A case-control study on the association between a healthy lifestyle and obesity among adult twins in Shanghai / 中华流行病学杂志

Objective: To investigate the associations between the numbers of healthy lifestyles and overweight/obesity and abdominal obesity in adult twins in Shanghai. Methods: Based on the Shanghai Twin Registry System Phase Ⅱ survey data in 2017-2018, a case-control study was conducted to analyze the association between healthy lifestyles and obesity and further adjusted for confounders by a co-twin control study. Results: A total of 7 864 adult twins (3 932 pairs) were included. In the co-twin case-control analysis for monozygotic twins, compared with participants with 0 to 2 healthy lifestyles, those with 3 and 4 to 5 healthy lifestyles had a 49% (OR=0.51, 95%CI: 0.28-0.93) and 70% (OR=0.30, 95%CI: 0.13-0.69) lower risk of overweight/obesity, respectively, and a 17% (OR=0.83, 95%CI: 0.44-1.57) and 66% (OR=0.34, 95%CI: 0.14-0.80) lower risk of abdominal obesity, respectively. For each additional healthy lifestyle, the risk of developing overweight/obesity was reduced by 41% (OR=0.59, 95%CI: 0.42-0.85), and the risk of developing abdominal obesity was reduced by 37% (OR=0.63, 95%CI: 0.44-0.90). Conclusion: An increasing number of healthy lifestyles was associated with a marked decreased risk for both overweight/obesity and abdominal obesity.

Application of newly designed modular hinged ankle prosthesis in the reconstruction of defect after surgical treatment of malignant tumor at the distal tibia / 中华骨科杂志

Objective:To investigate the outcome of surgical treatment of malignant tumor at the distal tibial after reconstruction with modular hinged ankle prosthesis.Methods:The data of 9 patients with malignant tumor at the distal tibia at Musculoskeletal Tumor Center of PKUPH from June 2020 to November 2021 were analyzed retrospectively. They were male patients with age of 17 (14, 24) years (range 11-56 years). There were five tumors at the left sides and four at the right sides. There were eight patients with osteosarcoma who received the neo-chemotherapy. Among eight osteosarcomas, one was Enneking IIA and seven Enneking IIB. Furthermore, there was only one patient with renal carcinama and with solitary metastatic lesion at the distal tibia. After the resection of tumor at the distal tibia, talus cartilage was removed and talus component was fixed by lag screws. The proper tibia component was used to restore the defect of tibia and the reduction of tibia and talus components were performed. The following clinical data were collected: baseline demographic features, surgical and follow-up data. The baseline demographic features included gender, age, side, lung or/and other metastasis at initial diagnosis, Enneking stage or systematic progression for renal carcinama, histological type. The surgical data included: surgery time, blood loss, length of bone involved by the tumor, prosthesis type. Monitoring data was also recorded: complications (ankle pain when loading, talar collapse, component loosing, infection and wound dehiscence), local recurrence, pulmonary and systematic metastasis, radiological image and the function at the last follow-up (MSTS and VAS evaluation).Results:Among these nine patients, the average blood loss was 245.6±103.9 ml (range 100-400 ml) and the mean surgery time was 178.9±56.9 mins (range 120-300 min). No patient was lost during the follow-up period and the average follow-up was 21.4±5.6 months (range 12.5-27.2 months). The excision length of tibia was 14 (11, 17) cm (range 11-28 cm). There were one case with 2# prosthetic base, three cases with 3# and five cases with 4#. Five had cement fixation of prosthetic stem and four had the pressing fixation. No pulmonary and other organ metastasis occurred among eight patients with osteosarcoma and one patient with distal tibia matastasis of renal carcinama. One patient with OShad the local recurrence and received the resection. One sustained the deep infection after four months and received the removal of prosthesis and spacer implant. At the final follow-up, except one with deep infection and receiving the removal of prosthesis and spacer implant, eight patients were assessed for the function. The average MSTS was 97.1%±3.3% (range 93%-100%). The VAS of all patients was 0. One patient with prosthesis removal had no functional evaluation. At the final follow-up, all patients walked without crutch. No breakage and loosening of prosthetic stem, talar collapse, prosthetic sinking and ankle pain occurred at the final follow-up.Conclusion:The early satisfactory outcome can be obtained for patients with segmental defect after resection of malignant tumor at the distal tibia, who received the newly designed modular hinged ankle prosthesis. Meanwhile, it's worth promoting in the reconstruction of large segmental defect at the distal tibia.

Design and function evaluation of 3D-printed hemi-elbow-arthroplastic total humeral prosthesis / 肿瘤研究与临床

Obiective:To investigate the design, the key points of surgery and the outcome of short-term follow-up of hemi-elbow-arthroplastic bionic total humeral prosthesis by using 3D-print.Methods:The clinical data of 8 patients with humerus malignant tumor who underwent total humerus resection and a 3D-printed auxiliary hemi-elbow-arthroplastic total humeral prosthesis replacement from March 2018 to March 2020 at Peking University People's Hospital were retrospectively analyzed. The operative data, oncological outcome, complication profiles of prosthesis and functional status of all 8 patients were also analyzed. There were 3 males and 5 females with a mean age of 5-37 years. Histological diagnosis included 5 cases of osteosarcoma, 2 cases of Ewing's sarcoma and 1 case of chondrosarcoma.Results:The time for production of the prosthesis was (9.8±2.7) d, the operation time was (209±23) min and intraoperative hemorrhage was (569±173) ml. All the prostheses were implanted successfully and no patients experienced intraoperative complications. While 2 patients had postoperative complications, 1 case of temporary palsy of radial nerve and 1 case of local recurrence. LARS artificial ligament or hernia patch was used to reconstruct joint capsule and tendon-ligament attached around the elbow and shoulder joint. The flexion and extension of the elbow was (118±15)° (100-140°) and (11±9)° (0-25°), and the abduction and anteflexion of the shoulder was (28±12)° (15-50°) and (26±9)° (15-40°), respectively. The postoperative Musculoskeletal Tumor Society (MSTS)-93 scale score was (24.1±1.5) scores. The median follow-up time was 17 months (12-32 months), 7 patients had disease-free survival and 1 patient survived with tumor.Conclusions:The novel 3D-printed total humeral prosthesis with hemi-elbow-arthroplasty has a good perioperative safety, which is effective in restoring the function of elbow joint, solving the problem of stress concentration of ulnar marrow lever of total elbow joint prosthesis and lowering long-term wear rate and loosening rate of prosthesis.

Arthrodesis reconstruction of distal tibia by 3D-printed porous prosthesis after malignant tumor resection / 中华骨科杂志

Objective:To evaluate the safety and short-term clinical postoperative functional outcomes of a novel 3D-printed porous prosthesis of the distal tibia for the bone defect after tumorectomy.Methods:From December 2017 to December 2019, a total of eight patients diagnosed with malignant bone tumor of the distal tibia were enrolled in this study. All cases received standard preoperative chemotherapy, after which osteosarcoma resection was performed and ankle arthrodesis was reconstructed using a 3D-printed prosthesis developed by our medical center. The contact surface between the distal part of the prosthesis and the talus is a 3D-printed porous surface, which is conducive to ankle fusion. The length of the prosthesis is adjusted by the conical mounting part of the modular prosthesis. The proximal part of the prosthesis can be fixed either biologically or with bone cement. At postoperative follow-up, the function of the fused ankle was assessed by radiographs and the monthly Musculoskeletal Tumor Society (MSTS) score.Results:Of the 8 patients, 5 were male and 3 were female, aged 8-29 years (mean 16.1±7.4 years), including 7 osteoblastic osteosarcomas and 1 telangiectatic osteosarcoma. Among the procedures, the mean length of osteotomy was 16 cm (11-20 cm). The method of fixation of the proximal part of the prosthesis included one case with 3D-printing of trabecular metal bone, one case with autogenous fibular graft, and six cases with bone cement. All patients were followed up for 7-39 months (mean 15.6±10.5 months). The distal prosthesis and talus were completely fused in all cases. The mean fusion duration was 4.3±0.7 months. The mean MSTS score was 84.2%±3.0% (mean 80%-90%). No tumor recurrence, wound complications, or prosthesis loosening were observed during the follow-up period.Conclusion:The novel 3D-printed distal tibial prosthesis is a safe and effective technique for reconstruction of a massive bone defect after tumorectomy of a malignant bone tumor, with high fusion rate, few complications, and satisfactory postoperative function.

Reconstruction with a bionic knee megaprosthesis after resection of a distal femoral osteosarcoma in children / 中华骨科杂志

Objective:We designed and applied a novel, bionic megaprosthesis for distal femur, which substituted the hinged articulation with an artificial ligament and a constrained tibial insert in order to maintain articular stability and reduce stress and the risks of wearing, loosening and breakage.Methods:We reviewed the cases of distal femoral osteosarcoma in children population who were initially treated in our center during 2019. Twelve cases of bionic distal femoral prosthesis (bionic group) and 21 cases of fixed-hinge distal femoral prosthesis (control group) were included. In the bionic group, there were six female and six male with the mean age as 8.8±2.6 y. One patient had pathological fracture. Staging according to Enneking system included 1 case of stage IIA, 10 cases of stage IIB and 1 case of stage III. In the control group, there were seven female and fourteen male with the mean age as 8.6±2.2 y. Pathological fracture was seen in three cases. Staging included 15 cases of stage IIB and 6 cases of stage III.We investigated the peri-operative safety, oncological outcome, complication profiles and post-operative functional status of the bionic prosthesis by comparing the baseline data, operative data, and oncological and prosthetic outcomes between the two groups.Results:The two groups were comparable in terms of baseline data including gender, age, height, weight and onset duration, and operative data including duration of operation (126.7±27.9 min vs 143.3±38.9 min, P=0.203), intra-operative hemorrhage (162.5±212.3 ml vs 247.6±175.6 ml, P=0.224) and duration of wound drainage (6.3±2.4 d vs 6.4±3.4 d, P=0.908). The mean follow-up duration of bionic group was 16.0±4.7 months, during which time three patients had systemic progression and one of them died of disease. Another patient had local recurrence and subluxation of the prosthesis that was treated by amputation. Subluxation might be related to the huge tumor mass and excessive resection of the quadriceps femoris. As for the control group, the mean follow-up duration was 12.7±4.5 months. Three patients had systemic progression and all patients were still alive by last follow-up. Local recurrence was seen in two patients and was treated by excision. No prosthetic complications were seen in the control group. The averaged range of motion (ROM) was greater in the bionic group than that in the control group (120.6°±13.6° vs 92.0°±7.7°, P<0.05), but the MSTS 93 scores were similar between groups (29.1±0.9 vs 29.5±0.6, P=0.337). Conclusion:Compared with the fixed-hinge distal femoral prosthesis, the bionic prosthesis had good peri-operative safety, did not increase the risks of prosthetic complications, and could achieve a better range of motion and a similar functional status based on the results of short-term follow-up.

Application of transverse tibial bone transport microangiogenesis combined with vacuum drainage in the treatment of diabetic foot ulcer / 中国医师进修杂志

Objective:To explore the application of transverse tibial bone transport microangiogenesis combined with vacuum drainage in the treatment of diabetic foot ulcer.Methods:During April 2018 to April 2019, the clinical data of 87 patients with diabetic foot ulcer who were performed transverse tibial bone transport microangiogenesis combined with vacuum drainage in Changxing County Hospital of Traditional Chinese Medicine of Zhejiang Province were collected. In this study, there were 64 cases of males and 23 cases of females, aged 43-84 years, and average age was (64.5 ± 8.4) years. Right foots of 42 cases and left foots of 45 cases received operation. The diabetic course was (13.7 ± 6.2) years. The area of ulcer was 2.2 cm × 3.0 cm-7.5 cm × 5.7 cm. According Wagner grade, 16 case was Ⅱ garde, 38 cases was Ⅲ grade, 30 cases was Ⅳ grade, and 3 cases was Ⅴ grade. All patients were given treatment of anti-infection, monitoring of blood glucose and correcting hypoproteinemia. Ankle-brachial index(ABI) and Michigan Neuropathy Screening Instrument (MNSI) score were used to evaluate the recovery of peripheral vessel and nerve before operation and 3 months after operation. All patients were evaluated by angiography or color Doppler ultrasound after operation.Results:All patients were followed up for 3-24 months with average 13.6 months, and the wound surface were healed. At 3 months after operation, the ABI increased from 0.59 ± 0.19 to 0.89 ± 0.28, the scores of MNSI decreased from (5.81 ± 1.60) scores to (4.42 ± 1.25) scores, and there were significant differences ( P<0.05). The postoperative angiography and vascular ultrasound of 74 cases showed satisfied regeneration of micro-vessel. Conclusions:Transverse tibial bone transport microangiogenesis combined with vacuum drainage can rebuild the micro-vessel in the treatment of diabetic foot ulcer, and improve the wound surface healing. It is an effective method in treatment of diabetic foot ulcer.

Food and nutrients intake among 223 residents in Yangpu District from 2011 to 2015 / 上海预防医学

Objective To analyze the intake and changes of food and nutrients in 223 residents of Yangpu District from 2011 to 2015. Methods From the China Nutritional Transition Cohort Study in 2011 and 2015, the data in the study was obtained on Yangpu District′s residents aged 2 and above.A dietary survey was conducted using the 3-day 24-hour dietary recall and condiment weighing method to obtain data on food and nutrients intake per reference man per day and the nutrient source of energy, and to analyze the intake status of different years. Results The intake of vegetables, fruits, livestock and poultry, aquatic products, eggs, milk and dairy products, soybeans and nuts, edible oil and salt per reference man per day was lower in 2015 than in 2011.The insufficient intake proportions of cereals and tubers, vegetables, fruits, aquatic products, eggs, milk and dairy products, soybeans and nuts, and edible oils were 56.0%, 84.0%, 98.2%, 56.0%, 70.2%, 97.8%, 85.3% and 91.1%, respectively, the excessive intake proportion of livestock and poultry meat was 51.6%;the intake of energy, protein, fat and micronutrient per reference man per day in 2015 was lower than in 2011, and the insufficient intake proportion of energy, protein, vitamin A, vitamin B1, vitamin B2, vitamin C, and calcium were 84.0%, 56.4%, 97.3%, 93.8%, 93.3%, 90.2% and 91.6%, respectively.In 2011 and 2015, it was found that residents who had the proportions of energy supply from carbohydrate lower than 50% accounted for 64.6% and 49.8%, those who had the proportions of energy supply from protein higher than 15% accounted for 76.2% and 40.4%, and those who had the proportions of energy supply from fat higher than 30% accounted for 76.7% and 72.9%. Conclusion In 2011-2015, the food and nutrients intakes among community residents in Yangpu District generally decrease, showing the coexistent problems of insufficient and excessive food intake, and the insufficient intake is serious.The insufficient intake of energy, vitamins and calcium is still a severe problem.And the dietary structure is not rational; the proportions of energy supply from three major nutrients are unbalanced.It is suggested that nutrition education for residents should be enhanced.

Experience in the treatment of postoperative cerebrospinal fluid leakage followed by surgical management of a spinal meningocele combined with infection / 中华整形外科杂志

A 37-year-old woman presented with a congenital spinal meningocele for 37 years and ruptured for 6 months. She was admitted to the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences in March 2018. The diameter of the lesion was about 10 cm, with purulent secretion and malodor. The superior gluteal artery perforator propeller flap was used to reconstruct the defect after the lesion resection. Part of the wound didn’t heal and cerebrospinal fluid leaked from the wound postoperatively. The wound eventually healed after wound debridement and drainage changing. Cerebrospinal fluid retention under the flap could result in wound dehiscence and cerebrospinal fluid leakage. The author introduced the treatment process and operative method. The preliminary experience in treating cerebrospinal fluid leakage after surgical management of the spinal meningocele was also summarized.

Application of artificial ligament in treatment of lower abdominal wall reconstruction after pubic tumor resection / 北京大学学报(医学版)

OBJECTIVE@#For patients who had hemipelvectomies involving the resection of a portion or the whole of the pubis, bony reconstruction was not recommended commonly. However, the soft tissue reconstruction of the lower abdominal wall may benefit these patients. The object of the study was to determine the clinical effect of lower abdominal wall reconstruction with LARS ligament after pubic tumor resection interms of patient-reported and objective outcome.@*METHODS@#In this series, we reviewed twenty-five patients who underwent pubic tumor resection followed by reconstruction with LARS ligament between February 2012 and February 2018 retrospectively. We evaluated the clinical outcome and complication of this surgical treatment. The function outcome was evaluated according the musculoskeletal tumor society scores (MSTS) for all the patients at the end of the last follow-up.@*RESULTS@#All the patients were stable during the surgery. There were eight patients who underwent resection of superior ramus of pubis, five patients who had resection of inferior ramus of pubis, and twelve patients who received both superior and inferior ramus of pubis. For all the patients, the mean blood loss was (774±580) mL. The mean operation time was (138±25) min. The mean hospital stay was (19±6) d. For the patients who had resection of superior ramus, inferior ramus, as well as both superior and inferior ramus, the mean blood loss were (763±802) mL, (730±315) mL and (808±485) mL, respectively. The mean operation time were (133±27) min, (135±35) min and (143±20) min, respectively. The mean hospital stay were (18±5) d, (22±9) d and (19±6) d, respectively. The mean follow-up time was (37±21) months. Local recurrence was observed in one patient with chondrosarcoma. One patient with renal cancer metastasis died of the disease. No ligament infection, ligament related complication and incisional hernias were observed. Twenty-three patients could ambulate without assistive devices, and the remaining two could walk by crutches. Postoperative pain was reported as none in nineteen patients, mild in three, and moderate in three. From a functional point, the mean MSTS score was 87±4.@*CONCLUSION@#Lower abdominal wall reconstruction with LARS ligament after pubic tumor resection could have satisfactory clinical outcome. It could prevent the occurrence of herniation, decrease the infection rate by minishing the dead space, and achieve good patient-reported outcome.

Comprehensive assessment on iodine nutrition and dietary iodine intake among Shanghai residents / 上海预防医学

Objective To assess the changes in iodine status and dietary iodine intake among Shanghai residents since common salt was iodized 20 years ago.Methods As-CE Catalysis spectrophotometry was used to determinate the urine iodine level in school-age children,pregnant women,wet nurse and adults of Shanghai between 1995 and 2015.B ultrasonic was used to determinate the thyroid volume of school-age children.And then the goiter rate was calculated.Direct titration or arbitration methods were applied to detect the household salt iodine level quantitatively.The survey was conducted by using 3 days 24-hour dietary questionnaire and condiment weighing methods to analyze the level of iodine intake and sources for the cases of all iodized salt consumption and all consumption of non-iodized salt.Results The median urine iodine concentration (UIC) of school age children was 72.3 μg/L in 1995,rose to 214-231 μg/L from 1997-1999,and then became stable between 100 μg/L and 200 μg/L since 2002.The goiter rate was below 5% among children aged 8-10 from 1995-2015 in Shanghai.The median urine iodine of pregnant women was between 126.5 μg/L and 139.8 μg/L.The median UIC of other populations were all between 100 μg/L and 200 μg/L: with adults,lactating women,infants and young children and women of childbearing age,the median urinary iodine was 138.4,123.1-131.1,150.1 and 125.6 μg/L.The qualified iodized salt at household consumption rate was 90% from 2001 to 2009,the percentage declined year by year from 2010.In the cases of all taking iodine salt,the median iodine intake volume for male aged 7-10,11-13,14-18 and over 18 was 200.3,235.5,252.7 and 215.4 μg/L;women aged 7-10,11-13,14-18 and over 18 was 193.0,213.8,208.3 and 186.1 μg/L.The contribution rate of iodine salt in the diet were 51.6%-54.1% and 49.1%-53% in men and women.Kelp,seaweed and fish and shrimp on the contribution of iodine are 7.6%-16.6% and 4.5%-7.4%.Conclusion In the past about 20 years,iodine nutritional status of residents in Shanghai has stabilized totally in a appropriate and safe level.However,the iodine nutrition of pregnant women was insufficient.As iodized salt is the major source of dietary iodine in coastal areas,it is still necessary to continue the policy of universal salt iodized in Shanghai to ensure residents'' needs for iodine and control the risk of iodine deficiency.

Prevalence of Thyroid Nodules and Its Relationship with Iodine Status in Shanghai: a Population-based Study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study was designed to evaluate the prevalence of thyroid nodules (TNs) and its relationship with urine iodine concentrations (UICs) after the regional rapid economic growth and lifestyle changes.</p><p><b>METHODS</b>A cross-sectional survey was conducted in the general population aged 15-69 years. A questionnaire regarding general and personal characteristics and relevant information was administered. Ultrasonography of the thyroid was performed, and serum triiodothyronine (T3), tetraiodothyronine (T4), serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), and TSH receptor antibody (TRAb) levels were measured for each individual subject.</p><p><b>RESULTS</b>The prevalence rates of TNs in the whole population, females and males were 27.76%, 34.04%, and 21.60%, respectively. The prevalence of multiple nodules increased with age, whereas the prevalence peaks differed between males and females. The median UICs in the whole population and females with non-TNs were higher than those of subjects with TNs (P=0.0035, P=0.0068). The median UICs in subjects with a single TN were higher than those in subjects with multiple TNs (P=0.0164, P=0.0127). The result showed a U-shaped curve relationship between UIC and prevalence of TNs. The prevalence of TNs was the lowest when the UIC was 140-400 μg/L.</p><p><b>CONCLUSION</b>The prevalence of TNs was nearly 30% and increased with age. The relationship between UIC and prevalence of TNs is U-shaped, with an increase in risk when the UIC was <140 μg/L and >400 μg/L. Very low or high UIC levels need attention and correction.</p>

Drinking Behavior and Associated Factors among Middle School Students in Shanghai, China / 生物医学与环境科学（英文）

The purpose of our study was to assess drinking status in middle school students and to understand the associated factors. The adjusted drinking rates were 50.9%, 39.8%, and 15.1% for lifetime, past-year, and current drinking, respectively. Multivariable logistic regression revealed the following variables positively related to drinking during the past year: family income, maternal educational level, family members who drink, parents who support drinking, best friends who drink, friends who encourage drinking, frequently attending friends' parties, smoking, and actuation trend (P<0.05). The main risk factors were friends (OR=6.77, 95% CI: 6.17, 7.43) and smoking (OR=4.70, 95% CI: 3.44, 6.43). These results contribute to obtaining the potential associated factors and aid in targeted intervention into the drinking behavior of middle school students.

Expressions of p16INK4a gene and Bmi1 gene in human corneal endothelial cells of different ages / 中华实验眼科杂志

Background p16INK4a gene plays an important role during the aging and senility.So it was well known to be a leading gene associated with aging.Corneal endothelial cells(CECs) always get trapped in the G1 phase due to the lack of proliferative ability.Whether it is relative with cell senescence is unclear.Objective This study was to investigate the expression ofp16INK4a gene and Bmi1 gene in human CECs from different aged donors ex vivo.Methods The corneal rims,the residual of corneal tissue preserved in DX solution after penetrating keratoplasty,was used in the present study.Parameters were recorded for the donor,including the age,death to preservation interval and preservation to surgery interval.Corneal endothelium survival rate and endothelial cell density were evaluated by trypan blue-alizarin red dying immediately after penetrating keratoplasty.Routine haematoxylin and eosin staining was also performed to proof the normal structure of the cornea.Sections of corneas from different aged donors were classified into ＜30 years group,30-50 years group and ＞50 years group and were immunostained to assess the expressions of p16INK4aprotein,Bmi1 protein and Ki67 protein in CECs.Total RNA was extracted from independent corneal sample for the evaluation of p16INK4a mRNA,Bmi1 mRNA and Ki67 mRNA expression in CECs by quantitative real-time PCR(qRT-PCR).Results The endothelial cell density of each group was (3069 ±172),(2748±64),(2444 ±178)cells/mm2,respectively.Haematoxylin and eosin staining showed the normal structure of corneal epithelium,stroma and endothelium.qRT-PCR examination revealed an age-related increase in p16INK4a mRNA expression in the CECs(F =5.703,P =0.014) and a decrease in Bmi1 mRNA and Ki67 mRNA expression (F =3.950,P =0.042;F=548.500,P =0.000).The further comparison verified a significant elevation in the expression of p16INK4a mRNA in the CECs of the ＞50 years group compared with ＜30 years group and significant decline in Bmil mRNA and Ki67 mRNA the expression (P =0.006,0.013,0.000).Immunohistochemistry in situ confirmed the expression and nuclear localization of p16INK4a protein in CECs,and the expressing intensities of Bmi1 and Ki67 proteins in the elder donors were weaker than those of the younger donors.The immunofluorescence exhibited that the expressing intensity of p16INK4a protein in CECs of 58 years old donor was higher than that of 23 years old donor,showing a consistent result with that of qRT-PCR.Conclusions Expression of p16INK4a gene increases and that of Bmi1 gene decreases upon age.These results suggest that p16INK4a gene is associated with senescence of human CECs.

Ewing's sarcoma of the pelvis: treatment results of 31 patients / 中华外科杂志

<p><b>OBJECTIVE</b>To define oncologic and functional outcomes of multidisciplinary treatment methods combined chemotherapy, surgery and radiotherapy, patients with Ewing's sarcoma of the pelvis who were treated at our center were analyzed.</p><p><b>METHODS</b>Thirty-one patients with Ewing's sarcoma of the pelvis were eligible for this analysis. Primary lung metastases occurred in ten patients who were classified as stage III according to the system of Musculoskeletal Tumor Society (MSTS). All the patients received multidisciplinary treatment methods combined chemotherapy, surgery and radiotherapy. Twenty-eight patients underwent limb-sparing surgery, three patients underwent hemipelvectomy. The complications, including radiation or surgery-related complications and mechanical failures were recorded, besides the functional results were evaluated according to the MSTS 93 criteria. Kaplan-Meier survival analysis and Cox multivariate analysis were used as statistical methods.</p><p><b>RESULTS</b>The 5-year overall survival (OS) rate for all the patients was 42.3%. The 5-year OS for patients with small tumor (< 10 cm) had a significant better prognosis than patients with large tumor (≥ 10 cm, 58.2% vs. 26.0%, χ(2) = 4.382, P < 0.05). The 5-year OS for patients with surgical stage IIb was significantly better than for those with surgical stage III (50.2% vs. 30.3%, χ(2) = 4.521, P < 0.05). The 5-year OS for patients with wide or radical surgery had a better prognosis than patients with marginal, intralesional surgery or no surgery (60.0% vs. 29.4%, χ(2) = 4.851, P < 0.05). In multivariate analysis, surgical stage III (RR = 2.480, 95%CI: 0.857 - 7.173) and resection margin (RR = 2.576, 95%CI: 0.474 - 14.011) were independent prognostic factors. The mean MSTS 93 score for all the patients was 63.3%. The complication rate in patients treated with surgery was 29.0% (9/31).</p><p><b>CONCLUSIONS</b>Patients with Ewing'sarcoma of the pelvis can benefit from multidisciplinary treatment in terms of improved survival, acceptable functional results and reasonable complications. Surgical staging and resection margin are independent prognostic factors.</p>

Hereditary benign telangiectasia without family history in China / 中华医学杂志(英文版)

A case of hereditary benign telangiectasia without family history was reported. A 39-year-old woman presented with small and tiny telangiectases on the face, neck, upper trunk and forearms at birth. The numbers and sizes of the lesions increased gradually and she had no hemorrhagic diathesis and systemic diseases. No similar patients were found in her family. Upon physical examination, telangiectases were found on the face, neck, upper trunk and forearms; and a telangiectatic erythema was found on the right forearm 25 mm × 40 mm in size. Histopathology examination showed a normal epidermis and dilation of the capillaries at upper dermis. Hereditary benign telangiectasia without family history was diagnosed.

The effects of occupational soluble chromate exposure on immunological function of T-cell / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the early changes of some immunological function of T-cell in chromate workers.</p><p><b>METHODS</b>A total of 115 workers exposed to different levels of soluble chromate were enrolled in exposed group; while 90 non-exposure workers who lived far away from the chromate plant were enrolled as control. The air concentration of soluble chromate was determined by atomic absorption spectrometry. CD3(+), CD3(+)CD4(+), CD3(+)CD8(+) and CD4(+)/CD8(+) of T-cell were determined by flow cytometry analysis.</p><p><b>RESULTS</b>The individual air chromate concentration in the exposed group was (27.51 +/- 33.25) microg/m(3), and the control group was (0.16 +/- 0.15) microg/m(3). The significant difference between the two groups was observed (z = 8.045, P < 0.01). The levels of the lymphocyte subsets (CD3(+), CD3(+)CD4(+), CD3(+)CD8(+) and CD4(+)/CD8(+)) in exposed group were (30.08 +/- 17.75)%, (1.04 +/- 1.73)%, (11.94 +/- 9.78)%, 0.10 +/- 0.14. While, those of control group were (63.00 +/- 13.57)%, (30.51 +/- 5.16)%, (14.82 +/- 4.59)%, 2.17 +/- 0.53, higher than that of the exposed group (z values were 4.484, 5.227, 1.976, -5.218, respectively, P < 0.05).</p><p><b>CONCLUSION</b>On the basis of individual air monitoring, the cellular immune function affected by soluble chromate is mainly based on T lymphocyte inhibition. The indicators CD3(+)CD4(+) mentioned above may be considered as efficient biomarkers in further research.</p>

Effect of nano-TiO(2) intratracheal instillation on lipid metabolism of AopE gene-knockout mice / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of nano-TiO(2) intratracheal instillation on the progression of dyslipidemia and atherosclerosis in apolipoprotein E-knockout mice.</p><p><b>METHODS</b>The nano-TiO(2) was ultrasound with phosphate-buffered saline solutions (PBS) into its suspension for exposure. A total of 46 specific pathogen free (SPF) level of 11-week-old male apolipoprotein E-knockout mice were randomly divided into groups by their body weights: non-treatment group (8 mice), PBS control group (9 mice), high dose group (1.0 mg/ml, 10 mice), medium dose group (0.5 mg/ml, 10 mice), and low dose group (0.1 mg/ml, 9 mice). Except the non-treatment group, mice from other groups were intratracheally instilled with 0.05 ml each time, twice a week. After exposure of 6 weeks, viscera index, blood TC, TG, HDL-C, LDL-C, and organic lipid ratio were assessed as biomarkers. Artery and aortic root issues were assessed by histopathology.</p><p><b>RESULTS</b>After 5 weeks exposure, mice body weights in high dose group ((29.7 ± 1.9) g) started to drop, compared to PBS control ((31.3 ± 1.9) g, t = -1.58, P < 0.05) and low dose group ((31.4 ± 1.4) g, t = -1.17, P < 0.05); after 6 weeks, high dose group ((28.8 ± 1.5) g) was lower than PBS control ((30.4 ± 1.9) g, t = -1.60, P < 0.05), non-treatment group ((30.2 ± 1.3) g, t = -1.43, P < 0.05) and low dose group ((30.6 ± 1.0) g, t = -1.83, P < 0.05). TC levels of non-treatment, PBS control, high dose group, medium dose group and low dose group were (2.92 ± 1.18), (3.12 ± 0.73), (4.19 ± 1.86), (3.46 ± 0.72) and (2.57 ± 0.64) mmol/L, respectively; TG levels were (0.39 ± 0.13), (0.39 ± 0.08), (0.60 ± 0.21), (0.55 ± 0.19) and (0.41 ± 0.11) mmol/L, respectively; HDL-C levels were (1.67 ± 0.45), (1.54 ± 0.67), (0.93 ± 0.50), (1.02 ± 0.48) and (1.31 ± 0.64) mmol/L; TG levels of high dose group were higher than that of non-treatment group (t = 1.27, P = 0.03) and low dose group (t = 1.62, P = 0.01); TG levels of medium dose group was higher than PBS control (t = 0.16, P = 0.04), and TC levels of high dose group were higher than PBS control (t = 0.22, P = 0.01), non-treatment group (t = 0.22, P = 0.04) and low dose group (t = 0.20, P = 0.03), and HDL-C levels of high dose group were lower than PBS control (t = -0.61, P = 0.04) and non-treatment group (t = -0.74, P = 0.04); organic lipid ratio of each group were (2.27 ± 0.51)%, (2.06 ± 0.53)%, (2.90 ± 0.50)%, (2.60 ± 0.23)%, (2.24 ± 0.45)%; high dose group were higher than PBS control (t = 0.85, P = 0.00), non-treatment group (t = 0.64, P = 0.03) and low dose group (t = 0.67, P = 0.01); medium dose group was higher than PBS control (t = 0.54, P = 0.02). The plaque lipid content and calcium content which showed the progression of atherosclerosis and plaque rupture were elevated in medium and high dose groups.</p><p><b>CONCLUSION</b>Intratracheal instillation of nano-TiO(2) can induce dyslipidemia and accelerate the development of atherosclerosis and plaque rupture in ApoE-/-mice.</p>

Ewing's sarcoma of bone:treatment results and prognostic factors / 中华外科杂志

<p><b>OBJECTIVE</b>To determine the prognostic factors from the view of clinic and pathology.</p><p><b>METHODS</b>A retrospective analysis was performed on a data set of 78 patients with Ewing's sarcoma treated at Peking University People's Hospital Musculoskeletal tumor center between July 1998 and July 2007. Five-year overall survival (OS), recurrence rate and prognostic factors were analyzed in this study. Univariate and multivariate analysis were performed to determine the prognostic factors for OS.</p><p><b>RESULTS</b>Fifty-three cases were followed up, follow-up time ranged from 8.0 to 101.0 months (median 37.6 months). The 5-year overall survival rate and local recurrence rate were 33.7% and 20.8% respectively. Univariate showed age < 20 years, metastases free at diagnosis, tumor located at extremities, tumor size < 10 cm, adequate surgical margin had better survival rate (all P < 0.05). Multivariate analysis demonstrated that metastases at diagnosis, primary site and tumor size were independent prognostic factors for OS.</p><p><b>CONCLUSION</b>The independent prognostic factors Ewing's sarcoma are metastases at diagnosis, primary site, tumor size.</p>

Investigation on distribution of HBV genotype and serotype from Tibetan in Tongde, Qinghai / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the distribution of HBV genotype and serotype from Tibetan in Tongde, Qinghai.</p><p><b>METHODS</b>Nested polymerase chain reaction (nPCR) was used for amplification of S gene and C gene of HBV from sera carried by Tibetan chronic HBV carrier in Tongde, Qinghai, then the HBV DNA positive products were sequenced by direct sequencing. Genotype and serotype were identified by analysis of sequence result.</p><p><b>RESULTS</b>271, which come from 311 sera samples with positive HBsAg randomly selected from natural community, were amplified and sequenced in both S gene and C gene successfully, 10 (3.7%), 261 (96.3%) out of them were identified as genotype C, recombinant between genotypes C and D respectively; 259 (95.6%), 10 (3.7%), 2 (0.7%) belonged to serotype ayw2, adr, adw2 respectively.</p><p><b>CONCLUSION</b>The recombinant between genotypes C and D was the main genotype in Tibetan chronic carrier with hepatitis Bin Tongde, Qinghai; the serotype of this areas was consisted largely of ayw2.</p>

The Effect Analysis of Pollution Sources Clearance in Yingnahe Reservoir Area in Dalian / 环境与健康杂志

Objective To evaluate the method and result of pollution sources clearance in the reservoir area. Methods Calculated the areas of pollution sources such as pigsties, livestock barns, lavatories, holes for sewage and tombs in the reservoir area of the Yingnahe River, Dalian City after cleared them up in 2002. Collected the soil samples which were not disinfected after clearing up, and the samples disinfected with quicklime or bleaching powder. Evaluation was done according to the GB7959-1987 Standard for the Non-hazardous Treatment of Night Soil. Results The area of pollution source of each livestock barn, pigsty, lavatory, birdhouse, hole for sewage, tomb was 77.4, 74.2, 31.7, 32.1, 36.3 and 158.5 m2 respectively. The qualification rates of the E.coli and the egg of worm counts in the soil samples collected from pollution sources of pigsties disinfected and not disinfected after clearance were 85.94%, 90.31% and 96.88%, 99.38% respectively, the differences were significant. The qualification rates of the E.coli(95.78%)and the egg of worm(99.85%)in the disinfected soil samples collected from the pollution sources in the reservoir area after clearance were close with that of the control collected from the hillside wasteland in the reservoir area. Conclusion Clearance combined with disinfection can make the clearance of pollution sources in the reservoir area meet the request of related standard.