Analysis of Agranulocytosis Time and Its Influencing Factors in Patients with Hematological Malignancies Treated with rhIL-11 combined rhG-CSF / 中国实验血液学杂志

OBJECTIVE@#To explore the intervention effect of recombinant human interleukin-11 (rhIL-11) and recombinant human granulocyte-colony stimulating factor (rhG-CSF) on the duration and severity of agranulocytosis in patients with hematological malignancies after chemotherapy, and to analyze the influencing factors.@*METHODS@#The data of hematological malignancy patients treated with rhIL-11 and rhG-CSF after chemotherapy in the hematology department of The First Hospital of Lanzhou University from July 2017 to July 2020 were collected retrospectively. The duration and differences of agranulocytosis in differeent groups were compared by univariate analysis, and the influencing factors of agranulocytosis duration were further analyzed by multiple regression analysis.@*RESULTS@#The duration of agranulocytosis in 97 patients was 6.47±2.93 days. The results of univariate analysis showed that there were no statistical differences in the duration of agranulocytosis among patients with different sex, age, height, weight, body surface area, body mass index (BMI), dose of rhG-CSF, dose of rhIL-11, spontaneous bleeding after administration of rhG-CSF and rhIL-11, and the duration of agranulocytosis in patients with different red blood cell count (RBC), hemoglobin(HGB) level, platelet count (PLT) and absolute neutrophil count (ANC), before administration of rhG-CSF and rhIL-11. There were significant differences in agranulocytosis time among patients with different disease types, chemotherapy cycle, fever after rhG-CSF and rhIL-11 administration, and different white blood cell count (WBC) baseline level before rhG-CSF and rhIL-11 administration (P＜0.05). Compared with patients with acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL), patients with acute myeloid leukemia (AML) had the longest duration of agranulocytosis, which was 7.07±3.05 d. Compared with patients with chemotherapy cycles of 4－6 and ≥7, patients with total chemotherapy cycle of 1－3 had the shortest duration of agranulocytosis, which was 5.25±2.48 d. Compared with patients without fever, patients with fever within 1 day after administration of cytokines and patients with fever within 2-5 days after administration of cytokines, the duration of agranulocytosis was the longest in patients with fever 6 days after administration of cytokines, which was 8.85±2.85 d. Compared with patients with WBC baseline <1.0×109/L, (1.0－1.9)×109/L and (2.0－3.9)×109/L, patients with WBC baseline ≥4.0×109/L had the shortest duration of agranulocytosis, which was 4.50±2.56 d. Multiple linear regression analysis showed that chemotherapy cycle, different fever after administration of rhG-CSF and rhIL-11, diagnosis of ALL and NHL, and WBC baseline level before administration of rhG-CSF and rhIL-11 were the influencing factors of the duration of agranulocytosis (P＜0.001).@*CONCLUSION@#The risk of prolonged agranulocytosis is higher in patients diagnosed with AML, with more chemotherapy cycles, lower WBC baseline before cytokines administration and fever later after cytokines administration, which should be paid more attention to.

Comparison of alignment and operative time between portable accelerometer-based navigation device and computer assisted surgery in total knee arthroplasty / 北京大学学报(医学版)

OBJECTIVE@#To explore the differences of alignment and operative time between portable accelerometer-based navigation device (PAD) and computer assisted surgery (CAS) in total knee arthroplasty (TKA).@*METHODS@#Data of patients using iASSIST (a kind of PAD) and OrthoPilot (a kind of CAS) for TKA in Peking University Third Hospital from December 2017 to December 2019 were retrospectively collected. The differences of preoperative general data, preoperative alignment, operative time and postoperative alignment were studied between the two groups.@*RESULTS@#A total of 82 patients were enrolled in our study, including 40 patients in the PAD group and 42 patients in the CAS group. Gender, age, body mass index (BMI), surgical side, preoperative hip-knee-ankle (HKA) angle and preoperative HKA angle deviation didn't show statistically significant difference between the PAD group and the CAS group (P>0.05). Postoperative HKA angle (180.8°±2.2° vs.181.8±1.6°, t=－2.458, P=0.016) and postoperative coronal femoral-component angle (CFA, 90.6°±1.8° vs. 91.6°±1.6°, t =－2.749, P=0.007) of the PAD group were smaller than those of the CAS group, but there was no significant difference in coronal tibia-component angle (CTA, 90.0°±1.3° vs.89.6°±1.4°, t=1.335, P=0.186) between the two groups. There was no significant difference in the rate of outliers (varus or valgus > 3°) for postoperative HKA angle (10.0% vs.11.9%, χ2 =0.076, P=0.783), CFA (12.5% vs. 14.3%, χ2=0.056, P=0.813) and CTA (2.5% vs. 0%, χ2=1.063, P=0.303). There was no significant difference in the accuracy of postoperative HKA angle (2.1° vs. 2.0°, t=0.055, P=0.956), CFA (1.4° vs. 1.8°, t=－1.365, P=0.176) and CTA (1.0° vs. 1.1°, t=－0.828, P=0.410) between the two groups. The precision of postoperative HKA angle (1.1° vs. 1.3°, F=1.251, P=0.267), CFA (1.3° vs. 1.4°, F=0.817, P=0.369) and CTA (0.8° vs. 0.9°, F=0.937, P=0.336) were also not significantly different. We also didn't find statistically significant difference in operative time between the two groups [(83.4±25.6) min vs. (86.5±17.7) min, t=－0.641, P=0.524].@*CONCLUSION@#PAD and CAS had similar accuracy and precision in alignment in TKA, and there was no significant difference in operative time, which indicates that PAD has a broad application prospect in TKA.

The Current Status and Research Progress of Antiviral Therapy in HCV-Associated Lymphoma --Review / 中国实验血液学杂志

Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease. HCV is not only related to hepatic malignancies but may also promote lymphoid neoplasms. Currently, research has confirmed HCV-related lymphoma, including marginal zone lymphoma (MZL), lymphoplasmacytic lymphoma (LPL), follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and Burkitt lymphoma (BL). Many types of research have shown that antiviral therapy can improve or even remission several HCV-related lymphomas. The direct-acting antiviral agents (DAAs) (such as NS5A protease inhibitors, NS4/4A protease inhibitors and viral polymerase inhibitors) have shown clinical advantages of high efficacy and low side effects for both virus elimination and tumor regression in several HCV-related lymphomas, which may make the selected HCV-related lymphoma patients treated without chemotherapy. In this review the research progress and development direction of antiviral therapy in treating HCV-related lymphoma has summarized briefly.

Predictive Factors of Early Weight Loss after Laparoscopic Sleeve Gastrectomy / 中国医学科学院学报

Objective To explore the clinical factors that can be used to predict the early weight loss after laparoscopic sleeve gastrectomy(LSG).Methods The clinical data of 64 obese patients undergoing LSG in Peking Union Medical College Hospital from August 2015 to January 2018 were retrospectively analyzed.We analyzed the relationship between different clinical factors and early weight loss,determined the independent predictors based on models,and estimated their test power by using the receiver operating characteristic(ROC)curves.Results Correlation analysis indicated that preoperative body mass index(=0.000,=0.000,=0.000),waist circumference(WC)(=0.000,=0.000,=0.000),whole body fat volume(=0.000,=0.006,=0.003),homeostatic model assessment for insulin resistance(HOMA-IR)(=0.000,=0.000,=0.002),and hypersensitive C-reactive protein(hsCRP)(=0.004,=0.002,=0.025)were negatively correlated with excess weight loss percentage(EWL %) after 3,6 and 12 months.Also,hsCRP after 6 months showed negative correlation with EWL % after 1 year(=0.029).Binary Logistic regression analysis showed that WC was an independent predictor of early weight loss(=0.018).ROC analysis showed that when the optimal cutoff value is 142.5 cm for WC, index was highest,with a sensitivity of 80% and a specificity of 87%.Patients were further divided into low WC group and high WC group based on this optimal cutoff value.The low WC group had significantly higher EWL% than the high WC group 3 months(=6.677,=0.000),6 months(=6.157,=0.000),and 1 year(=4.006,=0.000)after surgery.The low WC group also had significantly lower hsCRP than high WC group 6 months after surgery(=-3.510,=0.000).HOMA-IR showed no significant difference between these two groups(=-0.821,=0.412).Conclusions WC is an independent predictor of weight loss early after LSG.The patients with low WC have better weight loss effectiveness.

Effects of emodin on oxidative stress and inflammatory response in rats with acute spinal cord injury / 中国中药杂志

This paper was aimed to investigate the effects of emodin on oxidative stress and inflammatory response in rats with acute spinal cord injury（SCI）, and to explore the protective mechanism of emodin on neurons after SCI. Rat SCI models were established using a modified Allen's method. One hundred and ninety five Sprague-Dawley rats were randomly divded into sham (group A), model (group B), emodin group of 20 mg·kg⁻¹(group C), emodin group of 40 mg·kg⁻¹(group D), emodin group of 80 mg·kg⁻¹(group E). Functional recovery was evaluated using the Basso-Beattie-Bresnahan (BBB) scale and inclined plate test on the 3rd, 7th, 14th and 28th day. On the 7th day after SCI, neuron nylon body was observed with toluidine blue staining. The changes of myelinated nerve fibers were observed by transmission electron microscope. Nrf2, HO-1, NQO1, GFAP, NF-κB protein were detected by Western blot. The content of TNF-α, IL-1β, IL-6 were detected by ELISA. Immunofluorescence staining was performed to observe the expression of the GFAP, NG2 and ED-1. The BBB and inclined plate scores of group C, D and E were higher than group B on the 7th, 14th, 28th day,the difference was statistically significant (<0.05). On the 7th day, Nylon Body of group B and C started to fuse,the fusion of group D and E were significantly alleviated than group B and C. Transmission electron microscope showed that the changes of demyelination were obvious in group B and C, group D and E were significantly improved than group B and C. Western blot showed that Nrf2, HO-1, GFAP, NF-κB protein expression,group C, D, E compared with group B, NQO1 protein expression, group D, E compared with group B, the difference was statistically significant (<0.05). ELISA showed that the content of TNF-α, IL-6,group C, D, E compared with group B,the content of IL-1β,group D, E compared with group B, the difference was statistically significant (<0.05)；Immunofluorescence showed that the expressions of GFAP and NG2 in group C, D and E were higher than that in group B, and the group D and E were more obvious. The expression of ED-1 in group C, D, E were decreased significantly compared with group B. Emodin has protective effect on neurons after SCI. The mechanism may connect with activting Nrf2-ARE pathway, reducing the expression of NF-κB, ED-1, TNF-α, IL-1β, IL-6, and promoting the expression of GFAP and NG2.

Effects of tanshinone ⅡA sulfonate on nerve regeneration after cryopreserved sciatic nerve allograft in rats / 中国中药杂志

In order to investigate the protective effect of tanshinone ⅡA sulfonate on the sciatic nerve activty in rats after cryopreservation as well as the nerve regeneration and functional recovery after allograft and its possible mechanism, Sprague-Dawley (SD) rats were divded into four groups at different doses of tanshinone ⅡA sulfonate (A 0 mg·L⁻¹, B 80 mg·L⁻¹, C 160 mg·L⁻¹, D 480 mg·L⁻¹) cryopreserved at -80 °C for 24 weeks. Fresh control group nerve segments were harvested without cryopreservation. The ultrastructure and the viable cells of the nerve segments after cryopreservation were observed by electron microscopy, calcein-AM/propidium iodide staining, respectively. The expression of Bax and Bcl-2 was detected by Western blot. After cryopreservation, the nerve segments were cultured in vitro for one week, the mRNA and protein level of NGF and GDNF were detected by PCR and Western blot respectively. In addition, the above four cryopreserved groups transplanted to the Wistar rats by allografting (A', B', C', D'). At 16-week postoperation, muscle compound action potential latency and nerve conduction velocity were examined by electrophysiological. The number and the thickness of myelinated nerve fibers were analyzed by toluidine blue staining. The ultrastructure of the sciatic nerve by electron microscopy was observed. According to the results, after the cryopreserved for 24 weeks, compared with groups A and B, the nerve demyelination and vacuolation were weak, and the more viable cells, the decreased Bax and increased Bcl-2, the increased NGF and GDNF in group C and D. At 16-week poseoperation, the results demonstrated that the more larger and thickly regenerated myelinated axons, the shorter latency of muscle compound action potentials and higher nerve conduction velocity in groups C' and D' compared with groups A' and B'. According to these results, tanshinone ⅡA sulfonate exerted a significant protective effect on the viability of the nerves during cryopreservation at -80 °C and promoted nerve regeneration and functional recovery after transplantation especially in middle- and high-dose of tanshinone ⅡA sulfonate.

Additional Dose of Intravenous Tranexamic Acid after Primary Total Knee Arthroplasty Further Reduces Hidden Blood Loss / 中华医学杂志(英文版)

<p><b>Background</b>Total knee arthroplasty (TKA) is the most frequently performed procedure in treating advanced knee osteoarthritis. Excessive perioperative blood loss can sometimes lead to postoperative anemia. Tranexamic acid (TXA) is a potent fibrinolysis inhibitor which has been extensively used at the surgical incision and closure to lower overall blood loss in adult reconstruction surgery. Our previous study suggested that about two-thirds of the total blood loss (TBL) came from hidden blood loss (HBL) on postoperative days 1 and 2. The role of reducing HBL with TXA administration in postoperative TKA patients is unknown. The current study was designed to evaluate the efficiency and safety of supplemental intravenous (IV) TXA in further reducing HBL after primary TKA.</p><p><b>Methods</b>A prospective pilot study was conducted at a single institution on 43 consecutive patients who underwent unilateral TKA from September 2014 to February 2015. All patients were given 1 g of IV TXA 10-15 min before operation and another 1 g of IV TXA at the time of wound closure on the day of surgery. On postoperative days 1 and 2, the supplemental group (n = 21) was given additional 1 g of TXA intravenously twice a day, whereas the control group (n = 22) received an equal volume of saline. Drain output, hemoglobin (Hb), and hematocrit (HCT) were recorded preoperatively and 5 consecutive days postoperatively in both groups. HBL was calculated with the Gross formula. Pre- and post-operative lower extremity Doppler venous ultrasound was performed in all patients to detect deep vein thrombosis (DVT). The indexes were compared using the Mann-Whitney test, whereas the results of Hb and HCT were analyzed by repeated-measures analysis of variance. The difference was considered statistically significant if P < 0.05.</p><p><b>Results</b>The demographics and surgical characteristics of the two groups were comparable. Supplemental group had higher Hb level on postoperative days 1-5 compared to the control; however, the difference was not significant (F = 2.732, P = 0.106). The HCT of the supplemental group was significantly higher than that of the control group on postoperative day 5 (F = 5.254, P = 0.027). No significant difference was found in drainage volume and TBL, but the HBL was reduced in the supplemental group (supplemental 133.1 [71.8, 287.3] ml and control 296.0 [185.3, 421.4] ml, Z = 2.478, P = 0.013, median [interquartile range]). There was one DVT in the control group and none in the supplemental group. All patients were followed at 1 year after surgery, and no further complications were reported.</p><p><b>Conclusion</b>Based on the current study, additional doses of IV TXA could potentially further reduce HBL after primary TKA without increasing the risk of venous thromboembolism.</p>

Multidisciplinary Team and Nutrition Management for Bariatric Surgery / 中国医学科学院学报

Bariatric surgery remains the most successful treatment for morbid obesity. Multiple departments may be involved due to the presence of various co-morbidities and the complex procedure. Thus,the establishment of a multidisciplinary team based on endocrinology,gastrointestinal surgery,nutrition,and psychology is important to ensure a successful bariatric surgery. Although the bariatric surgery has definite effectiveness in decreasing body weight and improving comorbidities,patients may still face the risks including protein and/or micronutrient malnutrition and other complications after the bariatric surgery. The medium-and long-term follow-up and nutrition management after bariatric surgery mainly focus on the following two aspects: weight loss and improvement of obesity-related complications; and assessment and treatment of possible nutritional deficiencies and eating disorders.

Effectiveness of Laparoscopic Sleeve Gastrectomy in Treating Obesity and Its Co-morbidities / 中国医学科学院学报

Objective To analyze the effectiveness and safety of laparoscopic sleeve gastrectomy (LSG) in treating obesity and its co-morbidities.Methods The clinical data of obese patients undergoing LSG in Peking Union Medical College Hospital from August 2012 to August 2017 were retrospectively analyzed. Medium-term outcome measures included excess weight loss (%EWL),co-morbidity improvement,and complications.Results Seventy-five obese patients comprising 28 men[ body mass index(BMI):(47.3±7.5)kg/m ) ] and 47 women [BMI (41.1±7.0) kg/m ] were enrolled in this analysis. The common co-morbidities were liver dysfunction (53.3%),dyslipidemia (52.0%),obstructive sleep apnea (45.3%),type 2 diabetes mellitus (38.7%),and arterial hypertension (37.3%),which were improved by 75.0%,58.3%,83.3%,75.0% and 58.3% three years after surgery. The mean %EWL at 1,2,and 3 years after surgery was 81.6±34.7,80.9±30.2 and 79.7±30.8,respectively. The proportions of patients achieving successful weight loss were 81.7% (n=49),81.0% (n=34),and 79.3% (n=23) at 1,2,and 3 years (%EWL>50%). Early severe complications (Clavien-Dindo classification>2) occurred in 2.6% of patients,and the most common late complications was gastroesophageal reflux disease,which could be relieved by acid suppressants.Conclusion LSG is effective and safe in treating obesity and its co-morbidities.

Effects of Cold-inducible RNA Binding Protein on Cryopreserved Sciatic Nerve and Nerve Regeneration after Allograft / 中国康复理论与实践

@#Objective To investigate the effect of cold-inducible RNA binding protein(CIRP)on the viability of cryopreserved sciat-ic nerve and nerve regeneration after allograft. Methods Sciatic nerve segments of 15 mm from male Sprague-Dawley rats were placed in DMEM solution and pretreat-ed with 4 ℃, 15 ℃ and 32 ℃ for 24 hours (group A, group B and group C, respectively). Fresh nerve group (group D)without pretreatment was set up.The mRNA and protein level of CIRP was detected by RT-PCR and Western blotting,respectively.The above nerves were cryopreserved in liquid nitrogen for four weeks.The via-ble cells of the nerve segments after cryopreservation were observed by calcein-AM/propidium iodide staining. The expression of Bax and Bcl-2 was detected by Western blotting.After cryopreservation,the nerve segments were cultured in vitro for one week, the protein level of nerve growth factor (NGF) and glial cell line-derived neurotrophic factor(GDNF)was detected by Western blotting.In addition,the above four cryopreserved groups were transplanted to the Wistar rats by allografting(groups A',B',C'and D').Fresh nerve allograft group(E')and isograft group(F')were set up.At four-week post operation,the expression of CD4of the nerve and plasma level of interleukin(IL)-6 and interferon(IFN)-γ were detected by immunohistochemistry and ELISA,respectively.At 20-week postoperation, the muscle compound action potential (CMAP) and motor nerve conduction velocity (MNCV) were examined by electrophysiological examination. The number and the thickness of myelinated nerve fibers were analyzed by toluidine blue staining. The ultrastructure of the sciatic nerve was observed by electron microscopy. Results The mRNA and protein of CIRP were significantly higher in group C than in groups A and B(P<0.05).After 4 weeks of cryopreservation,compared with groups A,B and D,the viable cells increased,the expression of Bax decreased and the expression of Bcl-2 increased in group C (P<0.05). The expression of NGF and GDNF in-creased in group C than in groups A and B(P<0.05).At four-week postoperation,the expression of CD4and plas-ma concentration of IL-6 and IFN-γ significantly decreased in group C'than in group E'(P<0.05),however,no significant difference was found in group C'compared with groups D'and F'(P>0.05).At 20-week postopera-tion, CMAP, MNCV, the number of axon, and thickness of myelin sheath were significantly better in group C' than in groups A',B',D'and E'(P<0.05).Compared with groups A',B',D'and E',the myelinated nerve fibers were more, the fiber thickness was more uniform, the fiber distribution was wider, and the myelin sheath was thicker in groups C'and F'. Conclusion CIRP was induced at 32℃in the sciatic nerve,which exerted a significant protective effect on the viability of the nerves during cryopreservation,and promoted nerve regeneration and functional recovery after transplanta-tion.

Effect of Emodin on Spinal Cord Edema Induced by Acute Spinal Cord Injury in Rats / 中国康复理论与实践

Objective To investigate the effect of emodin on spinal cord edema induced by acute spinal cord injury (SCI) and its mechanism. Methods A total of 180 healthy female Sprague-Dawley rats were randomly divided into sham group(group A),model group(group B),and low-dose group(group C),middle-dose group(group D)and high-dose group(group E)of emodin,with 36 cases in each group.The SCI model was established with the modified Allen's method.Function-al recovery was evaluated with Basso-Beattie-Bresnahan(BBB)score and inclined plate test three days,seven days,14 days and 28 days after modeling.Three days after modeling,the pathological changes of the spinal cord were observed by HE staining; the water content of spinal cord was detected by dry-wet weight method, the blood-spinal cord barrier(BSCB)permeability was detected by Evans blue(EB)staining,and the expression of aquaporin-4 (AQP-4) and matrix metalloproteinase-2 (MMP-2) mRNA and protein were detected by RT-PCR and Western blotting respectively.Results The BBB score and inclined plate scores were better in groups C,D and E than in group B(P<0.05)seven days, 14 days and 28 days after modeling, especially in group E (P<0.05). Three days after modeling, HE staining showed that there was a large hemorrhage in the section of group B,the nerve cells were swollen and damaged, and a large number of inflammatory cells were infiltrated,the tissue gap was widened and the edema was severe. The above pathological changes were better in groups C,D and E than in group B,especially in group E.The spi-nal cord water content was higher in group B than in group A(P<0.05),and was lower in groups D and E than in groups B and C(P<0.05).EB content was higher in group B than in group A(P<0.05),and was lower in groups C, D and E than in group B (P<0.05). The expression of AQP-4, MMP-2 mRNA and protein were lower in groups C,D and E than in group B(P<0.05),especially in group E(P<0.05). Conclusion Emodin can alleviate spinal cord edema,and improve hind limb movement function after SCI,which could be related with the down-regulation of AQP-4 and MMP-2 expression,and the reduction of the permeability of BSCB.

Therapy-related Virus Reactivation in Lymphoma Patients with Hepatitis B Virus Infection--Review / 中国实验血液学杂志

The incidence of HBV infection in lymphoma patients is much higher than that in the general normal population. HBV reactivation caused by treatment is one of the common complications in considerable amount of lymphoma patients, which can induce fatal fulminating hepatitis in severe cases. The HBV reactivation in lymphoma patients is related to multiple factors, such as age, sex, HBV infectious state, HBV genotypes and gene mutations, and antitumor drugs. It's necessary to strengthen monitoring, prevention and treatment to HBV reactivation in the process of dealing with lymphoma. This review focuses on the epidemiological characteristics of lymphoma and HBV, as well as the risk factors, morbidity, pathogenesis, clinical feature, suggestion on prevention and treatment of HBV reactivation.

Effect of Icaritin on K562 Cell Proliferation and Intracellular Reactive Oxygen Species / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of icaritin (ICT) on proliferation of K562 cells and reactive oxygen species (ROS) in patients with chronic myeloid leukemia (CML).</p><p><b>METHODS</b>MTT assay was used to detect the effect of ICT on the proliferation of K562 cells. Flow cytometry was used to detect the apoptosis of K562 cells and intracellular ROS level. The expression of PARP protein was detected by Western blot.</p><p><b>RESULTS</b>ICT obviously inhibited the proliferation of K562 cells and induced their apoptosis, the expression of PARP protein was enhanced, and the intracellular ROS increased significantly.</p><p><b>CONCLUSION</b>The ICT showes the inhibitory effects on proliferation and apoptosis-inducing effects on K562 cells, and thier mechanism relats with the increase of reactive oxygen species in the cells.</p>

Four Methods for Calculating Blood-loss after Total Knee Arthroplasty / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Currently, various calculation methods for evaluating blood-loss in patients with total knee arthroplasty (TKA) are applied in clinical practice. However, different methods may yield different results. The purpose of this study was to determine the most reliable method for calculating blood-loss after primary TKA.</p><p><b>METHODS</b>We compared blood-loss in 245 patients who underwent primary unilateral TKA from February 2010 to August 2011. We calculated blood-loss using four methods: Gross equation, hemoglobin (Hb) balance, the Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) formula, and Hb-dilution. We determined Pearson's correlation coefficients for the four methods.</p><p><b>RESULTS</b>There were large differences in the calculated blood-loss obtained by the four methods. In descending order of combined correlation coefficient based on calculated blood-loss, the methods were Hb-balance, OSTHEO formula, Hb-dilution, and Gross equation.</p><p><b>CONCLUSIONS</b>The Hb-balance method may be the most reliable method of estimating blood-loss after TKA.</p>

Effect of Emodin Combined with AZT on the Proliferation and the Expression of BCL-2, NF-κB, TGF-β in the Leukemia Stem Cells-KG-1a cells / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of Emodin combined with 3'-azido-3'-deoxythymidine (AZT) on the proliferation and apoptosis of concentrated leukemia stem cells (CLSC)-human acute myeloid leukemia KG-la cells and expression of BCL-2, NF-κB and TGF-β.</p><p><b>METHODS</b>The tumor stem cell-like subpopulation in human leukemia cell line KG-1a was enriched with 5-fluorouracil (5-FU). The CD34⁺ CD38⁻ subpopulation in the KG-1a cells was detected with flow cytometry, the cell proliferation was detected by MTT method to study the of Emodin and AZT in the CLSC. The cell apoptosis was analyzed by flow cytometry. The expression of NF-κB, BCL-2 and TGF-β mRNA and proteins were measured with RT-PCR and Western blot respectively.</p><p><b>RESULTS</b>As compared with cells treated with mentioned above drugs alone, the inhibition of proliferation potential and apoptosis rate of cells in combination group markedly increase with time and concentration dependent member (P < 0.01), the expression of NF-κB, BCL-2 and TGF-β mRNA and proteins decreased.</p><p><b>CONCLUSION</b>Emodin combined AZT can synergistically inhibit the proliferation, induce cell apoptosis, and down regulate the expression of NF-κB, BCL-2 and TGF-β mRNA and proteins in the CLSC, the possible mechanism of synergistic effect may be associated with inhibiton of BCL-2 activation and down-regulation of the expression of NF-κB, and TGF-β.</p>

Profiling of microRNA-mRNA reveals roles of microRNAs in cervical cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cervical cancer is one of the most common malignant tumors in women. This study was designed to explore the expression profiles of microRNAs (miRNAs) and mRNAs and the gene regulation network in cervical tumorigenesis and to find candidate molecular markers and key tumorigenic genes in cervical cancer.</p><p><b>METHODS</b>miRNAs and mRNAs expression microarrays were used to detect the expression of miRNAs and mRNAs in normal and cancer cervical tissues. TargetScan 5.0 database (UK) was used to predict the target genes of the miRNAs, analyze their intersection with differentially expressed mRNAs and negatively correlate the intersection with miRNAs. Bioinformatic approaches were used to analyze functions and pathways of the target genes and establish miRNA-gene network.</p><p><b>RESULTS</b>Twenty-nine miRNAs and 2036 mRNAs were differentially expressed in normal and cervical tumor tissues. Among them, 13 miRNAs and 754 mRNAs were up-regulated in cervical tumor tissues and 16 miRNAs and 1282 RNA were down-regulated. The 327 target genes negatively related to miRNAs in the intersection were involved in functions and signal pathways. Down-regulated miRNAs targeted genes and up-regulated miRNAs targeted genes were involved in 415 and 163 functions, respectively, and in 37 and 17 significant pathways, respectively (P < 0.05, false discovery rate (FDR) < 0.05). We constructed the miRNAs-gene network and found that hsa-miR-15a, hsa-miR-106b and hsa-miR-20b were key nodes in the network.</p><p><b>CONCLUSIONS</b>The differentially expressed miRNAs and mRNAs in cervical cancer and related miRNA-gene network have been identified. They play important roles in cervical tumorigenesis and are involved in many important biological functions and signal transduction pathways. These findings lay a foundation for research on the molecular mechanism of miRNAs in the pathogenesis of cervical cancer.</p>

Risk factors for lower limb swelling after primary total knee arthroplasty / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Total knee arthroplasty (TKA) is a successful surgical technique for patients with advanced knee osteoarthritis; however, some peri-operative complications can not be predicted or avoided completely. This study aimed to investigate the factors affecting limb swelling after primary total knee arthroplasty, to guide and improve patient rehabilitation.</p><p><b>METHODS</b>Using a hospital database, we retroactively analyzed the mean changes in limb circumferences of 286 consecutive patients who underwent primary unilateral total knee arthroplasty between October 2007 and August 2009. The lower limb circumference change was calculated and analyzed statistically. The influence of age, gender, body mass index, the presence of deep vein thrombosis, methods of anti-coagulation, operation time, hidden blood loss, and type of prosthesis on post-operative lower limb swelling was studied.</p><p><b>RESULTS</b>Swelling was most pronounced from the third to the fifth post-operative day and usually occurred in both lower limbs. Swelling was significantly more pronounced in the operated limb than in the non-operated limb. The swelling above the knee was also significantly greater than that below the knee. The change in limb circumference at 10 cm above the knee was significantly different between the patients with body mass index ≤ 25 kg/m(2) and those with body mass index > 25 kg/m(2). However, the change in limb circumference at 10 cm below the knee was not significantly different between the two groups. There was no statistically significant difference in limb swelling between different age groups (P > 0.05). Similarly, gender, methods of anti-coagulation, the presence of deep vein thrombosis, the type of prosthesis, and operation time did not significantly affect post-operative limb swelling. Multivariate linear regression showed that the factors affecting post-operative limb swelling were body mass index and hidden blood loss.</p><p><b>CONCLUSIONS</b>Lower limb swelling after total knee arthroplasty is related to early post-operative hidden blood loss. The patient's hemoglobin level should be monitored. The degree of limb swelling is correlated with the patient's body mass index and the amount of hidden blood loss. Early intramuscular deep vein thrombosis formation has little effect on limb swelling.</p>

Impact factors for hidden blood loss after primary total knee arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the relative factors for hidden blood loss (HBL) after primary total knee arthroplasty (TKA).</p><p><b>METHODS</b>A retrospective study of 422 consecutive patients who underwent primary TKA between October 2007 and August 2009 was carried on. There were 60 male and 362 female patients with a mean age of 65.7 years. The HBL was calculated according to Gross formula. The effect of patient gender, age, body mass index (BMI), pre-operative diagnosis, unilateral or simultaneous bilateral TKA, tourniquet time, type of prosthesis, postoperative anticoagulation method and deep vein thrombosis (DVT) on the postoperative HBL were analyzed.</p><p><b>RESULTS</b>The HBL in patients underwent unilateral TKA was significantly lower than that in those underwent simultaneous bilateral TKA [(1284 ± 207) ml vs. (2248 ± 504) ml, P = 0.000]. Unvaried analysis showed that the HBL were associated with BMI, tourniquet time, prosthesis type and postoperative anticoagulation method. Multivariate linear regression analysis showed that the impact factors of postoperative HBL include BMI, tourniquet time and prosthesis type.</p><p><b>CONCLUSIONS</b>BMI, bilateral simultaneous TKA, tourniquet time and intercondylar open prosthesis impact the HBL after primary TKA. However, the influence of gender, age, diagnosis, postoperative anticoagulation method and DVT on the HBL are not significant.</p>

Intraoperative monitoring for safety of total hip arthroplasty using third-generation cementing technique / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Controversies on the safety of the cement application between cemented and uncemented total hip arthroplasty (THA) have been existing for decades. The purpose of this study was to observe the changes in mean arterial pressure (MAP), heart rate (HR) and oxygen pressure (PaO(2)) during cemented THA, and to evaluate the intraoperative safety of using the third-generation cementing technique and investigate whether the intraoperative risk is higher in acute femoral neck fracture patients than non-traumatic patients.</p><p><b>METHODS</b>Forty-two patients who underwent cemented THA between November 2005 and September 2007 were prospectively included in this study. The third-generation cementing technique as vacuum mixing and pulsatile lavage was used strictly. The MAP and HR were monitored and documented during each operation. Blood gas analysis was performed at exposure, cup implantation, stem implantation and wound closure. MAP, HR and PaO(2) were compared between pre- and post-cement application. Comparisons of MAP, HR and PaO(2) between patients with acute femoral neck fracture and non-traumatic patients were performed as well.</p><p><b>RESULTS</b>No intraoperative cardiopulmonary complication occurred in these cases. No obvious changes were observed in MAP, HR and PaO(2) after cement application. There was no significant difference in MAP, HR and PaO(2) between acute femoral fracture patients (18 patients) and non-traumatic patients (24 patients).</p><p><b>CONCLUSIONS</b>The results of this study suggested that the invasive blood pressure monitoring and blood gas analysis are essential for patients undergoing cemented THA, especially for patients with femoral neck fracture. The third-generation cementing technique is safe to use in THA.</p>

Selection of recombinant fowlpox virus coexpressing HIV-1 gag-gp120 and IL-6 / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To construct the recombinant fowlpox virus (rFPV) coexpressing HIV-1 gag-gp120 and hIL-6.</p><p><b>METHODS</b>The recombinant expressing plasmid pUTA-GE-IL6 was successfully constructed by inserting gag-gp120 gene and hIL-6 gene into the downstream of the combined promoter ATI-p7.5 and p7.5 tandem promoter respectively. After transfecting the plasmid into chicken embryonic fibroblast (CEF) cells preinfected with FPV 282E4 strain and selecting the recombinant virus under the pressure of BUdR. The recombinant virus was analyzed by nucleic acid probe hybridization and immunoblotting. In addition, the formation of virus-like particle and the expression of interested proteins in the recombinant virus-infected p815 cells were observed, and the immunogenicity of the recombinant virus was also analyzed.</p><p><b>RESULTS</b>There was colorable dot for the positive recombinant virus, immunoblotting analysis showed that the recombinant virus could expressed both gag-gp120 and IL-6. Virus-like particles (VLP) were formed in virus-infected cells, and the interested proteins could be expressed in mammalian cells infected by the recombinant virus. The immunity index from the immunized mice showed that the recombinant virus had good immunogenicity.</p><p><b>CONCLUSION</b>The recombinant fowlpox virus coexpressing gag-gp120 and IL-6 was successfully constructed, which may provide basis for the preparation of live vector genetic engineering vaccine and macromolecule particle vaccine against HIV-1.</p>