><b>CONCLUSION</b>Irradiation dose not show significant effect on apoptosis of hBMMSC, but the bFGF displays a effect on repairing the irradiation damage of hBMMSC and promotes the recovery of hBMMSC proliferation and osteogenic differentiation. The damage of hBMMSC proliferation and osteogenic differentiation associates with downregulation of PDGFRα expression induced by irrediation. PDGFRα involves in repairing effect of bFGF on irradiation damage of hBMMSC.</p>

Construction and identification of lentiviral vector containing human ILK-shRNA and mda7 gene / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To construct and identify lentiviral vector containing human ILK-shRNA and mda7 gene.</p><p><b>METHODS</b>Based on the human ILK gene sequences, RNAi target sequences were designed and cloned into the lentiviral vector pSicoR-eGFP by restriction endonuclease HpaI and XhoI double digestion and T4 DNA ligase ligation. Based on the human mda7 gene sequences, PCR primers were designed to clone the full-length mda7, and were cloned into the lentiviral vector pLVX-Puro. After the candidate clones were identified by DNA sequencing, the recombinant plasmid and the three packaging plasmids were co-transfected into the human embryonic kidney 293T cells by lipofectamine 2000 to produce the lentiviral particles. Human prostate cancer PC-3 cells were infected with the constructed lentiviral vector. The ILK and mda7 expression levels in PC-3 cells were quantified by qPCR and Western blot, respectively. The effect of ILK and mda7 on proliferation and migration of PC-3 cells were assessed by MTT method and Transwell assay, respectively.</p><p><b>RESULTS</b>ILK-pSicoR-eGFP and mda7-pLVX-Puro lentiviral vectors were successfully constructed. Strong green fluorescence was observed in the 293T cells under the fluorescent microscope after co-transfection of 293T cells with 4 plasmids of lentiviral vector. The transfection efficiency of the collected virus exceeded 90% in the 293T cells and the PC-3 cells were infected with the lentiviral particles with high efficiency. The A and B lentiviral vector inhibited the expression of ILK at both the mRNA and protein levels in PC-3 cells significantly. The mda7-pLVX-Puro lentiviral vector increased the expression of mda7 in PC-3 cells, and the ability was maintained for one month. Within 96 h, ILK and mad7 significantly inhibited the proliferation and migration of PC-3 cells (Ps<0.05).</p><p><b>CONCLUSION</b>The lentiviral vectors of ILK knockdown and mda7 over-expression have been successfully constructed and identified. The recombinant lentivirus can efficiently infect human prostate cancer PC-3 cells, in which ILK expression is inhibited and mda7 is over-expressed.</p>

B7-H4 expression is elevated in human U251 glioma stem-like cells and is inducible in monocytes cultured with U251 stem-like cell conditioned medium / 癌症

Previous studies indicated that B7-H4, the youngest B7 family, negatively regulates T cell-mediated immunity and is significantly overexpressed in many human tumors. Tumor stem cells are purported to play a role in tumor renewal and resistance to radiation and chemotherapy. However, the link between B7-H4 and tumor stem cells is unclear. In this study, we investigated B7-H4 expression in the medium of human glioma U251 cell cultures. Immunofluorescence results showed that U251 cells cultured in serum-free medium (supplemented with 2% B27, 20 ng/mL epidermal growth factor, 20 ng/mL basic fibroblast growth factor) maintained stem-like cell characteristics, including expression of stem cell marker CD133 and the neural progenitor cell markers nestin and SOX2. In contrast, U251 cells cultured in serum-containing medium highly expressed differentiation marker glial fibrillary acidic protein. Flow cytometry analysis showed serum-free medium-cultured U251 cells expressed higher intracellular B7-H4 than serum-containing medium-cultured U251 cells (24%-35% vs. 8%-11%, P < 0.001). Immunofluorescence in purified monocytes from normal human peripheral blood mononuclear cells revealed moderate expression of B7-H4 after stimulation with conditioned medium from U251 cells cultured in serum-containing medium. Moreover, conditioned medium from U251 stem-like cells had a significant stimulation effect on B7-H4 expression compared with serum-containing conditioned medium (P < 0.01). Negative costimulatory molecule B7-H4 was preferentially expressed in U251 stem-like cells, and conditioned medium from these cells more effectively induced monocytes to express B7-H4 than conditioned medium from U251 cells cultured in the presence of serum. Our results show that U251 stem-like cells may play a more crucial role in tumor immunoloregulation with high expression of B7-H4.

Advances in research on neuroprotective effects of inert gas / 浙江大学学报·医学版

Inert gas is a group of rare gases with very low activity, their application in medical field has increasingly drawn attentions. It is known that inert gases helium, xenon and argon have protective effects on nervous system and the mechanisms are related to eradicating free radicals, anti-inflammation, suppressing apoptosis, influencing ion channels and so on. Further study on the neuroprotective effect of inert gas will shed light on a new approach to treat neurological diseases.

Research advances on hydrogen therapy in nervous system diseases / 浙江大学学报·医学版

Oxidative stress plays a pivotal role in the pathogenesis of varied nervous system diseases. Recent studies have demonstrated that hydrogen has selective antioxidative effect. It selectively reduces the hydroxyl radical (*OH) and peroxynitrite (ONOO(-)), the most cytotoxic of reactive oxygen species (ROS); however, it does not affect other ROS, which play important physiological roles at low concentrations. A large body of experimental studies has proved that hydrogen, through anti-oxidation, anti-inflammatory and inhibiting apoptosis, has a significant therapeutic effect in various neurological diseases, such as ischemia, hypoxia, degeneration and spinal cord contusion. It provides us with a new clinical method for the prevention and treatment of neurological diseases.

Clinicopathologic study of parvovirus B19 infection in perinatal period / 中华病理学杂志

<p><b>OBJECTIVE</b>To characterize the risks and histopathological features of parvovirus B19 infection of infants in perinatal period.</p><p><b>METHODS</b>Routine pathological examination was performed on 1 neonate, 2 dead fetuses and 2 placentas using either autopsy or biopsy materials.</p><p><b>RESULTS</b>The diagnostic intranuclear inclusions were found in erythroblasts in the bone marrow, liver, spleen and lungs in one case, in the spleen and liver in one case, in the spleen in one case, and in the placentas in two cases.</p><p><b>CONCLUSIONS</b>Severe hemolytic anemia or fetal hydrop or hemophagocytosis caused by the infection of parvovirus B19 can lead to death of infected neonates and fetus. Pathological confirmation of parvovirus B19 infection relies on the identification of erythroblasts containing the diagnostic intranuclear inclusions.</p>

LRIG3 gene regulates biological activity of GL15 cell line / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effects of leucine-rich repeats and immunoglobulin-like domains 3 (LRIG3) on the biological activity of glioblastoma cell line GL15.</p><p><b>METHODS</b>Glioblastoma GL15 cells were cultured and transfected with LRIG3-EGFP plasmid. The location of LRIG3 in GL15 cells was observed with confocal microscopy. The proliferation and invasiveness of GL15 cells were detected with methyl thiazolyl tetrazolium (MTT) and Transwell methods respectively; the expression of epidermal growth factor receptor (EGFR) and LRIG3 mRNA and protein were detected with reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot respectively.</p><p><b>RESULT</b>After transfection with the plasmid LRIG-EGFP, LRIG3 fusion protein was found in cytoplasm of GL15 cells and cell proliferative and invasiveness were reduced. The expression of EGFR and LRIG3 varied with the duration of EGF treatment (100 ng/ml): the expression of EGFR decreased while the expression of LRIG3 increased as time prolonged.</p><p><b>CONCLUSION</b>LRIG3 can inhibit the proliferation and invasiveness of glioblastoma cells and may be used as a target gene in gene therapy of glioblastoma.</p>

Perivascular epithelioid cell tumor of uterus: report of 5 cases and literature review / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the pathologic features, diagnosis, differential diagnosis and biologic behavior of uterine perivascular epithelioid tumor.</p><p><b>METHODS</b>Five cases of uterine perivascular epithelioid cell tumor were studied by light microscopy and immunohistochemistry. Follow-up information was reviewed.</p><p><b>RESULTS</b>All the five tumors were composed by clear or eosinophilic cells arranged in nests and cords, associated with abundant small vessels and hyalinization in the stroma. Immunohistochemically, the tumor cells demonstrated positive staining for melanocytic markers (HMB45 and/or Melan-A), desmin and smooth muscle actin. The staining for cytokeratin and CD10 was negative. All the patients followed for a certain period are still alive, with no evidence of disease recurrence.</p><p><b>CONCLUSIONS</b>Perivascular epithelioid cell tumor is a rare mesenchymal tumor of uterus, with distinctive histologic and immunohistochemical features. It should be distinguished from clear cell carcinoma and epithelioid leiomyoma of uterus. Positivity for melanocytic markers (especially HMB45) plays an important role in the diagnosis of this tumor. In general, the tumor is categorized as benign, with uncertain malignant potential and malignant.</p>

The construction of an in vitro model of dural cells / 中国应用生理学杂志

<p><b>AIM</b>To study the healing mechanism of duraplasty a model of rabbit dural healing was constructed in vitro and the influences of collagen, laminin, polylysine on the migration and proliferation of dural cells were compared.</p><p><b>METHODS</b>Rabbit dura pieces 1.5 cm x 1.5 cm in size were created and were perforated in their central part with a 2 mm punch to mimic a dural defect. The dural pieces were cultured in 24-well plates which had been coated with collagen, laminin and polylysine respectively and the influence of different extracellular matrix on the migration and proliferation of dural cells was observed. Cells were subcultured on slides for immunocytochemistry to identify the characteristics of dural cells. The dural healing was observed by scanning electronic microscope.</p><p><b>RESULTS</b>Only the dura pieces cultured on collagen coated wells showed migration of cells into the central defect after a period of 8-10 days and dural defect healing occurred after 13-15 days. Dural cells stained strongly positive with antibodies against vimentin and negative with VIII factor. New collagen fibers were observed in the dural defects.</p><p><b>CONCLUSION</b>A kind of cell model for dural healing was constructed successfully in vitro. Cell migration from the dural defect margin is an important mechanism in the process of wound healing after duraplasty.</p>

Cohort mortality study of dust exposed miners in iron mine / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the main diseases jeopardizing the health of the iron miners and to explore the relationship between dust exposure and malignancies as well as other diseases.</p><p><b>METHODS</b>A retrospective study with a cohort of 7,469 workers employed between January 1, 1972 and December 31, 1974 in Daye Iron Ore Mine Co. in Hubei Province was conducted. Standardized mortality ratio (SMR) was calculated for the main causes of death using Chinese national mortality rates for reference.</p><p><b>RESULTS</b>All subjects were followed up through December 31, 2003 with an accumulation of 199, 108.0 person years. A total of 1,752 workers died. The cumulative mortality was 23.5%. The cancers, cerebrovascular diseases, non-malignant respiratory diseases and cardiovascular diseases were main diseases that threatened workers' life span. The SMR for all subjects was a little higher than expected based on the Chinese national mortality rates. The diseases causing the significantly higher death rate were the nasopharynx cancer, liver cancer, lung cancer, pneumoconiosis and accident with SMR 1.84, 1.51, 1.83, 14.94 and 1.25 respectively. Increased mortality was observed among dust-exposed workers in the cohort. The cumulative mortality from all causes such as stomach cancer, lung cancer, nonmalignant respiratory diseases, cardiovascular diseases and accident in dust exposed workers were significantly increased compared with those in non-exposure workers with RR 1.35, 1.83, 1.61, 2.27, 1.34 and 1.69 respectively.</p><p><b>CONCLUSION</b>The risk factors especially dust exposure affect the health and lifespan of the iron mine workers.</p>

Promotor hypermethylation of E-cadherin, p16 and estrogen receptor in prostate carcinoma / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate promotor hypermethylation of the CpG islands of E-Cadherin, p16 and estrogen receptor (ER) in prostate carcinoma and explore whether such methylation might play a role in the tumorigenesis and malignant progression of prostate carcinoma and their significance in the diagnosis, prognosis and treatment.</p><p><b>METHODS</b>Thirteen specimens of benign prostatic hypertrophy (BPH), 10 specimens of high grade prostate intraepithelial neoplasia (HGPIN) and 20 specimens of prostate carcinoma (with follow-up records) were collected from the patients who underwent radical prostatectomy or transurethral resection. Methylation-specific PCR (MSP) was used to detect the promoter hypermethylation of E-Cadherin, p16 and ER genes.</p><p><b>RESULTS</b>Hypermethylation percentages in prostate carcinoma were: E-Cadherin, 30%; p16, 25%; and ER, 65%. Almost all nonmalignant tissues (BPH and HG-PIN) lacked methylation of any genes.</p><p><b>CONCLUSION</b>Detecting promotor hypermethylation of E-Cadherin, p16 and ER may be helpful to differentiate nonmalignant lesions from prostate carcinoma.</p>

Clinical applications of devitalized autogenous calvarial bone flaps fixed with titanium clamps (CranioFix) for cranioplasty / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate reimplantation of devitalized autogenous calvarial bone flaps and the fixation of titanium clamps (CranioFix) for cranioplasty.</p><p><b>METHODS</b>From March 2000 to December 2003, 21 patients underwent (1) delayed reimplantation of preserved autogenous bone flaps, which were removed during the initial operations for increased intracranial pressure and stored in a freezer and autoclaved before use, or (2) immediate reimplantation of tumor invaded bone flaps that were devitalized by boiling. All of these flaps were fixed with titanium clamps (CranioFix). Resorption of the bone flaps was monitored by skull roentgenograms and computed tomography (CT). The clinical and aesthetic results were evaluated.</p><p><b>RESULTS</b>During the follow-up period of 6 to 30 months, no complications were found. There was slight resorption of the bone flaps in all cases, but the edge of the bone flaps was within the range of the titanium clamps according to skull roentgenograms and CT. Clinical and aesthetic results were highly satisfactory.</p><p><b>CONCLUSIONS</b>It is simple and practical using devitalized autogenous calvarial bone flaps for cranioplasty. The firmness decreasing of the reimplanted bone flap due to resorption can be prevented greatly by titanium clamps (CranioFix).</p>