rhBMP-2-Conjugated Three-Dimensional-Printed Poly(L-lactide) Scaffold is an Effective Bone Substitute

BACKGROUND@#Bone growth factors, particularly bone morphogenic protein-2 (BMP-2), are required for effective treatment of significant bone loss. Despite the extensive development of bone substitutes, much remains to be desired for wider application in clinical settings. The currently available bone substitutes cannot sustain prolonged BMP-2 release and are inconvenient to use. In this study, we developed a ready-to-use bone substitute by sequential conjugation of BMP to a three-dimensional (3D) poly(L-lactide) (PLLA) scaffold using novel molecular adhesive materials that reduced the operation time and sustained prolonged BMP release. @*METHODS@#A 3D PLLA scaffold was printed and BMP-2 was conjugated with alginate-catechol and collagen. PLLA scaffolds were conjugated with different concentrations of BMP-2 and evaluated for bone regeneration in vitro and in vivo using a mouse calvarial model. The BMP-2 release kinetics were analyzed using ELISA. Histological analysis and microCT image analysis were performed to evaluate new bone formation. @*RESULTS@#The 3D structure of the PLLA scaffold had a pore size of 400 lm and grid thickness of 187–230 lm. BMP-2 was released in an initial burst, followed by a sustained release for 14 days. Released BMP-2 maintained osteoinductivity in vitro and in vivo. Micro-computed tomography and histological findings demonstrate that the PLLA scaffold conjugated with 2 lg/ml of BMP-2 induced optimal bone regeneration. @*CONCLUSION@#The 3D-printed PLLA scaffold conjugated with BMP-2 enhanced bone regeneration, demonstrating its potential as a novel bone substitute.

Establishment and validation of a nomogram to predict overall survival of patients with gastric neuroendocrine neoplasms / 中华胃肠外科杂志

Objective: To establish a novel nomogram to predict overall survival of patients with gastric neuroendocrine neoplasms (g-NEN). Methods: A case control study was conducted. Clinicopathological and follow-up data of patients with g-NEN who were treated in two academic medical centers in Southern China between July 2008 and June 2018 were retrospectively collected, including 174 patients from Sun Yat-sen University Cancer Center and 102 patients from the First Affiliated Hospital of Sun Yat-sen University. Univariate survival analysis using Kaplan-Meier method and multivariate analysis using Cox regression were performed to identify prognostic factors. A nomogram was subsequently established based on prognostic factors. Harrell's concordance index (C-index), receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used to verify the performance of the model according to differentiation, calibration and clinical utility. Results: A total of 276 patients were enrolled in the study, of whom 189 patients were male and 87 were female. The age at diagnosis was below 60 years old in 150 patients and 60 years or older in 126 patients. There were patients diagnosed with gastric neuroendocrine carcinoma (g-NEC) and 101 patients with gastric neuroendocrine tumor (g-NET). The number of patients with primary tumor locating at upper, middle and lower parts of stomach was 131, 98 and 47, respectively. As for TNM stage, 72 patients were categorized as stage I, 26 patients stage II, 93 patients stage III, and 85 patients stage IV. Univariate analysis indicated that age, pathological type, primary site, Ki-67 index, T stage, N stage, and M stage were associated with overall survival of g-NEN patients (all P<0.05). Multivariate regression analysis testified that high Ki-67 index, advanced T stage and advanced M stage were independent prognostic factors (all P<0.05). The C-index of the nomogram was 0.806 (95%CI: 0.769-0.863). The calibration curve of the nomogram showed that the predicted survival rate was consistent with the actual survival rate in g-NEN patients. The ROC curves and DCA showed that the nomogram had better differentiation and clinical utility than the American Joint Committee on Cancer (AJCC) 8th TNM staging system (the area under the ROC curve was 0.862 vs. 0.792). Conclusion: The first nomogram to predict overall survival of patients with g-NEN is established and verified in this study, which provides individual prediction of 3-year overall survival rate and is applicable to both g-NET and g-NEC patients.

Fatty Acid Increases cAMP-dependent Lactate and MAO-B-dependent GABA Production in Mouse Astrocytes by Activating a G(αs) Protein-coupled Receptor

Medium-chain fatty acids (MCFAs) are mostly generated from dietary triglycerides and can penetrate the blood-brain barrier. Astrocytes in the brain use MCFAs as an alternative energy source. In addition, MCFAs have various regulatory and signaling functions in astrocytes. However, it is unclear how astrocytes sense and take up MCFAs. This study demonstrates that decanoic acid (DA; C10), a saturated MCFA and a ligand of G(αs) protein-coupled receptors (G(αs)-GPCRs), is a signaling molecule in energy metabolism in primary astrocytes. cAMP synthesis and lactate release were increased via a putative G(αs)-GPCR and transmembrane adenylyl cyclase upon short-term treatment with DA. By contrast, monoamine oxidase B-dependent gamma-aminobutyric acid (GABA) synthesis was increased in primary cortical and hypothalamic astrocytes upon long-term treatment with DA. Thus, astrocytes respond to DA by synthesizing cAMP and releasing lactate upon short-term treatment, and by synthesizing and releasing GABA upon long-term treatment, similar to reactive astrocytes. Our data suggest that astrocytes in the brain play crucial roles in lipid-sensing via GPCRs and modulate neuronal metabolism or activity by releasing lactate via astrocyte-neuron lactate shuttle or GABA to influence neighboring neurons.

High level IFN-γ may be one of the characteristics of chronic brucellosis / 中国人兽共患病学报

We sought to compare the level of peripheral blood gamma interferon(IFN-γ),interleukin 4 (IL-4),TGF-β1,IL-10 and IFN-γ/IL-4 between acute brucellosis and chronic brucellosis to look for biochemical markers for chronic brucellosis.A total of 42 acute brucellosis and 42 chronic brucellosis cases were selected randomly from the Endemic Disease Prevention and Control Center of Ulanqab City as the research subjects with 20 local healthy persons as healthy control.Comparisons of IFN-γ,IL-4,TGF-β1,IL-10 and IFN-7/IL-4 in the three groups were tested by One-Way ANOVA analysis.Parameters of IL-4,IFN-γ,TGF-β1,IL-10 and IFN-γ/IL-4 in peripheral blood were analyzed with T-test between acute brucellosis with chronic brucellosis.Results showed that the mean of IFN-,IL-4,TGF-β1 and IFN-γ/IL-4 was significant difference in the three groups(F =6.86,11.90,12.25,4.60,P＜0.01),but not of IL-10(F=2.72,P＞0.05).The mean of IFN-γ,IL-4 andIFN-7/IL-4 was significant difference between acute brucellosis with chronic group(t=-1.99,82,-3.3,P＜0.05),but not of TGF-β1 and IL-10(t=-1.90,-1.81,P＞0.05).Combined with TGF-β1 and IL-10 levels,high level IFN-γ may be regarded as one of the biochemical markers for chronic brucellosis.

Analysis of Pregnancy Outcomes among Interracial Couples in Korea

Although the prevalence of interracial marriages in Korea is increasing, little is known regarding the pregnancy outcomes of interracial couples. The aim of this study was to investigate the differences in pregnancy outcomes between Korean and interracial Korean-foreign couples. Data for infants born in 2011 and 2012 were obtained from the national birth registry of the Korean Statistical Office. The couples were subdivided into Korean father-Korean mother, Korean father-foreign mother, and foreign father-Korean mother groups. Pregnancy outcomes included neonates with low birth weight ( 4,000 g). In 2010 and 2011, 888,447 Korean father-Korean mother, 36,024 Korean father-foreign mother, and 4,955 foreign father-Korean mother neonates were delivered in Korea. After adjustment for parental age, educational level, parity, gestational age at delivery, and neonatal sex, the birth weights were found to be different between groups, with the highest number of foreign father-Korean mother and lowest number of Korean father-foreign mother pregnancies. Based on multivariate logistic regression analysis, the risk of low and large birth weights was higher in the Korean father-foreign mother and foreign father-Korean mother groups, respectively, compared with that in the Korean father-Korean mother group. There are significant differences in pregnancy outcomes including birth weights between Korean and interracial Korean-foreign couples.

A case of vulvar hematoma with rupture of pseudoaneurysm of pudendal artery

Vulvar hematomas are uncommon outside of the obstetric population and may be the result of trauma to the perineum. Vulvar hematomas most often present with low abdominal pain and urologic and neurologic symptoms. The vulva has rich vascularization that is supplied by the pudendal artery, a branch of the anterior division of the internal iliac artery. We describe a rare case of a 15-cm-sized vulvar hematoma with the suggested rupture of a pseudoaneurysm of the left pudendal artery without trauma injury. A 14-year-old girl presented with sudden pain and swelling in her left labium and was successfully treated with selective arterial embolization and surgical evacuation. We provide a literature review and discuss patient treatment and management strategies.

Effects of xihuangwan in assistant treatment of patients with advanced breast cancer / 中国中药杂志

In order to explore the possibility of Xihuangwan (XHW)'s application in assistant therapy in patients with breast cancer, short- and long-term clinical efficacy were assessed in this study. Eighty and four patients with advanced breast cancer were selected in this study. They were divided into control group and treatment group randomly and evenly. All patients received surgical treatment followed by chemotherapy regimen composed of PTX + EPI + CTX (TEC regimen). Treatment group received additional assistant treatment of XHW. Short-term clinical efficacy was assessed by KPS, lesion stabilizing rate and side effects in 3-month follow-up study. Long-term clinical efficacy was assessed by overall survival (OS) and free-progression survival (FPS). KPS increased significantly after treatment in all patients (P < 0.05), more significantly in treatment group than in control group after treatment (P < 0.05); lesion stabilizing rate in treatment group increased significantly in treatment group than in control group (92.86% vs. 85.71%, P < 0.05); there was no significant difference between control group and treatment group in occurrence of side effects. Compared with control group, OS and FPS increased significantly in treatment group. Data in this study showed that XHW was suitable in treatment of advanced breast cancer due to its satisfactory short-term and long-term therapeutic effects.

Effect of curcumin in inducing apoptosis of MDA-MB-213 cells by activating endoplasmic reticulum stress / 中国中药杂志

<p><b>OBJECTIVE</b>To explore the possible mechanism of curcumin in inducing the apoptosis of breast cancer cell MDA-MB-231.</p><p><b>METHOD</b>Curcumin of different concentrations at 0, 10 25, 50, 100, 150, 200 micromol x L(-1) were used to intervene breast cancer cells MDA-MB-231 for 24 hours. MTT was used to observe its effect on the proliferation of breast cancer cells. The flow cytometry was used to detect its effect on the cell apoptosis. The real-time quantitative PCR and Western blot was used to assess the expression levels of GRP78 and CHOP in breast cancer cells.</p><p><b>RESULT</b>Curcumin could inhibit the proliferative ability of breast cancer cells by inducing them in a concentration-dependent manner. Curcumin could significantly increase the expression levels of GRP78 and CHOP in breast cancer cells.</p><p><b>CONCLUSION</b>Curcumin could induce the apoptosis of breast cancer cells MDA-MB-231 by activating endoplasmic reticulum stress.</p>

Epidemiological survey of human brucellosis in Wulanchabu City of Inner Mongolia in 2010 / 中国地方病学杂志

Objective To understand the morbidity of human brucellosis in Wulanchabu City of Inner Mongolia in order to provide a basis for development of prevention and control measures.Methods According to the requirements in Baseline Survey Programme of Human Brucellosis in Inner Mongolia Autonomous Regionbetween November and December in 2010,stratified cluster sampling method was used to selected three townships according to the conditions of brucellosis(mild,moderate and serious) in 11 flags(cities,counties,districts) of the city.Three villages were extracted from each township.There were at least 200 persons aged 10 and older were investigated in every township.At least 600 people were investigated in every flag(city,county,district).Respondents were investigated about their awareness rate of basic knowledge about brucellosis,risk factors and common sense of prevention and treatment of the disease by using health education questionnaire.Based on the principle of informed consent,we collected respondents venous blood for preliminary screening using Hu red tablets.Brucellosis was confirmed with standard tube agglutination test and positive result was confirmed if 1:100 antibody concentration was two + or more.Prevalence,false negative rate as well as different age,gender,occupational incidence was calculated based on the network reported results of brucellosis in 33 townships of Wulanchabu in 2010.Results We distributed 6998 questionnaires and 6763 questionnaires were effective.The witting rate of basic knowledge about brucellosis was 57.99％(15 687/27 052); the witting rate of risk factors about brucellosis was 44.33％ (29 978/67 630); the witting rate for prevention and control of brucellosis was 41.66％(28 176/67 630),and total witting rate was 45.49％(73 841/162 312).The morbidity of brucellosis in Wulanchabu City was 91.39/10 000 (785/85 894) in 2010.Five hundred and ninety-one were serologically positive and the infection rate was 8.48％ (591/69 972).Nine hundred and three cases of patients were diagnosed with brucellosis and the prevalence rate of brucellosis was 105.13/10 000 (903/85 894).Missing report 377 cases,and the false negative rate was 48.03％ (377/785) in 2010.Men infection rate was 71.07％(420/3755) and women infection rate was 28.93％(171/3217).The infection rate[97.63％(577/591)] of people aged 31 and older was significantly higher than that [2.37％(14/591)] of the people aged 30 and younger.Infection rate of people engaged in aquaculture was 8.61％ (582/669).The infection rate of people working in livestock processing industry was 2.91％ (2/103).The infection rate of people working in animal by-product circulation was 2.85％ (2/70).The Infection rate of people working in other industries was 4.59％(5/109).Conclusions In Wulanchabu City,the morbidity of brucellosis and missing report rate are both high.The infection rate of people engaged in aquaculture is high and man morbidity is high.The awareness rate about prevention and treatment knowledge of brucellosis is low.We should carry out health education to inhabitants in endemic areas to improve their self-protection awareness and reduce the incidence of brucellosis.

Application of multiplex polymerase chain reaction to identify Brucella / 中国地方病学杂志

Objective To evaluate the effect of multiplex polymerase chain reaction(Multiple-PCR) in identification of Brucella strains.Methods Six standard Brucella strains (Brucella abortus,Brucella melitensis,Brucella suis,Brucella canis,Brucella ovis,Brucella neotomae) were used as positive controls and Escherichia coli O∶157 and Yersinia enterocolitica O∶9 were used as negative controls.A total of 29 Brucella strains were tested.Brucella strains were amplified by BCSP31-PCR and the species of Brucella with positive results were identified with Multiple-PCR method.Results The results of all 29 amplified Brucella strains were positive with BCSP31-PCR.The identified results of all Brucella strains were positive with Multiple-PCR,including 20 strains of Brucella melitensis,5 isolates of Brucella suis,3 strains of Brucella abortus and 1 strain of Brucella canis.Conclusion Multiple-PCR method is a rapid,specific,simple and low risk method for identification of Brucella species.

An epidemiological investigation of human brucellosis in Ulanqab, Inner Mongolia 2011 / 中国地方病学杂志

Objective To investigate the epidemiological characteristics of human brucellosis in Ulanqab of Inner Mongolia.Methods Three hundred and twenty patients with suspected brucellosis were selected,who had registered in the Ulanqab Center for Endemic Disease Control of Inner Mongolia from April to June 2011.The investigation covered general situation,such as gender,age,occupation and main clinical symptoms and so on.Blood samples were collected,and Rose Bengal plate agglutination test(RBPT) was used for serum screening.Those who were tested positive in RBPT were confirmed with tube agglutination test (SAT).Brucellosis was diagnosed according to Diagnostic criteria for Brucellosis (WS 269-2007).Data were analyzed with statistical software(SPSS 17.0).Results One hundred and thirty-four cases were positive in RBPT of the 320 people surveyed,of which 93 cases were positive in SAT; antibody titers were higher than 1 ∶ 100(++),therefore they were diagnosed as brucellosis,and the ratio was 29.1％(93/320).The number of patients with suspected brucellosis who were negative in SAT test was 41,and the ratio was 12.8％ (41/320).Among the 93 people who were infected,the constituent ratio of farmers and herdsmen who engaged in livestock was the highest,accounted for 63.4％(59/93) and 24.7％ (23/93) of the total number of patients ; infection rate of male (30.9％,55/178) was higher than that of females (26.7％,38/142) ; the number(39) of brucellosis patients who were over the age of 51 was the highest,and the ratio is 42.0％.The onset season mainly in May and August; main route of exposure was bare hands lambing,midwifery and contact with infected sheep pollutants.Conclusions Sheep is the main source of human Brucella infection in Ulanqab.It is the key to control the spreading of brucellosis through improving awareness of disease prevention among farmers and herdsmen as well intensifying the prevention and control of Brucella infection between livestock.

Hepatitis A virus infection during pregnancy in Korea: Hepatitis A infection on pregnant women

OBJECTIVE: Although there is a large body of data on acute hepatitis A virus (HAV) worldwide, data regarding the occurrence of HAV during pregnancy is limited. It is commonly acknowledged that HAV is not associated with severe outcomes or complications during pregnancy. In contrast, there are several reported cases of vertical HAV transmission. Moreover, it has been recently reported that HAV infection during pregnancy is associated with gestational complications. In Korea, the incidence of HAV infection has increased from 317 cases in 2002 to 13,117 cases in 2009. However, HAV infection during pregnancy is rarely reported in Korea. METHODS: This study was conducted as a retrospective cohort series of pregnant women presenting to Korea University Medical Center between January 2000 and October 2009 in whom a diagnosis of HAV infection was made. RESULTS: During study period, there were 12 cases of HAV in pregnant women, including two cases with preterm contraction, two cases with cholestatic hepatitis, and one case with fetal ascites and intra-abdominal calcification. CONCLUSION: HAV infection during pregnancy is associated with high prevalence of maternal and fetal complications. Because the incidence of HAV infection in women of reproductive age is increasing, a further focus on preventing HAV infection during pregnancy is warranted.

Comparison of the Seeplex HPV4A ACE and the Cervista HPV assays for the detection of HPV in hybrid capture 2 positive media / 부인종양

OBJECTIVE: To validate the efficacy of Seeplex HPV4A ACE for the detection of high-risk (HR) human papillomavirus (HPV) and HPV 16 and/or HPV 18 genotypes as compared to the PCR method and the Cervista HPV assays in cervical swab samples. METHODS: Besides liquid-based cytology, additional 97 cervical swab samples were collected for HPV genotyping by HPV4A ACE, Cervista HPV assays, and PCR method. To check the statistical differences, we also conducted the paired proportion test, Cohen's kappa statistic, and a receiver operating characteristic curve. RESULTS: Seeplex HPV4A ACE and the Cervista HPV HR showed substantial agreement with PCR for detection of HR HPVs (88.3%, kappa=0.767 and 81.7%, kappa=0.636, respectively). Seeplex HPV4A ACE also showed substantial agreement with the Cervista HPV 16/18 test (89.5%, kappa=0.628). Additionally, the sensitivity and specificity of Seeplex HPV4A ACE and Cervista HPV HR were 91.4% vs. 84.5% and 73.4%, vs. 72.7%, respectively, when those higher than low-grade squamous intraepithelial lesions were regarded as abnormalities. HPV genotyping for HPV 16/18 detected cervical intraepithelial neoplasias (CINs) better than HR HPV tests (66.7% vs. 24.6% by HPV4A ACE, 52.6% vs. 25.9% by Cervista HPV assays in CIN II or more, relatively). CONCLUSION: Seeplex HPV4A ACE is an effective method as the PCR and the Cervista HPV assays for the detection of HR HPVs and for genotyping of HPV 16 and 18.

Experience of Verbal Abuse, Emotional Response, and Ways to Deal with Verbal Abuse against Nurses in Hospital / 산업간호학회지

PURPOSE: This study tries to identify experience of verbal abuse, emotional response, and ways to deal with verbal abuse against nurses in hospitals. METHODS: This study was a descriptive research and conducted from April to July 2011. One hundred and seventeen nurses with over one-year experience in general wards were selected and evaluated. The data were analyzed using descriptive analysis, independent t-tests, and one-way ANOVA. RESULTS: The nurses' experience rate of verbal abuse during the entire period of work in hospitals was 98.3%. The majority of the nurses were verbally abused by patients (70.9%), followed by patients' relatives (65.8%), physicians (61.5%), and coworkers (58.1%). Overall negative emotional response score of nurses after verbal abuse was 38.82+/-8.28. Ways to deal with verbal abuse were as follows: suppression was 74.4%, complaining of an injustice to close people, 67.5%, and ignoring, 43.6%. CONCLUSION: Nurses have significantly been exposed to verbal abuse while working in hospitals. Therefore, hospital managers and nurse managers are required to inform other staff and visitors in hospitals the real condition of verbal abuse against nurses and provide a safe work environment by developing the report and disposal system of verbal abuse.

Analysis of failed arterial embolization for postpartum hemorrhage / 대한산부인과학회지

OBJECTIVE: To investigate what factors are associated with a failed arterial embolization for postpartum hemorrhage (PPH) and to attempt to estimate efficacy of arterial embolization. METHODS: Between 2004 and 2008, 60 patients at Korea University Medical Cencter underwent arterial embolization to control obstetrical hemorrhage. In all cases, arterial embolization was performed because of intractable hemorrhage unresponsive to conservative management. Medical records and angiographic results were reviewed. Arterial embolization failure was defined as the requirement for subsequent surgical procedure to control PPH with the procedure, and its results. RESULTS: Arterial embolization was attempted in 60 of deliveries. Failures occurred in 7 of 60 cases (11.7%) and in 4 of 7 cases (57.1%) of abnormal placentation (placenta previa totalis with or without placenta accrete or increta). Comparison of the failed and successful arterial embolization groups showed no differences in maternal characteristics, clinical status, and angiographic finding. Amount of total transfusion in failed arterial embolization group were larger than successful group although hemoglobin before embolization was not different. CONCLUSION: The only factor significantly associated with failed arterial embolization was an abnormal placentation. Arterial embolization is a safe and highly effective method to control PPH.

Relationship between Metabolic Syndrome and Bone Mineral Density in Middle-aged Women / 대한폐경학회지

OBJECTIVES: To determine the relationship between metabolic syndrome (MS) and bone mineral density (BMD) in middle-aged women. METHODS: Three hundred eight premenopausal women were included in this study, including 268 women without MS and 40 women confirmed to have MS according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria. Clinical markers including anthropometric parameters, the serum lipid profile, and glucose level were determined and analyzed with the BMD at the lumbar spine and femoral neck. RESULTS: There was no significant difference in femoral neck or lumbar BMD between the controls and women with MS. In correlation tests, the body mass index (BMI) showed a significant association with the femoral (r = 0.209, P < 0.001) and lumbar BMD (r = 0.176, P = 0.002). In addition, the waist circumference (WC) was also significantly correlated with the femoral (r = 0.142, P = 0.012) and lumbar BMD (r = 0.113, P = 0.048). CONCLUSION: The BMI and WC showed a significant positive association with the femoral and lumbar spine BMD in premenopausal women. Further studies with a large population will be needed to elucidate the combined effect of MS on BMD in middle-aged women.