A nomogram for preoperative prediction of lymph node metastasis in patients with intrahepatic cholangiocarcinoma based on inflammation-related markers / 中华外科杂志

Objectives: To construct a nomogram for prediction of intrahepatic cholangiocarcinoma (ICC) lymph node metastasis based on inflammation-related markers,and to conduct its clinical verification. Methods: Clinical and pathological data of 858 ICC patients who underwent radical resection were retrospectively collected at 10 domestic tertiary hospitals in China from January 2010 to December 2018. Among the 508 patients who underwent lymph node dissection,207 cases had complete variable clinical data for constructing the nomogram,including 84 males,123 females,109 patients≥60 years old,98 patients<60 years old and 69 patients were pathologically diagnosed with positive lymph nodes after surgery. Receiver operating characteristic curve was drawn to calculate the accuracy of preoperative imaging examinations to determine lymph node status,and the difference in overall survival time was compared by Log-rank test. Partial regression squares and statistically significant preoperative variables were screened by backward stepwise regression analysis. R software was applied to construct a nomogram,clinical decision curve and clinical influence curve,and Bootstrap method was used for internal verification. Moreover,retrospectively collecting clinical information of 107 ICC patients with intraoperative lymph node dissection admitted to 9 tertiary hospitals in China from January 2019 to June 2021 was for external verification to verify the accuracy of the nomogram. 80 patients with complete clinical data but without lymph node dissection were divided into lymph node metastasis high-risk group and low-risk group according to the score of the nomogram among the 858 patients. Log-rank test was used to compare the overall survival of patients with or without lymph node metastasis diagnosed by pathology. Results: The area under the curve of preoperative imaging examinations for lymph node status assessment of 440 patients was 0.615,with a false negative rate of 62.8% (113/180) and a false positive rate of 14.2% (37/260). The median survival time of 207 patients used to construct a nomogram with positive or negative postoperative pathological lymph node metastases was 18.5 months and 27.1 months,respectively (P<0.05). Five variables related to lymph node metastasis were screened out by backward stepwise regression analysis,which were combined calculi,neutrophil/lymphocyte ratio,albumin,liver capsule invasion and systemic immune inflammation index,according to which a nomogram was constructed with concordance index(C-index) of 0.737 (95%CI: 0.667 to 0.806). The C-index of external verification was 0.674 (95%CI:0.569 to 0.779). The calibration prediction curve was in good agreement with the reference curve. The results of the clinical decision curve showed that when the risk threshold of high lymph node metastasis in the nomogram was set to about 0.32,the maximum net benefit could be obtained by 0.11,and the cost/benefit ratio was 1∶2. The results of clinical influence curve showed that when the risk threshold of high lymph node metastasis in the nomogram was set to about 0.6,the probability of correctly predicting lymph node metastasis could reach more than 90%. There was no significant difference in overall survival time between patients with high/low risk of lymph node metastasis assessed by the nomogram and those with pathologically confirmed lymph node metastasis or without lymph node metastasis (Log-rank test:P=0.082 and 0.510,respectively). Conclusion: The prediction accuracy of preoperative nomogram for ICC lymph node metastasis based on inflammation-related markers is satisfactory,which can be used as a supplementary method for preoperative diagnosis of lymph node metastasis and is helpful for clinicians to make personalized decision of lymph node dissection for patients with ICC.

Survival analysis of patients with intrahepatic cholangiocarcinoma treated with adjuvant chemotherapy after radical resection based on CoxPH model and deep learning algorithm / 中华外科杂志

Objective: To establish a predictive model for survival benefit of patients with intrahepatic cholangiocarcinoma (ICC) who received adjuvant chemotherapy after radical resection. Methods: The clinical and pathological data of 249 patients with ICC who underwent radical resection and adjuvant chemotherapy at 8 hospitals in China from January 2010 to December 2018 were retrospectively collected. There were 121 males and 128 females,with 88 cases>60 years old and 161 cases≤60 years old. Feature selection was performed by univariate and multivariate Cox regression analysis. Overall survival time and survival status were used as outcome indicators,then target clinical features were selected. Patients were stratified into high-risk group and low-risk group,survival differences between the two groups were analyzed. Using the selected clinical features, the traditional CoxPH model and deep learning DeepSurv survival prediction model were constructed, and the performance of the models were evaluated according to concordance index(C-index). Results: Portal vein invasion, carcinoembryonic antigen>5 μg/L,abnormal lymphocyte count, low grade tumor pathological differentiation and positive lymph nodes>0 were independent adverse prognostic factors for overall survival in 249 patients with adjuvant chemotherapy after radical resection (all P<0.05). The survival benefit of adjuvant chemotherapy in the high-risk group was significantly lower than that in the low-risk group (P<0.05). Using the above five features, the traditional CoxPH model and the deep learning DeepSurv survival prediction model were constructed. The C-index values of the training set were 0.687 and 0.770, and the C-index values of the test set were 0.606 and 0.763,respectively. Conclusion: Compared with the traditional Cox model, the DeepSurv model can more accurately predict the survival probability of patients with ICC undergoing adjuvant chemotherapy at a certain time point, and more accurately judge the survival benefit of adjuvant chemotherapy.

Effect of postoperative adjuvant chemotherapy on prognosis of patients with intrahepatic cholangiocarcinoma:a multicenter retrospective study / 中华外科杂志

Objectives: To examine the influence of adjuvant chemotherapy after radical resection on the survival of patients with intrahepatic cholangiocarcinoma(ICC) and to identify patients who may benefit from it. Methods: The clinical and pathological data of 654 patients with ICC diagnosed by postoperative pathology from December 2011 to December 2017 at 13 hospitals in China were collected retrospectively. According to the inclusion and exclusion criteria,455 patients were included in this study,including 69 patients (15.2%) who received adjuvant chemotherapy and 386 patients (84.8%) who did not receive adjuvant chemotherapy. There were 278 males and 177 females,with age of 59 (16) years (M(IQR))(range:23 to 88 years). Propensity score matching (PSM) method was used to balance the difference between adjuvant chemotherapy group and non-adjuvant chemotherapy group. Kaplan-Meier method was used to plot the survival curve,the Log-rank test was used to compare the difference of overall survival(OS) and recurrence free survival(RFS)between the two groups. Univariate analysis was used to determine prognostic factors for OS. Multivariate Cox proportional hazards models were then performed for prognostic factors with P<0.10 to identify potential independent risk factors. The study population were stratified by included study variables and the AJCC staging system,and a subgroup analysis was performed using the Kaplan-Meier method to explore the potential benefit subgroup population of adjuvant chemotherapy. Results: After 1∶1 PSM matching,69 patients were obtained in each group. There was no significant difference in baseline data between the two groups (all P>0.05). After PSM,Cox multivariate analysis showed that lymph node metastasis (HR=3.06,95%CI:1.52 to 6.16,P=0.039),width of resection margin (HR=0.56,95%CI:0.32 to 0.99,P=0.044) and adjuvant chemotherapy (HR=0.51,95%CI:0.29 to 0.91,P=0.022) were independent prognostic factors for OS. Kaplan-Meier analysis showed that the median OS time of adjuvant chemotherapy group was significantly longer than that of non-adjuvant chemotherapy group (P<0.05). There was no significant difference in RFS time between the adjuvant chemotherapy group and the non-adjuvant chemotherapy group (P>0.05). Subgroup analysis showed that,the OS of female patients,without HBV infection,carcinoembryonic antigen<9.6 μg/L,CA19-9≥200 U/ml,intraoperative bleeding<400 ml,tumor diameter>5 cm,microvascular invasion negative,without lymph node metastasis,and AJCC stage Ⅲ patients could benefit from adjuvant chemotherapy (all P<0.05). Conclusion: Adjuvant chemotherapy can prolong the OS of patients with ICC after radical resection,and patients with tumor diameter>5 cm,without lymph node metastasis,AJCC stage Ⅲ,and microvascular invasion negative are more likely to benefit from adjuvant chemotherapy.

Impact of adjuvant chemotherapy on prognosis in intrahepatic cholangiocarcinoma patients underwent radical resection / 中华外科杂志

Objectives: To investigate the clinical value of adjuvant chemotherapy(ACT) in patients with intrahepatic cholangiocarcinoma(ICC) who underwent radical resection and to explore the optimal population that can benefit from ACT. Methods: A retrospective cohort study method was adopted. The clinical and pathological data of 685 patients with ICC who underwent curative intent resection in 10 Chinese hepatobiliary surgery centers from January 2010 to December 2018 were collected;There were 355 males and 330 females. The age(M(IQR)) was 58(14) years (range: 22 to 83 years). Propensity score matching(PSM) was applied to balance the differences between the adjuvant and non-adjuvant chemotherapy groups. Log-rank test was used to compare the prognosis of the two groups of patients. A Bayesian network recurrence-free survival(RFS) prediction model was constructed using the median RFS time (14 months) as the target variable, and the importance of the relevant prognostic factors was ranked according to the multistate Birnbaum importance calculation. A survival prognostic prediction table was established to analyze the population benefiting from adjuvant chemotherapy. Results: Among 685 patients,214 received ACT and 471 did not receive ACT. A total of 124 pairs of patients were included after PSM, and patients in the ACT group had better overall survival (OS) and RFS than those in the non-ACT group(OS: 32.2 months vs. 18.0 months,P=0.003;RFS:18.0 months vs. 10.0 months,P=0.001). The area under the curve of the Bayesian network RFS prediction model was 0.7124. The results of the prognostic factors in order of importance were microvascular invasion (0.158 2),perineural invasion (0.158 2),N stage (0.155 8),T stage (0.120 9), hepatic envelope invasion (0.090 3),adjuvant chemotherapy (0.072 1), tumor location (0.057 5), age (0.042 3), pathological differentiation (0.034 0), sex (0.029 3), alpha-fetoprotein (0.028 9) and preoperative jaundice (0.008 5). A survival prediction table based on the variables with importance greater than 0.1 (microvascular invasion,perineural invasion,N stage,T staging) and ACT showed that all patients benefited from ACT (increase in the probability of RFS≥14 months from 2.21% to 7.68%), with a more significant increase in the probability of RFS≥14 months after ACT in early-stage patients. Conclusion: ACT after radical resection in patients with ICC significantly prolongs the OS and RFS of patients, and the benefit of ACT is greater in early patients.

Clinical Characteristics of Peripheral Hemogram and DNMT3A Gene Mutation in Patients with Primary AML Treated by FLT3-ITD-mt and FLT3-ITD-wt / 中国实验血液学杂志

OBJECTIVE@#To explore the efficacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of relapsed or refractory peripheral T-cell lymphoma(PTCL).@*METHODS@#The clinical data of 6 patients with relapsed or refractory PTCL undergoing allo-HSCT from Sep. 2014 to Sep. 2018 in the department of hematology, aerospace center hospital were retrospectively analyzed. Complications and disease-free survival after HSCT were observed.@*RESULTS@#All the patients could well tolerate the conditioning regimen and acquired hematopoietic recon-struction. Following up till December 2018, with a median time of 11.5 months (1-51); acute GVHD developed in 2 cases and chronic GVHD developed in 5 cases, Among 6 cases one case died of viral pheumonia and the other 5 patients remained disease-free survival. The longest disease-free survival time has reached 51 months.@*CONCLUSION@#allo-HSCT is a safe and effective method for relapsed or refractory peripheral T-cell lymphoma, which can be chosen as salvage treatment method for patients with primary resistance. Optimization of the conditioning regimen may result in better efficacy of allo-HSCT.

Change of Neutrophils/ Lymphocyte Ratio in Patients with DLBCL before and after CHOP or R-CHOP Chemotherapy and Its Effect on Survival of Patients / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyze the change of neutrophil/lymphocyte ratio (NLR) in patients with diffuse large B cell lymphoma (DLBCL) patients before and after CHOP or R-CHOP chemotherapy and its effect on survival of patients.</p><p><b>METHODS</b>Clinical data of 60 patients with DLBCL were collected and were retrospectively analyzed. According to median NLR, 60 patients were divided into the group L in 33 cases (NLR< 2.27) and group H in 27 cases (NLR≥ 2.27). The curative effect and survival rate by using CHOP or R-CHOP after chemotherapy were compared between the two groups.</p><p><b>RESULTS</b>In the group H, the total effective rate after chemotherapy (55.56%) was significantly lower than that of group L (87.88%), which showed that the difference were statistically significant (P<0.05); the cumulative survival rate of 1,2,3 years in the group H (70.37%, 59.26%, 37.04%) were significantly lower than that in the group L (93.94%, 87.88%, 60.61%) (P<0.05). The NLR≥ 2.27 before chemotherapy was the factor influencing the prognosis of patients with DLBCL (P<0.05).</p><p><b>CONCLUSION</b>The NLR≥ 2.27 before chemotherapy may be used as a factor influencing the prognosis of patients with DLBCL, and the high NLR may indicate poor clinical efficacy and worse prognosis.</p>

Efficacy of alpha-lipoic acid combined with tamoxifen citrate in the treatment of oligoasthenospermia / 中华男科学杂志

Objective@#To investigate the effect of alpha-lipoic acid (α-LA) combined with tamoxifen citrate (TC) in the treatment of oligoasthenospermia.@*METHODS@#From June to November 2016, we treated 60 patients with oligoasthenospermia in our Department of Andrology, 30 (the trial group) with oral α-LA (0.6 g, qd) + TC (20 mg, qd) and the other 30 (the control group) with oral L-carnitine (1g, bid) + TC (20 mg, qd). Before and after 3 months of medication, we examined the semen parameters of the patients and the levels of their seminal oxidative stress biomarkers, including methylenedioxyamphetamine (MDA) and total antioxidant capacity (TAC) in the seminal plasma. We also compared the pregnancy rate and adverse reactions between the two groups.@*RESULTS@#Totally, 57 of the patients completed the treatment, 28 in the trial group and 29 in the control. Compared with the baseline, the patients of the trial group showed significant improvement after 3 months of medication in the semen volume (［2.50 ± 0.71］ vs ［3.37 ± 0.70］ ml, P 0.05) except in TAC, which was markedly more improved in the former than in the latter (P 0.05). After 3 months of treatment, 3 pregnancies were achieved in the trial group and 1 in the control (10.7% vs 3.45%, P >0.05). No obvious adverse events occurred during the treatment.@*CONCLUSIONS@#Alpha-lipoic acid combined with tamoxifen citrate can evidently improve semen parameters in oligoasthenospermia patients by relieving oxidative stress injury.

Abnormal Expression and Clinical Significance of B Lymphocyte Stimulating Factor in B Cell-derived Malignant Hematologic Diseases / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the expression and clinical significance of B cell lymphocyte stimulating factor (BLyS) in B cell-derived malignant hematological diseases.</p><p><b>METHODS</b>Fifty-seven cases of newly diagnosed B cell-derived hematologic malignancies were admitted and treated in our hospital from March 2015 to 2016 July. including 17 cases of multiple myeloma(MM) (A group) and 40 cases of B cell non-Hodgkin's lymphoma(B-NHL) (B group), 30 healthy volunteers were enrolled in control group(C group). The BLyS level in peripheral blood of A,B and C groups was detected by ELISA kit; for patient with hematologic malignancies, the BLyS level was detected again after chemotherapy and was compared with level before chemotherapy.</p><p><b>RESULTS</b>The BLyS level in patients with B cell-derived hematologic malignancies significantly increased, as compared with healthy volanteers(P<0.05). After chemotherapy, the BLyS level in patients all significantly dicreased (P<0.05); the BLyS level in peripheral blood of DLBCL and FL patients was significantly higher than that in patients with B-NHL of other types(P<0.05); the BLyS level in peripheral blood of patients at III-IV stage was significantly higher than that in patients at I-II stage.</p><p><b>CONCLUSION</b>The BLyS expression in B cell derived hematologic malignancies significantly increases, moreover the its expression level in B-NHL patients at different stages and histologic types is different, suggesting that detection of BLyS expression level in patients in vivo possesses a certain guiding role for diagnosis, staging and treatment of B cell-derived hematologic malignancies.</p>

Combined transgenic inhibition of CaMKII and Ik1 on cardiac remodeling / 生理学报

This study was aimed to establish an experimental mouse model of combined transgenic inhibition of both multifunctional Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) and inward rectifier potassium current (Ik1), and to observe whether the specific inhibition of both CaMKII and Ik1 can bring about any effects on cardiac remodeling. Mice were divided into 4 groups: wild type (WT), CaMKII inhibited (AC3-I), Ik1 inhibited (Kir2.1-AAA) and combined inhibition of both CaMKII and Ik1 (AC3-I+Kir2.1-AAA). Mice in each group received electrocardiogram (ECG) and echocardiography examination. ECG in the condition of isoproterenol (ISO) injection was also checked. The whole cell patch clamp technique was used to measure Ik1 and the transient outward potassium current (Ito) from enzymatically isolated myocytes of left ventricle. In the condition of basal status, no significant changes of heart rate, PR interval and QRS interval were observed. No mouse showed ventricular arrhythmias in all of the 4 groups. After ISO injection, each group presented no significant ventricular arrhythmias either. The indexes measured by M-mode (motion-mode) and two-dimensional echocardiography had no significant differences among the four groups. Ik1 in AC3-I group was significantly higher than those in other three groups (P < 0.01) because of the results brought about by CaMKII inhibition. Among the latter three groups, both Kir2.1-AAA group and AC3-I+Kir2.1-AAA group had a significant reduced Ik1 compared with that of WT group, which was due to the Ik1 inhibition (P < 0.01). Ito in AC3-I group was higher than that of the other three groups (P < 0.01), but there were no significant differences in Ito among WT, Kir2.1-AAA and AC3-I+Kir2.1-AAA groups. Thus, combined transgenic myocardial CaMKII and Ik1 inhibition eliminated the up-regulation of Ik1 in CaMKII inhibited mice, and had no effects on cardiac remodeling including heart structure and function as well as arrhythmias at the basic and ISO conditions. The results of this study may provide a basis for the further investigation of combined inhibition of CaMKII and Ik1 in pathogenic cardiac remodeling.

Study of Ag-containing on casting cobalt chromium alloy on the surface structure and the cell toxicity in vitro / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To detect cobalt chromium alloy antimicrobial coating silver of the surface structure and the cell toxicity in order to provide a theoretical basis for clinical application.</p><p><b>METHODS</b>Plasma spraying technique was adopted to prepare cobalt chromium alloy antimicrobial coating silver. Scanning electron microscopy, energy dispersive analysis and X-ray diffraction analysis were used to evaluate the surface properties. The methyl thiazolyl tetrazolium and flow cytometry method was adopted to test the L929 cell proliferation and the influence of the cell cycle.</p><p><b>RESULTS</b>The surface of the coating was uniform and compact, combined perfectly with substrate material. The content of the surface was mainly Ag, Cr and a small amount of Ag(2)O, Cr(2)O(3). After cobalt chromium alloy was cultured in leach liquor for 1, 2 and 3 days, the statistical result showed that there was no significant different between the three groups. The cytotoxic level of negative control group was level 0 at each time point and that of other groups was level 1 at each time point. There was no significant difference between cobalt chromium alloy and cobalt chromium alloy antimicrobial coating silver in cell toxicity (P > 0.05). There was no statistical significance of the influence on cell cycle between cobalt chromium alloy with Ag coating [the G2's rate of cell cycle was (8.23 ± 0.39)%] and cobalt chromium alloy group [the G2's rate of cell cycle was (8.70 ± 0.46)%] (P > 0.05).</p><p><b>CONCLUSIONS</b>The surface of the coating was stable and there was no significant difference between cobalt chromium alloy widely used in clinic and cobalt chromium alloy with Ag coating of the influence on proliferation of L929 cell and cell cycle, the cell compatibility of cobalt chromium with Ag coating is well.</p>

Antibiotic-loaded cement articulating spacer made by a self-made mold system in the treatment of the infected hip replacement / 中华外科杂志

<p><b>OBJECTIVES</b>To summarize the experience and lessons of the using of antibiotic-loaded cement articulating spacer made by a self-made mold system for the treatment of the infected hip replacement, and to evaluate its efficiency and role in the two-stage revision of infected total hip arthroplasty (THA).</p><p><b>METHODS</b>The patients with infected THA treated with two-stage revision protocol from August 2005 to December 2009 were reviewed. All of the 127 patients were debridement thoroughly and followed by implantation of an antibiotic-loaded cement articulated spacer made by a self-made mold system; Two-stage revisions were not followed until the infection were controlled. Among of them, 106 patients, 107 hips were gotten fully followed up. Evaluations were made for the efficiency of infection control, convenience of making, implanting and removing of the spacers, occurrence of complications, the deal of the special circumstances, the function and satisfaction of the patients.</p><p><b>RESULTS</b>The 107 hips were gotten an average of 34.3 months' (3 - 55 months) follow-up. The infection control rate was 96.3% after the first-stage surgery, the infection control rate was 94.4% at last follow-up after two-stage revisions. The breakage rate of the spacer was 4.7%, dislocation rate was 2.8%, removal of the spacers with difficulty were seen in 15 patients (14.0%). The satisfactory rate of the patients was 93.5%.</p><p><b>CONCLUSIONS</b>Antibiotic-loaded cement articulating spacer made by a self-made mold system is an effective methods for the two-stage revision of the infected hip replacement, characterized by simple, good reproducible, high rates of infection control, better joint function after surgeries, high rate of patients satisfaction and other advantages. And it can decrease the complications, such as the breakage, spacer dislocation of hip joint and difficulty in removal of spacer at the second stage revision. Using of metallic internal fixation or allograft bone combined with spacer does not affect the results of infection controlling.</p>

Different prognostic factors are associated with early and late intrahepatic recurrence following curative hepatectomy for patients with hepatocellular carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate prognostic factors related to early and late intrahepatic recurrences after curative hepatectomy for patients with hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>A retrospective review was conducted on medical records of patients with HCC treated by curative hepatectomy from January 2002 to January 2009. Clinicopathologic data were evaluated for their possible association with postoperative intrahepatic recurrence in univariate and multivariate analysis using Cox proportional hazard model. Recurrence time calculated by Kaplan-Meier method was compared using Log-rank test. Receiver operator characteristic curve (ROC) analysis with calculation of the area under the curve (AUC), sensitivity, and specificity where appropriated and risk stratification were applied to assess predictive ability of prognostic factors.</p><p><b>RESULTS</b>All 101 patients underwent curative hepatectomy. During follow-up period, 75 patients developed postoperative intrahepatic recurrence, among whom, 63 experienced early recurrence (84.0%) and the remaining had late recurrence (16.0%). The 1-, 2-, 3-and 5-year cumulative recurrent rates were 48.5% (49/101), 62.4% (63/101), 70.3% (71/101) and 74.3% (75/101), respectively. Multivariate analysis identified that tumor residual resectional margin, increased BCLC staging and severity of concomitant liver cirrhosis as independent prognostic factors predicting early recurrence while age ≥ 60 years and presence of tumor capsule predicting late recurrence. Cutoff point values (PI ≥ 2.798) predicted early recurrence with AUC 0.897 (95%CI = 0.829 - 0.965), sensitivity 76.6%and specificity 88.9% calculated from ROC. Median recurrent time of early recurrence and late recurrence reached statistically difference after risk stratification, 20.2 months vs. 4.4 months (χ(2) = 29.198, P = 0.000), 46.6 months vs. 28.6 months (Log-rank test, χ(2) = 8.479, P = 0.004), respectively.</p><p><b>CONCLUSIONS</b>Postoperative recurrence for HCC after curative hepatectomy should be differentiated as early recurrence and late recurrence, since each is associated with different risk factors, indicating possible different mechanism responsible for postoperative recurrence. Risk stratification can be used for prediction of different type of recurrence.</p>

L-carnitine: safe and effective for asthenozoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>One of the important reasons for male infertility is asthenozoospermia, for which there is no specific cure for the time being. The authors explored the clinical effect of L-carnitine for infertile males with asthenozoospermia.</p><p><b>METHODS</b>A total of 135 patients with asthenozoospermia were randomly divided into Groups A (n = 68) and B (n = 67), the former treated with L-carnitine (2 g/d) and vitamin E, while the latter with vitamin E only, both for 3 months. All the patients received semen analyses before and after the treatment, and were observed for adverse effects. The pregnancy rates of their wives were recorded.</p><p><b>RESULTS</b>Group A showed a significantly increased percentage of forward motile sperm after the treatment (45.4% +/- 11.1%) as compared with pretreatment (28.6% +/- 9.2%) (P < 0.01), but no statistically significant differences were found in sperm density and the percentage of the sperm of normal morphology (P > 0.05). The rate of pregnancy was significantly higher in Group A (31.1%) than in B (3.8%) after the treatment (P < 0.01). No adverse events were found during the treatment.</p><p><b>CONCLUSION</b>L-carnitine, capable of significantly improving sperm motility and raising the rate of pregnancy, is a safe and effective therapeutic option for asthenozoospermia.</p>

Comparison of the metastatic characteristics of HCCLM3 cells and SMCC-7721 cells in nude mice model / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To compare the metastatic characteristics of HCCLM3 cells and SMCC-7721 cells in nude mice model.</p><p><b>METHODS</b>Nude mice were divided into two groups (n = 8, each), mice were transplanted with HCCLM3 cells (group A) and SMMC-7721 cells (group B). Tumor size, metastasis rate and other clinical parameters were compared between the two groups. Statistical analysis was performed with the help of SPSS 16.0 for Windows computer software (SPSS, Inc., Chicago, IL). P values of less than 0.05 were considered statistically significant.</p><p><b>RESULTS</b>Intrahepatic metastases rate was 100% (8 / 8), mean intrahepatic primary tumor volume was (6954+/-1945) mm(3) in group A, Intrahepatic metastases rate was 62.5% (5/8), and mean intrahepatic primary tumor volume was (6034+/-2035) mm(3) in the group B. There was no statistical difference in the primary liver tumor size and intrahepatic metastases rate (P = 0.20; t = 6.38, P = 0.37, respectively). The numbers of intrahepatic metastases and the involved lobes, and the volume of tumor were 4.5 (median), 3, and 975 mm(3) (median) respectively, in group A, and these were 1 (median), 1 and 274 mm(3) (median) respectively in group B. The difference between two groups was statistically significant (Z values, -2.818, -2.289, and -1.975, respectively).The rate of lung metastasis and other organ metastasis in the A group was significantly higher than that in group B (P less than 0.001, P less than 0.041, respectively).</p><p><b>CONCLUSION</b>HCCLM3 cells have higher metastatic potential than SMMC-7721 cells in nude mice.</p>

Effect of recombinant human interleukin 11 on recovery of platelets after peripheral blood hematopoietic stem cell transplantation / 中国实验血液学杂志

The aim of this study was to explore the effect of recombinant human interleukin 11 (rhIL-11) on platelet recovery after peripheral blood hematopoietic stem cell transplantation and its side-effects. 20 patients with hematologic malignancies treated by allogeneic peripheral blood stem cell transplantation (PBSCT) were randomly divided into test and control groups. The patients in test group were treated with rhIL-11 since the day 6 after PBSCT, while the patients in control group were given supporting treatment. The results showed that the average time of the platelet to recover to 20 x 10(9)/L was 22.8 days in test group and 27.3 days in control group (p < 0.01). The average time for platelet to recover to 50 x 10(9)/L was 25.7 days in test group, and 32.3 days in control group (p < 0.01). The average number of megakaryocytes was 15.6 in test group, and 7.8 in control group on day 30 after PBSCT (p < 0.01). In conclusion, the rhIL-11 is able to accelerate platelet recovery after peripheral blood hematopoietic stem cell transplantation.

A comparative study of the role of two femoral shortening techniques in total hip arthroplasty on patients with Crowe's IV congenital dislocated hips / 中华外科杂志

<p><b>OBJECTIVE</b>To compare proximal femoral resection with transverse subtrochanteric osteotomy in the treatment of Crowe's IV congenital dislocated hip (CDH) with total hip arthroplasty (THA).</p><p><b>METHODS</b>Thirty-six primary hip arthroplasties were performed in patients with Crowe grade IV CDH from April 2003 to October 2007. These patients were divided into two groups, one for proximal femoral resection (n = 20) and another for subtrochanteric osteotomy (n = 16). The leg length discrepancy, rotation center height and Harris score were measured pre- and post-operation to compare the two methods of osteotomy.</p><p><b>RESULTS</b>All surgeries were successfully performed. The average leg discrepancy was 0.6 cm (range from 0 to 1.5 cm) for subtrochanteric osteotomy group and 0.3 cm (range from -1.0 to 1.5 cm) for proximal femoral resection group, there was no significant difference between them (P > 0.05). There were also no statistically significant difference between the two groups in other index. The complication rates were much higher in the proximal femoral resection group. At the latest follow up, the Harris score of subtrochanteric osteotomy group was 90 +/- 6, and the proximal femoral resection group was 83 +/- 8. There was statistical difference between the two groups (P < 0.05).</p><p><b>CONCLUSIONS</b>Although both the femoral shortening techniques can restore the leg length of Crowe IV CDH, the subtrochanteric osteotomy technique has advantage of avoiding the potential complications in the high riding patients (high dislocation > 4 cm).</p>

Administration of NF-?B decoy oligodeoxynucleotides palliates ischemia-reperfusion injury of rat liver graft / 中华器官移植杂志

Objective To investigate the protective effect and mechanisms of NF-?B decoy oli- godeoxynucleotides(ODNs)on rat liver graft following ischemia-reperfusion injury.Methods Ani- mals were randomly divided into 3 groups(n=8 in each group):control group,ischemia-reperfusion (IR)group,and decoy ODNs group,in which donor grafts were transfected with 120?g NF-?B decoy ODNs before graft procurement.Following 2 h of reperfusion,Kupffer cells(KCs)were isolated,and NF-?B biding activity was detected with electrophoretic mobility shift assay(EMSA),and TNF-?、IL- 6 mRNA expression was assayed by using RT-PCR method.Meanwhile,the liver and serum samples were collected,the histopathologic change of liver was examined by light microscope,and liver func- tion was analyzed.Results The NF-?B biding activity,TNF-?,IL-6 mRNA expression,and the ALT,TBIL levels in serum were significantly increased following 2 h of reperfusion in IR group as compared with those in control group(P＜0.01).A large amount of degeneration and necrosis in hep- atocytes accompanied with obvious congestion in hepatic sinusoid occurred.However,these tested in- dexes were significantly ameliorated in decoy ODNs group as compared with those in IR group(P＜0.01),and the architecture of hepatic lobules was remained.Conclusions KCs NF-?B activation fol- lowing reperfusion plays an important role in IRI in liver transplantation.Decoy strategy shows appar- ent effect on suppression of NF-?B activation,and thus inhibits the production of downstream cyto- kines,which protects the liver graft from IRI.

Clinical experience of treating infection after total hip arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To present the experience in the management of the infected total hip arthroplasty (THA).</p><p><b>METHODS</b>Forty-three cases (44 hips) of infection after THA were reviewed. Eighteen women and 25 men with a mean age of 54 years (range, 24-81 years) were studied. Follow-up ranged from 5 months to 16 years (mean, 3.2 years). Treatment strategies included: one-stage revision (n = 7), two-stage revision (n = 15), resection arthroplasty (n = 13), debridement and retain prosthesis (n = 5), and others (n = 3).</p><p><b>RESULTS</b>Forty cases had positive culture result with 59 organisms including 19 staphylococcus epidermidis and 10 staphylococcus aureus. Thirty-six cases had been followed up, and no case had infection recurrence. Twenty-nine cases had postoperative Harris hip score averaged 78.5 (45-98).</p><p><b>CONCLUSIONS</b>The diagnosis and treatment of infection after hip replacement is very difficult. The violence and antibiotic resistant rate of the organisms is high. Two-stage reconstruction of the infected hip is useful and effective because of higher eradication rate of the infection and good postoperative functional result.</p>